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When the International Initiative for Mental Health Leadership (IIMHL) was developed, one of the hopes was that the exchange visits among international sites would stimulate the development of collaborative working relationships. This article reviews one such collaborative project, the development and implementation of a comparative study of assertive community treatment teams, or assertive outreach teams as they are called in the UK and New Zealand.

People with severe persistent mental illness pose a significant challenge to managed care organizations and society in general. The financial costs are staggering as is the community impact including homelessness and incarceration. This population also has a high incident of chronic comorbid disorders that not only drives up healthcare costs but also significantly shortens longevity. Traditional case management approaches are not always able to provide the intense and direct interventions required to adequately address the psychiatric, medical and social needs of this unique population. This article describes a Medicare Advantage Chronic Special Needs Program that provides a Medical Home, Active Community Treatment, and Integrated Care. A comparison of utilization and patient outcome measures of this program with fee for service Medicare found significant reduction in utilization and costs, as well as increased adherence to the management of chronic medical conditions and preventative services.

Previous research has identified a need for greater clarity regarding the functions of multidisciplinary team (MDT) meetings in UK community mental health services. The purpose of this paper is to identify the functions of these meetings by systematically reviewing both primary research and academic discussion papers.

Papers relating to adult community mental health teams (CMHTs) in the UK and published between September 1999 and February 2014 were reviewed and appraised using NICE quality checklists. The search was broad in scope to include both general CMHTs and specialist CMHTs such as early intervention psychosis services and forensic mental health teams. A thematic synthesis of the findings was performed to develop an overarching thematic framework of the reported functions of MDT meetings.

None of the 4,046 studies identified directly investigated the functions of MDT meetings. However, 49 mentioned functions in passing. These functions were categorised into four thematic domains: discussing the care of individual patients, teamwork, team management and learning and development. Several papers reported a lack of clarity about the purpose of MDT meetings and the roles of different team members which hindered effective collaboration.

Without clearly agreed objectives for MDT meetings, monitoring their effectiveness is problematic. Unwarranted variation in their functioning may undermine the quality of care.

This is the first systematic review to investigate the functions of CMHT MDT meetings in the UK. The findings highlight a need for empirical research to establish how MDT meetings are being used so that their effectiveness can be understood, monitored and evaluated.

This article describes a quality assurance effort aimed at defining the characteristics of the patient population of the Connecticut Mental Health Center, a state‐funded agency that provides comprehensive clinical and rehabilitative services to persons with mental illness. Also described is how this information guided management decisions in both caseload distribution and clinical service development. This “Patient Profile Project” was informed by research principles which view evaluation as continual, rather than terminal activity that involves key stakeholders from all levels within the mental health system of care and makes maximum use of data in ongoing performance improvement initiatives. The service‐need index that the project produced represents our first efforts to accurately capture service need and use it in clinical decision making. This review of the Connecticut Mental Health Center Patient Profile Project illustrates the utility of a continuous evaluation system in promoting improvements in a large mental health treatment system.

The purpose of this paper is to outline the reflections of a person with lived experience of a severe mental illness (SMI) and former peer support worker in Montreal, Quebec, Canada, who has also worked for seven years in mental health research. It describes a tendency of resources and services to create ghettos of people with SMIs by failing to support the integration of people with SMIs into the community at large or in exploring options for meaningful, fulfilling occupation, reinforcing social exclusion and ghettoization.

This paper shows a reflective and narrative account of personal experiences and observations of the ghettoizing tendency in mental health services.

Mental healthcare professionals tend to support people with SMIs in engaging activities within resources for the mentally ill, and not in carrying out activities in the community at large. The range of activities offered is limited, an obstacle to finding meaningful, fulfilling occupation. Harmful psychological effects include self-stigma, low self-esteem and a sense of marginalization, generating a ghettoized mentality. The difficulties encountered in an effort to leave the mental health ghetto are touched on with examples of how to overcome them.

The need for professional support for social integration of people with SMIs is identified, which could ultimately favor social inclusion of people with SMIs.

It is written from the perspective of a user and provider of mental health services, who also has seven years’ experience in mental health research.

Individuals with intellectual disability (ID), mental health needs and criminal justice system involvement are likely to be admitted to forensic units; however, not all of those individuals are served in that system. It is, therefore, important to understand the profile of those admitted to non‐forensic specialized units for individuals with ID and mental health issues. This paper aims to address this issue.

Demographic, clinical and criminal profiles of individuals discharged over nine years from a specialized dual diagnosis program were reviewed to delineate clinical subgroups.

A total of 20 out of 84 total discharges were identified as having past or current criminal justice system involvement. The most common offence was assault and 60 per cent of these individuals had admissions longer than one year. Subgroups by psychiatric diagnosis differed in their age, legal status, offence history, and length of hospital stay, as well as in therapeutic interventions and discharge process.

The results suggest that inpatients with ID and criminal justice system involvement present with unique treatment, support and risk management needs based on psychiatric diagnosis. The number of individuals in clinical subgroups was low, thus further research is needed to determine if the observed patterns hold true in bigger samples.

The study delineates the complexity and heterogeneity of treatment and supports needs of individuals with intellectual disabilities and offending behaviour.

The author, who works in the field of health care, identifies the development of an innovative best practices psychosocial rehabilitation principles template, which provides both a conceptual framework and some core dimensions for rehabilitation practice and focused patient care. The steps and process in the development of the template are documented and reflect both staff and patient input in its formulation. There is an articulation, from an integrated perspective, of a patient‐centred, complementary, empowering and interdependent rehabilitation principles framework. There is also a delineation of the rationale for the template’s inception, literature review, conceptual composition, inherent challenges and potential applicability for enhancing rehabilitation care, outcomes and quality management.

The aim is to provide a brief overview of a series of articles tracing the emergence of several Mental Health Commissions (MHCs) in developed countries over recent years, sometimes to enhance mental health law administration, but often in connection with mental health reform strategies. The paper seeks to review the functions of, and elicit a framework for, Mental Health Commissions (MHCs) as effective vehicles for effective operation and reform of a mental health service system.

The approach of the paper is to identify the functions and limitations of Mental Health Commissions and then cluster them to form a typology of commissions.

There are broadly three types of MHCs: the first is more inspectorial and focussed on issues, concerns and complaints affecting the care of individuals, and is more restricted investigating the mental health service and the workings of mental health laws mainly to these ends; the second type is focussed on the entire mental health service system, including relevant all‐of‐government operations, concentrating on monitoring for and promoting system‐wide reform. While this appears to constitute a spectrum, with different MHCs mandated to work mainly at either end of it, there is conceivably a third type which has a combination of these functions. This occurs with some commissions, though an equal balance between these functions is unusual, so they usually can be assigned to a type on the basis of their predominant functions.

There was a limited sample size, obliging a non‐statistical descriptive analysis which may well affect the validity of these distinctions.

There is sometimes a combination of functions encompassing some features of both of these types. While type I MHCs can ensure that individual rights are upheld and that mental health laws and regulations are adhered to, to improve service quality, type II MHCs are likely to be more effective in achieving system‐wide mental health service reform.

MHCs can contribute to more holistic, evidence‐based and recovery‐oriented service delivery, which are more likely to lead to more desirable health and wellbeing outcomes for all mental health service users, their families and the community.

This typology provides a useful provisional framework for understanding the roles of MHCs in mental health services and in reform of the whole mental health service system and related systems.

The phenomenon of criminal behaviour has interested scholars from academic disciplines building on centuries of philosophical debate developed from emerging biological, psychological and social sciences. Criminological theories of causation are embedded in conceptual networks that link political ideology classified by philosophical underpinnings. For example, the late 18th and early 19th century utilitarianism consensus classical theory supported the notion of free will, suggesting that individuals were likely to commit crime if the pay‐off were greater than the retribution. In contrast, conflict marxist and radical criminology regarded crime as a function of poverty, reflecting a power imbalance in society. The late 19th century saw the emergence of the positivist school, which argued that factors including genetics, poverty, personality and the family were important in determining criminality. This article concentrates on the transmission of crime through families by reviewing a selection of the main studies in the area.