This study aims to investigate the views of commissioners, providers and criminal justice staff on how effective current health-care provision is at meeting the health…
This study aims to investigate the views of commissioners, providers and criminal justice staff on how effective current health-care provision is at meeting the health needs of people on probation. Understanding perceptions of what constitutes effective provision, where barriers are encountered and where improvements could be made is an important step towards improving access to care for this hard-to-reach group.
The research was part of a wider study. This paper focusses on findings from case studies conducted via semi-structured telephone interviews with 24 stakeholders in a purposive sample from six geographical areas of England. Interviews were conducted by researchers from a variety of backgrounds and an individual with lived experience of the criminal justice system. Data were analysed using thematic analysis.
Participants provided examples of effective health-care provision, which largely involved multi-agency partnership working. It was apparent that there are many barriers to providing appropriate health-care provision to people on probation, which are underpinned by the complexity of this population’s health-care needs, the complexity of the health-care landscape and problematic commissioning processes.
Improvements are needed to provide appropriate and accessible health care that meets the needs of people on probation, thereby reducing health inequalities. These include shared targets, improved funding, clearer pathways into care and giving probation a voice in commissioning.
To the best of authors’ knowledge, this is the first study of commissioner, provider and criminal justice staffs’ views on the effectiveness of current health-care provision at meeting the health needs of people on probation.
Brooker’s mini-series Dead Set displays numerous representations of British masculinity in crisis. Released just as the zombie narrative was regaining momentum, the series…
Brooker’s mini-series Dead Set displays numerous representations of British masculinity in crisis. Released just as the zombie narrative was regaining momentum, the series uses the threat of an apocalypse to expose British men as weak, cowardly and ultimately monstrous. Initially set within the confines of the Big Brother house, the characters have willingly come under scrutiny for the delectation of a scandal-hungry public. The men are seen to self-consciously perform their own brands of masculinity. However, when people quickly descend from figuratively devouring each other into actually devouring each other, these masculine ideals are left in tatters, and without them, the surviving men are in constant peril.
For the purposes of this chapter, I will look specifically at three characters within the series and how their representations adhere to the ideas put forward by Anthony Clare, among others – that contemporary masculinity is in a period of crisis. I also wish to uncover how representations of masculinity within the series reflect contemporary social and political concerns within British society – a distrust of state apparatus and the rise of a particularly malicious, right wing ideology are both prevalent here. The zombie has long been acknowledged as an allegory for society’s ills – but this chapter asks: what can those fighting (or failing) against the zombie threat tell us?
In view of the importance currently attached to evidence‐based health care, we present a systematic review of publications about the effectiveness of community mental health nursing interventions. Only 11 studies were identified which used an experimental design, focused solely on the nursing intervention, and were conducted in the UK since 1965. Not only is the evidence limited, but it does not examine those areas of work in which most community mental health nurses are involved, and the methodological rigour of the identified studies can be questioned. Other types of research with the potential to inform community mental health nursing practice are suggested. Research into the outcome of community mental health nursing interventions has made disappointing progress over the past decade.
Rates for self‐inflicted deaths (SIDs) were analysed in English and Welsh prisons. Whilst the overall reductions in SIDs are to be welcomed, the data demonstrate that…
Rates for self‐inflicted deaths (SIDs) were analysed in English and Welsh prisons. Whilst the overall reductions in SIDs are to be welcomed, the data demonstrate that there is variation in progress with SIDs reduction across the different types of prison. SIDs is increasing in high security prisons and these findings have implications for both research and commissioning. Those that commission prison mental health services in primary care trusts must recognise the need for targeted interventions that acknowledge three major issues indicated in the literature: the likely childhood trauma experienced by mentally disordered prisoners; a better recognition of the important role played by victimisation and intimidation in SIDs; and greater investment in alcohol treatment programmes in prison. Research should be commissioned that examines these factors in relation to SID.
Prisoners are at greater risk of developing mental health problems compared with people of a similar age and gender in the community. They are less likely to have their…
Prisoners are at greater risk of developing mental health problems compared with people of a similar age and gender in the community. They are less likely to have their mental health needs recognised, are less likely to receive psychiatric help or treatment, and are at an increased risk of suicide. Prison mental health in‐reach services have been developed in the UK to address these problems. An organisational case study method was used to generate theory about the links between the aims, processes and impacts of the introduction of mental health in‐reach teams to prison contexts. Case studies were undertaken on six sites and included interviews and focus groups with in‐reach team staff, prison healthcare staff, and discipline staff. The aims of prison mental health in‐reach were related to providing an equivalent service to a Community Mental Health Team, with a primary focus on serious mental illness, but a widening role. Achievement of these aims was mediated by the organisational context, active relationship development and leadership. Overall effects were positively reported by all stakeholders. Successful development was not just a function of time in post, but also a function of the effectiveness of leadership within the in‐reach teams. The more effective teams were having a wide impact on the response to mental health problems in the prison setting
The North of England characteristically has higher levels of alcohol‐related harm and higher levels of mental illness compared with the South. The purpose of this paper is…
The North of England characteristically has higher levels of alcohol‐related harm and higher levels of mental illness compared with the South. The purpose of this paper is to present observations on the use of services by people who have both alcohol and mental health problems to explore the equality and economic impact of services.
Inpatient hospital datasets as well as other NHS service datasets were examined to gather intelligence on alcohol and co‐occurring mental and behavioural disorders.
The study finds that there are high levels of dual diagnosis (DD) of alcohol and mental health in the North West with significantly higher rates in the more socially deprived areas and gap in access to services.
These health inequalities in relation to DD can only be demonstrated robustly for hospital inpatient admissions because other datasets currently provide intelligence only at larger geographies – such as Primary Care Trust – or by service provider.
Population surveys are useful to generate estimates of the prevalence of mental health issues in alcohol users which then reveal that there are greater inequalities in access to services in more deprived populations. Such valuable intelligence should be generated at the local level so that the most appropriate and the most cost effective services can be commissioned for the local population.
This is the first time that the economic cost of DD in the various services has been estimated.