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Article

Richard Bell

The purpose of this paper is to demonstrate the learning from the multi-agency evaluation of the Leeds Dual Diagnosis Care co-ordination protocol undertaken by the Leeds…

Abstract

Purpose

The purpose of this paper is to demonstrate the learning from the multi-agency evaluation of the Leeds Dual Diagnosis Care co-ordination protocol undertaken by the Leeds Dual Diagnosis (DD) Project in 2013. The evaluation aimed to identify the prevalence of people with DD accessing network member services, and to identify the standard of care network members provided for people with DD in relation to the Leeds Care Co-ordination Protocol.

Design/methodology/approach

The evaluation adopted a service evaluation methodology and included features of real world research. Two standardised self-completion questionnaires were administered using Survey Monkey™ software.

Findings

The majority of service could provide prevalence data however the quality of data provided was significantly impacted by the limitations of client management systems. Completion of specific DD training beyond basic awareness was generally low and many participants were confused about the different levels of training available. Standards of care varied, a substantial amount of joint working was taking place via informal pathways which relied on established relationships and trust between practitioners and services. Jointing working was often informal when people were not under the Care Programme Approach.

Research limitations/implications

Due of the methodological choices the evaluation cannot be considered impartial. The prevalence data gathered lacks robustness and does not reflect the number of people who meet clinical threshold for DD as valid screening tools were not used by all services. The standards of care identified only reflect practitioner's personal views and do not provide a definitive answer to the standard of care being delivered. The response rate in relation to standards of care was low with large amounts of missing data negatively impacting the external validity of data gathered.

Practical implications

The completion of this evaluation demonstrates that it is extremely challenging to undertake a multi-agency evaluation with limited resources. It has highlighted key challenges and areas for future development locally in relation to DD. The themes explored are likely to be of interest to commissioners, service managers, DD consultant nurses and anyone involved in the strategic development of DD.

Originality/value

The evaluation has generated information which is of practical significance to local commissioners and Leeds DD Network Members. The knowledge and learning from this evaluation has subsequently been used by the Leeds DD Strategy Group to inform the new action plan for the DD Project, the re-commissioning of substance misuse services and the new mental health framework being developed for Leeds.

Details

Advances in Dual Diagnosis, vol. 7 no. 4
Type: Research Article
ISSN: 1757-0972

Keywords

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Article

Katalin Ujhelyi Gomez, Jerome Carson, Gill Brown and Mark Holland

Positive psychology (PP) interventions have been suggested to be beneficial in the treatment of dual diagnosis (DD). The purpose of this paper is to investigate the…

Abstract

Purpose

Positive psychology (PP) interventions have been suggested to be beneficial in the treatment of dual diagnosis (DD). The purpose of this paper is to investigate the perspective of psychosocial intervention (PSI) workers to explore the potential of a positive strengths-based approach in DD recovery.

Design/methodology/approach

A qualitative approach was employed with PSI workers who attended and observed a positive intervention delivered to DD clients. A focus group explored what these practitioners are already doing that resembles PP and their opinion regarding the utility of such interventions in recovery.

Findings

Findings revealed that practitioners were already engaging in positive practice, however, randomly and infrequently with limited impact. Although this new approach was found valuable, potential challenges were identified and a possible discrepancy between staff views of clients and clients’ views of themselves in terms of their potential was detected.

Research limitations/implications

The study involved a small and homogeneous sample. Further research is necessary to investigate staff views and ways of integrating PP with traditional treatment.

Practical implications

Rather than merely attending to the psychological problems and dealing with symptoms, it is also necessary to directly target well-being to enable people to flourish with consideration of their readiness to change.

Originality/value

Addressing a gap in the literature, the present study explored positive themes in current practice and forms part of the evaluation of a newly developed strengths-based approach for individuals with coexisting problems.

Details

Advances in Dual Diagnosis, vol. 12 no. 3
Type: Research Article
ISSN: 1757-0972

Keywords

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Article

Colin Hemmings and Alaa Al‐Sheikh

There has been limited evidence on which to base services in the community for people who have intellectual disabilities and coexisting mental health problems. Recent…

Abstract

Purpose

There has been limited evidence on which to base services in the community for people who have intellectual disabilities and coexisting mental health problems. Recent research involving service users, carers and professionals has identified a number of key service components that community services should provide. More detail is needed to explore how best these components could be implemented and delivered. This paper aims to discuss these issues.

Design/methodology/approach

A total of 14 multidisciplinary professionals from specialist intellectual disabilities services in the UK were interviewed about their opinions on four key areas of community service provision. These included the review and monitoring of service users, their access to social, leisure and occupational activities, the support, advice and training around mental health for a person's family or carers and “out of hours” and crisis responses. The interview data was used for coding using the NVivo 7 software package and then analyzed using thematic analysis.

Findings

Analysis of participants' views on these key essential service components produced wider themes of importance. The ten major emergent themes for services were: their configuration/structure, their clarity of purpose/care pathways, their joint working, their training, their flexibility, their resources, their evidence‐base, being holistic/multidisciplinary, being needs‐led/personalised and providing accessible information.

Originality/value

These views of experts can help inform further research for the development and the evaluation of services.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 7 no. 3
Type: Research Article
ISSN: 2044-1282

Keywords

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Article

C. Ellie Wilson, Ged Roberts, Nicola Gillan, Chris Ohlsen, Dene Robertson and Janneke Zinkstok

This paper aims to provide an overview of the recent National Institute for Health and Clinical Excellence (NICE) clinical guidance for diagnosis and treatment of adults…

Abstract

Purpose

This paper aims to provide an overview of the recent National Institute for Health and Clinical Excellence (NICE) clinical guidance for diagnosis and treatment of adults with Autism Spectrum Disorder (ASD) and to discuss clinical and practical implications.

Design/methodology/approach

This is a summary and discussion of the NICE guidance for adults with autism. This includes discussion of relevant related guidance, the need for transition services for young people with ASD, education of professionals, applicability of the guidance to people with intellectual disabilities and challenges related to implementation of the guidance in a changing National Health Service.

Findings

The guidance provides an excellent overview of current and state-of-the-art strategies for diagnosis and treatment of ASD-related behaviours, and their level of evidence. In terms of diagnosis, the main recommendation for clinicians is to carry out a comprehensive assessment for adults with suspected autism, taking into account co-morbid mental health problems and potential unmet needs. In addition, NICE makes recommendations regarding pharmacological and psychological interventions and these are discussed. The guidance also makes specific recommendations regarding service design, for example the formation of Autism Strategy Groups. This will hopefully support the development of specialist adult autism services.

Originality/value

This paper provides new insights into the implications of the recently published NICE clinical guidance for autism in adults, relevant for health care professionals, service managers and service users.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 8 no. 1
Type: Research Article
ISSN: 2044-1282

Keywords

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Article

Rodney M. Goodman, John Miller, Padhraic Smyth and Hayes Latin

Describes an approach to real‐time expert systems for integratednetwork management. Presents an overview of expert systems technology,proceeding to develop the…

Abstract

Describes an approach to real‐time expert systems for integrated network management. Presents an overview of expert systems technology, proceeding to develop the requirements for a real‐time system in network management. Describes a system being developed (1989) by Pacific Bell. Describes NETREX, a prototype real‐time system, aimed at automatically maintaining Pacific Bell′s internal data networks. Concentrates on an application for solving problems with travel tickets in real time.

Details

Office Technology and People, vol. 5 no. 3
Type: Research Article
ISSN: 0167-5710

Keywords

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Article

Jun Ma and Li Yu

To modernize budgeting system is a challenge issue in many developing countries. To some scholars (Schick, 1998a, 1998b; Ma, 2009a), developing countries must first put…

Abstract

To modernize budgeting system is a challenge issue in many developing countries. To some scholars (Schick, 1998a, 1998b; Ma, 2009a), developing countries must first put into place basic budgetary controls before moving to more advanced models of budgeting. This approach of “basic first,” however, is questioned by others (e.g., Andrew, 2006). Drawing on China's recent budget reforms, this essay reconfirms the validity of the “basics first” approach. In China, budget reform since 1999 has begun to install budgetary controls for state finance, leading to an enhancement of budgeting capacity and financial accountability. However, governments at the same time have begun to be plagued by the unexpected problem of delays in spending and the accumulation of significant underexpenditures. Contrary to what many people may believe, we contend that this somewhat odd problem arises not because the new budgeting system has exercised too much control but rather because the new system is not yet effective in exerting budgetary controls.

Details

Journal of Public Budgeting, Accounting & Financial Management, vol. 24 no. 1
Type: Research Article
ISSN: 1096-3367

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Article

Jane Salvage and Rob Keukens

This article explores the social context, prevalence and treatment of problems related to dual diagnosis in the countries of Eastern Europe, drawing on an extensive…

Abstract

This article explores the social context, prevalence and treatment of problems related to dual diagnosis in the countries of Eastern Europe, drawing on an extensive literature search as well as the authors' wide personal experience of working with mental health reformers in policy, education and service delivery in most countries in the region. It describes the region's historical and societal background, and sets out basic epidemiological information, including the rate and impact of mental illness and alcohol and substance abuse. It reviews what services are available for people with dual and triple diagnosis; outlines the barriers to progress; and makes recommendations for improvements.

Details

Advances in Dual Diagnosis, vol. 3 no. 3
Type: Research Article
ISSN: 1757-0972

Keywords

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Article

Douglas Polcin

Persons with serious alcohol and drug problems who are attempting to maintain abstinence often lack an alcohol- and drug-free living environment that supports sustained…

Abstract

Purpose

Persons with serious alcohol and drug problems who are attempting to maintain abstinence often lack an alcohol- and drug-free living environment that supports sustained recovery. Residential recovery homes, called “sober living houses” in California, are alcohol- and drug-free living environments that offer long-term support for persons with addictive disorders. They do not offer formal treatment services but usually encourage or mandate attendance at self-help recovery groups such as Alcoholics Anonymous. The paper aims to discuss these issues.

Design/methodology/approach

The approach involved analysis of the strengths and weaknesses of different research designs for studying residential recovery homes. Alternatives to randomized designs that are able to capture “real world” data that are readily generalized are described and understudied topics are identified.

Findings

A significant limitation of traditional randomized designs is they eliminate mutual selection processes between prospective residents and recovery home residents and staff. Naturalistic research designs have the advantage of including mutual selection processes and there are methods available for limiting self-selection bias. Qualitative methods should be used to identify factors that residents experience as helpful that can then be studied further. Innovative studies are needed to investigate how outcomes are affected by architectural characteristics of the houses and resident interactions with the surrounding community.

Practical implications

Use of the recommended strategies could lead to findings that are more informative, intuitively appealing, and interpretable.

Social implications

Recovery homes and similar programs will be more responsive to consumers.

Originality/value

This paper represents one of the first to review various options for studying recovery homes and to provide suggestions for new studies.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 36 no. 3
Type: Research Article
ISSN: 0964-1866

Keywords

Content available

Abstract

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 7 no. 4
Type: Research Article
ISSN: 2050-8824

Abstract

Details

Advances in Dual Diagnosis, vol. 3 no. 3
Type: Research Article
ISSN: 1757-0972

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