Search results

The purpose of this study is to assess if the new community-enhanced rehabilitation team reduced anxiety and readmissions in service users discharged from an inpatient rehabilitation setting.

The study used both qualitative and quantitative methodology. Service user’s anxiety level was measured before being discharged and at the end of the Community Enhanced Rehabilitation Team (CERT) transition intervention. Six service users were interviewed to gain further understanding of their experiences of anxiety.

Findings showed the anxiety score was significantly lower (M = 1.5, 95% CI [0.051,2.99], t(20) = 2.159, p = 0.043) following the CERT intervention (M = 8.6, SD = 6.4) compared to before (M = 10.1, SD = 7.0). No service user receiving the CERT intervention was readmitted to hospital within 12 weeks of discharge from the inpatient setting, compared to three service users (15% of those discharged) who were discharged to other community services.

Community rehabilitation pathways would benefit from having interventions to aid patient transitions from inpatient to the community. The National Health Service (NHS) trusts develop community rehabilitation teams as recommended by the National Institute for Health and Care Excellence (NICE), and they should consider including transitional support as part of their model.

It is recommended that as NHS trusts design and implement community mental health teams, they should consider including transition support as part of their model.

People with severe and enduring mental health difficulties who have been in an inpatient rehabilitation setting would benefit from community transitional support. This study suggests that such support helps reduce anxiety and readmission.

Community rehabilitation teams are currently being developed across the NHS as part of the NHS long-term plan. These teams are new, and as such, there is a dearth of information regarding their effectiveness. To the best of the authors’ knowledge, this is one of the first studies to evaluate outcomes in these new teams.

This study aims to evaluate how a community psychiatry model, referred to as the Mental Health Action Trust (MHAT) in India, provides decentralized care and comprehensive services to people with severe mental illness living in poverty. Using the complex adaptive system (CAS) framework, the authors aim to understand the factors that contribute to the diverse outcomes of the MHAT community mental health programme as observed in four different locations.

Four MHAT clinics were purposively chosen from two districts in Kerala. A comparative case study methodology was used to document each clinic’s MHAT services and activities, as found during field visits and interviews with staff members and volunteers.

The study shows that all four clinics met the basic aim of providing free, quality mental health care to the poorest populations, although not all aspects of the comprehensive model could be equally provided. Alignment with the MHAT vision, appropriate leadership, the relationship with partners and their level of community engagement determined the varied success between clinics.

The current study evaluation stresses that community ownership is crucial. Careful attention must be paid to the characteristics of selected partners, including their leadership styles and ability to garner resources.

This study aims to introduce and define the concept of phygital brand community (PBC). It discusses the potential conflicts that can arise from engaging in multiple PBCs and propose an enriched netnographic methodological approach to explore the role of PBC engagement overlap and its influence on the phygital experience.

Following a critical analysis of the inherent limitations of netnographic methodological approaches in the context of PBCs, this study develops an enriched netnographic research protocol that accounts for the challenges of engagement overlap among PBCs.

This study proposes two methods of analysis, namely, “participatory netnography” and “witness netnography,” which are derived from a mixed-methodology approach that integrates elements of netnography.

The findings of this study underscore the requisite methodological refinements imperative for enhancing netnographic analysis, particularly in its application for a better comprehension of individual behaviors within the realm of PBCs. In pursuit of this objective, the identified adjustments encompass ethical considerations, evaluation methods and their application in a digital milieu, where intricate mechanics and technologies frequently elude conventional methodologies.

In this study, the authors present a novel conceptualization of PBCs, highlighting their role and development, as well as the challenges they pose. To adequately capture the impact of PBC engagement overlap, the authors propose the need for an enriched mixed-methodological approach.

This commentary explores the challenges and themes enumerated by the associated article “Why am I still in hospital? Evaluation of delayed discharges from two learning disability assessment and treatment units in England”. This commentary broadens and outlines the research’s background, premise and potential impact. This paper aims to critically examine the evidence on this subject.

This commentary considers the attitudes to inpatient care for people with learning disabilities in the past decade and outlines a possible compact for the future.

Contrary to popular and emotive beliefs that using specialist inpatient psychiatric settings for people with learning disabilities is universally a poor practice, there are defined occasions when such settings are needed and imperative in the clinical pathway. If people with learning disabilities can access inpatient settings at the right time for the right reason, psychiatric outcomes could be improved. Timely discharge is imperative and currently lacking due to a lack of suitable engagement mechanisms between inpatient settings and the community. Thus, evidence-based outcome tools are essential to facilitate appropriate discharge.

There is an ongoing debate on the value and utility of specialist inpatient psychiatric units for people with learning disabilities. This commentary provides a balanced, evidence-based insight into this discussion.

This paper aims to report on the results of a global search to identify the characteristics of successful sexual offender treatment programs, with a view to providing guidance for program development.

A keyword search was conducted of criminology and social science databases. Successful programs were selected on evaluations that used standard scientific designs.

This study identified 18 evaluations of 16 programs showing significant reductions in reconvictions. Most programs used cognitive behavioural therapy (CBT), with both group and individual sessions; and many evidenced multisystemic therapy (MST) approaches involving families and/or local communities. CBT-based approaches were also common in the 20 unsuccessful programs identified in the study, although fewer MST-oriented features were in evidence. Noncustodial settings, and combined custodial-noncustodial settings, were also more prominent in the successful programs.

There is a shortage of studies focused on the specific components of successful treatment programs for sexual offenders, including for subsets of offenders, such as ethnic minority groups and women.

The findings demonstrate the need for more investment in treatment programs with strict evaluation processes. New and modified programs are likely to benefit from the application of CBT, MST and a community-based reintegration component. More research is needed on effective elements of sexual offender treatment programs.

To the best of the authors’ knowledge, this appears to be the first study that examines features of successful sexual offender treatment programs, compared to unsuccessful programs, using a case-study approach. The findings reinforce the known value of CBT and systemic approaches as core features of programs but raise important questions about what other components are key to activating success.

Institutional abuse is a worldwide phenomenon with the UK also subject to several high-profile abuse scandals perpetuated on people with learning disabilities and/or mental health conditions living within institutional settings. This study aims to provide a broad perspective of safeguarding practices within institutional care to inform practice and service development in this area.

A narrative overview was undertaken of a range of empirical evidence, discussion papers, enquiry reports, reports from regulatory bodies and professional guidance to explore safeguarding practices within institutional care for individuals with learning disabilities and/or mental health conditions.

A range of literature was identified that exposed and explored abuse in this context. Three key themes were identified: failings within institutional care; safeguarding issues and concerns; and good practice within institutional care. Whilst guidance is available, standards are explicit and protocols facilitate improvement potential in this area, a consistent message was that statutory recommendations for reform have not been effective.

This paper provides an important resource for practitioners and service providers involved in institutional care. An accessible overview of both the empirical evidence and grey literature on adult safeguarding within institutional settings is provided, along with a range of standards and resources that specify practice in these settings.

Despite the well-known positive effects of fruits and vegetables, their consumption in many countries is lower than those recommended. This study aims to systematically examine the effects of community-based interventions on fruits and vegetables consumption in adults.

To collect relevant publications, the authors searched electronic databases including PubMed/MEDLINE, Scopus and Web of Science from January 2000 to July 2021. Considering random models, this study analyzed the data using weighted mean differences (WMD) and 95% confidence intervals (CI).

Among 1,621 retrieved publications, 21 articles met the inclusion criteria. The overall effect size demonstrated that, at the end of the trials, the educational interventions increased the consumption of aggregated fruits and vegetables (WMD: 0.55 serving/day, 95%CI: 0.34, 0.77), and vegetables (WMD: 0.15, 95%CI: 0.09, 0.21, I2: 33.2%; p = 0.103) in the intervention groups, compared to the control groups.

The subgroup analyses that were based on the type of interventions (face-to-face education compared to online interventions), location (home-based compared to the other types of interventions) and duration (24 weeks and higher) of interventions, and accompanied financial support reduced between-group heterogeneity. An efficient interventional program on increasing fruits and vegetables consumption should be part of a multi-component project.

To the best of the authors’ knowledge, no systematic review and meta-analysis has provided a summary of the effects of community-based interventions on fruits and vegetables consumption in adult populations, and there is no fixed conclusion that could be drawn in this regard.

To share a case study of a service improvement review of practice and ambition for Health and Wellbeing Boards in the English West Midlands in the changing context of Integrated Care Systems.

Mixed qualitative methods: 33 semi-structured interviews with senior care and health leaders; a computer-based self-assessment tool for Health and Wellbeing Boards; and desktop analysis of Joint Health and Wellbeing Strategies.

“Place-based partnership” is a motivating concept, embracing the agency of leaders in pursuing local strategies and solutions. The need for strong leadership was recognised. The opportunity for Integrated Care Systems to contribute to narrowing health inequalities was welcomed by building on local place-based models, maximising council expertise in managing population health and wellbeing in their areas.

The case study is a snapshot of a developing area at a time when further government guidance for Integrated Care Systems was pending. More specific analysis of place-based partnerships in the West Midlands in the context of Health and Wellbeing Boards and Integrated Care Systems would seem beneficial. In addition, further research of subsequent changes such as the Hewitt Review is also considered important.

The review shows the assertion of “place” as a unifying concept for Health and Wellbeing Boards and Integrated Care Systems. It suggests closer involvement of leaders in children's services with local Health and Wellbeing Boards is needed.

Health and Wellbeing Boards and Integrated Care Partnerships share common aims of improving the health and wellbeing of local populations. Maximising integration especially on preventative approaches and fully engaging communities in health would have positive social impact.

The case study adds to the relatively less well-developed literature on Health and Wellbeing Boards and their link with Integrated Care Partnerships.