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Sensory modulation is an emerging approach that aims to reduce distress and agitation in mental health service users and potentially avoid the necessity for coercive practices such as seclusion and restraint. Despite the growing use of this intervention, there has been limited research exploring the implementation of sensory modulation at an organisational level, both internationally and within the New Zealand context. The purpose of this study is to investigate the implementation of a sensory modulation programme in two New Zealand inpatient mental health services using an exploratory organisational case study design.

Organisational case study design methodology was used to explore the implementation of a sensory modulation programme in two New Zealand acute adult inpatient mental health services. This study explored how key organisational and staff factors (including policies and practices related to de-escalation and seclusion reduction) influence sensory modulation implementation. Cases were described and examined the pattern of findings.

Strategies found to support implementation were identified at environmental, organisational, group and individual staff levels. Aspects highlighted as being particularly important included taking an inter-professional approach in leadership and training, rostering flexibility and leeway in staffing levels to support training attendance and responsiveness to crises.

The facilitators and strategies highlighted in this study may be used to support the design and implementation of future sensory modulation programmes in New Zealand and internationally.

The complexity of factors that influenced the implementation of the sensory modulation approach within an inpatient setting made determining the effectiveness of the approach challenging. However, the general principles and strategies identified in this study offer useful insights for the design and implementation of future sensory modulation programmes.

Workshops are commonly used to up-skill staff and their usefulness can be determined by measuring whether or not learning needs have been met and, in particular, whether attitudes have changed. In the field of mental health, sensory modulation workshops have been introduced to educate staff about preventative measures that reduce the use of seclusion and restraint for service users with challenging behaviours. The purpose of this paper is to evaluate the impact of such a workshop.

A one-day workshop was developed based on a review of the literature and feedback from previous workshops, and with input from an industry-based reference group. An evaluation tool was designed to measure the learning outcomes, i.e., the knowledge, skills, and attitudes of the 23 participants. The Statistical Package for the Social Sciences (SPSS v20) was used to analyse the data. Multi-variate analysis of variance was used to determine the relationship between variables.

A significant increase in the knowledge, skills, and attitudes of mental health staff was identified after the one-day workshop (F=106.346, df=1, p<0.000). When considering which participants showed most benefits, it was shown that the demographics had no effect, i.e., education level, practice discipline, years of work experience in mental health, and previous sensory modulation training.

Measuring learning outcomes provides essential information about whether or not the learning objectives have been met. This allows future workshops to be tailored to ensure that the learning opportunity is at the correct level for the learners. More traditional evaluations that elicit the views of the content covered and teaching methods should additionally be used to supplement this information.

Workshops are often evaluated on the basis of the participants’ subjective response to a quick questionnaire. Developing a tool to measure outcomes is a more effective way to determine what has been learned and to ensure that positive outcomes for individuals and their organisations can be reached.

Many neo-Weberians adopt the state’s authority-monopolizing aim as their theoretical expectation. Through a case study of the Peruvian state and Lima’s squatter settlements, I provide evidence in support of the opposite contention: that states may unintentionally produce non-state extractive-coercive organizations. During the mid- to late-twentieth century, Lima’s population grew rapidly. Since they had few economic resources, the new urban poor requisitioned public lands and set up dozens of squatter settlements in the city’s periphery. Other researchers have identified several novel political phenomena stemming from such urban conditions. I focus here on the impact of the state. Using secondary and primary data, I examine three periods during which the state applied distinct settlement policies and one in which it did not apply a settlement policy, from 1948 to 1980. I find that when it applied each of the settlement policies, the state produced non-state political authorities – neighborhood elites – who extracted resources from squatters and tried to control neighborhood turf even against state encroachment, and that the state’s non-involvement did not produce them.