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Changes have occurred in the pattern of services for people with learning disabilities and mental illness and/or challenging behaviour over recent years, with the development of a variety of service models across the UK. In SE London, residential services are based predominantly on a supported housing model and the strong philosophical premise that people should not be excluded from a community residential service because they have complex physical, behavioural or mental health needs. Local services, therefore, are supporting individuals with a wide range of need. This paper describes the development of specialist mental health and challenging needs services in support of this model. The issues raised are outlined, together with a list for action and priorities to overcome the difficulties encountered, including the maintenance of an effective infrastructure.

This Case Study gives an account of the factors that led up to the joint commissioning unit (JCU) within the health and social services scene in Shropshire; analyses the concept of strategic joint commissioning; and describes the role of the JCU and how it works.

The purpose of this paper is to examine three recent papers on mental health services and social inclusion.

A search was carried out for recent papers on mental health and social inclusion. The author selected three papers that each spoke to a similar theme, from slightly different angles, and that seemed to advance understanding of how social inclusion might be supported to a greater degree in mental health services.

One paper vividly describes some of the blocks to social inclusion, and what that can feel like from a service user perspective, and also points to ways for peer workers to support service users’ social inclusion. A second paper illustrates how mental health professionals and peer workers can choose to stand up for people’s human rights despite lack of organisational support for such actions. The third paper describes pioneering co-designed work to build dedicated support for social inclusion alongside mental health services.

All three papers highlight the ongoing need for better support for social inclusion in mental health services across different countries. They also show how such support can be implemented and even made more mainstream. This raises hope for wider progress in mental health services becoming real enablers of social inclusion.

Contrary to want-based services, customer participation has got lesser attention in high-credence services like health care. Customer participation for patients with chronic illnesses could be life-threatening and goes beyond the service organization’s physical environment. Realizing the importance of transformative service research in health-care services, this study aims to propose and validate the conceptualization of customer participation for patients with chronic illnesses.

The study uses sequential exploratory research design with mixed method research. The first phase is a qualitative exploration of the nature and meaning of customer participation by synthesizing theory and insights from semi-structured interviews (N = 75) with doctors, patients and paramedical staff. Next, survey data (N = 690) of patients with chronic illnesses is used to validate the proposed conceptualization. Finally, nomological validity was also tested on an additional survey data set (N = 362) using SEM and FsQCA.

The findings reveal that health-care customer participation is a three-dimensional behavioral construct in which a customer can participate by sharing information, involving in decision-making and ensuring compliance. The study also demonstrates that customer participation is a critical driver of satisfaction with life and perceived control on illness.

The research provides policy guidelines for owners and operators of health-care organizations in developing frameworks for collecting participation data, which can be used in strategies for seeking customer participation.

The research conceptualizes and validates “customer participation” as a multidimensional higher-order construct for patients with chronic illnesses, rarely focused in services marketing and management research on health care.

This study proposes targeted modernization of the Department of Defense (DoD's) Joint Forces Ammunition Logistics information system by implementing the optimized innovative information technology open architecture design and integrating Radio Frequency Identification Device data technologies and real-time optimization and control mechanisms as the critical technology components of the solution. The innovative information technology, which pursues the focused logistics, will be deployed in 36 months at the estimated cost of $568 million in constant dollars. We estimate that the Systems, Applications, Products (SAP)-based enterprise integration solution that the Army currently pursues will cost another $1.5 billion through the year 2014; however, it is unlikely to deliver the intended technical capabilities.

Bundled payments for care are an efficient mechanism to align payer, provider, and patient incentives in the provision of health care services for an episode of care. In this chapter, we use agency theory to examine the evolution of bundled payment programs in private and public payer arrangements, and postulate future directions for bundled payment development as a key component in the provision and payment of health care services.

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.

This paper explores optimal service resource management strategy, a continuous challenge for health information service to enhance service performance, optimise service resource utilisation and deliver interactive health information service.

An adaptive optimal service resource management strategy was developed considering a value co-creation model in health information service with a focus on collaborative and interactive with users. The deep reinforcement learning algorithm was embedded in the Internet of Things (IoT)-based health information service system (I-HISS) to allocate service resources by controlling service provision and service adaptation based on user engagement behaviour. The simulation experiments were conducted to evaluate the significance of the proposed algorithm under different user reactions to the health information service.

The results indicate that the proposed service resource management strategy, considering user co-creation in the service delivery, process improved both the service provider’s business revenue and users' individual benefits.

The findings may facilitate the design and implementation of health information services that can achieve a high user service experience with low service operation costs.

This study is amongst the first to propose a service resource management model in I-HISS, considering the value co-creation of the user in the service-dominant logic. The novel artificial intelligence algorithm is developed using the deep reinforcement learning method to learn the adaptive service resource management strategy. The results emphasise user engagement in the health information service process.

The purpose of the present study is to investigate whether family caregivers with a stronger sense of coherence (SOC) who are caring for community dwelling older adults with cognitive impairment are less likely to use mental health services. An adaptation of the Anderson behavioral model of access to health care was employed as a conceptual framework. Data were collected for 304 impaired older adult/family caregiver dyads. Caregiver mental health service use and sense of coherence were measures as well as predisposing factors (age, gender, race, education, type of familial relationship, family size, and co-residence with impaired family member), enabling factors (self-reported awareness of services, travel times to mental health services, social support, and insurance), and need factors (chronic health conditions and distress). The impaired elder’s age, level of physical impairment, and level of memory impairment were also examined. Logistic regression results indicated that caregivers who have a stronger SOC were less likely to use mental health services (OR=0.91, p=0.006). Other significant independent predictors of mental health service use were social support (OR=0.34, p=0.032) and caregivers aiding family members with higher levels of physical impairment (OR=1.14, p=0.033). The results of this study support clinicians and planners developing mental health services that use SOC to mitigate the detrimental effects of caregiving. Future research is needed to target effective measures to positively manipulate this variable.

This chapter provides a description of an ongoing service learning initiative and exemplars of reflection on service for nursing students at the Pine Ridge Indian Reservation in South Dakota. The service, health promotion, is provided to the Oglala Lakota, or Lakota, on the reservation through community screenings for adults and health education for the prevention of children’s health issues. Nursing student participants have the unique experience of learning about the Lakota culture, while also offering service via health promotion to a population that experiences ongoing health disparities and inequity. The Lakota and the Pine Ridge Reservation are examined, including the setting, history, culture, and disparities. Students improve their transcultural nursing skills and develop an awareness of their role in working toward social justice and health equity. Students blog daily during the trip and complete a final summative project as their reflection on service. The service learning initiative process is detailed, from choosing students for the experience to pre-travel student preparation to the actual travel. The reflection on service via blogging is discussed, including the evidence on the benefits of using this social media platform. The experience at Pine Ridge is also reviewed focusing on the details of the service learning initiative and cultural activity participation. Lastly, an overview of the final summative project is provided. Throughout the chapter, students’ reflections on service via blog posts are provided as evidence of the transformative quality of this initiative.