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A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot.

This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels.

The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals.

This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.

The purpose of this study is to investigate the transfer of learning among older adults and the importance of physical activity (PA) related to aging in place.

A mixed-methods approach examined 10 older adults aged 65–88, who were receiving occupational therapy and contemplating aging in place. Semistructured interviews determined participants' perceptions of aging in place and PA. Accelerometers assessed levels of PA over 14 days.

Interviews revealed that most participants were aware of the importance of PA but did not specify PA as being a primary contributor to continued independence with aging. Accelerometer data revealed that, on average, 96.7% of the day is spent in sedentary behavior.

Health-care professionals may ask the question, “What will my patient do with the information he or she has learned?” This study was useful to increase understanding of older adults’ learning, lifestyles and effects on aging independently.

As older adults have true expectations of requirements for successful aging in place, realistic levels of PA and transfer of learning could improve the intended outcome of aging independently.

PA is often an overlooked factor for occupational engagement and aging in place and is novel to investigate in combination with interviews.

This study aims to evaluate the quality of a speech and language therapy (SLT) swallow service provided to adults with intellectual disability (ID) by exploring the process and outcome factors; to explore the process of what is done to and for the patient including identifying dysphagia, choking and pneumonia risk, typical interventions and management; examine clinical outcomes; and explore the relationship of outcomes with risk factors, satisfaction with the service and the impact of the service on the number of choking incidents and admissions to acute hospital with swallow concerns.

There were three specific work packages: (1) collecting and scrutinising patient data from the clinical record for adults with ID referred to the SLT swallow service over a six-month period. The researcher created aims, defined the limits to achieve the aims, designed a standardised data collection form, set out where data was in the clinical record, piloted, set limits for collection and trained reviewers; (2) gathering experience and satisfaction surveys from patients, caregivers and referrers over the six-month study period; and (3) monitoring choking adverse incident reports and hospital admission with swallow concerns for the whole ID population.

Choking and hospital admission were the main reasons for referral, and pneumonia risk significantly predicted dysphagia impairment. The research highlighted common dysphagia risk factors, interventions and recommendations for this population. The SLT swallow service is a quality service that is highly valued by patients, their caregivers and referrers. The service achieves significant clinical improvements, helps identify dysphagia and provides management to reduce associated risks.

This study found common dysphagia risk factors, interventions and recommendations; it also found that the therapy outcome measures/Royal College of Speech and Language Therapy online outcome tool was a meaningful outcome measure, and that pneumonia risk significantly predicted dysphagia impairment, all of which could inform the identified dysphagia research priorities for this population.

Naming usual care in treatment and recommendations could help ensure a fair service and could help form quality indicators. People with ID, their caregivers and staff generated valuable ideas for improvement, and further involvement work could create a logic model for the service. Other future work could explore the use of screening tools, increase multidisciplinary team working, improve access to instrumental assessments, raise awareness of swallowing and promote important oral health and medication reviews. By using this information to shape quality improvement work and policies, one can work toward addressing high health-related inequalities and preventable deaths associated with dysphagia in this vulnerable population.

It may be useful to raise awareness that adults with ID age earlier and that one should not exclude them from older people’s services because of an age threshold, often set higher than their life expectancy. This study highlighted a possible inequality of access issue for adults with ID who do not have direct care or day care staff. There is a need to increase access to awareness training so caregivers and general practitioners can recognise swallow difficulties and know how to make a referral for a swallow assessment.

Overall, the evaluation of the swallow service to adults with ID suggests that SLT have a quality service for adults with ID that is highly valued and provides significant clinical improvements. By building on these strengths, SLT could extend the reach, influence and impact of their services to help those adults with ID who have emerging swallow difficulties or who do not access the service.

By older adulthood, the majority of individuals will have experienced at least one traumatic event. Trauma-informed care (TIC) is proposed to improve effectivity of health-care provision and to reduce likelihood of services causing retraumatisation. This study aims to assess the effectiveness of staff training in TIC in older adult services.

TIC training was delivered across eight Older Adult Community Mental Health Teams in the same UK organisation. Questionnaires were administered before and after training: a psychometrically robust measure, the Attitudes Related to Trauma-Informed Care, was used to assess TIC-related attitudes, and a service-developed scale was used to measure changes in TIC competence. Data was analysed using linear mixed effects modelling (LMM). Qualitative data regarding the impact of training was gathered one month after training through a free-text questionnaire.

There were 45 participants, all of whom were white British. LMM on pre- and post-data revealed that staff training significantly increased competencies across all measured TIC domains. Overall, staff attitudes were also significantly more trauma-informed after training. Qualitatively, staff identified time as the only additional resource required to deliver the skills and knowledge gained from training.

Training was found to be effective in increasing TIC-related skills and attitudes. Organisations aiming to become trauma-informed should consider staff training as one aspect of a wider development plan.

To the best of the authors’ knowledge, this paper is the first to examine TIC training for staff working in Older Adults Mental Health Services. Recommendations for services aiming to develop a trauma-informed culture have been provided.

The main aim of this paper is to provide a living tribute of lived expert by experience and researcher Andrew Voyce.

Andrew provided the author with a list of names of people he might approach to write a tribute on his behalf.

The accounts describe the influence that Andrew has had both as an educator and as a trusted colleague for the people approached.

In many ways, the voices of people with mental health problems have been marginalised. Few mental health journals, with only some exceptions, encourage lived experience contributions.

The mental health agenda continues to be dominated by professional groups. The remarkable individuals who continually battle with serious mental illness are often lost in official discourses.

Despite the fact that the topic of mental health is now much more in the public domain, research tells us that the most effective anti-stigma strategy is contact with sufferers.

The archivist Dr Anna Sexton co-produced one of the few mental health archives that only featured people with lived experience. Andrew was one of the four people featured in it. This account “showcases” the work of this remarkable man.

Interprofessional practice (IPP) is one way to structure collaborations to more effectively meet the complex needs of students in educational settings. This article explores the lessons learned when one research team implemented interprofessional education (IPE) experiences in partnership with a public elementary school and pre-service professionals from elementary education, special education and communication science and disorders.

This reflective article explores the lived experiences of researchers and partners who completed an IPE experience within one professional development school’s site. Researcher anecdotes are included to support the viewpoints shared.

It was discovered that IPE experiences are essential to facilitate meaningful collaborations for pre-service professionals to learn with and from one another; however, this requires time, preparation and is most effective when teacher mentors and university professors lead with vulnerability and model flexibility. Investment in IPE is challenging but worth the effort when learning outcomes are realized.

Specific details regarding the structure of this experience are shared as well as future directional goals for programs hoping to implement IPE in their professional practice programs.

Anchored with turbulence emanating from the COVID-19 pandemic, the work environment has become more stressful with debilitating effects on the well-being of employees. Employees rely on varying means of coping including drug abuse. However, the association between drug abuse and suicidal thoughts among employees in Ghana is unknown. Therefore, this study sought to examine the relationship between drug abuse and suicidal thoughts among employees in Ghana.

In a cross-sectional survey, this study purposively sampled 470 employees from three sectors of the Ghanaian economy (telecommunication, banking and manufacturing). The data was analysed using the multivariate analysis (MANOVA), Pearson’s r test and hierarchical regression.

Analysis of data revealed a positive relationship between drug abuse and suicidal thoughts, indicating that drug abuse is a risk factor for suicidal thoughts. Besides, it was also revealed that banking sector employees have a higher risk of having suicidal thoughts than employees in the telecommunication and manufacturing sectors.

Managers of organisations need to redesign work to embrace the challenging circumstances brought about as a result of COVID-19 and post-COVID implications. The work environment needs to be more supportive to shield employees from the physical and emotional demands of work during and after this period of the COVID-19 pandemic. Today than ever, investment in the implementation of employee-assisted programmes (EAPs) and employee well-being programmes (EWPs) to equip employees with the needed skills to cope with stressful conditions has been more than justified.

From a broader perspective, this study identifies drug abuse as a key risk factor for suicidal thoughts among employees, thereby highlighting the fact that smoking cessation programs and drug management therapies are an integral part of well-being programmes aimed at establishing equilibrium and gradually creating a wide gap between employees and suicidal thoughts.

This paper aims to describe the unique health challenges facing female commercial sex workers (FSWs), including issues related to their marginalisation and difficulty accessing health care. It proposes solutions to some of these problems.

This paper addresses this sensitive subject through the methodology of a literature review, drawing on a variety of relevant published literature to inform a modern understanding of the current health challenges faced by this population.

This paper discusses issues around criminalisation of commercial sex workers, complexities of family planning, sexually transmitted infection prevention, mental health and substance abuse and how increasing health-care worker awareness of the health needs of this vulnerable population can be a positive step in building trust within this relationship. Although adoption of the proposed recommendations put forth in this paper may help to eliminate some of the barriers encountered by female sex workers, further research is recommended.

The subject of commercial sex worker health care is neglected in the academic literature. This review explores the topic in an open and balanced manner and presents a broad and updated overview of the current health-care challenges faced by FSWs as well as opportunities for optimising access and quality of sex worker health care.

Clinical staff working in mental health services experience high levels of work-related stress, burnout and poor well-being. Increased levels of stress, burnout, depression and anxiety and poorer mental well-being among health-care workers are associated with more sick days, absenteeism, lower work satisfaction, increased staff turnover and reduced quality of patient care. Virtual reality (VR) relaxation is a technique whereby experiences of pleasant and calming environments are accessed through a head-mounted display to promote relaxation. The purpose of this paper is to describe the design of a study that assesses the feasibility and acceptability of implementing a multi-session VR relaxation intervention amongst mental health professionals, to improve their relaxation levels and mental well-being.

The study follows a pre–post-test design. Mental health staff will be recruited for five weeks of VR relaxation. The authors will measure the feasibility and acceptability of the VR relaxation intervention as primary outcomes, alongside secondary outcomes evaluating the benefits of VR relaxation for mental well-being.

The study aims to recruit 20–25 health-care professionals working in both inpatient and specialist community mental health settings.

Research indicates the potential of VR relaxation as a low-intensity intervention to promote relaxation and reduce stress in the workplace. If VR relaxation is shown to be feasible and acceptable, when delivered across multiple sessions, there would be scope for large-scale work to investigate its effectiveness as an approach to enable health-care professionals to de-stress, relax and optimise their mental well-being. In turn, this may consequently reduce turnover and improve stress-related sick leave across health-care services.

Over 2.7 million workers are employed in the UK construction industry and with the fragmented nature of the construction sector; cases of poor mental health of workers are on the increase. This upsurge in the number of workers experiencing poor mental health could directly impact construction safety with significant financial adverse consequences on employers and the UK economy. Studies have identified lapses within the construction sector emphasising the lack of transparency regarding reporting of mental health and well-being of construction workers due to the inadequate engagement from employers and the lack of genuine leadership commitment to tackle mental health.

This study adopted a non-probability purposive sampling strategy, using a self-selected sample. A self-administered questionnaire benchmarked against the mental health core and enhanced standards tools by the “Stevenson/Farmer review of mental health and employers” served as the basis for the methodology. A total of 106 industry managers from highways, construction, maritime, utilities, home building, rail and haulage/fleet were involved in this study.

The findings indicate that the industry is making good strides towards addressing mental health issues; poor mental health have significant financial burdens on businesses and the economy; some contractors have mental health initiatives and programmes in place; there is inconsistency of support available to employees; some contractors now integrate leadership training; the level of engagement vary based on the strategy and action plan adopted by organisations; different mechanisms are adopted for monitoring mental health issues, and there are cross-industry initiatives.

A limitation of this study is the number of participants which is not representative of the entire UK construction workforce. Therefore, the findings from this study as much as it presents some understanding of employee mental health and well-being cannot be overtly generalised across multiple industries, different geographic regions or contexts.

Employers should have a clear representation of the mental health of their employees to help them understand what affects worker’s mental well-being and how they can support them. Disregarding the multifaceted causes of mental ill-health due to the perceived financial implications could be more devastating for the industry.