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This paper presents a research study that demonstrates the inadequacy of the traditional biomedical approach to caring for older people and shows the benefits of using a more holistic, bio‐psychosocial approach. An ethnographic inductive approach was taken. Non‐participant observation was performed on complete episodes of nursing practice, followed by semi‐structured interviews to explore and ratify theories in use. Phase one of the data analysis used qualitative inductive analysis to generate main categories and themes. Phase two was a process of factor isolation, which identified factors of practice theories in use. The themes identified were: nursing therapeutics; preventative nursing; communication; nurse‐patient relationships; collaborative nursing; nursing assessment; decision making; and management of patient care. Further analysis identified that important theoretical factors included: encouraging; responding; comforting; explaining; maintaining ability; judgement in action; and collaborating. This knowledge is embedded in the practice theories of practitioners but it is only by exploring and critiquing these that we can hope to understand the complex nature of nursing practice as it relates to the care of older people.

Current national policies present a challenge to the existing mental health workforce as most staff have not been trained to work with people within the context of their social support network. This paper presents two complementary training initiatives designed to enable mental health staff to meet the range of needs of families: (1) an in‐house accredited (one‐year) course that has enabled the successful creation of specialist family intervention in psychosis teams; and (2) a whole‐team trust‐wide training programme (three‐day course) to promote partnership working with families by both community and inpatient teams. Issues that have enabled the successful translation of training to practice are considered.

This paper highlights the social context of common mental disorders in primary care and the paucity of evidence relating to effective social interventions. It introduces the ABC‐E Model of Emotion, which combines social interventions with psychological therapy, and discusses how the implementation of the new role of graduate primary care mental health worker (GPCMHW) provides an opportunity for holistic practice in helping individuals experiencing mild to moderate mental health difficulties in primary care. It provides a case example of the implementation of the ABC‐E model and makes recommendations for further research including the evaluation of the model and GPCMHW training programmes.

The purpose of this paper is to describe first the rationale for an embedded process for learning difficulties and disabilities in the criminal justice system (CJS). This is followed by an example of how this approach has been delivered in one offender setting. The use of a novel computerised assessment tool is described, and the way it has been used to undertake the initial screening processes and provide person centred guidance for staff and the individuals. The bio-psychosocial approach to supporting individuals moving through the CJS is suggested as an approach that could be potentially used in other prisons settings. The paper also highlights some of the current challenges in doing so.

This paper presents a review of the currently literature to provide a rationale for the example of the embedded approach taken.

The approach, aligns to the challenges cited in much of the research.

The model presented can be used as a basis for potentially delivering such a system in other prisons settings and to highlight areas that remain contentious.

The embedded model represents a bio-psychosocial approach to supporting individuals moving through the CJS so has important implications.

This is novel approach.

The purpose of this paper is to determine the experience participating in a health promotion program for refugee and asylum seekers and torture survivors in a safety net clinical setting.

Refugee and asylum seeker torture survivors participated in a seven-week health promotion program at a safety-net clinic. Participants interviewed before, during and after the program was designed to improve and maintain health promotion program quality.

Six major themes emerged: social networks; tools/techniques/skills; wellness planning; spiritualism; health maintenance; and social/group interaction. Preliminary results suggest that this multi-pronged approach is feasible and acceptable to foreign-born torture survivors.

Torture impacts many facets of one’s life. A program which addresses health from a multidisciplinary perspective has promise to facilitate healing.

The impact of torture and human rights violations significantly affects many facets of peoples’ lives including emotional, social, physical and spiritual dimensions. Therefore a program which utilizes a multidisciplinary integrated bio-psychosocial and spiritual approach has the potential to simultaneously address many domains facilitating healing.

BeWell, a bio-psychosocio-spiritual health promotion strategy aimed at improving health service quality and increasing patient satisfaction to support positive health outcomes by implementing in-classroom/person modules for patients, to the authors’ knowledge is unique in its efforts to encompass multiple domains simultaneously and fully integrate an approach to wellbeing.

Mental health assessment in people with learning disability can be a challenging process for clinicians. The more severe the cognitive impairment and level of learning disability, the less likely it is that the clinician can reliably confirm the diagnosis of a psychiatric disorder. Coordinated, multi‐modal interdisciplinary team assessment is the way forward, as it draws together the bio‐psychosocial model of interviewing and mental health care planning. In this article we go through the psychiatric assessment structure and highlight the differences in assessing people with learning disability compared with their peers in the general population. We give special consideration to mental health assessments in emergency settings, and to people with challenging behaviour.

This position paper focuses on the current tensions and challenges of aligning inpatient care with innovations in mental health services. It argues that a cultural shift is required within inpatient services. Obstacles to change including traditional perceptions of the role and responsibilities of the psychiatrist are discussed. The paper urges all staff working in acute care to reflect on the service that they provide, and to consider how the adoption of new ways of working might revolutionise the organisational culture. This cultural shift offers inpatient staff the opportunity to fully utilise their expertise. New ways of working may be perceived as a threat to existing roles and responsibilities or as an exciting opportunity for professional development with increased job satisfaction. Above all, the move to new ways of working, which is gathering pace throughout the UK, could offer service users1 a quality of care that meets their needs and expectations.

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.

Within human services, client satisfaction is highly prioritised and considered a mark of responsiveness in service delivery. A large body of research has examined the concept of satisfaction from the perspective of service users. However, not much is known about how service providers construct client satisfaction. The purpose of this paper is to throw light on healthcare professionals’ perspectives on patient satisfaction, using tuberculosis (TB) clinics as a case study.

In-depth interviews were conducted with 35 TB clinic supervisors purposively sampled from six out of the ten regions of Ghana. An unstructured interview guide was employed. The recorded IDIs were transcribed, edited and entered into QSR NVivo 10.0 and analysed inductively.

Respondents defined service satisfaction as involving education/counselling (on drugs, nature of condition, sputum production, caregivers and contacts of patients), patient follow-up, assignment of reliable treatment supporters as well as being attentive and receptive to patients, service availability (e.g. punctuality at work, availability of commodities), positive assurances about disease prognosis and respect for patients.

Complementing opinions of health service users with those of providers can offer key performance improvement areas for health managers.

To the best of the authors’ knowledge, this is a first study that has examined healthcare providers’ views on what makes their clients satisfied with the services they provide.