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Mentally disordered offenders (MDO), contary to general belief, are not the sole concern of specialist and secure services. Their numbers are far greater in the community. Instead of denying involvement with and responsibility for this group, mainstream mental health services need to recognise the reality of their presence on their caseloads and take steps to provide services to them. However this client group often has complex needs that may transcend the capacity of individual key workers or single agencies to meet. This has important implications for the training, supervision and support of individual staff, and for improved liaison and inter‐agency working, particularly with forensic practitioners in prisons and secure mental health services.

The role of the primary mental health worker (PMHW) is relatively new within child and adolescent mental health services (CAMHS). Different organisational structures have emerged and it is important to study the advantages and disadvantages associated with different PMHW practice models. The current study uses a large, representative sample of PMHWs and operationalises practice models according to the PMHWs' self‐reported location and team alignment thus identifying three models (namely CAMHS outreach, primary care based, and dedicated PMHW team). Comparisons between the models are made in relation to organisation and management, inter‐agency links, and job satisfaction with the aim of exploring the strengths and weaknesses of each model. The results suggest that each model meets the aims of the role and there is greater similarity than dissimilarity between models. However, it also indicates that attention should be paid to improving the working environments and training and development opportunities for all PMHWs irrespective of model, but with particular consideration given to improving the support available to PMHWs working in primary care based models.

The results of a Q methodological study of professional understandings of the notion of risk in mental health services within the UK are discussed in relation to the relevance for staff training and quality assurance. The study attempted to access the diversity of understandings of risk issues amongst a multi‐professional group of staff (n = 60) attending inter‐agency risk training workshops in 1998. Q methodology is presented as both an appropriate means for such inquiry and as a novel experiential technique for training purposes. A tentative argument is advanced that the qualitative accounts generated by Q research could assist in systematic reviews of quality, complementing the singularly quantitative approaches typically represented in the audit process.

An evaluation of the impact on participants' health and wellbeing of a vocational training programme in Northern Ireland begun under the European Union's Horizon initiative.

At the core of raising awareness about adult protection lies the formidable task of introducing social and health care staff and others to what abuse is and what can be done about it. This is a task that may appear overwhelming in terms of numbers, time and cost. Here the lead training manager for East Sussex describes how one county has developed a multi‐agency programme of adult protection courses.

The NHS reforms increased emphasis on a managerial culture. In primary care this raised questions about responsibility and philosophical approaches. Greater integration between agencies brings benefits, but creates tensions. Failure to bridge the gap may result in dysfunctional teams and compromised quality of patient care. The different orientations may manifest themselves in several ways but lead to frictions that can breed hostility and prevent effective teamwork. Explores issues involving social service and community nurse teams in Dorset to identify a new framework for working, by recognizing and respecting differences and by creating a climate of dialogue. The process involves three stages. First, mutual awareness by use of meta planning which revealed several important themes, different priorities, political dynamics and organizational constraints. Second, behavioural contracting facilitated by role reversal and third, the development of consensus working protocols as a bridge for professional gaps.

Most agencies involved in dealing with the aftermath of major disasters recognize that reacting effectively involves, among other things, the collection and provision of accurate and timely information to other agencies, to the various groups of people directly involved in the disaster and to the general public. Focuses on three disasters of different kinds – Kegworth, Hillsborough and Towyn–and analyses the data gathered on these disasters and their aftermaths. Examines the flow of information during and after a disaster and considers the problems the various agencies involved may encounter in acquiring and disseminating information. Finds that, in all three disasters, plans for information handling were appreciably revised in the light of experience gained and similar deficiencies in plans were found in each case.

Four routes or pathways have now been identified by which individuals may come within the scope of PSA 16 National Indicator 149, which is concerned with monitoring efforts to achieve settled accommodation for individuals with significant mental health problems. This article focuses on their needs and the identification of those with mental health needs as seen through these four principal routes. An understanding of these four possible pathways can help to identify areas for priority action, local delivery chains and partnerships, and also highlight some of the challenges and risks in and for delivery.

The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis. It also explores whether lessons are being learned from the findings and recommendations of an increasing number of reviews on self-neglect cases.

Further published reviews are added to the core data set, mainly drawn from the websites of safeguarding adults boards (SABs). Thematic analysis is updated using the domains used previously. The domains and the thematic analysis are grounded in the evidence-based model of good practice, reported in this journal previously.

Familiar findings emerge from the thematic analysis and reinforce the evidence-base of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners working with such cases. Multiple exclusion homelessness and alcohol misuse are prominent. Some SABs are having to return to further cases of self-neglect to review, inviting scrutiny of what is (not) being learned from earlier findings and recommendations.

The national database of reviews commissioned by SABs remains incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. National Health Service Digital annual data sets do not enable the identification of reviews by types of abuse and neglect. However, the first national analysis of SARs has found self-neglect to be the most prominent type of abuse and/or neglect reviewed. Drawing together the findings builds on what is known about the components of effective practice, and effective policy and organisational arrangements for practice.

Answering the question “why” remains a significant challenge for SARs. The findings confirm the relevance of the evidence-base for effective practice but SARs are limited in their analysis of what enables and what obstructs the components of best practice. Greater explicit use of research and other published SARs might assist with answering the “why” question. Greater scrutiny is needed of the impact of the national legal, policy and financial context within which adult safeguarding is situated.

The paper extends the thematic analysis of available reviews that focus on study with adults who self-neglect, further reinforcing the evidence base for practice. Propositions are explored, concerned with whether learning is being maximised from the process of case review.

A NETWORK OF COMMUNITY‐based service for people in Fareham and Gosport with enduring mental illness was developed by Southern Focus Trust ‐ formerly the Portsmouth Housing Trust. The experience of setting up this supported living service has demonstrated how flexibility and open working with clients have been able to meet the changing needs of people with enduring mental illness. The flexibility of the service has meant that residents have been able to remain in their home as their needs change and hospital admission is prevented.