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The purpose of this paper is to report on the aspects of an exploratory investigation into the scale and nature of the financial abuse of adults lacking mental capacity.

It uses mixed-methods study which comprises of: a review of safeguarding adults’ statistics; analysis of court case findings; classification of types of financial abuse, victims and perpetrators; qualitative exploration of professional views of the nature of financial abuse of those lacking mental capacity; and a consideration of policy implications.

It demonstrates the significance of financial abuse within the spectrum of abuse experienced by adults at risk; the wide range of both victims lacking capacity being abused and type of financial abuse; its often hidden nature embedded within the family; and the limitations of processes designed to protect.

The investigation reveals the paucity of statistical data available on the nature of financial abuse and the outcomes of official investigations into reported cases, both of which limit analysis and understanding of the phenomenon.

It demonstrates the need for greater transparency and consistency in the reporting of safeguarding and legal processes to enable practitioners and policymakers to fully understand the nature and significance of this abuse for both victims and society.

It questions the extent to which existing protective processes are sufficient in terms of safeguarding victims and deterring perpetrators.

It involves original research that brings together data from a range of sources involved in the protection of a particular hard-to-reach group of individuals (those lacking capacity) from a particular type of risk (financial abuse) of increasing social significance.

Treatment of Cotard's syndrome with electroconvulsive therapy (ECT) has been seen to be an effective treatment option when pharmacological options are not successful. Recent changes in the Mental Health Act 2007 used within the United Kingdom has resulted in clinicians unable to prescribe treatment for patients who have capacity but are not providing consent for treatment. We report a case of a patient in the UK with Cotard's phenomenon and severe depression, where the only effective treatment of ECT was restricted due to changes in mental health law. The role of maintenance ECT as well as the ethical dilemma faced is discussed.

Using a mixed methodology comprising interviews, case file analysis and descriptive statistics, this study aims to examine the experiences of all 43 young people in Wales subject to secure accommodation orders between 1st April 2016 and 31st March 2018.

Children in the UK aged 10–17 years who are deemed to be at a significant level of risk to themselves or others may be subject to a secure accommodation order, leading to time spent in a secure children’s home (SCH) on welfare grounds. Following a rise in the number of children in Wales referred to SCHs for welfare reasons, this paper describes these young people’s journeys into, through and out of SCHs, giving insight into their experiences and highlighting areas for policy and practice improvements.

Findings indicate that improvements in mental health support and placement availability are key in improving the experiences of this particularly vulnerable group of young people throughout their childhood.

Other practical implications of the study’s findings, such as improvements in secure transport arrangements, are also discussed.

While the findings are limited by the reliance on self-report methods and the size of the study, namely, the small number of young people with experience of SCHs who were able to participate, the findings build on the existing knowledge base around children’s residential accommodation and provide new insights into how best to support these children.

Local Safeguarding Adults Board (SAB) policies, procedures, guidance and related documents on self-neglect were gathered and analysed, to map what approaches are being taken across England. This paper aims to identify areas of divergence to highlight innovations or challenges faced by SABs.

Self-neglect documents were identified by searching SAB websites. Data were extracted into a framework enabling synthesis and comparison between documents.

This paper reports on how English SAB documentation defines self-neglect, treats executive capacity, lays out pathways for self-neglect cases, advises on refusal of service input and multi-agency coordination and draws on theories or tools. Greater coherence in understanding self-neglect has developed since it was brought within safeguarding in 2014; however, variation remains regarding scope, referral pathways and threshold criteria.

This review was limited to published SAB documentation at one point in time and could not consider either the wider context of safeguarding guidance and training or implementation in practice.

This review provides an overview of how SABs are interpreting national guidance and guiding practitioners. The trends and areas of uncertainty identified offer a resource for informed research and policy-making.

To the best of the author’s knowledge, this is the first systematic survey of SAB self-neglect policies, procedures and guidance since self-neglect was included under safeguarding.

The purpose of this paper is to understand how women with a diagnosis of schizophrenia or bipolar disorder approach medication decision making in pregnancy.

The study was co-produced by university academics and charity-based researchers. Semi-structured interviews were conducted by three peer researchers who have used anti-psychotic medication and were of child bearing age. Participants were women with children under five, who had taken anti-psychotic medication in the 12 months before pregnancy. In total, 12 women were recruited through social media and snowball techniques. Data were analyzed following a three-stage process.

The accounts highlighted decisional uncertainty, with medication decisions situated among multiple sources of influence from self and others. Women retained strong feelings of personal ownership for their decisions, whilst also seeking out clinical opinion and accepting they had constrained choices. Two styles of decision making emerged: shared and independent. Shared decision making involved open discussion, active permission seeking, negotiation and coercion. Independent women-led decision making was not always congruent with medical opinion, increasing pressure on women and impacting pregnancy experiences. A common sense self-regulation model explaining management of health threats resonated with women’s accounts.

Women should be helped to manage decisional conflict and the emotional impact of decision making including long term feelings of guilt. Women experienced interactions with clinicians as lacking opportunities for enhanced support except in specialist perinatal services. This is an area that should be considered in staff training, supervision, appraisal and organization review.

This paper uses data collected in a co-produced research study including peer researchers.

The purpose of this paper is to present findings from a mixed-methods study on the impact that COVID-19 has had on adult safeguarding. The research sought to explore the challenges and opportunities presented by COVID-19 to both frontline and non-frontline professionals working in adult safeguarding.

A mixed-methods project was undertaken comprising a literature review, survey, semi-structured interviews and a small number of freedom of information requests. This paper presents the findings predominantly from the survey and interviews.

Unsurprisingly, COVID-19 has presented a variety of challenges for professionals working in adult safeguarding. The themes that occurred most often were the day-to-day changes and challenges, relationships across sectors, information and navigating the ethical questions in safeguarding.

To the best of the authors’ knowledge, the findings represent the first focused qualitative mixed-method study aimed at understanding more about the impact the pandemic has had on adult safeguarding through the eyes of those professionals working in that field.

The impact of frontline robots (FLRs) on customer orientation perceptions remains unclear. This is remarkable because customers may associate FLRs with standardization and cost-cutting, such that they may not fit firms that aim to be customer oriented.

In four experiments, data are collected from customers interacting with frontline employees (FLEs) and FLRs in different settings.

FLEs are perceived as more customer-oriented than FLRs due to higher competence and warmth evaluations. A relational interaction style attenuates the difference in perceived competence between FLRs and FLEs. These agents are also perceived as more similar in competence and warmth when FLRs participate in the customer journey's information and negotiation stages. Switching from FLE to FLR in the journey harms FLR evaluations.

The authors recommend firms to place FLRs only in the negotiation stage or in both the information and negotiation stages of the customer journey. Still then customers should not transition from employees to robots (vice versa does no harm). Firms should ensure that FLRs utilize a relational style when interacting with customers for optimal effects.

The authors bridge the FLR and sales/marketing literature by drawing on social cognition theory. The authors also identify the product categories for which customers are willing to negotiate with an FLR. Broadly speaking, this study’s findings underline that customers perceive robots as having agency (i.e. the mental capacity for acting with intentionality) and, just as humans, can be customer-oriented.

The purpose of this paper is to describe Karen refugee women’s experience of resettlement and the factors which structured community capacity to support their mental health and well-being.

A postcolonial and feminist standpoint was used to bring Karen women’s voice to the knowledge production process. Data were collected through ethnographic field observation, in-depth semi-structured individual and focus group interviews with Karen women as well as healthcare and social service providers.

Three interrelated themes emerged from the data: Karen women’s construction of mental health as “stress and worry”; gender, language and health literacy intersected, shaping Karen women’s access to health care and social resources; flexible partnerships between settlement agencies, primary care and public health promoted community capacity but were challenged by neoliberalism.

Karen women and families are a diverse group with a unique historical context. Not all the findings are applicable across refugee women.

This paper highlights the social determinants of mental health for Karen women and community responses for mitigating psychological distress during resettlement.

Public health policy requires a contextualized understanding of refugee women’s mental health. Health promotion in resettlement must include culturally safe provision of health care to mitigate sources of psychological distress during resettlement.

This research brings a postcolonial and feminist analysis to community capacity as a public health strategy.

Stereotypes are simplified and widely shared visions held by a social group regarding a place, object, event or recognizable set of people united by certain characteristics or qualities. They are “dangerous” mental models because they are widely disseminated, devious and capable of acting even unconsciously in individuals, social groups and organizations altering the rationality of assessments and choices and producing discrimination and prejudice. Stereotypes acritically extend from a characteristic of a significant percentage of a category to the totality of individuals. The process of generalization triggered by a stereotype produces the error of discrimination and prejudice. There are numerous forms of stereotypes, but this study takes into account gender stereotypes because they act pervasively, often subtly, to reduce “productivity”. People who are aware of being discriminated perceive an unsatisfactory fulfillment of their motivations, which reduces their incentive to improve their performance. Since productivity measures the efficient use of energy from working in production processes, the author believes that wherever gender stereotypes are at play, there is a productive “waste of energy”, an inefficiency in work activity with harmful effects for organizations of all kinds, including families.

The work aims to demonstrate that wherever gender stereotypes are at play, a “waste of energy” manifests itself in terms of productivity, representing an inefficiency in work activity with harmful effects for organizations of all kinds, including families. To describe the negative effects stereotypes produce in organizations, some models are presented based on the methods and language of systems thinking. These models, although typically qualitative, are capable of exploring the most accepted theories in the literature: tournament theory, the Pygmalion effect, the Galatea effect, self-fulfilling prophecies, the Queen bee syndrome, the role congruency theory, the glass ceiling theory (“think manager, think male” and “family responsibilities wall”). The paper follows a predominantly organizational and corporate approach, although the copious literature on stereotypes belongs largely to the area of social psychology and organization studies.

The paper does not consider the psychological origin of stereotypes but highlights their use as routines-shortcuts for evaluations and decisions demonstrating that, when adopted in social systems and within organisations, stereotypes produce different forms of discrimination: in social rights, in work, in careers and in access to levels of education and public services, reducing performance and limit potential. The paper also examines some ways gender and culture stereotypes can be opposed, presenting a change management strategy and some concrete solutions proposed by the process–structure–culture model for social change (PSC model).

The main limitation of the work is that it focuses on gender stereotypes, choosing not to consider the “intersection effect” of these with other stereotypes: racial stereotypes, religious stereotypes, color stereotypes, age stereotypes, sex and sexual orientation stereotypes, and many others, whose joint action can cause serious inefficiencies in organizational work.

As stereotypes are a component of social culture and are handed down, by use and example, from generation to generation, the maintenance over time of stereotypes used by individuals to evaluate, judge and act can be seen as an effect of the typical action of a combinatory system of diffusion, which can operate for a long time if not effectively opposed. Il PSC model indicates the strategy for carrying out this opposition.

With regard to gender stereotypes, it should be emphasized that in organizations and social systems, “gender diversity” should be considered an opportunity and not as a discriminating factor and thus encouraged by avoiding harmful discrimination. In fact, this diversity, precisely because of the distinctive characteristics individuals possess regardless of gender, can benefit the organization and lead to an increase in organizational and social performance. The United Nations 2030 Agenda for Sustainable Development (2020) Goal 5: Achieving gender equality and empowering all women and girls is examined in this context.

This study views the action of gender stereotypes as especially harmful “mental models”, highlighting the distortions they cause in the allocation of productive energy in society, groups and organizations. The paper follows a predominantly organizational and corporate approach, although the copious literature on stereotypes belongs largely to the area of social psychology. Using the “logic” and “language” of systems thinking, theories and models that describe and interpret the distorting effects of organizational choices based on stereotypes rather than rational analysis are highlighted. The action of stereotypes and their persistence over time can also be described using combinatory systems theory. With this paper, the author hopes that by acting on the three wheels of change highlighted by the PSC model, through legal provisions, control tools and actions on the culture operated by educational and social aggregative institutions, it should not be impossible to change the prevailing culture so that it becomes aware of the harmful influence of gender stereotypes and other discriminatory mental models and come to reject them. The author hopes this paper will help to understand the need to make this change.

In Ireland, the Assisted Decision Making (Capacity) Act 2015 provides a statutory framework to adults who are experiencing difficulties with decision-making. This legislation has significant implications for all who work in health and social care. Increasing age and life expectancy, alongside the rising incidence of chronic health conditions and dementia-related diseases, indicates that more individuals are likely to experience challenges regarding decision-making capacity. Therefore, the need for more consistent, best-practice processes to assess decision-making capacity is likely to increase. To ensure occupational therapists are responsible in their contributions, and to ensure those with disabilities are supported, clinicians must be well-informed of the principles underscoring the Act. The purpose of this paper is to provide an overview of this multidisciplinary issue, including recent legislation, and consider how occupational therapy can contribute.

The authors reviewed current literature and considered occupational therapy’s role in decision-making capacity assessment.

Occupational therapists have potential to play a key role in multi-disciplinary assessments of decision-making capacity for clients. Further research is required to explore professional issues, identify clinical best practices and determine training and resource needs.

This paper seeks to provoke consideration of how occupational therapists can contribute to capacity assessment from a client-centred, occupation-based perspective that is mindful of ethical and legislative considerations.