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The purpose of this paper is to consider the role of the Mental Health Act (MHA) 1983 in safeguarding adults at risk of abuse and neglect. The author has undertaken a thematic review of Safeguarding Adults Reviews (SARs) commissioned in England and Adult Practice Reviews (APRs) commissioned in Wales where the MHA 1983 was a central aspect to the review.

Reviews were included based on specific determinants, following analysis of SARs, APRs and executive summaries. This should not affect the credibility of the research, as themes were identified in conjunction with analysis of literature regarding use of the MHA in the context of adult safeguarding. Consequently, this review has been underpinned by evidence-based research in the area of study.

The interaction between statutes, such as the MHA 1983 and Care Act 2014, signify challenges to professionals, with variable application of mental health legislation in practice.

Lack of a complete national repository for review reports means that it is likely that the data set analysis is incomplete. It was noted that limitations to this research include the fact that Safeguarding Adults Boards in England may not publish SAR reports or may choose to publish an executive summary or practice brief instead of the full SAR report, therefore limiting the scope of disseminating learning from SARs, as this is difficult to achieve where the full report has not been published. The author aimed to mitigate this by undertaking comprehensive searches of Local Authority and SAB websites, in addition to submitting Information requests to ensure that this research encompassed as many relevant review reports as possible.

This is an important and timely topic for debate, given that the UK Government is proposing reform of the MHA 1983. In addition, existing thematic reviews of SARS tend to be generalised, rather than specifically focused on the MHA.

This study aims to improve the efficiency of the assessment process within a Step4 Psychological Therapies Service by identifying factors related to assessment non-attendance and service suitability for referred clients.

Referral and assessment information was accessed between October 2019 and March 2020 from Step4 routine service data, electronic client records where necessary and Step4 staff self-report questionnaires.

All clients offered an assessment during this time attended. Findings indicated several factors could influence service suitability in meeting client need. These included individual differences such as readiness to change, which was not necessarily identified at referral or prior to assessment, and potential systemic factors, such as the opt-in procedure, which possibly impeded access. Though the necessity for assessment in clarifying client needs and treatment was indicated, an assessment (from referral to assessment appointment) that led to discharge could take an excess of one working day of service time, associated with considerable opportunity cost to other clients awaiting assessment. Recommendations are made for improving assessment efficiency.

With a high prevalence of poor mental health in the UK, efforts must be made to identify and reduce additional demand upon service time and resources within mental health services to effectively meet people’s needs. Recommendations to improve assessment process efficiency include the use of a standardised referral form, offer of follow-up support procedures, increased client involvement, a streamlined opt-in battery and ongoing monitoring to ensure shared practice between clinicians. These are transferable to other mental health services, with implications for subsequent quality and timeliness of care.

Rates of self-harm are elevated in prison, and there is limited evidence to support the efficacy of brief risk screening at reception to predict and prevent self-harm. This study aims to examine the predictive validity of the self-harm/suicide screening items embedded in a prison mental health screening tool from two key domains strongly associated with risk: previous suicidal/self-harm behaviour, and recent ideation.

A sample of men and women were screened on entry to prison, with eight screening items covering the two key domains of risk. Follow-up data on self-harm incidents were collected for 12 months post-screening. The predictive validity of individual screening items, item combinations and cumulative screening score was examined for the overall sample and for men and women separately.

Individual screening items across the two domains were all strongly associated with self-harm in the follow-up period, with odds ratios varying from 2.34 to 9.24. The predictive validity of both individual items, item scores and item combinations demonstrated high specificity but low to moderate sensitivity, and modest area under the curves (AUCs). Predictive validity was generally better for men than women; however, differences were not statistically significant.

Identifying those at risk of self-harm in prisons remains challenging and brief universal screening at prison entry should be only one component of a broader prison risk assessment and management strategy.

To the best of the authors’ knowledge, this study is one of very few to prospectively examine self-harm behaviour following risk screening. Predictive validity was examined in a representative sample of individuals in custody, and for men and women separately.

This study aims to describe patients presented in an interprofessional, virtual education program focused on the mental health of adults with intellectual and developmental disabilities (IDD), as well as present interprofessional recommendations for care.

In this retrospective chart review, descriptive statistics were used to describe patients. Content analysis was used to analyze interprofessional recommendations. The authors used the H.E.L.P. (health, environment, lived experience and psychiatric disorder) framework to conceptualize and analyze the interprofessional recommendations.

Themes related to the needs of adults with IDD are presented according to the H.E.L.P. framework. Taking a team-based approach to care, as well as ensuring care provider knowledge of health and social histories, may help better tailor care.

This project draws on knowledge presented in a national interprofessional and intersectoral educational initiative, the first in Canada to focus on this population.

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 refugee journey is fraught with challenges before, during and after resettlement. There is a critical need for mental health support upon arrival, and refugees face language, cultural and logistical barriers. Arts-based therapies are a promising approach to mitigating such barriers. The purpose of this study was to elicit professional stakeholder perspectives on mental health challenges among refugees, the value of arts-based programs and future directions.

The authors conducted three 90-min focus groups with 19 professional stakeholders in North Carolina, USA. This included mental health professionals, professors and community services/resettlement workers. Participants were identified from professional networks and snowball sampling. Each group was held by videoconference, audio recorded and transcribed. Data were analyzed through a team-based approach using applied thematic qualitative analysis.

Interviewees described a need for targeted, culturally compatible mental health services for refugee families, including trauma-informed, family-focused services with language interpretation. Arts-based therapies were viewed as highly acceptable and culturally responsive approaches for understanding distress and building resilience and less stigmatizing than traditional mental health services. Services in schools and community settings would further reduce stigma and minimize logistical barriers. Participants identified needing strong, culturally sensitive assessment tools to measure treatment progress as a key future direction.

The study offers novel insights into the value of arts-based approaches and considerations for program development. The next phase of the project will obtain the perspectives of refugee parents and children to understand client preferences for arts-based therapies.

Learning to be someone in today’s world requires training, knowledge, adaptive skills, differentiated skills, and mastery of instrumental and advanced technological tools to manage complex, new, and crucial problems that societies face. Citizens need to satisfy their basic needs, and they want to feel fulfilled. These are determinants of mental health/health, essential goods for the growth and evolution of humanity, and for the survival of the planet that shelters it.

The objectives of this chapter are: (1) reflect on the influence of mental health/health in high-level training processes, which require the student to mobilize physical and mental capabilities and functions; (2) realize to what extent the use of digital technology is an essential tool for learning and developing skills for higher education students; (3) addressing the question: Are higher education institutions (HEIs) and professors prepared for the challenges they face today? And, at the confluence of the previous three: (4) analyze the health/mental health interconnections, the use of digital technologies and training paths, as pillars of human development and the progress of societies.

In HEIs, there is evidence of the intersection of students’ learning abilities with the contexts that are favourable to them, namely, due to the possibility of finding space to create, develop potentials, acquire high-level knowledge and skills, present themselves to society as reliable, credible, and promising professionals for success in the organizations they form part of.

For the preparation of this exploratory and reflective chapter, the collaboration of some higher education teachers in the Autonomous Region of Madeira (RAM) was requested, also basing it on their own experience and knowledge acquired as a teacher, researcher, and expert in the field of mental health.

The perspective presented for reflection and analysis is limited by the look and the way we interrogate and interpret the realities where we operate, for these same reasons, imbued with subjectivity.

Resilience is an increasingly important concept that contributes to sustainability and wellbeing of a community. Asset-based community development (ABCD) may offer promising approaches to boosting community resilience in Australia, especially within marginalised groups.

A scoping review was conducted to conceptualise existing literature on ABCD approaches to building resilience. Research databases were searched with relevant details.

Thirty-three sources were identified as meeting the inclusion criteria and were reviewed in terms of six themes: integration and identity, health, mental health, education, employment and community planning. Issues identified by the literature within these themes can be alleviated through asset-based approaches. Implications for planning of asset-based programs and policy change are discussed in light of the findings.

The results of this study provide several implications for practise, policy recommendations and future research into this area. Results suggest that increasing capacity around asset-based coping mechanisms, such as support networks through religious and cultural groups, would promote community development and foster resilience. Furthermore, policy on refugees in multiple areas, such as psychological service provision and employment, should be redesigned in a way that acknowledges their complex and diverse needs and facilitates their integration into the community. Though multiple ways to achieve this goal have been explored in literature, a sustained and broader approach is necessary to see widespread change. Further research and funding are required to explore and implement appropriate responses. Based on the findings and discussion above, the authors make the following policy recommendations. Service providers need to be aware of and incorporate culturally appropriate programs in the areas of mental health assessment and intervention, education and employment. The trauma-informed approach should be used when dealing with refugee groups and other groups who have faced hardships. Government policy should focus on improving community engagement to create and strengthen social networks, which are vital in boosting integration into the community and increasing health education and access to services. Government should focus on asset-based approaches in designing education and employment integration programs to promote social belonging and community engagement, and thus, community resilience, which will consequently have beneficial individual and group outcomes. The current governmental policy surrounding refugees should be overhauled with the goal of successful refugee integration in mind, such as incorporating the ability for refugees to access vital services such as employment and skills transferability programs. Due to current policy, these services are inaccessible to a large portion of refugees, hindering their integration. Government needs to create specific guidelines for the provision of psychological services to refugees to improve the quality of mental health services available to this group.

This paper comprises an original data analysis of the relevant existing literature by the project team. The process was rigorous, and no content of the analysis has been published previously except the material published by other authors. All previously published materials were duly acknowledged.

This review aims to examine the literature on refugees’ and asylum seekers’ resilience, its historical evolution, key principles, assumptions and recommendations, while focusing on the Canadian context.

A narrative literature review has been applied to this manuscript. This approach allows the integration of a wide scope of literature and perspectives, from academic literature to grey literature (e.g. governmental reports and dissertations). Nevertheless, the limitations of this type of review were also discussed.

In spite of the gaining popularity of the resilience lens, which emphasizes an individual’s ability to overcome adversities and stressful events, more work is required for its effective integration into health practice, programs and policies, particularly as it relates to refugees’ and asylum seekers’ mental health care.

Careful consideration of refugees’ and asylum seekers’ mental health needs and Canadian mental health service delivery and policies is a critical first step in reaching such a goal.

People who experience mental illness often demonstrate limited help-seeking behaviours. There is evidence to suggest that media content can influence negative attitudes towards mental illness; less is known about how media impacts help-seeking behaviours. The purpose of this study is to identify if media plays a role in people’s decisions to seek help for their mental health.

The databases Academic Search Complete, CINAHL Plus with Full Text, MEDLINE, APA PsycArticles, APA PsycInfo, Social Sciences Full Text [H.W. Wilson] and Soc Index were systemically searched for papers in the English language that investigated the link between media and help-seeking for mental illness.

Sixteen studies met eligibility criteria. There was some evidence to suggest that various forms of media – including video and online resources – can positively influence help-seeking for mental health. Print media had some limited effect on help-seeking behaviours but was weaker in comparison to other forms of media. There was no evidence to suggest that media discourages people from seeking help.

This review identified that, given the heterogeneity of the included papers, and the limited evidence available, there is a need for more focused research to determine how media impacts mental health-related help-seeking behaviours.