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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.

Data from different countries suggest a higher prevalence of anxiety, depression and suicides among manual and trade workers in the construction industry than in the general population. The present review examines the causes and effects of poor mental health and the effectiveness of interventions to improve manual and trade workers' mental health in the construction industry. It also identifies gaps in research and makes several suggestions for practice and future research.

A systematic literature review was conducted to examine and consolidate evidence reported in 54 relevant journal articles published between 2010 and 2021 on the mental health of manual and trade workers.

Three major themes emerged in the review of the 54 journal articles: causes of poor mental health, effects of poor mental health and interventions to improve mental health. The leading causes of poor mental health among construction manual and trade workers are poor work-life balance, high job demand, poor cultural norms and mental health stigma, chronic bodily pain, lack of social support, workplace injustice and job insecurity. The prominent effects of poor mental health are suicidality, drug and alcohol addiction, poor workplace safety and poor work performance. Moreover, the study found that some of the strategies recently implemented in the construction industry to improve mental health are deemed ineffective, or their effectiveness remains inconclusive.

The review's scope is limited to research on manual and trade workers, and it did not investigate the mental health of construction professionals and construction management students.

The review provides valuable insights into the causes and effects of poor mental health among manual and trade workers and the effectiveness of mental health interventions in the construction industry.

This study aims to use the dual-continuum model of mental health to explore mental health in Australian construction apprentices from the perspective of key stakeholders in the apprenticeship model. In particular, this study explored how construction apprentices, Vocational Education and Training (VET) teachers, industry employers and mental health workers understood the construct of mental health, factors associated with the dimension of psychological distress/symptoms of mental illness, and factors associated with the dimension of mental wellbeing.

This study used an exploratory qualitative research design. Data from 36 semi-structured interviews were analysed using thematic analysis. Participants comprised 19 Australian construction apprentices, 5 VET teachers, 7 industry employers and 5 mental health workers.

In total, 14 themes were generated from the data set. Participants across stakeholder groups reported a limited understanding about mental health. Participants cited a range of negative personal, workplace and industry factors associated with psychological distress/symptoms of mental illness, but only reported a few factors associated with mental wellbeing.

To the best of the authors’ knowledge, this study is one of the first to use the dual-continuum model of mental health to explore the mental health of Australian construction apprentices, and to explore the factors associated with both dimensions of this model from the perspective of key stakeholders in the Australian construction apprenticeship model.

This study aims to construct a mental health service system for middle school students in the post-COVID-19 era with the framework of Six Sigma DMAIC (define, measure, analyze, improve and control) and analyze the influencing factors of the mental health service system to study the implementation strategies of quality-oriented mental health services in middle schools.

This study was conducted in Tianjin, China, from September to November 2022, and 350 middle school students from Tianjin Public Middle School were selected as subjects. A questionnaire survey was used to collect data. In this study, the Six Sigma DMAIC method, sensitivity analysis method, exploratory factor analysis and principal component analysis were used to analyze the mental health services provided to middle school students.

Based on the Six Sigma DMAIC framework, this study indicates that the contribution rate of the mental health service process factor is the largest in the post-COVID-19 era. The mental health cultivation factor ranks second in terms of its contribution. Mental health quality and policy factors are also important in the construction of middle school students’ mental health service system. In addition, the study highlights the importance of parental involvement and social support in student mental health services during the post-COVID-19 era.

To the best of the authors’ knowledge, a study on middle school students’ mental health in the post-Covid-19 era has not yet been conducted. This study developed a quality-oriented mental health system and analyzed the influencing factors of mental health for middle school students based on data analysis and the Six Sigma DMAIC method.

The role of evidence-based psychological knowledge in cases of juvenile offending is essential to make appropriate decisions relating to youth who violate legal or social norms, as it carries implications for treatment, intervention and practice. Psychological expert opinions therefore need to meet high formal and methodological requirements while maintaining ethical standards. The purpose of this study is to investigate psychological expert opinions in cases of juvenile misbehavior reported to regional courts in Poland. Juvenile court proceedings concern cases of demoralization and/or delinquent offenses. Demoralization is a legal concept described in the Act of June 9, 2022 on juvenile support and resocialization. This concept was not defined; it was only described through examples of behaviors indicating demoralization. These include the following: violations of the principles of community life; evading compulsory education or schooling; use of alcohol, narcotic drugs, psychotropic substances, their precursors, substitutes or new psychoactive substances; and prostitution.

To reach these goals, court records of juvenile cases in six district courts (N = 253) were gathered and analyzed. A semistructured questionnaire was used to examine the cases in which psychologists were appointed and to analyze the procedures used by these experts for assessing adolescents and their families.

Findings revealed that family judges appoint psychologists both in cases of “demoralization” (i.e. status offenses) and in cases of juvenile delinquency. The opinions were delivered by psychologists who were mostly members of diagnostic teams. Results indicate that such opinions generally comply with the minimal standards recommended by the Ministry of Justice, yet a few problems were observed with the determination of levels of demoralization.

The limitations of diagnostic tools used by psychologists are discussed, and recommendations for future practice are provided.

The current study evaluated (1) characteristics of the community leadership development program associated with successful participant recruitment, (2) active ingredients that promoted fellow engagement and program completion and (3) how the program addressed blackness and racism.

Individual interviews were conducted with a representative subset of former program fellows.

Results indicated that offering training in small cohorts and matching fellows with individual mentors promoted program interest. Program strengths and unique ingredients included that the program was primarily led by people from the Black community, program malleability, and that the program was a partnership between fellows and leadership. Additionally, the program was responsive to fellows’ needs such as by adding a self-care component. Fellows also noted dedicated space and time to discuss race and racism. Results offer a unique theoretical perspective to guide leadership development away from the uniform or standardized approach and toward one that fosters diversity and equity in leadership.

Altogether, this work demonstrates how leadership development programs can be participant-informed and adapted to participants’ social and cultural needs.

This paper – the final paper of a series of three – aims to discuss the implications of the findings from a service user needs assessment of people experiencing homelessness in the Northwest of England. It will expand on the previous paper by offering a more detailed analysis and discussion of the identified key themes and issues. The service user needs assessment was completed as part of a review of local service provision in the Northwest of England against the backdrop of the COVID-19 pandemic.

Semi-structured questionnaires were administered and used by health-care professionals to collect data from individuals accessing the Homeless and Vulnerable Adults Service (HVAS) in Bolton. The questionnaires included a section exploring Adverse Childhood Experiences. Data from 100 completed questionnaires were analysed to better understand the needs of those accessing the HVAS.

Multiple deprivations including extensive health and social care needs were identified within the cohort. Meeting these complex needs was challenging for both service users and service providers. This paper will explore key themes identified by the needs assessment and draw upon further comments from those who participated in the data-gathering process. The paper discusses the practicalities of responding to the complex needs of those with lived experience of homelessness. It highlights how a coordinated partnership approach, using an integrated service delivery model can be both cost-effective and responsive to the needs of those often on the margins of our society.

Data collection during the COVID-19 pandemic presented a number of challenges. The collection period had to be extended whilst patient care was prioritised. Quantitative methods were used, however, this limited the opportunity for service user involvement and feedback. Future research could use qualitative methods to address this balance and use a more inclusive approach.

This study illustrates that the needs of the homeless population are broad and varied. Although the population themselves have developed different responses to their situations, their needs can only be fully met by a co-ordinated, multi-agency, partnership response. An integrated service model can help identify, understand, and meet the needs of the whole population and individuals within it to improve healthcare for a vulnerable population.

This study highlighted new and important findings around the resilience of the homeless population and the significance of building protective factors to help combat the multiplicity of social isolation with both physical and mental health problems.

The discussion provides an opportunity to reflect on established views in relation to the nature and scope of homelessness. The paper describes a contemporary approach to tackling current issues faced by those experiencing homelessness in the current context of the COVID-19 pandemic. Recommendations for service improvements will include highlighting established good practices including embedding a more inclusive/participatory approach.

Institutional abuse is a worldwide phenomenon with the UK also subject to several high-profile abuse scandals perpetuated on people with learning disabilities and/or mental health conditions living within institutional settings. This study aims to provide a broad perspective of safeguarding practices within institutional care to inform practice and service development in this area.

A narrative overview was undertaken of a range of empirical evidence, discussion papers, enquiry reports, reports from regulatory bodies and professional guidance to explore safeguarding practices within institutional care for individuals with learning disabilities and/or mental health conditions.

A range of literature was identified that exposed and explored abuse in this context. Three key themes were identified: failings within institutional care; safeguarding issues and concerns; and good practice within institutional care. Whilst guidance is available, standards are explicit and protocols facilitate improvement potential in this area, a consistent message was that statutory recommendations for reform have not been effective.

This paper provides an important resource for practitioners and service providers involved in institutional care. An accessible overview of both the empirical evidence and grey literature on adult safeguarding within institutional settings is provided, along with a range of standards and resources that specify practice in these settings.

The mental healthcare is experiencing an ever-growing surge in understanding the consumer (e.g., patient) engagement paradox, aiming to vouch for the quality of care. Despite this surge, scant attention has been given in academia to conceptualize and empirically investigate this particular aspect. Thus, drawing on the Stimulus-Organism-Response (S-O-R) paradigm, the study explores how patients engage with healthcare service providers and how they perceive the quality of the healthcare services.

Data were collected from 279 respondents, and the derived conceptual model was tested by using Smart PLS 3.2.7 and PROCESS. To complement the findings of partial least squares (PLS)-based structural equation modeling (SEM), the present study also applied fuzzy set qualitative comparative analysis (fsQCA) to identify the necessary and sufficient conditions to explore substitute conjunctive paths that emerge.

Findings show that patients’ perceived intimacy (PI), cohesion and privacy enhance the quality of mental healthcare service providers. The results also suggest that patients’ PI, cohesion and privacy have indirect effects on the perceived quality of care (PQC) by the service providers through consumer engagement. The fsQCA results derive that the relationship among conditions leading to patients’ perception of the quality of care in regard to mental healthcare service providers is complex and is best reflected as multiple and conjectural causation configurations.

The findings from this research contribute to the advancement of studies on patients’ experiences by empirically examining the unique dynamics of interaction between consumers (patients) and mental healthcare service providers, thereby enriching both the literature on social interactions and the understanding of the consumer–provider relationship.

The results of this study provide practical implications for mental healthcare service providers on how to combine the study variables to enhance the quality of care and satisfy more patients.

A significant research gap has ascertained the inter-relationship between PI, cohesion, privacy, engagement and PQC from the perspective of mental healthcare service providers. This research is one of the primary studies from a managerial and methodological standpoint. The study contributes by combining symmetric and asymmetric statistical tools in service marketing and healthcare research. Furthermore, the application of fsQCA helps to understand the interactions that might not be immediately obvious through traditional symmetric methods.

The current review aims to focus on how risk and protective factors for self-harm in secure mental health hospitals are captured in the literature.

Fifty-seven articles were included in a systematic review, drawn from an initial 1,119 articles, post duplicate removal. Databases included Psycinfo, Psycarticles, Psycnet, Web of Science and EBSCO host. A thematic analysis was used, which included a meta-ethnographic approach for considering qualitative papers.

There was a clear focus on risk factors, with eight identified (in order of occurrence): raised emotional reactivity and poor emotion regulation; poor mental health; traumatic experiences; personality disorder diagnosis and associated traits; increased use of outward aggression – dual harm; constraints of a secure environment and lack of control; previous self-harm and suicide attempts; and hopelessness. Protective factors featured less, resulting in only three themes emerging (in order of occurrence): positive social support and communication; positive coping skills; and hope/positive outlook.

This includes a proposal to move focus away from “risk” factors, to incorporate “needs”, in terms of individual and environmental factors. There is also a need for more attention to focus on developing high quality research in this area.

The research captures an area where a synthesis of research has not been comprehensively undertaken, particularly with regards to capturing protective as well as risk factors.