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This paper aims to extend previous findings by identifying the mental health correlates of both acute and chronic substance use behaviors among a large nationally representative sample of juvenile offenders.

Survey of Youth in Residential Placement interview data from 6,920 juvenile offenders (76% male) detained in 290 US facilities were analyzed to determine bivariate relationships between two indicators of substance use (acute and chronic) and seven mental health domains (depression/isolation, anxiety, anger, trauma, inattention, hallucinations and suicidality).

Prevalence rates of above average indications for all seven mental health domains were significantly higher among offenders under the influence of a substance at the time they committed their instant offense compared to those not under the influence. Offenders with above average indications in the seven studied mental health areas reported a higher level of chronic effects of substance use relative to those with average or below mental health indications.

The results have important implications for the assessment and treatment of co-occurring mental health issues among juvenile offenders with substance use issues. Juveniles with above average mental health indications may be more prone to experiencing a number of substance-related problems. Observed results may guide the implementation of routine assessment procedures at the juvenile detention level. Intake specialists should screen and administer comprehensive mental health assessments for juveniles who report substance intoxication at the time of their instant offense. Juvenile offenders who report clinical levels of mental health symptoms should receive a comprehensive assessment of substance use and related problems.

Although the co-occurrence of substance use and mental health issues among juvenile justice involved populations is well documented, previous research studies in this area have included a number of limitations. Relatively small offender sample populations, often from a single facility, warrant further work with a large, nationally representative sample of juvenile offenders. Inconsistency in measures of substance use and the failure to distinguish between acute and chronic measures of substance use in prior studies also require further investigation. This study contributes to the extant co-occurring substance use and mental health knowledge base by identifying the mental health correlates of both acute and chronic substance use behaviors among a large nationally representative sample of juvenile offenders.

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 paper will consider the process of psychological assessment for people with learning disabilities and mental ill‐health. The paper will describe a formulation‐driven approach with reference to a social‐cognitive model of mental ill‐health in people with learning disabilities. I will illustrate this process with a brief case study of an assessment within this model.

The issue of mental health and policing is a subject that has been debated from a number of different perspectives. The purpose of this paper is to report on the findings of a case study that explored mental health difficulties and vulnerability within police custody.

The design of the study was qualitative, and it utilised telephone, semi-structured interviews with all levels of the custody staff. This approach was taken because the aim of the study was to explore how people in different roles within the organisation worked to safeguard vulnerable people in custody.

The findings from this study identified a number of interesting themes that could be explored further in later studies. Overall, the respondents expressed frustration that vulnerable people find themselves in police custody for low-level crime, when it could have been avoided with improved mental health services in the community. Additionally, the findings demonstrated that despite the processes that are designed to safeguard the detainee, tensions still exist including, timely access to mental health assessments, appropriate training and support for staff and the use of appropriate adults.

Although the study was small in scale, the custody facility delivered detainee facilities for about 5,000 individuals per year. The research and information obtained supported the police lead for mental health to identify opportunities for improving the customer journey, as well as recognising the need for further research to identify how officers and staff relate to vulnerable individuals in contact with the police service.

Despite the limitations of the study, the findings have captured interesting data from a range of professionals working in one police custody suite, and therefore it presents a holistic overview of some key issues around mental health, vulnerability and safeguarding within the context of police custody.

Suicide is a major cause of preventable mortality and primary healthcare professionals, including pharmacists, require appropriate training to communicate with and support people at risk of suicide. Mental Health First Aid (MHFA) training teaches participants how to communicate with and support people experiencing suicidal thoughts. The purpose of this paper is to use a novel MHFA assessment approach involving simulated role-plays enacted by people with a lived experience of mental illness and explore MHFA participants’ and simulated patients’ views of participating in simulated role-plays of mental health crises.

MHFA is embedded into the Sydney School of Pharmacy curriculum. Post-MHFA training, pharmacy students were randomly allocated to participate in or observe a simulated role-play of one of three suicide crisis scenarios, with a person with a lived experience of mental illness. Two purpose-designed, semi-structured interview guides were used to conduct student focus groups and interviews with simulated patients to explore their views. Focus groups and interviews were digitally recorded, transcribed verbatim and thematically content analysed using a constant comparison approach.

In total, 22 pharmacy students participated in two focus groups and three simulated patients participated in interviews. Five themes emerged including: the benefits of participating; the value of having a lived experience; challenges with suicide assessment; communication; and the value of immediate feedback and debrief.

Students and simulated patients both benefited from participating in the role-plays. Students valued practicing their MHFA skills post-training with simulated patients with lived experiences. This unique approach to post-training assessment provides an opportunity to practice skills realistically and authentically, in a safe, learning environment.

Financial stress has been found to contribute to mental health deterioration associated with job loss. This study examined whether specific types of income support programs (e.g., unemployment benefits and welfare) reduce the negative impacts of job loss on middle-aged women’s mental health in the United States. Two samples of women previously employed before their mental health assessments in their 40s and 50s were selected from the National Longitudinal Survey of Youth 1979 (NLSY79). We conducted regression analysis to predict their mental health scores using employment and income support program status. The model also controlled for baseline health before job loss, socioeconomic status, and demographic and family life characteristics. Compared to their continuously employed counterparts, 50 +  women who had job loss without unemployment benefits had significantly worse mental health. However, those receiving unemployment benefits did not have significantly worse mental health. Unemployment benefits’ ameliorating effect was not found in the 40 +  sample; and welfare programs did not have similar mental health effects. Our findings suggest that certain types of income support policies are beneficial to the mental health of certain cohorts of middle-aged women. For different groups of women, additional and alternative measures are needed to reduce the mental health damage of job loss.

The purpose of this paper is to provide information for non-specialists on identifying the characteristics, assessment and support needs of people with intellectual disabilities (ID) accessing mainstream services.

A review of relevant policy and research literature is supplemented with observations from the authors’ own experience of working in mental health services for people with ID.

With change in provision of services the likelihood of mainstream staff encountering someone with ID will increase. However, information on whether a person has ID or their level of ID is not always available to professionals in acute mental health services meeting an individual for the first time. Reliance on observational and interview-based assessments can leave people with ID vulnerable to a range of over- and under-diagnosis issues. This is as a result of difficulties with communication and emotional introspection, psychosocial masking, suggestibility, confabulation and acquiescence. For people with poor communication, carers will be the primary source of information and their contribution has to be taken into account.

Knowing or suspecting an individual has ID allows staff to take into account the various assessment, diagnosis and formulation issues that complicate a valid and reliable understanding of their mental health needs. Awareness about an individual’s ID also allows professionals to be vigilant to their own biases, where issues of diagnostic overshadowing or cognitive disintegration may be important considerations. However, understanding some of the practical and conceptual issues should ensure a cautious and critical approach to diagnosing, formulating and addressing this population’s mental health needs.

This synthesis of a review of the literature and observations from the authors’ experience of working in mental health services for people with ID provides an informed and practical briefing for those encountering people with ID accessing mainstream services.

There is an ongoing debate about how specialist psychiatric services for people with learning disabilities and mental health problems should be developed. Nursing personnel are the largest professional group involved with care provision, yet to date there has been little research addressing the knowledge and experiences of learning disability and mental health nurses co‐working with this population. This aim of this study was to explore the perceptions of these nurses, using qualitative methods. The findings are discussed in relation to A Vision for Change (DoHC, 2006) and in comparison with the innovative collaborative working that has occurred with the UK.

Health impact assessment (HIA) is a systematic research and public engagement tool used to elevate health and equity in public policies. However, HIA practitioners often overlook potential mental health impacts. The purpose of this paper is to review the degree to which mental health is included in HIAs in the USA.

The authors conducted a systematic review of 156 HIAs that were completed between 1993 and 2013 for their inclusion of mental health. HIAs were subdivided to assess if mental health conditions or their determinants were measured, and if predictions or mitigation strategies were made in the scoping, assessment, or recommendations phases.

Overall, 73.1 percent of HIAs included mental health. Of the HIAs that included mental health (n=114), 85.1 percent also included the determinants of mental health and 67.6 percent included mental health outcomes. 37.7 percent of HIAs measured baseline mental health conditions and 64.0 percent predicted changes in mental health as the result of implementing the proposed policy, plan, or program. Among the HIAs that made predictions about mental health, 79.5 percent included recommendations for potential changes in mental health, while only 46.6 percent had measured mental health at baseline.

Although many HIAs included mental health in some capacity, this paper quantifies that mental health is not included in a robust way in HIAs in the USA. This presents a difficulty for efforts to address the growing issues of mental health and mental health inequities in the populations.

This paper represents the first academic endeavor to systematically assess the state of the field of HIA for its inclusion of mental health.

Attempts to shed light on the mental health needs of ethnic minorities and the inadequacies of the existing mental health needs for them. Considers the drawbacks in the delivery system and provides guidelines for improved assessment, treatment, treatment strategies and preventative measures. Uses analysis of recent psychological and sociological developments in the field of mental health.