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The government has frequently stated its aim to include 50% of all young people in higher education, and yet there is still no strategic national plan that adequately considers the specific needs of students with mental health difficulties. Phil Scarffe, Mental Health Co‐ordinator at Nottingham Trent University describes how his Mental Health Support Team improves access for students with mental health difficulties, and explores how the Disability Discrimination Act applies to such students within a higher education context.

The term “dual diagnosis” has been widely accepted as referring to co‐existing mental illness and substance misuse. However, it is clear from the literature that individuals with these co‐existing difficulties continue to be excluded from mainstream mental health services. The term “dual diagnosis” can be pejorative and therefore, complicate or obstruct engagement. It is argued within this paper that the association between mental illness and substance misuse (including alcohol misuse) is an intricate and often a complex relationship involving a multitude of psychosocial factors that cannot be simply explained by an individual having two co‐existing disorders. From this perspective, this paper seeks to argue that the term “dual diagnosis” should be actively de‐emphasised.

This paper offers a critique of “dual diagnosis” and the potential impact on access and treatment through discussion of the literature and reflections on service provision.

The paper identifies five principles termed the “5 key principles”, which support individuals with a wide spectrum of co‐existing difficulties and to counteract the stigma often associated with the term “dual diagnosis”. These collective principles allow the practitioner to consider the needs of the service user from the service user's perspective and therefore not be distracted by the perceived set of expected behaviours that are implied by the “dual diagnosis” label.

This paper offers a critique of the term “dual diagnosis” and explores the impact of this in terms of service users and makes practical suggestions for alternative ways of conceptualising co‐existing mental health and substance difficulties.

This article describes selected findings from a research study examining the travel experiences (including walking, using public transport, cars, bikes, or taxis) of people experiencing mental health difficulties, specifically in relation to travelling to learning or work. The research sits within the Mental Health Partnership Programme run by the National Institute of Adult Continuing Education, the Learning and Skills Council and the Inclusion Institute, which works to improve access to and success in learning for adults experiencing mental health difficulties.

Mounting evidence of a crisis in mental health care for young people has underlined the need for early and better recognition of mental health difficulties in children. Recent policy suggests that schools and teachers must play a pivotal role in smoother pathways to care. This will necessitate enhanced working relationships between schools and child and adolescent mental health services (CAMHS). However, there is little understanding as to how teachers and mental health professionals currently relate to one another or what difficulties undermine ‘joined up’ care. In this study we examine current systems of collaboration between schools and child and adolescent mental health services, paying particular attention to relationships between schoolteachers and mental health professionals. Data was collected using semi‐structured, in‐depth interviews. Our findings indicate deep‐seated barriers to good collaboration. Moreover, teachers experience significant frustration through feeling excluded from the mental health care management of children despite being affected professionally by such decisions taken, the delays to intervention and poor communication between agencies. Interprofessional trust and mutual suspicion emerged from these interviews as an over‐arching factor. The implications arising from expectations for greater inter‐agency collaboration are discussed.

This research aimed to investigate staff knowledge and attitudes towards working with adults with both a learning disability and a mental health difficulty. Government policy in the UK suggests a shift in service provision such that the treatment of people with a learning disability who have mental health problems should be undertaken by mainstream mental health services rather than specialist learning disability services.Staff members from both specialist and mainstream services took part in a series of focus groups to discuss their experiences and attitudes about working with this group of people. The transcriptions of the groups were analysed to identify common themes. Findings from the study suggest that staff within mainstream services currently feel that they are inadequately trained to deal with the often complex mental health needs of this group. Conversely, staff in learning disability services expressed concern about losing their specialist skills in generic services.The implications of the themes raised are discussed, particularly in relation to future service provision. Care will need to be taken if service redesign is to be achieved without detriment to service users.

The literature tends to use ‘asylum seeker’ and ‘refugee’ interchangeably, creating uncertainty about the mental health of asylum seekers. However, asylum seekers occupy a unique position in British society which differentiates them from people with refugee status and which may have implications for their mental health. For example, ‘asylum seekers’ are supported and accommodated in dispersal areas under the National Asylum Support Service and they are not entitled to work. This mixed‐methods study investigated asylum seekers' symptoms of psychological distress, using mental health screening questionnaires (N = 29) and asylum seekers' subjective experiences of the asylum process, its potential impacts on their mental health, and participants' suggestions for tackling mental health needs, using in‐depth interviews (N = 8). Asylum seekers, refugees and practitioners working with asylum seekers were consulted from the outset regarding the cultural sensitivity of the measures used. Given the potential limitations of using ‘idioms of distress’ across cultures, interview data provided rich descriptive accounts which helped locate the mental health needs that the asylum seekers experienced in the specificities of each participant's social context. Asylum seekers originated from 13 countries. The results revealed that psychological distress is common among asylum seekers (for example anxiety and post‐traumatic stress), but so are post‐migratory living difficulties (for example accommodation, discrimination, worry about family back home, not being allowed to work). They also report mixed experiences of health and social care services. These results suggest that asylum seekers' unique social position may affect their mental health. Implications for practice are presented and potential limitations highlighted.

Continuity of forensic mental health care is important in building protective structures around a patient and has been shown to decrease risks of relapse. Realising continuity can be complicated due to restrictions from finances or legislation and difficulties in collaboration between settings. In the Netherlands, several programs have been developed to improve continuity of forensic care. It is unknown whether professionals and clients are sufficiently aware of these programs. The paper aims to discuss this issue.

The experienced difficulties and needs of professionals and patients regarding continuity of forensic care were explored by means of an online survey and focus groups. The survey was completed by 318 professionals. Two focus groups with professionals (15 participants), one focus group and one interview with patients (six participants) were conducted.

The overall majority (85.6 percent) reported to experience problems in continuity on a frequent basis. The three main problems are: first, limited capacity for discharge from inpatient to outpatient or sheltered living; second, collaboration between forensic and regular mental health care; and, third, limited capacity for long-term inpatient care. Only a quarter of the participants knew the existing programs. Actual implementation of these programs was even lower (3.9 percent). The top three of professionals’ needs are: better collaboration; higher capacity; more knowledge about rules and regulation. Participants of the focus groups emphasized the importance of transparent communication, timely discharge planning and education.

Gathering best practices about regional collaboration networks and developing a blueprint based on the best practices could be helpful in improving collaboration between setting in the forensic field. In addition, more use of systematic discharge planning is needed to improve continuity in forensic mental health care. It is important to communicate in an honest, transparent way to clients about their forensic mental health trajectories, even if there are setbacks or delays. More emphasis needs to be placed on communicating and implementing policy programs in daily practice and more education about legislation is needed Structured evaluations of programs aiming to improve continuity of forensic mental health care are highly needed.

Policy programs hardly reach professionals. Professionals see improvements in collaboration as top priority. Patients emphasize the human approach and transparent communication.

The purpose of this paper is to describe mental health-related contact with educational professionals amongst children in the British Child and Adolescent Mental Health Survey (BCAMHS) 2004.

BCAMHS 2004 was a community-based survey of 5,325 children aged 5-16, with follow-up in 2007. This paper reports the percentage of children with a psychiatric disorder that had mental health-related contact with education professionals (categorised as teachers or specialist education services) and the percentage with specific types of psychiatric disorders amongst those contacting services.

Two-thirds (66.1 per cent, 95 per cent CI: 62.4-69.8 per cent) of children with a psychiatric disorder had contact with a teacher regarding their mental health and 31.1 per cent (95 per cent CI: 27.5-34.7 per cent) had contact with special education either in 2004 or 2007, or both. Over half of children reporting special education contact (55.1 per cent, 95 per cent CI: 50.0-60.2 per cent) and almost a third reporting teacher contact in relation to mental health (32.1 per cent, 95 per cent CI: 29.7-34.6 per cent) met criteria for a psychiatric disorder.

Many children in contact with education professionals regarding mental health experienced clinical levels of difficulty. Training is needed to ensure that contact leads to prompt intervention and referral if necessary.

This is the first paper to report on mental health-related service contact with education professionals in the 2004 BCAMHS survey along with its 2007 follow-up. It identifies high levels of teacher contact which represent challenges in supporting staff with training, resources and access to mental health services.

While epidemiological studies have linked economic hardship and financial difficulties with psychological distress and suicide, investigation of financial concerns among users of public mental health services has been limited. Moreover, empirical data regarding a relationship between financial difficulties and mental health symptoms are lacking. The purpose of this paper is to examine the prevalence of financial difficulties among patients attending community mental health clinics, and to examine the relationship between such difficulties and psychological distress and suicidality.

Participants attending three community mental health clinics in British Columbia, Canada provided demographic information, including annual income, and completed brief measures of personal financial management, psychological distress and suicidal behavior.

Although more than half of participants reported good-to-excellent ability to pay their bills on time, nearly half indicated poor long-range saving and financial planning. Lower annual income was directly related to suicidality. Financial management difficulties were associated with psychological distress, and were significantly related to suicidality after controlling for the effects of income and psychological distress.

The findings highlight the need for attention to distress and suicidality as potential sequelae of financial management difficulties, and carry implications for further research, clinical intervention and social policy. The findings confirm the need to address financial needs and money management abilities among users of public mental health services.

This study aims to examine the relationship between objective and subjective aspects of financial well-being, the role of family financial support and depression symptoms of Chinese older adults.

This study used two waves (2015 and 2018) of the Harmonized China Health and Retirement Longitudinal Study. Two financial ratios: the expenditure-to-income ratio and the financial assets ratio, were used to measure the objective aspect of financial well-being. Perceived money management difficulty was employed to measure the subjective aspect of financial well-being. Depression symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D) score. Three analytical models, including an ordinary least squares (OLS) model, an OLS model controlling for lagged depression and a random effects model using panel data, were used to examine the relationships between the objective and subject aspects of financial well-being and depression.

The results from the three models showed consistent relationships: the expenditure-to-income ratio was a positive contributor, while the financial assets ratio was a negative contributor to depression of older adults in China. The robustness check using binary-coded financial ratio thresholds showed that reaching the suggested thresholds was negatively associated with depression. Perceived money management difficulty contributed positively to depression. The robustness check using the fixed effects model showed no significance of the two ratios, while perceived money management difficulty was positively associated with depression. The insignificance might be due to data limitation (limited waves or rare changes across waves).

The findings indicate that both objective and subjective financial well-being matters in relation to depression symptoms and, therefore, to the overall mental health of the Chinese elderly. Developments in public policies are needed to promote accessible financial services, assistance programs, mental health services and facilities for the older population in China.