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Evidence-based psychological therapies are available for severe and enduring mental health problems, but resources and access to these are limited within England. Practitioners in community mental health teams (CMHTs) can act as gatekeepers for access to psychological therapies for those in secondary care, but little is known about how they make referral decisions. This paper aims to understand how CMHT practitioners make decisions about who to refer or not, to secondary care psychological therapy services (PTS).

A total of 11 CMHT practitioners were interviewed to understand the decision making processes underpinning their referrals or otherwise, to a PTS within NHS England. The data were analysed qualitatively using thematic analysis.

Thematic analysis resulted in 11 sub-themes under three main themes of the self, the organisation and wider structure and the service user. Results indicated that some participants were referred automatically for psychological therapy if a service user asked or if there was external pressure to refer, while others’ decisions were informed by contextual information such as the service user’s ability to engage or change, risk status and limited organisational resources.

This study explores the decision making of multi-disciplinary professionals referring to PTS. The findings have important implications for understanding some of the factors that can influence patient access to psychological treatment in secondary care.

The purpose of this paper was to examine law enforcement officers' perspectives on job stress and barriers to supportive resources when working child sexual abuse cases in a large southern state. It is well documented in the literature that professionals who work in healthcare, emergency services and law enforcement face tremendous amounts of stress and consequences to their physical and mental health. Little research has been done to examine how child sexual abuse investigations impact law enforcement, and how these specialized officers perceive access to supportive resources.

This qualitative study was part of a larger quantitative study and included 20 law enforcement officers who participated in anonymous, semi-structured phone interviews.

Findings included (1) child sexual abuse cases are difficult, specialized and disturbing (2) barriers to supportive resources include law enforcement culture, the stigma of asking for help, awareness and accessibility of resources and leadership as gatekeeper to the resources and (3) officers perceive both formal and informal resources to be helpful and at best should be proactively available to all officers in the state. A model of the findings was developed to illustrate the implications for practitioners and scholars.

This study was not without weaknesses, specifically the small number of participants, volunteer sampling does not represent the general population and the sampling technique means some demographics may have been missed by researchers.

This study adds to the literature on law enforcement mental health, occupational health and mental health resources. It confirms established research in the literature and provides insight into officer perspectives about barriers that prevent access to informal and formal supports that could improve their emotional well-being.

This study is the first of its kind, to our knowledge, that asks detectives and investigators of child abuse cases about mental health resources. These law enforcement officers are at high-risk for traumatic stress, compassion fatigue and burnout due to the specialized cases they investigate.

This paper aims to analyse the publication trend and trajectories of the Journal of Social Marketing (JSOCM) from its inception in 2011 to 2020.

The bibliometric approach is used to present publication characteristics. For so doing, the bibliographic data was extracted from the Scopus database.

The results show an increasing trend in the publication and in the number of citations. Moreover, the findings also revealed that although JSOCM received publications worldwide, countries from the developed world such as Australia and the USA are the most productive countries.

As the first retrospection of the journal, this study not only educates and enriches JSOCM’s global readers and aspiring contributors but may also be helpful to its editorial board, as it provides several inputs to navigate the way forward.

The search for alternatives to inpatient mental health care in the UK and further afield has been going on over the last few decades of the previous century. Amongst the range of alternatives that have been developed are community‐based mental health crisis houses that seek to work with people, who may otherwise have been admitted to hospital. Amethyst House is a four‐bed mental health crisis house based in inner city Liverpool and works solely with the local Crisis Resolution Home Treatment Team (CRHTT) to work with people who require support that could not be delivered at home. The purpose of this paper is to report the findings of one element of a service evaluation: the effectiveness of the service in relation to the mental health needs of people admitted.

The paper describes the service model, which integrates the crisis house and the CRHTT, with the latter acting as gatekeepers to the service.

Findings showed improvements in mental health symptomatology and disabilities associated with the crisis between admission and discharge from the service.

The paper describes the profile of the people who used the service over a six‐month period in 2009, their care pathways through the service and their clinical outcomes between admission and discharge.

This paper aims to present the critical reflections of three women implementers formerly working in projects that seek to support the mental health and well-being (MHW) of postgraduate researchers (PGRs), which has become a recent focus for UK researchers and policymakers. The paper offers an experience-based perspective on tensions in PGR-MHW project implementation by providing personal accounts of several social dilemmas the authors encountered. From reflecting on experiences, the authors derived recommendations for mitigating such dilemmas when designing and delivering future projects.

There is considerable heterogeneity between primary care systems that have evolved in individual national cultural environments. Models of Child Health Appraised (MOCHA) studied how the transfer of models or their individual components can be achieved across nations, using examples of combinations of settings, functions, target groups and tracer conditions. There are many factors that determine the feasibility of successful transfer of these from one setting to another, which must be recognised and taken into account. These include the environment of the care system, national policy-making and contextual means of directing population behaviour – in the form of penalties and incentives, which cannot be assessed or expected to work by means of rational actions alone. MOCHA developed a list of criteria to assess transferability, summarised in a population characteristics, intervention content, environment and transfer (PIET-T) process. To explore the process and means of transferability, we obtained consensus statements from the researchers on optimum model scenarios and conducted a survey of stakeholders, professionals and users of children’s primary care services that involved three specific health topics: vaccination coverage in infants, monitoring of a chronic or complex condition and early recognition of mental health problems. The results give insight into features of transferability – such as the availability and the use of guidelines and formal procedures; the barriers and facilitators of implementation and similarities and differences between model practices and the existing model of child primary care in the country. We found that successful transfer of an optimal model is impossible without tailoring the model to a specific country setting. It is vital to be aware of the sensitivity of the population and environmental characteristics of a country before starting to change the system of primary care.

Research with vulnerable groups is crucial to get their input into public policy design that will directly impact on them. However, there are many methodological and ethical challenges involved in encouraging participation from groups with a wide range of intellectual, cognitive and physical capacities while ensuring that the rights and well-being of participants are protected. Rather than exploring ethical theories, this chapter is a case study describing the practical ethical considerations that were involved in designing and holding a series of focus groups with adult health and social care service users from vulnerable cohorts. It is based on a series of focus groups which the Institute of Public Health (IPH) held with specified cohorts as part of a policy development process on adult safeguarding for the Department of Health (DOH) in Ireland. The four cohorts were people with intellectual disability, cognitive impairments, significant mental health challenges and nursing home residents. This chapter does not describe the findings of the focus groups but outlines the ethical and methodological considerations that arose in designing and conducting this research, and the practical ethical safeguards employed to mitigate risk and comply with Irish and EU General Data Protection Regulation (GDPR) legislation governing health research. It outlines the ethical issues around protecting confidentiality and using incentives to encourage participation, how individuals' capacity to give informed consent was maximized, the risk-assessment and mitigation procedures used to prevent harms arising and the measures put in place to provide follow-up emotional support to participants.

The purpose of this paper is twofold: to explore how gatekeepers’ ways of regulating the researchers’ access to knowledge in/about care services reflect the systemic and interpersonal values that inform Danish welfare systems’ daily workings at the street level; and also explore how the authors’ methodological experiences mirror the value-informed regulatory strategies that professionals and users themselves experience in their daily encounters in the same local practices that the authors have studied.

The paper takes its empirical point of departure in a multisited ethnographic field study of the management of citizens with complex problems in Danish welfare systems.

By means of Michael Lipsky’s outline of access regulation, the authors will analyze the following regulatory strategies that are identified during the fieldwork: “Gatekeepers’ sympathy and creaming,” “Queuing and delay,” and ‘Withdrawal of consent and “no resources.” The paper suggests that trust, shared goals and sympathy seem to be key to the process of getting access.

Despite principles of neutrality, equal rights and access to services in welfare systems, the authors’ experiences thus tend to support other research within bureaucratic and care organizations, which has found that interpersonal relations, sympathy, dislikes, norms and values, etc., can heavily influence timely access to services, tailored information and support.

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.

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.