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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 purpose of this paper is to provide a brief overview of the literature to date which has focused on co-production within mental healthcare in the UK, including service user and carer involvement and collaboration.

The paper presents key outcomes from studies which have explicitly attempted to introduce co-produced care in addition to specific tools designed to encourage co-production within mental health services. The paper debates the cultural and ideological shift required for staff, service users and family members to undertake co-produced care and outlines challenges ahead with respect to service redesign and new roles in practice.

Informal carers (family and friends) are recognised as a fundamental resource for mental health service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited by mental health professionals or taken into account during decision making. This issue is considered alongside new policy recommendations which advocate the development of co-produced services and care.

Despite the launch of a number of initiatives designed to build on peer experience and support, there has been a lack of attention on the differing dynamic which remains evident between healthcare professionals and people using mental health services. Co-production sheds a light on the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer recovery workers across England, there has been little research or service development designed to focus explicitly on this particular dynamic.

Despite these challenges, coproduction in mental healthcare represents a real opportunity for the skills and experience of family members to be taken into account and could provide a mechanism to achieve the “triangle of care” with input, recognition and respect given to all (service users, carers, professionals) whose lives are touched by mental distress. However, lack of attention in relation to carer perspectives, expertise and potential involvement could undermine the potential for coproduction to act as a vehicle to encourage person-centred care which accounts for social in addition to clinical factors.

The families of people with severe and enduring mental illness assume a major responsibility for the provision of care and support to their relatives over extended time periods (Rose et al., 2004). Involving carers in discussions about care planning could help to provide a wider picture about the impact of mental health difficulties, beyond symptom reduction. The “co-production of care” reflects a desire to work meaningfully and fully with service users and carers. However, to date, little work has been undertaken in order to coproduce services through the “triangle of care” with carers bringing their own skills, resources and expertise.

This paper debates the current involvement of carers across mental healthcare and debates whether co-production could be a vehicle to utilise carer expertise, enhance quality and satisfaction with mental healthcare. The critique of current work highlights the danger of increasing expectations on service providers to undertake work aligned to key initiatives (shared decision-making, person-centred care, co-production), that have common underpinning principles but, in the absence of practical guidance, could be addressed in isolation rather than as an integrated approach within a “triangle of care”.

Severe mental illness affects a significant number of people and, if left untreated, leads to poor quality of life and disability. Many of the aspirations proposed for new models of care assert that better preventative services, closer integration between professionals, and increased access to cognitive behavioural therapy in primary care will bring substantial benefits and improved outcomes. The purpose of this paper is to explore the benefits of integrating mental health services into primary care, and improving collaboration between secondary services and primary care. There is a transition underway in healthcare whereby a focus on illness is being supplemented with, or refocused towards achieving better patient well-being. New approaches to service provision are being proposed that: focuses on more holistic outcomes; integrates services around the user; and employs innovative system techniques to incentivise professional and organisational collaboration. Such a transition must be inclusive of those with mental health needs managed in primary care and for those people with serious mental illness in secondary care.

This paper discusses the issues of professional collaboration and the need to provide mental healthcare in a continuous and coordinated manner and; how this may improve timely access to treatment, early diagnosis and intervention. Importantly, it is essential to consider the limitations and reality of recent integration initiatives, and to consider where the true benefit of better integrating mental health into a more collaborative system may lie.

Identifying and addressing issues of parity is likely to call for a new approach to service provision that: focuses on outcomes; co-designs services integrated around the user; and employs innovative contracting techniques to incentivise provider integration.

There is a transition underway in healthcare whereby a focus on illness is being supplemented with or refocused towards working towards wellness. Such a transition requires primary care mental health services to be provided in a continuous and coordinated manner in order to meet the health needs of people with serious mental illness.

It discusses the issues of professional collaboration and how this may improve timely access to treatment, early diagnosis and intervention. It is essential to consider the limitations and reality of recent integration initiatives, and to consider where the true benefit may lie.

The purpose of this paper is to investigate aspects of organizational culture among the nursing staff of public mental health services organizations in Cyprus. Specifically, highlights are provided of possible differences on the attitudes of nurses regarding actual and desired aspects of organizational culture with respect to demographic characteristics such as gender, years of service and experience.

A descriptive explanatory type survey study was conducted in all public mental health services organizations of Cyprus. Specifically, a questionnaire was given to a representative sample of the nursing population, and data were collected and analyzed. The survey questionnaire was based on the organizational culture profile (OCP) methodology. Statistical analysis was carried out using correlational analysis, t-tests and analysis of variance (ANOVA).

Results showed that there are significant discrepancies between the actual organizational culture and what is desired by staff members of public mental health services organizations in Cyprus. Further, significant differences are identified between actual and desired organizational culture moderated by the type of work, which is determined by the workplace.

Even though, organizational culture is a major research topic little has been done in the context of public mental healthcare organizations. Further, for the case of Cyprus, it is the first time that such a study is carried out. The results presented in this paper may provide the foundation for measures to be taken for improving the existing operation of public mental healthcare organizations.

Barbara M. Altman, a Sociologist with a Ph.D. from the University of Maryland, is currently a Special Assistant on Disability Statistics at the National Center for Health Statistics and an Adjunct Associate Professor at the University of Maryland, College Park. Her previous position was Senior Research Fellow with the Agency for Healthcare Research and Quality. She is a past president of the Society for Disability Studies and served on the founding Board of Directors of that organization. Her disability research interests focus in three areas: operationalization of disability definitions/measures in survey data; access to, financing and utilization of health care services by persons with disabilities, particularly working age persons and women with disabilities; and disability among minority groups. She is the author of a number of articles and book chapters on disability topics, and has served as editor of special issues of Disability Studies Quarterly and Journal of Disability Policy Studies. She is co-editor of this series Research in Social Science and Disability.Deborah J. Anderson, Ph.D., has conducted policy research in the area of Aging and Developmental Disabilities at the University of Minnesota since 1985. Her studies have included analyses of the health status, health conditions and health-related limitations and needs of older adults with mental retardation living in a variety of residential settings as well as in their own homes. These studies have included a longitudinal study of a 10% sample of older adults living in residential facilities licensed by developmental disabilities agencies, the National Nursing Home Survey of 1985, the National Medical Expenditure Survey of 1987, and the National Health Interview Disability Supplement (NHIS-D) of 1994–1995. She has also studied careproviders of older adults with mental retardation, innovative programs serving aging adults with developmental disabilities/mental retardation, and state agencies’ preparation for serving adults with mental retardation as they aged. Most of this research has been conducted as part of the NIDRR-funded RRTC on Aging and Developmental Disabilities. Dr. Anderson is also an Associate Professor in the Department of Psychology at St. Olaf College in Northfield, MN.Lynda L. Anderson, M.A., M.P.H., is a Resource Manager at No Place like Home in Robbinsdale, Minnesota. Ms. Anderson earned a Master of Arts degree in Human Service Administration and a Master of Public Health degree in Community Health. Ms. Anderson is a doctoral candidate in Work, Community and Family Education at the University of Minnesota. She has more than eighteen years of experience working with people with disabilities as a Direct Support Professional, Program Director, and Researcher. She has participated in NHIS-D analysis activities for the last five years.Sharon N. Barnartt, Ph.D., is Professor of Sociology at Gallaudet University. She has co-authored two books: Deaf President Now: The 1988 Revolution at Gallaudet University (1995) and Contentious Politics in the Disability and Deaf Communities (2001). She has also presented papers and published widely in the areas of socio-economic status and disability/deafness, legal and disability policy issues, and social movements in the deaf and disability communities. She is a former president of the Society for Disability Studies, co-editor of Research in Social Science and Disability and on the editorial board of Journal of Disability Policy Studies.Phillip W. Beatty, M.A., is a Senior Research Associate at the National Rehabilitation Hospital Center for Health & Disability Research in Washington, DC. His recent research focuses on predictors of access to health services among adults with disabilities. Mr. Beatty is also conducting research to determine the ways in which functional outcomes information is being used by stakeholders in the medical rehabilitation industry.Edward Brann, M.D., M.P.H., is Acting Director of the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention. The division conducts a number of research and program activities for people with disabilities.Hong Chen, M.S., is an Economist in RTI International’s Division of Health Economics Research. His work focuses primarily on the analysis of large claims and survey databases, with an emphasis on diabetes prevention, substance abuse, and competitive bidding for durable medical equipment.Lisa J. Colpe, Ph.D., M.P.H., is a Clinical Epidemiologist Specializing in Survey Design and Research. At the time the work on this chapter was done, she was an Epidemiology Training Program Fellow in the Division of Health Interview Statistics, National Center for Health Statistics.Roger B. Davis, Sc.D., is Associate Professor of Medicine at Harvard Medical School and Associate Professor of Biostatistics at the Harvard School of Public Health. Dr. Davis has overseen the statistical design of numerous clinical trials, especially involving cancer and AIDS therapies. An expert in survival analysis, he also participates in health services research and clinical epidemiology studies with colleagues at Beth Israel Deaconess Medical Center, where he serves as Biostatistician in the Division of General Medicine and Primary Care.John Drabek, is an Economist in Office of Disability, Aging, and Long-Term Care Policy in the U.S. Department of Health and Human Services. He received his B.A. in Economics from Northwestern University, and his Ph.D. in Economics from the University of California, Santa Barbara. Prior to joining the federal government, he performed research at the University of Southern California, and at the University of California, Los Angeles.Laura J. Dunlap, M.A., is a Health Economist in RTI International’s Center for Interdisciplinary Substance Abuse Research. Since joining RTI in 1994, she has worked on studies analyzing the costs and benefits of substance abuse treatment, the effect of treatment services on post-treatment outcomes, and the costs and cost-effectiveness of public health and treatment interventions aimed at special populations such as drug users and low-income women.Holly J. Fedeyko is a former employee of the Disability and Health Branch, CDC in Atlanta, Georgia. While at the CDC she focused her efforts on Research in disability issues as related to questions from the National Health Interview Survey. She received her M.P.H. in Epidemiology and Environmental Health from Emory and her B.S. in Biology from McGill. She is currently employed as an analytical consultant for a private company and now resides in the San Francisco Bay area.Frances K. Goldscheider, University Professor and Professor of Sociology, began her Brown career in 1974. Since obtaining her Ph.D. in Demography from the University of Pennsylvania in 1971, Goldscheider has focused her research on census and survey data to address questions related to family structure and coresidential relationships, examining causes and consequences of change. Goldscheider pioneered research on the single-person household, and on home leaving and return to the nest of young adults, and has examined issues of labor force and family decisions of 20th century American women. She is an expert on family structure and relationships, fertility, parenthood, household economy, and marriage. Her intergenerational focus (on the living arrangements of young adults and the elderly) has expanded to include gender issues, particularly marriage and divorce, with a strong concern with the consequences of family structure for investments in childhood and young adulthood. Recent research interests include men’s roles in parenting and in the family.Scott D. Grosse, Ph.D., is a Health Economist at the National Center for Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention. He conducts applied research on the costs associated with various childhood conditions and economic evaluations of screening programs and interventions intended to improve health and developmental outcomes in children.Gerry E. Hendershot, Ph.D., is a Consultant on Disability and Health Statistics. From 1985 to 2001, he held various positions on the staff of the National Health Interview Survey, including Assistant to the Director for Data Analysis and Dissemination. He had a lead role in promoting, designing, and analyzing the National Health Interview Survey on Disability. He is the author of many published statistical reports on disability and other health-related topics.Dennis P. Hogan, Professor of Sociology, joined the Population Studies and Training Center at Brown University in 1995. He received a Ph.D. in Sociology from the University of Wisconsin-Madison in 1976. He has taught at both the University of Chicago, where he acted as associate director of the Population Research Center, and Pennsylvania State University, where he served as director of the Population Research Institute. In 1997, Hogan was named to an endowed professorship as the Robert E. Turner Distinguished Professor of Population Studies. Some of his research interests include the interrelationships of the family lives of individuals and their social environments, the measurement of disability, family consequences of disability, and the transition to adulthood. Hogan’s current research focuses on child disability. He is the principal investigator on grants supporting this program from the National Institute for Child Health and Human Development, the National Center for Medical Rehabilitation Research, the Assistant Secretary for Planning and Evaluation, the Federal Interagency Forum on Child and Family Statistics Subcommittee on Disability and the Spencer Foundation.Ghada al Homsi, M.S., is an Economist in RTI International’s Center for Interdisciplinary Substance Abuse Research. Her work focuses on the analysis of large surveys and the design and maintenance of databases of program costs.Amanda A. Honeycutt, Ph.D., is an Economist in RTI International’s Division of Health Economics Research. Since joining RTI in 1998, she has led a number of studies on the cost-of-illness, the cost of intervention programs, and the cost-effectiveness of prevention and treatment interventions that focus primarily on diabetes, HIV/AIDS prevention, and children’s health, disability, and development.Peter C. Hunt, M.P.H., was an Association of Schools of Public Health Fellow in the Division of Health Interview Statistics, National Center for Health Statistics, at the time work on this chapter was done. He subsequently served as a Special Assistant to the Director of the National Institute of Disability and Rehabilitation Research. He is currently a Research Associate at the University of Pittsburgh Model Center on Spinal Cord Injury.Lisa I. Iezzoni, M.D., M.Sc., is Professor of Medicine at Harvard Medical School and Co-Director of Research in the Division of General Medicine and Primary Care, Department of Medicine, at Beth Israel Deaconess Medical Center in Boston. Her primary research interest is risk adjustment for assessing health care quality and improving the fairness of payments. A 1996 recipient of The Robert Wood Johnson Foundation Investigator Award in Health Policy Research, she also studies health policy issues relating to mobility impairments. Dr. Iezzoni is a member of the Institute of Medicine.Gwyn C. Jones, Ph.D., M.S.W., M.Ed., is a Senior Research Associate at the National Rehabilitation Hospital Center for Health & Disability Research in Washington, DC. She is a former ATPM/CDC Fellow and current grantee. Her research and publications have focused on health risks, chronic conditions, and use of preventive services among working-age adults with disabilities, prescription drug use among non-elderly adults with disabilities, and rural Medicaid managed care for adults with disabilities.Judith D. Kasper, Ph.D., is a Professor in the Department of Health Policy and Management, and a Senior Research Associate in the Center for Health Services Research, at The Johns Hopkins Bloomberg School of Public Health. Her research interests include health policy in long-term care, aging and disability, access to health care for vulnerable populations, and the development and application of data sources for health policy and health services research. Dr. Kasper holds a Ph.D. in sociology from the University of Chicago.K. Charlie Lakin, Ph.D., is the Director of the Research and Training Center on Community Living at the University of Minnesota. Mr. Lakin has had extensive experience in gathering, analyzing, and using statistics from many primary and secondary data sources with the products of this work included in more than 200 publications in developmental disabilities and related services. Mr. Lakin was a member of the six-person external technical advisory panel on the instrumentation for the Disability Supplement. Mr. Lakin serves as Associate Editor of Mental Retardation, and consulting editor of The Journal of the Association for Persons with Severe Handicaps (JASH), the Journal on Intellectual and Developmental Disability and Social Science and Disability.Sheryl A. Larson, Ph.D., is a Research Associate at the Research and Training Center on Community Living at the University of Minnesota. She earned her Ph.D. in Educational Psychology from the University of Minnesota. She has 20 years of experience in services to persons with DD as a residential counselor, behavior analyst, social worker, and program evaluator and has worked for the RTC for the last 14 years. Ms. Larson was the Co-Principal Investigator for a two-year NIDRR Field Initiated Project which used the National Health Interview Survey Disability Supplement to examine the characteristics and service needs of persons with intellectual or developmental disabilities. She directed a supplement to the Research and Training Center on Community Living’s core grant that funded an international user’s conference in June 2000 for researchers analyzing NHIS-D topics. She has co-authored several papers using NHIS-D data. Dr. Larson has also co-authored several books, book chapters, journal articles and technical reports on workforce development issues, residential services, and community integration for persons with developmental disabilities and is a consulting editor of Mental Retardation.Donald J. Lollar, Ed.D., Senior Research Scientist, Division for Human Development and Disability, National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention in Atlanta. His advanced degrees are from Indiana University, and his most recent writings include co-editing an Archives of Physical Medicine and Rehabilitation supplement on the Science of Disability Outcomes, and articles for the 2003 Annual Review of Public Health and 2002 Public Health Reports outlining public health strategies to improve the health and well-being of people with disabilities. He has spent the past seven years developing public health science and programs to improve the health of people with disabilities, prevent secondary conditions, and increase participation in society. He currently serves as the co-lead of the Healthy People 2010 workgroup on Disability and Secondary Conditions (Chap. 6 of HP 2010). Dr. Lollar began involvement with the WHO classification ICIDH in 1994 while still in private practice, assessing potential utility of ICIDH-2 for clinical records. He is currently a part of the team to adapt the ICF to improve its utility for children and youth.Pamela Loprest is a Labor Economist and Senior Research Associate at the Urban Institute. Her research focuses on low-wage labor markets and how government policies can help to reduce and remove barriers to work among disadvantaged populations. Dr. Loprest has a Ph.D. in Economics from the Massachusetts Institute of Technology and has been at the Urban Institute since 1991.Elaine Maag is a Research Associate in the Urban Institute’s Income and Benefits Policy Center. Her research focuses on policies affecting youth with disabilities and employment opportunities for adults. She also conducts research on how tax policy affects low-income families. Ms. Maag holds an M.S. in Public Policy from the University of Rochester.Jennifer M. Park is a Post-Doctoral Fellow at the Harvard Graduate School of Education. Her current research is funded by a grant she holds from the American Education Research Association to examine cognitive development among first grade youth with and without emotional impairment. Her dissertation explored cognitive growth among kindergarteners with and without perceptual impairment. Dr. Park holds a Ph.D. in Sociology from Brown University, where her research examined the diverse effects of child disability on family outcomes.Elizabeth K. Rasch, M.S., P.T., is an Associate Service Fellow at the National Center for Health Statistics, CDC, working in the area of disability statistics. She is a Ph.D. candidate at the University of Maryland, Department of Physical Therapy and Rehabilitation Science, with a concentration in Epidemiology. Her research interests include the health of persons with disabilities, factors that contribute to disability, as well as the use of and access to healthcare services by persons with disabilities. She has been actively involved in research since 1985 and has published articles and book chapters on topics related to disability and rehabilitation.Anne W. Riley, is an Associate Professor in the Department of Health Policy and Management, in the division of Health Services Research, at the Johns Hopkins Bloomberg School of Public Health. Dr. Riley has expertise in the assessment of mental health and health, especially of children and adolescents, methods development, and evaluation systems for monitoring the outcomes of care for youth.Diana E. Schendel, Ph.D., is a Lead Health Scientist at the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention. She directs both intramural and extramural epidemiologic studies of reproductive and developmental outcomes, with a primary focus on cerebral palsy, autism, and other neurodevelopmental problems.Hilary Siebens, M.D., is Lecturer in the Department of Physical Medicine and Rehabilitation (PMR) at Harvard Medical School and Associate Director, PMR Service, at the Massachusetts General Hospital. She received clinical training in internal medicine, geriatrics, and PMR. Her publications address exercise among older adults, models of rehabilitation, and quality improvement initiatives.Lois M. Verbrugge, Ph.D., M.P.H., is Distinguished Senior Research Scientist in the Institute of Gerontology at the University of Michigan. She has contributed to disability theory and has conducted analyses of arthritis disability, gender differences in morbidity and mortality, and co-morbidity, using large-scale data sets. Her recent publications have emphasized the relative benefits of equipment and personal assistance for disability, the interleaving of aging and disability, and global indicators of disability. She was awarded the American Psychological Association Distinguished Contribution to Women’s Health Award in 1994.Whitney P. Witt, Ph.D., M.P.H., is an Assistant Professor of Medicine in the Division of General Internal Medicine and Center for Healthcare Studies at the Northwestern University, Feinberg School of Medicine. Dr. Witt’s prior work focuses predominately on people living with HIV/AIDS, including children and their families. Over the last five years, she has applied her experience in advocacy, policy, and research on vulnerable and high-cost, chronically ill populations to the field of maternal and child health services research. Dr. Witt’s research emphasizes the importance of family adaptation in ensuring the mental health of children with disabilities and for helping these children obtain access to mental health services. Most recently, her work has focused on the impact of maternal depression on familial health and mental health, preventive care practices, and use of health and mental healthcare services. She holds a Ph.D. in health services research and a M.P.H. from the Johns Hopkins Bloomberg School of Public Health and a B.A. in women’s studies and law from Hampshire College.Li-shou Yang, Ph.D., is Research Investigator in the Institute for Social Research at the University of Michigan. Trained in social demography, her research focuses on the family, the life course, and social change.

The role of implicit provider bias in mental health care is an important issue that continues to be of concern in the twenty-first century for the Black/African American community. Access to mental health and quality care remains elusive as members of this social group lack access to mental health screening, diagnosis, and attention due to institutional and cultural barriers. Supporting the position that implicit and explicit provider bias exists in the mental health profession, this chapter will explore how implicit provider bias is an intractable institutional barrier that prevents Black/African Americans from accessing mental health and quality care. A review of the implications related to mental health outcomes with Black/African American clients will also be explored.

A brief overview of the Black/African American cultural responses to implicit provider bias will be discussed later in this chapter. There will be an exploration of the ways to help identify, address, and eliminate implicit provider bias using evidence-based personal and community engagement strategies that promote mental health wellness within the Black/African American community. Implications for best practices in Black/African American mental health will also be addressed to eradicate the risk of unethical or medical malpractice with Black/African American clients, reduce the mental health disparity experienced by Blacks/African Americans, and create mental health equity for this population.

The purpose of this paper is to describe the mental healthcare system for people with intellectual disabilities (ID) in Switzerland. It covers the current provision of mental healthcare services as well as educational and research aspects, and summarises both the historical development and the current data on demography, health economics, legislation and national policy.

The authors performed an extensive literature research and evaluated the (very sparse) literature, conducted some interviews with recognised experts and carried out extensive internet-based research on the topic.

There are numerous, well-funded, well-staffed and well-equipped facilities for people with ID. These facilities have highly trained special education teachers and social education workers. Legislation, the insurance system as well as the policies and strategies on a national level are basically in line with people’s with ID needs. On the other hand, there are too few specialist physicians and psychologists, not enough training centres and too few specialist psychiatric services, both inpatient and outpatient. Medical and psychological research in this field is also insufficient.

In Switzerland, the development of treatment facilities typically does not start with a decision by a central authority to implement a policy in a top-down process. Usually, these organisations develop on the basis of some local initiatives and spread throughout the country. The process is likely to be similar in the case of services for people with mental health and intellectual disabilities (MHID), and the situation can be expected to be much better throughout the country within a few years. Furthermore, specific training programmes are expected to be created for physicians and psychologists of various disciplines, to promote an interdisciplinary approach.

This review fills a gap in that there are very few published reviews on the provision of MHID services in Switzerland.

The aim of this chapter is to explore changes since the COVID-19 pandemic in welfare policies and services for people with learning disabilities and autism in England, focusing mainly on educational and health and social care sectors.

A review of official policy documents published on GOV.UK from January 2020 to May 2021 has been conducted using keywords on the topic in question, and semi-structured interviews took place in 2022 with four key informants/stakeholders working in health and social care or education sectors of people with learning disability or autism in England.

The main findings indicate a need to shift practices online due to the pandemic, for both education and health and social-care practice. It is also clear that reforms and adjustments were implemented in guidance, policies and frameworks for the support of persons with learning disabilities and autism. It has been increasingly difficult for people with disabilities to access healthcare services and medication during the pandemic, and this has had an impact on their overall health and wellbeing too. Experts suggested that smoother changes and more support are required, in terms of provision of services, research, access to healthcare, educational services, mental health, employment, as well as more public funding on such services for people with learning disabilities and autism.

The main lessons learned were focusing on the use of online resources, digitalisation of services and access to them, but also difficulty of the system to adapt fast to major changes required in order to support people with disabilities.

The purpose of this paper is to describe physical and mental health characteristics of incarcerated youth both internationally and in New South Wales (NSW) Australia. To outline current practices in the provision of mental and physical healthcare for incarcerated youth internationally and in NSW.

Population relevant literature will be outlined as applicable. Health service delivery will be discussed, with an emphasis on the experiences of NSW physical and mental health service provision for incarcerated youth.

This paper illustrates that in NSW there was a parity of provision between physical and mental healthcare, though there were deficits in what should ideally be provided. Internationally there was clear evidence that current minimum standards of healthcare in both physical and mental healthcare domains remain unmet.

Provision of physical and mental healthcare for incarcerated youth warrants global improvement. Further research into current provisions, across jurisdictions and subsequent standardisation of practice, will improve health outcomes for this vulnerable group.

This is the first paper to describe mental and physical healthcare provision in NSW for incarcerated youth framed within the broader context of international health service provision for similar populations.

This article aims to bring readers up to date with policy developments in England and Northern Ireland in the last two years since the journal first reported on these issues.

As well as looking at changes to policy and legislation, the paper highlights not only the differences but also the shared concerns for people with intellectual disability living in the two countries, e.g. equal access to healthcare as experienced by the general population.

In spite of shared visions of inclusion and equality in mental health care, there are major differences in how both countries approach these issues. Recently this has been highlighted by significant shifts in policy. In Northern Ireland strategies designed to inform the delivery of evidence based services for the future have been witnessed. Whilst in England there has also been a move towards public protection within mental health legislation and the reaffirmation of the need to move towards more individual services. Whilst policy initiatives in both countries have been encouraging; they need to be implemented so issues such as access to healthcare and geographical disparity are addressed by local providers.

Although there is a desire for change, the reality is that the policies and legislation introduced to address issues such as accessing mental health care and service standards have still to make a significant impact to people's daily lives.

This paper offers an update of current practice and policy relating to mental health for people with intellectual disabilities in England and Northern Ireland.