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The purpose of this paper is to outline what early support should be offered to children and young people with neurodevelopmental conditions including those who are autistic or have intellectual disability. A review of all child and adolescent mental health services (CAMHS) services in the Northwest completed by NHS England and Improvement (Doyle and Ryan, 2021) found that there was no clear Tier 2 offer (for mild to moderate mental health issues) for autistic children and young people or for those with intellectual disability. Following this review, a project group that had developed a model for mental health services for autistic children and young people and for those with intellectual disability (Wee et al., 2021) was tasked with articulating the “Getting Help” offer for children and young people with neurodevelopmental conditions, including intellectual disability.

A working group was created consisting of professionals from mental health, education and local authority and lived experience representatives of coproduction partners. A brief review of the background literature was also conducted. Six meetings were held to create a framework for the “Getting Help” offer and to discuss what the offer should be based on professional expertise and lived experience.

Recommendations for the Getting Help multi-agency offer included pre- and post-assessment support as part of a single attention deficit hyperactivity disorder/autism/neurodevelopmental pathway, community support for children with intellectual disability, access to adapted mental health support and the need for early recognition and support for avoidant and restrictive food intake disorder. Key themes from working group discussions included the reduction in the quality of services experienced by children and families due to silo working, which increased the risk of falling between multi-agency services and led to early signs of neurodevelopmental needs, or mental health issues being missed. Another theme was aiming for equity of access and outcomes.

This work is a response to a coproduced review of CAMHS in the Northwest and incorporates the lived experience of young people and families. It also adopts a holistic multi-agency neurodevelopmental approach rather than focusing on a single diagnosis or service.

This study aims to investigate the experiences of service providers supporting male victims and female perpetrators of intimate partner violence (IPV). The study explored the drivers, methods and treatments of female-perpetrated IPV, the nature and impact of abuse towards male victims, the barriers and facilitators to service provision and the impact on the practitioners themselves.

The study used a qualitative approach, using reflexive thematic analysis to analyse semi-structured interviews with 13 experienced service providers.

Two overarching themes were identified: systemic issues in service provision, including challenges with multi-agency approaches, funding and availability of services and the impact on practitioners; and gender stereotypes, which created barriers to male victims' help-seeking and influenced the treatment of female perpetrators.

The findings suggest the need for a multi-level approach, addressing gendered inequalities in IPV policy and funding, implementing gender-inclusive, evidence-based and trauma-informed practices, and raising public and professional awareness to challenge the dominant “domestic violence stereotype”.

This study provides a detailed, in-depth exploration of the experiences of service providers supporting “non-typical” populations in IPV, revealing the complex, multi-faceted challenges they face within a system that is inherently designed to support female victims of male perpetrators.

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.

Dual diagnosis [co-occurring mental health and addiction challenges] and recovery from the same are multifaceted and complex issues. These multifaceted and complex issues are difficult, time-consuming and require a multi-agency approach to their treatment. This chapter aims to present the characteristics that embody co-occurring disorders with the idea of defining this symbiotic relationship for the reader. This text will also highlight the paucity of resources currently available to those with a dual diagnosis.

We identify lessons from a project sponsored by a large charitable trust, which sought to build capability for end-of-life (EOL) care in Hong Kong through interdisciplinary and multi-agency collaboration.

An in-depth case study drawing on 21 in-depth interviews with diverse stakeholders was conducted. Lyman et al.’s (2018) model of organisational learning (OL) in healthcare settings was applied to analyse the relative emphasis on particular contextual factors and mechanisms, and to identify outcomes perceived to have been achieved.

Infrastructure such as materials for assessment and education received the most emphasis among the contextual factors and deliberate learning such as training sessions received the greatest attention among the mechanisms. While perceptions indicated that desired outcomes were being achieved in terms of social impact, there were relatively few mentions of “soft” factors such as enhanced motivation, leadership or OL skills among staff.

This study extends the literature on how to create valuable social impact through OL. While prior studies have examined social impact in terms of solutions for social and environmental problems, ours is one of the few that examines how improvements are made to organisations’ capability to deliver such impacts in the context of healthcare.

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.

Discussions about progressive gender reform across Melanesia highlight the need for more gender-inclusive policies and improved conditions for women and girls throughout all sectors. However, for many of these countries, attempts to address the problems are marred by insufficient resources and low prioritization of the issue and traditional, cultural and religious perspectives about gender and gendered roles. This article discusses how police responses are coordinated to address domestic and family violence (DFV) and provides a critical reflection on both internal responses and the complexities of multi-partner operations beyond urban spaces.

This article draws on the findings from a stakeholder engagement focus group with 20 participants from four Melanesian countries – Fiji, Papua New Guinea, the Solomon Islands and Vanuatu – to provide insight into policing innovations in rural contexts.

There is a need for improved multisector partnerships, increased police presence and greater reliance on indigenous strategies to improve responses to DFV in resource-constrained contexts.

The article provides insight into an under-researched area and makes recommendations for improving responses to DFV in rural areas in small-island developing states.

Despite the rhetoric emphasising partnership working, there has been a dearth of research related to the educational practices that reify interprofessional partnerships for young children with special educational needs. This doctoral study examined the subtle power shifts in the interactions between early years educators and other professionals against the backdrop of deficit policy discourses and institutional challenges. This research adopted a case study approach and utilised methodological triangulation to unveil educators' phronetic knowledge. The findings point to power differentials and partnership inequities which affect the roles and identities of early years educators. Participants assumed emergent leadership roles that encompassed elements of social pedagogy and pedagogical eclecticism which eschewed medicalised interventions in favour of intuitive pedagogical approaches centred on the child and family.

This study builds on the extant research of the authors on illegal rural enterprise (IRE). However, instead of taking a single or micro case approach within specific sections of the farming and food industries we examine the concept holistically from a macro case perspective. Many IRE crimes simply could not be committed without insider knowledge and complicity, making it essential to appreciate this when researching or investigating such crimes.

Using data from published studies, we introduce the theoretical concept of “Shadow infrastructure” to analyse and explain the prevalence and endurance of such criminal enterprises. Using a multiple case approach, we examine data across the cases to provide an analysis of several industry wide crimes—the illicit halal meat trade; the theft of sheep; the theft of tractors and plant; and the supply of illicit veterinary medicines.

We examine IRE crimes across various sectors to identify commonalities in practice and in relation to business models drawing from a multidisciplinary literature spanning business and criminology. Such enterprises can be are inter-linked. We also provide suggestions on investigating such structures.

We identify academic and practical implications in relation to the investigation of IRE crime and from an academic perspective in relation to researching the phenomenon.

This study combines data from numerous individual studies from a macro perspective to provide practical solutions to a multifaceted problem.

The current study aimed to examine the population of girls in two secure children’s homes (SCHs) in the North East of England to consider the impact of menstruation on girls’ physical, mental and emotional wellbeing within secure settings. Gender-responsive approaches and understanding gender differences are central to trauma-informed provision within the Children and Young People Secure Estate (CYPSE). Whilst trauma-informed approaches are central, it could be argued that basic gender differences, such as the menstrual cycle, are currently being overlooked within research and practice.

A case file audit examined documentation of 24 girls who were admitted across both sites between January 2022 and January 2023.

Of the sample (n = 24), 50% had information recorded regarding their menstrual cycle during admission assessments. Six girls (25%) disclosed experiencing irregular menstruation. Painful cramping was noted by two girls (8%). One girl (4%) disclosed heavy bleeding, and menorrhagia (abnormal heavy bleeding) was reported for one further girl (4%). One girl (4%) disclosed early onset menarche. Case formulations tended to focus less on girls’ menstrual cycles or the potential impact of this on wellbeing. However, 100% of case formulations considered the potential impact of trauma and/or disrupted attachment on girls’ presentations.

The results indicate the impact of menstrual cycles on girls’ physical, mental and emotional wellbeing may benefit from much further consideration. Implications are presented alongside directions for future research.