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Article
Publication date: 8 January 2018

Patrick Callaghan and Andrew Grundy

The purpose of this paper is to examine empirical, epistemological and conceptual challenges and clinical narratives in the application of risk assessment and management…

Abstract

Purpose

The purpose of this paper is to examine empirical, epistemological and conceptual challenges and clinical narratives in the application of risk assessment and management in mental health.

Design/methodology/approach

The authors used a narrative review of empirical, conceptual and clinical literature.

Findings

The worldwide prevalence of violence in mental health settings remains high. Risk assessment and management approaches, while well intentioned as an attempt to reduce harm and increase people’s safety, have negligible effect on both. They are invariably individual centric, ignore wider environmental, societal and behavioural influences that foment violence and have a stigmatising effect on people using mental health services. They also reinforce the myth that people who are mentally unwell threaten society and that through current risk assessment and management approaches, we can minimise this threat.

Research limitations/implications

There is a need to reconsider the study and application of violence risk assessment in mental health.

Practical implications

The practice of risk assessment and management in mental health is marred by an overuse of risk assessment measures that are limited in their predictive efficacy. As a result, they have little value in preventing, reducing and/or managing harm. The language of risk punishes and stigmatises service users and reinforces the image of menace. An alternative language of safety may nourish and protect. A collaborative approach to safety assessment based upon recovery-focussed principles and practices may fuse professionals and service users’ horizons. Combining service users’ self-perception, professionals’ sound clinical judgement, assisted by electronically derived risk algorithms and followed by evidence-based risk management interventions, may lessen the threat to service users, reduce harm and transform the practice of violence risk assessment and management.

Social implications

Risk appraisals discriminate against the small number of people who have a mental illness and are risky, an example of preventive detention that is ethically questionable. On the basis of the limitations of the predictive efficacy of actuarial measures, it is ethically dubious to subject people to interventions with limited benefits. Risk assessment processes tend to reinforce stigma by classifying individuals as risky, sanctioning society’s prejudices and fear through scientific authority.

Originality/value

The increasing focus on risk assessment and management to tackle violence in mental health is fraught with empirical, conceptual and practical concerns; the authors have suggested ways in which these concerns can be addressed without compromising people’s safety.

Details

The Journal of Mental Health Training, Education and Practice, vol. 13 no. 1
Type: Research Article
ISSN: 1755-6228

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Article
Publication date: 17 May 2018

Dominiek Coates, Patrick Livermore and Raichel Green

There has been a significant growth in the employment of peer workers over the past decade in youth and adult mental health settings. Peer work in mental health services…

Abstract

Purpose

There has been a significant growth in the employment of peer workers over the past decade in youth and adult mental health settings. Peer work in mental health services for older people is less developed, and there are no existing peer work models for specialist mental health services for older people in Australia. The authors developed and implemented a peer work model for older consumers and carers of a specialist mental health service. The purpose of this paper is to describe the model, outline the implementation barriers experienced and lesson learned and comment on the acceptability of the model from the perspective of stakeholders.

Design/methodology/approach

To ensure the development of the peer work model met the needs of key stakeholders, the authors adopted an evaluation process that occurred alongside the development of the model, informed by action research principles. To identify stakeholder preferences, implementation barriers and potential solutions, and gain insight into the acceptability and perceived effectiveness of the model, a range of methods were used, including focus groups with the peer workers, clinicians and steering committee, consumer and carer surveys, field notes and examination of project documentation.

Findings

While the model was overall well received by stakeholders, the authors experienced a range of challenges and implementation barriers, in particular around governance, integrating the model into existing systems, and initial resistance to peer work from clinical staff.

Originality/value

Older peer workers provide a valuable contribution to the mental health sector through the unique combination of lived experience and ageing. The authors recommend that models of care are developed prior to implementation so that there is clarity around governance, management, reporting lines and management of confidentiality issues.

Details

Mental Health Review Journal, vol. 23 no. 2
Type: Research Article
ISSN: 1361-9322

Keywords

Content available
Article
Publication date: 1 December 1999

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Details

Microelectronics International, vol. 16 no. 3
Type: Research Article
ISSN: 1356-5362

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Article
Publication date: 14 October 2013

Roger Openshaw and Margaret Walshaw

Educational standards debates are a promising area of investigation for transnational study by historians of education. Drawing upon the work of Foucault, Kliebard, and…

Abstract

Purpose

Educational standards debates are a promising area of investigation for transnational study by historians of education. Drawing upon the work of Foucault, Kliebard, and Aldrich, the paper critically examines some of the outstanding features of the emerging debate over literacy and numeracy standards that sharply divided teachers, educational officials, parents, and employers in New Zealand during the mid-to-late 1950s. These included the polarisation of opinion across the nation, the involvement of the national media, and the tactics of mass persuasion adopted by the various protagonists.

Design/methodology/approach

The paper utilises contemporary theory to critically interrogate an historical episode in which controversy over literacy and numeracy standards in schools led first to an in-house report, and finally to a national inquiry. The paper draws upon contemporary newspaper commentary, professional journals and parliamentary debates, as well as a considerable amount of archival material held at Archives New Zealand repositories in both Wellington and Auckland.

Findings

The paper contributes to the field by illustrating the way in which historical debates over literacy and numeracy lie at the intersection of completing claims to truth. Behind such claims lie rival conceptions of education that make it unlikely that standards issues will ever be resolved satisfactorily. Hence the title of the paper, which refers to a jocular suggestion by a newspaper editor of the time that only an “August Assembly of Suave Venusians” could adjudicate in the debate.

Originality/value

The value of the paper is that it links current theories on transnationality with archival research in order to critically examine a national case study. Much of the primary source material has never been utilised previously for research as Archives New Zealand has only just released the relevant files for research purposes.

Details

History of Education Review, vol. 42 no. 2
Type: Research Article
ISSN: 0819-8691

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Article
Publication date: 1 March 1994

D.J.J. Lowrie

Two members of ISHM‐Hungary, Professor Zsolt Illyefalvi‐Vitéz, ELC representative, and Professor Gábor Harsányi, president and TPC representative, attended the NATO…

Abstract

Two members of ISHM‐Hungary, Professor Zsolt Illyefalvi‐Vitéz, ELC representative, and Professor Gábor Harsányi, president and TPC representative, attended the NATO Advanced Research Workshop on MCM‐C/Mixed Technologies in Florida, USA, in May co‐sponsored by ISHM‐US and organised by:

Details

Microelectronics International, vol. 11 no. 3
Type: Research Article
ISSN: 1356-5362

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Article
Publication date: 12 December 2020

Melanie Jay Narayanasamy, Louise Thomson, Carol Coole, Fiona Nouri and Avril Drummond

There has been little research into the use and efficacy of Mental Health First Aid (MHFA) across UK workplaces. This paper aims to investigate the implementation of MHFA…

Abstract

Purpose

There has been little research into the use and efficacy of Mental Health First Aid (MHFA) across UK workplaces. This paper aims to investigate the implementation of MHFA across six UK organisations, identifying key barriers and facilitators.

Design/methodology/approach

Twenty-seven workplace representatives were recruited from six organisations through purposive sampling and took part in semi-structured interviews exploring their experiences of workplace MHFA. The data underwent thematic analysis, identifying key themes around implementation.

Findings

Implementation varied across organisations, including different reasons for initial interest in the programme, and variable ways that MHFA-trained employees operated post-training. Key barriers to successful implementation included negative attitudes around mental health, the perception that MHFA roles were onerous, and employees’ reluctance to engage in the MHFA programme. Successful implementation was perceived to be based on individual qualities of MHFA instructors and good practice demonstrated by trained individuals in the workplace. The role of the inner organisational setting and employee characteristics were further highlighted as barriers and facilitators to effective implementation.

Research limitations/implications

MHFA is a complex intervention, presenting in different ways when implemented into complex workplace settings. As such, traditional evaluation methods may not be appropriate for gaining insights into its effectiveness. Future evaluations of workplace MHFA must consider the complexity of implementing and operationalising this intervention in the workplace.

Originality/value

This study is the first to highlight the factors affecting successful implementation of MHFA across a range of UK workplaces.

Details

The Journal of Mental Health Training, Education and Practice, vol. 16 no. 2
Type: Research Article
ISSN: 1755-6228

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Article
Publication date: 28 April 2020

Oluwadunsin Moromoke Ajulo, Jason von Meding and Patrick Tang

Vulnerability is understood as susceptibility to hazards born out of the complex interaction within the system scales. The current global economic system focuses on…

Abstract

Purpose

Vulnerability is understood as susceptibility to hazards born out of the complex interaction within the system scales. The current global economic system focuses on persistent growth and a top-down approach to wealth distribution, which not only puts a strain on the Earth's resources but also on communities by increasing vulnerability. Localised economy, on the other hand, uses a bottom-up approach to wealth distribution, whereby local resources are harnessed for sustainability of the local economy. Localising economies facilitate degrowth by shifting our focus to the quality of economies and the redefinition of growth and prosperity. The purpose of this study is to highlight the potentials of localisation and degrowth for vulnerability reduction.

Design/methodology/approach

In this study, the authors conducted a case study of the Lyttelton community in New Zealand, their local initiatives and how these efforts have been used to build capacities and reduce vulnerabilities in the community. Data were sourced from both primary and secondary sources. Primary data were sourced through observation of the day-to-day running of the community and interviews with community members, while secondary data were sourced from existing literature on the community and related concepts.

Findings

Lyttelton community provides a good example of a community where bottom-up initiatives are particularly felt, and there is very limited dependence on the conventional economic system to solve their problems. The study shows that degrowth initiatives within the community have gained momentum because initiators see the value in their coming together as a community and doing what is right for themselves and the environment. Furthermore, localisation fosters innovation, personal growth and development and care for the environment.

Originality/value

This paper contributes to the existing knowledge by discussing some local initiatives that serve an underlying purpose for degrowth based on a study carried out in Lyttelton, New Zealand. The study findings established that there is need for more focus on sensitisation about the risks of growth mania and the potential for degrowth in bringing about actual prosperity, for saving the environment and disaster risk reduction. Also, the encouragement of local production and existing institutions like the timebank, which give members access to the needed resources and skills contribute to vulnerability reduction.

Details

Disaster Prevention and Management: An International Journal, vol. 29 no. 6
Type: Research Article
ISSN: 0965-3562

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Book part
Publication date: 27 December 2018

Abstract

Details

Perspectives on Diverse Student Identities in Higher Education: International Perspectives on Equity and Inclusion
Type: Book
ISBN: 978-1-78756-053-6

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Book part
Publication date: 27 December 2018

Abstract

Details

Perspectives on Diverse Student Identities in Higher Education: International Perspectives on Equity and Inclusion
Type: Book
ISBN: 978-1-78756-053-6

Content available
Article
Publication date: 3 December 2018

Patrick Joseph Sullivan

The purpose of this paper is to consider some of the legal implications of adopting a harm minimisation approach in supporting people who self-injure within inpatient…

Abstract

Purpose

The purpose of this paper is to consider some of the legal implications of adopting a harm minimisation approach in supporting people who self-injure within inpatient mental health units. It is argued that a focus on risk and the increasing influence of the law and legal styles of thinking often associated with the allocation of blame have produced a more risk adverse clinical environment. As a result health professionals are more likely to err on the side of caution rather than engage in practices that although potentially therapeutic are not without their risks.

Design/methodology/approach

The analysis draws on the clinical, philosophical and legal literature to help understand how harm minimisation may support people who self-injure. It considers some of the complex medico-legal issues that arise in a clinical environment dominated by risk.

Findings

A focus on risk and accountability has produced an environment where the law and legal styles of thinking have come to influence practice. This is often associated with blame in the minds of the health professional. Given the legal obligation to prevent suicide, health professionals may take a conservative approach when working with people who self-injure. This makes the adoption of harm minimisation difficult.

Originality/value

This paper provides a legally informed analysis of some of the challenges associated with using harm minimisation techniques with people who self-injure. It adds to the literature regarding this area of clinical practice.

Details

The Journal of Mental Health Training, Education and Practice, vol. 14 no. 1
Type: Research Article
ISSN: 1755-6228

Keywords

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