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The purpose of this paper is to describe a feasibility study into the development and pilot of a psychoeducational group for people with intellectual disability and co-morbid mental disorder (including mental illness and personality disorder) within forensic settings.

“Mind Matters”, a psychoeducational programme for people with an intellectual disability and co-morbid mental disorders is a group based programme in a medium secure hospital, adapted and developed to be suitable for people with intellectual disability therapist multidisciplinary approach was key to its development. An open group on a 16-bedded ward for individuals with mild to moderate intellectual disability and co-morbid mental illness was delivered over a six-week period.

The group was positively received in pilot by participants and members of the clinical teams. Attendance and engagement of participants were key measures of the success of the programme. In addition to the apparent increased social skills and motivation to engage with future psychological intervention.

The authors believe that this approach benefitted both the group members and staff on ward, reinforcing strategies for maintaining positive mental health. It also stimulated engagement, discussion about mental disorders including mental illness, personality disorder and intellectual disabilities.

This paper shows how a psychoeducational approach to mental disorder and mental health in individuals with an intellectual disability is possible, beneficial and well received.

There are few reliable psychometric measures of the psychopathology of offenders with intellectual disabilities (ID). However, previous research has indicated that the emotional problems scale (EPS) is useful in identifying a range of treatment needs and in predicting risk to self and others. The purpose of this paper is to compare the severity of the emotional and behavioural problems of a small sample of offenders with ID in medium and low secure services, as assessed by EPS. Additionally, the data are tentatively compared with those reported in previous research to precipitate discussion regarding the changes in clinical populations in secure care over time.

The study collected demographic and EPS data for patients with ID (n=25) on medium secure and a low secure wards. Data were collected as part of routine clinical practice, with EPS forms being completed by nursing and other multi-disciplinary staff.

It was found that there was no statistically significant difference in EPS scores between medium and low secure patients with ID. The authors also highlight differences between the current sample and the normative data collected by previous research.

The data regarding the psychopathology of medium and low secure patients with ID provide insight into the ever changing resourcing needs and risk profiles of this complex patient group. In addition, there is a dearth of empirical research that comments on the clinical differences observed over time in forensic populations. As the current data differ from pre-existing normative data, the potential shift in populations and also implications for the accuracy of clinical decision making based on the assessment are discussed.

The purpose of this paper is to present the development and evaluation of an original training package for staff members on an awareness of an adapted Dialectical Behaviour Therapy programme, the “I Can Feel Good” programme (Ingamells and Morrissey, 2014) designed for individuals with intellectual disabilities (ID) and problems managing emotions. The quality and effectiveness of the training was assessed and is reported in this paper.

The training was delivered for staff working with individuals with ID in a UK medium-secure psychiatric hospital and was attended by nursing staff. The workshop consisted of six modules: “Introduction to the programme”, “Mindfulness”, “Managing feelings”, “Coping in Crisis”, “People skills” and “Application and summary”. Level of self-reported knowledge, confidence and motivation regarding seven aspects of the training was measured by an evaluation questionnaire completed pre and post training.

The results of this study showed that following the training there was a significant increase in self-reported knowledge, confidence and motivation regarding the seven aspects of the training. When perceptions of staff behaviours are observed, although in the right direction, this change was found not to be significant.

This study highlights the potential for staff training to increase awareness of newly adapted therapeutic programmes for individuals with ID. The staff training may increase their ability and willingness to facilitate the running of such programmes and ability to support learning transfer in group members.

The social climate of psychiatric institutions correlates with multiple outcomes related to staff and patients. Research into social climate in Learning Disability services is limited. Staff and patients in Learning Disability services have documented both positive and negative experiences. No research has directly compared the social climate of Learning Disability and non-Learning Disability psychiatric services. The purpose of this paper is to understand how these compare. The study will also compare staff and patient views of social climate and the impact of security on social climate in Learning Disability services.

A total of 64 patients and 73 staff, from Learning Disability and non-Learning Disability psychiatric hospitals completed the Essen Climate Evaluation Schema (EssenCES) measure of social climate.

Patients in Learning Disability and non-Learning Disability services did not differ in their perceptions of social climate. Staff in non-Learning Disability services had a more positive perception of social climate than staff in Learning Disability services. Patients and staff did not differ in their views on climate. Security was negatively related to patients’ Experienced Safety.

The findings suggest that staff perceive that the deficits associated with Learning Disabilities may limit patients’ therapeutic experience and relationships with their peers. Despite this, patients with Learning Disabilities feel supported by their peers, have positive views of the treatment process and feel as safe as non-Learning Disabled psychiatric patients.

The purpose of this paper is to describe the discovery of the application of DNA profiling to the criminal justice system.

Researching the origins of the discovery of the application of DNA to the criminal justice system via an analysis of the first case in which it was applied to.

It was discovered that the first application of DNA profiling to the criminal justice system meant that a young man with intellectual disabilities was saved from wrongful prosecution. The case study also raises ethical issues concerning the mass screening of targeted populations by way of DNA.

The case study is descriptive in nature and draws from earlier work describing the events which unfolded.

Outlines the author’s experiences and the lessons learnt from work in the field of management training for doctors and other medical personnel. Explains the policy of using a dual approach: economic concepts and ideas in practical situations. States that by adopting this participative, problem‐solving approach and involving the discipline of economics in tandem with other skills and subjects, it addresses some of the issues which medical personnel face in their places of work.

Emergency Department (ED) presentations in older people are associated with a wide range of adverse events, which increase the risk of lengthy hospitalisation and poor outcomes. Pathfinder is an inter-organisational initiative delivered in partnership between Beaumont Hospital Occupational Therapy and Physiotherapy departments and the National Ambulance Service. Pathfinder responds to non-serious and non-life-threatening emergency medical service (EMS) calls. This study aims to demonstrate how Pathfinder can safely treat a proportion of older people at home by using alternative care pathways (ACPs), therefore avoiding unnecessary ED presentations. Once a decision has been reached to treat the person at home, the Pathfinder follow-up team delivers functional rehabilitation and case management in the persons’ home over the subsequent days.

This paper outlines the Pathfinder assessment, management and interventions in one clinical case example. Outcome measures include the level of patient satisfaction obtained via routine telephone feedback questionnaire and re-presentation to Beaumont Hospital within 30 days.

This paper illustrates through a case example the benefit of a collaborative multi-disciplinary rapid response team for non-serious and non-life-threatening EMS calls in older adults. The patient in this case example had no further EMS calls or ED presentations for 30 days after Pathfinder intervention and reported a high level of satisfaction with the service.

ED presentation was avoided through comprehensive multi-disciplinary assessment, including immediate access to intensive follow-up support in the person’s own home.

The Pathfinder service is improving access to ACPs for older people in the Beaumont Hospital catchment area. Pathfinder will now be spread nationally, with local adaptation, so that older people in other parts of Ireland will also benefit from this integrated model of care.

Patient feedback surveys confirm older adults want access to alternative care pathways.

Health economics is now a well‐established topic within the discipline of economics. A 5,500‐item bibliography covering material up to 1982 is available (Blades et al, 1986). Health economists write on such diverse matters as (to select at random) demand for acute care in hospitals, the costs of illness, the economics of alcoholism, cost‐benefit analysis in magnetic resonance imaging, and the pros and cons of any number of ways of financing the delivery of health services. Here in the UK the Health Economists' Study Group boasts around 150 members. Meanwhile, hardly a day goes by without the newspapers containing items concerning topics which could form the basis for health economists' involvement in analysis, evaluation and, in some cases, policy advice. The jargon of economics and evaluation is becoming familiar to a wider audience: thus articles on cost‐effectiveness and cost‐benefit analysis appear regularly in medical journals and the quality‐adjusted life‐year (QALY) has featured on TV. Thus a review of some of the recently published books in this area would appear appropriate at this juncture.

Provides a review and synthesis of the finance literature regarding foreign investment and the real estate literature dealing with foreign investment in US real estate. Addresses the motivations for investing in US real estate, including the potential for increased returns as well as the potential for risk reduction. Proposes an investment decision making model indicating factors that foreign investors need to consider when investing in US real estate.