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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.

Social psychology has focused on an individual’s reaction to emergencies and witnessing a crime, which has developed theories of bystander intervention and bystander apathy. The purpose of this study is to explore why people choose to intervene when they are a bystander to intimate partner violence (IPV) and the psychological processes that underpin this. Decision-making was explored drawing on literature from the whistleblowing field.

Through a mixed methods epistemology, this study explored factors that explained intervening behaviour concerning IPV. In total, 212 participants who had known someone who was a victim of IPV were recruited from the general population.

A logistic regression model indicated that conscientiousness and fairness were found to predict intervening behaviour. Being a child witness was found to predict non-intervening behaviour. Qualitative analysis revealed three types of bystander apathy: those who lacked capability as they were children; those who were indifferent and did not see it as their place to intervene; and those who wanted to intervene but did not as they were frightened of exacerbating the situation.

IPV has significant physical and psychological effects on victims. However, the choice to intervene is complex, and bystander intervention in this study was also associated in some cases with not only a continuation of the IPV behaviour towards the victim but also aggression and physical violence towards the bystander (whistleblower retaliation). Based on the findings of this study, recommendations are made for how to support bystanders and victims of IPV.

This study involved participants with real-life experience of being a bystander to IPV. The mixed methodology provided an insight into the psychological processes, which underpin bystander experiences of IPV and maps onto the literature in relation to whistleblowing.

This paper aims to illuminate the issue of workplace violence (WPV) against psychiatry residents. Workplace violence is known to negatively impact physical and emotional well-being, professional development and the quality of the care that mental health professionals provide to patients. The authors discuss the prevalence of, risk factors for and consequences of WPV against psychiatry residents, as well as the need for support and resources to help residents cope with the emotional challenges of their job.

This paper is a review of the literature on WPV against psychiatry residents, and includes studies on its prevalence, associated risk factors and consequences.

Psychiatry residents face a heightened risk of WPV, including physical and verbal attacks, which can harm their mental and physical health and disrupt their continuity of care. Factors that contribute to WPV against psychiatry residents include exposure to aggressive or violent behaviors, inadequate training in WPV, understaffing, the stigmatization of mental illnesses, and discriminatory treatment. Furthermore, psychiatry residents who encounter WPV may develop negative emotions and attitudes toward their patients, which can compromise the care they provide.

The inherent heterogeneity of study designs highlighted in this review could hinder the establishment of definitive conclusions about the impact of workplace violence on psychiatry residents. A focus on studies published in English may inadvertently exclude relevant literature in other languages, potentially limiting the comprehensiveness of study findings.

This paper highlights resident physicians’ personal experiences with and perceptions of WPV encountered during residency training. In response, potential solutions are proposed to address WPV, including increased support for resident physicians, mandatory reporting of WPV incidents, and a cultural shift toward zero tolerance for WPV. In addition, the paper raises awareness of the limited research on this topic and the importance of further investigation.

Intersectionality addresses complex avenues of oppression that emanate at the intersections of one’s identities. However, the intersectional framework assumes static identities, which are increasingly being acknowledged for their fluidity. This research explored the extent of the fluidity of social identities to draw implications for the application of the framework in research.

27 participants from a post-graduate elective course on diversity and inclusion identified their significant social identities, and submitted a write-up using hermeneutic phenomenology in which the participants shared their lived experiences of the fluidity of their social identities in different spaces they occupy or find themselves in.

Fluidity-triggering stimuli in different environments and their associations with identity-related motives were uncovered using thematic analysis. Stimuli operating at micro-, meso- and macro-levels rationally explained identity fluidity. However, in addition to types, intensity and frequency of stimuli, psychological factors, such as identity status, were decisive in determining the degree of generalization of stimuli across individuals and spaces that significantly influenced identity fluidity.

This research explored the extent of the fluidity of social identities to draw implications for the application of the intersectional framework in research. The findings contribute to future research by identifying limitations of the intersectional framework based on the fluidity of social identities arising from environmental stimuli that operate at micro-, meso- and macro-levels, and the extent of psychological generalization of these stimuli across spaces.

The purpose of this study is to advance a novel evaluation index system and evaluation approach for ability of older adults in China.

This study constructed a comprehensive older adult ability evaluation index system with 4 primary indicators and 17 secondary indicators. Grey clustering analysis and entropy weight method are combined into a robust evaluation model for the ability of older adults.

The result demonstrates that the proposed grey clustering model is readily available to calculate the disability level of elderly individuals. The constructed index system more comprehensively considers all aspects of the disability of the elderly.

This study provides a quantitative method and a more reasonable index system for the determination of the disability level of the elderly.

Violence toward frontline health-care workers (HCWs) from patients and visitors is a pervasive issue that ranges from verbal and psychological abuse to physical assault. The emergence of the COVID-19 pandemic has led to increased reports of escalated verbal workplace aggressions (VWPAs); however, most studies have been conducted internationally. Studies based in the USA have focused on physical violence experienced by nurses and paramedics in emergency situations. The purpose of this study is to learn about the experiences of different levels of frontline HCWs with VWPA from patients and visitors and discover ways to address this issue.

This qualitative descriptive study asked registered nurses, licensed practical nurses and patient care technicians from one health-care system about their experiences with patient and visitor VWPA using an anonymous, voluntary open-ended survey and in-person interviews. In all, 31 participants completed the survey and 2 were interviewed. Data were analyzed using content analysis.

Three themes emerged from the data: the experience, moving through and moving forward. Frontline HCWs described experiences of VWPA, indicating its forms, frequency and conditions. They used coping, along with personal and professional measures, to manage and move through the situation. Moving forward was captured as suggestions for the future and conveyed hope for a perfect state.

The experiences of frontline HCWs offered insight into how they perceive and cope with difficult encounters. Recommendations relate to not only implementing interventions that support frontline HCWs but also creating a culture where aggression is not tolerated and addressing perpetrator behavior is a priority.

The purpose of this paper is to examine the current state of the literature on the variables associated with self-harm and aggression in women who committed a criminal offence.

Studies were identified through online databases, namely, PsycINFO, PubMed, ERIC and EBSCOhost, as well as manual searches of reference lists of the selected studies. The target population included women who committed a criminal offence and have engaged in self-harm and aggressive behaviors during their incarceration, either in correctional institutions or in forensic psychiatric settings.

Of the 1,178 studies identified, nine met inclusion criteria. The studies were conducted in six different countries and included data from 6360 female participants. Few studies examine self-harm and aggression in women who committed a criminal offence which speaks to the still sparse literature on this topic. This review of the association between self-harm and aggression in women offenders highlights the finding that a small group of women is often involved in both self-harm and aggression. The authors have identified possible psychological factors associated with women engaging in both self-harm and aggression. The findings also reveal a possible connection between types of aggressive behaviors and specific time periods during sentences or stays in forensic psychiatry.

The findings of this scoping review have clinical implications which may be considered by both researchers and the case management teams of women involved in both self-harm and aggression.

Despite the limited number of studies examining self-harm and aggression in women, this scoping review highlights gaps in the literature as well as notable psychological correlates of women who engage in self-harm and aggression.

Violence and aggression against mental health professionals is a global concern with well-documented consequences. In the UK, mental health care is increasingly delivered in the community, yet little research has explored practitioner experiences of workplace violence (WPV) outside of inpatient settings. This study aimed to explore how mental health professionals in a UK community mental health team (CMHT) perceive, experience and cope with WPV.

Face-to-face semi-structured interviews were conducted with ten multidisciplinary professionals based in a CMHT in a UK city. Data was analysed using interpretative phenomenological analysis.

Three interconnected themes emerged. WPV was accepted as inevitable: participants carried on working despite its impact, and feeling unheard by management they gave up on change, perpetuating the perceived inevitability of WPV. Peer support and organisational resources like debriefing, counselling and occupational health improved coping. Stigma and ideas of professional responsibility were barriers to access.

To mitigate against the negative consequences of WPV, CMHTs could offer peer support initiatives, improve communication and availability of organisational resources and involve staff in post-incident decision-making. Recommendations are made to shift the attitude of acceptance of WPV and encourage help-seeking.

The purpose of the chapter is to explain how boys learn to mask their expression of fears and emotions. The aim is to understand how boys internalize socially prescribed masculine traits, including masking of fear, certain emotional expressions and discomfort. The sample consisted of 20 parents, 30 school teachers and 50 boy students and 50 girl students between the ages of 11 and 14 from government-funded co-education schools in Delhi, India. School observation, focus group discussion, and interviews were used for data collection. The study found that gendered social norms are enforced on boys in the form of ‘boy codes’. These boy codes are so deep rooted in daily practices that they are considered as an essential ‘ideal male’ trait. Although the ‘ideal male image’ is presented as a uniform category among boys, the masking of fears and emotional expressions is not the same for all boys. Thus, many boys internalized the ideal male images in the form of hegemonic displays of masculinity, where they are focused on conforming to rigid masculine traits. However, through challenge, negotiation and renegotiation, many boys would like to conduct themselves according to their personal masculinity. There is a shift among some boys from the internalization of the traditional male image to giving meaning to personal experiences that deviate from the ideal male figure without the fear of being judged by society.

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.