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This article explores the social context, prevalence and treatment of problems related to dual diagnosis in the countries of Eastern Europe, drawing on an extensive literature search as well as the authors' wide personal experience of working with mental health reformers in policy, education and service delivery in most countries in the region. It describes the region's historical and societal background, and sets out basic epidemiological information, including the rate and impact of mental illness and alcohol and substance abuse. It reviews what services are available for people with dual and triple diagnosis; outlines the barriers to progress; and makes recommendations for improvements.

The purpose of this paper is to develop a method for multiple soft fault diagnosis of nonlinear circuits including fault detection, identification of faulty elements and estimation of their values in real circumstances.

The method for fault diagnosis proposed here uses a measurement test leading to a system of nonlinear equations expressing the measured quantities in terms of the circuit parameters. Nonlinear functions, which appear in these equations are not given in explicit analytical form. The equations are solved using a homotopy concept. A key problem of the solvability of the equations is considered locally while tracing the solution path. Actual faults are selected on the basis of the observation that the probability of faults in fewer number of elements is greater than in a larger number of elements.

The results indicate that the method is an effective tool for testing nonlinear circuits including bipolar junction transistors and junction field effect transistors.

The homotopy method is generalized and associated with a restart procedure and a numerical algorithm for solving differential equations. Testable sets of elements are found using the singular value decomposition. The procedure for selecting faulty elements, based on the minimal fault number rule, is developed. The method comprises both theoretical and practical aspects of fault diagnosis.

This paper describes the efforts of an academic and practitioners to work together to improve the care of people with a dual diagnosis within one acute mental health care ward. The project was informed by a practitioner action research approach. The group sought to build alliances between academics and practitioners to address problems in practice. The paper focuses on the outcomes for the nurses and trainers, as well as considering its impact on overall care delivery.

Individuals with intellectual disability (ID), mental health needs and criminal justice system involvement are likely to be admitted to forensic units; however, not all of those individuals are served in that system. It is, therefore, important to understand the profile of those admitted to non‐forensic specialized units for individuals with ID and mental health issues. This paper aims to address this issue.

Demographic, clinical and criminal profiles of individuals discharged over nine years from a specialized dual diagnosis program were reviewed to delineate clinical subgroups.

A total of 20 out of 84 total discharges were identified as having past or current criminal justice system involvement. The most common offence was assault and 60 per cent of these individuals had admissions longer than one year. Subgroups by psychiatric diagnosis differed in their age, legal status, offence history, and length of hospital stay, as well as in therapeutic interventions and discharge process.

The results suggest that inpatients with ID and criminal justice system involvement present with unique treatment, support and risk management needs based on psychiatric diagnosis. The number of individuals in clinical subgroups was low, thus further research is needed to determine if the observed patterns hold true in bigger samples.

The study delineates the complexity and heterogeneity of treatment and supports needs of individuals with intellectual disabilities and offending behaviour.

The closure of long‐stay National Health Service (NHS) hospitals has seen the placement of people with learning disabilities who offend or have offending‐type behaviours placed ‘out of area’ many miles from local services. This move of people out of area has made it difficult in many localities to develop local services and to monitor the quality of care for this group. This paper describes the start of an exercise to examine potential local care pathways for those who present with offending behaviours and to look at differences between the out of area group, and another receiving treatment locally. Within the two groups we found no significant differences regarding rates of psychiatric disorder, quality of life or levels of unmet need. The main difference was that the out of area group was largely characterised by a range of aggressive and challenging behaviour, necessitating the additional structure and securities provided by out of area placements.

When the International Initiative for Mental Health Leadership (IIMHL) was developed, one of the hopes was that the exchange visits among international sites would stimulate the development of collaborative working relationships. This article reviews one such collaborative project, the development and implementation of a comparative study of assertive community treatment teams, or assertive outreach teams as they are called in the UK and New Zealand.

This paper aims to explore the potential utility of Identity Structure Analysis (ISA) in single-case and group-level outcome and process evaluations.

A study was conducted to evaluate mentalization-based therapy by using ISA and its linked framework software, Ipseus. Ten patients with borderline personality disorder and substance use disorder were involved in the study. ISA/Ipseus was administered prior to and at the completion of the treatment. Five-year follow-up data, comprising behavioural indicators, were also collected and compared to ISA/Ipseus results.

Improvements occurred in the evaluation of stressful, demanding and emotionally burdening situations. Evaluations on concerned others also improved, together with progress in self-reflection. Changes in the evaluation of recovery-related themes were less salient. On a case level, changes in the self-states and role models were consistent with the results of the five-year-follow up data. An initial crisis state seems suggestive of progress, while initial defensive positions with high positive self-regard, of stagnation.

ISA/Ipseus, integrating the benefits of qualitative and quantitative approaches in evaluation, is a potential method to explore the complexity of identity changes during therapy.

This paper offers readers a review of the literature on alcohol and illicit drug misuse in people with learning disabilities, focusing on six key areas. First, clarity is provided on the definition of ‘misuse’. Second, prevalence rates are examined along with the methodological difficulties involved in such studies, the authors arguing that prevalence rates are higher than current estimates. Third, the authors explore the relationship between the intra‐ and inter‐personal risk factors. Fourth, the nature of the substance misuse is explored, with a focus on offending behaviour. Fifth, a range of treatment modalities are described with a series of recommendations for more robust evidence‐based interventions. Last, the authors explore the gaps in policy that lead to a dearth in service provision as well the barriers which people with learning disabilities face on entering treatment services. The paper cites four innovative projects that address this population's needs in England, and illustrates how Northern Ireland has positioned the needs of this hidden population within the Department of Health, Social Services and Public Safety (Northern Ireland).

In the prison system there are high percentages of mentally disordered offenders, often with co‐morbid psychiatric disorders. In addition, the setting and ward atmosphere in prisons are not designed to care for psychiatric patients and places a burden on vulnerable inmates. Management of care of the different subgroups in the prison population is therefore necessary on four different levels, from basic health care to forensic psychiatric treatment. A fifth level is forensic care, which is directed towards re‐integration into the community rather than treatment at the symptom‐level of disease. Continuity of care, evidence‐based care and coercion within mental health care are discussed with regard to their forensic ethical meaning towards both patients and the community. Drawing on the Dutch situation a case is made for the promotion of voluntary treatment for those prisoners