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Purpose This study of HMP Birmingham was part of a much larger investigation of health needs assessment (HNA), in the context of a new “HNA Toolkit” developed by Public Health England for use in the prison service. The paper aims to discuss this issue.Design/methodology/approach In 2015, details of prison healthcare in HMP Birmingham had figured in the authors’ analysis of documents. In 2018, a crisis in Birmingham typified problems developing more widely in England and Wales. Was the crisis predictable from the initial HNA?Findings Recommendations embodied in the 2015 HNA were not acted upon; the eventual problems that combined to overwhelm the running of HMP Birmingham were predictable.Originality/value Lessons from this case study could inform more coherent commissioning of prison health services. This in turn could promote timely developments for improved health and morale in the prison, amongst prisoners and staff. Longer term, this might help to avoid future crises. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper arose out of a Public Mental Health Network meeting in September 2015 and a suggestion then by the editor of the British Journal of Psychiatry. The British Journal of Psychiatry had just published an editorial by the chief medical officer for England that challenged the current concept of wellbeing, within health policy.Design/methodology/approach The analysis is structured around three key elements of the chief medical officer’s challenge to the concept of “wellbeing”: has wellbeing been scientifically defined? Does improving wellbeing prevent mental illness? Is there any robust, peer-reviewed evidence to support a wellbeing “approach” to mental health?Findings Wellbeing is definable provided there is recognition that it has multiple dimensions. At least some of these dimensions relate to health, with most published research focused on personal wellbeing.Originality/value This policy analysis addresses the three questions above, within the context of mental health improvement and training for public mental health. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to relate the health services' prevention imperative to a new priority area, youth suicide.Design/methodology/approach The content is based on the latest UK policy documents and participation in recent events for policy-makers.Findings Suicide among young people is increasing, and traditional approaches are not reducing these deaths. Involving young people as researchers or trainers has been helpful, and policy-makers need to address the present social and cultural risk factors.Research limitations/implications Evidence differs between countries, and a local context may be important.Practical implications In the UK, local profiles are being developed and there is an increasing need identified for relevant training for a wide range of professionals.Social implications The participation of young people in developments may be emancipatory, for all concerned.Originality/value Because this year, young persons' mental health will be an international priority, this may be the time to galvanise action for improved planning and resources for the prevention of youth suicide. [ABSTRACT FROM AUTHOR]

The article discusses the improvement of mental health and wellbeing and the reduction of health inequalities in school children and young people in England.

From a UK Government perspective, most current public health approaches to alcohol focus on the behaviour of individuals (e.g. theNudgetowards changed drinking: Marteau, T.M., Ogilvie, D., Roland, M., Suhrcke, M., & Kelly, M.P. (2011). Judging nudging: can nudging improve population health?BMJ,342, 263–265) and, increasingly, psychiatric approaches focus on adjusting microscopic circuits within the brain of individuals [Caan, W. (2012). Defining addiction, with more humanity.Contemporary Social Science,7. doi: 10.1080/21582041.2012.683577 (published first online 28 May)]. Although it has been apparent for a long time that a major area where alcohol causes harm is within the family and that involving family members in interventions (e.g.Social Behaviour and Network Therapy) is effective in reducing harm, most services for addiction neglect families as either assets or liabilities for treatment [Alcohol Concern. (2000).Britains’ ruin? London: Alcohol Concern; Caan, W. (2000a). Working with families. InWorking with families – making it a reality(p. 102). Birmingham: NHSE West Midlands; Copello, A., & Orford, J. (2002). Addiction and the family: Is it time for services to take notice of the evidence?Addiction,97, 1361–1363]. In the UK, over 6% of adults grew up in a family where at least one parent drank excessively [Alcohol Concern. (2000).Britains’ ruin? London: Alcohol Concern] and since at least 8% of children live now in such homes it is not surprising that I found the extra training staff in Parenting Programmes requested most often was for problems with alcohol [Caan, W. (2010). Fair society, healthy lives. Timing is everything.BMJ,340, 495]. This year we face a turning point:The Government's Alcohol Strategyhas a narrow emphasis on ‘supporting individuals to change’ [HM Government. (2012).The government's alcohol strategy(p. 21). London: Home Office]. This article promotes a more balanced alcohol policy, where understanding family ties and the history and quality of relationships are recognised as important – and valuable. [ABSTRACT FROM AUTHOR]

Objective To determine how often clinical research from doctoral degree programmes is unpublished and to see if one can characterise differences between those researchers who do or do not publish their work or between the institutions where they studied. Design Secondary research with data in the public domain: combining a national dataset of healthcare doctoral theses with related publications traceable in two widely accessible databases. Data sources The Index to Theses was searched for UK doctoral theses and the databases Web of Knowledge and SCOPUS searched by author name for literature derived from each thesis. Confirmatory details about student names or their doctoral programmes were obtained from university websites, if required. Eligibility criteria Search terms were chosen to identify only projects directly related to human health. Thesis records included 'clinical trials' or 'clinical research'. The awards were all doctorate-level degrees between 2000 and 2010. 'Related' publication in the Web of Knowledge or SCOPUS was interpreted very broadly to include publications with any research commonality with the degree project as recorded in the Index to Theses. Results A sample of 82 theses from 39 universities provided the initial material for a literature search. The Web of Knowledge contained more publications from more students than SCOPUS held. Of the doctoral research samples, 39 out of 82 theses (47.6%) produced no discernable publications. The 43 students whose research was published typically began publishing before completing their degree (mean time 1.3 years preceding their award). Not all types of doctorates were associated equally with publication: all 11 MD theses in our sample had related publications (100%). Conclusions Research evidence associated with doctoral degrees is often left unpublished, across many settings. Sharing such evidence is a scientific and ethical duty. Supporting students in publishing preliminary work while they are still in doctoral programmes may be the most productive response. The large number of doctorates awarded in 'medical' disciplines every year represents a substantial investment in training and a resource for evidence- based medicine that should not be squandered. [ABSTRACT FROM AUTHOR]

Dependence on mind-altering chemicals (‘addiction’) is a common, world-wide phenomenon with a long history and implications for health, family stability, economic prosperity and public safety. Currently, a vocal group of clinicians in North America has redefined addiction just in terms of neuroscience, focusing on disordered brain circuitry. Over the centuries, various narrow ‘definitions’ of addiction have not helped save lives or made humanity saner or more resilient. This paper challenges the reduction of a multi-faceted phenomenon to some microscopic pathology in individual addicts. The dependence syndrome combines biological, inter-personal and societal dimensions. Many people affected personally would add trans-personal (e.g. spiritual) and inter-generational (e.g. family system) dimensions to that syndrome. Addiction appears either to grow or to recover within the whole complex milieu that links individuals and their society. [ABSTRACT FROM AUTHOR]

Purpose DS This is an unprecedented period of organisational change in English primary care. The aim of this paper is to draw on findings from the most recent period of rapid change for primary care, with lessons that may have profound implications for the implementation of forthcoming Health Service reforms. Design/methodology/approach DS Front line practitioners from two primary care Trusts were surveyed in terms of their reaction to change and those questionnaire findings were used to design interviews for a cross-section of staff with varied responsibilities. Findings DS General practitioners (GPs) differed from all other staff groups. Most GPs found change unwelcome and stressful, especially if individually they felt they had little influence on an externally imposed re-organisation. They also felt accumulated changes had distanced them from patient care which had been a major motivating factor. Originality/value DS The reforms currently proposed in the NHS and Social Care Bill compel GPs to take on unfamiliar commissioning roles, in new organisational structures. Implementation of the Bill needs to take into consideration the health impact on key medical colleagues, if it ignores the work satisfaction GPs derive from clinical care and the mental health consequences of loss of control over working practice. [ABSTRACT FROM AUTHOR]

Purpose -- This is an unprecedented period of organisational change in English primary care. The aim of this paper is to draw on findings from the most recent period of rapid change for primary care, with lessons that may have profound implications for the implementation of forthcoming Health Service reforms. Design/methodology/approach -- Front line practitioners from two primary care Trusts were surveyed in terms of their reaction to change and those questionnaire findings were used to design interviews for a cross-section of staff with varied responsibilities. Findings -- General practitioners (GPs) differed from all other staff groups. Most GPs found change unwelcome and stressful, especially if individually they felt they had little influence on an externally imposed re-organisation. They also felt accumulated changes had distanced them from patient care which had been a major motivating factor. Originality/value -- The reforms currently proposed in the NHS and Social Care Bill compel GPs to take on unfamiliar commissioning roles, in new organisational structures. Implementation of the Bill needs to take into consideration the health impact on key medical colleagues, if it ignores the work satisfaction GPs derive from clinical care and the mental health consequences of loss of control over working practice. [ABSTRACT FROM AUTHOR]

Purpose -- This paper aims to report on a 12-item measure developed by the authors, which assesses and monitors the wellbeing of employees across an organisation: Wellness at Work (W@W). Design/methodology/approach -- The W@W questionnaire for employees was delivered in parallel with a multi-site survey undertaken by the Health and Safety Executive, during the development of their management standards. This paper reports its testing across a higher education workforce with 552 diverse participants. Findings -- This survey revealed that individuals with low or deteriorating "wellness" gave distinctive responses to questions about their future work, and enabled widespread discussion within the organisation about actions to improve employee wellbeing. Originality/value -- W@W is a practical measure for use in workplace settings. [ABSTRACT FROM AUTHOR]

Background: Mutuality is a feature of many 'self-help groups' for people with mental health and/or substance misuse needs. These groups are diverse in terms of membership, aims, organisation and resources. Collectively, in terms of the pathways for seeking help, support, social capital or simply validation as people, mutual aid groups figure at some time in the life story of many psychiatric and/or substance misuse patients. From the viewpoint of clinical services, relations with such groups range from formal collaboration, through incidental shared care, via indifference, to incomprehension, suspicion, or even hostility. How should mental health and substance misuse clinicians relate to this informal care sector, in practice? Aims: To synthesise knowledge about three aspects of the relationship between psychiatric/substance misuse services and mutual aid groups: profile groups' engagement of people with mental health and/or substance misuse needs at all stages of vulnerability, illness or recovery; characterise patterns of health benefit or harm to patients, where such outcome evidence exists; identify features of mutual aid groups that distinguish them from clinical services. Method: A search of both published and unpublished literature with a focus on reports of psychiatric and substance misuse referral routes and outcomes, compiled for meta-synthesis. Results: Negative outcomes were found occasionally, but in general mutual aid group membership was repeatedly associated with positive benefits. Conclusions: Greater awareness of this resource for mental health and substance misuse fields could enhance practice. [ABSTRACT FROM AUTHOR]

Aims: To examine whether the observed diversity between national patterns of smoking prevalence could require modification of the World Health Organization (WHO) linear model for an international `smoking pandemic' (a worldwide epidemic) to address data from non-western countries.Method: We conducted secondary research using current measures in three publicly available databases: Globalink, the International Labour Organization and the World Bank (all internetaccessible). The measures we used are the separate percentage data for men and women on: smoking and employment and national income per capita (US$) and percentage growth per annum.Results: Regression analysis showed that women smokers were more frequent in countries with higher national income, but women were less likely to smoke in countries of rapid growth. Men were less likely to smoke in countries with higher national income, but more likely to smoke in countries of rapid growth. Two principle components together explained 62% of all the variance in the international data. The largest factor was positively correlated with the percentage of employed females, the percentage of female smokers and national income per capita, but negatively correlated with the percentage of male smokers and percentage annual growth. The effect of female employment was not continuous, but above a threshold of 51%, was associated with a higher prevalence of female smoking. The smaller, second factor was only weakly correlated with any smoking variables.Conclusions: In his 1994 model (subsequently adopted by the WHO) Lopez looked at historical trends in `stages' of smoking prevalence. These have been associated with `stages' of economic development. We extended this analysis to look at a dynamic change (% annual growth) and a social indicator (employment). Male and female smoking is affected differentially by economic change and by level of income. These are also strongly related to the percentage of women in employment. This has implications for workplace policies on smoking. [ABSTRACT FROM PUBLISHER]

Valuing People: A New Strategy for Learning Disability for the 21st Century (Department of Health, 2001a,b) aimed to introduce 'health facilitation' to improve the identification of health needs and access to appropriate care for people with learning disabilities. One London Borough took a leading role in implementing this new function, in the form of dedicated, fun-time health facilitators. The authors examined the implementation and its impact, employing an innovative collaboration between professionals from practice, education and research. The clinical nurse involved was observed during her first year of health facilitation. The authors evaluated her impact on professionals, people with learning disabilities and the wider system of health. In some areas (for example, information technology) the health facilitator could make little progress in one year. However, she connected with a widening circle of local people and services, for example, in introducing health action plans for adults with a learning disability. Across the Borough some professionals became more aware of specific health issues in their local population. [ABSTRACT FROM AUTHOR]

This investigation explored the impact of alcohol on sexual behaviour in relation to the possible increased risk of chlamydia trachomatis. A sample of 208 women were recruited aged 16—24 years who had been tested at a pilot site for the national chlamydia screening programme. This formed a prospective community case series using questionnaires, case note review and focus groups. Eight women took part in the focus group discussions. The questionnaire contained quantitative details of past and present alcohol use (e.g. ‘binge-drinking’) sexual behaviours and partners and beliefs related to chlamydia. The results of chlamydia screening and the answers to a question about having had treatment for chlamydia were grouped in relation to alcohol use. The main findings were that three variables were associated with increased risk of chlamydia. These were age at which they first drank alcohol; number of lifetime partners and alcohol consumed on a ‘heavy’ night by the sub-group who displayed binge-drinking. [ABSTRACT FROM AUTHOR]

Widespread effects are reported on UK economic productivity through poorly managed depressive illness in the workplace. Starting in 1999, the authors have investigated the onset, treatment and recovery from depression as experienced personally by members of the caring professions, using first-hand accounts to generate a composite picture of 'what works for me' in managing depression, and in particular 'what works' in maintaining or returning to employment in health and social care. This paper reports findings from a survey of 500 social workers. Negative perceptions of previous help from professional sources (such as general practitioner, psychiatrist or psychotherapist) were related specifically to three persisting, negative effects at work: lack of concentration, low confidence, and irritability (with tiredness).These occupational effects were strongly associated with each other. In relation to occupational health, inadequate treatment of depression may allow these negative effects on performance to persist. The findings are discussed in relation to conceptual frameworks about well-being taken from 'positive psychology' that suggest future approaches to both prevention and rehabilitation of these occupational problems. [ABSTRACT FROM AUTHOR]

This paper describes the development of an innovative interprofessional doctorate in health and social care, within an academic framework designed explicitly to ensure that candidates must demonstrate qualities of cognitive application commensurate with doctoral study, yet must also meet the practice-focused outcomes of a professional doctorate. The degree requires students to attend highly interactive workshops in Stage 1 that encourage academic debate and 'doctoral' development, in contrast to the 'taught' modular elements of many other professional doctorates. Papers submitted during Stage 1 assume increasing levels of complex doctoral skills in developing a research proposal that undergoes the same rigorous evaluation required of PhD students in securing University Approval. The degree is awarded at the end of Stage 2 only after defence of a thesis in a viva voce examination that involves procedures and processes defined by the University for the award of PhD. [ABSTRACT FROM AUTHOR]

Rationale:Doctoral training should provide insight into the evolution of research capability in nursing.Methods:Research designs were evaluated from abstracts of 204 theses extracted from the ASLIB database, 1983–2002. Most were from PhD/DPhil degrees, but a few were Professional Doctorates.Findings:‘Educational’ and ‘organisational’ settings dominated, indicating their sustained popularity. A total of 11 methodological frameworks were noted, with ‘Ethnography’, ‘Social history’, ‘Work environment’ and ‘Grounded theory’ being the most popular. ‘Interviews’ with individuals and ‘Questionnaire survey’ were easily the most popular of 28 different research tools/techniques.Comparing abstracts from 1997–2002 with those from 1983–1996 identified significant changes in methodologies and methods used. The frequency of ‘Phenomenology’, ‘Work environment’ and ‘Grounded theory’ methodologies increased. The ‘Patient led’ framework appeared for the first time, albeit in just a few theses. The incidence of ‘Ethnography’ declined. Some methods only appeared for the first time during the 1990s, e.g. ‘Focus groups’. Of the methods, ‘Interviews’ increased substantially but ‘Questionnaires’ decreased slightly. In terms of developing clinical research, we noted an increased frequency of ‘All experimental’ methods. Multiple methods, used in 71% of theses overall, increased in incidence during the late 1990s, a change that was significantly associated with ‘post-1992’ universities. Over time, there was a significant increase in the number of methodologies and methods used, per thesis.Conclusions:This study documents the breadth of research designs used by students researching nursing. It provides evidence for an evolution of designs with an increasing diversity that indicates a growing maturity of nursing research culture. [ABSTRACT FROM PUBLISHER]

Purpose – The purpose of this paper is to investigate the claim by the Chief Medical Officer for England that “There is virtually no robust, peer-reviewed evidence to support a ‘well-being’ approach to mental health”. Design/methodology/approach – Secondary research using research literature from two widely available databases, Scopus and Applied Social Sciences Index and Abstracts. Randomised controlled trials were sought that focused on “well-being” (including well-being or wellness), from 2004 to the present. Findings – With both clinical samples and non-clinical populations, a variety of experimental trials were found. Studies were identified with both positive benefits and no benefits from intervention. The most numerous type of paper reported positive benefits for clinical patients. Research limitations/implications – Only a single reader classified the studies in this investigation, so the inter-rater reliability may be limited. Only two databases were searched. However, future work (such as that in progress by the What Works Centre for Wellbeing) may find an abundance of evidence on mental well-being. Practical implications – In many settings, well-being can improve after intervention. Social implications – What is measured as “well-being” may need to take into account the perspective of the specific population being studied. Originality/value – This small-scale study was undertaken to inform policy in the new Public Mental Health Network. [ABSTRACT FROM AUTHOR]

Examines the efficacy of using readmission rates as indicators of outcome in comparing psychiatric services. Admission rates and intervals to readmission for four types of patients, grouped by diagnoses.

Background: The study aimed to identify, classify and measure the relative frequency of events preceding violent incidents in psychiatric hospitals.Method: Possible antecedents for 1000 incidents in three associated psychiatric hospitals over 13 months were investigated with an 'untoward incident database'.Results: From eyewitness accounts, 921 incidents (92%) could be related to one of 15 categories of antecedent involving characteristics of the patient, or of the hospital regime, or interactions with other individuals. Overall, the most common antecedents involved patients who were generally agitated or disturbed (286), restrictions on patients associated with the routine hospital regime (192) or provocation by other patients, relatives or visitors (175). Incidents arising from staff members initiating contact with patients were very rare (7). Twenty-one patients were involved in 10 or more incidents, including 19 (90%) who were detained under the Mental Health Act. These patients were more likely to commit assaults after certain antecedents (self-harm, absconding or arson) which were serious incidents in themselves.Conclusions: Staff training on specific safety issues will be needed under the new Management of Health and Safety at Work Regulations. [ABSTRACT FROM AUTHOR]

More than 100 years after Freud's original endorsement of the drug, the use of cocaine is a problem for both users and for society, which struggles to organise effective responses to the epidemic of the last decade. During the 1980s the rapid spread of smokeable cocaine (including 'crack') was seen in the Americas (particularly the US). The initial simple predictions of an identical European epidemic were mistaken. The available data on the extent of cocaine use and of cocaine problems in the UK are examined. New forms of cocaine have been developed by black-market entrepreneurs ('freebase' and 'crack'), and new technologies have emerged for their use; with these new technologies have come new effects and new problems. The general psychiatrist now needs a knowledge of directly and indirectly related psychopathology which has an increasing relevance to the diagnosis and management of the younger patient. [ABSTRACT FROM AUTHOR]

Editorial. Focuses on the inadequacy of research conducted in primary mental health care. Three areas where researching problems lie; International developments on research.

Focuses on the project management for mental health projects. Common deficiencies of mental health project; Requirements of project management; Two prerequisites for a successful project management.

Editorial. Focuses on health benefit groups (HBGs) and their role in the mental health care system of Great Britain. National Casemix Office's purposes in developing HBGs; Differences of HBGs with Health Resource Groups; Benefits of HBGs for primary mental health patients; Financial constraints to the commissioning of mental health services in the country; Role of efficient clinicians in the success of HBGs.

The importance of assessing the user's view of services is rapidly becoming a central concern for both purchasers and providers of mental health services. We conducted a questionnaire interview study of day hospital attenders in 1992 and 1993. The reasons for attendance, satisfaction with this service, links with alternative community services and the evaluation of groups within the day hospital setting were investigated. Social factors were the most important reasons for attendance. Overall, satisfaction was very high, although specific areas demonstrated improvements between the 1992 and 1993 surveys. Consistently positive views of self-selecting groups, of all sizes, were reported. In contrast, few attenders received significant support from other care agencies. Users' views may need to be compared with other measures and across other settings. However, this study has implications for research into care management and into the therapeutic process in day care. [ABSTRACT FROM AUTHOR]

By protecting vulnerable people from poverty and debt, welfare systems can be powerful tools for promoting mental health. However, the details of how welfare systems are implemented determine whether they also cause harm. Here, we review evidence and principles that might guide the development of mental health-promoting welfare systems. [ABSTRACT FROM AUTHOR]