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Why you should read this article: • To understand the complexity of the needs of people with delirium superimposed on dementia • To enhance your knowledge of second-generation activity theory • To recognise the consequences of the separation of physical health and mental healthcare. Background: Delirium superimposed on dementia (DSD) affects the physical, mental and cognitive well-being of the person. The separation of physical health and mental health means that the care of people with DSD is at odds with the multifaceted aetiology and presentation of the condition. There is a lack of research on DSD from a mental health perspective. Aim: To explore UK mental health nurses’ experiences of providing care for people with DSD. Method: Individual semi-structured interviews were conducted with seven mental health nurses from one NHS trust in England. Participants’ experiences were considered through the lens of second-generation activity theory. Data were analysed using framework analysis. Findings: Six themes were identified: awareness of guidance and tools; guidance or tools as ‘paper exercises’; knowing the patient; the multidisciplinary team; care burden; and mental health versus physical health. Conclusion: When providing care for people with DSD, mental health nurses use their skills in knowing patients as individuals. However, this aspect of ‘knowing’ cannot be readily translated into the use of a numerical scoring tool. An integrated approach is required to support the care of people with DSD. [ABSTRACT FROM AUTHOR]

The research available on the use of positive risk-taking in clinical practice is surprisingly limited. The purpose of this article is to highlight the limitations and make recommendations about how risk-taking could shape future practice in mental health services. A search of databases including CINAHL and PsycINFO for papers that included the keywords recovery, risk management, positive risk-taking and risk management found that mental health practitioners were keen to promote positive risk-taking with patients to enable their recovery. Barriers to this included a culture of blame should a negative outcome arise, and the need for more support and guidance from management. As positive risk-taking has been shown to be an important part of successful recovery, there is a need for more research to support its application in clinical practice. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To learn about the differences between psychiatric intensive care, low secure and locked rehabilitation units • To understand how service provision in psychiatric intensive care, low secure and locked rehabilitation units has changed since 2006 • To gather information on the types of interventions offered by the different psychiatric intensive care facilities Psychiatric intensive care can take place in a variety of settings, including psychiatric intensive care units (PICUs), low secure units (LSUs) and locked rehabilitation units (LRUs). These units have a range of referral, admission and discharge care pathways, staffing profiles and core interventions. The aim of this service evaluation was to compare present provision in PICUs and LSUs with results from the first national survey of PICUs and LSUs in 2006. The service evaluation also aimed to define the role of LRUs. The authors used a cross-sectional, 'census day' questionnaire with six-month follow-up design. Overall, 111 NHS units participated in the evaluation. Results included that PICUs were smaller and usually had a mixed-sex distribution of service users; LSUs mostly comprised single-sex facilities; and LRUs mostly comprised single-sex units with a significantly longer mean length of stay than the other types of unit. PICUs primarily cared for service users exhibiting acute behavioural disturbance, first-episode psychosis or psychotic crisis and, compared with the other types of unit, more often used high-dose medication and electroconvulsive therapy. [ABSTRACT FROM AUTHOR]

The article reports on an approach introduced by Barnet, Enfield and Haringey Mental Health National Health Service Trust in London, England known as the enablement programme to improve outcomes for people needing to improve their mental well-being.

The article explores the effectiveness of the adopted practice of zero tolerance by the British National Health Service (NHS) as a strategy to tackle violence against healthcare workers in London, England. It evaluates and determines the critical failures in the implementation of zero tolerance. It also probes on the apparent reasons behind the adoption of the NHS in England.

An introduction to the journal is presented about the National Health Service (NHS) Mental Health Implementation Plan 2019/20-2023/24, with topics mentioned such as NHS England, Royal College of Nursing (RCN), and RCN mental health forum chairperson Ed Freshwater.

The NHS in England and Wales is facing a tough winter, no matter what the weather will be. But the situation is going to be especially challenging this year because there are 7,600 nursing and midwifery vacancies in mental health services, which equates to one in ten posts being unfilled. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including mental health care in Great Britain, suicide prevention conferences, and smoking cessation.

An introduction is presented in which the editor discusses an article within the issue concerning the shortage of hospital beds at mental health service institutions in Great Britain.

The article reports on the call for experts on mental health to help the British National Institute for Health and Care Excellence (NICE) in producing a guidance on safe nurse staffing levels in 2015.

The article reports on a petition by mental health nursing student Beth Byrom in 2015 to call for British politicians' commitment to protect the National Health Service (NHS).