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Journal article

The UK drugs strategy 2017: contexts and analysis

Author:
STOTHARD Blaine
Journal article citation:
Drugs and Alcohol Today, 17(4), 2017, pp.205-217.
Publisher:
Emerald

Purpose: The purpose of this paper is to examine the content of the strategy and assess its claims to be evidence based. Design/methodology/approach: This study is a close-reading of the text with commentary on specific content and reference to wider contexts. Findings: The strategy makes use of evidence in its sections on treatment. Much evidence, including that of the UK ACMD, is dismissed or ignored. The issue of funding in times of austerity is not considered in the strategy. The range and complexity of drug use and users are not fully considered. Research limitations/implications: The strategy can be seen as an idealised ambition with little basis in reality without funding to support its aims. Social implications: There is no consideration of the impact of macro-economic policy on the extent of drug misuse. Originality/value: Other commentaries on the strategy are emerging. This paper is a more extensive consideration than has so far appeared. (Publisher abstract)

Journal article

Using Photovoice as a method to engage bereaved adults with intellectual disabilities in research: listening, learning and developing good practice principles

Authors:
TAJURIA Gulshan, READ Sue, PRIEST Helena M.
Journal article citation:
Advances in Mental Health and Intellectual Disabilities, 11(5/6), 2017, pp.196-206.
Publisher:
Emerald

Purpose: People with intellectual disabilities experiencing loss or bereavement are at risk of developing additional mental health problems, and may struggle to access suitable support. The purpose of this paper is to present the adaptations done while using Photovoice as a creative method for bereaved people with intellectual disabilities participating in a research exploring loss and support. This paper will further briefly add information on how the use of Photovoice supported the development of whole research project. Design/methodology/approach: This paper explores the use of Photovoice as a method of research engagement for bereaved adults with intellectual disabilities. Photovoice enables participants to take and discuss photographs illustrating their loss and support experiences. The paper focusses on a preparatory Photovoice workshop with the research participants, outlining the processes and activities used to maximise involvement, promote learning and achieve shared understanding. Findings: Preparation was the key to the effectiveness of this workshop and it recommends that appropriate adaptions are useful in Photovoice with adults with intellectual disabilities effectively. The paper outlines principles of good practice for using Photovoice in this research context, which may transfer to other similar research settings. Using Photovoice facilitated later one-to-one interviews with the participants, where their photographs were discussed together. Originality/value: This paper illustrates the innovative use of Photovoice methodology in research involving bereaved people with intellectual disabilities. Photovoice has not previously been used with this specific population within the bereavement and loss context, so this paper adds to the developing evidence base. (Publisher abstract)

Journal article

Revealing the training on intellectual and developmental disabilities among forensic mental health professionals: a survey report

Journal article citation:
Journal of Intellectual Disabilities and Offending Behaviour, 8(4), 2017, pp.176--87.
Publisher:
Emerald

Purpose: The purpose of this paper is to assess the training forensic mental health professionals in the USA receive on intellectual and developmental disabilities (I/DD). Given the difficulties obtaining accurate prevalence rates of these disabilities in criminal justice settings, it is important to understand how these disabilities are being evaluated and the level of understanding about these disabilities evaluators hold. Design/methodology/approach: An online survey was distributed to forensic mental health professionals in the USA that included questions on training opportunities in graduate education, post-graduate forensic training, and professional training opportunities. Participants were also asked about their current work, how they assess I/DD, and their estimates on the percentage of cases they see with I/DD. Findings: Respondents reported some training that focused heavily on assessment methods. Most respondents estimated between 5 and 25 percent of their cases involving I/DD and reported using a wide range of assessment methods. Finally, many respondents reporting more training needed in this area. Practical implications: More training is needed for forensic mental health professionals on identifying I/DD. Additionally, professional guidelines on what tools and methods to rely on to identify these disabilities is paramount to ensure homogeneity of methods and, thus, better estimates of overall prevalence in criminal justice settings. Originality/value: This is the first assessment focused on how forensic mental health professionals are trained to identify I/DD and can be used to improve identification of I/DD in forensic settings. (Publisher abstract)

Journal article

Incompatibilities and seclusion of patients with an autism spectrum disorder detained in high-secure psychiatric care

Authors:
MURPHY David, BUSH Emma-Louise, PUZZO Ignazio
Journal article citation:
Journal of Intellectual Disabilities and Offending Behaviour, 8(4), 2017, pp.188-200.
Publisher:
Emerald

Purpose: Whilst individuals with an autism spectrum disorder (ASD) represent a relatively small proportion of patients detained in high-secure psychiatric care (HSPC), previous research suggests that such individuals present with difficulties and needs significantly different from non-ASD patient groups. However, to date, there has not been any formal examination of how individuals with an ASD are represented in records of key risk management actions (i.e. seclusions and incompatibilities with other patients). The paper aims to discuss these issues. Design/methodology/approach: An observation of hospital data examining two key risk management actions for a group of individuals with an ASD is detained in one HSPC hospital. These include the number of formal incompatibilities with other patients and the number of, and hours in, seclusion. Both actions require extra staff and security provisions and can decelerate the rehabilitation and recovery process. Findings: In addition to suggesting an overall increase in the general prevalence of ASD within the hospital compared to previous estimates, individuals with an ASD appear to have a disproportionately higher number of incompatibilities with other patients compared to those patients without an ASD and experience more and longer periods of seclusions. Originality/value: Although the methodological limitations of the study are acknowledged, explanations for the findings are discussed along with future research and recommendations as to how ASD patients might be best managed in the hospital. It is argued that the findings add further support for a specialist ASD service within HSPC. (Publisher abstract)

Journal article

Football teams for people with intellectual disabilities living in the community: “it helps your self-esteem and that, don’t it?”

Author:
WHITE Rose
Journal article citation:
Journal of Intellectual Disabilities and Offending Behaviour, 8(4), 2017, pp.201-211.
Publisher:
Emerald

Purpose: People with intellectual disabilities (ID) can be vulnerable to developing mental health problems. It has been found that participating in regular exercise can help to improve emotional well-being, both in typically developing people and those with ID. The purpose of this paper is to investigate the experiences of community clients with ID who have engaged in a football training programme, and the perceived impacts on attitudes, mood and behaviour. Design/methodology/approach: Interviews with seven patients from generic or forensic community ID services were conducted. The transcripts were analysed using interpretative phenomenological analysis. Findings: Two master themes were identified from the interviews, “Striving” and “Togetherness”. Originality/value: The most important factors related to taking part in the football programme were the social, emotional and personal growth associated with being part of a team and general enjoyment of being part of something. Although aspects of football knowledge and physical fitness were still evident, their impact seemed to be less significant. The experience of football was overwhelmingly positive. (Publisher abstract)

Journal article

A review of the pharmacological management of sexually offending behaviour in learning disabled offenders

Authors:
SLOAN Stephanie, BREWSTER Eleanor
Journal article citation:
Journal of Intellectual Disabilities and Offending Behaviour, 8(4), 2017, pp.166-175.
Publisher:
Emerald

Purpose: The management of sexual offending is a major challenge, particularly in men who have an intellectual disability. Psychological therapies have been shown beneficial, and programmes designed for use in the general population have been adapted for use in offenders who have an intellectual disability. There is also a role for pharmacological management, although the quality of evidence for this is noticeably lacking, most likely associated with the ethical and legal issues encountered in conducting well designed and controlled trials in this area. The purpose of this paper is to look at the pharmacological management options available. Design/methodology/approach: A literature search of electronic databases was undertaken. Additionally, the references lists for identified papers were examined for any further relevant publications. Findings: The two main categories of drugs used in the management of inappropriate sexual behaviour are the testosterone-lowering drugs and the psychotropic drugs. Most trials were open and utilised self-report measures of drug effectiveness, limiting their usefulness. Most trials noted beneficial effect. Side effect profiles and patient adherence can limit the effectiveness of anti-libidinal medication in practice. Originality/value: There is very limited evidence available for the use of pharmacological agents in the management of inappropriate sexual behaviour, owing to the lack of adequately controlled clinical trials. New studies are therefore required, particularly of larger sample sizes, longer durations, and examining characteristics of those who benefit from pharmacological treatment, although the ethical issues of conducting such studies is duly acknowledged. (Publisher abstract)

Journal article

A critical review of current police training and policy for autism spectrum disorder

Author:
HEPWORTH Diana
Journal article citation:
Journal of Intellectual Disabilities and Offending Behaviour, 8(4), 2017, pp.212-222.
Publisher:
Emerald

Purpose: The purpose of this paper is to critically review the current police training and criminal justice policy regarding the treatment of suspects with autism spectrum disorder (ASD) during the initial stages of the criminal justice system (CJS), and provide potential policy reform and areas for further research. Design/methodology/approach: By reviewing extant literature, research and policy documents, this paper provides a critical review of the current policy and training for dealing with suspects with ASD in the current CJS in England and Wales for suspects with ASD. Findings: This paper proposes that current policy and police staff training is insufficient during all initial stages of the criminal justice process. Although there are emerging policies and schemes which are promising, they require further research and national participation. Policy reform and improved training is required to ensure minimal opportunities for miscarriages of justice to those individuals with ASD. Originality/value: This paper provides a chronological journey through the initial stages of the CJS in England and Wales for a suspect with ASD, and the challenges that they may face. Suggestions are made based on criminological and psychological research to remedy the potential opportunities for miscarriages of justice. (Publisher abstract)

Journal article

What makes a nursing home a home? Insights from family members and friends

Authors:
WEEKS Lori, CHAMBERLAIN Stephanie, KEEFE Janice
Journal article citation:
Housing Care and Support, 20(4), 2017, pp.152-163.
Publisher:
Emerald

Purpose: The purpose of this paper is to explore the concept of homelikeness from the perspective of family members and friends of nursing home residents across different models of nursing homes. Design/methodology/approach: This mixed-methods study examined survey data collected from 397 family members and friends of residents living in 23 nursing homes representing three models of care (traditional, new augmented, and full scope). Participants completed a homelikeness scale and a measure of the importance of nursing home spaces to family members and friends. This study also involved conducting three focus groups with 20 family members and friends to provide further insights into the findings. Findings: Analysis of survey data indicated quite high levels of homelikeness overall. Significant differences did emerge between traditional model nursing homes compared to new full-scope and new augmented models for all items in the homelikeness scale and for many items about nursing home spaces. Qualitative results provided insights into how homelikeness can be fostered through public and private spaces and through care and relationships. Research limitations/implications: As this study was conducted in one Canadian province, the results may not be applicable to other geographic areas. In addition, there are limitations in survey response rate. Practical implications: Homelikeness can be supported across models of care by fostering relationships between residents and staff, ensuring that that family and friends feel welcome, and creating public and private physical spaces that are conducive to new and ongoing relationships. Originality/value: The results provide evidence to nursing home decision makers about how to foster a homelike environment in various models of nursing homes. (Publisher abstract)

Journal article

Rapid rehousing of formerly homeless jail and prison inmates

Authors:
HIGNITE Lance R., HAFF Darlene R.
Journal article citation:
Housing Care and Support, 20(4), 2017, pp.137-151.
Publisher:
Emerald

Purpose: The purpose of this paper is to assess the programmatic effectiveness of a post-incarceration support service, Jail In-Reach, to rapidly and permanently re-house newly released offenders with a documented history of homelessness, substance abuse and mental health disorders. Design/methodology/approach: Data were obtained from SEARCH Homeless Services using the Adult Texas Recommended Assessment Guidelines survey instrument by the Texas Department of State Health Services. Repeated measures analysis of variance were performed to determine the effects of select predictors on the likelihood of permanent housing, which, for this research, is considered programmatic success. Findings: Results indicate clients exhibited decreased risks of self-harm, employment problems, housing instability, co-occurring substance use, and criminal justice involvement as well as increased social support. Over half of the program participants either disappeared from the program or only secured temporary housing. Research limitations/implications: This was a small pilot project with limited generalizability. There have been no follow-up studies to examine long term permanent housing success. No data were available as to why participants dropped out of the program. Practical implications: Intensive advocacy and support services provided pre- and post-institutional release could provide formerly homeless inmates with co-occurring substance abuse and mental health issues with positive outcomes. Social implications: Housing stability and connections to social service agencies are key factors for ensuring ex-offenders do not become re-incarcerated. Originality/value: This paper contributes to the literature related to reducing homelessness among ex-offenders, to the effectiveness of critical time intervention-based programming, and the need for building social capital amongst this unique and underserved population. (Publisher abstract)

Journal article

Multidisciplinary attitudes to people with dementia; training and environmental factors play a role in caring for people with dementia in a Cardiac Catheterisation Laboratory

Authors:
AINSWORTH Karen, RICHARDSON Cliff
Journal article citation:
Quality in Ageing and Older Adults, 18(4), 2017, pp.235-245.
Publisher:
Emerald

Purpose: The purpose of this paper is to explore multidisciplinary attitudes and environmental factors affecting dementia care in the Cardiac Catheter Laboratory (CCL). Design/methodology/approach: Questionnaires (n=87) were distributed in a hospital CCL in the North of England. The authors utilised the Dementia Attitudes Scale which incorporates two subscales: Social Comfort and Dementia Knowledge. In addition, a newly devised questionnaire asking about perceptions of how the CCL environment affected care of patients with dementia was added. Findings: The response rate was 71 per cent (n=62). Years’ experience in the CCL was associated with lower Social Comfort scores. Dementia training was associated with higher mean Dementia Attitudes Scale and Social Comfort scores. Participants who had undertaken “Professional studies” had higher Dementia Attitudes Scale and Dementia Knowledge mean scores but “On-the-job” training was perceived as most beneficial. Unit co-ordinators and nurses felt the CCL was an unfavourable environment for patients with dementia. Care was perceived to be impaired by environmental functionality, equipment and the presence of ionising radiation. Research limitations/implications: The small sample limits generalisability. Although the Dementia Attitudes Scale is a validated questionnaire it has not been widely used so reliability of these results is unclear. Practical implications: Caring for patients with dementia has unique challenges especially in areas like the CCL. These results suggest that practical experience and training can affect the perception of staff to patients with dementia hence there may be a need to assess what would be the most appropriate training to give health professionals in the future. Originality/value: The authors believe this to be the first multi-professional research study into care of patients with dementia in a specialised acute unit. This was the most diverse sample known to have attitudes to dementia measured quantitatively in an acute hospital department and the results need to be replicated before practice should be changed. (Edited publisher abstract)

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