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Purpose Team formulation, used to understand patient problems and plan care, is a growing practice in adult mental health and learning disability services. The purpose of this paper is to explore definitions applied to team formulation (as distinct to therapy formulation), its underpinning theories, and the inter-relationship between the team and the process of formulation.Design/methodology/approach A database search (main search term of team formulation) of peer-reviewed studies was conducted using PRISMA guidelines. A main and second reviewer conducted quality appraisals and thematic analysis. Data were analysed by convergent qualitative synthesis design using thematic analysis to transform evidence from quantitative and qualitative studies into qualitative findings.Findings Initial searching produced 4,532 papers, 10 of which were eligible for inclusion. Team formulation has no distinct definition. Theories underpinning the practice of therapy formulation emanating from general psychological theory underpin team formulation. Seven studies applied psychological theories to the examination of team formulation. No studies examined the impact of the team on the formulation. Six themes were generated regarding the impact of team formulation on the team; "increased knowledge and understanding", "altered perceptions, leading to altered relationships, feelings and behaviours", "space to reflect", "useful when stuck or challenged", "perceived increase in effectiveness" and "improved team working".Research limitations/implications Limited evidence and variable quality compromised the availability of review evidence.Originality/value This is the first review to examine team formulation through the context of the team. The authors argue that a conceptual framework to encompass team inputs, processes and outputs in team formulation practice should guide future research. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to outline the historical background and policy context of mental health services for people with intellectual disability (ID) in Ireland. It then considers recent implementation and lessons from the Irish experience.Design/methodology/approach The policy background and research literature relevant to the development of mental health services for people with ID in Ireland was reviewed and discussed.Findings Mental health services in Ireland remain in a state of change, moving towards the implementation of specialist multi-disciplinary teams in the community, alongside previous models of care and service.Research limitations/implications This paper summarises recent advances and research regarding mental health services for people with ID in Ireland.Practical implications The paper illustrates the process of delivering changes to mental health services with practical implications for mental health services internationally.Originality/value This is the first paper in many years to summarise the development of mental health services for people with ID in Ireland. There has been considerable recent change and it is therefore important to provide a useful reference for the current status of services. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to describe the barriers and facilitators to an effective transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It also presents a new entry into considering how the transition can be improved.Design/methodology/approach Insights into the transition from CAMHS to AMHS were gathered through eight semi-structured interviews with mental health professionals. Two methods of data analysis were employed to explore the emerging themes in the data and the observed deficit approach to organisational development.Findings The findings identified a vast volume of barriers in comparison to facilitators to the transition. Adolescents who transition from CAMHS to AMHS initially experience difficulty adapting to the differences in the services due to the short duration of the transition period. However, despite the established barriers to the transition, adolescents tend to adapt to the differences between the services. Findings also showed a negative framing towards the transition amongst the mental health professionals which resembles a deficit approach to organisational development.Originality/value This paper explores mental health professionals’ perspectives regarding the transition in Dumfries and Galloway, Scotland. The transition is increasingly recognised as an area in health care that requires improvement. This research provides a new way to consider the transition by exploring the perceived deficit approach to organisational development in the services. [ABSTRACT FROM AUTHOR]

Purpose Music therapy programs are increasingly common and necessary in mental health services. However, there is little knowledge of the key factors which influence the successful implementation of new therapeutic programs. The purpose of this paper is to explore how stakeholder input influenced the implementation and sustainability of a new music therapy program in four services within a large government funded mental health department in Melbourne, Australia.Design/methodology/approach For a period of 12 months, two cycles of assessment, action and evaluation were conducted where data were collected through interviews with staff members, feedback from consumers and attendance in sessions.Findings A number of influential factors were identified as important in the successful implementation and future sustainability of the music therapy program. These included: the degree of staff support received; how the program was structured and facilitated; promotion of the program within the service; evaluation of the program; and congruence with the existing therapeutic program.Research limitations/implications Results suggest that successful implementation and future sustainability of a music therapy program is dependent on the flexibility of the program to the context and culture of the existing setting.Originality/value This is the first study to incorporate contributions from stakeholders in the implementation of a new music therapy program in a mental health service. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to systematically appraise the effect of use of interpreters for mental health problems in old age. The primary objective of the review is to assess the impact of a language barrier for assessment and management in relation to mental health problems in the old age. The secondary objectives are to assess the effect of the use of interpreters on patient satisfaction and quality of care, identify good practice and make recommendations for research and practice in the old age mental health. Design/methodology/approach -- The following data sources were searched for publications between 1966 and 2011: PubMed, PsycINFO, CINAHL and Cochrane Library. The authors found in previous reviews that a substantial number of papers from developing and non-English speaking countries are published in journals not indexed in mainstream databases, and devised a search strategy using Google which identified a number of papers, which could not be found when the search was limited to scientific data bases only (Farooq et al., 2009). The strategy was considered especially important for this review which focuses on communication across many different languages. Thus, the authors conducted a search of the World Wide Web using Google Scholar, employing the search term Medical Interpreters and Mental Health. The search included literature in all languages. The authors also searched the reference lists of included and excluded studies for additional relevant papers. Bibliographies of systematic review articles published in the last five years were also examined to identify pertinent studies. Findings -- Only four publications related specifically to "old age" and 33 addressed "interpreting" and "psychiatry" generally. Four articles presented original research (Parnes and Westfall, 2003; Hasset and George, 2002; Sadavoy et al., 2004; Van de Mieroop et al., 2012). One article (Shah, 1997) reports an "anecdotal descriptive account" of interviewing elderly people from ethnic backgrounds in a psychogeriatric service in Melbourne and does not report any data. Therefore, only four papers met the inclusion and exclusion criteria and present original research in the field of "old age", "psychiatry" and "interpreting". None of these papers present UK-based research. One is a quantitative study from Australia (Hasset and George, 2002), the second is a qualitative study from Canada (Sadavoy et al., 2004), in the third paper Van de Mieroop et al. (2012) describe community interpreting in a Belgian old home and the final paper is an American case study (Parnes and Westfall, 2003). Practical implications -- Interviewing older patients for constructs like cognitive function and decision-making capacity through interpreters can pose significant clinical and legal problems. There is urgent need for training mental health professionals for developing skills to overcome the language barrier and for interpreters to be trained for work in psychogeriatrics. Social implications -- The literature on working through interpreters is limited to a few empirical studies. This has serious consequences for service users such as lack of trust in services, clinical errors and neglect of human rights. Further studies are needed to understand the extent of problem and how effective interpreting and translating services can be provided in the routine clinical practice. It is also essential to develop a standard of translation services in mental health that can be measured for their quality and also efficiency. At present such a quality standard is not available in the UK, unlike Sweden (see www.regeringen.se/sb/d/3288/a/19564). This omission is disturbing -- especially when decisions on human rights are being considered as part of the Mental Health Act. Such a standard can best be achieved by collaboration between medical profession and linguists' professional associations (Cambridge et al., 2012). Originality/value -- Whilst translation/interpretation has been addressed more generally in mental health: specific considerations related to old age psychiatry are almost absent. This needs urgent rectification given that a large proportion of older people from BME communities will require translation and interpretation services. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to present a qualitative analysis of the facilitators of recovery in in-patient psychiatric rehabilitation from the service users' perspective. Design/methodology/approach -- Interviews with 31 in-patients were coded and analysed thematically at an interpretive level using an inductive approach. Findings -- The dominant themes identified were hope, agency, relationships and opportunity. Totally, 20 subthemes were identified. Agency was more important to men than women and agency, hope and relationships were all more important to detained patients. Research limitations/implications -- Interview data were collected in writing rather than taped. The results may not be transferrable to patient populations with significantly different demographic or service factors. Practical implications -- Services need to target interventions at the areas identified by service users as important in their recovery. The findings suggest both environmental and relational aspects of care that may optimise recovery. Services also need to be able to measure the quality of the care they provide. A brief, culturally valid and psychometrically assessed instrument for measuring the recovery orientation of services is required. Originality/value -- As far as the authors are aware no qualitative work to date has examined the recovery experiences of psychiatric rehabilitation in-patient service users in order to understand what services require to do to enable recovery from their perspective. The conceptual framework identified in this paper can be used to develop a service user self-report measure of the recovery orientation of services. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to critically discuss how the psy-sciences have been, and continue to be, typified by some critics, as colonizers and are credited with Imperialistic motivations. However, rarely are these critiques developed beyond a pejorative characterisation. Design/methodology/approach -- This paper reviews the criticisms of psychiatry as colonial and outlines the tensions in taking different frames of reference in the mental health field, before going on to suggest theoretical and research perspectives arising from postcolonial theory that might advance these critical positions more coherently and the implications of doing so. Findings -- This study suggests an engagement with humanities-based methods and fields such as postcolonial scholarship. Social implications -- This argument is timely, especially given recent controversies over the publication of DSM5, the scaling up agenda for mental health in the Global South and increased attention to the agenda of Big Pharma. Originality/value -- Postcolonial intersections with psy-science remains a relatively undeveloped area in the critical literature. [ABSTRACT FROM AUTHOR]

Purpose Interactions between individuals experiencing mental health (MH) problems and the police are complex and may affect the way in which both parties react to and experience the interactions. The purpose of this paper is to examine three commonly used interventions to improve these interactions.Design/methodology/approach Mixed methods were used to examine embedded MH professionals in command and control rooms, Liaison and Diversion Teams and Street Triage. The authors also reviewed the use of Section 136 (s136) of the Mental Health Act 1983 (2007) during the period these interventions were deployed.Findings There was strong support for these interventions but also gaps, resource and operational issues that need to be addressed if they are to have optimal effect on delivering appropriate diversion from the justice system, reduce reoffending and improve MH outcomes for individuals. The use of s136 remained relatively constant.Originality/value Despite a recent increase in the level of investment related to these interventions the evidence base remains limited. This study provides baseline of research evidence for those who commission and provide services for individuals experiencing mental ill health and who are in contact with the justice system. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to present a qualitative analysis of the role of self-harm self-help groups from the perspective of group members.Design/methodology/approach A qualitative case study approach guided the research, which involved working with two self-harm self-help groups and all regularly attending members.Findings A thematic approach to the analysis of the findings indicates that self-harm self-help groups can provide a safe, non-judgemental space where those who self-harm can meet, listen and talk to others who share similar experiences for reciprocal peer support. Offering a different approach to that experienced in statutory services, the groups reduced members’ isolation and offered opportunities for learning and findings ways to lessen and better manage their self-harm.Research limitations/implications This was a small-scale qualitative study, hence it is not possible to generalise the findings to all self-harm self-help groups.Practical implications The value of peers supporting one another, as a means of aiding recovery and improving well-being, has gained credence in recent years, but remains limited for those who self-harm. The findings from this research highlight the value of self-help groups in providing opportunities for peer support and the facilitative role practitioners can play in the development of self-harm self-help groups.Originality/value Self-harm self-help groups remain an underexplored area, despite such groups being identified as a valuable source of support by its members. This research provides empirical evidence, at an individual and group level, into the unique role of self-harm self-help groups. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to report an analysis of arrangements in English mental health trusts to meet the needs of adult service users who are homeless. Homelessness is associated with various forms of mental ill-health, yet homeless people are not always well-served by statutory mental health services. In recent years, practice guidance seeking to improve health outcomes for the homeless has emphasised the need for NHS services to improve care pathways and professional provision for this service user group, in part by collaborating more closely with homelessness organisations.Design/methodology/approach Responses to freedom of information requests sent to trusts were analysed. The requests asked trusts for information concerning partnerships with external agencies, particular projects/staff, training available to trust professionals, referral pathways, and intervention models/approaches informing work with homeless service users.Findings In total, 49 trusts provided information that could be used in the analysis. Just under half of these had dedicated arrangements or resources, including outreach teams and clinical staff co-located in accommodation and support services for the homeless. The remaining trusts indicated that they either had some limited specific arrangements, such as links between local agencies working with the homeless and existing services, or no dedicated arrangements in place. Training to help trust professionals address issues associated with homelessness tended to be minimal if provided at all.Originality/value This analysis adds further evidence to concerns that homeless people’s mental health needs are not being adequately considered by services at a local level and that there is a lack of appropriate pathways through which they can access care and treatment. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore how those engaged in service user involvement (SUI) initiatives perceive involvement and recovery; whether involvement is related to their recovery process and, if so, how.Design/methodology/approach An exploratory qualitative method, social constructionist grounded theory, was adopted throughout the research process. Nine semi-structured interviews were undertaken with participants who self-defined as having current or previous mental health problems and who were engaged in SUI initiatives.Findings Most participants identified explicit links between their own experiences of SUI and recovery. These links represented a connection between the characteristics they perceived to be inherent to involvement and their personal definitions of recovery. In contrast, experiences of consultation and involvement as patient service users was limited and identified as an area for improvement. The core of the tentative grounded theory constructed suggests that individuals found in involvement elements which were concordant with and supported their own definitions of recovery and which were not apparent in their experiences as patients.Research limitations/implications The small sample and narrow constituency of participants limit the nature of the claims made by the study.Practical implications This study highlights the value of involvement in promoting recovery and indicates the merit of promoting meaningful involvement across the spectrum of the service user experience.Originality/value This study offers a unique contribution to the current literature, highlighting the links made between involvement and personal recovery. [ABSTRACT FROM AUTHOR]

Purpose - This paper aims to give an overview of the exposure of abusive practices in services for people with intellectual disabilities, and the resulting inquiries and reports. It also aims to consider the common findings and recommendations and what difference they have made to support and services for people with intellectual disabilities whose behaviour is described as challenging. Design/methodology/approach - The paper briefly reviews the main inquiries, subsequent reports and the recommendations made. The common themes are discussed and considered in the light of the most recent Department of Health Review following the Panorama Undercover Care documentary (unpublished at the time of writing). Findings - The paper highlights the recurrent themes which persist through a series of inquiries and reports. Originality/value - The paper suggests what needs to happen to ensure that recommendations translate into action on the ground, to deliver better outcomes for individuals. [ABSTRACT FROM AUTHOR]

Purpose – Evidence-based medicine (EBM) is a technical and scientific paradigm in clinical practice that has delivered major improvements in the outcome of care in medicine and surgery. However, its value in psychiatry is much less clear. The purpose of the paper is thus to examine its value by subjecting empirical evidence from EBM to a conceptual analysis using the philosophy of Thomas Kuhn. Design/methodology/approach – The authors examine evidence drawn from meta-analyses of RCTs investigating the efficacy of specific treatments for depression in the form of antidepressant drugs and CBT. This shows that the non-specific aspects of treatment, the placebo effect and the quality of the therapeutic alliance as seen by the patient, are more important in determining outcome than the specific elements (active drug, specific therapeutic elements of CBT). Findings – Using the philosophy of Thomas Kuhn, it is shown that these non-specific and non-technical elements are anomalies that indicate that the technological paradigm in the treatment of depression is fundamentally flawed. Practical implications – Non-specific elements of mental health care are essential in fostering hope, trust and meaning. They constitute non-technical factors that are central to the concept of caring, and vital for recovery, and which resonate strongly with the growth of survivor and user-led systems of support for people who experience distress and madness. As such they pose a major challenge to scientific psychiatry and mental health services based in this. The analysis has major implications for the primacy of the natural sciences in the education and training of those involved in mental health work, and demonstrates the importance of an open debate about the value of the scientific imagination in mental health work. Social implications – This paper is important because it supports user-led self-defined notions and understandings of recovery, and does so using a philosophical conceptual analysis. Originality/value – This conceptual analysis is highly original. To the authors' knowledge no one has subjected EBM to a detailed conceptual analysis using the ideas of Thomas Kuhn. [ABSTRACT FROM AUTHOR]

Purpose - Given the increased prevalence of mental health problems amongst people with intellectual disabilities, it seems pertinent to consider how the recovery approach could potentially benefit practice within mental health services for people with intellectual disabilities. This paper seeks to explore the similarities between recovery principles and existing approaches in services for people with intellectual disabilities; it also aims to reflect on the potential barriers to the explicit uptake of the "recovery" approach in this context. Design/methodology/approach - The presence and implementation of "recovery" approaches within mental health services for people with intellectual disabilities are reviewed. This is achieved through an examination of existing practices that could be described as recovery oriented, along with reflections on how these relate to the recovery approach. Questions are raised regarding whether practices can be regarded as "recovery oriented", without first consulting service users. Findings - Further consideration is needed about the extent to which mental health services for people with intellectual disabilities are recovery oriented and how recovery would be defined amongst people with intellectual disabilities. Research limitations/implications - It is suggested that further research using qualitative methodology is conducted, to enable the voice of service users to be heard. Originality/value - The paper is one of the first to explore the relevance of the recovery approach to people with intellectual disabilities. Given the increasing emphasis on recovery approaches within mainstream services, it seems vital to give consideration to the potential for its meaningful application to people with intellectual disabilities and mental health problems. [ABSTRACT FROM AUTHOR]

Purpose – The aim of this paper is to highlight the challenges in evaluating psychological input into acute wards using more traditional methods; and also to provide an example of how it is possible to evaluate such services capturing outcomes at multiple levels. Design/methodology/approach – Data were gathered from multiple levels including staff, patients and the wider organisation mainly using self report questionnaires. The paper looks at the impact on satisfaction, service utilisation, development of recovery principles, quality of therapeutic environment and alliance with treatment teams following the introduction of a dedicated psychology team. Findings – The results show positive trends in patient experiences of the ward environment, alliance with treating teams and staff recovery principles, along with reduced readmission rates and length of stay in hospital. Qualitative data demonstrate the value of the service to both staff and patients. Research limitations/implications – Much of the data do not meet the criteria for more sophisticated statistical analysis. Originality/value – The paper provides an example of evaluation of a contemporary model of service delivery for which there is currently a limited evidence base and looks to stimulate current thinking on the practice of mental health service delivery. [ABSTRACT FROM AUTHOR]

Purpose – This paper seeks to provide a commentary on the previous paper in this issue, "Love is simply not enough". Design/methodology/approach – The commentary draws on research findings and recent policy about personalisation to consider those factors influencing the development of effective family and professional partnerships. Findings – The paper notes the way in which families have often been undermined by those authorities responsible for providing support. While a lifelong caring role will be a positive choice for some families, it should not be a requirement. Originality/value – The commentary draws attention, in particular, to the importance of local authorities working more effectively with family carers. [ABSTRACT FROM AUTHOR]

Purpose – The perspectives of frontline clinical staff working with individuals in later life within an inpatient mental health setting, of their role in recovery, have not yet been explored. The purpose of this paper is to understand what recovery means within an inpatient mental health setting for older adults. The authors address clear implications for clinical practice. Design/methodology/approach – Semi-structured interviews were conducted with 11 multidisciplinary participants across two specialist older adult recovery units at an independent hospital in the UK. Thematic analysis was applied to the transcripts. Findings – Three main themes were identified: participants identified their normative task as the promotion of “moving on” (clinical recovery) and their existential task as personal recovery. The context in which recovery happens was highlighted as the third theme. These represented competing workplace goals of clinical and personal recovery. This highlights the need to give permission to personal recovery as the process that enables mental health recovery in older adults. Originality/value – Staff working in a inpatient mental health service for older adults discussed the meaning of recovery and their role in enabling recovery. This has implications for sustainable clinical practice in this setting. Recovery-orientated practice in this setting is required but the detail is not yet understood. [ABSTRACT FROM AUTHOR]

Purpose – There is growing interest in self-management support for people living with mental health problems. The purpose of this paper is to describe the evaluation of a co-designed and co-delivered self-management programme (SMP) for people living with depression delivered as part of large scale National Health Service quality improvement programme, which was grounded in the principles of co-production. The authors investigated whether participants became more activated, were less psychologically distressed enjoyed better health status, and quality of life, and improved their self-management skills after attending the seven-week SMP. Design/methodology/approach – The authors conducted a longitudinal study of 114 people living with depression who attended the SMP. Participants completed self-reported measures before attending the SMP and at six months follow up. Findings – Patient activation significantly improved six months after the SMP (baseline M=49.6, SD=12.3, follow up M=57.2, SD=15.0, t(113)=4.83, p < 0.001; d=0.61). Participants’ experience of depression symptoms as measured by the Patient Health Questionnaire-9 significantly reduced (baseline M=15.5, SD=6.8, follow up M=10.6, SD=6.9, t(106)=7.22, p < 0.001, d=−0.72). Participants’ anxiety and depression as measured by the Hospital Anxiety Depression Scale also decreased significantly (baseline anxiety: M=13.1, SD=4.2, follow up M=10.2, SD=4.4, t(79)=6.29, p < 0.001, d=−0.69); (baseline depression: M=10.3, SD=4.6, follow up M=7.7, SD=4.5, t(79)=5.32, p < 0.001, d=−0.56). The authors also observed significant improvement in participants’ health status (baseline M=0.5, SD=0.3, follow up M=0.6, SD=0.3, t(97)=−3.86, p < 0.001, d=0.33), and health-related quality of life (baseline M=45.4, SD=20.5, follow up M=60.8, SD=22.8, t(91)=−2.71, p=0.008, d=0.75). About 35 per cent of participant showed substantial improvements of self-management skills. Originality/value – The co-produced depression SMP is innovative in a UK mental health setting. Improvements in activation, depression, anxiety, quality of life and self-management skills suggest that the SMP could make a useful contribution to the recovery services in mental health. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore how staff attend to their well-being when working in an inpatient mental health setting with older adults with dementia and complex mental health needs; how staff understand the link between their well-being and the well-being of patients. Design/methodology/approach – A semi-structured group interview was held with 11 members of two multidisciplinary teams. The discussion was audio-recorded and analysed using thematic analysis. Findings – Staff reported managing their well-being by both connecting with and avoiding the difficult emotions of the work. The team avoided the gravity of the work through humour, a task-focus, an absence of thinking and the displacement of workplace frustrations onto an outgroup. Connecting with emotions was done in tolerable ways: in contained reflective spaces, in the presence of supportive others, through genuine connections with patients as people and when the organisation demonstrated care for the staff. Practical implications – Avoidant strategies appeared to represent short-term ways of maintaining staff well-being, while connecting with the gravity of the work appeared to represent what we hope is a more sustainable approach to managing well-being. A crucial premise for staff well-being is teams embedded within organisations that care for their employees. Originality/value – Poor staff well-being can have serious consequences for an organisation, particularly in the existentially challenging environment of dementia care. This study offers a unique opportunity to explore staff well-being in a UK inpatient mental health setting with older adults with dementia and complex mental health needs. [ABSTRACT FROM AUTHOR]

Purpose -- This paper seeks to present the viewpoint of a family carer of a young man with autism. Design/methodology/approach -- The paper presents the author's views and experiences of caring for a family member with autism. It is a personal account of the impact that "autism" can have on family carers. Findings -- It is a long, arduous, lonely and silent journey that carers travel, long before any recognition comes with diagnosis. Originality/value -- The paper provides a unique insight into the day to day experiences of a family carer of a person with autism. [ABSTRACT FROM AUTHOR]

Purpose -- A schema for more clearly understanding the emotional and psychological abuse and neglect of people with intellectual disability was developed to support a narrative study with people with intellectual disability, families and other supporters about the lived experience of this maltreatment in disability accommodation services in Australia. This paper aims to describe the underpinning review of emotional and psychological abuse and neglect and the evolving new framework. Design/methodology/approach -- A review of existing understandings of this form of abuse in research and policy was conducted, and a framework developed and tested for "trustworthiness" with participants in the research. Findings -- A framework of emotional and psychological abuse and neglect is presented. It centres on the misuse of power and control, details behaviours and interactions which can occur when it is inflicted, and is tested against the experiences of people who have experienced this sort of abuse and neglect. Research limitations/implications -- This is an evolving framework, applied through one study only. Further application and research is needed to test the robustness of the framework. Originality/value -- A more complex construction of emotional and psychological abuse and neglect may inform the development of service policy and support education for people with disability, families, and workers. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to present the findings of research commissioned by a Primary Care Trust in the UK to assess the implementation of a new pilot Human Givens mental health service (HGS) within primary care. Design/methodology/approach – Participating General Practitioners practices were designated as either "Human givens" or "Control" practices. The study focused on service users with mild to moderate depressed mood measured using HADS. The well-being of these participants was examined at the point of referral, and after four, eight and 12 months using three well-being questionnaires. Findings – The results revealed that emotional well-being significantly improved during the first four months following referral for both groups and this improvement was maintained up to and including one year post referral. Compared to the Control group Human givens therapy was found to be of shorter duration, lasting one or two sessions compared to standard treatment which lasted on average four sessions. Originality/value – Apart from the psychological insight and emotional support, it is suggested that Human givens therapy might help the client to better function in society and maintain a sense of social integration. This has benefits to other providers of social care. [ABSTRACT FROM AUTHOR]

Purpose - This pilot study aimed to investigate whether adults with mild/moderate intellectual disabilities could accurately self-report their attachment style. It explored whether there is a relationship between attachment style and challenging behaviour and/or mental health problems. Additionally, the paper examines the distribution of attachment styles in people with intellectual disabilities, based on the hypothesis that it might be different to that of the general population.Design/methodology/approach - Adults with intellectual disabilities (n = 60) and people who supported them (n = 39) completed questionnaires based on Hazan and Shaver's attachment categories and mental health diagnoses. Supporters also provided information about challenging behaviour.Findings - People with mild/moderate intellectual disabilities show the same range of attachment styles as the general population. Links between challenging behaviour and insecure attachment were found, and there was an association between depression and insecure-avoidant attachment.Originality/value - Applications of attachment theory in individual therapy and at a policy level are explored in light of the findings, as well as directions for future research. There appears to be a relationship between insecure attachment and depression in people with intellectual disabilities. This has implications for the psychological treatment of people with intellectual disabilities and interventions should be developed that focus on attachment relationships. Attachment behaviour may not be linked to challenging behaviour as directly as has been previously suggested, certainly for people with mild moderate intellectual disabilities. [ABSTRACT FROM AUTHOR]

This discussion paper reviews and critiques literature related to the evolution of the medical humanities as an academic discipline and its contribution to healthcare provision. We argue that despite considerable advances in the field of medical humanities, needs have been identified for a more inclusive, outward-facing and applied discipline. These needs can be met in the form of what we have called the health humanities, which both embrace interdisciplinarity and engage with the contributions of those marginalised from the medical humanities - for example, allied health professionals, nurses, patients and carers. It is argued that there is a need for new thinking to develop the discipline of health humanities, to develop, provide and share research, expertise, training and education. [ABSTRACT FROM AUTHOR]