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Purpose Young people can often “fall through the gaps” between Child and Adolescent Mental Health services (CAMHS) and Adult Mental Health services (AMHS). This discursive viewpoint study aims to reflect a conversation among the authors on how CAMHS and AMHS psychiatry came together to develop and embed a UK community “Youth Mental Health Service”. Design/methodology/approach This reflective viewpoint study explores the perspectives of three of the lead CAMHS and AMHS psychiatrists from the implementation phase of a community youth mental health service. It explores, in a discursive way, these individuals’ views on some of the key facilitators and barriers in the development of the service that aimed to “bridge the gap” for young people. Findings These clinicians’ reflections recognise the importance of strong clinical leadership in enabling a youth/young adult model of mental health to be implemented. They also recognise how culture internal and external to a service has a key role to play in the success and sustainment of implementing an innovative model. This study describes a merging of CAMHS and AMHS psychiatry to meet the needs of young people in the most developmentally appropriate way. Originality/value This reflective study highlights the need for services and systems to think creatively about how they can allow flexibility for CAMHS and AMHS psychiatrists to learn and plan together, as well as gain experiences across the age ranges, to facilitate collaborative working that is developmentally appropriate and meets the needs of young people in a way that is accessible to them.

Using simple national income accounting and a fixed coefficient two sector model this paper examines how the problem of capital valuation upsets the foundations of the marginal productivity theory of distribution. Assuming no capital valuation problem and zero Wicksell effect, both marginalist theory and the labour theory of value hold. However, the same equation that makes the Wicksell effect zero also entails the profit realization condition of effective demand for the ‘golden age’. This argument is extended providing a new perspective to the link between effective demand and capital theory.

This short paper is a demonstration of the difficulty with the textbook production function which uses the notion of capital as a factor of production. Because, this notion is logically incompatible with the other notion of the money value of capital needed for distribution theory. Theories of production and distribution become incompatible. Outside a one commodity world, this leads to insurmountable circular reasoning. The value of capital cannot be measured without first knowing its distributional parameters (e.g. real wage or the profit rate) and if they are known the marginal productivity theory based on the notion of the relative scarcity of capital as a factor of production is not only superfluous but meaningless. The scarcity of something which cannot be measured even in theory cannot be defined.

The debate about how to reconcile political with economic democracy is translated within the framework of wage and profit-led growth in this article. The inherent tension between providing sufficie...

Objective: Young people affected by mental health disorders have greater sexual health needs compared to their peers. Less is known about this need across illness severity. Method: A cross-sectional survey of the sexual health of those attending outpatients or inpatients within a youth mental health service was conducted. Statistical differences between groups were explored. Results: One hundred and seven young people (18–25 years) participated and of these, 37.7% were inpatients who had more severe psychiatric symptoms than outpatients. While inpatients were as likely to be sexually active as outpatients, they were significantly less likely to have a regular sexual partner (25% vs 64.5%). Additionally, they used amphetamines more frequently during sex (28.6% vs 5.8%). Sexual dysfunction was experienced by 55.6% of inpatients and 37.9% of outpatients. Conclusions: High-risk sexual behaviours and sexual dysfunction were highly prevalent in both groups. For some behaviours and dysfunction, this prevalence was higher in the inpatient population. Holistic clinical services that address the mental, physical and sexual health needs of consumers are needed both within inpatient and outpatient settings.

Aim This study aimed to determine the prevalence of high-risk sexual behaviours, sequelae and associated factors in young people attending a youth mental health service. Methods The study design was a cross-sectional survey of 103 young people aged between 15-25 years carried out across four specialist mental health clinics. A questionnaire on the sexual health of secondary level students was adapted for this study. Mental health symptomatology was assessed through the Brief Psychiatric Rating Scale (BPRS). Results The mean age was 20.9 (SD ±2.8) years, with 50.5% being female, 41.7% male and 7.7% transgender. A total of 52.4% (N = 54) attended the psychosis [EPPIC] clinic; 15.6% (N = 16) attended the ultra-high risk for psychosis [PACE] clinic; 19.4% (N = 20) attended the personality disorders [HYPE] clinic; and 12.6% (N = 13) attended the mood clinic [YMC]. The mean BPRS score was 47.7 (SD ±12.2). A total of 77.7% of young people had previously been sexually active and of these, 37.5% did not use consistent contraception; 26.3% had been pregnant, of which 95.2% were unplanned. A total of 68.8% reported having been tested for sexually transmitted infections and 25.5% tested positive. The severity of symptoms or clinical characteristics were not associated with engagement in high-risk sexual behaviours. Conclusions These results indicate that young people with mental health disorders have high needs in regard to their sexual health, which could be addressed by incorporating sexual health referral pathways into early intervention services.

This paper generalizes the principle of effective demand to incorporate banking and finance as two distinct sectors. The traditional commercial banking sector is regulated and the modern shadow banking sector is mostly an unregulated provider of financial services. Through a stylized model the interconnectedness between the two sectors is analysed. The analysis shows how an almost infinite supply-side capacity of finance is created and explores its relation to the level of aggregate demand in the real economy. The impact of finance on the real economy is explored in both profit- and wage-led regimes at different levels of interconnectedness between commercial and investment banking.

The paper analyses corporate-led jobless growth propelled by development-induced displacement caused by land acquisition by the State. It shows as its inevitable outcome an expanding informal sector which encroaches upon land-related natural resources allocated to the corporate sector. This reduces the latter’s labour productivity and competitiveness along with negative impact on environment and social cohesion. Using the example of India as a multiparty democracy, the paper points to the emergence of a dangerous developmental politics of mutualism between political parties and corporations over land acquisition, which subverts the very democratic process through which political power is wielded.

Macroeconomic strategies and policies have differed significantly among Asian countries, and yet some common issues recur despite their immense diversity in inherited historical initial conditions, differences in political systems, geopolitical situations, location and size, and natural resource endowments. The chapter examines from a comparative perspective issues like unemployment, state versus market, domestic versus foreign market, degree of openness in trade, investment and finance, industrial and technology policy, decentralization, and economic and social inequality. While some countries have been more successful than others in dealing with these issues, our comparative perspective also shows development itself as a moving target, thus requiring flexible institutional and policy responses at each separate stage of development, which makes uniform guidelines misleadingly over-simplistic.

Aim Up to half of patients with borderline personality disorder report auditory verbal hallucinations that are phenomenologically indistinguishable from those in schizophrenia, occur early in the course of the disorder, and are enduring, distressing and disabling. In clinical practice, this symptom is widely assumed to be unresponsive to treatment with antipsychotic medication and early intervention is rarely offered. The Verbal Experiences Response in Borderline personality disorder to Aripiprazole TrIal Medication (VERBATIM) study aims to be the first controlled trial to investigate the effectiveness of conventional pharmacotherapy for this symptom in this patient group. Method VERBATIM is a 12-week, triple-blind, single-centre, parallel groups randomised controlled trial, with a 27-week follow-up period. Participants between the ages of 15 and 25 years receive either aripiprazole or placebo daily, commencing at 2 mg and increasing to 10 mg by day 15. Further dose escalations (up to 30 mg) may occur, as clinically indicated. This trial was prospectively registered with the Australian and New Zealand Clinical Trials Registry ACTRN12616001192471 on 30/08/2016. Results The primary outcome is severity of auditory verbal hallucinations assessed using the Psychotic Symptom Rating Scale. Secondary outcomes include the severity of general psychopathology, borderline personality pathology, social and occupational functioning and change in brain resting state connectivity. The primary endpoint is week 12 and secondary endpoint is week 39. Conclusion The results will inform treatment decisions for individuals with borderline personality disorder who present with auditory verbal hallucinations.

The paper sets up a model of economic crisis by investigating the role played by movement in asset price as a driver of the dynamic interaction between the real and the financial sectors. Such movement influences income determination in the real economy in the short period through aggregate demand leading to the emergence of two macroeconomic regimes. A short period flow model, underpinned by the stock flow consistent accounting framework, is developed to formalize the dynamics of interaction between real and financial sectors mediated by movement in asset price, generates bistability, abrupt crashes, and systemic fragility in the macroeconomic regimes.

This article explains a curious redirection of economic policies that uses the policy framework of Kalecki and Keynes only to undermine it. It does not negate their theory of demand management, but reformulates it to serve the powerful interests of finance in the era of financial globalisation. As a result, accountability to finance rather than to the citizens becomes more important for democratic governments, and credit rating dominates democratic performance.

The author surveys shifts in macro-economic policy and thought from Keynes and Kalecki to the present, tracking the changing climate of economic opinion. As Kalecki foresaw, the success of Keynesian demand management was undermined when, in an era of full employment, the power of labour threatened industrialists’ authority over the economy. From the 1970s, this led governments to introduce pro-capitalist measures. Countering recessions with budget deficits was now seen as irresponsible. The rise of globalisation meant that domestic demand management became less effective, especially in economies highly dependent on imports. Opening up economies meant that their exchange rates and stock markets became more vulnerable to capital flights. As the reach of finance became increasingly global, those private credit rating agencies became the game changers. Today private credit agencies, through their rating of the investment climate and sovereign risk of a country, in effect rate the quality of its government. Capitalist democracies are now dominated by private finance. Management of the investment climate is increasingly done through the virtual rather than the real economy, creating artificial financial asset and housing market bubbles. At the same time, in the neglected real economy, inequality and unemployment have increased, and living standards are falling.

This paper examines how variable output and profit share jointly determine investment and saving, while the difference between investment and saving drives the changes in output and profit share. Analysis of the resulting pair of differential equations yields novel implications for the multiplier process. In this more general framework a number of separate strands of the Keynesian-inspired literature can be understood. In particular, the model incorporates both forced saving and profit squeeze to analyse the stability of the dynamical system, and brings out the complex relation between in and out-of-equilibrium profit-led and wage-led regimes.

This paper demonstrates through a formal model how the wealth effect created by a stock market boom leads to the expansion of demand and output mostly through debt-financed private consumption. However, inherent in this expansion is the threat of a subsequent contraction caused by the rising burden of servicing debt and falling creditworthiness. The formal analysis captures more precisely these conditions; it shows that, even in the medium run, the growth rates of the wealth in the stock market and of the real economy may move in opposite directions.

This new approach incorporates on the demand side the problem of effective demand and unemployment, while rejecting on the supply side the oversimplistic use of a production function, with or without capital--labour substitution. The focus on the adoption and diffusion of labour productivity growth permits viewing supply as being driven endogenously by inter-class conflict over distribution as well as inter-class conflict among rival firms over market shares. The result is a race between growth rates in labour productivity and in the real wage rate, which drives demand and productivity growth on the one hand, while making wage share reasonably constant on the other. The existence and stability properties of the steady state are also examined. Copyright 2006, Oxford University Press.

Along the line suggested by Nicholas Kaldor, the paper incorporates into the analysis of a dual economy effective demand as a problem of generation of agricultural surplus and its realisation into purchasing power for industrial goods. Through this approach, it is shown how one obtains empirical predictions about uneven sectoral growth rates, as well as an effect of the movement in the terms of trade on long-term industrial growth which is contrary to that suggested by Lewis. The paper also specifies the process of dynamic adjustment of industrial growth in a self-reinforcing circular flow under conditions of sufficiently high agricultural growth, extending the effective demand argument in a dual economy. Copyright 2003, Oxford University Press.

By means of a discrete time, dynamic model this paper shows that, despite correct short-term expectations about price change by all agents concerned, the economy may exhibit chaotic behaviour rather than convergence to a natural, equilibrium rate, when wage bargain takes place according to the usual specification of the Phillips curve while firms maximize profit. The lack of coordination between profit-maximizing firms and wage-bargaining workers may result in an irregular dynamic path which questions whether the natural rate, even if it exists, is at all knowable in these circumstances.

Using illegal trade in narcotics as an example, where regular seizure of part of the merchandise by the law-enforcing authorities imposes a transaction cost on the monopolist supplier, this paper demonstrates the result that a higher transaction cost might increase the volume supplied for trade. The result of the formal model also applies to the opposite situation, e.g. when trade is legal, as in seventeenth- and eighteenth-century maritime trade, but pirates illegally seize part of the merchandise to impose a transaction cost on the traders. The more general implications of this analysis are also discussed.

This article raises the question of whether standard economics with the general equilibrium model at its core applies situational analysis in a Popperian sense. Contrary to Popper's own view, the authors come to the conclusion that this is not the case. Standard economics fails to represent elements essential to any social situation in an adequate manner. It comprises uncertainty, time and space, social interaction, unintended effects, as well as culture and institutions. The authors suggest, therefore, the socioeconomic context as an alternative approach to analyzing social situations. It consists of four basic elements: (1) dominant worldviews, (2) institutions and technologies, (3) relative prices, and (4) political instruments. The alternative approach was applied with some success to analyzing inter alia problems of unemployment as well as of transformation.

Nayyar Deepak, Bhaduri Amit. Le consensus de Washington et la libéralisation de l'économie. In: Tiers-Monde, tome 38, n°150, 1997. Vues du Sud (Le 150e numéro de la Revue Tiers Monde) pp. 295-310.

International audience; Transient epileptic amnesia (TEA) is a recently described epilepsy syndrome characterized by recurrent episodes of isolated memory loss. It is associated with two unusual forms of interictal memory impairment: accelerated long-term forgetting (ALF) and autobiographical amnesia. We investigated the neural basis of TEA using manual volumetry and automated multi-atlas-based segmentation of whole-brain magnetic resonance imaging data from 40 patients with TEA and 20 healthy controls. Both methods confirmed the presence of subtle, bilateral hippocampal atrophy. Additional atrophy was revealed in perirhinal and orbitofrontal cortices. The volumes of these regions correlated with anterograde memory performance. No structural correlates were found for ALF or autobiographical amnesia. The results support the hypothesis that TEA is a focal medial temporal lobe epilepsy syndrome but reveal additional pathology in connected brain regions. The unusual interictal memory deficits of TEA remain unexplained by structural pathology and may reflect physiological disruption of memory networks by subclinical epileptiform activity.