Background
FACTS is a Wales‐wide mental health service for 10–17‐year‐olds with needs beyond the remit of mainstream child and adolescent mental health services (CAMHS). As a purely ...consultation‐liaison service, it differs from other UK services in the field.
Aims
To describe a complete cohort of referrals to FACTS 2013–2017 with service exit by June 2018.
Methods
Clinical, social and offending data were extracted from FACTS records.
Results
80 young people completed a FACTS episode, averaging nearly a year (309 days; range 13–859 days). Mostly boys (65, 81%) of mean age 15.4 years (range 9–18), two‐thirds (n = 53) had three or more referral reasons, one invariably being threatened/actual harm to others; only half were criminal‐justice involved. Half (41, 51%) were committing sexually harmful acts. Half were self‐harming (41, 51%). All but seven had had at least one adverse childhood experience (ACE), nearly half (35, 44%) four or more. Nevertheless, post‐traumatic stress disorder (PTSD) was rarely diagnosed (7, 9%); just over one‐quarter (23, 29%) had no diagnosis at all. Correspondence analyses endorsed two distinct Attention deficit hyperactivity disorder groups, distinguished by presence/absence of evidenced brain damage or dysfunction. Suicide‐related behaviours clustered with the other diagnoses, flashbacks and psychotic symptoms with no diagnosis. Change in home circumstances during a FACTS episode was slight.
Conclusions
The complexity of presenting problems and service involvement evidences need for FACTS. The extent of persistently harmful sexual behaviours is a novel finding, suggesting need for more expert input for this at other service levels. Rarity of PTSD diagnoses was surprising given the extent of ACEs. This raises concerns that services focus on disorder signs rather than the child's inner life. Given the extent of problems, minimal change may be a positive outcome – especially when remaining in the community. Further development of this service should include explicit case‐by‐case goals and indicative outcome markers.
To understand experience of early imprisonment in one prison under low staffing levels. A researcher, independent of the prison, interviewed each prisoner soon after reception and 3-4 weeks later. ...The first question of the second interview was: 'I'd like to start by asking you about your experience of the last 3-4 weeks in prison'. Data are verbatim answers to this. Narratives were brief, so responses from all 130 participants were analysed, using grounded theory methods.
The core experience was of 'routine' - characterised by repetitive acts of daily living and basic work, and little reference to life outside prison - generally resolved passively, towards boredom and 'entrapment'.
This 'routine' seems akin to the 'institutionalism' described in the end days of the 1960s' mental hospitals. In an earlier study of similar men at a similar stage of imprisonment, under higher staff:prisoner ratios, experience was initially more distressing, but resolved actively and positively, suggesting that staff loss may have affected rehabilitative climate.
Longitudinal data on interethnic and interracial dating were collected from over 2000 students at a large multiethnic university. Results indicated that, controlling for relevant background ...variables, students who exhibited lower levels of ingroup bias, intergroup anxiety, and group identification before college were more likely to date members of other ethnic and racial groups during college. In addition, controlling for relevant background variables and precollege group attitudes, students who dated outside their group more during college showed less ingroup bias and intergroup anxiety at the end of college, but also felt more pressure not to socialize with or date members of other groups. Some findings varied across ethnic and racial groups. Results are discussed in terms of theories of intergroup contact and interethnic and interracial dating.
Tragic and high profile killings by people with mental illness have been used to suggest that the community care model for mental health services has failed.
To consider whether such homicides have ...become more frequent as psychiatric services have changed.
Data were extracted from Home Office-generated criminal statistics for England and Wales between 1957 and 1995 and subjected to trends analysis.
There was little fluctuation in numbers of people with a mental illness committing criminal homicide over the 38 years studied, and a 3% annual decline in their contribution to the official statistics.
There are many reasons for improving the resources and quality of care for people with a mental disorder, but there is no evidence that it is anything but stigmatising to claim that their living in the community is a dangerous experiment that should be reversed. There appears to be some case for specially focused improvement of services for people with a personality disorder and/or substance misuse.
Contributors
Hans Schanda (Austria), Kris Goethals (Belgium), Peter Marinov (Bulgaria), Neophytos Papaneophytou (Cyprus), Jan Vevera (Czech Republic), Tina Gram Larsen (Denmark), Andres Lehtmets ...(Estonia), Hanna Putkonen (Finland), Florence Thibaut (France), Norbert Nedopil (Germany), Giogos Alevizopoulos (Greece), Peter Silfin (Hungary), Enda Dooley (Ireland), Francesca Villanti (Italy), Ingrida Cera (Latvia), Hans-Gerd Gumprecht (Luxembourg), Anton Grech (Malta), Ellen van Lier (Netherlands), Knut Rypdal (Norway), Małgorzata Opio (Poland), Máximo Fernández Colón (Portugal), Nicoleta Tataru (Romania), Lubomira Izakova (Slovakia), Peter Pregelj (Slovenia), Esperanza Gomez (Spain), Per Lindqvist (Sweden), Marc Graf (Switzerland), Jenny Shaw, Christine Kennedy, John Crighton (England & Wales, Northern Ireland and Scotland respectively, United Kingdom UK).
When a mental health service user kills, concerns arise about that service. Our aim was to examine consequent reviews of services across the European Union (EU), Norway, and Switzerland. A systematic review of published literature and a questionnaire survey with a psychiatrist with forensic expertise from each EU country, Switzerland, and Norway were completed. Collated findings were circulated to respondents for correction and/or further observations. There were no relevant journal publications from the EU outside the UK. Survey responses came from 28 of 30 countries surveyed. An inquiry almost always occurred in four countries and at least sometimes in all but five others. Where an inquiry occurred, it was generally internal rather than by an independent body. The UK has a national inquiry database; Norway, the Netherlands, and Finland collect similar data nationally, but most EU countries do not. Legal (civil or criminal) or disciplinary proceedings were uncommon anywhere, but in France and in Italy a treating psychiatrist has been convicted of manslaughter; service authorities appear more-or-less immune everywhere. Except where inquiry is invariable, victims' relatives generally drive actions. The concept of individual inquiry after homicide is widely recognised and often occurs, but practice varies. The impact of such process still requires evaluation.
Comprehensively representing learning and knowing in visual arts education continues to be a challenge to the field. In this article, the author shares experiences, possibilities, and implications ...related to data/artistic visualization and assessment in art education.
This study examined the joint impact of gender and ethnicity on expectations of general discrimination against oneself and one's group. According to the double-jeopardy hypothesis, women of color ...will expect to experience more general discrimination than men of color, White women, and White men because they belong to both a low-status ethnic group and a low-status gender group. Alternatively, the ethnic-prominence hypothesis predicts that ethnic-minority women will not differ from ethnic-minority men in their expectations of general discrimination because these expectations will be influenced more by perceptions of ethnic discrimination, which they share with men of color, than by perceptions of gender discrimination. All results were consistent with the ethnic-prominence hypothesis rather than the double-jeopardy hypothesis.
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