Physical restraint in a therapeutic setting; a necessary evil?

Physical restraint of people experiencing mental health problems is a coercive and traumatic procedure which is only legally permitted if it is proportionate to the risk presented. This study sought to examine the decision-making processes used by mental health staff involved in a series of restraint episodes in an acute care setting. Thirty nurses were interviewed either individually or in focus groups to elicit their views on restraint and experience in specific incidents. Four factors which influenced the decision to restrain were identified: contextual demands; lack of alternatives; the escalatory effects of restraint itself; and perceptions of risk. While some of these factors are amenable to change through improvements in practice, training and organisational culture, nurses viewed restraint as a necessary evil, justified on the basis of the unpredictable nature of mental illness and the environment in which they worked.     

Individuals’ experiences of sexual offending therapy in a forensic psychiatric setting

There is a paucity of research exploring individuals’ experiences of sexual offending therapy, particularly in forensic psychiatric settings. This study qualitatively explored the perspectives of six male medium-secure patients regarding the treatment programme they completed to address their sexual offending behaviour. Thematic analysis of interviews generated two themes: the experience of transition through the programme and the experience of engagement. The importance of gaining service-user feedback and the implications for programme design and delivery are discussed.     

Promoting work-related activities in a high secure setting: exploration of staff and patients’ views

Introduction: Adults diagnosed with mental disorders, in particular those who have a history of offending, have low employment rates. Here we explore staff and patients’ views on the importance of work and vocational activities offered at a high secure hospital. Method: Two hundred seventy-six patients and 106 staff were approached; 54.3% of the patients and 58% of staff completed the questionnaire. Results: Educational achievement in patients was low but nearly two-thirds of patients had been engaged in some form of work prior to admission. Staff and patients felt that vocational opportunities offered in the hospital should more closely resemble ‘real work’ and they broadly agreed on the areas of activities of potential benefit. Staff felt more strongly than patients that patients lose work-related skills during admission. Both groups recognised the importance of work for mental health and in preventing reoffending. Conclusion: Detention in such settings provides an opportunity for patients to maintain as well as expand on skills aiding their future reintegration into work settings.     

Does commitment affect the meaning of fairness?: Commonality and stability of fairness criteria in a political setting

This study explored political fairness criteria in Japan: examining their commonality and stability. Respondents were divided into three groups according to their commitment to the incumbent Government, as measured by neutrality, trust, and respect. Regression analyses revealed that Procedural Fairness was the commonly used criterion in judging the total fairness of the consumption tax. Citizens' commitment affected fairness criteria and their relative weights. Another regression analysis was performed to examine the meaning of procedural fairness. A comparison with our previous study (Takenishi and Takenishi, 1990) indicated that the procedural fairness criteria remained stable: however, voice became a criterion because of the Government's campaign. Results suggested than democratic ethicality, which consists of social values and beliefs, was important.Each author contributed equally.     

'Your personality is the intervention': a grounded theory of mental health nurses’ beliefs about hope and experiences of fostering hope within a secure setting

Hope is an important factor in psychological resilience and change, and recovery from mental health difficulties. Recently, there has been an increased focus on recovery-oriented practice within forensic mental health settings. Several policies include calls for mental health practitioners to inspire hope for recovery in the individuals they work with. However, there is little suggestion of how to implement such recommendations in practice or research exploring how staff foster hope in forensic settings. This study used grounded theory to explore nurses’ perspectives and experiences of hope within a medium secure setting. A model was developed from the data that integrated nurses’ beliefs about hope, practices to develop service users’ hope and the emotional impact of this work. The nurses’ values played a significant role in their work to develop hope. Recommendations are made to help manage the emotional impact and address challenges unique to fostering hope within forensic settings.     

We've had training, now what? Qualitative analysis of barriers to domestic violence screening and referral in a health care setting

The present study assesses barriers to identification and referral of domestic violence (DV) victims by staff at a health care institution following a 3-hr DV training program in which 752 health care providers participated. Focus groups are conducted with staff in hospital departments that serve a high volume of women. Responses to focus group questions identify system-wide and individual hospital department barriers. These barriers have implications for health care organizations trying to implement DV screening protocols through training alone to change staff behavior in diverse clinical settings. Limitations of this study and future research recommendations are also discussed.     

Youth labor migration and its family setting,The Netherlands 1850–1940

This article is based on the reconstructed life course patterns of about 1500 adolescent men and women, born between 1833 and 1912 in the Dutch province of Utrecht. The incidence of youth migration is investigated by sex, birth period, and birthplace. The influence of the family on the decision to migrate is analyzed with event history techniques. The results are evaluated in the context of regional customs related to the process of leaving home. A large number of persons, between 30 and 55 percent of all unmarried youths, participated in youth migration. However, family strategies were more directed toward keeping offspring from migrating than toward stimulating them to move.     

Is there a Need for a European Criminology?

Readers were invited in Issue 4, 2000 to give their comments on the subject of European criminology. The Editors also invited some scholars on a personal title. The comments, ranging from 1,200 to 2,000 words are presented in alphabetical order. The comments are written by: Rosemary Barberet, Josine Junger-Tas, Martin Killias, H.-J. Schneider, Alenka élih, Henrik Tham, Bas van Stokkom and Lode Walgrave. Together they offer a view on the ideas and different views on European criminology.     

Intimate partner violence research in the health care setting: what are appropriate and feasible methodological standards?

The past 20 years of research has exposed the profound cost of intimate partner violence (IPV) in health care problems and health care dollars for victims and bystanders. As a result, professional organizations encourage clinicians to identify IPV victims and to refer them to community resources. To date there is little evidence to show the value of these efforts, and many completed studies are criticized for methodological weaknesses. IPV studies are challenging to design, and the double-blind randomized controlled trial may be an impossible standard. To move forward, funders and study committees are encouraged to reassess the standards for IPV research methodologies.     

Sexsomnia – a forensic psychiatric challenge – a case report

In rare penal cases, a defendant makes a claim that he or she was asleep at the time of an alleged crime. This article discusses a case of alleged sexsomnia where a man claimed that he had been asleep during a sexual encounter (rape) with a woman. The question that often arises during an investigation and in court is how complex a behaviour is someone able to perform and still be asleep? To assist the court in answering this question, forensic psychiatric experts may be appointed. But the experts were not present during the act and must therefore consider each case on the basis of the available information and existing research. This paper provides a brief overview of the research regarding sexsomnia. It will also discuss what kind of information is important to elaborate in these cases in order to clarify the premises for the experts’ conclusions to the court.     

Lak?a?ā as a Creative Function of Language

When somebody speaks metaphorically, the primary meanings of their words cannot get semantically connected. Still metaphorical uses succeed in conveying the message of the speaker, since lak?a?ā, a meaning-generating faculty of language, yields the suitable secondary meanings. Ga?ge?a claims that lak?a?ā is a faculty of words themselves. One may argue: “Words have no such faculty. In these cases, the hearer uses observation-based inference. They have observed that sometimes competent speakers use the word w in order to mean s, when p, the primary meaning of w does not make any semantic sense. In all such cases, s is actually related to p. After having observed this, when the hearer hears the utterance of w, and realizes that w’s primary meaning p is semantically unfit for the sentence-meaning, they infer on the basis of their prior observation that ‘the competent speaker must mean s by uttering w’. Thus lak?a?ā becomes a success.” This apparently well-argued reduction does not stand the critical examination; neither in Ga?ge?a’s framework, nor even in the general theory of language. For one can compose and interpret potentially infinite novel sentences based on lak?a?ā while the observational inferences one can make are finite. Ga?ge?a says very clearly that as far as the secondary meaning is concerned, no prior observation is required. This paper will argue that not only does language yield secondary meanings through lak?a?ā, but it also restricts the use of secondary meanings; for one cannot mean just anything by saying something. Lak?a?ā is a creative function with infinite potential within the limits set up by the language faculty.