Conclusion: Mental health and legal responses to the adolescent mental health crisis: Raising the bar on best interests and promoting family connectedness in divorcing families

We are currently facing an unprecedented increase in adolescent mental health problems resulting in alarmingly high levels of depression, anxiety, and suicidality. Significant mental health problems among youth pose unique challenges to families in the process of separation and divorce, as well as to family law professionals across all disciplines. The current adolescent mental health crisis calls for new ways of approaching our work with high conflict families to promote family connectedness and shift away from adversarial approaches that may exacerbate conflict and further destabilize families. As a conclusion to the special issue on adolescent mental health needs, the authors make multidisciplinary best practices recommendations and advocate for systems level changes in recognition of the needs of youth in crisis at this pivotal developmental stage.     

Establishing a Social-Darwinist Mentality in Japan’s Paternalist State: The Potential of Resistance by a Counter-Public

ABSTRACT

From a historical perspective, the welfare net in Japan was established from above without democratic participation and expanded only slowly. This expansion in many cases was aimed at enhancing national cohesion, especially during war time. During the current neoliberal era, Japan’s paternalistic welfare state has been able to put into practice the dismantling of national pension and health-care systems without the need for any theoretical re-orientation. In response, counter-publics have engaged in protest and resistance. By doing so, the victims of modernization and those who are socially weak and disadvantaged in multiple ways are able to regain their self-esteem and personal integrity.     

Bacterial Cross‐contamination Potential Associated with Contaminated Currency

Previous studies have shown a significant amount of contaminants on paper currencies. It is important to study the transfer of microorganisms between paper currencies to determine whether it meets the level of a human health threat. This cross‐contamination potential was analyzed by seeding new US 1‐dollar bills with Bacillus thuringiensis, and pressing or rubbing them against clean currency to determine the amount of bacteria transfer to the unseeded currency. The transferred amount of bacteria was recovered, plated, incubated, and the colony‐forming units were quantified. Among the recovery methods tested, the most efficient method, vortexing for 10 min with a recovery efficiency of 40 ± 8.1%, was used in this analysis. The resulting transfer rates were 4.8%, 8.6%, and 14.3% when pressed for 24 h, 72 h, and rubbed together, respectively. These transferred amounts of bacteria are significant and have the potential to spread infectious diseases.     

Justifications for Non-Consensual Medical Intervention: From Infectious Disease Control to Criminal Rehabilitation

A central tenet of medical ethics holds that it is permissible to perform a medical intervention on a competent individual only if that individual has given informed consent to the intervention. Yet it occasionally seems morally permissible to carry out non-consensual medical interventions on competent individuals for the purpose of infectious disease control (IDC). We describe two different moral frameworks that have been invoked in support of non-consensual IDC interventions and identify five desiderata that might be used to guide assessments of the moral permissibility of such interventions on either kind of fundamental justification. We then consider what these desiderata imply for the justifiability of carrying out non-consensual medical interventions that are designed to facilitate rehabilitation amongst serious criminal offenders. We argue that these desiderata suggest that a plausible case can be made in favor of such interventions.     

'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.     

Therapeutic engagement in medium-secure care: an interpretative phenomenological analysis of service users’ experiences

Service users (SUs) detained in forensic hospitals are usually required to engage in psychological therapies aimed at reducing mental distress and/or for preventing further offending. Poor therapeutic engagement (TE) can lead to adverse clinical outcomes and reoffending, at a cost to the individual, staff, the service provider, and the public. To understand what factors influence TE from a SUs’ perspective, the experiences of 10 male residents of a medium-secure hospital were explored. Using a service-user informed design, interpretative phenomenological analysis of interview data was completed. Four superordinate themes emerged: different worlds; what the individual brings; what the therapy entails; and control. Consideration of how these factors may be of use to professionals working in secure care settings is discussed in relation to existing theory and research.     

“Supporting me through emotional times,all different kinds of behaviour.” Forensic mental health service users understanding of positive behavioural support

This service evaluation project explored service users’ experiences of positive behavioural support (PBS) within a medium secure mental health service. Interpretative phenomenological analysis (IPA) was used to analyse interviews with ten service users. Four main themes emerged from the data: My plan; How I understand PBS; How PBS has helped me, the benefits; and Making the plan work. Overall, service users viewed their experience of having a PBS plan positively. They reflected that the plans offered staff greater understanding of their behaviours and needs, enabling them to receive appropriate support. Service users valued the experience of being involved in the process, offering important insights into their experiences. They also expressed frustrations about staff not following the plan and not understanding why they had a plan whilst others did not. Limitations of the study, clinical implications and ideas for future research have been discussed.     

Transfers from prison to hospital under Sections 47 and 48 of the Mental Health Act between 2011 and 2014

In England and Wales, prisoners with mental disorder of such severity as to warrant inpatient treatment may be transferred to hospital under the Mental Health Act. UK Government guidance recommends that this process should be completed within 14 days; however, evidence suggests that in many cases it can take much longer. This retrospective service evaluation of 64 male prisoners, who were transferred under Section 47 or Section 48, aimed to evaluate transfer durations. The mean time from referral to admission was 76 days. Prisoners with a psychotic disorder were admitted more quickly. Remand prisoners were admitted more quickly than sentenced prisoners. Findings suggest that, in the UK the transfer time of prisoners under Sections 47 and 48 of the Mental Health Act continues to far exceed the 14-day target which raises concern about equivalence of care for prisoners. Our findings support arguments for fundamental amendments to the admissions process.     

新入狱罪犯的特点及改造对策探析

受社会政治、经济发展变化的影响,我省近三年内新收押罪犯的构成出现了新的变化,其心理和行为均出现了新的特征,对刑罚执行工作提出了新的挑战。笔者采取情况普查与个案调查相结合、摸底分析与座谈讨论相结合的方法,对我省2001年1月1日至2003年8月31日期间监狱新收押的罪犯情况进行了调查研究,从新入狱罪犯的构成特点和其心理行为特征分析入手,提出相应的改造对策,为我省的监管安全和教育改造工作提供了有用的参考和必要的理论支撑。