Professionalizing Arts Management in Healthcare Facilities

An urgent need exists for trained specialists to manage organizational policies and practices involving arts programs and activities in healthcare facilities. This article introduces the field of arts in health and argues for what is currently needed within the academic and professional field of arts management to advance this emerging arena of arts management theory and practice. The authors integrate key references from existing scholarship alongside additional survey data to offer recommendations for developing professional management of the arts in healthcare facilities like hospitals, hospices, and long-term care centers. The article provides an overview of the responsibilities of arts managers in healthcare institutions, as well as insight into the knowledge, competencies, and skills that arts managers require to effectively work in these settings. The article concludes with articulating a conceptual framework for a long-term research trajectory to inform further advancement of this distinct sub-field of arts management.     

Health characteristics of older police custody detainees in London,UK

The number of older adults involved in the criminal justice system is rising. Little is known about the state of health in older people who are arrested. This study compared characteristics and health care needs of older police custody detainees with their younger counterparts. The health characteristics of 57 police detainees aged over 50 were compared with 543 younger detainees. Older detainees had significantly higher rates of physical illness and risk of alcohol withdrawal. Although there were equivalent rates of mental disorder and drug taking compared with younger detainees, a higher proportion had presentations consistent with cognitive impairment due to possible dementing processes. Over 80% of older detainees were recommended to have a health assessment in police stations based on their presentation. Police detainees over 50 should be considered to have a health assessment as routine procedure. Further investigation should also be conducted into cognitive impairment in this group.     

Using the National Diabetes Audit to improve the care of diabetes in secure hospital in-patient settings in the UK

To examine the ability of two forensic units, one high secure and one medium secure, to meet the NICE (National Institute for Health and Care Excellence) standards of care for diabetes. We applied the National Diabetes Audit programme, which uses as standards the NICE guidelines, to assess the quality of care provided for patients in two forensic units. Of the 500 patients, 200 in high secure and 300 in medium secure, 88 (17.6%) had type 2 diabetes. None had Type 1 diabetes. Of those with Type 2 diabetes, the care of 74 (84%) met all 8 NICE recommended standards. Glucose levels were lower in the medium/low secure unit compared to the higher security environment. Whilst achievement of process-based outcomes was higher than those reported nationally, achieving clinical outcomes was more challenging. High-quality diabetic care can be provided for patients in forensic units. Benchmarking physical health outcomes against national criteria in mental health inpatients is a potential method of improving outcomes.     

An initial evaluation of the Global Review Form as an approach to measuring individual change

Background: Routine assessment of individual change in forensic mental health services is increasingly recognised as important. However, existing tools have been criticised and their periodic use make them unsuited to directly measure the impact of interventions. This paper describes the initial evaluation of the Global Review Form (GRF) as a framework for measuring change over time. Specifically, measurement properties, feasibility and usefulness in routine practice are examined. Method: 28 male service users in three distinct areas of an adult secure service (low secure, locked rehabilitation and high relational support housing) were rated over a 20-week period by their multidisciplinary teams. Findings: The GRF showed promising construct validity and appropriate stability and sensitivity to change across time. It enabled measurement and understanding of individual change over time. Staff feedback suggested the GRF is a useable and practical outcome measuring tool. Conclusions: The GRF shows promise for use as a routine outcome monitoring tool within forensic mental health services.     

Mental health,substance use,and offending patterns among Native American youth in juvenile detention

Research has shown that youthful offenders in the juvenile justice system report an array of substance use and emotional and other mental health needs. The current study closely examined these issues in a large national sample (n = 539) of Native American youth drawn from the Survey of Youth in Residential Placement. Results demonstrated that frequent substance use was associated with the likelihood of being detained for a drug offense, while emotional and mental health needs were associated with detention for the most serious offenses. These results highlight the need for comprehensive substance use and other mental health assessments for Native American youth in the juvenile justice system.     

Matching consequences to behavior: implications of failing to distinguish between noncompliance and nonresponsivity

Neither punitive nor therapeutic approaches alone are effective at addressing the dual public health and public safety concerns associated with managing criminal behavior perpetrated by people who have psychiatric and substance use disorders. The optimal solution may instead require the integration of both criminal justice supervision and treatment. Using problem-solving courts (PSCs) as a model, we focus on one dimension of this integrated approach, distinguishing between behavior that stems from willful noncompliance with supervision and behavior that results from nonresponsivity to treatment. First, we discuss the public health and public safety consequences of using singular approaches to address the criminal behavior of this population. We then present lessons learned from PSCs that distinguish between noncompliant and nonresponsive behaviors in making treatment and supervision decisions. Finally, we consider how the concepts of nonresponsivity and noncompliance may be extended, via policy, to probation and parole settings as well as mental health and substance abuse treatment services outside the criminal justice setting in order to enhance public health and safety.     

The public health implications of United Kingdom offender healthcare policy: a holistic approach to achieve individual and societal gains

In 2009, two seminal documents were published by the United Kingdom (UK) government concerning healthcare services for offenders. The Bradley review into diversion for people with mental health problems and learning disabilities emphasised a need to improve offender health, not least because of the high economic costs to society as a whole resulting from unresolved mental illness, physical ill-health and substance abuse problems commonly experienced by offenders. The Bradley review made wide-reaching recommendations for change, requiring strong partnership between health and justice agencies at both central government and local levels. A framework for the delivery of Bradley's recommendations has been set out in Improving health, supporting justice, the Department of Health's offender health strategy which sets out the direction of travel for the next 10 years.This paper discusses the reality of working toward improving health services for this marginalised group in the context of the influence of the current straitened financial climate on the allocation of resources to publically funded healthcare in the UK; it examines the historically based, and widely held, belief in the principle of “less eligibility” within our society, whereby there is much public and media resistance to allocating resources to improving care for offenders when other, more “deserving”, groups are perceived to be in continuing need.     

Why community compulsion became the solution - Reforming mental health law in Sweden

The aim of this article is to understand how compulsory community care (CCC) has become a solution in mental health policy in so many different legal and social contexts during the last 20 years. The recent introduction of CCC in Sweden is used as a case in point, which is then contrasted against the processes in Norway, England/Wales and New York State.In Sweden, the issue of CCC was initiated following high-profile acts of violence. Contrary to several other states, there was agreement about the (lack of) evidence about its effectiveness. Rather than focusing on dangerousness, the government proposal about CCC was framed within an ideology of integrating the disabled. The new legislation allowed for a broad range of measures to control patients at the same time as it was presented as a means to protect positive rights for patients. Compared to previous legislation in Sweden, the scope of social control has remained largely the same, although the rationale has changed — from medical treatment via community treatment and rehabilitation, to reducing the risk of violence, and then shifting back to rehabilitation in the community.The Swedish approach to CCC is similar to Norway, while New York and England/Wales have followed different routes. Differences in ideology, social control and rights orientations can be understood with reference to the general welfare and care regimes that characterize the four states.     

我国医疗机构分类管理制度探讨

我国的医疗机构分类管理制度已实施10年,在医改背景下对其进行系统分析具有重要意义。本文通过分析医疗机构分类管理制度的构成、内容和实施现状,指出该制度在法律基础、分类方法、配套制度等方面存在的问题,并从法律规范的建设、政府职能的转变、行政管理方式的改变等方面提出了政策建议。