Services For People Research Articles

Debate: How much should nonspecialists be involved in mental health care for children and young people when resources are limited? Working with police forces to improve mental health crisis care for young people.

The last few years have seen a mental health crisis for children and young people in the UK, with more young people presenting to services at crisis point. Young people have reported that there is a general lack of support before reaching the point of crisis and police forces in the UK have seen a rise in callouts related to youth mental health problems. We provide an overview of the evidence for joint responses from police and mental health services and highlight the importance of including people with lived experience in the development of crisis services. Most of the available data relates to interventions for adults, with very few studies including children and young people. We outline a new study in the UK aiming to evaluate a joint response for young people experiencing a mental health crisis. Whilst resources for children and young people's crisis services remain limited, joint response models with police forces can help to provide much needed intervention.

Understanding the medication regimens associated with anticholinergic burden in older people's mental health services in the UK.

Medications with anticholinergic properties are associated with a range of adverse effects that tend to be worse in older people. To investigate medication regimens with high anticholinergic burden, prescribed for older adults under the care of mental health services. Clinical audit of prescribing practice, using a standardised data collection tool. Fifty-seven trusts/healthcare organisations submitted data on medicines prescribed for 7915 patients: two-thirds (66%) were prescribed medication with anticholinergic properties, while just under a quarter (23%) had a medication regimen with high anticholinergic burden (total score ≥3 on the anticholinergic effect on cognition (AEC) scale). Some 16% of patients with a diagnosis of dementia or mild cognitive impairment were prescribed medication regimens with a high anticholinergic burden, compared with 35% of those without such diagnoses. A high anticholinergic burden was mostly because of combinations of commonly prescribed psychotropic medications, principally antidepressant and antipsychotic medications with individual AEC scores of 1 or 2. Adults under the care of older people's mental health services are commonly prescribed multiple medications for psychiatric and physical disorders; these medication regimens can have a high anticholinergic burden, often an inadvertent consequence of the co-prescription of medications with modest anticholinergic activity. Prescribers for older adults should assess the anticholinergic burden of medication regimens, assiduously check for adverse anticholinergic effects and consider alternative medications with less anticholinergic effect where indicated. The use of a scale, such as the AEC, which identifies the level of central anticholinergic activity of relevant medications, can be a helpful clinical guide.

Routine outcomes to investigate differences between ethnic minorities and White British people presenting to emergency services for injury: the stakeholder consultation.

Research has found differences in processes and outcomes of care between people in ethnic minorities and White British populations in some clinical conditions, although findings have been mixed. The Building an understanding of Ethnic minority people's Service Use Relating to Emergency care for injuries study is investigating differences in presentation, experience and health outcomes between people from ethnic minorities and White British people who seek emergency health care for injury. Our aim was to consult with stakeholders to define measurable outcomes available in routine ambulance and emergency department data; to assess the appropriateness of existing outcome measures for ethnic minorities and White British people; and to identify any gaps. Clinicians, public contributors, researchers, people from the third sector, public health, healthcare inclusion were invited to join an online workshop to discuss routine outcomes. Twenty participants attended the stakeholder consultation, with only one being a public contributor, a limitation. Eleven were from a minority ethnic background and seven were female. The integrated list of outcomes included 25 items, combining routine outcomes from the Building an understanding of Ethnic minority people's Service Use Relating to Emergency care for injuries protocol and literature (n = 17) with additional outcomes (n = 8). Notably, the initial list lacked provisions for safeguarding referrals and cases of treatment refusal, which were new additions. Safety concerns arose due to the lack of safeguarding referrals, treatment refusal and self-discharge. Factors such as pre-existing health conditions, injury location and experiences of discrimination were identified as possible influences on care quality and waiting times for ethnic minority patients. Although the number of stakeholders taking part in our consultation was low, their participation identified outcomes not found in routine data, supporting the adoption of a mixed-methods approach to answer our research questions. A future consultation could look to include more public members and wider range of clinicians including those who work in safeguarding and rehabilitation services. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR132744.

Participation of Citizen as Social Capital in LAPOR! Application in Indonesia

Citizen engagement is crucial for the success of smart cities. In urban areas, communities as social capital has an interpersonal bond that unites people. Due to the complexity of urban issues like pollution, waste, and population density, citizens can monitor the government's work priorities to solve the problem. This article focuses on smart cities from a human-centered perspective, emphasizing the role of information technology. In Indonesia, citizens' rights awareness is facilitated by the National Public Service Complaint Management System (SP4N) or People's Aspiration and Online Complaints Service (LAPOR!), which acts as social capital. This article explores five key aspects of smart cities and smart citizenship: governance, citizen participation, infrastructure, public spaces, and urban livability. While ICT-driven approaches can swiftly transform cities, a community-based approach fosters long-term shifts. Meanwhile, limited citizen involvement contributes to ecosystem degradation in Indonesia and underscores the urgency and importance of citizen engagement in urban planning. In democratic societies, citizens hold power, and concepts of smart citizenship encompass civic intelligence and, at the same time, also value local knowledge. In Indonesia, LAPOR! reflects smart citizenship, enabling transparent reporting of aspirations and complaints. However, factors like limited access and education of citizens affect its use. This research used qualitative methods with content analysis methods. Qualitative content analysis is used to examine the textual content of websites. Using LAPOR! SP4N in Indonesia to see the implementation of the concept of smart society and smart city. Participatory processes should contribute substantially to urban planning and governance. Information technology serves as a temporary solution for long-term urban planning issues. Broader concerns like public policy and participatory democracy must also be considered. In conclusion, this article explores the dynamic relationship between smart cities and smart citizenship, highlighting the importance of active citizen engagement and the potential of technology to empower communities for positive urban transformations.

Key professional stakeholders roles in promoting older people's autonomy in residential care.

Older people's autonomy is an ethical and legal principle in everyday residential care, but there is a lack of clarity about the roles and responsibilities of the key professional stakeholder groups involved. This study aimed to identify and define the roles and responsibilities of the key professional stakeholder groups involved in promoting older people's autonomy in residential care settings. We used a Delphi method with two iterative rounds of online group discussions and collected data from experts in older people's care in Finland in summer 2020. The data were analyzed using deductive-inductive content analysis methods. According to Finnish legislation, this type of research did not need approval from a research ethics committee. Informed consent from the participants was obtained and they were informed about the voluntary nature and confidentiality of the study and their right to withdraw at any time. Key professional stakeholders had different roles and responsibilities, but their shared, integrated goal was to achieve older people's autonomy in residential care settings. Their combined roles and responsibilities covered all aspects of promoting older people's autonomy, from care and service planning and daily decision-making to service structures that included ethical competencies and monitoring. Multipronged, variable, coordinated strategies were required to identify, assess, and promote autonomy at different levels of care. Key professional stakeholders need to work together to provide an unbroken chain of care that provides older people with autonomy in residential care settings. In future, more knowledge is needed about how to create structures to achieve the shared goal of older people's autonomy in these settings.

Regional trends in mental health inequalities in young people aged 16–25 in the UK and the role of cuts to local government expenditure: Repeated cross-sectional analysis using the British household panel Survey/UK household longitudinal survey

Young people's mental health globally has been in decline. Because of their low perceived need, young people's services tend to be the first cut when budgets are reduced. There is a lack of evidence on how a reduction in services and opportunities for young people is associated with their mental health. Additionally, how this may be magnified by place and the assets and challenges of place. The aim of this study is to explore trends in young people's mental health measured by GHQ-12 over time in the twelve regions of the UK. We estimated an interrupted time series model using 2010 as a break point from which there was a shift in government policy to a prolonged period of large reductions in central government funding. Repeated cross-sectional data on young people aged 16–25 is used from the British Household Panel Survey and its successor survey UK Household Longitudinal Survey. Results showed a statistically significant reduction in mental health for young people living in the North East, Wales, and the East of England. The North East was the region with the largest reduction in funding and saw the greatest reduction in young people's mental health. Next, we look at how reductions in local government expenditure related to services for children and young people: children's social services, education, transportation, and culture; explain the observed decline in mental health. We employ a Blinder-Oaxaca Decomposition approach comparing young people's mental health between 2011 and 2017. Results show a marginally statistically significant decrease in young people's mental health over this time. Unobserved factors related to transport spending and children's social services explain some of this gap. Area level factors such as deprivation, infrastructure, and existing assets need to be considered when distributing funding for young people's services to avoid exacerbating regional inequalities in mental health.

Characterizing models of adolescent and youth-friendly health services in sub-Saharan Africa: a scoping review.

This scoping review provides an up-to-date overview of the evidence on adolescent and youth-friendly health services (AYFHS) in sub-Saharan African countries. We conducted a search of four databases and grey literature sources to identify English language publications from January 1, 2005, to December 14th, 2022. The review synthesized evidence on the models and characteristics of AYFHS, the application of World Health Organization (WHO) standards, and whether AYFHS have improved young people's health outcomes. In total, 77 sources were included in the review, representing 47 AYFHS initiatives spanning 19 countries, and three multi-country reports. Most commonly, AYFHS were delivered in public health facilities and focused on sexual and reproductive health, with limited application of WHO standards. Some evidence suggested that AYFHS increased young people's health service utilization and contraceptives uptake. There is a clear need to strengthen and develop innovative and multi-pronged approaches to delivering and evaluating AYFHS in this region.

Audit on Management of Behavioural and Psychological Symptoms Among Dementia Patients in Humber Older People's Mental Health Services

Audit on Management of Behavioural and Psychological Symptoms Among Dementia Patients in Humber Older People's Mental Health Services

Development and evaluation of a personalised sleep care plan on child and adolescent in-patient mental health wards.

The study evaluated a package of measures to improve sleep on psychiatric wards admitting patients from children and young people's services (CYPS). Sleep disturbance has significant impact on adolescent mental health, and in-patient wards can directly cause sleep disturbance, independent of the problem that led to admission. We developed a CYPS-specific package (TeenSleepWell) that promoted a better sleep environment, enhanced staff education about sleep, screened for sleep disorders, and raised awareness of benefits and side-effects of hypnotics. This included personalised sleep care plans that allowed a protected 8 h sleep period when safe. Evaluation over 2 years showed enhanced in-patient care: 57% of patients were able to have a protected sleep period. There was no increase in adverse events and there was a decrease in hypnotics issued. Improving sleep during in-patient CYPS admissions is possible and personalised sleep care plan should be a care standard.

Change, Adversity, and Adaptation: Young People's Experience of the COVID-19 Pandemic Expressed through Artwork and Semi-Structured Interviews.

This study explores how young people's mental health was affected by the COVID-19 pandemic using artwork and semi-structured interviews. The mental health impacts of the pandemic are important to understand so that policy and practice professionals can support those affected, prepare and respond to future crises, and support young people who are isolated and restricted in other contexts. Co-designed participatory art workshops and interviews were conducted with 16-18-year-olds (n = 21, 62% female) from the London-based Longitudinal cohort Study of Cognition, Adolescents and Mobile Phones (SCAMP). Artworks and interview transcripts were qualitatively co-and analysed with young people. From interviews, six themes were identified: adaptation, restriction, change, challenges, overcoming adversity, and lockdown life. From the artwork, four themes were identified: trapped, negative mental wellbeing, positive emotions, and technology. Everyday factors such as home environment, social support, hobbies, habits, and online education were key determinants of how challenged and restricted participants felt, and their capacity to overcome this. This demonstrates the importance of wider (social and environmental) determinants and supports a systems-level public health approach to young people's mental health. For example, young people's mental health services should collaborate with other sectors to address such determinants in a holistic way. Clearer guidance and support with occupation, relationships, environment, routine and activities could mitigate the negative mental health impacts of major environmental changes on young people.

EFEKTIVITAS SISTEM PELAYANAN RAKYAT SIDOARJO (SIPRAJA) SEBAGAI PELAYANAN PUBLIK DI DESA GEMPOLSARI KABUPATEN SIDOARJO

The Sidoarjo Regency Government presents innovative public service products based on electronic technology in the form of applications, namely the Sidoarjo People's Service System (SIPRAJA). This research aims to measure the effectiveness of SIPRAJA as a public service in Gempolsari Village, Sidoarjo Regency. The quantitative research method used is one variable in a descriptive approach based on the theory of innovation characteristics according to Rogers which requires a sample of 100 respondents. This research has the results that the indicators of relative superiority, compatibility, complexity, testability and observability are very effective. So, the overall conclusion is that the effectiveness of SIPRAJA in Gempolsari Village, Sidoarjo Regency with a final result of a percentage value of 69% is included in the very effective category.

Experiences of help-seeking from professional services for a child or young person's mental health concerns during the pandemic: A qualitative study.

The immediate response to the Covid-19 pandemic saw school closures and a shift in provision to online health services for children and young people experiencing mental health concerns. This study provides mental health and referral services with an insight into difficulties experienced as well as recommendations on potential improvements. Semi-structured interviews with 11 parents and six young people. Reflexive thematic analysis was used to analyse the data. Parents and young people reported mixed experiences on accessing mental health support. Priorities and pressures on health services impacted the likelihood of choosing to seek and being able to obtain help. Parents and young people had varying expectations and experiences in help-seeking during the pandemic which were also impacted by others' experiences and views. For many, the relationship with the professional they were in contact with impacted their mental health treatment. Provision was sometimes accessed via private services due to long waiting lists or problems that did not "meet threshold". Understanding the experiences of seeking mental healthcare during the pandemic can inform improvements to access to services at a time when people are most vulnerable. Accessible provision other than private services needs to be made for those on waiting lists. For those who do not meet service threshold, intermediary support needs to be secured to prevent unnecessary exacerbation of symptoms and prolonged problems. If schools are to remain the hub for children and young people's mental health services, they should be considered essential services at all times.

After COVID-19: preparing staff for future surges in respiratory illness in children and improving well-being.

The coronavirus disease 2019 (COVID-19) pandemic was a challenging experience for children and young people's services, and the workforce. The Valuing All Staff Together programme was a one-year project hosted by the North West Paediatric Critical Care, Surgery in Children, Long Term Ventilation Operational Delivery Network to support teams caring for children and young people to reflect on their experiences of the COVID-19 pandemic. Using an online survey, focus groups and interviews, it gave staff the opportunity to explore and understand the effects of the pandemic and the subsequent surge in demand, including how these affected services and the emotional health and well-being of staff. This would enable better preparation for future surges in respiratory illness in terms of learning, training and development. This article describes the programme's aim, method and findings, and the main recommendations for practice.

Lifelong learning

Helen Haygarth, Family Hubs Engagement and Participation lead for Durham Children and Young People's Services, shares more about her journey through education and the importance of CPD for staff.

Children and Young People's inpatient and PICU mental health services: transformation in an evidence vacuum

Children and Young People's inpatient and PICU mental health services: transformation in an evidence vacuum

What are practitioners' views of how digital health interventions may play a role in online child sexual abuse service delivery?

Online child sexual abuse (OCSA) affects considerable numbers of children globally and is associated with a variety of mental health problems. Existing practitioner studies suggest that young people are infrequently asked about online abuse and practitioners have a fragmented understanding of the problems experienced or how they might approach them. There are very few evidence-based interventions that guide clinical assessment or practice. Digital Health Interventions (DHIs) have the potential to be an effective option where children and young people's services are challenged, including accessibility and anonymity. The aim of this study was to explore mental health practitioners' views of how DHIs may play a role in supporting young people who have experienced OCSA, and the role they can play in healthcare delivery. In-depth qualitative interviews and one focus group were conducted with 25 child mental health professionals across two sites (Manchester and Edinburgh). Data was analyzed using reflexive thematic analysis. Three overarching themes and 9 sub-themes were identified: (1) feeling a little bit lost; (2) seeing potential problems; and (3) knowing what works. Practitioners expressed interest in a DHI to support this client group and saw it as a way of managing waiting lists and complementing existing therapies. They felt that many young people would see this as a preferred medium to in-person therapy, would be empowering, and offers new ways of learning how to stay safe online. However, there were concerns about how much time would be needed by staff to deliver a DHI, anxieties about safety issues in relation to content and data protection, some of which may be unique to this population of young people, and concerns about the absence of a therapeutic relationship with vulnerable children. Our findings indicated that practitioners were uncertain about working with children subjected to OCSA but were receptive to the possibility of using a DHI to support their practice and to reduce waiting lists. Concerns were expressed about the time needed for staff training and support as well as concerns over patient safety and the lack of evidence about the effectiveness of an unsupported DHI.

Lifelong learning

Helen Haygarth, Family Hubs Engagement and Participation lead for Durham Children and Young People's Services, shares more about her journey through education and the importance of CPD for staff.

The contribution of community service during the transition to adulthood to health in adulthood.

Prior studies have linked young people's community service to indicators of health, yet little research takes the long view by connecting youth's community service to health in the next decade of life. Using a lifespan developmental lens, this study examined community service over the transition to adulthood and uses change over time in community service to predict indicators of behavioral, physical, and psychological health at ages 35 and 40. Data were taken from Monitoring the Future U.S. national multi-cohort data spanning ages 18-40 in high school cohorts from 1976 to 1995 for age 40 (N = 4300) and 1976 to 2000 for age 35 (N = 5879). Models estimated a growth curve model for community service from ages 18 to 30 and found that the slope for community service was associated with alcohol use, binge drinking, marijuana use, healthy behaviors, and life satisfaction at ages 35 and 40, with cigarette use at age 35 only, and with self-esteem and depressive symptoms at age 40 only. Less decline in community service over the transition to adulthood was associated with lower substance use, more healthy behaviors, and higher psychological well-being in adulthood. This study contributes evidence that community service and health are linked across the lifespan and suggests the value of examining the long-term implications of developmental change across adolescence and the transition to adulthood.

Implementation of Sidoarjo People's Service System (SiPraja)

This study explores the implementation of the Sidoarjo People's Service System (SiPraja) in Boro Village, Tanggulangin District, Sidoarjo Regency, focusing on factors influencing its execution. Using purposive sampling, the research identifies communication, resources, disposition, and bureaucratic structure as key factors affecting policy implementation, in line with George Edward III's framework. Findings reveal that SiPraja has been effectively implemented, with bidirectional communication and sufficient human and infrastructural resources. However, challenges persist in the disposition, particularly in adapting to the SiPraja application, and the absence of a standard operating procedure in Boro Village. This study contributes to the understanding of innovative public service systems, emphasizing the need for addressing disposition challenges for enhanced effectiveness. Highlight : Effective Bidirectional Communication: SiPraja's success is attributed to robust bidirectional communication, fostering interaction between citizens and government officials. Resource Sufficiency: Human resources, facilities, and infrastructure are deemed adequate, contributing to the seamless implementation of SiPraja. Disposition Challenges: Despite overall success, challenges in user disposition towards the SiPraja application highlight the need for targeted interventions and training. Keywords: SiPraja, Public Service Innovation, Policy Implementation, Bureaucratic Reform, Communication

Pelatihan Menghasilkan Uang Secara Online dengan Bisnis Afiliasi untuk Siswa Magang SMK di Kampus Universitas Mahakarya Asia

This digital era, the internet has opened up new opportunities in the business world, especially through online business models such as affiliate businesses. These businesses allow individuals to promote other people's products or services and earn commissions from any transactions generated through affiliate links. Affiliate businesses offer potential solutions, but not all internship participants have the understanding and/or skills to take advantage of these opportunities. For this reason, Mahakarya Asia University provides practical training on affiliation. This approach combines theoretical understanding and practical experience, ensuring students increase their knowledge and practical skills.The method of implementing this service involves pre-implementation, implementation and evaluation stages. Identification of problems, interviews with internship supervisors, and socialization of material are carried out at the pre-implementation stage. The training was carried out face-to-face involving 25 vocational school students in the Mahakarya Asia University computer laboratory on September 9 2023. Evaluation is carried out to measure students' success in applying the knowledge and skills acquired during training.The training results show that students are able to register and create a Shopee affiliate account, create affiliate video content, and disseminate affiliate links via social media. Evaluation of participants' understanding showed that most students understood the material and were successful in the practicum. Overall, this affiliate business training is expected to provide additional competency and opportunities to earn income online.