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Despite the critical role families play in the care and recovery journeys of people who experience enduring mental distress, they are often excluded by the mental health services in the care and decision-making process. International trends in mental health services emphasise promoting a partnership approach between service users, families and practitioners within an ethos of recovery.
This paper evaluated the acceptability of and initial outcomes from a clinician and peer co-led family information programme.
A sequential design was used involving a pre-post survey to assess changes in knowledge, confidence, advocacy, recovery and hope following programme participation and interviews with programme participants. Participants were recruited from mental health services running the information programme. In all, 86 participants completed both pre- and post-surveys, and 15 individuals consented to interviews.
Survey findings indicated a statistically significant change in family members’ knowledge about mental health issues, recovery attitudes, sense of hope and confidence. In addition, the interviews suggested that the programme had a number of other positive outcomes for family members, including increased communication with members of the mental health team and increased awareness of communication patterns within the family unit. Family members valued the opportunity to share their experiences in a ‘safe’ place, learn from each other and provide mutual support.
The evaluation highlights the importance of developing information programmes in collaboration with family members as well as the strength of a programme that is jointly facilitated by a family member and clinician.
As a result of developments in the meteorological and geological sciences, the Romantic period saw the gradual emergence of attempts to understand the climate as a dynamic global system that could potentially be affected by human activity. This chapter examines textual responses to climate disruption cause by the Laki eruption of 1783 and the Tambora eruption of 1815. During the Laki haze, writers such as Horace Walpole, Gilbert White, and William Cowper found in Milton a powerful way of understanding the entanglements of culture and climate at a time of national and global crisis. Apocalyptic discourse continued to resonate during the Tambora crisis, as is evident in eyewitness accounts of the eruption, in the utopian predictions of John Barrow and Eleanor Anne Porden, and in the grim speculations of Byron’s ‘Darkness’. Romantic writing offers a powerful analogue for thinking about climate change in the Anthropocene.
A number of applications utilise the energy focussing potential of imploding shells to dynamically compress matter or magnetic fields, including magnetised target fusion schemes in which a plasma is compressed by the collapse of a liquid metal surface. This paper examines the effect of fluid rotation on the Rayleigh–Taylor (RT) driven growth of perturbations at the inner surface of an imploding cylindrical liquid shell which compresses a gas-filled cavity. The shell was formed by rotating water such that it was in solid body rotation prior to the piston-driven implosion, which was propelled by a modest external gas pressure. The fast rise in pressure in the gas-filled cavity at the point of maximum convergence results in an RT unstable configuration where the cavity surface accelerates in the direction of the density gradient at the gas–liquid interface. The experimental arrangement allowed for visualisation of the cavity surface during the implosion using high-speed videography, while offering the possibility to provide geometrically similar implosions over a wide range of initial angular velocities such that the effect of rotation on the interface stability could be quantified. A model developed for the growth of perturbations on the inner surface of a rotating shell indicated that the RT instability may be suppressed by rotating the liquid shell at a sufficient angular velocity so that the net surface acceleration remains opposite to the interface density gradient throughout the implosion. Rotational stabilisation of high-mode-number perturbation growth was examined by collapsing nominally smooth cavities and demonstrating the suppression of small spray-like perturbations that otherwise appear on RT unstable cavity surfaces. Experiments observing the evolution of low-mode-number perturbations, prescribed using a mode-6 obstacle plate, showed that the RT-driven growth was suppressed by rotation, while geometric growth remained present along with significant nonlinear distortion of the perturbations near final convergence.
Involuntary admission can be traumatic and is associated with negative attitudes that persist after the episode of illness has abated.
We aimed to prospectively assess satisfaction with care at the points of involuntary admission and symptomatic recovery, and identify their sociodemographic, clinical and service experience predictors.
Levels of satisfaction with care, and clinical and sociodemographic variables were obtained from a representative cohort of 263 patients at the point of involuntary admission and from 155 of these patients 3 months after termination of the involuntary admission. Data were analysed with multiple linear regression modelling.
Higher baseline awareness of illness (B = 0.19, P < 0.001) and older age (B = 0.05, P = 0.001) were associated with more satisfaction with care at baseline and follow-up. Transition to greater satisfaction with care was associated with improvements in awareness of illness (B = 0.13, P < 0.001) and in symptoms (B = 0.05, P = 0.02), as well as older age (B = 0.04, P = 0.01). Objective coercive experiences were not associated with variation in satisfaction with care.
There is wide variation in satisfaction with coercive care. Greater satisfaction with care is positively associated with clinical variables such as increased awareness of illness.
A theoretical model of individuals' experiences before, during and after involuntary admission has not yet been established.
To develop an understanding of individuals' experiences over the course of the involuntary admission process.
Fifty individuals were recruited through purposive and theoretical sampling and interviewed 3 months after their involuntary admission. Analyses were conducted using a Straussian grounded theory approach.
The ‘theory of preserving control’ (ToPC) emerged from individuals' accounts of how they adapted to the experience of involuntary admission. The ToPC explains how individuals manage to reclaim control over their emotional, personal and social lives and consists of three categories: ‘losing control’, ‘regaining control’ and ‘maintaining control’, and a number of related subcategories.
Involuntary admission triggers a multifaceted process of control preservation. Clinicians need to develop therapeutic approaches that enable individuals to regain and maintain control over the course of their involuntary admission.