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The field of Global Mental Health (GMH) aims to influence mental health policy and practice worldwide, with a focus on human rights and access to care. There have been important achievements, but GMH has also been the focus of scholarly controversies arising from political, cultural, and pragmatic critiques. These debates have become increasingly polarized, giving rise to a need for more dialogue and experience-near research to inform theorizing. Ethnography has much to offer in this respect. This paper frames and introduces five articles in this issue of Transcultural Psychiatry that illustrate the role of ethnographic methods in understanding the effects and implications of the field of global mental health on mental health policy and practice. The papers include ethnographies from South Africa, India, and Tonga that show the potential for ethnographic evidence to inform GMH projects. These studies provide nuanced conceptualizations of GMH's varied manifestations across different settings, the diverse ways that GMH's achievements can be evaluated, and the connections that can be drawn between locally observed experiences and wider historical, political, and social phenomena. Ethnography can provide a basis for constructive dialogue between those engaged in developing and implementing GMH interventions and those critical of some of its approaches.

In drei Artikeln wird die politische, wirtschaftliche und soziale Situation in Angola untersucht, nachdem die UNITA am 20.9.93 einen einseitigen Waffenstillstand erklärt hat. Ein Artikel schildert die Lage in Kuito, wo sich Regierungstruppen und UNITA gegenüberstehen und sich die Gesundheits- und Nahrungsmittelversorgung extrem zuspitzt. Die beiden anderen Artikel untersuchen einerseits die Bemühungen und Chancen für einen Frieden, zum anderen beschreiben sie das Los der Zivilbevölkerung und die wirtschaftliche Krise des Landes. (DÜI-Sbd)

Purpose
– The purpose of this paper is to analyse in detail the findings from 40 serious case reviews (SCRs) involving adults who self-neglect, and to consider the commissioning and reporting of such inquiries in the context of accountability that also involves the Coroner and the Local Government Ombudsman.


Design/methodology/approach
– This study comprised a cross-case analysis of 32 SCRs, using a four-layer design of the adult and their living context, the team around the adult, the organisations around the team, and the Local Safeguarding Board around the organisations.


Findings
– Available reports tend towards description of events rather than appraisal of what influenced practice. They highlight the challenges in cases of self-neglect practice, including person-centred approaches, capacity assessment and securing engagement. Familiar themes emerge when the spotlight turns to professional and organisational networks, namely information-sharing, supervision, recording and compliance with procedures and legal rules. Some Local Safeguarding Adults Boards found the process of conducting and then using serious case reviews for service improvement challenging.


Research limitations/implications
– The cross-case approach to thematic analysis focuses on reports into situations where outcomes of professional and organisational intervention had been disappointing. Nonetheless, the themes derived from this analysis are similar to other research findings on what represents best practice when working with cases involving self-neglect.


Practical implications
– The paper identifies learning for the effective commissioning and conduct of SCRs, and for service improvement with respect to practice with adults who self-neglect.


Originality/value
– The paper offers further detailed analysis of a large sample of SCRs that builds the evidence-base for effective practice with adults who self-neglect and for efficient management of process of commissioning and conducting SCRs.

Purpose
– The purpose of this paper is to report the findings from research into 40 serious case reviews (SCRs) involving adults who self-neglect.


Design/methodology/approach
– The study comprised analysis of 40 SCRs where self-neglect featured. The reviews were found through detailed searching of Local Safeguarding Adult Board (LSAB) web sites and through contacts with Board managers and independent chairs. A four layer analysis is presented of the characteristics of each case and SCR, of the recommendations and of the emerging themes. Learning for service improvement is presented thematically, focusing on the adult and their immediate context, the team around the adult, the organisations around the team and the Local Safeguarding Board around the organisations.


Findings
– There is no one typical presentation of self-neglect; cases vary in terms of age, household composition, lack of self-care, lack of care of one's environment and/or refusal to engage. Recommendations foreground LSABs, adult social care and unspecified agencies, and focus on staff support, procedures and the components of best practice and effective SCRs. Reports emphasise the importance of a person-centred approach, within the context of ongoing assessment of mental capacity and risk, with agencies sharing information and working closely together, supported by management and supervision, and practising within detailed procedural guidance.


Research limitations/implications
– There is no national database of SCRs commissioned by LSABs and currently there is no requirement to publish the outcomes of such inquiries. It may be that there are further SCRs, or other forms of inquiry, that have been commissioned by Boards but not publicised. This limits the learning that has been available for service improvement.


Practical implications
– The paper identifies practice, management and organisational issues that should be considered when working with adults who self-neglect. These cases are often complex and stressful for those involved. The thematic analysis adds to the evidence-base of how best to approach engagement with adults who self-neglect and to engage the multi-agency network in assessing and managing risk and mental capacity.


Originality/value
– The paper offers the first formal evaluation of SCRs that focus on adults who self-neglect. The analysis of the findings and the recommendations from the investigations into the 40 cases adds to the evidence-base for effective practice with adults who self-neglect.

Purpose – The purpose of this paper is to analyse in detail the findings from 40 serious case reviews (SCRs) involving adults who self-neglect, and to consider the commissioning and reporting of such inquiries in the context of accountability that also involves the Coroner and the Local Government Ombudsman. Design/methodology/approach – This study comprised a cross-case analysis of 32 SCRs, using a four-layer design of the adult and their living context, the team around the adult, the organisations around the team, and the Local Safeguarding Board around the organisations. Findings – Available reports tend towards description of events rather than appraisal of what influenced practice. They highlight the challenges in cases of self-neglect practice, including person-centred approaches, capacity assessment and securing engagement. Familiar themes emerge when the spotlight turns to professional and organisational networks, namely information-sharing, supervision, recording and compliance with procedures and legal rules. Some Local Safeguarding Adults Boards found the process of conducting and then using serious case reviews for service improvement challenging. Research limitations/implications – The cross-case approach to thematic analysis focuses on reports into situations where outcomes of professional and organisational intervention had been disappointing. Nonetheless, the themes derived from this analysis are similar to other research findings on what represents best practice when working with cases involving self-neglect. Practical implications – The paper identifies learning for the effective commissioning and conduct of SCRs, and for service improvement with respect to practice with adults who self-neglect. Originality/value – The paper offers further detailed analysis of a large sample of SCRs that builds the evidence-base for effective practice with adults who self-neglect and for efficient management of process of commissioning and conducting SCRs.

PurposeThe purpose of this article is to report the findings from research into the governance of adult safeguarding policy and practice in England, with particular focus on interagency partnership arrangements expressed through Safeguarding Adults Boards.Design/methodology/approachThe study comprised a systematic search and thematic analysis of English‐language literature on adult safeguarding governance, a survey of Safeguarding Adults Board documentation, and key informant interviews and workshops with professionals involved in adult protection.FindingsThe effectiveness of adult safeguarding governance arrangements has not been subject to prior formal evaluation and thus the literature provided little research‐led evidence of good practice. The survey and workshops, however, revealed a rich and complex pattern of arrangements spanning a number of dimensions – the goals and purpose of interagency working, the structures of boards, their membership, chairing and rules of engagement, their functions, and their accountabilities.Research limitations/implicationsThe research focus here is England, and thus does not incorporate learning from other jurisdictions. Whilst the research scrutinises the extent to which Boards practise empowerment, service users and carers are not directly involved in the fieldwork aspects of this study. In view of the absence of outcomes evidence identified, there remains a need to investigate the impacts of different forms of governance.Practical implicationsDrawing on this research and on governance frameworks in the context of related interagency fields, the article identifies standards to benchmark the approach to governance taken by Safeguarding Adult Boards.Originality/valueThe benchmarking framework will enable Safeguarding Adults Boards to audit, evaluate, and further develop a range of robust governance arrangements.

PurposeThe research reported here aims to scope the concept of self‐neglect as it is explored in the literature and interpreted in practice by professionals involved in adult safeguarding.Design/methodology/approachThe approach taken included a systematic search and thematic analysis of English‐language literature on self‐neglect, workshops with UK‐based adult safeguarding leads and practitioners from social services, police and health services, and scrutiny of Safeguarding Adults Boards' documentation.FindingsThe concept of self‐neglect is complex with contrasting definitions and aetiology, accompanied by debates on the principles that guide intervention. Decision‐making capacity is a key pivot upon which professional responses to self‐neglect turn. Intervention in self‐neglect requires careful exploration in the context of principles of personalisation, choice, control, and empowerment that underpin policy in adult social care and safeguarding.Research limitations/implicationsAs a conceptual scoping review, this study seeks to establish broad themes of use to practitioners working with self‐neglect. It thus does not carry out a full quality review of the literature identified and discussed, but serves as a base for this to be done in future.Practical implicationsAssessment in self‐neglect should consider the influence of a number of possible causative factors, and intervention must balance respect for autonomy on the one hand and a perceived duty to preserve health and wellbeing on the other.Originality/valueThis article summarises and critically analyses the emerging key features of evidence‐informed practice in the challenging field of self‐neglect.