Suchergebnisse

Intro -- Social Work with Autistic People -- Cover -- Of related interest -- Title Page -- Copyright -- Contents -- Foreword by Alex Ruck Keene -- Foreword by Ruth Allen -- Acknowledgements -- 1. Where Does Autism Fit from a Social Work Perspective? -- 1.1 Autism in the context of social work -- 1.2 Why do I need to do anything differently for autism? -- 1.3 Autism and co-occurring conditions -- 1.4 Undiagnosed autism -- 1.5 How can this book help social workers? -- 2. Social Care Assessment and Autism -- 2.1 Before the assessment -- 2.2 During the assessment -- 2.3 Chapter summary and key points -- 3. Social Care Eligibility and Autism -- 3.1 Assumptions -- 3.2 Thresholds or barriers? -- 3.3 Autistic needs in daily living -- 3.4 Chapter summary and key points -- 4. Person-Centred Care Planning and Autism -- 4.1 Person-centred approaches, needs-led planning and the wider context -- 4.2 What does good care look like? Goals -- 4.3 What does good care look like? A framework -- 4.4 Chapter summary and key points -- 5. Life Stages, Aging, Transition Planning and Autism -- 5.1 Introduction -- 5.2 Autism and attachment difficulties -- 5.3 Human development and developmental delay in autism -- 5.4 Autistic identity development -- 5.5 Managing transitions -- 5.6 Chapter summary and key points -- 6. Assessing Mental Capacity and Autism -- 6.1 Introduction -- 6.2 Who does the assessment? -- 6.3 Assumptions -- 6.4 Autistic people and the development of decision-making skills -- 6.5 Providing all relevant information -- 6.6 Types of decision -- 6.7 Timing -- 6.8 The functional test -- 6.9 Chapter summary and key points -- 7. Supporting Decision Making and Autism -- 7.1 Introduction -- 7.2 Lack of experience -- 7.3 Adapting communication -- 7.4 Providing information -- 7.5 Weighing information and making a decision.

Purpose
– The purpose of this paper is to outline how questions relating to capacity arise in the context of safeguarding, and when applications to the Court of Protection are required in relation to those who may lack capacity. It also seeks to provide guidance as to how applications to the Court of Protection should be made so as to ensure that they are determined effectively and in a proportionate fashion.


Design/methodology/approach
– The paper draws on the practical experience of practising barristers appearing before the Court of Protection, and on the experience of a social worker who is an MCA/DOLS lead at a London local authority. The paper proceeds by way of a review of the relevant statutory provisions, an overview of the Court of Protection and then to a practical analysis of when and how applications to the Court need to be made.


Findings
– When to go to the Court of Protection in the safeguarding context is poorly understood, and there has not been proper recognition of the fact that proceedings for "adult care orders" have a strong forensic analogy with applications for care orders in relation to children. It is only by recognising these forensic similarities that local authorities can properly make use of the Court of Protection in the discharge of their obligations to vulnerable adults in their area.


Practical implications
– The paper should lead to a recognition that there is a specialist "adult protection court" within the Court of Protection, and that applications for adult care orders to that court require specific and careful preparation and presentation. It will therefore lead to better use of the Court of Protection in the safeguarding context and – ultimately – a better balance between empowerment and protection of vulnerable adults who may lack capacity.


Originality/value
– The paper is original in combining both legal and social work expertise to reach practical conclusions as to why such poor use has been made of the Court of Protection in safeguarding context. Its value lies in the deployment of that expertise to suggest how better use can be made in the future.

With complex legal and ethical dilemmas arising daily in intensive care medicine, it can be hard to know who to admit and when, the stage at which invasive management should be withdrawn, or who should even decide. Clinically focused, this book explores landmark rulings on controversies in critical care to aid your day-to-day decision making

Background:Insight into illness is often used in clinical and legal contexts, for example, as evidence of decision-making capacity. However, it is unclear whether this disadvantages certain groups protected under equality legislation. To our knowledge, this question has yet to be addressed systematically. Therefore, the present study reviews empirical studies that look at the relationship between insight and sociodemographic variables.Methods:A systematic search of six bibliographic databases (CENTRAL, CINAHL, Cochrane Library of Systematic Reviews, EMBASE, MEDLINE and PsycINFO) was conducted, which yielded 6,192 results. Study characteristics and outcomes (associations between insight and socio-demographic variables) were then extracted from 207 eligible studies. This included protected characteristics under the Equality Act (2010): age, sex, ethnicity, marital status and religion. Weighted confidence estimates were calculated and relevant moderators included in a random effects meta-analysis. A study protocol was registered prospectively on PROSPERO, ID: CRD42019120117.Results:Insight was not strongly associated with any sociodemographic variable. Better insight was weakly but significantly associated with white ethnicity, being employed, younger age and more years of education. The age associations were mostly explained by relevant moderating variables. For people with schizophrenia, the associations between sociodemographic variables and insight were comparable to associations with decision making capacity.Conclusions:Our results suggest that insight is not strongly associated with any sociodemographic variables. Further research is needed to clarify potential associations, particularly with non-white ethnicity and proxies for social support.

Background : The idea that people with severe mental illness should be able to plan in advance for periods of illness as a means of enhancing autonomy has been long debated and is increasingly being enshrined in codes of practice and mental health legislation. It has been argued that the ethical imperative for this is especially pronounced in bipolar (BP), a condition in which sufferers often experience episodic crises interspersed with periods of wellness. However, there is a paucity of published research investigating experiences of advance decision making (ADM) in people with BP or their attitudes towards it. Methods : An online survey of BPUK's mailing list was conducted. 932 people with BP completed the survey (response rate 5.61%). Descriptive statistics and regression analysis were conducted to compare experience of with attitudes towards ADM and variables associated with interest in ADM. Results : A majority indicated a desire to plan care in advance of losing capacity (88%) but most had not done so (64%). High numbers of respondents expressed a wish to request as well as refuse treatment and most wanted to collaborate with psychiatrists, including on issues around self-binding. The most frequent motivation to utilise ADM was a desire to be more involved in mental health decisions. Interest in self-binding was associated with experience of compulsory treatment and trust in mental health services. Interest in refusals of all medication was associated with younger age and lack of trust in mental health services. Interest in ADM in general was associated with younger age but not educational level, ethnicity or gender. Conclusions : This study demonstrates an appetite for ADM amongst people with bipolar that is independent of educational status and ethnicity. As states reform their mental health laws, attention needs to be given to the distinctive attitudes toward ADM amongst people with bipolar.

We argue that predictions of a 'tsunami' of mental health problems as a consequence of the pandemic of coronavirus disease 2019 (COVID-19) and the lockdown are overstated; feelings of anxiety and sadness are entirely normal reactions to difficult circumstances, not symptoms of poor mental health. Some people will need specialised mental health support, especially those already leading tough lives; we need immediate reversal of years of underfunding of community mental health services. However, the disproportionate effects of COVID-19 on the most disadvantaged, especially BAME people placed at risk by their social and economic conditions, were entirely predictable. Mental health is best ensured by urgently rebuilding the social and economic supports stripped away over the last decade. Governments must pump funds into local authorities to rebuild community services, peer support, mutual aid and local community and voluntary sector organisations. Health care organisations must tackle racism and discrimination to ensure genuine equal access to universal health care. Government must replace highly conditional benefit systems by something like a universal basic income. All economic and social policies must be subjected to a legally binding mental health audit. This may sound unfeasibly expensive, but the social and economic costs, not to mention the costs in personal and community suffering, though often invisible, are far greater.