• Assessment of risk and special observations in mental health practice: A comparison of forensic and non-forensic settings

      Whitehead, Elizabeth; Mason, Tom; University of Chester (Blackwell, 2006-10-26)
      This article discusses research into the use of special observations in both forensic and non-forensic psychiatric settings. A comparative approach was adopted to establish if the perceived risk factors leading to the adoption of special observations were similar in both settings. Three groups of nursing staff were requested to assess 30 patients who were placed on special observations. Before this, nurses were requested to rate the risk factors in terms of their severity on a 7-point Likert scale. The rank-ordering analysis revealed a similarity of identified risk factors and anova (one-way, unrelated) and the Jonckheere Trend Test revealed that there were significant differences between the scores in the forensic and the non-forensic settings.
    • Binary construct analysis of forensic psychiatric nursing in the UK: High, medium and low security services

      Mason, Tom; King, Lisa; Dulson, Julie; Faculty of Health and Social Care, University of Chester (Australian College of Mental Health Nurses Inc., 2009-05-06)
      The aim of this study was to idenfity if differences in perceptions of the role of forensic psychiatric nurses exist across the three levels of secure psychiatric provision: high, medium and low. Any differences may reflect the type of clinical conditions found in different levels of security provision. An information gathering schedule containing a validated 7-point Likert scale was distributed to 1200 forensic psychiatric nurses across the UK in 2005. A response rate of 34.6 was achieved, with 122 from high-security, 159 from medium-securitya nd 135 from low-security services. Differences in perceptions regarding role constructs were found across all three levels, with numerous differences being statistically significant using analysis of variance. The implications are in relation to the development of skills and competencies, which should target specific clinical conditions in relation to effective interventions, the development of a specialist education and training curriculum focused on treatment outcomes and the need for further research to draw together theory and practice. Finally, creative policy initiatives should be developmed to cross-fertilize the levels of security provision in order that staff may acquire and deliver experiences in high, medium and low security psychiatric services.
    • Binary constructs of forensic psychiatric nursing: A pilot study

      Mason, Tom; Dulson, Julie; King, Lisa; University of Chester (Blackwell, 2009-02-06)
      The aim was to develop an Information Gathering Schedule (IGS) relevant to forensic psychiatric nursing in order to establish the perceived differences in the three levels of security, high, medium and low. Perceived differences in the role constructs of forensic psychiatric nursing is said to exist but the evidence is qualitative or anecdotal. This paper sets out a pilot study beginning in 2004 relating to the development of two rating scales for inclusion into an IGS to acquire data on the role constructs of nurses working in these environments. Following a thematic analysis from the literature two sets of binary frameworks were constructed and a number of questions/statements relating to them were tested. The Thurstone Scaling test was applied to compute medians resulting in a reduction to 48 and 20 items for each respective framework. Two 7-point Likert scales were constructed and test-retest procedures were applied on a sample population of forensic psychiatric nurses. Student's t-test was conducted on the data and the results suggest that the IGS is now suitably for application on a larger study. The IGS was piloted on a small sample of forensic psychiatric nurses. The two scales were validated to coefficient values ranging from 0.7 to 0.9. Amendments were made and the IGS was considered acceptable.
    • Caring for a child with a learning disability born into the family unit: Women's recollections over time

      Lovell, Andy; Mason, Tom; University of Chester (Taylor & Francis, 2011-08-01)
      Caring over time for a child/young adult with a learning disability requires that the family, and in particular the mother, negotiate their needs with services and professionals, and these negotiations are complicated further by significant behavioural issues in the children. This study reports on a series of interviews undertaken with mothers of children and young adults with learning disabilities and a history of challenging behaviours. The interviews were supplemented by documentary data from clinical and other notes in order to provide a more detailed view of the issues arising from caring over time. Detailed thematic analysis revealed five key themes demonstrating the cumulative effect of caring for someone with such complex needs, the centrality of that individual’s needs to the lives of those interviewed and the ongoing negotiation between family and professionals required in order for the former to work out how to continue caring both effectively and on their own terms. All the names of mothers and children are psuedonyms.
    • The changing dynamic of stigma

      Whitehead, Elizabeth; Mason, Tom; Carlisle, Caroline; Watkins, Caroline; Chester College of Higher Education ; Caswell Clinic/University of Glamorgan ; University of Liverpool ; University of Manchester (Routledge, 2001-07-12)
      This book chapter discusses the experience of stigma within social, political, media, and cultural influences
    • Cultural change in a learning disability secure service: The role of the ‘toggle’ group

      Astbury, Geoff; Lovell, Andy; Mason, Tom; Froom, Katy; University of Chester ; University of Chester ; University of Chester ; 5 Boroughs Partnership NHS Foundation Trust, Warrington (2011-04-01)
      This paper reports the findings of a study into the management of change within a learning disability service in transition from medium to low security status. The relationship between the service culture and resistance to change was a key consideration. A focus group approach was utilized with eight professionals from a range of disciplines meeting on six separate occasions, and the data was subsequently subject to thematic analysis. The study findings revealed markedly different perceptions of the response of the staff team to the implementation of change, with three groups adopting markedly different identities and allegiances. A dynamic group, embracing change and showing initiative, a strategically resistant group, and a third group, the ‘toggle’, swaying towards one of the other two groups according to changing circumstances. The paper concludes that the toggle group were extremely influential with regard to the implementation of change, and may be of significance in analysis of strategies of resistance.
    • Domestic violence: A multi-professional approach for healthcare practitioners

      Keeling, June J.; Mason, Tom; University of Chester (Open University Press, 2008-05-01)
      This book takes a multi-agency approach to domestic violence and looks at a large range of issues that impact on those working in the health and social care fields. It begins with identification of situations where abuse may occur, including intimate partner violence, child and adolescent abuse, same-sex violence and elderly abuse. The book considers the commonalities for survivors of abuse - such as the right to feel safe and protected from violence - and evaluates how health and social care professionals can work towards a positive outcome for all of the individuals involved.
    • Forensic nurses' perceptions of labels of mental illness and personality disorder: Clinical versus management issues

      Mason, Tom; Hall, Rebecca; Caulfield, Mike; Melling, Katherine; University of Chester (Blackwell, 2010-02-09)
      Anecdotally, forensic psychiatric nurses generally have a more negative perception of people diagnosed with a personality disorder and this negativity is focused more towards managing the behaviours rather than on treatment efficacy and clincal outcomes. this study reports on research carried out across the High, Medium and Low secure psychiatric services in the UK. One thousand two hundred questionnaires were distributed with a response rate of 34.6%. The results indicated a statistically significant differences across High (z=9.69; P< 0.01), Medium (z=11.06; P< 0.01) and Low (z= 9.57; P=0.01) security with a focus on the management of people with a personality disorder using the Wilcoxon paired samples test. There was also a statistically significant difference in relation to a more clinical/treatment focus for those with a diagnosis of mental illness in Medium (z= 9.69; P=0.01) and Low (z= 9.57; P<0.01) security but not in the High security services. Finally, the results showed significant differences between High, Medium and Low security on each of the four scales of Personality Disorder Clinical - Personality Disorder Management and Mental Illness Clinical - Mental Illness Management. This raises issues of stigma, prejudice and discrimination and suggests a refocus on skills development, acquisition and application for those with a label of personality disorder.
    • Forensic psychiatric nursing: Skills and competencies: I role dimensions

      Mason, Tom; Lovell, Andy; Coyle, David L.; University of Chester (Blackwell, 2008-01-18)
      This paper reports on an investigation into the skills and competencies of forensic psychiatric nurses from the perspective of three groups (a) forensic psychiatric nurses, (b) non-forensic psychiatric nurses and (c) other disciplines. A national survey of freonsc psychiatric services in the UK was conducted, and information gathered on the perceived skills and competencies in this growing field of psychiatric practice. From 3360 questionnaires, 1172 were returned making a response rate of 35%. The results indicate a small discrepancy between forensic nurses' and non-forensic nurses' perceptions of the role constructs of forensic practice. However, a larger difference was noted between nurses'perceptions and other disciplines' perceptions of the constituent parts to forensic psychiatric nursing. Nurses tend ed to focus on personal qualities both in relation to themselves and th epatients, while the other disciplines focused on organizational structures both in defining the role and in the resolution of perceived deficits. The findings have implications for multidisciplinary working, as well as policy formulation and curriculum development in terms of the skills and competencices of forensic nurse training.
    • Forensic psychiatric nursing: Skills and competencies: II Clinical Aspects

      Mason, Tom; Coyle, David L.; Lovell, Andy; University of Chester (Blackwell, 2008-01-18)
      This study reports on research undertaken to identify the skills and competencies of forensic psychiatric nurses working in secure psychiatric services in the UK. The rationale for this research is the lack of clarity in the role definition of nurses working in these environments and the specific content that may underscore the curriculum for training forensic nurses. Over 3300 questionnaires were distributed to forensic psychiatric nurses, non-forensic psychiatric nurses and other disciplines and information obtained on (1) the perceived clinical problems that give forensic nurses the most difficulty, (20 the skills best suited to overcome those problems and (3) the priority aspects of clinical nursing care that needs to be developed. A 35% response rate was obtained with 1019 forensic psychiatric nurses, 110 non-forensic psychiatric nurses and 43 other disciplines. The results highlighted a 'top-ten' list of main problems with possible solutions and main areas for development. the conclusions drawn include a focus on skills and competencies regarding the management of personality disorders and the management of violence and aggression.
    • Forensic psychiatry: Influences of evil

      Mason, Tom; University of Chester (Humana Press, 2005-12-15)
      Many conscientious mental health professionals caring for disturbed patients have either unscientifically formulated for themselves notions of 'evil' to explain the behavior of their patients, or have been given patients described by judges and the press as 'evil'. Although such notions may be deemed unscientific, beyond the purview of medicine, and better suited for discussion by theologians and moral philosophers, the fact remains that these notions of 'evil' have a definite impact on the practice of psychiatry, if not all medical fields.
    • The future of nursing: Career choices in potential student nurses

      Whitehead, Elizabeth; Mason, Tom; Ellis, Jackie; University of Chester (Mark Allen, 2007-04-01)
      Young people leaving schools and sixth-form colleges have the opportunity to choose a career path from an increasing number of courses in colleges of further and higher education. Nursing studies are now competing with a range of health-related disciplines such as health studies, psychology and complementary therapy. Compared with nursing studies, many of these courses appear more exciting and appealing to studnets who are in the process of choosing a career or programme of study. while the increased choice is a positive move for students it may contribute to the shortage of students currently entering some areas of nursing. Indeed, some specialities in nursing, including mental health and learning disabilities, are so depleted in students that they are reaching a point of crisis. There is also concern that recruitment into nursing remains predominantly female and White British. Given the diversity of the UK population and the reliance on school leavers as a potential source of supply, it is important to understand why male students and those from multiracial and multicultural environments choose, or do not choose, nursing studies. This research study involved a sample of 106 16-year old students from three secondary schools in the North-West and South-East of England. The questionnaire results, collected in schools, revealed that students held tradtional views or knew very little about the nursing profession.
    • Historical developments

      Whitehead, Elizabeth; Carlisle, Caroline; Watkins, Caroline; Mason, Tom; Chester College of Higher Education ; University of Liverpool ; Manchester University ; Caswell Clinic/University of Glamorgan (Routledge, 2001-07-12)
      This book chapter discusses stigma and social exclusion within a historical context, focusing on the work of Durkheim, Goffman, Edward Jones, & Scambler.
    • Key concepts in learning disability

      Talbot, Pat; Astbury, Geoff; Mason, Tom; Faculty of Health and Social Care, University of Chester (SAGE, 2010-02-15)
      This book offers an A-Z format which covers a wide variety of topics on learning disabilities.
    • Key concepts in nursing

      Mason-Whitehead, Elizabeth; McIntosh, Annette; Bryan, Ann; Mason, Tom; Faculty of Health and Social Care, University of Chester (SAGE, 2008-03-17)
      Each entry features a snapshot definition of the concept, a broader discussion, key points, a case study and examples of further reading.
    • Managing risk: A qualitative study of community-based professionals working with learning-disabled sex offenders

      Hutchinson, John; Lovell, Andy; Mason, Tom; University of Chester (2012-02-19)
      This study reports on research conducted to examine how community practitioners manage the difficulties of risk assessment in relation to people with a learning disability and a history of sexually offensive or abusive behaviour. Semi-structured interviews were conducted with a number of key professionals from various disciplines, all currently involved in the assessment process with the aim of determining potential referral to community settings. Data analysis revolved around a thematic exposition of factors influencing the relationship between the objective science of psychiatric investigation and the subjective interpretation of real-world practicalities in working with this group. Findings surrounded three major themes, frame conflict, relating to the difficulties of decision making in this area, therapeutic performance, whereby professionals were expected to engage in some form of active intervention, and safety outcomes, involving consideration of the problematic nature of judging the likelihood of re-offending.
    • Manifesto for change

      Carlisle, Caroline; Watkins, Caroline; Mason, Tom; Whitehead, Elizabeth; University of Liverpool ; Manchester University ; Caswell Clinic/University of Glamorgan ; Chester College of Higher Education (Routledge, 2001-07-12)
      This book chapter offers suggestions for healthcare professionals working with people who may be stigmatised. It offers suggestions on how practice may be taken forward in the areas of education, reserch and development, and individual professional practice.
    • Pre-admission nursing assessment in a Welsh medium secure unit (1991–2000): Part 1 - an analysis of practice and cost

      Watt, Andrew; Topping-Morris, Barry; Mason, Tom; Rogers, Paul; Institute of Cardiff, University of Wales ; Caswell Clinic, Glanrhyd Hospital ; Glanrhyd Hospital / University of Glamorgan / Chester College of Higher Education ; Institute of Psychiatry / Glanrhyd Hospital (Elsevier, 2003-04-16)
      This article discusses the practice of pre-admission assessments and details a method for estimating the cost of forensic nursing assessments in terms of the investment of nursing time.
    • Relationship to practice

      Watkins, Caroline; Carlisle, Caroline; Whitehead, Elizabeth; Mason, Tom; Manchester University ; University of Liverpool ; Chester College of Higher Education ; Clinic/University of Glamorgan (Routledge, 2001-07-12)
      This book chapter discusses the macro and micro levels of practical impact that theories relating to stigma can have on individuals and groups.
    • The social construction of stigma in health care settings

      Mason, Tom; Mason-Whitehead, Elizabeth (Chester Academic Press, 2006)
      This book chapter discusses stigma in health care settings from the perspective of social constructivism.