BBC Radio 'File on Four' - DASH to Instrumentalise

Of course, I'd like to see Hodges' model applied to many purposes.

As probably posted at some point, the thought of Hodges' model being instrumentalised goes back a long way. To the time of microcomputers in fact and 'CAPA' which stood for 'Computer-Aided Patient Assessment':

Jones, P. (1986) Computing in Nursing NEWS. Computerised Patient Assessment. Nursing Times. 85: 5. Sep 3-9;82(36):63-5. PMID: 3532039

[Describes 'CAPA', a BBC BASIC microcomputer program for student nurses.]

Even before discovering Hodges' model in the late 1980s, I was sensitive about being seen to mechanise nursing and care delivery. Nursing was still preoccupied with the nursing process and individualised care. The last thing I would want is to be seen as supporting the processing of patients. The person, their social context and identity becoming lost. It was a long-term and ongoing co-author who drew my attention to Hodges' model as an instrument. Which I've considered for each and across the care domains. CAPA was simplistic, even beyond the programming language employed. A dependency score from 1-5 was allocated (it's a long time ago!) to each of the activities of daily living for a patient:

Roper, N., Logan, W., & Tierney, A. J. (2000). The Roper-Logan-Tierney model of nursing: Based on activities of living. Churchill Livingstone.

In healthcare we are trained and become accustomed to the use of many assessment tools, checklists; this includes mental health nursing and specific therapies. Emphasis, is rightly placed upon the safety, validity and hence testing of tools. Some are 'broad brushes'. Others are specific - outcomes, anger, a carer's knowledge, conviction of belief, mood, impulsivity and many more. Drift away from the original goal and purpose and problems can (predictably) ensue. Training will and must be updated, but do all assessment tools have a 'Use By' date? Hopefully there is ongoing development, version control and sustained trials and testing of the instruments themselves.

'File on Four' BBC Radio 4 this evening concerns DASH, which stands for "Domestic Abuse, Stalking and ‘Honour’- based abuse".

Community - Kids - Photographer - Police

My maternal grandfather was a man of few words (WWI). He did recount tales of when as a lad, he and his friends would knock the policeman's (and it was a 'man' back then) helmet off and leg it. It was, another time in several senses. Given his war experiences, I now wonder how easy it was to end up working at a gas works? Passive, re-traumatisation? Or, just grateful to have a job in the 1920-30s? 

After he retired he had a job as a 'cocky watchman' in a park. I remember visiting him in his hut with my mother. 

These photographs more 'recent' from the 1970s suggests 'community' policing, and calls for its return here in the UK in the 1990s(?). 

The policewoman on the right, also put me in mind of the 'nurse/doctor ...' running in the opening credits of MASH. 

individual

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Leonard Freed Police scooter patrol. New York City, USA. 1978. © Leonard Freed | Magnum Photos	Leonard Freed | Police Work A policewoman plays with local kids in Harlem. New York City, USA. 1978. © Leonard Freed | Magnum Photos

Police Work by Leonard Freed (Reel Art Press, £49.95) reelartpress.com.

https://www.reelartpress.com/catalog/edition/240/leonard-freed:-police-work

My sources:
The Daily Telegraph, Review, 7 December 2024, p.14. 

Neighbourhood Watch. Sunday Times Magazine, 17 November 2024. pp.42-47.

Images: Magnum Photos

https://www.magnumphotos.com/newsroom/police-work-leonard-freed-magnum-photos/

Black Mental Health Manifesto

"Concrete action is needed to improve mental healthcare for black communities otherwise generations will keep being “held back from achieving their full potential”, a new coalition has warned.

The group said it is calling for “positive change” to alter a system within which it said black people are being failed when they at their most vulnerable.

The coalition – which includes the Black Minds Matter charity, the Centre for Mental Health and Mind as well as smaller grass-roots organisations – has launched what it called the Black Mental Health Manifesto."

        continued ...

Individual

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      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

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Group

Mental Health / Illness - Parity of Esteem Holistic: Assessment, Planning, Intervention, Evaluation - Competency? Diagnosis of Psychoses	Physical health change/revision - WHEN? Objectivity of assessment / Cultural literacy
Black communities and Families Culture, History Radical future? Stigma, Stereotype Social determinants	Racism. Economic, Political determinants Poverty, Housing insecurity Statistics - Admissions / Recourse to MHA Incarceration, Injustice Mental Health Law - Mental Health Act CHANGE/REVISION - when? Coalition

The need for Holism 2.0 ... (c/o Porter, 1997)

 or 4.0?

"Disease became conceptualized after 1900 as a social no less than a biological phenomenon, to be understood statistically, sociologically, psychologically - even politically. Medicine's gaze had to incorporate wider questions of income, lifestyle, diet, habit, employment education and family structure - in short, the entire psycho-social economy. Only thus could medicine meet the challenges of mass society, supplanting outmoded clinical practice and transcending the shortsightedness of a laboratory medicine preoccupied with minute investigation of lesions but indifferent as to how they got there. It was only radicals and prophets who appealed to a new holism - understanding the whole person in the whole society; respected figures with the temple of medical science, including Kurt Goldstein (1878-1965) and René Dubos (1901-82), author of Mirage of Health (1959), were emphatic that the mechanical model of the body and the sticking plaster formula would at best palliate disease (too little, too late) but never produce true health." p.634.

Roy Porter, The greatest benefit to mankind: a medical history of humanity from antiquity to the present, London, HarperCollins, 1997.

INDIVIDUAL

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HUMANISTIC --------------------------------------  MECHANISTIC      

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GROUP

"The psychiatrization of everything occurred first in the United States. It was a trend deliciously mocked in some of Stephen Sondheim's lyrics to West Side Story (1956), in which the crazy mixed-up New Yorkers taunt the police officer on the warpath: Officer Krupke, you're really square; This boy don't need a judge, he needs an analyst's care! It's just his neurosis that oughta be curbed, He's psychologic'ly disturbed. We're disturbed, we're disturbed, we're the most disturbed, Like we're psychologic'ly disturbed. " p.519.

frontispiece

Socio-Economic Determinants of Health Social Justice History Culture

Police 'the Law' Mental Health Act Political determinants of Health

Image - frontispiece in Porter's book "Renaissance anatomical illustrations often followed artistic conventions (situating the skeleton in a lifelike pose in a landscape) and played wittily on the tensions between life and death. The contemplating of the skull prefigures Hamlet's later meditation. Line drawing, Valverde de Hambusco, Historia Historia de la composicion del cuerpo humano, Roma, 1556."

Image source:
https://www.royalacademy.org.uk/art-artists/work-of-art/lateral-view-of-male-skeleton

Join us 6/16 - Virtual tour of The Healing Project's new digital archive

"Join us on Thursday, June 16, 2022 from 12-1p PT / 3-4p ET for a virtual tour of The Healing Project’s brand new digital archive! We’ll discuss what the art, stories, and realities of incarcerated people in the US mean for health professionals’ work to advance health equity in the context of historical and contemporary social justice movements."

 
INDIVIDUAL

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GROUP

(mental) health equity*	(physical) health equity*
arts social justice history social health equity^ healing communities	incarcerated people detention police health workers political health equity^

 

*individual (lived) experience

^collectively experienced (and also 'lived')

Where does violence sit, stand, shout, strike, stun ... in h2cm?

My source: 

Spiritof1848 Listserv WWW.SPIRITOF1848.ORG #Spiritof1848

High Intensity Networks - serenity integrated mentoring SIM model of care

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'Serenity' a humanising term? TRAUMA informed? Expressing distress Poor coping skills Suicidal ideation, Plans, Intent Self-harm Personal Responsibility -  Serenity Practitioner values? Therapeutic modality Access to Therapy - DBT ...? Active research in this field - Parity? Chaotic presentation [Define] High Intensity: Needs highly personalised care 'person-centred care' 'This' is why I became a MH Nurse: Values

High Intensity Network# and “serenity integrated mentoring” (SIM) model of “care” Nursing theory: 'patiency' Integrated Recovery Programme - IRP [Define] High Intensity: Attempted suicide, Frequency, Nos. of services, Nos. of A&E attendances, Dual, n-diagnosis, Data Evidence-base Independent review Mare Serenitatis: Peace on the Moon? Resource allocation: Framing the problem* 'Clinically'

Language & Terminology 'High Intensity' Education of students: 'committed' - 'completed'? Care in the Community (Social) Serenity Social Justice Community - MH Nursing - of Practice Therapeutic relationships Historical artefact: The therapeutic alliance

Policing, Law & Enforcement “high intensity users” (HIUs) of emergency services Mental Health [Police officers] Teams Criminalisation Decriminalisation of Suicide 1961 (Organisational) Serenity? High Intensity (Service-centred) Cost, Time, Personnel, Services involved Commissioning, Policy Outcomes - Cost Savings? NMC MH Nursing Standards MH Nursing Curricula

^#Website not provided: "Service Temporarily Unavailable" 

*There is a 'problem' here. Is the main symptom and sign however, evidence of an ongoing lack of parity of esteem?

My source: Twitter - various

 

HSJ: Human centred systems - the case for [disintegrated] integration

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Listening, communication slip ups YOU! are a - “bed blocker” “frequent flyer” My purpose Valuable or Vulnerable person? “PROTECT the Person”	Services, Teams, Silos Repeated doubling up, duplication Threshold raising simplify the steps 1940s style factory production line model ? 5-year cycle, interventions, (budget) ? Place-based
Neighbourhoods Anthropology of Communities PUBLIC - 'shared purpose' lived experience - develop a more flexible multidisciplinary workforce coproduction :: purchaser provider led model of commissioning social scaffolding in neighbourhoods -	initiatives Organisation 'INTEGRATE' Sovereignty, governance structures, pooled budgets “PROTECT the NHS” Public Service reform:  local government, dept of work and pensions,  police, housing and community and voluntary organisations.  - joint investment models

 

Human centred systems - the case for integration, By Donna Hall, 15 February 2021. HSJ. https://www.hsj.co.uk/service-design/human-centred-systems-the-case-for-integration/7029472.article 

 

My source: https://twitter.com/antlerboy/status/1392547724201971716?s=20

Seeing red ... the colour of social progress and justice ...?

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	Toya Sarno Jordan / Reuters

Photograph: Toya Sarno Jordan / Reuters - Seeing red A member of a feminist collective paints the helmet of a riot police officer during a protest against gender and police violence in Mexico City. More than 1,000 Mexican women were murdered because of their gender last year, and there was also a rise in sexual harassment and assault by police.

World News, The Daily Telegraph [UK], 13 November 2020, p.17.

http://www.toyasarnojordan.com/

Photo: https://uk.reuters.com/news/picture/top-photos-of-the-day-idUKRTX898PP

Black Minds Matter - too (by Daniel Davies)

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group - population

 

"Black British men are four times more likely than white men to be hospitalised for poor mental health, and are less likely to seek help before they reach crisis point. The system in place to support them is broken, yet few in power have acknowledged the problem until now. So, how do we fix it? We spoke to men who have fallen foul of a dysfunctional service, and those campaigning for change"

 

 

MIND	b o d y
Shared Values 'One Mind'

 

See also:

https://www.menshealth.com/uk/author/220007/daniel-davies/

My source:

https://twitter.com/cityalan/status/1318822496557256704?s=20

Deradicalisation: Sheep dips and holistic approaches

"Need to treat these people as individuals, not as generic sheep-dip things ..."

"Approach needs to be holistic, all encompassing ..."

individual

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group - population

Individual beliefs Personality, Character Mindsets Vulnerability Religion - subverted Need for Theological interventions 'Truth' Motivation Rehabilitation Purpose	Assessment Intervention Evaluation Process Subjective - Objective Resource intensive Surveillance
Culture Social values, social media Community leadership Community response Reintegration of Terrorist Offenders Practice Public Awareness - Preparedness ACT Awareness E-Learning	(Counter) Terrorism Prison (aptitude?) Sentence served Prison early  release Deradicalisation programmes -  (Globally none are 100% success) Martyn's Law Policy Funding

My source:
BBC Radio 4 Today 3 February 2020.

Book: "The Healing Next Time"

SELF - individual

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group - POPULATION

"Roy McFarlane’s second poetry collection, The Healing Next Time, is a timely and unparalleled book of interwoven sequences on institutional racism, deaths in custody and of a life story set against the ever-changing backdrop of Birmingham at the turn of the millennium. Here forms a potent and resolute narrative in lyrical and multidimensional poems which refuse to look the other way or accept the whitewashed version of events."

TIME

healing

Roy McFarlane, "The Healing Next Time"

Book cover artwork: Barbara Walker

My source: Richard Booth Bookshop, Hay-on-Wye

Capital letter. Start of Sentence.

Prison, Offenders, Release ... in h2cm

individual

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Mental Health Assessment - diagnosis? Learning disability Ongoing counselling, legacy issues PTSD? Addiction services Custody Liaison Mental Health Nurses Understanding of – my [care] plan, stress & vulnerability, relapse signature Literacies, writing, numeracy Life chances Key skills: interviews, exams, assertiveness, strengths ...	Medication: prescribing, compliance, concordance, safe prescribing Addiction, Substance misuse Assurance of physical health, exercise Location – familiar with the area? Logistics – transport Technology* Treatment for Offenders Sentence length
Re-integration into society Social attitudes Sex Offenders Role of family Relationships (Legacy issues - 'resolve'?) (Re-)Housing The social network they may return to Contact with a  support group* Having a ‘buddy’ when available	Determinate Sentence (half) Policy (integration?) and Funding Offender Assessment System Rehabilitation of offenders Employment – work Opportunities for training - education Allocation to a GP and other health services Organisation of State Benefits Probation services, Charities Statutory supervision Mental Health Act Community assignment

Once we have sufficiently addressed what is identified using Hodges' model, we can can stand together in the center with an improved chance of achieving person-centred care and Recycling Lives?

 
If you can suggest changes, additions, please get in touch h2cmng AT yahoo.co.uk

The power of words ii

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Educate
	Re-Educate

The power of words

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veil	sur-veil

Hodges' model: Evidence-Based Integrated Healthcare - Policy, Mental Health & Research Funding

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Mental health research 3% Quarter of all health costs	Medical Research...
2011-2014  33% rise in mental health related incidents dealt with by the police	Council.. £801.4 million for projects - mental health allocated £21.8 million Funding also via other bodies - National Inst. for Health Research

My source: Bennett, R. (2016) Research fund spends 3% on mental health. The Times, 25 March 2016. p.24.

Mental Life and Death in Squares*

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Mental  health

"Approximately half of all deaths in or following police custody involve detainees with some form of mental health problem. The IPCC is keen to get a better insight into the issues concerning mental health and custody. A key way in which individuals with mental disorder may have contact with the police is when they are in a public place and are believed to be in need of ‘immediate care and control. ... " Please see: IPCC

'cost to ...'

Deaths in police custody

BBC: Custody deaths represent failure...

*or rectangular cells.

Doyle, M., Jones, P. (2013). Hodges’ Health Career Model and its role and potential application in forensic mental health nursing. Journal of Psychiatric and Mental Health Nursing. 20, 7, 631-640.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2850.2012.01961.x/abstract