Section A: This paper reviews the existing theoretical and empirical literature of relevance to offenders with severe mental illness (SMI) in the UK. Due to the lack of theory accounting for progress through forensic mental health services (FMHS) as currently constituted, the adjacent areas of mental health recovery and forensic rehabilitation are the major focus. Relevant empirical literature is synthesised and critically evaluated and this paper concludes by (a) summarising research challenges that remain pertinent to this area of enquiry and (b) outlining recommendations as to how research can usefully proceed. Section B: The UK’s increasing recognition of offenders with SMI and the lack of a theoretical account specific to this group provided the rationale for this study. The aim was to develop a preliminary model of the ways offenders with SMI progress through FMHS towards reintegration with the community. Semi-structured interviews were conducted with seven FMHS-users and three FMHS staff members. Grounded theory was used to build a preliminary model, which contained six main categories: learning about and managing mental health, establishing facilitative relationships with staff, moving on from prison and early experiences of FMHS, developing self-direction, doing work in therapy, and managing wider support networks. Findings extend existing literature by providing a preliminary theoretical account of the multiple domains that influence progression of offenders with SMI towards reintegration with the community. Results are discussed with regard to the existing literature and clinical implications are outlined. Recommendations for future research are made. Section C: In order to reflect upon the process of conducting this project, the author considers four questions: (1) what research skills have been developed and what skills continue to require development?, (2) what would be done differently were this project to be repeated?, (3) what changes in clinical practice will occur as a consequence of this research?, and (4) what areas would future research focus on and how would this be approached?

The history of psychiatry is littered with serious failures of governance, to the detriment of mentally disordered people, especially those resident in psychiatric hospitals. Current mental health providers, increasingly focussed on community care, have also struggled to develop effective internal governance systems. Nine peer-reviewed research papers, published by the author (mostly with others) and the wider literature, reveal deficits in mental health governance at a jurisdictional, professional, and corporate level. In this thesis new governance solutions are developed against this background, built on contemporary principles in mental health and healthcare management. A new model of mental health governance is presented, based on the key demands of the strategic and regulatory environment, articulated as rights, risks and recovery. This integrated healthcare governance approach, covering provider policy, staff training and service audit, can monitor and ensure the protection of patients’ rights, as well as those of others; it also promotes the management of clinical risks, and of patients’ recovery outcomes. Rights-based risk-reduction training is the core interventional element of the model, whilst the monitoring element can be formalised as part of a Balanced Scorecard reporting system. This thesis makes a contribution to research methodology, theory and practice in mental health, human rights, healthcare management and governance. The model generates specific propositions for testing in mental health governance, with the potential for application in wider settings of service provision.

Recent South African research has confirmed that there is reason to be concerned about the mental health status and well-being of our youth. School-going youth are engaging in a wide array of risk behaviours that seriously threaten their well-being and hamper their chances of experiencing success in the future. The aim of this research was to explore factors relating to risk, resilience and health promoting schools in order to enhance the well-being of youth in South Africa.

Recent South African research has confirmed that there is reason to be concerned about the mental health status and well-being of our youth. School-going youth are engaging in a wide array of risk behaviours that seriously threaten their well-being and hamper their chances of experiencing success in the future. The aim of this research was to explore factors relating to risk, resilience and health promoting schools in order to enhance the well-being of youth in South Africa.

Philosophiae Doctor - PhD / Recent South African research has confirmed that there is reason to be concerned about the mental health status and well-being of our youth. School-going youth are engaging in a wide array of risk behaviours that seriously threaten their well-being and hamper their chances of experiencing success in the future. The aim of this research was to explore factors relating to risk, resilience and health promoting schools in order to enhance the well-being of youth in South Africa. / South Africa