The development of integrated working across health and social care has featured strongly in recent policy directives in both England and Scotland. This is part of a wider agenda of partnership and collaboration, with a range of options from the creation of unified structures as in the care trusts in England to localised arrangements for joint working between individual professionals. This article presents a detailed matrix of drivers and barriers to integrated working which has been developed through a number of case studies of community care practice pursued as part of work undertaken for the Joint Future Group of the Scottish Executive. Drivers and barriers in three key areas are highlighted: national policy frameworks, the local planning context, and operational factors. It is anticipated that the matrix should provide a useful framework for the detailed scrutiny and operationalisation of integrated working.

Accessible summary  There are a growing number of parents with learning disabilities living in the community. Parents sometimes have a hard time with housing, money and support. Parents with learning disabilities sometimes do not have their children living with them. People with learning disabilities can be good parents with proper support. Advocacy helps parents with learning disabilities have their voices heard. Summary There are increasing numbers of parents with a learning disability living in the community although the exact numbers are unknown. Existing research suggests that this group of parents faces disadvantage and discrimination on a number of levels. This study reports on the findings of a small pilot study that examined the lived experience of five parents with a learning disability living in Scotland. The research focused particularly on the role of advocacy in supporting parents. The study found that the parents faced a number of challenges not only in relation to their parenting role but also in the circumstances characterising their lives more generally. Parents were likely to be socially isolated and had limited support networks. Support services did not always meet the needs of parents with a learning disability, and joint working between agencies appeared to be particularly problematic. The study concludes by suggesting that advocacy can be effective in supporting parents to have their voices heard.

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Background: Citizenship has been promoted within mental health for several decades however, its application in the field of mental health policy and practice is relatively novel. The voices of people who experience mental health problems (MHPs) are often absent in ongoing discourses about citizenship.Aims: To explore how adults with experience of MHPs and other life disruptions identify potential barriers to citizenship.Method: A community based participatory research approach was adopted with peer researchers. Six focus groups (N = 40) using semi-structured interviews were conducted, consisting of participants who had experience of MHPS and other life disruption(s) within the last 5 years. The focus groups were audio recorded, transcribed verbatim and analysed in NVIVO using a thematic approach.Results: Three major themes associated with participants lived experiences of barriers to citizenship were identified: 'stigmatisation (internal & external) creates further divide';'being socially excluded leads to isolation'; and 'a sense of difference (as perceived by the self and others)'.Conclusions: Those who have experienced major life disruption(s) face multi-level barriers to citizenship. An awareness of such barriers has important implications for mental health research, policy and practice. Citizenship-oriented implementation strategies that aim to address multi-level barriers merit further investigation.

Purpose -The purpose of this study is to evaluate the effectiveness of user and carer involvement in a new one-year postgraduate certificate course for Mental Health Officers (MHOs) in Scotland, covering the first year of its delivery (2009)(2010).Design/methodology/approach -This was explored in two ways: first, by assessing the level of user and carer involvement against a modified framework; and second, by measuring students' confidence in working with people with mental health issues over the duration of the course, and through interviews with students and service users and documentary analysis. Findings -The findings indicate user and carer ''influence'' and ''partnership'' over the design and delivery of the learning, teaching and assessment strategy, but no degree of ''control'' over any aspect of the course. Teaching provided by users and carers was associated with marked improvement in students' confidence in engaging with and upholding the rights of users and carers in the context of the MHO role. Students reported increased awareness of the lived reality of compulsory treatment. Users reported benefits from feeling they had helped facilitate future good practice.Research limitations/implications -The research design does not allow for causal links to be made between increases in student confidence and user and carer involvement.Practical implications -The study identified substantial barriers to effective user and carer involvement but confirmed its potential as a positive change agent for post-qualifying social work education.Originality/value -This study contributes to the evidence base by demonstrating the value of service user and carer involvement in post qualifying social work education.