Nottinghamshire Healthcare NHS Foundation Trust

This review aims to synthesise the evidence regarding the use and provision of dementia services and support for people with dementia and/or supporters from South Asian, African or Caribbean backgrounds living in the UK.

A narrative synthesis systematic review of the original research articles published up to April 2024 was conducted. A lay summary of the initial review findings was evaluated by experts-by-experience (n = 15) for scrutiny and to enable further discussions, to produce key recommendations for further developing dementia services.

A total of 18 studies (16 qualitative and 2 mixed methods studies) met the full inclusion criteria and were included in the review. The review findings and experts-by-experience consultations highlighted that: (1) dementia is not openly discussed or disclosed within many diverse ethnic communities. This can lead to family carers and people with dementia feeling isolated and unsupported. (2) Mainstream dementia support services and hospitals often do not meet diverse communities' cultural and religious needs, and (3) home-based care supported by external care agencies can be helpful but ensuring consistency of care staff in their culturally appropriate care can be extremely difficult to ensure.

Encouraging South Asian, African and Caribbean communities to increase their dementia knowledge is important. However, mainstream dementia support services also need to incorporate their cultural and religious essentials into care packages to encourage their help seeking behaviours and tackle dementia stigma. Collaborative service developments between the diverse communities, Health and Social Care providers and policy makers are essential to ensure equitable and culturally appropriate dementia care for diverse community members in the future.

Recovery-oriented approaches in mental health emphasize personal growth, agency, and meaningful community integration. While endorsed by policies and reforms, the practical implementation of such approaches remains challenging, particularly in settings like Denmark, where structural fragmentation, professional hierarchies, and resource constraints may limit the adoption of holistic recovery principles.

This qualitative study employed focus group interviews with 21 health professionals from inpatient units and Assertive Community Treatment (ACT) teams in Danish mental health services. Using inductive content analysis, we examined participants' perceptions, understandings, and experiences in implementing personal recovery-oriented practices.

Four categories emerged: (1) "Creating New Control in Recovery" highlighted the importance of personal agency and collaborative care involving patients, families, and community stakeholders; (2) "Recovery-Oriented Practice within Professional Parameters" underscored efforts to balance patient preferences with clinical responsibilities; (3) "Barriers to Implementing Recovery-Oriented Practice" revealed systemic constraints, resource limitations, and emotional strain on staff; and (4) "Advocating for a Paradigm Shift towards Recovery-Oriented Approaches" emphasized the desire for interprofessional collaboration, the inclusion of peer workers, and structural reforms.

The findings demonstrate that while Danish health professionals recognize the value of personal recovery-oriented care, their capacity to realize this approach is constrained by organizational structures, professional hierarchies, and limited resources. Strengthening systemic support, enhancing interprofessional collaboration, and integrating peer expertise are critical to fostering more equitable, person-centered mental health services. These insights contribute to a nuanced understanding of recovery-oriented implementation in European contexts and may inform strategies that better support professionals and service users in achieving sustained, meaningful recovery.

This article considers the legal regulation of discharge conditions that amount to deprivation of liberty (DoL) in the sense of Article 5 of the European Convention on Human Rights following the UK Supreme Court's decision in Secretary of State for Justice v MM in 2018. The 2019 response of the Secretary of State for Justice to the MM judgment and the proposed "Supervised Discharge" provision of the UK 2022 Mental Health Bill are reviewed from a critical perspective with several important problems identified. It is recommended that the advice of the Secretary of State to make use of leave provisions under s17 of the MHA in place of conditional discharge is considered cautiously as this may be liable to future legal challenge. The 2022 Draft Bill is likely to yield an effective solution but it is lacking important provisions to ensure accountability of healthcare providers where Supervised Discharge is authorised, opportunities for therapeutic relaxations of restrictions, and safe systems for the recall and conveyance of patients under the Supervised Discharge regime.