Monetary costs of agitation in older adults with Alzheimer's disease in the UK: prospective cohort study.

Objective: While nearly half of all people with Alzheimer's disease (AD) have agitation symptoms every month, little is known about the costs of agitation in AD. We calculated the monetary costs associated with agitation in older adults with AD in the UK from a National Health Service and personal social services perspective.

Design: Prospective cohort study.

Non-pharmacological interventions for agitation in dementia: systematic review of randomised controlled trials.

Background: Agitation in dementia is common, persistent and distressing and can lead to care breakdown. Medication is often ineffective and harmful.

Aims: To systematically review randomised controlled trial evidence regarding non-pharmacological interventions.

START (STrAtegies for RelaTives) study: a pragmatic randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of a manual-based coping strategy programme in promoting the mental health of carers of people with dementia.

Background: Two-thirds of people with dementia live at home, receiving most care from family carers, about 40% of whom have clinically significant depression or anxiety. This impacts on the person with dementia, families and society, predicting care breakdown. There are currently no clinically effective and cost-effective NHS family carer interventions.

A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia.

Background: Agitation is common, persistent and distressing in dementia and is linked with care breakdown. Psychotropic medication is often ineffective or harmful, but the evidence regarding non-pharmacological interventions is unclear.

Objectives: We systematically reviewed and synthesised the evidence for clinical effectiveness and cost-effectiveness of non-pharmacological interventions for reducing agitation in dementia, considering dementia severity, the setting, the person with whom the intervention is implemented, whether the effects are immediate or longer term, and cost-effectiveness.

Discrimination against people with a mental health diagnosis: qualitative analysis of reported experiences.

Background: Discrimination towards people with a mental health diagnosis has public health implications. Recently, efforts have been made to tackle discrimination through campaigns and education. Understanding experiences of discrimination is vital in targeting efforts effectively.

Improving the end-of-life for people with dementia living in a care home: an intervention study.

Background: One in three adults, most of whom are living in a care home at the time, dies with dementia. Their end-of-life is often in hospital, where they may experience uncomfortable interventions without known benefit and die rapidly with uncontrolled pain and comfort needs. This study aimed to improve end-of-life care for people with dementia in a care home by increasing the number and implementation of advanced care wishes.

England's time to change antistigma campaign: one-year outcomes of service user-rated experiences of discrimination.

Objective: This study evaluated the progress at one year of England's Time to Change (TTC) program, launched in 2009, toward meeting its target to reduce mental health-related stigma and discrimination by 5%.

Methods: TTC comprises three national components: antistigma marketing campaign activities, mass physical exercise events (Time to Get Moving) to facilitate social contact between people with and without mental health problems, and an online resource on mental health and employment (Time to Challenge). Part of the TTC evaluation consists of an annual national phone survey of mental health service users.

Care at the end of life for people with dementia living in a care home: a qualitative study of staff experience and attitudes.

Objective: The aim of this study is to examine barriers and facilitators to care home staff delivering improved end-of-life care for people with dementia.

Method: Individual qualitative interviews of 58 staff in a 120-bed nursing home where the staff and the residents' religion differed were carried out. Interviews continued until a maximum variation sample was achieved and theoretical saturation was reached.

The effect of disclosure of mental illness by interviewers on reports of discrimination experienced by service users: a randomized study.

User involvement in research is widely valued, but evidence of its impact in quantitative research is lacking. We investigate whether survey responses are affected by interviewers' experience of mental health problems. We hypothesized that when the interviewer has experienced mental health problems, participants would be more likely to consent to participate, leave fewer items unanswered, report higher levels of discrimination and express greater satisfaction with the interview.

Reducing stigma and discrimination: Candidate interventions.

This paper proposes that stigma in relation to people with mental illness can be understood as a combination of problems of knowledge (ignorance), attitudes (prejudice) and behaviour (discrimination). From a literature review, a series of candidate interventions are identified which may be effective in reducing stigmatisation and discrimination at the following levels: individuals with mental illness and their family members; the workplace; and local, national and international. The strongest evidence for effective interventions at present is for (i) direct social contact with people with mental illness at the individual level, and (ii) social marketing at the population level.