Formerly referred to as Foundation Trust  equivalent  this designation applies only to trusts providing high secure psychiatric services. There are just three: Nottinghamshire Healthcare, india Health NHS Trust and Merseycare. Nottinghamshire Healthcare gained Foundation Trust standard on 2 November 2010. The other two trusts are in the assessment process.

These trusts abide by the same Department of Health definition for a Foundation Trust but the Secretary of State for Health maintains a direct line of communication and accountability with them because the SoS has the responsibility to provide healthcare to patients who have been detained under the Mental Health Act, and have been judged to pose a grave and immediate danger to the public.

Unlike full Foundation Trusts, equivalent Foundation Trust organisations have a developing role: Governors have no statutory role. The Board of Directors have no statutory duty towards the governors. The governors cannot, without the Board of Directors' permission, have any control over the direction of the The governors cannot appoint or remove trust auditors. The chair and directors are not appointed by their board of governors. Equivalent Foundation Trust organisations are still regulated by Monitor, and can retain surplus cash and can sell property and retain the cash from the sale.

Roots of human cooperation may be found in empathy. For example, when several infants are in a room, and one of them starts crying, others start crying too.

Language allows humans to cooperate on a very large scale. Certain studies have shown that fairness affects human cooperation; individuals are willing to punish at their own cost (altruistic punishment) if they believe that they are being treated unfairly. Sanfey, et al. conducted an experiment where 19 individuals were scanned using MRI while playing an Ultimatum Game in the role of the responder. They were receiving offers from other human partners and from a computer partner. Remarkably, responders refused unfair offers from human partners at a significantly higher rate than those by a computer partner. The experiment also showed that altruistic punishment is associated with negative emotions that are being generated in unfair situations by the anterior insula of the brain.

It has been observed that image scoring promotes cooperative behavior in situations where direct reciprocity is unlikely. In situations where reputation and status are involved, humans tend to cooperate more.