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Purpose: This paper aims to illuminate the issue of workplace violence (WPV) against psychiatry residents. Workplace violence is known to negatively impact physical and emotional well-being, professional development and the quality of the care that mental health professionals provide to patients. The authors discuss the prevalence of, risk factors for and consequences of WPV against psychiatry residents, as well as the need for support and resources to help residents cope with the emotional challenges of their job. Design/methodology/approach: This paper is a review of the literature on WPV against psychiatry residents, and includes studies on its prevalence, associated risk factors and consequences. Findings: Psychiatry residents face a heightened risk of WPV, including physical and verbal attacks, which can harm their mental and physical health and disrupt their continuity of care. Factors that contribute to WPV against psychiatry residents include exposure to aggressive or violent behaviors, inadequate training in WPV, understaffing, the stigmatization of mental illnesses, and discriminatory treatment. Furthermore, psychiatry residents who encounter WPV may develop negative emotions and attitudes toward their patients, which can compromise the care they provide. Research limitations/implications: The inherent heterogeneity of study designs highlighted in this review could hinder the establishment of definitive conclusions about the impact of workplace violence on psychiatry residents. A focus on studies published in English may inadvertently exclude relevant literature in other languages, potentially limiting the comprehensiveness of study findings. Originality/value: This paper highlights resident physicians' personal experiences with and perceptions of WPV encountered during residency training. In response, potential solutions are proposed to address WPV, including increased support for resident physicians, mandatory reporting of WPV incidents, and a cultural shift toward zero tolerance for WPV. In addition, the paper raises awareness of the limited research on this topic and the importance of further investigation. [ABSTRACT FROM AUTHOR]

Purpose: For over 15 years, Mental Health First Aid™ (MHFA) has successfully been delivered in Wales, United Kingdom, with growing interest in the MHFA programme and increasing course attendees. Trainers, aware of the need for support, know the importance of MHFA being accessible for different communities and learner groups. MHFA has always focused on increasing mental health literacy. One marginalised group, with lower mental health literacy than the general population, is Deaf people, a group with increased risk of mental health problems. This paper aims to provide insights about why Deaf people are twice as likely as hearing people to experience mental health problems. Design/methodology/approach: During this paper, the authors have used four focal points i) exploring situational contexts for Deaf people; ii) reasons why Deaf individuals are at greater risk of mental health problems; iii) the authors explore a project, "Hear Deaf", and implementation of MHFA Wales by Deaf MHFA trainers; and iv) initiatives to influence and impact on policymakers. Findings: During the project, nine MHFA courses were delivered to Deaf communities across different locations in Wales, often with information and advertisements circulated directly to Deaf communities through Deaf clubs, resulting in 120 Deaf people trained. The authors conclude with their own reflections as a researcher and an MHFA who work predominantly with Deaf communities. Originality/value: This paper provides a discussion on the specific risks for Deaf people around mental health and the importance of mental health promotion programmes for Deaf communities. Further research is needed regarding the impact of MHFA on Deaf populations. [ABSTRACT FROM AUTHOR]

Purpose: Stalking is considered a public health priority with a range of adverse outcomes. This paper aims to explore existing literature on children and adolescents as perpetrators of stalking, with a focus on rates of stalking and victim and perpetrator characteristics associated with stalking. Design/methodology/approach: A review of research where stalking was engaged in by those 18 years old and younger was conducted, where 17 manuscripts met criteria for review. Findings: This review found a prevalence of young people engaging in stalking of between 5.3% and 36%. Considerations including demographics, typologies, prior relationship characteristics, stalking and pursuit tactics, cyberstalking and a brief consideration of the impact are given. Practical implications: Literature considering perpetration remains thin, and future research should seek to move towards a widely acceptable definition of stalking, as well as considering effective interventions for early intervention, and to consider the role of mental health services in supporting perpetrators and victims, who may not always be mutually exclusive groups. Originality/value: This paper extends previous literature reviews; the authors understand this to be original work that contributes to a gap in the literature. [ABSTRACT FROM AUTHOR]

Purpose: Contextual to the recognition of the complex interplay between health and behavioral aspects, integrated behavioral health (IBH) has emerged. Although this model is becoming popular in the Western world, its presence in the global context is not promising. This paper aims to explore the need for IBH in India and address its barriers to implementation and possible solutions. Design/methodology/approach: We analyzed the case of IBH and its potential implications for India using the current evidence base, authors' reflections and experience of implementing similar programs. Findings: This paper identifies contextual factors, including increased instances of non-communicable diseases and psychosocial and cultural determinants of health, that necessitate the implementation of IBH programs in India. The key features of different IBH models and their applicability are outlined. The current status of IBH and potential challenges in implementation in India in terms of human resources and other factors are delineated. We also discuss the potential models for implementing IBH in India. Originality/value: Integrating behavioral health in primary care is considered an effective and sustainable model to promote health and well-being across various target populations. Towards this end, this paper is the first to discuss the contextual factors of IBH in India. It is a significant addition to the knowledge base on IBH and its possible implementation barriers and strategies in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Purpose: The English-speaking Caribbean is currently at a crossroads regarding the education and training of home-grown psychologists meeting the ever-increasing demands for mental health care in the region. This paper recommends an innovative approach to build capacity in mental health care in the English-speaking Caribbean that will require partnerships between the regional university, experienced registered practising psychologists, professional resources in the diaspora, public health and education institutions, which will produce trained clinical supervisors, PhD psychologists and improved mental health services in the region. Design/methodology/approach: Documents about the postgraduate programmes in psychology from the regional university were sourced. PubMed, Medline and Google Scholar were searched for the English language published articles using the key phrases psychology AND/OR psychologist AND/OR education AND training AND mental health. Searches of the reference lists of included articles were also undertaken. Findings: Postgraduate psychology programmes in the region have become stalled at the master's level. Meanwhile, doctoral-level training is being sought outside the Caribbean largely due to the lack of availability of trained clinical supervisors. Moreover, training outside the region may lead to deficits regarding cultural relevance of practices, as well as impede the overall development of Caribbean psychology. Research limitations/implications: This paper provides insights into the current practice of education and training for Caribbean postgraduate psychology students and the implications for the development of the practice of psychology in the region. Recommendations for educational and training strategies are provided. Practical implications: The proposed framework presented will help upgrade experienced master's-level trained psychologists to PhDs with training in clinical supervision through Research Advancing Intensive Supervision Education (RAISE) doctoral programmes and can cultivate improved mental health services with a wider reach across the Caribbean. Social implications: Raising the training standards of the psychologists, preparing clinical supervisors and increasing access to practicum sites will improve the trajectories of psychologists within the English-speaking Caribbean and the mental health of the population. Such changes will help to ensure the use of culturally appropriate therapies with Caribbean clientele. There are many social implications for capacity building within the practice and research domains of the preparation of psychologists. For example, increased access to psychological care, improved well-being of citizens, decreased prevalence of work absenteeism and improved management of citizens' mental health and well-being. Originality/value: This paper provides insights into the current practice of education and training for Caribbean postgraduate psychology students and the implications for the development of the practice of psychology in the region. Recommendations for educational and training strategies are provided. The proposed organising framework presented offers a new conceptual model that can be used to guide the capacity building of psychologists within the English-speaking Caribbean. The proposed framework will help upgrade experienced master's-level trained psychologists to PhDs with training in clinical supervision through RAISE doctoral programmes and can cultivate improved mental health services with a wider reach across the Caribbean. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the intersection of cultural processes and immigration in parental understanding of adolescent mental health and mental health seeking behaviors among African immigrants in Western countries. The present study examines the perspectives of Congolese immigrant parents on adolescent mental health in Brussels, Belgium, and Raleigh, North Carolina, USA – two geographic regions with relatively large Congolese migrant populations. This study highlights a needed understanding of cultural and acculturative context in shaping the beliefs of Congolese immigrants and explores potential barriers of seeking health services. Additionally, it recognizes health issues among this underrepresented and underserved population. Design/methodology/approach: Fifteen Congolese immigrant parents, eight in the USA and seven in Belgium, participated in structured qualitative interviews using an adapted version of Kleinman Questions and behavioral scenarios on depression, post-traumatic stress disorder and oppositional defiant disorder. Interviews were audio recorded, and participants were assigned pseudonyms to de-identify responses. English interviews were transcribed verbatim by a trained team of undergraduate research assistants, and French interviews were transcribed verbatim by the first author and a graduate research assistant. Following transcription, the first and second authors used a rapid analytic approach (Hamilton, 2013). The first and second authors conducted a matrix analysis to observe thematic patterns. Findings: Parents interpreted adolescent behavior to be more problematic when the scenarios were overtly outside of their cultural realm of values and beliefs. Parents preferred methods of intervention through religious practices and/or family and community efforts rather than seeking mental health services in their host countries as a secondary option. The authors' findings provide an understanding of the values and beliefs of this underrepresented demographic, which may be useful to guide health professionals on how to support this community in a culturally responsive way. Research limitations/implications: Limitations to the current study include the structured nature of the interview guide that did not allow for in-depth qualitative exploration. Interviewed participants had lived in their host countries for more than 10+ years. Thus, the authors' findings are not reflective of new immigrants' experiences. Parents' perspectives were likely shaped by exposure to Western beliefs related to support for mental health (e.g. knowledge of psychologists). Future studies should focus on recent refugees due to exposure to traumatic events and experiences reflective of the Democratic Republic of Congo's (DRC's) current socio-political situation, and how these are understood in the context of adolescent mental health. Further, due to the hypothetical nature of the scenarios, the authors cannot be sure that participants would engage in the identified approaches with their children. Additionally, hearing from the youth's perspective would provide a clearer insight on how mental health and seeking professional help is viewed in a parent–child relationship. Finally, the data for this study were collected in 2019, prior to the COVID-19 pandemic. Although the authors cannot speak directly to Congolese refugee and immigrant experiences during this significant historical period, given the rise in mental health concerns in refugee populations more broadly (Logie et al., 2022), the authors' findings speak to how parents may have responded to increased mental health symptoms and point to additional barriers that these populations may have faced in accessing support. The authors' study emphasizes the need for dedicating resources and attention to this population, especially the development of culturally tailored messaging that invites community members to support the mental health needs of their community. Practical implications: The authors' findings provide important implications for mental health professionals. This study provides a clearer understanding of how Congolese immigrant parents view mental health and help-seeking within their cultural frame. Although parents may seek professional help, a distrust of mental health services was expressed across both cohorts. This suggests that mental health professionals should acknowledge potential distrust among this population and clarify their role in supporting the mental health of adolescent immigrants. Clinicians should inquire about familial cultural beliefs that are parent- and child-centered and modify their interventions to fit these belief structures. Originality/value: This paper addresses the gap in knowledge about mental health perspectives of Sub-Saharan African immigrant populations, specifically those from the DRC. [ABSTRACT FROM AUTHOR]

Purpose: In 2020, the significance of "lived experience" and "service user" accounts of recovery has become central to the delivery of mental health policy and practice. Reflecting on the first known account of personal recovery in the late-20th century provided new hope and encouragement that those living with mental illness could live a fulfilling life. Taking this into consideration, the purpose of this paper is to explore the relevance to this experience of those using services today. Design/methodology/approach: The authors present a critical literature review, which is underpinned by a systematic approach adopted from Higgins and Pinkerton (1998). This involved a six-step approach seeking to answer the question – What are the service users' views on the recovery concept within mental health services? Findings: The conceptualisation of recovery continues to focus on biomedical parameters. A new interpretation of recovery is beginning to materialise: social recovery. This new interpretation appears to be achievable through six key influencers: health, economics, social interaction/connection, housing, personal relationships and support. Originality/value: Building on Ramon's (2018) argument regarding the need for mental health policy to focus on the concept of social recovery, this study extends on this proposition by providing a foundational evidence base. More specifically, it not only supports the need for this shift in policy but also identifies a new interpretation building in practice. Furthermore, the authors highlight six key pillars that could potentially shape such provisions for policy. [ABSTRACT FROM AUTHOR]

Purpose: Varying stakeholders have highlighted how recovery-oriented mental health services such as youth mental health services have traditionally focused on supporting individual resources to promote recovery (e.g., agency) to the exclusion of addressing structural issues that influence recovery (e.g. poverty). One response to this criticism has been work helping people with mental health problems recover a sense of citizenship and sense of belonging in their communities. Work on citizenship has yet to influence youth mental healthcare in Canada's provinces and territories. This paper aims to highlight ways that youth mental healthcare can better help youth recover a sense of citizenship. Design/methodology/approach: The arguments described in this paper were established through discussion and consensus among authors based on clinical experience in youth mental health and an understanding of Canada's healthcare policy landscape, including current best practices as well as guidelines for recovery-oriented care by the Mental Health Commission of Canada. Findings: Here, this study proposes several recommendations that can help young with mental health problems recover their sense of citizenship at the social, systems and service levels. These include addressing the social determinants of health; developing a citizenship-based system of care; addressing identity-related disparities; employing youth community health workers within services; adapting and delivering citizenship-based interventions; and connecting youth in care to civic-oriented organizations. Originality/value: This paper provides the first discussion of how the concept of citizenship can be applied to youth mental health in Canada in multiple ways. The authors hope that this work provides momentum for adopting policies and practices that can help youth in Canada recover a sense of citizenship following a mental health crisis. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the challenges of coproduction at individual, team, service, organisational and system level and critically describes the work of one organization to describe ways in which coproduction can be facilitated. Design/methodology/approach: This is a case study of the approaches developed (coproduced) within an independent not-for-profit mental health consultancy organization to facilitate coproduction at every level. Findings: Although much is published about coproduction in research, there is relatively little guidance relating to coproduction in practice. This paper describes the meaning, purpose and impact of coproduction at different levels and gives examples of how it can be achieved. The learning from his work is drawn together to present a series of findings with recommendations including: inclusion, managing power difference, accommodating difference, generating new ways forward rather than debating and selecting existing options. Originality/value: The literature on coproduction in practice is replete with guidance rather than examples of good practice. It is also apparent that the ambition for coproduction has progressed rapidly from coproduction between service providers and people using services to coproduction with all relevant stakeholders. This paper provides contemporary examples of coproduction in different forms and at different levels with attention to ways of overcoming challenges. [ABSTRACT FROM AUTHOR]

Purpose: Engaging with heritage to support mental health and wellbeing has become a focus of research and policy, more recently moving towards social prescription of heritage interventions. While there are benefits to active participation, there are potential risks to those taking part and to the non-renewable historic remains and landscape that form the core of these projects. The purpose of the current research paper was to develop best practice guidelines for organisations offering heritage projects as interventions for people who live with mental health issues to protect both participants and heritage. Design/methodology/approach: There were two research phases; a Sandpit with World Café discussions to produce a set of research priorities, and a Delphi Consultation, using three questionnaires distributed over six months, to develop best practice guidelines. The panel in both phases comprised experts through lived experience, policy, practice and research. Findings: The Authentic and Meaningful Participation in Heritage or Related Activities (AMPHORA) guidelines cover three stages: project development, project delivery and project follow-up, with a set of action points for each stage. Of particular importance was authentic participation and expertise to ensure appropriate management of heritage/ historic environment assets and support for participants. Social implications: The AMPHORA guidelines can assist all organisations in the delivery of safe projects that support the mental health of those involved, as well as enhancing and protecting the historic environment. Originality/value: To the best of the authors' knowledge, these are the first research-led guidelines that help heritage organisations support those living with mental health issues. [ABSTRACT FROM AUTHOR]

Purpose: This service evaluation aims to understand the experiences of service users (SUs) who accessed an early intervention in psychosis (EIP) service during the Coronavirus pandemic using qualitative and quantitative methodologies and compare these to a previous pre-pandemic study conducted within the same service (Watkins et al., 2018). Design/methodology/approach: This paper collated experiences of individuals accessing an EIP service to inform service development. Questionnaires and individual interviews were conducted to provide quantitative and qualitative data. Descriptive statistics and T-test confidence intervals were created from the results and compared to findings of Watkins et al. (2018). Interviews were transcribed verbatim and analysed using Braun and Clarke's (2006) thematic analysis. Findings: Data showed participants were largely satisfied with all areas of the service with "work or education", "living skills", and "addictions" scoring highest. Though participants reported no overall dissatisfaction, satisfaction levels dropped in "social activities" compared to the findings of Watkins et al. (2018), perhaps due to the national restrictions put in place to manage the spread of Coronavirus during this time. Interview analysis identified three themes of importance consistent with prior literature, highlighting the importance of relationships and validation during recovery. Research limitations/implications: This evaluation did not consider whether participants had accessed the service prior to the pandemic or only during, meaning that some participants could have a point of comparison with the service pre-pandemic, whereas others might not. Similarly, the participants were not the same as those of the Watkins et al.'s (2018) evaluation, meaning that direct comparisons of pre- and post-pandemic experiences were not possible. In addition, this evaluation collected data at only one time point early in the pandemic; therefore, it is unknown if client experiences of services differed as the pandemic and restrictions continued over time. Originality/value: The Covid-19 pandemic has been an unprecedented challenge for health services, and the effects of this are becoming widely reported. This evaluation of clinical services offers a valuable perspective of service user experience of receiving mental health services during a global health crisis further offering a comparison to pre-pandemic services and the experiences of those who used them. [ABSTRACT FROM AUTHOR]

Purpose: By older adulthood, the majority of individuals will have experienced at least one traumatic event. Trauma-informed care (TIC) is proposed to improve effectivity of health-care provision and to reduce likelihood of services causing retraumatisation. This study aims to assess the effectiveness of staff training in TIC in older adult services. Design/methodology/approach: TIC training was delivered across eight Older Adult Community Mental Health Teams in the same UK organisation. Questionnaires were administered before and after training: a psychometrically robust measure, the Attitudes Related to Trauma-Informed Care, was used to assess TIC-related attitudes, and a service-developed scale was used to measure changes in TIC competence. Data was analysed using linear mixed effects modelling (LMM). Qualitative data regarding the impact of training was gathered one month after training through a free-text questionnaire. Findings: There were 45 participants, all of whom were white British. LMM on pre- and post-data revealed that staff training significantly increased competencies across all measured TIC domains. Overall, staff attitudes were also significantly more trauma-informed after training. Qualitatively, staff identified time as the only additional resource required to deliver the skills and knowledge gained from training. Practical implications: Training was found to be effective in increasing TIC-related skills and attitudes. Organisations aiming to become trauma-informed should consider staff training as one aspect of a wider development plan. Originality/value: To the best of the authors' knowledge, this paper is the first to examine TIC training for staff working in Older Adults Mental Health Services. Recommendations for services aiming to develop a trauma-informed culture have been provided. [ABSTRACT FROM AUTHOR]

Purpose: Perceptions of ageing towards the self and towards others can positively and negatively impact an older adult's mental wellbeing. This paper aims to consolidate literature examining the relationship between perceptions of ageing and depression in older adults to inform both practice and policy for older adult mental health services. Design/methodology/approach: Quantitative research articles examining perceptions of ageing and depression in older adults were identified through searches on three electronical databases, alongside forward and backwards citation searches. A total of 14 articles involving 31,211 participants were identified. Findings: Greater negative attitudes towards ageing were associated with higher levels of depressive symptoms and greater positive attitudes towards ageing were associated with lower levels of depressive symptoms or higher levels of happiness. However, the causal direction of this relationship could not be determined. Studies demonstrated that perceptions of ageing also act as a moderator in the relationship between depression and health status, hopelessness and personality traits. Future research should attempt to examine the relationship between perceptions of ageing and depression in older adults to attempt to identify the causal direction of this relationship. Originality/value: This is the only systematic review the authors are aware of consolidating literature which explores the relationship between older adults' perceptions of ageing and depression. It is hoped that these findings will be able to inform both policy and practice to improve older adults' care and support for depression. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate how institutional and organisational factors affect case management of patients with mental disorders by GPs in Italy and Spain. The paper highlights the importance of improving the effectiveness of primary care to ensure easy access to mental health services, which is crucial in responding to the increasing incidence of mental disorders and preventing negative outcomes. Design/methodology/approach: This article details a qualitative research study that examines the management of patients with mental disorders by general practitioners (GPs) in Italy and Spain, using cross-national comparison and in-depth interviews with GPs as research methods. Findings: The study revealed that Italian self-employed GPs have more scheduling autonomy than Spanish Health Centre GPs. Both face high work pressure and resource scarcity, highlighting the need for targeted training. The COVID-19 pandemic led to a rise in phone consultations. Originality/value: This study provides novel insights into mental health management by examining the case management of patients with mental disorders by GPs in Italy and Spain, with a focus on the impact of institutional and organisational factors. The cross-national comparison and in-depth interviews enhance the originality of the study, offering a nuanced understanding of the constraints faced by GPs in their work context. Furthermore, the comparison of the similar primary care frameworks of Italy and Spain may offer insight into their evolution. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe family intervention (FI) with four families in which the service user is under the care of forensic mental health services. There is a focus on identifying how systemic practice is used or adapted in working with families who have a family member who has presented risk and caused harm. Design/methodology/approach: Four case studies are used to provide a basis for the exploration of commonalities in practice between the cases and the utility of FI within forensic services, which have the dual purpose of promoting mental health recovery and reducing offending/risk behaviour. Findings: Family work can be a key healing tool in the recovery journey of forensic service users and their families. An integrated systemic and psycho-educational FI approach was found to be appropriate in the cases described. Issues particular to forensic services are identified; these include the role of safety planning; the function of talking about the history of trauma in the family including the impact of offending behaviour; mediating difficult relationships between family members and professionals; and overcoming barriers to having difficult and emotive conversations. Research limitations/implications: The absence of outcome assessments limits the findings to observational data and self-reported experiences from the authors. Practical implications: FI can be safely and effectively used within forensic settings, facilitated by practitioners competent in working with trauma and complexity, as an integrated component of the therapeutic treatment. Originality/value: There are recognised barriers to the provision of FI within forensic settings, with limited research regarding the application of such therapies with forensic patients and their families. This paper adds to the small pool of knowledge regarding useful applications of FI in such settings. [ABSTRACT FROM AUTHOR]

Purpose: This paper presents a thematic synthesis of mental health policies published in England from 1999 to 2020. Design/methodology/approach: This paper aims to present a thematic synthesis of mental health policies published in England from 1999 to 2020. The authors specifically focus on ethnicity-related mental health issues highlighted in policies, policy recommendations and performance measurements of policy implementation. Findings: Findings from this synthesis demonstrate that ethnic mental health inequalities remain comparable over the past two decades. Ongoing issues include a lack of data on the ethnicity of mental health services users. Where data is available, these highlight ethnic inequalities in access to, experiences of and outcomes of mental health services, as well as a lack of cultural capability in health-care professionals. Policy recommendations have also remained the same during this time and include: collecting data on the ethnicity of service users, raising awareness of the cultural needs of Black and Minority ethnic populations amongst health-care professionals, recruiting BME staff into mental health care services and improving community engagement. The synthesis identified poor indicators of performance measurement on policy implementation and weak monitoring regimes. Practical implications: The synthesis identified poor indicators of performance measurement on policy implementation and weak monitoring regimes. Originality/value: This paper presents a thematic synthesis of mental health policies published in England from 1999 to 2020. [ABSTRACT FROM AUTHOR]

Purpose: Studies have shown positive housing retention and quality of life outcomes in moving on initiatives (MOIs). However, less is known about how movers' health service use changes post-move. This paper aims to explore physical and mental health service use over time for participants in New York City's MOI program. Design/methodology/approach: This paper uses data collected at baseline, 12-months post move and 24-months post move to explore patterns in mental and physical health service use and their association with mental and physical health status for participants (N = 41). Health status was measured with the Medical Outcomes Study Short Form Survey Instrument. Findings: Three mental health service use patterns emerged: service use at all time points, inconsistent service use across time points and no service use at any time point. Significant group differences in mental health were found at baseline and 12 months. Two physical health service use patterns emerged: service use at all three time points and inconsistent service use across time points. Significant group differences were found in mental health at 12 and 24 months. Originality/value: This study showed that physical and mental health service use varied slightly over time for participants, with the majority of service use being for outpatient/non-acute care. The findings also point to possible relationships between service use and mental health status. Positive and negative implications of these findings are framed within the broader context of PSH and MOI goals. [ABSTRACT FROM AUTHOR]

Purpose: Transition from inpatient mental health care to community living can be very difficult, as people are at an increased risk of suicide, self-harm and ultimately readmission into hospital. There is little research conducted exploring peer support workers' (PSWs) lived experiences that could provide insight into the key transitions of care, particularly the support required after discharge from inpatient mental health care. The purpose of this paper is thus to provide a particular insight into what it feels like being discharged from psychiatric care from a PSW's perspective, how may support be improved post-discharge and what factors might impact the potential for readmission into inpatient care. Design/methodology/approach: A qualitative, phenomenological approach was adopted to explore and describe PSWs' lived experiences of transitioning from psychiatric care. Four PSWs who were employed by a UK secure mental health facility were recruited. PSW is a non-clinical role with their main duty to support patients, and they were considered for this type of the study for their experience in negotiating the discharge process to better carry out their job as a PSW. Findings: After being discharged from psychiatric care, PSWs experienced issues that had either a negative impact on their mental wellbeing or even resulted in their readmission back into inpatient psychiatric care. This study identified three inter-related recurrent themes – continuity of support, having options and realisation, all concerning difficulties in adjusting to independent community life following discharge. The findings of the study highlighted the importance of ensuring that service users should be actively involved in their discharge planning, and the use of effective post-discharge planning processes should be used as a crucial step to avoid readmission. Research limitations/implications: A deeper insight into the factors that impact on readmission to secure care is needed. The active involvement of service users in effective pre- and post-discharge planning is crucial to avoid readmission. Practical implications: Mental health professionals should consider developing more effective discharge interventions in collaboration with service users; inpatient services should consider creating more effective post-discharge information care and support packages. Their lived experience empowers PSWs to play a key role in guiding patients in the discharge process. Originality/value: This is the first study, to the best of the authors' knowledge, to explore what it feels like being discharged from inpatient mental health care by interviewing PSWs employed at a forensic mental health hospital by adopting a phenomenological approach. This paper offers a deeper insight into the transition process and explores in detail what support is needed post discharge to avoid potential readmission from PSWs' perspectives. [ABSTRACT FROM AUTHOR]

Purpose: Lesbian, gay and bisexual (LGB) individuals experience higher rates of mental health difficulties in comparison to their heterosexual counterparts (Meyer, 2003; Plöderl and Tremblay, 2015). This is in part due to the experience of homophobia and stigmatisation within society. This discrimination has also been perpetuated within the mental health field, where LGB individual's sexuality has been pathologised. In response to this historical stigmatisation a number of policies have been created to develop ethical practice while working with this minority group (APA, 2012; BPS, 2019; HSE, 2009; PSI, 2015). The purpose of this paper is to capture the experience of LGB individuals within mental health services and examine if these guidelines are being adhered to. Design/methodology/approach: This study is a meta-narrative synthesis of 13 empirical papers, published between 1999 and 2019. Findings: This study has found both negative and positive experiences of service users. The paper discusses major themes, implications for practice and directions for future research. Originality/value: This is the first systematic review to look at the experiences of clients who have attended mental health services. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to discuss the importance of compassion in health care and experiences of Compassion Circles (CCs) in supporting it, placing this into the national policy context of the National Health Service (NHS), whilst focusing on lessons from using the practice in mental health care. Design/methodology/approach: This conceptual paper is a discussion of the context of compassion in health care and a description of model and related concepts of CCs. This paper also discusses lessons from implementation of CCs in mental health care. Findings: CCs were developed from an initial broad concern with the place of compassion and well-being in communities and organisations, particularly in health and social care after a number of scandals about failures of care. Through experience CCs have been refined into a flexible model of supporting staff in mental health care settings. Experience to date suggests they are a valuable method of increasing compassion for self and others, improving relationships between team members and raising issues of organisational support to enable compassionate practice. Research limitations/implications: This paper is a discussion of CCs and their conceptual underpinnings and of insights and lessons from their adoption to date, and more robust evaluation is required. Practical implications: As an emergent area of practice CCs have been seen to present a powerful and practical approach to supporting individual members of staff and teams. Organisations and individuals might wish to join the community of practice that exists around CCs to consider the potential of this intervention in their workplaces and add to the growing body of learning about it. It is worth further investigation to examine the impact of CCs on current concerns with maintaining staff well-being and engagement, and, hence, on stress, absence and the sustainability of work environments over time. Social implications: CCs present a promising means of developing a culture and practice of more compassion in mental health care and other care contexts. Originality/value: CCs have become supported in national NHS guidance and more support to adopt, evaluate and learn from this model is warranted. This paper is a contribution to developing a better understanding of the CCs model, implementation lessons and early insights into impact. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented practice and related professional practice issues. Design/methodology/approach: A qualitative hermeneutic phenomenological study was conducted from a social constructivist perspective. Semi-structured interviews with 17 psychologists were analysed using reflexive thematic analysis. Findings: Twenty-four themes were identified, which were clustered into four overarching themes. Participants viewed themselves and psychology in Ireland more broadly as peripheral to seclusion. They believed that seclusion possessed no inherent therapeutic value but viewed it as an uncomfortable and multi-faceted reality. Participants regarded seclusion and recovery as largely inconsistent and difficult to reconcile, and they perceived systemic factors, which had a pervasive negative impact on seclusion and recovery in practice. Practical implications: The findings highlight the perceived complexity of seclusion and its interface with recovery, and the need to conscientiously balance conflicting priorities that cannot be easily reconciled to ensure ethical practice. The findings suggest psychologists are well-suited to participate in local and national discussions on using seclusion in recovery-oriented practice. Originality/value: This study offers a unique insight into psychologists' perceptions of seclusion and considers the implications of these views. Participants' nuanced views suggest that psychologists can make valuable contributions to local and national discussions on these topics. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to report on the use and content of written guidance produced by mental health services in England and Wales describing hospital leave for informally admitted patients. Design/methodology/approach: Guidance on leave was requested from National Health Service (NHS) mental health trusts in England and health boards in Wales (n = 61) using a Freedom of Information submission. Data were analysed using content analysis. Findings: In total, 32 organisations had a leave policy for informal patients. Policies varied considerably in content and quality. The content of policies was not supported by research evidence. Organisations appeared to have developed their policies by either adapting or copying the guidance on section 17 leave outlined in the Mental Health Act Codes of Practice for England and Wales (Department of Health, 2016; Welsh Government, 2016). Definitions of important terms, for example, leave and hospital premises, were either absent or poorly defined. Finally, some organisations appeared to be operating pseudo-legal coercive contracts to prevent informal patients from leaving hospital wards. Research limitations/implications: Research should be undertaken to explore the impact of local policies on the informal patient's right to life and liberty. Practical implications: All NHS organisations need to develop an evidence-based policy to facilitate the informal patient's right to take leave. A set of national standards that organisations are required to comply with would help to standardise the content of leave policies. Originality/value: To the best of the author's knowledge, this is the first study to examine the use and content of local policies describing how informal patients can take leave from hospital. [ABSTRACT FROM AUTHOR]

Purpose: "Social recovery" is a long-cited aim within the UK early intervention in psychosis (EIP) services; however, there is a lack of evidence regarding existing social recovery provisions and how these can be improved. This paper aims to evaluate an existing social drop-in facility within an EIP team, ran within the Birmingham and Solihull Mental Health NHS Foundation Trust, and highlight the potential benefits of delivering such services for people diagnosed with first episode psychosis. Design/methodology/approach: Attendance and basic demographic statistics (age, gender and ethnicity of attendees) were collected over a period of 13 weeks. In addition, two semi-structured focus groups were conducted: one with EIP staff members (community psychiatric nurses and support workers) and the other with current service users, with both groups describing their satisfaction and experience of the drop-in facility and how it can be improved. Findings: Inductive thematic analysis was used to analyse data from both focus groups, with six overarching meta-themes being identified: reflection, environment, emotional experience, recovery, activities and interactions. Service users and staff reflected that the drop-in facility was an asset to the service, although work could be done to improve overall attendance. Originality/value: This paper explores how a social drop-in facility can provide a supportive, positive environment that aids recovery from psychosis for service users and improves working conditions for the EIP staff. [ABSTRACT FROM AUTHOR]

Purpose: This is a discussion paper describing the reflections of clinical leads within well-established intensive intervention and risk management services (IIRMS). IIRMS has developed in the past five years, with a small number of services leading in the development of a psychologically informed case management approach to working with individuals released from prison on probation licence, who have a history of high risk, high harm violent convictions linked to pervasive psychological and interpersonal problems. Design/methodology/approach: Clinical leads of three services considered a period of 23 months up to December 2019, in which the outcomes for all individuals on their caseload at that time were reviewed. Reflections on the themes included the reasons for a premature return to prison and emerging themes for those who appeared to be successfully resettled. Findings: Approximately one-third of the individuals were returned to prison, and for most, this occurred within the first 18 months of release. There was considerable unanimity between clinical leads regarding the themes, and problems with relative youth, substance misuse, relationship difficulties, managing transitions and complacency featured. There were four themes identified in those who appeared to have settled successfully in the community. Practical implications: The identified themes provide key learning that will be enshrined in an updated version of the guidance for all IIRMS, with the overall aim of reaching out and engaging with a group of individuals who are most at risk of exclusion from services. Originality/value: Although there are limitations associated with the informal approach of this paper, the reflections of the clinical leads have provided a valuable addition to the very limited empirical literature in this field. [ABSTRACT FROM AUTHOR]

Purpose: Risk assessment is a fundamental part of clinical practice in mental health and learning disability services in the UK. Most services use a tool or framework to structure their clinical judgments, but there does not appear to be a consensus on which risk assessment tool should be used. This paper aims to describe the development, implementation and evaluation of an evidence-based formulation informed risk management (FIRM) framework in mental health and LD services. Design/methodology/approach: The development of FIRM and evaluation was based on the model for improvement, with an emphasis on co-production broken down into three distinct yet interdependent phases of co-production: co-design, co-create and co-deliver. Following the implementation of the FIRM framework, a post-implementation survey was distributed to a sample of clinical staff to capture experiences in the first three months post-implementation. Findings: The three co-production stages were pivotal for successful implementation in clinical practice. The key ingredients for success seemed to be acknowledging human factors and varied responses to change, communication, engagement and involvement of stakeholders. Early evaluation post-implementation demonstrated the benefits in terms of confidence in use, formulation of risk, risk management and communication. Further quality improvement initiatives are underway to evaluate impact up to 12 months post-implementation and to improve the quality of FIRM in practice. Future research is planned to look at enhancing personalised risk assessment and management. Originality/value: This paper describes and demonstrates the value of co-production with clinicians and stakeholders in service development. The FIRM has improved the clinical practice of risk assessment, formulation and management and use of digital technology. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this mixed methods rapid study was to identify the barriers and facilitators to implement relational and environmental risk management approaches to manage suicidality in inpatient services. Design/methodology/approach: To achieve this within a short timeframe, a rapid review approach was chosen. Both research (qualitative and quantitative studies) and non-research material (policies, guidance and reports) were retrieved. The review was conducted across five databases: MEDLINE, EMBASE, EMCARE, PsycINFO and CINAHL for English language citations within the last ten years (2009 –2019). Findings: A total of 17 primary research papers and a further 73 reviews and grey literature were included. There was evidence that the removal of anti-ligature equipment, by which regular checks of the environment to identify and remove ligature points and increased levels of observation are carried out well, reduces suicide in hospital. Research limitations/implications: There is a gap in research investigating "engagement activities" eliciting exactly what they are and determining how they might be effective. There is a need for new innovative ways for managing risk of suicide in hospitals that bring together meaningful engagement and maintaining safety. Originality/value: Keeping people safe during an inpatient stay in a mental health service is a core function of mental health practitioners. This paper brings together what is already known about risk management and highlights areas for further investigation. [ABSTRACT FROM AUTHOR]

Purpose: The more disadvantaged members of society generally experience poorer outcomes following the development of mental ill-health. The purpose of this paper is to scope the literature and synthesise findings on the inequalities and mental health within secure mental health settings. Design/methodology/approach: Six electronic databases were searched to identify relevant studies. These were included if they examined the association between inequalities and mental health in women's secure mental health settings. Findings: Of the 608 studies reviewed, 14 met the inclusion criteria. In these papers, violence and/or abuse were described as the most prevalent inequalities. The second most frequent group of inequalities identified were socio-economic. Only three published studies researched the impact of ethnicities. Physical health, alcohol abuse and a dysfunctional family upbringing were only mentioned in one of the studies. Gender identity, transitioning and sexual orientation was not considered in any papers. These are areas, which require further investigation to determine their specific impact in this setting. Research limitations/implications: This review highlights the dearth of high-quality research-based evidence underpinning an understanding of the impact of inequalities on women in secure mental health settings. The existing studies suggest that inequalities have a very particular impact and that intersectionality plays a key role. Further research is required to further understand how inequalities impact the lives of women in secure mental health settings. Practical implications: The inequalities that women experience in relation to mental health need to be further researched in the context of intersectionality. There are also research gaps in terms of gender identity, sexual orientation and socio-economic background. Further primary research using a more complex methodological paradigm is required to explore these factors and their impact on mental health service provision. Social implications: The role of inequalities should be considered as part of an overall care package, including the experiences of adverse childhood experiences and this should contribute towards the development of a trauma-based care approach. Originality/value: To the best of the authors' knowledge, this is the first study to scope literature about inequalities experienced in women's secure psychiatric settings considering intersectionality. [ABSTRACT FROM AUTHOR]