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Background: Responsible Clinicians are professionals who are primarily accountable for the care and treatment of patients detained under the Mental Health Act, 1983 in England and Wales. The role has only been taken up by under 100 nurses and psychologists since 2007. The aim of this study was to explore the experiences of non-medical Responsible Clinicians, to inform our understanding of interprofessional dynamics and professional identity in contemporary mental healthcare., Methods: A qualitative study comprising thematic analysis of interviews with twelve non-medical Responsible Clinicians., Results: A major theme of 'Interpretations of responsibility' emerged, with two sub themes: 'Responsibility as leadership 'and 'Responsibility as decision making'. Taking on the role had implications beyond the care of specific patients. Participants saw themselves as having the power to shape their team and service whilst exercising their authority to make difficult decisions about risk and restrictions., Conclusions: More widespread adoption of the non-medical Responsible Clinician role should not be seen solely as a solution to workforce shortages or lack of opportunities for professional advancement. Consultant nurses and psychologists who take on this role are seising the opportunity to steer service developments more widely, influencing team dynamics and perceptions of accountability., (Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.)

There is increasing pressure within universities to address student mental health. From a whole university or settings-based perspective, this could include curriculum-embedded approaches. There is little research about how this should work or what approaches might be most effective. Semi-structured interviews were conducted with fifty-seven undergraduate students from five disciplines (Psychology, English studies, Nursing, International Politics, and War Studies) to understand students' perspectives. Students reflected on wellbeing module content and, more broadly, on curriculum processes (teaching, pedagogy, assessment) within their degree. Reflexive thematic analysis was applied to transcripts, generating three themes: embedding wellbeing in the curriculum; assessment, challenge, and academic support; and social connection and interaction. The findings provide evidence for teaching, pedagogy, and assessment practices supporting higher education student wellbeing. These align with recommended good teaching practices, such as considering appropriate assessment methods followed by effective feedback. Students saw the benefits of being academically challenged if scaffolded appropriately. Strong peer connection, teacher-student interaction, and communication were crucial to learning and wellbeing. These findings provide implications for future curriculum design that can support learning and wellbeing.

Background: Speech-language therapists use counselling to address the psychological well-being of people affected by post-stroke aphasia. Speech-language therapists report low counselling knowledge, skill and confidence for working in post-stroke aphasia which may be related to a lack of counselling training specific to the needs of this client group. Aims: To identify current training in counselling for speech-language therapists to address psychological well-being in people affected by post-stroke aphasia. Specifically, the intent was to establish the objectives, content, amount, teaching methods and outcomes of counselling training provided to speech-language therapists working with people affected by post-stroke aphasia. Methods & Procedures: Eleven databases were searched from inception to January 2018 using terms relating to counselling, psychological well-being, speech-language therapy, stroke, aphasia and training. Studies using any research methodology and design were included. Nine studies were critically appraised and synthesized as a systematic review using the Search, AppraisaL, Synthesis and Analysis (SALSA) framework. Main Contribution: Information on counselling training came from the UK, United States and Australia. Student speech-language therapists received training in goal-setting and generic counselling skills. After qualification, speech-language therapists received counselling training from mental health professionals within stroke workplaces, from external providers and further education. A range of teaching techniques and counselling approaches were described. Self-report and themes from qualitative data were the primary measures of counselling training outcomes. Moderate correlations were reported between counselling training and levels of speech-language therapists' knowledge, comfort, confidence and preparedness to counsel people affected by post-stroke aphasia. Conclusions: Research in counselling training for speech-language therapists working in post-stroke aphasia is limited, with a small number of primarily low-quality studies available. Training in generic counselling skills and brief psychological approaches with support from mental health professionals in the stroke workplace enabled speech-language therapists to feel knowledgeable, skilled and confident to address the psychological well-being of people affected by post-stroke aphasia. Evidence about the effectiveness of counselling training on speech-language therapists' confidence and competence in practice and on client outcomes in psychological well-being in post-stroke aphasia is required.

In university settings, peer support brings people together based on their student identity. Peer support has been advocated as an innovative intervention to aid student mental health and wellbeing as part of a whole university approach, especially post-pandemic when student support is critical. While the literature describes three types of university peer support for student mental health and wellbeing, peer-led support groups, peer mentoring, and peer learning, the sector lacks agreed definitions for these interventions. Formal reporting on peer support initiatives is rare, suggesting further types of peer support practice may exist. This qualitative study, comprising semi-structured interviews with 16 university staff members at 14 different institutions, aimed to generate comprehensive definitions of the types of peer support used in the sector through template analysis. The study also sought to understand the current practice, experiences, and challenges around implementing peer support interventions for undergraduate and postgraduate students' mental health and wellbeing from the perspective of the staff who support and coordinate these programmes. Five types of peer support were identified and defined. In addition, the challenges of engagement, resource and capacity, and evaluation were highlighted. Finally, lessons learnt provided potential ways to address the challenges outlined and provided sector guidance for further developing peer support as part of a whole university approach to student mental health and wellbeing. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To identify the importance of emergency nurses being able to provide appropriate care for patients who self-harm • To learn about the findings of a systematic review that examined the effects of educational interventions on emergency nurses' attitudes towards patients who self-harm • To recognise the need for improved training for emergency nurses on suicide and self-harm Negative nurse attitudes towards emergency department patients who self-harm may increase the risk of repeated self-harm and suicide. This article details a systematic review that aimed to examine the evidence on the efficacy of educational interventions to improve the attitudes of emergency nurses towards patients who self-harm. Eight articles describing six intervention studies, published between 2001 and 2018, met the criteria for inclusion. The review found that educational interventions for emergency nurses improved their attitudes to patients who self-harm, but there was a lack of consistency in the approaches used and a reliance on self-report measures. Further training for emergency nurses is needed because of their crucial role in self-harm and suicide prevention. [ABSTRACT FROM AUTHOR]

Objectives: This study explored healthcare professionals' accounts of being practitioner trainers in a mental health Recovery College, where they worked with peer trainers, who were people with lived experience of mental illness, to co-produce workshops for mental health service users and staff. The aim of this study was to understand the process of co-production in the Recovery College from the perspective of practitioner trainers. Design: Single-site case study. Setting: A Recovery College in the South of England, open to staff and service users from one mental health care provider organisation. Methods: Semi-structured interviews with eight mental healthcare professionals. Transcripts were thematically analysed. Results: A central image of 'the workshop as crucible' emerged from the three themes derived from the analysis. Co-facilitating the workshop was a 'structured' encounter, within which health professionals experienced 'dynamism' and change. For them, this involved experiences of 'challenge and discomfort'. Conclusion: Findings from this study contribute to the evidence base for the evaluation of Recovery Colleges by focusing on the training impact on staff. Findings suggest that taking on a trainer role in Recovery College co-production is beneficial for healthcare professionals as well as mental health service users, especially if healthcare professionals are open to the dynamism and possible discomfort of these workshop encounters. Future research, however, should expand beyond single-site case studies to test the extent to which this metaphor and themes are appropriate to describing the 'transformative' element of co-production. [ABSTRACT FROM AUTHOR]

In 2017 more than 2,000 unaccompanied children sought asylum in the UK. This article summarises the policy and research literature on the mental health needs and experiences of unaccompanied asylum-seeking children (UASC) in the UK, with the aim of suggesting how to enhance practice and improve outcomes for this vulnerable group. UASC have significant mental health needs with high rates of post-traumatic stress disorder, depression and anxiety; the asylum process greatly affects their well-being. Higher levels of distress in older adolescents who are seeking asylum suggests that lower levels of social support have detrimental outcomes for their mental health. Barriers to service use include mistrust, stigma and service providers' lack of cultural awareness which affect UASC's help-seeking behaviours and identification of their needs. This indicates that mental health services should be available in the spaces commonly used by UASC, such as schools and community centres, to provide psychoeducation, training to other agencies and to inform culturally sensitive interventions. [ABSTRACT FROM AUTHOR]

Abstract: The effects of mental health nurses’ own experience of mental illness or being a carer have rarely been researched beyond the workplace setting. This study aimed to explore how the experience of mental illness affects mental health nurses’ lives outside of and inside work. A sample of 26 mental health nurses with personal experience of mental illness took part in semistructured interviews. Data were analysed thematically using a six‐phase approach. The analysis revealed the broad context of nurses’ experiences of mental illness according to three interwoven themes: mental illness as part of family life; experience of accessing services; and life interwoven with mental illness. Participants typically described personal and familial experience of mental illness across their life course, with multiple causes and consequences. The findings suggest that nurses’ lives outside of work should be taken into account when considering the impact of their personal experience of mental illness. Similarly being a nurse influences how mental illness is experienced. Treatment of nurses with mental illness should account for their nursing expertise whilst recognizing that the context for nurses’ mental illness could be much broader than the effect of workplace stress. [ABSTRACT FROM AUTHOR]

The aim of the present study was to measure the subjective well-being of a group of 225 UK registered mental health nurses (MHN) using three survey measures, and to identify whether certain demographic and workplace factors correlated with subjective well-being measure scores. An online survey incorporating the subjective well-being questions used by the Office for National Statistics, the Satisfaction with Life Scale, and the Warwick Edinburgh Mental Well-Being Scale was administered to members of two professional bodies for MHN. There was good consistency between the three subjective well-being measures, each demonstrating that UK MHN had a relatively low subjective well-being. Apart from the Office for National Statistics question, 'Overall, to what extent do you feel the things you do in your life are worthwhile?', demographic and workplace factors did not correlate with subjective well-being measure scores, although the characteristics of being male, living alone, and being aged 40-49 years were associated with lower mean scores on all three measures. The findings of the exploratory study suggest that a similar study should be undertaken with a larger representative population of MHN, and that qualitative research should explore why and how UK MHN have relatively low subjective well-being. The limitations of this study, namely the response rate and sample representativeness, mean that the results of the present study must be tested in further research on the MHN population. [ABSTRACT FROM AUTHOR]

Students experiencing disability face many barriers in university education, which are often poorly understood by university teaching staff. This is more likely to be the case regarding students with nonapparent conditions, such as mental health issues and acquired brain injury. This study employed an online survey, supplemented by semi-structured interviews, to investigate the views and actions of teaching staff at one university in relation to supporting these two student groups: those with mental health issues and those with acquired brain injury. Survey responses indicated that university staff generally held positive views about both student groups, but that there was inadequate staff training to assist staff in knowing how to support these groups. Staff most commonly supported students by directly negotiating adjustments with students, maintaining regular contact, and using the university's disability services. The results of this study support previous calls for improved staff training and also draw attention to the competing demands on staff of supporting student learning whilst managing other institutional forces at play in universities. [ABSTRACT FROM AUTHOR]

Within mental health legislation in England and Wales the Responsible Clinician for specific patients should be the Approved Clinician with the most appropriate expertise to meet their primary assessment and treatment needs. The study aimed to explore nurse and psychologist perspectives on becoming a Responsible Clinician in the context of their limited uptake of the role and calls for an increase in advanced practice roles within mental health. It comprised a qualitative inquiry in the form of a thematic analysis of 12 semi-structured interviews. Four sub-themes emerged under the theme of 'becoming a Responsible Clinician'. They were: (i) the Responsible Clinician amongst other roles; (ii) developing in the role; (iii) working with psychiatrist colleagues; and (iv) organisational context. Responsible Clinicians were juggling the role with other senior clinical responsibilities, often without a coherent programme of ongoing educational development or organisational support structures. If mental health service provider organisations adopt this extended role more widely then role-specific support and supervision arrangements should be in place as part of a coherent workforce strategy. This is particularly important given the legal and ethical responsibilities of the Responsible Clinician. [ABSTRACT FROM AUTHOR]

• Student midwives' experience of pre-registration training may be described as 'a rollercoaster' of emotional fluctuation and relentless change. • Students were aware of the importance of emotion management and self care as part of professional socialisation but were not confident regarding how to develop such skills. • Student midwives value opportunities for individual support from midwifery educators and regular opportunities to connect with their peers. Midwifery student mental wellbeing is an important consideration for the sustainability of the profession, however it has seldom been the subject of empirical research. Previous studies of the lived experience of midwifery students have focused on the impact of transition experiences and student satisfaction, rather than specifically on mental health and students' views on support for their mental wellbeing. A qualitative descriptive study using semi-structured interviews. A midwifery undergraduate programme in one university in the South of England. 20 BSc midwifery students. Two inductive themes were developed from our analysis. The theme of 'the rollercoaster' encapsulated students' experience over the length of the course, characterised by multiple culture shocks of being in different worlds, from one clinical placement to the next, from university to clinical placement. This experience was emotionally taxing. The theme of 'being noticed, feeling connected' encapsulated midwifery students' views on what could help them enjoy their training. They wanted to be seen as individuals by at least one educator, they wanted opportunities to connect with their peers and they wanted the support available to them to be consistent. Listening to students' insights into the lived experience of being a midwifery student can enable midwifery educators to improve the way courses are designed and support structures are put in place. The importance of having consistent contact with peers and educators cannot be underestimated. The emotional demands of midwifery training must be acknowledged. Educators should identify ways in which they can provide students with consistent individualised support and regular opportunities to meet with their peers. [ABSTRACT FROM AUTHOR]