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The article discusses the orientation failures in medicine and psychiatry in Great Britain. Orientation failures refers to dislocations between the subject's cognition of time, space or person, and the relevant reference systems. The described orientation failures are determined by whether the subject chooses to orientate himself in relation to public or private reference systems.

The current study explored the role of pre-existing and pandemic-time child, family or environmental factors in the presentation of mental health symptoms of autistic youth and their parents during the pandemic. Participants were parents/carers of autistic children (Autism Spectrum Treatment and Resilience Cohort, N = 67, M age = 9 years) and adolescents (QUEST cohort, N = 112, M age = 17 years). Parents completed an online survey that asked about child and parental mental health, infection experience, and changes to education arrangements, family life, housing and finances during the pandemic. Pre-existing measures of mental health, autism and adaptive functioning were also utilised. More engagement and enjoyment in education provision and going outside was associated with better child and parental mental health. In multivariate multiple linear regression models, more pre-existing attention deficit hyperactivity disorder symptoms were associated with more behavioural/attention deficit hyperactivity disorder symptoms during the pandemic in the pre-adolescent cohort, and with greater emotional symptoms in the adolescent cohort. More pre-existing parental mental health problems were associated with more parental mental health symptoms during the pandemic in both cohorts. Knowledge of pre-existing mental health and pandemic-related stressors may help care planning. Encouraging engagement and enjoyment in education and promoting physical exercise are key intervention targets. Ensuring access to attention deficit hyperactivity disorder medication and support is important, especially if this is managed jointly across school and home. What is already known about the topic: The COVID-19 pandemic and the associated restrictions impacted all of society. There is emerging evidence showing a range of impacts on autistic children and young people and their families. Further research that looks at how individuals coped during the pandemic while considering how they were doing before the pandemic is needed. What this paper adds: This article explores whether how well autistic youth were doing before the pandemic influenced how they coped during the pandemic. It also looked at how well their parents were doing during the pandemic and whether any pre-pandemic factors influenced how they coped. Samples of both primary-school-aged autistic children and autistic teenagers and their parents were surveyed to answer these questions. More engagement and enjoyment in education provision during the pandemic and getting outside more were linked with better child and parental mental health during the pandemic. More attention deficit hyperactivity disorder before the pandemic was linked with more attention deficit hyperactivity disorder and behavioural problems during the pandemic in primary-school-aged autistic children, and more emotional problems during the pandemic in autistic teenagers. Parents with more mental health problems during the pandemic had more mental health problems before the pandemic. Implications for practice, research or policy: Encouraging engagement and enjoyment in education and promoting physical exercise are key intervention targets. Ensuring access to attention deficit hyperactivity disorder medication and support is important, especially if this is managed jointly across school and home. [ABSTRACT FROM AUTHOR]

Background: Outcomes for children who have been received into state care due to maltreatment or neglect are very poor in comparison to the general population. A mental health focussed intervention is being trialled in the UK which seeks to improve outcomes for such children. Although the main study is concerned with outcome evaluation (child mental health measures), a robust process evaluation adds nuance to the findings by examining the relationship between the interventions, the participants and the context-thereby determining what works, for whom and in what context. This paper sets out the protocol for that process evaluation. Methods: The process evaluation is embedded within a Randomised Control Trial and uses Realist Evaluation as its theoretical framework. It sets out the mechanisms of change that are used to effect positive outcomes and outlines the various aspects of the context (including service provision and the legal system that provides the statutory basis for involvement with families). Data collection is primarily qualitative and takes place with a large group of stakeholders. The analysis of the interplay between context, mechanisms and outcomes will provide a richer understanding of the main trial outcomes. Discussion: The nature of the interaction between the social, legal and practice context is complex. The use of a variety of methods including case studies, focus groups and analysis of routine data are justified and it is argued that they will provide for greater understanding of the nature of the interactions within such a challenging context. [ABSTRACT FROM AUTHOR]

During World War I, civilians became a target of the war machine. Air raids transformed the lives of those not involved in active combat and blurred the lines between the home front and the war front. This paper argues that the experience of air raids in World War I was comparable to the combat stress at the Western Front. The author bases her argument on contemporary publications in medical journals, measures taken by British authorities to prevent air-raid shock, and contemporary case records. The narratives of air-raid shock – similarly to those of shell-shocked soldiers – reflect the feelings of terror and loss of control, and demonstrate the profound effect these experiences could have on individuals' mental health. [ABSTRACT FROM AUTHOR]

In the United States, the National Institute of Mental Health (NIMH) is seeking to encourage researchers to move away from diagnostic tools like the Diagnostic and Statistical Manual of Mental Disorders (the DSM). A key mechanism for this is the "Research Domain Criteria" (RDoC) initiative, closely associated with former NIMH Director Thomas Insel. This article examines how key figures in US (and UK) psychiatry construct the purpose, nature, and implications of the ambiguous RDoC project; that is, how its novelty is constituted through discourse. In this paper, I explore and analyze these actors' accounts of what is new, important, or (un)desirable about RDoC, demonstrating how they are constituted through institutional context and personal affects. In my interviews with mental health opinion leaders, RDoC is presented as overly reliant on neurobiological epistemologies, distant from clinical imaginaries and imperatives, and introduced in a top-down manner inconsistent with the professional norms of scientific research. Ultimately, the article aims to add empirical depth to current understandings about the epistemological and ontological politics of contemporary (US) psychiatry and to contribute to science and technology studies (STS) debates about "the new" in technoscience. Accordingly, I use discussions about RDoC as a case study in the sociology of novelty. [ABSTRACT FROM AUTHOR]

Healthcare workers, globally, volunteered time and skills to the COVID-19 pandemic frontline response. In March 2020, the predicted high demand for extra critical care beds led to the rapid construction of the UK National Health Service (NHS) Nightingale field hospital, London. I volunteered to develop and deliver psychological preparedness training – coined 'Psychological PPE' – to over 2300 frontline staff over an 8-week period. Existing research has identified broad themes of the impact working on the COVID-19 frontline has on healthcare workers but does not capture in-depth accounts of individuals' experiences. Using autoethnographic enquiry, this research explores my frontline experience at the NHS Nightingale during this time, and the personal impact this had on me. Reflexive thematic analysis explored themes of recognition and sacrifice, emotional lability and fragility, and the impact of transitions. Findings inform personal recovery, as well as future research and policy development pertaining to the sustainable recovery of our NHS people. [ABSTRACT FROM AUTHOR]

Adolescence is a period of increased vulnerability for low well-being and mental health problems, particularly for girls and older adolescents. Accurate measurement via brief self-report is therefore vital to understanding prevalence, group trends, screening efforts, and response to intervention. We drew on data from the #BeeWell study (N = 37,149, aged 12–15) to consider whether sum-scoring, mean comparisons, and deployment for screening were likely to show bias for eight such measures. Evidence for unidimensionality, considering dynamic fit confirmatory factor models, exploratory graph analysis, and bifactor modeling, was found for five measures. Of these five, most showed a degree of non-invariance across sex and age likely incompatible with mean comparison. Effects on selection were minimal, except sensitivity was substantially lower in boys for the internalizing symptoms measure. Measure-specific insights are discussed, as are general issues highlighted by our analysis, such as item reversals and measurement invariance. [ABSTRACT FROM AUTHOR]

Based on an extended period of qualitative research with mental health service-users in north-east England, this article considers the various forms of 'magical work' and 'recovery work' that emerge in the lives of people living with severe mental health problems. Given the now sizeable body of literature which seeks to problematize traditional conceptual boundaries of work, the article asks to what extent these hidden and unusual work-forms might also be considered legitimate members of the category. Rather than argue for the expansion of the construct to accommodate these activities, the paper attempts simply to problematize the extent to which so-called 'mad' forms of work are irresolvably different to more conventional forms of occupation. In challenging notions of the psychiatric patient as inevitably inactive, new vocabularies for service-user work are explored. Concluding remarks are also directed to recent policy debates concerning 'back-to-work' welfare reform for long-term out of work service-users. [ABSTRACT FROM AUTHOR]

Summary This article reports research that aimed to identify and evaluate potential resilience benefits of visual arts interventions for young people with complex needs. The study involved a review of the ‘arts for resilience’ literature and a case study of 10 weekly resilience-building arts workshops for 10 young people experiencing mental health complexities and/or learning difficulties. Findings We found a significant existing evidence-base linking visual arts practice to individual and community resilience, across disciplinary fields including art therapy, social work, community health, visual arts practice and geographies of health. Visual art activities were utilised to both educate young people about resilience and enhance young people’s overall resilience. Qualitative research material developed from the case study shows that even short-term visual arts interventions can impact on young people’s resilience – crucially, participation was extremely beneficial to young people’s sense of belonging and ability to cope with difficult feelings (topics which arose repeatedly during interview, focus group discussion and observation). Applications Our review and findings from this small case study provide some initial insights into the resilience benefits of participation in visual arts activities. This, combined with the resilience-based practice framework presented here, could aid the effective targeting of interventions for social workers and others working with young people with complex needs. Alongside this research paper, an arts for resilience practice guide has been produced by the project team (including young people). It contains instructions on how to conduct a range of practical visual arts activities that we identified as being resilience-promoting. [ABSTRACT FROM AUTHOR]

Military-to-civilian community reintegration in Northern Irish (NI) veterans has not been previously examined. The existing reintegration studies indicate that post-military service life can be challenging for many veterans. The current exploratory study aimed to identify service-related predictors of community reintegration difficulties in a sample of 749 NI veterans. Data were collected through a cross-sectional self-report survey of UK Armed Forces veterans residing in NI. Service-related variables were examined as predictors of overall and subdomain-specific reintegration difficulties. Combat exposure, time spent deployed in NI, length of service, being medically discharged, and being physically injured during service were significant predictors of reintegration difficulties. Receiving a mental health diagnosis since discharge and having been medically discharged were the two strongest predictors. Further results and implications are also discussed. Post-service adjustment to civilian life is affected by service variables, with implications for military/post-military interventions aimed at mitigating difficult transition experiences. [ABSTRACT FROM AUTHOR]

Music students in tertiary education struggle with a range of health-related problems. We investigated students' self-referrals for counseling at a UK conservatoire to explore trends in students' attendance at counseling sessions over time and identify their reasons for seeking and continuing to attend counseling. We conducted a secondary analysis of data collected from 645 students by two in-house counselors at the conservatoire between 2000 and 2016. We obtained analogous data on all students registered during the same period for comparison and conducted nonparametric tests of association between the groups. A total of 645 students attended a mean of eight (Mdn = 4) counseling sessions over the 16-year period: 63% were female, 79% were from the UK, and 72.5% were undergraduate students. The percentages of students attending counseling increased from 2 (1%) in 2000–2001 to 71 (13%) in 2015–2016. The presenting concerns of almost one in 10 students who sought counseling were related to self-esteem, self-confidence, ego strength, and coping ability. Their main reasons for continuing to attend counseling were also to do with self and identity, relationships, academic concerns, loss, abuse, and anxiety. Female students, postgraduate students, and those studying singing were most likely to attend counseling sessions. [ABSTRACT FROM AUTHOR]

Research suggests that among all children living in social care, those in residential care have the highest mental health need. This systematic review and meta-analysis is the first to establish the type and prevalence of mental health disorders and symptoms among children in residential care. A systematic search of PsycINFO, MEDLINE, Scopus, Web of Science Core Collection, ASSIA, IBSS and grey literature databases from January 1989 to July 2022 was conducted (N = 11, 246). Articles were eligible for inclusion where they: (1) included a sample living in residential provision similar to that provided in the UK, (2) used standardised screening tools or psychiatric assessments, using diagnostic classification systems, and (3) reported prevalence estimates. Pooled prevalence estimates were calculated using random-effects meta-analysis. 21 articles with prevalence rates for a total of 4287 children, adolescents and young adults were included. Almost half the children had symptoms indicative of a probable mental health disorder (46%; 95% confidence interval (CI) 35–58). Externalising problems (49%; 95% CI 34–65), were more common than internalising problems (39%; 95% CI 26–53) and prevalence rates for conduct disorder (34%; 95% CI 17–55), depression (26%; 95% CI 18–35), emotional symptoms (17%; 95% CI 8–28), and somatic symptoms (14%; 95% CI 8–20) were estimated. The findings provide evidence that the prevalence of mental health disorders and symptoms are particularly high among children in residential care. These pooled estimates should be interpreted with caution due to high heterogeneity and further epidemiological research is needed to guide policy in different countries. [ABSTRACT FROM AUTHOR]

Introduction People with co-occurring mental health and substance misuse problems are among the most excluded in society. A need to feel connected to others has been articulated in the occupational science literature although the concept of belonging itself has not been extensively explored within this paradigm. This paper reports findings from research that explored the meaning and experience of belonging for four people living with dual diagnosis in the United Kingdom. Method Researchers employed an interpretative phenomenological approach to the study. Four semistructured interviews were carried out. The interviews were guided by questions around the meaning of belonging, barriers to belonging and how belonging and not belonging impacted on participants’ lives. Data analysis facilitated the identification of themes across individual accounts and enabled comparisons. Findings Data analysis identified four themes – belonging in family, belonging in place, embodied understandings of belonging and barriers to belonging. Conclusion The findings add further insights into the mutable nature of belonging. A link between sense of belonging and attachment theory has been proposed, along with a way to understand the changeable and dependent nature of belonging through ‘dimensions of belonging’. [ABSTRACT FROM AUTHOR]

The police have underdeveloped links with mental health and social care services despite daily contact with mentally ill individuals. They struggle with identifying and managing the mentally ill in custody, and consistently express a lack of support from partner agencies. In 2010, our research team developed a mental health screening tool and pathway for use by police custody officers, The Police Mental Health Screening Questionnaire (PolQuest). However, due to the large number of agencies with different organisational goals and responsibilities that deal with mentally disordered offenders, the introduction of a screening tool alone was considered insufficient. Thus, an action learning group comprising key professionals from relevant services in one geographical area was tasked with developing a manual and training materials to support the implementation of PolQuest by frontline staff. This paper reflects upon the key themes that emerged from the experience of action learning as a method for engaging multi-agency staff, operating under different occupational goals and cultures, to develop shared practice-oriented outcomes. Data analysed include the facilitator’s reflective notes, meeting minutes and emails. The action learning process was considered a useful method for engaging multi-agency stakeholders in developing materials to support PolQuest’s implementation in vivo. [ABSTRACT FROM AUTHOR]

Until around 1979, ‘confused’ or mentally unwell people over 65 years of age tended to be labelled as having ‘senile dementia’. Senile dementia was usually regarded as a single, inevitably hopeless condition, despite gradually accumulating clinical and pathological evidence to the contrary. Specific psychiatric services for mental illness in older people began to emerge in the 1950s, but by 1969 there were fewer than 10 dedicated services nationally. During the 1970s, ‘old age psychiatrists’ established local services and campaigned nationally for them. By 1979, about 100 old age psychiatrists were leading multi-disciplinary teams in half the health districts in England. This paper explores the tortuous development of these new services, focusing on provision for people with dementia. [ABSTRACT FROM PUBLISHER]

Levels of debt and poor mental health are at an all-time high among UK families, while the gap between rich and poor has also widened. Exposure and susceptibility to advertising, belief that purchased products will lead to happiness (materialism), and poor mental well-being have been shown to be linked in previous research, but the role of children's socio-economic status has seldom been taken into account. A greater understanding of the effects of this dynamic among those without the ready money to purchase highly advertised and desired products is important, particularly given the connections with children's low self-esteem. This study aimed to (1) quantify differences in TV advertising exposure, materialism, and self-esteem between deprived and affluent children, (2) measure differences in susceptibility to the effect of TV advertising exposure on materialism between deprived and affluent children, and (3) measure differences in susceptibility to the effect of materialism on self-esteem between deprived and affluent children. It was found that children from deprived backgrounds were more materialistic than children from affluent homes, and that this was the result of both higher exposure to advertising and higher belief in the credibility of advertising. At the same time, we found that children from affluent backgrounds were more susceptible to advertising's reinforcing effect on materialism, whereas children from deprived background were more susceptible to materialism's detrimental effect on self-esteem. Two different dynamics appear to be at play in the two groups. This adds a new dimension to our understanding of the role of advertising in a society with high levels of inequality. [ABSTRACT FROM AUTHOR]

This study undertook a replication of the work conducted by Sumsion in 2004 in the United Kingdom regarding the application of a definition of client-centred practice. Twelve occupational therapists employed by a local mental health facility and working with adult outpatients participated in semi-structured interviews. Template analysis and open coding were used to analyse the data. The resulting concept map indicated that collaboration and meaningful goals were at the centre of client-centred practice and formed the two main categories of data. The therapist and the client were the protagonists in these categories, but the family, team and system also played major roles. A table within this paper outlines all the categories and themes that arose from the data. However, space limitations required a focus on only the category of collaboration and the therapist and client facilitators and challenges within this category. The therapists used both attitudes and actions to facilitate the client-centred process and the clients brought strengths to this relationship. Nevertheless, both groups faced many challenges that had to be overcome to enable the successful implementation of client-centred practice. [ABSTRACT FROM AUTHOR]

The number of university students experiencing mental health issues in the UK is increasing and a high number of students are dropping out of university as a result. Literature highlights a lack of knowledge regarding this topic and the significance in educating society. The aim of this qualitative study was to provide further insights as to why students are experiencing anxiety and into help-seeking behavior amongst university students. A thematic analysis was used to analyze a total of 118 blog entries of students discussing the impact of university on mental health. Findings highlighted three main themes: Balancing priorities, Fear of failure, and Critical incidents. These themes are discussed in terms of possible risk factors contributing to students experiencing anxiety while at university. Findings together with recommendations listed in this study offer higher education staff and institutions the opportunity to explore areas of focus and improve university students' mental health. [ABSTRACT FROM AUTHOR]

Objectives: Within current research, little is known about the long-term outcomes of craniosynostosis. A priority-setting exercise by UK charity Headlines Craniofacial Support identified 2 key questions in this area: (1) What are the long-term physical and psychological effects for individuals with syndromic and non-syndromic craniosynostosis? and (2) Are individuals with craniosynostosis likely to suffer from mental health difficulties, or are they more resilient? The aim of the current study was to conduct an initial investigation of these priority questions. Methods: A comprehensive UK-wide survey consisting of 9 standardized psychological outcome measures and open-ended questions was distributed online. Thirty-six eligible adults (69.4% female) with a mean age of 30.8 years responded to the survey. Participants reported having single suture craniosynostosis (27.8%) or syndromic craniosynostosis (52.8%), with 19.4% being unsure of their diagnosis. Sample means were compared to published norms using independent samples t tests. Qualitative responses were analysed using inductive content analysis. Results: Compared to the general population, participants reported significantly less favorable scores related to appearance concerns, attachment in adult relationships, anxiety, optimism, and resilience. Self-worth, depression, and social anxiety scores were similar to norms. Qualitative responses provided additional insight into participants' satisfaction with appearance, physical health, medical treatment, employment, relationships, and recurrence risks. Few participants had accessed psychological support. Discussion: This preliminary study illustrates the potential long-term implications for individuals with craniosynostosis. Improved treatment protocols are needed to address physical health concerns in adulthood, while dedicated psychological resources are necessary to promote emotional well-being, social confidence, and resilience. [ABSTRACT FROM AUTHOR]

This article presents findings from an in-depth qualitative study focused exclusively on the first-hand experiences of small and micro businesses managers who have responded to employees with mental health difficulties. Despite growing policy focus on workplace mental health, empirical research evidence on management experiences of responding to mental health issues in a small or micro business context is rare. Drawing on in-depth interviews with 21 UK-based small and micro business managers who described 45 individual employee cases, we examine how managers traverse a support-performance continuum, and use a tension-based lens to analyse the tensions that managers experienced. We examine three key tensions for small and micro business managers that surfaced when responding to employees with mental health problems: (1) Individual vs Collective; (2) Confidence vs Caution; (3) Informal vs Formal. Our analysis exposes how managers handle tensions when managing at the nexus of support and performance and contributes a deeper understanding of the dynamics and challenges of managing mental health problems in small and micro businesses. [ABSTRACT FROM AUTHOR]

Although we know there are high rates of mental health difficulties amongst young people in out-of-home care (i.e. social welfare-involved children), there is limited evidence on the longitudinal development of these problems, particularly from when they enter the care system. Using the routinely collected carer-reported strengths and difficulties questionnaire, we explored internalising (emotional and peer) and externalising (conduct and hyperactivity) difficulties for 672 young people across their first 3 years in the UK care system (2–16 yrs, 51% boys, 76% Caucasian). In all cases stable profiles (resilient or chronic) were most common, while changing profiles (recovery or delayed) were less common. Findings showed that entry into the care system is not enough of an intervention to expect natural recovery from mental health difficulties. Number of placements and being separated from siblings were associated with greater difficulties. Implications for child welfare and mental health systems are discussed. [ABSTRACT FROM AUTHOR]

Research indicates substantial overlap between child abuse and neglect (CAN), exposure to domestic violence and sibling abuse, with multiple victimisation experiences conferring greater risk for adverse mental health outcomes than does exposure to a single subtype. The application of latent class analysis (LCA) to child maltreatment has gained momentum, but it remains the case that few studies have incorporated a comprehensive range of subtypes, meaning that real-life patterns in victimisation experiences cannot be accurately modelled. Based on self-report data from an ethnically diverse sample (N = 2813) of 10–17 year olds in the United Kingdom, the current study used LCA to model constellations among nine types of maltreatment in the home (physical, emotional and sexual abuse; physical and emotional neglect; exposure to physical and verbal domestic violence, or a drug-related threat; and sibling violence). A four-class solution comprising of a low victimisation class (59.3% of participants), an emotional abuse and neglect class (19.0%), a high verbal domestic violence class (10.5%) and a maltreatment and domestic violence class (11.2%) provided the best fit for the data. Associations with sociodemographic variables were examined, revealing differences in the composition of the classes. Compared to the low victimisation class, participants in the verbal domestic violence class, emotional abuse and neglect class and especially the maltreatment and domestic violence class, reported higher symptoms of anxiety and depression and an increased likelihood of non-suicidal self-injury, suicide ideation and suicide attempt. The findings carry important implications for understanding patterns of child maltreatment, and the implications for preventative strategies and support services are discussed. [ABSTRACT FROM AUTHOR]

Background: The number of children with a life-limiting condition is increasing. The mothers of these children commonly provide extensive care at home for their child and are at a higher risk of poor health than other mothers. The impact of this is rarely explored from mothers' perspectives. Aim: To explore mothers' accounts of their physical and mental health, experiences of accessing healthcare and who they think should support their health. Design: Qualitative semi-structured interviews were conducted and analysed using thematic analysis. Setting/participants: Thirty mothers of children with a life-limiting condition were recruited via three UK children's hospices and social media. Results: Mothers felt that their health concerns could be misunderstood by professionals, describing untimely and inappropriate support that failed to recognise the nature of caring for a child with a life-limiting condition. This led to mothers' reluctance in addressing these concerns. Mothers felt unable to prioritise their own needs, relative to those of their child and worried about who would look after their child if they did become unwell. They described stress as a result of battles with services rather than as a result of caregiving. Mothers valued feeling recognised as caregivers, which made it easier to look after their health alongside their child's. Hospice support was particularly valuable in this respect. Conclusions: A more unified system that recognises not only the unique set of challenges presented to mothers caring for a child with a life-limiting condition, but the value of palliative care services in supporting these mothers, is required. [ABSTRACT FROM AUTHOR]

Background: People with MS (pwMS) have had higher rates of anxiety and depression than the general population before the COVID-19 pandemic, placing them at higher risk of experiencing poor psychological wellbeing during the pandemic. Objective: To assess mental health and its social/lifestyle determinants in pwMS during the first wave of the outbreak in the United Kingdom. Methods: This is a community-based, prospective longitudinal cohort and cross-sectional case–control online questionnaire study. It includes 2010 pwMS from the UK MS Register and 380 people without MS. Results: The Hospital Anxiety and Depression Scale scores of pwMS for anxiety and depression during the outbreak did not change from the previous year. PwMS were more likely to have anxiety (using General Anxiety Disorder-7) and/or depression (using Patient Health Questionnaire-9) than controls during the outbreak (OR: 2.14, 95% CI: 1.58–2.91). PwMS felt lonelier (OR: 1.37, 95% CI: 1.04–1.80) reported worse social support (OR: 1.90, 95% CI: 1.18–3.07) and reported worsened exercise habits (OR: 1.65, 95% CI: 1.18–2.32) during the outbreak than controls. Conclusion: Early in the pandemic, pwMS remained at higher risk of experiencing anxiety and depression than the general population. It is important that multidisciplinary teams improve their support for the wellbeing of pwMS, who are vulnerable to the negative effects of the pandemic on their lifestyle and social support. [ABSTRACT FROM AUTHOR]

There has been limited research and policy directed toward defining and understanding child-to-parent aggression (CPA), resulting in inconsistent definitions, understandings, and responses, which has a detrimental impact on families. In particular, there have been limited qualitative studies of those working on the frontline of CPA, hindering the development of effective policy. The present qualitative study therefore aimed to explore practitioner perspectives of CPA. Twenty-five practitioners from diverse fields (e.g., youth justice, police, charities) participated in four focus groups relating to their experiences of working with CPA in the United Kingdom. Thematic analysis of focus groups revealed three key themes: definitions of CPA, understanding of CPA risk factors, and responding to CPA. Practitioners understood CPA to be a broad use of aggression to intimidate and control parents and highlighted a range of individual (e.g., mental health, substance abuse) and social (e.g., parenting, gangs) risk factors for CPA. Further, practitioners felt that current methods of reporting CPA were ineffective and may have a detrimental impact on families. The findings of this study have implications for CPA policy and support the need for a multiagency and coordinated strategy for responding to CPA. [ABSTRACT FROM AUTHOR]

Research has shown that visual impairment may impact daily functioning, health, and well-being negatively for adults of all ages. Ex-service personnel ('veterans') too may be at risk of poor health and well-being outcomes associated with post-military life, and this may be exacerbated by the presence of visual impairment. Despite this, research considering the experience of blind veterans has been limited and has not yet assessed well-being for these individuals across a broad spectrum of life domains. Rather, it has highlighted poor mental health and psychological well-being in working-age visually impaired veterans. However, the experiences of older visually impaired veterans (who make up the majority of visually impaired veterans in the United Kingdom) have been poorly represented in the literature. This pilot study aimed to provide a preliminary assessment of holistic well-being in an adult sample of 97 UK blind veterans, predominantly composed of older age veterans (majority over 80 years). Cross-sectional well-being data were collected using a validated measure of well-being (the Well-Being Inventory [WBI]). Results suggest that members of Blind Veterans UK are functioning well and are satisfied across four life domains (vocation, finances, health, and social relationships). Lower health satisfaction was identified, particularly in blind veterans with comorbid mental health conditions. Results are discussed in relation to the older age of the sample, the limitations of face-to-face survey administration, and the applicability of the WBI finance domain in this age cohort. Recommendations are made for future research in this population. [ABSTRACT FROM AUTHOR]

Evidence suggests that mental health interventions are more effective when they consider the whole context of schools; addressing the needs of all students, their families, and staff; otherwise known as a whole-school approach (WSA). The UK Government is piloting WSAs to transform mental health and wellbeing by locating educational mental health practitioners in educational settings across England. This study aims to develop a 'bottom-up' understanding of the contextual factors and mechanisms that underlie WSAs in Trailblazer schools in the North East and North Cumbria, to gain insight into the facilitators and barriers of delivering a WSA, and optimal evaluation methods. To undertake a realist evaluation, we included the generation of initial programme theories from existing academic literature and policy documents; 'theory gleaning' interviews with NHS/local authority stakeholders, Trailblazer staff and school senior leaders; refining and development of theories; and individual interviews and focus groups with pupils, parent/carers and school staff. The findings will enable Trailblazer partners to better understand how their WSAs to mental health contain the essential components for transformation in schools in the region. This will contribute to the embedding of continuous evaluation into regional Trailblazers' practice for participating schools, for subsequent annual waves and producing relevant findings for non-Trailblazer schools. Complementing the national evaluation of all 25 Wave 1 Trailblazer pilot sites, this study will generate an explanatory theoretical account of how to optimally design, implement and evaluate WSAs by exploring the contextual factors associated with implementation of WSAs. [ABSTRACT FROM AUTHOR]

This study examined reactions to the UK government's Better Health campaign through a thematic analysis of tweets. Four themes were generated: Embracing Better Health; There is no Better Health without mental health; Inconsistent messaging; Only a surface-level solution. Findings suggest the campaign is problematic, given its lack of consideration for mental health and wider societal factors that contribute to obesity. The campaign could exacerbate mental health difficulties for individuals with eating disorders due to its focus on weight and perceived fat-shaming approach. Recommendations are made to develop future campaigns that avoid negative public responses, minimise harms, and maximise intended benefits. [ABSTRACT FROM AUTHOR]

The novel coronavirus disease 2019 (COVID-19) pandemic and associated mitigation strategies such as "lockdown" are having widespread adverse psychological effects, including increased levels of anxiety and depression. Most research using self-reported data highlights the pandemic's impact on the psychological well-being of females, whereas data for mental health emergency presentations may reflect the impact on male mental health more accurately. We analyzed records of male mental health emergencies occurring in the East Midlands of the United Kingdom during the first national "lockdown." We computed two binary logistic regression models to (a) compare male mental health emergencies occurring during "lockdown," 2020 (5,779) with those occurring in the same period in 2019 (N = 4,744) and (b) compare male (N = 5,779) and female (N = 7,695) mental health emergencies occurring during "lockdown." Comparisons considered the characteristics of mental health emergencies recorded by ambulance clinicians (Primary Impressions), and the socioeconomic characteristics of communities where emergencies use the Index of Multiple Deprivation. We found that during "lockdown," male emergencies were more likely to involve acute anxiety (odds ratio [OR]: 1.42) and less likely to involve intentional drug overdose (OR: 0.86) or attempted suicide (OR: 0.71) compared with 2019. Compared with females, male emergencies were more likely to involve acute behavioral disturbance (OR: 1.99) and less likely to involve anxiety (OR: 0.67), attempted suicide (OR: 0.83), or intentional drug overdose (OR: 0.76). Compared with 2019, and compared with females, males experiencing mental health emergencies during "lockdown" were more likely to present in areas of high deprivation. Understanding the presentation of male mental health emergencies could inform improved patient care pathways. [ABSTRACT FROM AUTHOR]

Introduction: A major amendment to the Mental Health Act 2007 was to broaden the professional groups eligible to undertake specific roles under the Act. One such role was the approved mental health professional (AMHP), whose responsibility is to conduct assessments of people deemed mentally disordered to determine whether they meet the criteria for detention, known as 'sectioning'. Traditionally, this role was undertaken by social workers. Although occupational therapists are now eligible to undertake the role, uptake has been low. Method: A critical literature review was conducted to explore the AMHP role and occupational therapy in order to develop an understanding of the fit between the two. A wide-ranging search identified 282 articles, 30 of which were relevant to the review question. Findings: Coding identified four overarching interrelated themes: values, social (work) perspective, independence of the AMHP role and impact on therapeutic relationship. Coherence exists between social work values and occupational therapy values so it is more likely that structural issues, rather than incongruent values, are impeding occupational therapists' uptake of the AMHP role. Conclusion: A register of occupational therapists employed as AMHPs, and further research exploring reasons for low uptake, is recommended. [ABSTRACT FROM AUTHOR]

In this paper the powerful relations between mental health and nature are explored with reference to past asylum horticultural practices and to contemporary community gardening schemes for people with mental-health problems in the United Kingdom. Through the use of archival evidence, alongside contemporary voices of experience, understandings of the therapeutic and social dimensions to nature work are outlined and deconstructed. It is argued that particular discourses concerning the powers of nature (work) in managing madness and mental-health problems are largely consistent across time and space (from the asylum to the community). However, in the contemporary era it is particular types of nature work that arguably contribute most directly to state agendas for social inclusion, and therefore to securing the place of people with mental-health problems in mainstream society. By briefly profiling the voices of staff and ‘volunteers’ from two urban garden schemes in England and Scotland, different experiences of garden work as ‘restorative’ and as ‘interventionist’ will be discussed. I conclude by evaluating how embodying and enacting gardening work act as a sustainable vehicle for new versions of social citizenship for people traditionally marginalised in mainstream society. [ABSTRACT FROM AUTHOR]

Background : Young people spend a large proportion of their time in school, which presents both risk and protective factors for their mental health. A supportive school culture can promote and protect good mental health by creating experiences of safety and belonging amongst staff and students. In this qualitative study, we seek to explore whether a participatory action research (PAR) approach is an effective way to promote and improve student mental health. Methods : Participatory action research is an approach in which people collaboratively research their own experience: the researched communities become co-researchers of their own experiences in a specific context. We will work with four secondary schools in the UK to develop PAR projects. In each school, a group of 2–4 staff and 6–8 students will work together to develop a shared understanding of their school culture and to introduce activities or changes to make the culture more supportive of student mental health. We will evaluate the effectiveness of the PAR approach through i) a review of school documents pertaining to mental health (e.g., policies and Ofsted reports), ii) interviews with staff members (n = 40), parents (n = 8) and students (n = 24–40) before and after the PAR intervention, iii) observations and reports of the PAR group meetings and iv) interviews with members of the PAR groups after the PAR intervention. Discussion : We anticipate that our research findings will advance knowledge on effective methods to develop a positive school culture that will contribute to the improvement of young people's mental health and well-being. We will seek to identify the mechanisms through which school culture can have a positive impact on mental health and develop a logic model and a school culture toolkit that can be utilised as a resource to inform public health interventions to promote mental health in a range of educational settings. [ABSTRACT FROM AUTHOR]

This study explored the lived experience of people with inflammatory bowel disease and anxiety/depression. It utilised a deductive biopsychosocial framework. Overall, 24 patients and 20 healthcare professionals from two countries participated. In the United Kingdom, the main themes included (1) bidirectional relationship between inflammatory bowel disease and mental health, (2) the need for healthcare integration and (3) lack of awareness about the disease. In Australia, (1) the 'vicious cycle' of inflammatory bowel disease and psychosocial health, (2) the need for biopsychosocial healthcare integration and (3) the stigma of a hidden disease. Better communication around mental illness is essential in improving inflammatory bowel disease healthcare. [ABSTRACT FROM AUTHOR]

This article describes a pilot qualitative research study, exploring the impact of bereavement experiences, on pre-qualifying social work students in two UK Universities with diverse demographics. The research study took place in the context of general concern about the mental health of UK University students and suggests that social work students may be at particular risk of developing emotional wellbeing issues linked to bereavement. Interviews followed a free association narrative technique, with analysis of the data highlighting four main themes. Firstly, bereavement is associated with practical problems which may trigger wellbeing issues. Secondly, there is an increased need for specific bereavement training and support to be embedded within social work programmes, alongside skills and knowledge of cultural diversity and the part this plays in the bereavement process. Lastly, the study demonstrated that bereavement experiences are not isolated but linked to other losses and therefore students may need effective support to process these before they can effectively support others. The study appears to be distinctive in its focus on the impacts of bereavement on social work students and has significant implications for the ways in which students are supported by social work education programmes, as well as paving the way for further research in this area. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapy has long had a strong presence in military mental healthcare. Today's veterans have complex needs and can face challenges reintegrating into civilian life. This exploratory study investigated whether veterans receiving mental health treatment who participated in a bespoke occupational therapy and resilience workshop intervention improved their perceived participation in everyday life. Method: An interpretivist hermeneutic phenomenological approach was used to explore veterans' perspectives. Ten participants took part in two semistructured focus groups. Thematic analysis was used to identify and analyse patterns within the data. Findings: Most participants developed occupational goals and started to make lifestyle changes; participants developed an appreciation of the value of occupation; participants developed insight into their recovery journeys; and value was placed on the 'healing power' of the group. Conclusion: This exploratory study provides preliminary evidence to suggest occupational therapy was influential in helping participants understand the impact of occupation on health and start making lifestyle changes. Participants also reflected on their recovery journeys. The benefits of doing this within a group environment appear to have been particularly therapeutic. Original occupational therapy research in this specialism is sparse. This novel study provides insight that can further discussion and enhance understanding about what the profession can offer this client group. [ABSTRACT FROM AUTHOR]

This article reports findings from the first empirical study in the United Kingdom on forced-to-penetrate cases, where a man is forced to penetrate a woman either orally, vaginally, or anally with his penis and without his consent. Using an online survey, data were collected in relation to the physical and emotional impacts experienced by 154 men following their most recent forced-to-penetrate experience. Quantitative and qualitative data were collected through the use of closed and open-ended survey questions, where participants were asked about the context and circumstances of their most recent experience and whether they had suffered any physical injuries. A unipolar scale was used to measure the emotional impact on participants, with an open-ended follow-up question gathering qualitative data. The majority of participants did not report suffering physical injuries, but those that did suffered injuries to their genitalia and upper bodies. Participants most frequently indicated that their most recent forced-to-penetrate experience had had a severe negative emotional impact on them. Negative emotional impacts disclosed by participants were complex, ranging from anxiety and depression, to self-harm and suicidal thoughts and attempts. Quantitative analysis highlighted that when certain variables were present, participants more frequently reported physical injuries, as well as higher average levels of emotional harm. The findings from the study challenge existing understandings of masculinity and rigid sex and gender roles, which assume that men will always consent to sexual activity with a woman and that they cannot or do not experience emotional or physical harms at the hands of a woman. The findings are also considered in relation their implications for law and legal discourse, where evidence of harm is used as a justification for the criminalisation of certain behaviors and the severity of the legal response through sentencing. [ABSTRACT FROM AUTHOR]

The article focuses on the need of proper health policy in Great Britain for the management of patients with psychiatric disorders in the community. To meet the need of patients with mental illness the role of the general practitioner has still to be agreed. Since the inception of the National Health Service of Great Britain, the matter has received sporadic attention.

Writing online narratives of postpartum psychosis allows both self-analysis and catharsis and can also be viewed as a type of sociopolitical expression. Eight narratives posted on the Action on Postpartum Psychosis website were analyzed using Burke's narrative analysis. This method focuses on a pentad of key elements of story: scene, act, purpose, agent, and agency. What drives this narrative analysis is the identification of problematic areas referred to as ratio imbalances between any two of these five terms. The ratio imbalance between Agent and Act appeared most often in these eight narratives. The agent was the mother and the act most often was either her hallucinations or delusions. The second most frequent area of tension was between Scene and Agent. Problematic scenes for the agent (mother) involved admission to the psychiatric ward, entering the electroconvulsive therapy room, or nighttime. These ratio imbalances pinpoint places where clinicians can target specific interventions. [ABSTRACT FROM AUTHOR]

'Healthy prisons' is a well-established concept in criminology and prison studies. As a guiding principle to prisoners' quality of life, it goes back to the 18th century when prison reformer John Howard regarded the improvement of ventilation and hygiene as being essential in the quest for religious penitence and moral reform. In more recent, times, the notion of the 'healthy prison' has been more commonly associated with that which is 'just' and 'decent', rather than what is healthy in a medical or therapeutic sense. This article interrogates the 'healthy prison' more literally. Drawing on data gathered from a UK prison located on a seashore, our aim is to explore prisoners' rational and visceral responses to water in a setting where the very nature of enforced residence can have negative effects on mental health. In expanding the possibilities for the theorization of the health benefits that waterscapes may generate, and moving the discussion from healthy 'green space' to healthy 'blue space', the article reveals some of the less well-known and under-researched interconnections between therapeutic and carceral geographies, and criminological studies of imprisonment. [ABSTRACT FROM AUTHOR]

This article introduces the special issue on UK gangs and youth violence. Written to coincide with the launch of the National Centre for Gang Research at the University of West London, this collection adds the voices of academics who have spent years researching serious violence to a conversation dominated by policymakers and media commentators. The authors examine trends in youth violence and offer a brief history of UK gang research before previewing the contribution of the seven empirical articles dealing with police gang databases, knife crime, county lines drug dealing, contextual safeguarding, offender mental health, gang disengagement and criminal desistance. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to identify the barriers and facilitators to the implementation of a high fidelity individual placement and support service in a community forensic mental health setting. Method: In-depth interviews were conducted with clinical staff (n = 11), patients (n = 3), and employers (n = 5) to examine barriers and facilitators to implementation of a high fidelity individual placement and support service. Data was analysed using thematic analysis, and themes were mapped onto individual placement and support fidelity criteria. Results: Barriers cited included competing interests between employment support and psychological therapies, perceptions of patients' readiness for work, and concerns about the impact of returning to work on welfare benefits. Facilitators of implementation included clear communication of the benefits of individual placement and support, inter-disciplinary collaboration, and positive attitudes towards the support offered by the individual placement and support programme among stakeholders. Offences, rather than mental health history, were seen as a key issue from employers' perspectives. Employers regarded disclosure of offending or mental health history as important to developing trust and to gauging their own capacity to offer support. Conclusions: Implementation of individual placement and support in a community mental health forensic setting is complex and requires robust planning. Future studies should address the barriers identified, and adaptations to the individual placement and support model are needed to address difficulties encountered in forensic settings. [ABSTRACT FROM AUTHOR]

Stigma is not a self-evident phenomenon but like all concepts has a history. The conceptual understanding of stigma which underpins most sociological research has its roots in the groundbreaking account penned by Erving Goffman in his best-selling book Stigma: Notes on the Management of Spoiled Identity (1963). In the 50 years since its publication, Goffman's account of stigma has proved a productive concept, in terms of furthering research on social stigma and its effects, on widening public understandings of stigma, and in the development of anti-stigma campaigns. However, this introductory article argues that the conceptual understanding of stigma inherited from Goffman, along with the use of micro-sociological and/or psychological research methods in stigma research, often side-lines questions about where stigma is produced, by whom and for what purposes. As Simon Parker and Robert Aggleton argue, what is frequently missing is social and political questions, such as 'how stigma is used by individuals, communities and the state to produce and reproduce social inequality'. This article expands on Parker and Aggleton's critique of the limitations of existing conceptual understandings of stigma, through an examination of the anti-stigma campaign Heads Together. This high-profile campaign launched in 2016 seeks to 'end the stigma around mental health' and is fronted by members of the British Royal Family. By thinking critically with and about this campaign, this article seeks to both delineate the limitations of existing conceptual understandings of stigma and to begin to develop a supplementary account of how stigma functions as a form of power. We argue that in order to grasp the role and function of stigma in society, scholarship must develop a richer and fuller understanding of stigma as a cultural and political economy. The final part of this introduction details the articles to follow, and the contribution they collectively make to the project of rethinking the sociology of stigma. This collection has been specifically motivated by: (1) how reconceptualising stigma might assist in developing better understandings of pressing contemporary problems of social decomposition, inequality and injustice; (2) a concern to decolonise the discipline of sociology by interrogating its major theorists and concepts; and (3) a desire to put class struggle and racism at the centre of understandings of stigma as a classificatory form of power. [ABSTRACT FROM AUTHOR]

Schwartz Rounds are evidence-based interdisciplinary discussions where health care staff can share experiences of the emotional and social aspects of care, to support improvements in patient care. Developed in acute services, they are now being implemented in various settings including U.K. community and mental health services where their implementation has not been researched. Realist evaluation was used to analyze three community and mental health case studies of Round implementation, involving Round observations (n = 5), staff interviews (n = 22), and post-Round evaluation sheets (n = 206). Where Schwartz Rounds were successfully implemented and facilitated, the discussions enabled emotional resonance across interdisciplinary colleagues about caring experiences, enabling the recognition of a common humanity. Participants appreciated attending Rounds and saw they improved communications, trust, and openness with colleagues and enabled more compassionate care with patients. The wide geographical dispersal of staff and work pressures were challenges in attending Rounds, and strong leadership is needed to support their implementation. [ABSTRACT FROM AUTHOR]

A political attempt in the United Kingdom to address health inequalities in the past decade has been the government’s initiative to employ local health trainers (HTs) or health trainer champions (HTCs) to support disadvantaged individuals with aspects of their health-related behaviors. HT/HTCs provide health-related information and support to individuals with healthy eating, physical activity, and smoking cessation. They undertake community engagement and direct individuals to relevant health services. They differ in that HTs are trained to provide health interventions to individuals or groups and to make referrals to specialist health care services when necessary. This article provides an evaluation of HT/HTCs interventions across three sites, including one prison, one probation service (three teams), and one mental health center. An evaluation framework combining process and outcome measures was employed that used mixed methods to capture data relating to the implementation of the service, including the context of the HT/HTCs interventions, the reactions of their clients, and the outcomes reported. It was found that HT/HTCs interventions were more effective in the prison and mental health center compared with the probation site largely as a result of contextual factors. [ABSTRACT FROM AUTHOR]

The article focuses on the retrospective accounts of the experiences of childhood sexual abuse survivors on therapeutic support received before the age of 18 in Great Britain. It notes that the survey has formed part of a broad programme of research on therapeutic interventions for children who are affected by sexual abuse. It mentions the National Society for the Prevention of Cruelty to Children (NSPCC) under the Rebuilding Childhoods programme.

The article presents the opinion of the author on the better treatment of psychiatric patients in the community and the need of good mental health service in Great Britain. According to the author about one-fifth of the work of general practice in the country is involved directly or indirectly with psychiatric problems. He says that most of these psychiatric problems are managed by general practitioners, without any referral to specialist psychiatric services.

Introduction: In England, the Payment by Results reimbursement system was introduced for mental health services. Occupational therapists developed the indicative care packages for identified clusters endorsed by the system. This study sought to systematically gather and document occupational therapists’ viewpoints on the appropriateness of a range of therapy aims and, thereby, inform the creation of the occupational therapy indicative care packages. Method: This study is a descriptive, internet-based survey of therapists in six National Health Service trusts in the United Kingdom. Findings: A total of 262 therapists completed the survey for a response rate of 61.07%. Most were female (85.5%) with varying levels of experience (less than 5 years [33%]; between 5 and 20 years [54%]; over 20 years [13%]). Therapists evaluated the most appropriate aims specified for three occupational performance levels of service users and for six occupational areas. Additional aims were reported by therapists, and there was near-consensus for more than half of the aims, with over 75% of therapists agreeing on their appropriateness. Conclusion: Findings from experts’ empirical knowledge inform practice by providing evidence for specifying service outcomes that are theory based and occupation focused in guiding the development of recommended occupational therapy objectives. [ABSTRACT FROM AUTHOR]

Little is known of Joshua Harrison Stallard other than that he was a provincial medical practitioner who moved to London and campaigned for improvement in metropolitan workhouses. In the pamphlet reproduced here, Stallard draws attention to the build-up of lunatics in workhouses due to lack of asylum beds. He also argues for the increased use of home care for lunatics instead of continually expanding asylum provision, and points to the need for training of asylum doctors. [ABSTRACT FROM PUBLISHER]

This article aims to add a regional science perspective and a geographical dimension to our understanding of substantive questions regarding self-reported happiness and well-being through the specification and use of multilevel models. Multilevel models are used with data from the British Household Panel Survey and the Census of UK population to assess the nature and extent of variations in happiness and well-being to determine the relative importance of the area (district, region), household, and individual characteristics on these outcomes. Having taken into account the characteristics at these different levels, we are able to determine whether any areas are associated with especially positive or negative feelings of happiness and well-being. Whilst we find that most of the variation in happiness and well-being is attributable to the individual level, some variation in these measures is also found at the household and area levels, especially for the measure of well-being, before we control for the full set of individual, household, and area characteristics. However, once we control for these characteristics, the variation in happiness and well-being is not found to be statistically significant between areas. [ABSTRACT FROM PUBLISHER]

In this article the author discusses the sentencing in young offenders in Great Britain. He asserts that the sentencing provisions by the Court of Appeal through the imposition of an extended sentence for public protection (EPP) under Criminal Justice Act (CJA) of 2003 can prevent the risk of serious harm in public and can be an option to indeterminate term of detention (DPP). He cites several considerations in imposing the sentence to offenders including age, offence, and mental health factors.