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Since 2010, government policy in England has positioned further education almost exclusively as employment-orientated training for school leavers whilst also imposing severe budget cuts. During this period, values-based pedagogies that foreground social justice for students, many of whom come from low-income households, have been undermined. Following the COVID-19 pandemic, there is evidence that the mental health and well-being of further education students has suffered but little is known about the pandemic's effects on teachers.This paper presents analysis of primary research data drawn from interviews with a small sample of further education teachers and managers in the English West Midlands about their mental health and well-being during the pandemic. The paper frames the research data by acknowledging that both mental health nursing and further education teaching are currently riven by contradictions with an epistemological basis anchored in meritocratic and neoliberal policy. Using Lefebvrian theory, our analysis suggests that for further education staff, the pandemic has sharpened the tensions experienced in an already precarious professional role. Key findings were that the further education funding regime drove a 'business as usual' management attitude during the pandemic, and an intensification of work and the erosion of pedagogical practice negatively affected staff's mental health. [ABSTRACT FROM AUTHOR]

In England, failing to achieve a 'good pass' (C/4 grade) in key subjects is thought to have serious negative implications. Yet evidence on this issue remains relatively sparse. This paper therefore presents new evidence on the link between meeting a key threshold on high-stakes examination and a wide array of future outcomes. Using Next Steps survey data collected from around 4,000 young people in England, we explore the short-to-medium term benefits of achieving a 'good pass' (grade C/4) in English Language, double science and mathematics. Results from our regression analyses point towards a sizable association with future educational attainment; those who achieve a good pass in GCSE mathematics are around 5 percentage points more likely to hold a university degree by age 26 than observationally similar individuals who fail to meet this threshold. No link is found with future wellbeing and mental health, while results for labour market outcomes are somewhat mixed. The findings potentially motivate the need for GCSEs to move away from awarding a set of discrete grades and towards a continuous measurement scale. Alternatively, if discrete grades are to be retained, computer adaptive testing should be introduced for GCSEs to increase measurement precision around high-stakes grade boundaries. [ABSTRACT FROM AUTHOR]

The findings presented here derive from a wider study that sought to establish a baseline understanding of mental health and wellbeing among the agricultural community in England and Wales. This paper focuses on selected questions that investigated levels of anxiety and associated stress factors among farm women, a group which has been relatively neglected within previous research on farming mental health in the United Kingdom. A questionnaire survey was widely distributed to members of the agricultural community in England and Wales (n = 15,296) in both paper and online formats. The survey included a number of standardised instruments to assess mental health and wellbeing, including the Generalised Anxiety Disorder-7 scale (GAD-7). Focusing on a sub-sample of female respondents (n = 3487), this paper details the findings from the GAD-7, alongside those from a selection of other questions investigating sources of stress, loneliness and perceived business viability. A significant proportion of female respondents were experiencing anxiety at the time of survey completion, with 23.3% reaching the threshold for clinically relevant anxiety based on their GAD-7 scores (medium or severe anxiety, scores≥10). A further 34.6% were classified as experiencing mild anxiety (scores 5–9) whilst 42.1% were not suffering from anxiety (scores 0–4). Medium/severe anxiety was identified as being associated with a number of stress factors, feelings of loneliness and pessimistic perceptions of farm business viability. There were important age-based differences, with working-aged women identified as more likely to suffer from anxiety, loneliness and certain stressors than older women. The findings reported here indicate concerning levels of anxiety among farming women and this should be seen as a call to action. There are clear associations between anxiety and a range of stressors and, although we cannot ascertain causality, these point to issues that demand attention in efforts to improve mental health within this social group. The factors contributing to anxiety are, however, multiple and complex and farm women may be affected by particular gender-based challenges that have not yet been explicitly explored in relation to mental health. Further research is needed to investigate and understand these issues in greater depth. [ABSTRACT FROM AUTHOR]

This paper will explore the ways in which behaviour features in the accounts of 'off rolling' processes in schools in England volunteered by participants – senior school leaders, SENCos and parents, in an ongoing multi-stranded research project. In addition to analysing these accounts, this paper draws on contextual features and concepts such as parrhesia and authenticity in a probing of methodological considerations. The status of such accounts as data will also be considered given the high stakes accountability environment in which school principals strive to fulfil their legal remit in the field of inclusion. The trustworthiness of findings in qualitative research is more usually the focus of attention; however, our studies to date imply that some professionals carefully manage the image of their school and visibility of exclusionary practices to the detriment of students with mental health and behavioural issues. The methodological implications of conducting research in politicised and highly sensitive areas will be discussed. [ABSTRACT FROM AUTHOR]

As a result of a changing legal and policy context, statutory social work with adults in the UK has undergone a series of radical reforms. Underpinning these changes has been an ideological shift in the way adult social care should be provided. A clear 'direction' including a focus on autonomy, self-determination and personal responsibility is being promoted. These represent changes for both social workers and people receiving services. However, it has been suggested that policy may not fully acknowledge the factors that may undermine the ability of some individuals to take control of and manage their own needs. This paper draws on findings from two research projects, undertaken with social work practitioners located in statutory adult social care teams in the North East of England. The first explored the involvement of older people in adult safeguarding and the second considered capacity assessments and best interest decision making by social workers under the Mental Capacity Act [2005. Retrieved from ]. This paper presents key findings regarding how social workers attempt to reconcile the gap between the profile of the service user in policy and the reality of the people that social workers are supporting in practice. Key recommendations for policy, practice, and further research are also discussed. [ABSTRACT FROM AUTHOR]

In this paper, we use a UK case study to explore how the COVID-19 pandemic affected the mental health (emotional, psychological, social wellbeing) of farmers. We outline the drivers of poor farming mental health, the manifold impacts of the pandemic at a time of policy and environmental change, and identify lessons that can be learned to develop resilience in farming communities against future shocks. We undertook a survey answered by 207 farmers across the UK, focusing on drivers of poor mental health and the effect of the COVID-19 pandemic. We also conducted 22 in-depth interviews with individuals in England, Scotland and Wales who provide mental health support to farmers. These explored how and why the COVID-19 pandemic affected the mental health of farmers. These interviews were supplemented by 93 survey responses from a similar group of support providers (UK-wide). We found that the pandemic exacerbated underlying drivers of poor mental health and wellbeing in farming communities. 67% of farmers surveyed reported feeling more stressed, 63% felt more anxious, 38% felt more depressed, and 12% felt more suicidal. The primary drivers of poor mental health identified by farmers during the pandemic included decreased social contact and loneliness, issues with the general public on private land, and moving online for social events. Support providers also highlighted relationship and financial issues, illness, and government inspections as drivers of poor mental health. Some farmers, conversely, outlined positive impacts of the pandemic. The COVID-19 pandemic is just one of many potential stressors associated with poor farming mental health and its impacts are likely to be long-lasting and delayed. Multiple stressors affecting farmers at the same time can create a tipping point. Therefore, there is a need for long-term support and ongoing evaluation of the drivers of poor mental health in farming families. [ABSTRACT FROM AUTHOR]

Children who spend time in the care of their local authority, usually due to neglect or abuse within the birth family, tend to experience significant educational disruption and have lower educational outcomes, on average, than other young people. However, little is known about those subsequently participating in higher education, who comprise just under one percent of the student body in England. The paper synthesises three contrasting datasets to map participation patterns among care-experienced young people for the first time. Considerably more enter higher education than previously thought, but they remain significantly less likely to participate than other young people. Furthermore, they tend to enter later, with less prestigious qualifications and to lower status institutions. The paper concludes by discussing key differences between the datasets, reflecting on difficulties with identifying and recording care-experienced students which may account for an apparent lack of progress in encouraging their participation despite concerted policy efforts. [ABSTRACT FROM AUTHOR]

In seventeenth-century England, many religiously devout people believed they had an obligation to immediately stifle any sinful thought that entered their minds. As some prominent clerics during the time period recognised, however, the effort to subdue unwelcome thoughts often can increase the thoughts. Indeed, recent cognitive science research bears out the counterintuitive phenomenon that trying to suppress an undesired thought can boomerang. With this in mind, just how effective was the endeavour in seventeenth-century England to purify thoughts? The paper argues that it was frequently counterproductive. The paper also explores a disagreement among mental health professionals, historians, and literary scholars regarding how to interpret the numerous seventeenth-century English autobiographical descriptions of tormenting, uncontrollable sinful thoughts. For instance, were the ungovernable blasphemous thoughts that Pilgrim's Progress author John Bunyan (1628-1688) recounted experiencing the product of a bodily illness equivalent to obsessive-compulsive disorder? The question presents methodological challenges. [ABSTRACT FROM AUTHOR]

Trans and non-binary youth (TNBY) face high levels of interpersonal and social adversity as well as disproportionate rates of mental health issues such as depression, self-harm and suicidal ideation. Among protective factors, context plays a key role. In addition to parental support, access to gender-affirming medical care begins to emerge as crucial for young people needed them. This paper compares, through thematic analysis, the experiences of TNBY with regard to access and experiences to care in Canada, Switzerland, England, and Australia. It identifies similarities and differences in barriers to access to care, as well as impacts of gender affirming care on young people and their well-being. The article concludes with a discussion on the importance of prompt and easier access to gender-affirming medical care, of training of professionals, and a hypothesis about the role of context in TNBY well-being. [ABSTRACT FROM AUTHOR]

The contribution and role of psychologists, psychiatrists or mental health practitioners in working alongside forced migrants may take many forms. The guidance on which this paper is based, came about when several members of the British Psychological Society (including those with lived experience and insight and those who had set up services); became aware of the need for good practice guidance for clinicians working with refugees, asylum seekers including forced migrants across Britain. These guidelines cover a range of areas where clinicians work with individuals in clinical contexts, schools, nurseries, colleges and within community organisations. [ABSTRACT FROM AUTHOR]

Research has long demonstrated the exclusion and Othering experienced by young people with disabilities in education. This paper presents findings from an ethnographic study conducted in an 'elite' sixth-form college in England, set against the backdrop of a shifting social, political, and cultural landscape, where neo-liberal discourses of dis/ability and healthism—centring on mental health and wellbeing—are becoming further embedded in educational policy. Drawing on theoretical work by Bourdieu and Foucault, we demonstrate how the students in this study appeared able to re-make disability as a liberal intellectual identity marker and use it as a form of capital within the bounded college sub-field. However, we argue that these empowered disabled subjectivities were strongly middle-classed and precarious. The findings have implications through advancing current understandings of young people's complexifying relationships with disability in education, of enduring inequalities around disability, and how social class is implicated in this. [ABSTRACT FROM AUTHOR]

The English National Child Measurement Programme (NCMP) is a nationally mandated public health programme. It provides data for child excess weight indicators in the Public Health Outcomes Framework, part of the government's approach to reducing childhood obesity. Drawing on a meta-ethnographic synthesis of household members' experiences of the programme, we conceptualise the NCMP as a 'technique of futuring' to generate new insights into how it (re)shapes and (re)imagines past, present, and future responsibilities and practices for overweight children, parents, and carers, in potentially harmful ways. For children categorised by the NCMP as overweight, the NCMP is an emotionally significant event, driving new bodily practices, new food practices and changed relationships with peers. This paper outlines how parents come to resist and reframe the programme and its results, to protect their children from a weight-focused future. They consider the potential risks of bullying, dysfunctional eating, and mental health consequences more important than future risks of overweight. We show how parents of children categorised as overweight preserve their claim to 'responsible' and 'good' parenting amongst peers, whilst shifting the blame for childhood obesity to other, 'irresponsible' parents, thus reproducing moralising and responsibilising discourses inherent within the 'behaviour change' messaging of the NCMP and associated research. Finally, we consider a central paradox of this programme and the use of NCMP population level monitoring data to (re)shape lives at the individual and social level – the children it sets out to help are the most likely to experience harm as a result of it. [ABSTRACT FROM AUTHOR]

In this paper, we present an account of the nature of relational security and the need for robust, comprehensive and consistent implementation within secure and forensic mental health settings in England and Wales. Within this, we review and critique the See Think Act framework of relational security and consider how it may be further developed. We conclude by making a series of evidence-based recommendations for improving the quality of relational security as it is deployed within secure and forensic mental health settings. [ABSTRACT FROM AUTHOR]

Against a backdrop of austerity, this mixed method paper provides a contemporary understanding of stressors in English policing by examining stressors experienced by police employees in the UK. In the first study, police officers (n = 223) and police staff (n = 134) in a county police force in England completed measures of operational and organisational stressors. Significantly higher scores were found for operational and organisational stressors in police officers compared to police staff. Police officers also reported higher operational and organisational stressor scores in comparison to norms for an international sample. In the second study, 27 police employees from the same force participated in focus groups exploring stressors in policing. The qualitative findings built on the first study by providing detailed insights into stressors presently experienced by police employees and the impact of police reform on stress. Implications of the findings and recommendations for future research are discussed. [ABSTRACT FROM AUTHOR]

This paper asks if Diaspora is an intellectually overloaded term or if, alternatively, it augments existing understandings of migrant's experiences when individuals are adrift from their homeland. Fundamentally, Diaspora is a concept that transcends the nation-state as the primary unit of analysis of migration movements and developments. Although some migrations are voluntary, most are not: thus, this paper addresses involuntary migrations, this emphasis drawing support from Cohen's Global Diasporas (2008) which employs an elastic method but with 'victim diasporas' taking precedence: by victim diasporas, Cohen means Jews, Africans, Armenians and Irish. This paper, of course, explicates matters in respect of 'the Irish', the second largest dispersed group in history. [ABSTRACT FROM AUTHOR]

Background:The Mental Health Act Commission (MHAC) is a body which monitors the care and treatment of patients compulsorily detained in hospital in England and Wales. It does this through listening to their views and by observing the conditions in which they are held; this direct exposure to the experience of service users contrasts with other models of quality assurance which rely mainly on secondary data. Aims: This paper reviews the work of the Commission, focusing on its visiting role and methodology. Methods: The paper is based on published and unpublished literature, drawing also on personal experience as a member of the MHAC. Results: It argues that textual data tend to be privileged over talk because of the need for evidence-based recommendations and that patients' views are for this reason relatively neglected in Commission reports. The paper highlights ambiguities in the role of the Commission and identifies two divergent goals, firstly protection of legal rights, secondly audit and inspection. Conclusions: The paper finds that it has been difficult for the MHAC to reconcile these goals. While it has successfully raised standards of compliance with the Mental Health Act, it has been less successful in tackling wider issues of quality of care. There is a risk that its user-centred approach may be lost as a result of changes in regulatory structures. [ABSTRACT FROM AUTHOR]

Hoarding has become increasingly prominent in clinical practice and popular culture in recent years, giving rise to extensive research and commentary. Critical responses in the social sciences have criticised the cultural assumptions built in to the construct of 'hoarding disorder' and expressed fears that it may generate stigma outweighing its benefits; however, few of these studies have engaged directly with 'hoarders' themselves. This paper reports on in-depth, semi-structured interviews with 10 individuals living in England, who received assessment and intervention for hoarding from Social Services. Their narratives drew on the cultural repertoire of values and discourses around waste and worth, the mediation of sociality and relationships through material objects, physical constraints on keeping order and the role played by mental health. Analysing these perspectives anthropologically shows how dominant models of hoarding, such as the DSM-5 paradigm, potentially lend themselves to reductionist understandings that efface the meaning 'hoarding' may have and thereby deny agency to the person labelled as 'hoarder'. More culturally informed analysis, by contrast, affords insights into the complex landscape of value, waste, social critique, emotion, interpersonal relationships and practical difficulties that may underlie hoarding cases, and points the way to more person-centred practice and analysis. [ABSTRACT FROM AUTHOR]

The overcoming of professional boundaries to collaboration in patient care has become one of the goals of mental health service policy in England over the past 25 years, predominantly through the creation of community mental health teams. However, research has shown that these boundaries have been slow to come down, and some commentators have pointed to the benefits of appropriate boundaries. This paper introduces a theoretical framework, which seeks to categorise boundary activity in organisations and then examines the boundary activity of professional groups and community teams during the integration of mental health and social care service provision in one locality in the southwest of England. The paper identifies the ways in which this integration impacted on boundary activity and draws out the messages for mental health policy and practice that emerge. [ABSTRACT FROM AUTHOR]

There is growing interest in the health correlates of people detained in police custody, and a number of innovations have been introduced to try to meet the complex needs of detainees. The implementation of Criminal Justice Liaison and Diversion (CJL&D) Services commissioned by the Department of Health in England is a substantial part of this investment. In this paper, we describe data from 858 detainees who were referred to the CJL&D service of a busy metropolitan police station in the North East of England. The detainees referred to the service had complex mental health needs, substance misuse and a range of vulnerabilities requiring specific intervention. The effective operation of these teams and how they interface with health and criminal justice systems also depend upon a number of systematic issues that emanate both from within the teams, and from external policy drivers. [ABSTRACT FROM AUTHOR]

In mental health, communication is thesine qua non, not only for considering a diagnosis, but also for developing a treatment plan. Words, on the one hand, and the relationship between the clinician and the service user, on the other, are two of the main components of mental health and therapeutic treatment. The presence of an interpreter has the potential to have an effect on the dynamics of the mental health or therapeutic encounter. This may pose a series of challenges and opportunities for all three members of the triad. This paper reports on a study conducted with interpreters working with recent migrants, mainly refugees and asylum seekers at two organisations based in the South of England. Two focus-groups with interpreters were conducted. Several differences between interpreting in mental health and interpreting in other settings were noted by the interpreters. Five overarching themes were identified in this study. These were: the role of the interpreter in the mental health encounter, the dynamics within the therapeutic triad, the interpreter-clinician relationship, power and alliances within the room and the personhood of the interpreter. The first two themes are presented within this paper, although the themes are not entirely discrete categorisations. [ABSTRACT FROM PUBLISHER]

Background: The concept of recovery is contested throughout the existing literature and in mental health services. Little research exists that gives voice to service user perspectives of recovery. Aim: This paper explores how service users in two recovery oriented services run by the National Health Service in North West England talked about recovery and what it meant to them. Method: 14 service users accessing these services took part in semi-structured qualitative interviews focusing on the concept of recovery. Data were analysed using an interpretive phenomenological analysis approach. Results: Service users talked about recovery as a dynamic, day to day process as well as an outcome; specifically related to being discharged from inpatient settings. A number of factors including relationships and medication were cited to have the potential to make or break recovery. Conclusions: The study highlights the continued dominance of the biomedical model in mental health services. Service users appear to have internalised staff and services’ understanding of recovery perhaps unsurprisingly given the power differential in these relationships. Implications for clinical practice are explored. [ABSTRACT FROM AUTHOR]

Young people are at a high risk of developing mental health disorders or illnesses. Mental health promotion (MHP) interventions can reduce this risk. Using the Medical Research Council (MRC) framework for the development and evaluation of complex interventions, this study designed and acceptability tested a methodologically robust school-based mental health promotion intervention. A scoping review and focus groups with stakeholders were conducted during the development phase of the MRC framework. The scoping review involved identifying evidence for effective school-based MHP interventions. Focus groups were then used to determine the acceptability of components identified by the scoping review and to clarify the target or goal of taking part in the intervention. A logic model, showing the theory of change underpinning an intervention designed on the basis of this development phase, was subsequently developed. The scoping review established that MHP interventions typically focus on stigma and stereotypes, mental health literacy and knowledge and help-seeking, and use these foci to determine impact. Common intervention components include group discussion, videos, presentations, storytelling and handouts. Testing of these commonly occurring components targeting knowledge and attitudes towards mental health and stigma and stereotypes suggested all were acceptable to stakeholders. Using the MRC framework to guide the development and test the acceptability of a MHP intervention, this study has produced a complex evidence-based health promotion intervention using interactive activities and videos. Further phases will involve a process evaluation of the intervention fidelity and feasibility testing. [ABSTRACT FROM AUTHOR]

Historically there has been a significant under-recognition of mental health problems among people in the criminal justice system, and little research exploring the issues encountered by those with mental health problems who come into contact with the criminal justice system. Recent policy has highlighted the importance of early identification of mental health needs in criminal cases, and the role of diversion of offenders into appropriate mental health services. However research suggests that currently the provision of mental health services for offenders is patchy, and it has been suggested that improved interagency communication and training is required to improve the diversion of offenders with mental health problems into more appropriate mental health provision. The aim of this paper is to consider the current position of those with mental health conditions within the criminal justice system in England, and discuss how joint interagency training can improve understanding of the diversion agenda for the range of practitioners that come into contact with offenders with mental health problems. The perspectives of a range of practitioners who attended a joint interagency training day will be discussed, and recommendations for future training will be offered. [ABSTRACT FROM AUTHOR]

A small-scale consultation of care leavers in South London was undertaken in 2013–2014, in order to inform a pilot mentoring scheme to reduce depression in young women through supporting their transition from care to independence. Research on the social factors implicated in the onset and course of depression indicates that social support during stressful events can be protective. Youth mentoring is now widely offered to disadvantaged young people. This paper examines what some young people told us about if and how our proposed mentoring intervention might help in maintaining their well-being through the stress of leaving care. Eleven participants of focus group discussions told us they could see clear benefits in receiving mentoring at this time, and discussed the kind of mentor and activities they might like. However, most did not want a mentor now. Thematic analysis of the discussions arising identified unpaid, open-ended ‘natural mentoring’ relationships as particularly important to them in maintaining their well-being. We consider the fit with related research, and emerging new policy, and the implications for our proposed study, and conclude that supporting the establishment and continuation of natural mentoring is a particularly promising way forward. [ABSTRACT FROM PUBLISHER]

Background: The general public regard mass media as their main source of information about mental illness. Psychiatrists are reluctant to engage with the media. There is little understanding of why this is the case. Aims: The paper looks to explore attitudes of mental health clinicians and the media towards one another. Method: Media and mental health clinicians in the southwest of England completed self-report surveys. Results: Of 119 questionnaires returned 85 were mental health clinicians and 34 media professionals. Both groups agreed that stigma is a major issue and clinicians have a key role influencing media portrayal of mental illness. The media view their reporting to be more balanced than clinicians and lack awareness of clinician mistrust towards them. Those clinicians with media training (13%) felt significantly more comfortable talking to media and significantly less mistrustful of them. Clinicians who had experience of working with media felt more comfortable doing media work. Only 15% of media professionals had received mental health awareness training. Conclusions: Media training and experience are associated with an increased willingness of mental health professionals to engage with the media. Reciprocal awareness training between media and mental health professionals may be a simple intervention worth pursuing. [ABSTRACT FROM AUTHOR]

The reform of the Mental Health Act in 2007 saw the introduction of Supervised Community Treatment Orders (CTOs) in England and Wales. It is argued that this marks a fundamental shift in the rights of those subject to mental health legislation. This paper will explore the developments in mental health policy in the 1980s and 1990s that form the backdrop to the introduction of CTOs. It uses Simon's Governing through crime (2007) as a basis to explore the developments in mental health policy that resulted in the final introduction of CTOs. The paper explores the paradox at the heart of mental health policy. This paradox being that while the protections and the rights of the mentally ill have increased in a formal legal sense, this has not resulted in the achievement of full citizenship that the idealism of the original proponent of the closure of the asylums envisaged. The policy of deinstitutionalisation was based on a series of progressive notions and explicit rights based approach to the treatment of citizens with mental health problems. However, the implication of this policy has not resulted in the end of stigma, marginalisation and discrimination. Many commentators would suggest that the asylums have now come to the community rather than the reverse. The mental health policy response to the failings of community care was one characterised by an increased managerialist culture with a focus on audit and risk. These events are discussed in terms of Cohen's (1972) notion of a `moral panic'. In addition, they are analysed as part of Hall and others' view of the crisis of legitimacy faced by Welfare States from the early l970s onwards. The eventual result was the introduction of CTOs. This marks a fundamental shift in the balance between individuals with mental health problems and the therapeutic state. It is argued that the fact that such a significant change has been introduced in the face of opposition from virtually all the key stakeholders in the area indicates that the 'mentally ill' and the 'mad' continue to be a marginalised. [ABSTRACT FROM AUTHOR]

This paper discusses the aims, process and outcomes of an interdisciplinary workshop day held for undergraduate students from Social Work, Mental Health Nursing, Adult Nursing, Midwifery and Occupational Therapy courses. The day's activities focused on mental health and were based on the use of service user narrative within three different workshops. The feedback from the students showed that the day was relevant to the curriculum that they were engaged in; allowed them to interact with and explore the perspectives of different professional groups; assisted them in understanding the lived experience of mental health difficulties; offered them the opportunity to consider implications for practice; was enjoyable and added 'value'. [ABSTRACT FROM AUTHOR]

Little research is available on the assessment and treatment of deaf people who commit sexual offences. Most studies provide statistical information on offenders or medical discussion on the causes of violence among deaf people. Sex offender treatment programmes for deaf people are rare internationally and only two such groups exist in Europe. The first of the European treatment programmes was set up at the National Centre for Mental Health and Deafness (NCMHD) in Manchester, United Kingdom. This paper reviews the literature around deaf people and forensic mental health needs, describes the sex offender treatment programme based at the NCMHD, discusses distinguishing characteristics of a deaf sex offender, why treatment should be specialized for deaf offenders and why current treatment should be researched. [ABSTRACT FROM AUTHOR]

A pragmatic solution for the provision of care for prisoners with serious mental illness, who are often subject to delays in hospital transfer, is the creation of specialist prison units. This paper analyses the development of a prison unit in England for prisoners with 'serious mental illness'. The unit was developed within over-lapping health and justice contexts, including expectations, pressures and priorities, which impacted on the outcomes expected and achieved. The methodology included attendance at Steering group meetings, analysis of a minimum dataset, and interviews with key stakeholders. A number of key sites of contestation are analyzed including: admission criteria; aims; activities; staffing; the physical environment; and discharge. [ABSTRACT FROM AUTHOR]

This paper considers the role played by universal, school-based social and emotional learning (SEL) programmes in addressing the mental health needs of children and young people. Theory and research in the field are discussed. Particular attention is paid to the social and emotional aspects of learning (SEAL) programme in England, a flagship National Strategy under the New Labour government whose outcomes were mixed. We examine the findings of the various evaluations of SEAL and consider what learning can be taken forward to inform future attempts to prevent emotional and behavioural problems in school settings. Recommendations include proper trialling of SEL initiatives before they are brought to scale, the use of research to inform and improve programme design, the need to temper expectations, and the importance of educating implementers about the importance of implementation quality. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative study of UK mental health practitioners' experiences of working with the contested condition, dangerous and severe personality disorder (DSPD). Our interviews focused on the issues of treatability, risk assessment and decision-making in multi-disciplinary teams. We discuss the approach of values-based medicine (VBM) as a useful framework for interpreting the data: respondents cited both explicit values (based on occupational training) and implicit values (based on personal beliefs and subjective perceptions). There was evidence of conflicting values -- within individuals, between occupational groups, and between individuals in occupational groups -- which led to widespread uncertainty and caution about whether and how those with 'dangerous' personality disorders could be treated. These disputes were resolved by a 'slide to pragmatism', whereby practitioners, reluctantly acknowledging their own empowerment in the process, sought to make whichever choice was least risky for their own professional reputation, and most pragmatic, given the resources available. [ABSTRACT FROM AUTHOR]

This paper reports on a content analysis undertaken on oral history narratives with Ethiopian forced migrants residing in London. The study adopted a grounded theory approach to examine factors which impacted on, and contributed to, mental ill health for those forced migrants who participated. This research suggests that the issues and impact of deprivation, combined with the complex interaction of social and psychosocial factors, are crucial in impacting on mental ill health. It is apparent for those participants that economic deprivation, poor housing conditions and the immigration asylum process can exacerbate existing, as well as creating new, psychological stressors and in many cases has acted as a barrier to integration. This analysis identified themes and concepts and developed an integrated approach which acknowledged the multitude of social, political and administration factors which can significantly improve quality of life for Ethiopian forced migrants. [ABSTRACT FROM AUTHOR]

This paper reports on oral history interviews undertaken with Ethiopian forced migrants in London and focuses on the significance that the traditional coffee (Buna) ceremony has on mental well-being among participants. It was evident from participants that the Buna ceremony provides opportunities to preserve cultural heritage as a strategy for overcoming forms of social isolation and disadvantage. The ceremony enables participants to meet, talk, support; and especially where mental distress is associated with loss of social support, the Buna ceremony can be viewed as a mutual self help group, where individuals are involved in the maintenance of well-being. [ABSTRACT FROM AUTHOR]

This paper describes brief work with pregnant teenagers, adolescent mothers, their infants and their wider families, a group who would not ordinarily seek treatment in child and adolescent mental health services. The work takes place in a community context in London and includes a home visiting service for young people unable to attend appointments in an advanced stage of pregnancy or in the early weeks of new motherhood. Accounts of emotional deprivation, disrupted care and separation in early childhood are often a feature of the history of many of these adolescents. Two case examples are considered in some detail. It is argued that for some young people, embarking on parenthood in adolescence is accompanied by the displaced attempt at repairing their own early relationships, as an alternative to the painful work of mourning. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative study of the subjective impact of a visual arts project in a Mental Health NHS Trust in England. A qualitative approach was adopted including documentary analysis, focus groups and over 50 in-depth interviews. Arts were found to help shape healing environments through four processes: modernisation; enhancing valued features; diminishing negative aspects; and creating opportunities for service users and staff. Responses to the artworks were diverse, and modernisation was sometimes perceived as diminishing staff and service users' control over the environment. Arts seemed to be strongly valued when they enhanced control and enabled service users to affirm non-stigmatised identities. Arts projects in similar settings are likely to face complex issues of control, identity and stake. A key challenge is balancing “prestige” with “authenticity.” While consensus may be difficult to achieve, the study points towards the high value that stakeholders place on arts in these settings. [ABSTRACT FROM AUTHOR]

With the waves of reform occurring in mental health legislation in England and other jurisdictions, mental capacity is set to become a key medico-legal concept. The concept is central to the law of informed consent and is closely aligned to the philosophical concept of autonomy. It is also closely related to mental disorder. This paper explores the interdisciplinary terrain where mental capacity is located. Our aim is to identify core dilemmas and to suggest pathways for future interdisciplinary research. The terrain can be separated into three types of discussion: philosophical, legal and psychiatric. Each discussion approaches mental capacity and judgmental autonomy from a different perspective yet each discussion struggles over two key dilemmas: whether mental capacity and autonomy is/should be a moral or a psychological notion and whether rationality is the key constitutive factor. We suggest that further theoretical work will have to be interdisciplinary and that this work offers an opportunity for the law to enrich its interpretation of mental capacity, for psychiatry to clarify the normative elements latent in its concepts and for philosophy to advance understanding of autonomy through the study of decisional dysfunction. The new pressures on medical and legal practice to be more explicit about mental capacity make this work a priority. [ABSTRACT FROM AUTHOR]

Objectives. There has recently been much emphasis on the role of `partnerships' between local community `stakeholders' in strategies to redress health inequalities. This paper examines obstacles to participation in such partnerships by African-Caribbean lay people in local initiatives to improve mental health in a town in southern England. We present a `social psychology of participation' which we use to interpret our data. Our work seeks to illustrate some of the micro-social mechanisms through which social inequalities are perpetuated, using Bourdieu's conceptualisation of the role played by various forms of capital (economic, social, cultural and symbolic) in perpetuating social inequalities. Design. Our empirical research consists of a qualitative case study of attitudes to participation in mental-health-related partnerships in a deprived community. In-depth interviews and focus groups were conducted with 30 local community `stakeholders', drawn from the statutory, voluntary, user and lay sectors. Results. While interviewees expressed enthusiasm about the principles of participation, severe obstacles to its effective implementation were evident. These included severe distrust between statutory and community sectors, and reported disillusionment and disempowerment within the African-Caribbean community, as well as low levels of community capacity. Moreover, divergent understandings of the meaning of `partnership' suggested that it would be difficult to satisfy both community and statutory sectors at once. Conclusions. We suggest that disadvantaged and socially excluded communities are often deprived of the social resources which would provide a solid basis for their participation in partnerships with state health services. In the absence of efforts to remove such obstacles, and to generate the necessary resources for participation, partnerships may be `set up to fail', leaving social inequalities to prevail. [ABSTRACT FROM AUTHOR]

Discusses issues concerning the amendment of the Mental Health Act in England. Preliminary considerations before any Act of Parliament is repealed; Legal definition of mental disorder; Civil powers over a person diagnosed by a mental health practitioner; Preliminary examinations; Concern for high-risk patients.

The COVID-19 has had an impact on almost every aspect of life throughout the world. The quarantine, limited social life, and fear of contamination have triggered psychological symptoms in societies. The need for mental health services has increased, and online psychological counselling, which provides psychological help with no risk of infection, has become more popular. The purpose of this study was to examine the impact of the COVID-19 on psychological counselling services and compare the general situation of publications on online psychological counselling before and during the pandemic. For this purpose, 463 publications related to online psychological counselling in the Web of Science (WoS) database were examined. The results were discussed in the context of trends and differences before and during COVID-19. [ABSTRACT FROM AUTHOR]

This article examines how deaths related to mental health in England and Wales are investigated and the extent to which lessons are learned in their aftermath. It uses two concepts from academic literature to discuss organisational responses to these deaths: organisational learning, and organised irresponsibility. Organisational learning stresses the importance of learning lessons from data; in contrast, Beck's concept of organised irresponsibility states that organisational lesson learning is impeded by the fragmented and risk-averse nature of public institutions. The article considers 210 organisational responses to Reports to Prevent Future Deaths (PFDs) issued by Coroners. PFDs are sent to any organisation Coroners believe could act to prevent future deaths. The article identifies three findings: Firstly, organisations tend to produce generic responses rather than addressing specific issues raised by Coroners. Second, organisations tend to cite existing policies as responses to Coroners despite those policies not preventing specific deaths. Third, institutions seek to displace blame onto other organisations in attempting to avoid accepting responsibility for the death. The article adds to the canon of knowledge on deaths in healthcare, and in the care of the state by identifying significant structural weaknesses that impede organisational lesson learning about preventable deaths. [ABSTRACT FROM AUTHOR]

Covid-19 has had an especially detrimental impact on mental health of people with intersectional marginalized identities. Yet, research evidence on this impact is lacking, with efforts to generate it stymied by pandemic restrictions. To explore how a socially excluded gender minority group—transgender and non-binary (TGNB) prisoners—experienced, and coped with, the pandemic stressors. The data were collected via correspondence with 15 TGNB prisoners in England and Wales in April-October 2020 using an exploratory person-centred qualitative longitudinal approach and examined using reflexive organic thematic analysis. The pandemic and its restrictions to support structures and health care detrimentally impacted TGNB prisoners' mental health and wellbeing. TGNB prisoners experienced added stressors associated with their intersecting incarceration and gender minority positions, including prolonged solitary confinement and reduced access to gender-affirming health care. Environmental resources for problem-focused, emotion-focused, socially supportive and disengagement coping were reduced by the prison pandemic regime, with adaptive coping through positive distraction and engagement with TGNB/LGBTQ community particularly affected. During a pandemic and beyond, greater support and innovative practices are needed to improve the TGNB prisoners' access to gender-affirming care and to TGNB/LGBTQ community, to protect their mental health and wellbeing. [ABSTRACT FROM AUTHOR]

The theoretical understanding of firesetting behaviour has predominantly been developed with men in prisons or psychiatric hospitals without neurodevelopmental disabilities. Consequently, there is a lack of evidence regarding the validity of current theory when applied to adults with intellectual disabilities and/or autism. Thirteen adults in England with intellectual and other developmental disabilities were interviewed about the affective, cognitive, behavioural, and contextual factors leading up to and surrounding a recorded firesetting incident. Interviews were analysed using a Grounded Theory approach. The resulting model consists of four phases: (1) background, (2) early adulthood, (3) pre-offence period, and (4) offence, and post offence period. The model accounts for unique precursors to firesetting including mental health deterioration, poor problem solving, and new motivations for firesetting. Unlike other offence chain theories, the significance of post-offence behaviour and cognitions are highlighted. [ABSTRACT FROM AUTHOR]

The aim of this study is to critique and extend psychological approaches to resilience by examining retrospective accounts of LGBT people in England who had directly experienced or witnessed events that were salient as significantly negative or traumatic. Pre-screening telephone interviews identified ten individuals who matched inclusion criteria (mean age: 39 years; range 26–62 years) as part of a larger study. Interviews were semi-structured and informed by a literature review undertaken at the start of the study. We identified three themes of that extend the resilience literature for LGBTQ+ people: (1) identifying and foregrounding inherent personal traits – how non-contextual inborn qualities or attributes needed external effort to be recognised and operationalised; (2) describing asymmetric sources of social support and acceptance – the importance of positive environment is unequally available to LGBT people compared to heterosexuals, and uneven within the LGBT group; and (3) blurring distinctions between resilience and coping – experiential approaches to moving beyond distress. We suggest that narratives of resilience in the accounts of LGBT people can inform the development of resilience promotion models for minoritized individuals and support movement away from deficit-focused approaches to health policy. [ABSTRACT FROM AUTHOR]

Responding to reports of missing children is an everyday occurrence in many police agencies, and a significant source of police demand. In England, there is a statutory requirement that all those under the age of 18 be offered a return home interview (RHI) within 72 hours of returning from a missing episode. The main purpose of an RHI is to better understand the reasons why a young person went missing and, where necessary, put measures in place to safeguard that young person and reduce the likelihood of them going missing again. Although widely practiced in England, there is currently limited research on the conduct of and information elicited from RHIs. In an attempt to help fill this research gap, this article reports the findings of an exploratory analysis of 113 RHIs carried out in one police force area in England. Findings indicate that 42% (n = 48) of the sampled RHIs occurred within the required 72-hour timeframe. Absent or incomplete information was common, particularly in relation to the presence and types of vulnerabilities associated with missing children. In terms of those interviewed, nearly half of the interviewees did not consider themselves to be missing. Moreover, many exhibited a high prevalence of mental health concerns, conflict at home and drug and alcohol use. The implications of the findings for safeguarding children and preventing missing incidents are discussed. [ABSTRACT FROM AUTHOR]

The quality of parent-child relationships during adolescence has the potential to impact adolescents' mental health. This study explored how seven dyads (parent-child) might experience a two-component intervention (Method of Levels therapy-MOL and a parent-child activity) over four months. Following this, six dyads were interviewed and a thematic analysis was conducted. The most helpful aspect of the intervention for participants was the opportunity to talk. The intervention facilitated helpful conversations that increased participants' awareness and broadened their perspective on the topics discussed. This process helped participants find solutions to their problems. Young people and parents reported that the Shared Goals activity helped them improve their communication and relationships. Young people stated that MOL allowed them to figure things out for themselves. [ABSTRACT FROM AUTHOR]

In the United Kingdom, 1.5 m partners, friends and family members provide substantial care and support to people experiencing mental health problems. Previous studies have focused on the experiences of such carers in community settings. This study focused on carers of those detained in inpatient settings under the Mental Health Act 1983 who maintain relationships via Section 17 (s.17) leave. Semi-structured telephone interviews with five carers were analysed thematically and identified that carers: struggled with the emotional impact of s.17 leave, experiencing anxiety, guilt, and stigma; experienced practical challenges and self-sacrificed in order to support s.17 leave; but reported positive impacts on the maintenance and development of their and the detained person's social identities and networks. However, these carers received very little support. Implications for social workers include the need to support carers before, during and after s.17 leave, through supporting their involvement in planning the leave, ensuring that escorted leave is staffed by those known to the carer, raising awareness of carer needs and referring carers for support and/or psychoeducation and a care needs assessment. Social workers are well-placed to take a holistic view and support carers in navigating the challenges that caring for somebody around s.17 leave can bring. [ABSTRACT FROM AUTHOR]

International research reveals underrepresentation and problems of retention, amongst care leavers in higher education, are universal. Drawing upon qualitative research in England, we highlight legacy as an under-explored and double-edged feature of care leavers' motivations to enter and persist in university study. While restricting access to the propulsive power of material resources, in the context of a widening participation policy mandate, our interviewees' care experiences also shaped an 'orientation framework' providing a strong desire to 'prove people wrong' through study. Supporting this orientation were examples of significant other relations; but interviewees' linked lives also meant the past could resurface in the present, resulting in strong emotional reactions. These could threaten orientation to university study by undermining self-reliance and fragile mental health. As the problem of care leavers' retention occurs across different higher education systems with varied structural and cultural specifics, it appears to transcend such issues. We conclude further study of the nuanced issue of legacy may help better elucidate the problem of retention and we advocate for 'corporate parenting' moving beyond an objective list approach to well-being. [ABSTRACT FROM AUTHOR]

Children's absence from primary school is associated with lower attainment and social difficulties, and persistent absence at this age often continues or worsens as children progress into secondary education. It is therefore important to intervene early to interrupt this negative trajectory. This study used individual semi-structured interviews to explore the perspectives of eight members of primary school staff, who had experience supporting children with difficulty regularly attending school, from both mainstream and special primary schools in England. Data were analysed using thematic analysis. Participants perceive school non-attendance to be a complex and challenging issue that can have a significant negative impact, and can be caused and maintained by multiple factors related to the child, family and school/education. Participants believe prevention is key and identify several different social/emotional and learning-focused interventions they have used to support children to attend school regularly, with varying degrees of success. Participants emphasise that success of any intervention relies strongly on collaboration between parents, school staff and other agencies involved. Findings from this study suggest that sufficient resource, early intervention, development of a school community, collaboration with families, liaison with other professionals and targeted evidence-based strategies are all important in improving attendance in this age range. [ABSTRACT FROM AUTHOR]

This article uses the outcome of a small-scale research project – the 'Diary Toolkit' (DT) – to explore the creative process of crafting a multimodal, sensory diary as a positive tool for teacher wellbeing. In an educational climate facing the repercussions of the COVID-19 pandemic, the DT offered an epiphanic space for teachers in England, helping them navigate their way through this highly emotional and anxious time. Indeed, against the backdrop of COVID, a hidden pandemic has arisen: a decline in teachers' mental health and wellbeing. The article situates the DT within the field of reflective practice as a creative approach, arguing that in addition to supporting teaching and learning, it can also help teacher wellbeing. To demonstrate this, some key findings from the 'Reimagining the Diary' (2018) project are used, focusing, in particular, on those around choice/creativity, and structure/parameters. The article concludes by stating that the creative process of crafting a sensory and multimodal diary gives teachers the healing and nurturing space currently needed, as well as an opportunity to represent their wellbeing in multiple ways so that they can flourish inside and outside the classroom. [ABSTRACT FROM AUTHOR]

Running is a popular and convenient form of leisure-time physical activity, with participation levels increasing in the United Kingdom in low physical activity groups such as women and overweight individuals, following the introduction of schemes such as Couch to 5km (C25 K). However, despite the popularity of these programmes, there is little research into the social and psychological processes involved in effective engagement and long-term behaviour changes. Therefore, the aim of the study was to explore the impact of participation in a 10-week group-led beginners running programme on participant motivation, attendance and well-being using Self-Determination Theory (STD) as a theoretical framework. Participants (N = 124; Mage = 40.74) were recruited from a beginners' running programme based in the North West of England and self-completed questionnaires during weeks 2, 6 and 10. Future intentions to run were also assessed at 3- and 6-month follow up. Results demonstrated the positive impact an adapted C25 K model can have upon elements of self-perceptions (particularly perceived competence) and future intentions to run. The path analysis, which looked at average values over time, demonstrated that leader autonomy support positively impacted upon participants' basic needs satisfaction, which led to the development of more self-determined motivation, and in turn led to higher levels of attendance and mental well-being. Critically for drop-out, results from multiple regression analysis indicated that individuals with a higher BMI rated leader autonomy support as lower and felt less competent during the programme. A number of research and practical recommendations are discussed. [ABSTRACT FROM AUTHOR]