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Obesity and associated morbidity and mortality are major challenges for people with severe mental illness, particularly in secure (forensic) mental health care (patients who have committed a crime or have threatening behaviour). This study aims to explore experiences of weight management in secure mental health settings.

This study used a mixed-methods approach, involving thematic analysis. A survey was delivered to secure mental health-care staff in a National Health Service (NHS) mental health trust in Northern England. Focus groups were conducted with current and former patients, carers and staff in the same trust and semi-structured interviews were undertaken with staff in a second NHS mental health trust.

The survey received 79 responses and nine focus groups and 11 interviews were undertaken. Two overarching topics were identified: the contrasting perspectives expressed by different stakeholder groups, and the importance of a whole system approach. In addition, seven themes were highlighted, namely: medication, sedentary behaviour, patient motivation, catered food and alternatives, role of staff, and service delivery.

Secure care delivers a potentially “obesogenic environment", conducive to excessive weight gain. In future, complex interventions engaging wide-ranging stakeholders are likely to be needed, with linked longitudinal studies to evaluate feasibility and impact.

To the best of the authors’ knowledge, this is the first study to involve current patients, former patients, carers and multidisciplinary staff across two large NHS trusts, in a mixed-methods approach investigating weight management in secure mental health services. People with lived experience of secure services are under-represented in research and their contribution is therefore of particular importance.

This chapter will provide an overview of the lived experience and peer support context and draws on the origins of peer work in mental health arenas. The recovery movement will be discussed and peer support will be put in context as an alternative/adjunct/complimentary role to the predominant biomedical model. What is the role of peer support in mental health settings? What is it that a peer does on a day-to-day basis? What are the principles and practices that a person with lived experiences engages in to operationalise peer support? What are the outcomes associated with peer support working and what does peer work look like when it works well? What type of settings does the peer work in and what teams are they a part of? This chapter explores some of the challenges peers face when integrating into teams and organisations. The dominance of the biomedical model will be discussed and how this can potentially impact on the peer's role in these settings.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) goal to end the acquired immunodeficiency syndrome (AIDS) epidemic as a public health threat by 2030 emphasises the importance of leaving no one behind. To determine progress towards the elimination goal in Ghana, an in-depth understanding of human immunodeficiency virus (HIV) care from the perspective of vulnerable populations such as persons living with HIV in incarceration is necessary. This study aims to explore the experiences of incarcerated individuals living with HIV (ILHIV) and on antiretroviral therapy (ART) in selected Ghanaian prisons to help inform policy.

The study adopted a qualitative approach involving in-depth interviews with 16 purposively selected ILHIV on ART from purposively selected prisons. Interviews were conducted between October and December 2022. Thematic analysis was performed using the ATLAS.Ti software.

Three themes were generated from the analysis: waking up to a positive HIV status; living with HIV a day at a time; and being my brother’s keeper: preventing HIV transmission. All participants underwent HIV screening at the various prisons. ILHIV also had access to ART although those on remand had challenges with refills. Stigma perpetuated by incarcerated individuals against those with HIV existed, and experiences of inadequate nutrition among incarcerated individuals on ART were reported. Opportunities to improve the experiences of the ILHIV are required to improve care and reduce morbidity and mortality.

Through first-hand experiences from ILHIV in prisons, this study provides the perception of incarcerated individuals on HIV care in prisons. The insights gained from this study can contribute to the development of targeted interventions and strategies to improve HIV care and support for incarcerated individuals.

Globally “non-urgent” health care services were ceased in response to the 2020 outbreak of COVID-19, until 2021, when restrictions were lifted. In the UK, this included speech and language therapy services. The implications of COVID-19 restrictions have not been explored. This study aimed to examine the impact of the UK’s COVID-19 response on speech and language therapy services.

An online survey of the practice of speech and language therapists (SLTs) in the UK was undertaken. This explored SLTs’ perceptions of the demand for their services at a time when COVID-19 restrictions had been lifted, compared with before the onset of the pandemic. The analysis was completed using descriptive statistics and content analysis.

Respondents were mostly employed by the UK’s National Health Service (NHS) or the private sector. Many participants reported that demands on their service had increased compared with before the onset of the pandemic. The need to address the backlog of cases arising from shutdowns was the main reason for this. Contributing factors included staffing issues and redeployment. Service users were consequently waiting longer for NHS therapy. Private therapy providers reported increased demand, which they directly attributed to these NHS challenges.

This presents the only focused account of the impact of the national response to COVID-19 on speech and language therapy services in the UK. It has been identified that services continue to face significant challenges, which indicate a two-tier system is emerging. Healthcare system leaders must work with service managers and clinicians to create solutions and prevent the system from being overwhelmed.

The training and education of peers represents an important milestone in the peer's journey to work within organisational settings. Historically, peer support occurred based on a mutual relationship whereby one peer often with more experience provided support and guidance to another. However, as peers began to move into organisations staffed by professionals, a standard of training and education became needed if peers were to be accepted. This chapter outlines these issues, as well as discussing the training standards, the academics and soft skills needed. Some of the challenges peers face during their education and their continued development will be discussed. This chapter will focus on the training of peers for mental health and substance use settings in addition to other emerging areas in social inclusion.

Recovery Colleges were developed to support the recovery of people with mental health difficulties through courses co-produced by professionals and people with lived experience. This study aims to examine the use of Recovery Colleges to support people with dementia.

A survey was circulated to UK Recovery College and memory service staff, exploring provision, delivery and attendance of dementia courses. Open responses provided insight into participant views about recovery in post-diagnostic support and the practicalities of running dementia courses.

A total of 51 Recovery College staff and 210 memory service staff completed the survey. Twelve Recovery College dementia courses were identified across the UK. Three categories emerged from the qualitative data: post-diagnostic support, recovery in the context of dementia, challenges and areas of innovation.

This study highlights the benefits and practicalities of running Recovery College courses with people with dementia. Peer-to-peer learning was seen as valuable in post-diagnostic support but opinions were divided about the term recovery in dementia.

This paper compares how the two interacting themes of “Whistleblowing” or “Speaking Up” and the duty of candour (DoC), which are both concerned with safety and quality improvement in health care, got onto the agenda of the British National Health Service (NHS).

It uses the approach of multiple streams and the methodology of interpretive content analysis in a deductive approach that focusses on both manifest and latent content. It examines official documents that discuss the DoC or whistleblowing or cognate terms in connection with the British NHS from 1999 to 2019.

The main conceptual finding, which mirrors many previous studies, is that it seems difficult to operationalise many of the sub-components of the multiple streams approach. The main empirical finding points to the “focusing event” of the Francis Report into the Mid Staffordshire Trust of 2013 and the importance of its Chair, Sir Robert Francis, as a policy entrepreneur.

This is one of the first studies to focus on both issues of whistleblowing and the DoC and the first to compare them through the lens of the multiple streams approach. It has two main conceptual advantages over most previous studies in the field: it compares whistleblowing and the duty of candour rather than the dominant approach of a single case study and explores the different outcomes of failed as well as successful couplings of the streams.

This study aims to investigate how institutional and organisational factors affect case management of patients with mental disorders by GPs in Italy and Spain. The paper highlights the importance of improving the effectiveness of primary care to ensure easy access to mental health services, which is crucial in responding to the increasing incidence of mental disorders and preventing negative outcomes.

This article details a qualitative research study that examines the management of patients with mental disorders by general practitioners (GPs) in Italy and Spain, using cross-national comparison and in-depth interviews with GPs as research methods.

The study revealed that Italian self-employed GPs have more scheduling autonomy than Spanish Health Centre GPs. Both face high work pressure and resource scarcity, highlighting the need for targeted training. The COVID-19 pandemic led to a rise in phone consultations.

This study provides novel insights into mental health management by examining the case management of patients with mental disorders by GPs in Italy and Spain, with a focus on the impact of institutional and organisational factors. The cross-national comparison and in-depth interviews enhance the originality of the study, offering a nuanced understanding of the constraints faced by GPs in their work context. Furthermore, the comparison of the similar primary care frameworks of Italy and Spain may offer insight into their evolution.

This service evaluation aims to understand the experiences of service users (SUs) who accessed an early intervention in psychosis (EIP) service during the Coronavirus pandemic using qualitative and quantitative methodologies and compare these to a previous pre-pandemic study conducted within the same service (Watkins et al., 2018).

This paper collated experiences of individuals accessing an EIP service to inform service development. Questionnaires and individual interviews were conducted to provide quantitative and qualitative data. Descriptive statistics and T-test confidence intervals were created from the results and compared to findings of Watkins et al. (2018). Interviews were transcribed verbatim and analysed using Braun and Clarke’s (2006) thematic analysis.

Data showed participants were largely satisfied with all areas of the service with “work or education”, “living skills”, and “addictions” scoring highest. Though participants reported no overall dissatisfaction, satisfaction levels dropped in “social activities” compared to the findings of Watkins et al. (2018), perhaps due to the national restrictions put in place to manage the spread of Coronavirus during this time. Interview analysis identified three themes of importance consistent with prior literature, highlighting the importance of relationships and validation during recovery.

This evaluation did not consider whether participants had accessed the service prior to the pandemic or only during, meaning that some participants could have a point of comparison with the service pre-pandemic, whereas others might not. Similarly, the participants were not the same as those of the Watkins et al.’s (2018) evaluation, meaning that direct comparisons of pre- and post-pandemic experiences were not possible. In addition, this evaluation collected data at only one time point early in the pandemic; therefore, it is unknown if client experiences of services differed as the pandemic and restrictions continued over time.

The Covid-19 pandemic has been an unprecedented challenge for health services, and the effects of this are becoming widely reported. This evaluation of clinical services offers a valuable perspective of service user experience of receiving mental health services during a global health crisis further offering a comparison to pre-pandemic services and the experiences of those who used them.

This study aims to understand the progressive marketization of health data collection and use, through a study of its historical development in France, from the 1930s to the present day.

The authors collected a set of legal, institutional, political and media data. These came from the INA (National Audiovisual Institute), the French national newspaper websites and the websites legifrance.gouv.fr and vie-publique.fr. The authors then conducted a thematic content analysis.

The study results highlight the changes in the health-care system related to the increased use of data in France over three major periods. The first period – 1930s to 1980s – is marked by the creation of the French social security system to collect large sets of data to better manager people’s health care. The second period – 1980s to 2000s – is characterized by the adoption and assimilation of tools to manage patient data through several national and European regulations. The last period – 2000s to the present – saw the introduction of measures in favor of the digitalization of health care, and consequently of data, in parallel with the advancement of digital technologies in general. The institutional dynamics in healthcare have evolved with the nature of the actors and their practices, in connection with new perceptions about health data.

This research sheds light on the historical transformation of health data collection and use in France, revealing the involvement of diverse stakeholders, the discourses driving data development and the need for regulation. It exposes the dual nature of health data collection and use, initially sanctioned by the state and public entities but later exploited for private interests.