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We report the findings from a study exploring the experiences of individuals undergoing MRI scanning for research. Semi‐structured interviews took place before and after scanning with 17 participants; 12 were healthy volunteers and five were patients with a diagnosis of remitted depression. Themes of apprehension and curiosity prior to scanning were common in both groups. Patients were often confused about the procedure. Negative feelings were an issue at the outset, characterised by shock related to the physical surroundings, after which positive feelings, for example relaxation, were often experienced, and in the case of patients, learning more about their brain. Written information about imaging was deemed satisfactory; however the ability to ‘experience’ aspects of scanning beforehand was suggested. Scanning may be viewed as a process beginning prior to the procedure itself and involving positive and negative emotions. Increased information, reassurance and a more interactive intervention to reduce anxiety may be beneficial and may improve individuals' experience of this widely used procedure.

In April 2010, Nottinghamshire Healthcare NHS trust won Regional Innovation Funding to recruit, train and employ six peer support workers in community mental health teams. At the time, practical examples of the employment of peer support workers were lacking in England. An earlier paper focuses on the lessons learned in this first year of peer support. The aim of this paper is to examine the nature and dynamics of peer support: what the peers did with clients and what difference this made.

The project was evaluated using a simple evaluation model reflecting service structure, processes and outcomes, collected through qualitative methods: documentary analysis, semi‐structured interviews and a focus group.

The six peers worked with 83 clients over the six month period. They offered emotional, practical, social support, support specific to care and support specific to recovery. They felt that the shared knowledge that they too had experienced mental health challenges was critical in engaging with clients in a trusting relationship and in informing their work.

In the absence of English service models for peer support workers, this paper provides some guidance for new peer support teams, and some evidence to support the helpful nature of peer support work.

In April 2010, Nottinghamshire Healthcare NHS trust won Regional Innovation Funding to recruit, train and employ six peer support workers in community mental health teams. At the time, practical examples of the employment of peer support workers were lacking in England. The aim of this paper is to communicate the key lessons learned in this first year of peer support in the hope that these will provide a foundation for other services to build upon.

The project was evaluated using a simple evaluation model reflecting service structure, processes and outcomes, collected through qualitative methods: documentary analysis, semi‐structured interviews and a focus group.

The peer support employment process has been broken down into its fundamental components (selection, recruitment, training, supervision relationships, recovery approach and discharge of clients) and within each of these sections a brief narrative is provided to explain some of the challenges faced. Each section ends with recommendations based on the lessons learned as a result of the pilot study.

A second paper will examine the nature of peer support: what the peers did with clients and what difference this made.

At present many mental health services are planning to employ peer support workers and this paper provides some early guidance for implementing this process in the NHS.

The purpose of this paper is to share the experiences and reflections of a peer support worker over the course of a day working in mental health services.

A narrative approach has been taken to structure reflections based on the experience of returning to work after taking sick leave.

Reflections are offered based on the process of returning to work and the way that this experience sheds light on personal recovery.

This paper adds to the small number of accounts of the experiences of peer support working in mental health services and as such is highly original.

The “outcomes revolution” in healthcare has yet to impact strongly on secure intellectual disability (ID) services in the UK. The purpose of this paper is to review the service-level outcome studies that exist for this population, and to explore some of the challenges of conducting such research. It further describes some illustrative routine outcome data from the National High Secure Learning Disability Service.

Routinely collected outcome measures (length of stay; violent incidents; Emotional Problem Scale (EPS) Behaviour Rating Scale and EPS Self-Report Inventory) were analysed for two overlapping cohorts of patients resident in the high-secure service between 2008 and 2013.

The median length of stay of those discharged during the study period (n=27) was around 9.9 years (range one to 40 years). A significant proportion (25 per cent) of discharges resulted in an eventual return to high security. There did not appear to be a treatment effect over two to three years using staff-rated global clinical measures, but patient-rated clinical measures did reduce. Violent incidents also reduced significantly over a longer period of four years in treatment.

There are identified challenges to research design and outcome measurement which need to be addressed in any future cross-service studies.

There are relatively few published outcome studies from forensic ID services. None of the studies have used clinical measures of changes or patient-rated outcome measures.

The purpose of this paper is to describe the experiences of a day in the life of a peer support worker based within an NHS trust and to use these experiences as a basis for reflection on key issues in recovery focused practice and peer support.

A reflective approach is used to consider the experience of ending peer support relationships and the emotion which this creates for both parties.

Reflections are offered relating to boundaires, grieving and the experience of endings within peer support and other contexts.

As a narrative account of the experience of a peer support worker, this paper adds to the small number of reflective pieces in this area.

Recovery is the predominant discourse within current UK drug policy, promoted as freedom from dependence. In support of such a policy driver, prison drug recovery wings have been piloted in ten prisons in England and Wales to address high drug prevalence rates in prisoner populations. The purpose of this paper is to explore the development of these specialist wings within the context of wider developments to tackle reoffending among drug-using prisoners.

The first part of the paper offers an analysis of the emergence of the recovery paradigm in the prison context through analysis of official policy documents. The second draws predominantly upon two process evaluations of the drug recovery wings, alongside literature on prison drug treatment.

There is limited empirical evidence to inform the debate about whether prisons can provide settings to facilitate recovery from the effects of illicit drug use. What is available suggests that effective therapeutic environments for recovering drug users could be established within prisons. Key components for these appear to be sufficient numbers of staff who are competent and confident in providing a dual role of support and discipline, and a common purpose of all prisoners committing to recovery from illicit drugs and supporting each other. Further research regarding the impact of drug recovery wings upon health, crime and wider social outcomes is needed.

This paper provides an updated perspective on the development of drug treatment in prisons, with a particular focus on the implications of the new recovery paradigm.

Recent years have seen growing concern about the climate crisis. Lack of adequate attention on this issue from governments and industries has prompted social movements against climate change. Youth activism has been particularly effective at advancing the cause, especially campaign work by children, most notably Greta Thunberg. The tourism industry impacts global carbon emissions, particularly due to international travel. Sustainable tourism is therefore becoming increasingly important in order to help respond to the climate crisis and protect the individual rights of citizens, including children. Children have unique and important insights to offer, yet they are in a democratically weak position given that they cannot vote and are often wholly reliant on others to represent their interests. However, when we allow children to occupy legal and political spaces and support them with participatory democracy, such as through supporting the child's right to protest or supporting strategic litigation, significant progress can be made for climate justice and a more sustainable future. Adults have a responsibility to respond positively to the work of youth activists to help nurture and encourage the environmentally conscious attitudes of children into adulthood.