User experiences of online community support for mental ill health

This doctoral study explores the use of online user-led community support forums for people with diagnosed and self-diagnosed mental ill health. The study is a qualitative analysis of three online forums and four semi-structured interviews incorporating twenty-nine participants. There is a lack of research into online communities using multiple methods, and my study uses two methods, virtual ethnography and semi-structured interviews, to ensure that there is a breadth and diversity to the research, allowing participants to choose different ways to participate. The thesis is framed within the context of austerity measures in the United Kingdom, and cuts in funding for many aspects of mental health social care. Negative attitudes to mental health issues by members of society and policymakers can lead to an increase in people isolated through lack of formal service support. The study explores the use of a particular form of support, online community support forums, an area that is currently experiencing a growth in research. My original contribution to knowledge is that peer-to-peer online communities enable people to construct their own mental health narrative by combining the lived experience of others with their own experience. By doing so, people can escape the social labelling, the stigma, and recreate a sense of self out of, or detached from, the medical and social discourses. This study highlighted how online forums can restore sociality and how online communities help people to clarify their own mental health narrative. As such, online forums and communities contribute to and are a new aspect of the health pathway. This research therefore, helps to inform gaps in health pathways, so that more suitable, cost-effective online resources can be created to reduce the effects of mental illness and support those who are unable to find support elsewhere

What Makes for Effective Youth Mentoring Programmes: A rapid evidence summary

There is a large body of research, policy and comment on youth mentoring schemes. Despite this, there is very little evidence on whether such programmes work and, if they do, what makes them effective. This rapid review of the literature explores the existing evidence around what factors make youth mentoring (or intergenerational) programmes effective. We found that youth mentoring programmes can improve outcomes across academic, behavioural, emotional and social areas of young people’s lives. These impacts are small, but nevertheless significant. There is no evidence that youth mentoring programmes can improve physical health, although few studies examine this particular outcome. The evidence provides a number of insights into what makes youth mentoring programmes effective, including that longer mentoring relationships are associated with better outcomes, the importance of training and motivation, the need for goal-orientated programmes and the key role of the matching process

Conceptualizing multiplicity spectrum experiences: a systematic review and thematic synthesis

Background: Dissociative identity disorder and depersonalization–derealization have attracted research and clinical interest, facilitating greater understanding. However, little is known about the experience of multiplicity of self outside of traumagenic or illness constructs. Consequently, this systematic review explored how people identifying as having multiple selves conceptualize their experiences and identity. Methods: A comprehensive search of qualitative studies reporting lived experiences of multiplicity was conducted through PsycINFO, PubMed and Scopus (PROSPERO ID: CRD42021258555). Thirteen relevant studies were retrieved (N = 98, 16–64 years, conducted in the United Kingdom, the United States, Hungary and Poland). Results: Using line-by-line thematic synthesis, four analytical themes were developed: multiplicity: disorder versus experience; impact of understanding multiplicity; importance of supporting multiplicity; and continuum of experiences. Discussion: This review highlights heterogeneity within multiplicity-spectrum experiences, emphasizing the need for person-centred, individualized understanding, separate from mental health conceptualizations. Therefore, training in person-centred individualized care to promote self-concept clarity is needed across health, education and social care. This systematic review is the first to synthesize voices of people with lived experience across the multiplicity spectrum, demonstrating how qualitative research can contribute to advancing our understanding of this complex phenomena with the community, acknowledging reciprocal psychosocial impacts of multiplicity and providing valuable recommendations for services

A rapid evidence assessment of sickle cell disease educational interventions

Aims and objectives: To assess the impact of educational interventions on the knowledge and attitude of healthcare professionals (HCPs) regarding sickle cell disease (SCD) pain management in the UK. Background: Variations and inadequate pain management due toHCPs’ lack of knowledge and negative attitude is still an ongoing global concern for SCD patients despite availability of effective treatment and evidence-based guidelines. Several international studies have implemented interventions aimed at improving knowledge, attitude, and pain management. No review on the effectiveness of these interventions was found. Also, no previous intervention done in the UK was found from the thorough search of research databases. However, there are estimated 240,000 genetic carriers with about 12,500–15,000 estimated people living with SCD in the UK. Design: Rapid Evidence Assessment of existing evidence. Methods: A rapid evidence assessment was conducted between March 2021–January 2022 following the PRISMA 2020 guidelines. Included papers must have an educational intervention about SCD or related symptom management where the learners were HCPs. Excluded papers were those not published in English or before 2010. The following databases were searched: CINAHL, MEDLINE, PubMed America and Europe, Scopus, PsycINFO and Web of Science. Data quality was assessed using the Mixed Methods Assessment Tool (MMAT) and analysed using a narrative approach. Results: Ten studies were included in the final review. Overall, they reported improved outcomes in six main themes: knowledge, attitude, perception, adoption, satisfaction and efficiency. Five studies reported statistically significant improvement in at least one outcome, four studies reported positive improvement, and two studies reported no significant improvement in knowledge and attitude. These heterogeneous studies were implemented once, and all designs were prone to bias; this makes it difficult to state how effective interventions are for SCD. Conclusion: Current evidence of positive improvement in HCPs’ knowledge and attitude is insufficient for generalisation and recommendation for adoption. However, we believe that implementing validated educational interventions remains essential for effective acute SCD pain management and patient-centred care. Further research is needed to find a suitable educational intervention that can be replicated. Relevance to clinical practice: Quality SCD education, timely crisis management and reduced patient stigma are crucial in reducing the risk of rapid clinical decompensation to avoid developing life-threatening complications. Understanding SCD can also support the building of therapeutic relationships between the patient and practitioner. Trial registration: This review was not registered

Salience games : private politics when public attention is limited

We develop a theoretical model in which an industry and NGO play salience games - they act strategically to influence public attention to social impacts in the sector. Salience stimulates extra donations for the NGO, and thus firms have incentives to hide the damage they do to avoid public attention. How can an NGO design its mission (how to divide income between campaigning and other projects, and what sorts of campaigns to run) to thrive in such a setting? We show that when public attention is scarce, a greater campaign orientation induces industry to invest in greater obfuscation, starving the NGO of funds. The NGO in turn strategically biases its mission away from campaigns, and in favor of sector-wide versus firm-specific campaigns, but not by as much as a welfare-motivated planner would want. When public attention is avoided by a mixture of substantive and symbolic action, we show that a greater weight on the former induces the NGO to become more campaign-oriented, with social damage lower

The effectiveness of probation supervision towards reducing reoffending A Rapid Evidence Assessment

In response to the lack of universal agreement about ‘What Works’ in probation supervision (Trotter, 2013) we undertook a Rapid Evidence Assessment of the empirical literature. Our analysis of research into the effect of probation supervision reducing reoffending included 13 studies, all of which employed robust research designs, originating in the USA, UK, Canada and Australia, published between 2006 and 2016. We describe the papers included in our review, and the meta-analyses of their findings. Overall, we found that the likelihood of reoffending was shown to be lower for offenders who had been exposed to some type of supervision. This finding should be interpreted cautiously however, given the heterogeneity of the studies. We suggest future research and methodological considerations to develop the evidence base concerning the effectiveness of probation supervision

Young People and Mental Health: How do young people want mental health support to be delivered?

In this article, Kim Heyes, Elaine Craig, Paul Gray, Kate Whittenbury, Lauren Barclay and Jessica Leigh (a group of researchers and young people) draw on a recent consultation to argue that the current system of mental health support for young people is broken

An analysis of minoritisation in domestic homicide reviews in England and Wales

This article considers how minoritisation features in Domestic Homicide Reviews (DHRs) in England and Wales and identifies critical learning in relation to addressing minoritisation. Five themes were identified: i) the invisibility of race, culture and ethnicity; ii) perceptions and experiences of services; iii) use of stereotypes and the culturalisation of domestic violence and abuse (DVA); iv) lack of interpreters; and v) DHR recommendations. Our analysis illustrates that statutory sector services should strengthen their responses to Black and minoritised victims by ensuring proper recording of cultural background is used to inform practice; engage professionally trained interpreters with an awareness of DVA; resist framing DVA as endemic to minoritised cultures; and enhance trust and confidence in public services within minoritised communities. The best examples of DHRs challenged service narratives and usually sought expertise from a specialist Black/minoritised DVA service or community organisation (frequently minoritised women's rights organisations)