Diagnosis special issue - Introduction: Moving beyond diagnosis: Practising what we preach

John Cromby, Dave Harper and Paula Reavey introduce the special issue

Diagnosis special issue - Part 6: Don’t jump ship! New approaches in teaching mental health to undergraduates

Dave Harper, John Cromby, Paula Reavey, Anne Cooke and Jill Anderson with some pointers

Harnessing lived experience in a community-based intervention to address gambling-related harms

Background Lived experience of people directly or indirectly affected by public health issues can provide unique insights into how to improve interventions. Increasing availability of gambling necessitates involving communities in efforts to reduce gambling-related harms. This presentation reports qualitative exploratory research into the value of lived experience across a city-region gambling harm reduction initiative in the UK. Methods Focus groups and interviews were used to explore the practical application of lived experience with participants: advisory panel members, external stakeholders, community project staff, and public health professionals. Collaborative data analysis combined the framework method with theme development inductively (from participants’ accounts) and deductively (from academic and grey literature). Results Four themes were identified: (1) lived experience spans formal and informal settings with different activities and personal impacts; (2) organic and structured pathways to lived experience involvement coexist; (3) the emotional work of people affected by gambling-related harms ranges from frustration at policy inertia to deeper understanding of their own recovery journey; and (4) lived experience encompasses diverse experiential knowledges. Conclusions Involving lived experience in this intervention increased participants’ awareness of the harmful role of the gambling industry and critical reflection on the representativeness of lived experience. Harnessing lived experience at a regional level requires multi-setting support free from stigma and industry influence to ensure the sustained vitality of a diverse lived experience community specialised in gambling-related harms and equipped to navigate conflicting emotions and a challenging policy environment. Key messages • Increasing availability of gambling necessitates involving communities in efforts to reduce gambling-related harms. • The use of lived experience in gambling-related harms prevention efforts and research can inform intervention development

Involving Lived Experience in regional efforts to address gambling-related harms: going beyond ‘window dressing’ and ‘tick box exercises’

Background Lived Experience (LE) involvement has been shown to improve interventions across diverse sectors. Yet LE contributions to public health approaches to address gambling-related harms remain underexplored, despite notable detrimental health and social outcomes linked to gambling. This paper analyses the potential of LE involvement in public health strategy to address gambling-related harms. It focuses on the example of a UK city-region gambling harms reduction intervention that presented multiple opportunities for LE input. Methods Three focus groups and 33 semi-structured interviews were conducted to hear from people with and without LE who were involved in the gambling harms reduction intervention, or who had previous experience of LE-informed efforts for addressing gambling-related harms. People without LE provided reflections on the value and contributions of others’ LE to their work. Data analysis combined the Framework Method with themes developed inductively (from people’s accounts) and deductively (from the literature, including grey literature). Results Four themes were identified: (1) personal journeys to LE involvement; (2) the value added by LE to interventions for addressing gambling-related harms; (3) emotional impacts on people with LE; and (4) collective LE and diverse lived experiences. Two figures outlining LE involvement specific to gambling harms reduction in the UK, where public health efforts aimed at addressing gambling-related harms coexist with industry-funded programmes, are proposed. Conclusions Integrating a range of LE perspectives in a public health approach to gambling harms reduction requires local access to involvement for people with LE via diverse routes that are free from stigma and present people with LE with options in how they can engage and be heard in decision-making, and how they operate in relation to industry influence. Involving LE in gambling harms reduction requires enabling people to develop the affective and critical skills necessary to navigate complex emotional journeys and a challenging commercial and policy environment

Effectiveness of an online intervention for parents/guardians of children aged 4-7 years who are concerned about their child's emotional and behavioural development: protocol for an online randomised controlled trial (EMERGENT study).

The demand for resources to support emotional and behavioural development in early childhood is ever increasing. However, conventional interventions are lacking in resources and have significant barriers. The Embers the Dragon programme helps address the growing unmet need of children requiring support. The delivery of the current project seeks to help support parents, reduce the burden placed on pressed services (eg, Child and Adolescent Mental Health Services) and to help improve the emotional and behavioural development of children. This project aims to investigate the efficacy and acceptability of Embers on parenting and children's psychosocial outcomes. 364 parents/guardians of children aged between 4 and 7 will be recruited via the internet, schools and general practitioners (GPs). This is an online waitlist-controlled trial with three arms: (1) control arm, (2) access to Embers arm and (3) access to Embers+school. Participants will be randomised (1:1) into (1) or (2) to evaluate the use of Embers at home. To evaluate scalability in schools, (3) will be compared with (2), and (1) to test efficacy against treatment as usual (not receiving the intervention). Qualitative interviews will also be conducted. Primary outcomes are the Parental Self-efficacy Scale, Strengths and Difficulties Questionnaire and qualitative interviews. Outcomes will be compared between the three groups at baseline, 8, 16 and 24 weeks. Ethical approval has been granted by the London South Bank University ethics panel (ETH2324-0004). To recruit via GPs, NHS ethical approval has been applied for, and the IRAS (331410) application is under consideration by the Central Bristol REC. The results of the project will be submitted for publication in a peer-reviewed journal. Parents/guardians will provide informed consent online prior to taking part in the study. For the interviews, assent will be taken from children by the researchers on the day. ISRCTN58327872. [Abstract copyright: © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Sexuality, risk, and organisational misbehaviour in a secure mental healthcare facility in England

Sexuality in secure mental healthcare has been overlooked in both clinical praxis and academic research. In the UK, there exist no formal policies to inform staff approaches to managing inpatient sexuality. The limited research that has been undertaken in this field has found that often, prohibitive approaches are favoured, which may affect how inpatients conceptualise and experience their sexuality in the long-term. The aim of this study was to identify discursive constructions of inpatient sexuality, as articulated within semi-structured group interviews with inpatients and ward staff from a secure mental healthcare facility in England. The analysis identified constructions of inpatient sexuality within two overarching and conflicting discourses: one of the normalcy and legitimacy of sexual expression in human experience; and the other of risk, wherein sexuality needed to be regulated and obstructed. Inpatients’ expressions of sexuality could often only be conceptualised in terms of “organisational misbehaviour”, acts that violated the implicit norms and codes of the institution. It is suggested that recoding inpatient sexuality as misbehaviour could have implications for inpatients’ long-term recovery

Choreographies of sexual safety: forensic mental health and the limits of recovery

Medium secure forensic psychiatric units are unique environments within the broader “post asylum” landscape of mental health services. Length of stay is much greater and restrictions on behavior, including sexual behavior, are legally and institutionally legitimated, due to concerns regarding risk. As a result, sexuality is rarely explored with service users and no official policies on sexual conduct and sexual safety have yet been developed, despite sexuality being linked to positive recovery outcomes

Intravenous digoxin as a bioavailability standard

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/116960/1/cpt1975171117.pd