Recovery-orientated care is becoming generally accepted as the best practice, and continued development in the ways it is practiced is necessary to ensure improvement of ongoing care. Forensic patients often experience double stigmatization (the dual stigma of mental illness and offending behaviour) and during admission to hospital may lose touch with their community supports. While working through their personal recovery, patients develop therapeutic relationships with their multidisciplinary team members. When positive, these relationships can enhance a patient's recovery. Clinical staff members participated in 88 in-depth interviews, which were transcribed, reviewed, and analysed using thematic analysis. From analysing the data, main themes and subthemes emerged related to staff's perceptions of therapeutic relationships. When developing relationships, staff need to overcome receptiveness issues by increasing trust through understanding their preconceptions, reducing stigma, sharing innocuous stories, and giving patients the time they need. The key pillar underpinning all traits ascribed to patients and staff is collaboration and approaching treatment protocols with a social approach is essential to enhancing recovery. Staff shared a holistic view of recovery that incorporated the benefits of positive relationships and the need to create a sense of home within the institution.

Background : Sexual harassment occurs within the nursing profession globally, challenging the health and safety of nurses and the quality and efficiency of health systems. In Sri Lanka, no studies have explored this issue in the health sector; however, female employees face sexual harassment in other workplace settings. Objective : To explore female nurses’ perceptions of workplace sexual harassment in a large state hospital in Sri Lanka. Methods : This is a qualitative study conducted in an urban, mainly Buddhist and Singhalese context. We invited all female senior and ward nurses working in the hospital to participate in the study. We conducted individual in-depth interviews with four senior nurses and focus group discussions with 29 nurses in three groups. Results : The nurses described a variety of perceived forms of sexual harassment in the hospital. They discussed patient-perpetrated incidents as the most threatening and the clearest to identify compared with incidents involving doctors and other co-workers. There was significant ambiguity regarding sexual consent and coercion in relationships between female nurses and male doctors, which were described as holding potential for exploitation or harassment. The nurses reported that typical reactions to sexual harassment were passive. Alternatively, they described encountering inaction or victim blaming when they attempted to formally report incidents. They perceived that workplace sexual harassment has contributed to negative societal attitudes about the nursing profession and discussed various informal strategies, such as working in teams, to protect themselves from sexual harassment in the hospital. Conclusions : Sexual harassment was a perceived workplace concern for nurses in this hospital. To develop effective local prevention and intervention responses, further research is required to determine the magnitude of the problem and explore differences in responses to and consequences of sexual harassment based on perpetrator type and intent, and personal vulnerabilities of the victims, among other factors.

BackgroundThe COVID-19 pandemic, school closures, and social distancing measures have disrupted young people's daily routines, learning, and social relationships. We examine the changes in adolescent mental health over time and explore the relationship between how connected students felt to their school and peers before the pandemic and how this affected their mental health during school closures and on return to school. MethodsThis is a longitudinal three-wave panel survey with students aged 13-15 years in 17 secondary schools across the South West of England. Students completed a self-report survey before the pandemic (October, 2019), during the first UK lockdown (May, 2020), and shortly after returning to school (October, 2020). Matched data across all three waves were available for 603 students. Anxiety and depression were measured using the Hospital Anxiety & Depression Scale (HADS). School connectedness was measured using six items adapted from the Psychological Sense of School Membership (PSSM) scale. Peer connectedness was measured using a seven-item subscale as published by Jose, Ryan, and Pryor (2012). The study was approved by the University of Bristol Medical School ethics committee (reference 84883). Findings There was an overall decrease in anxiety score from before the pandemic (median 7, IQR 4-11) to during the first UK lockdown (median 6, IQR 3-10). Wilcoxon signed-rank tests indicated that this difference was statistically significant (z=-7•061, p<0•0001). Anxiety levels then increased on return to school (median 8, IQR 4-11), which was also statistically significant (z=6•983, p<0•0001). No changes were observed for levels of depression over the three timepoints. Low school connectedness at baseline predicted a significant increase in anxiety when students returned to school (β 1•33, 95% CI 0•55-2•11; p=0•001). No significant association was found between low peer connectedness before the pandemic and anxiety levels on return to school (β 0•53, 95% CI -0•24 to 1•30; p=0•175).Interpretation Our findings suggest that most students adapted well to school closures, and in fact experienced less anxiety than before the pandemic. Students who reported feeling poorly connected to school before the pandemic are likely to experience higher levels of anxiety on return to school. This study highlights the need for routine mental health and wellbeing monitoring in schools to identify key areas of support and to inform school-based public health interventions.

This paper briefly describes how the contexts of social and emotional wellbeing in Aboriginal and Torres Strait Islander communities impacts on perinatal and infant mental health. In response to these issues, a perinatal and infant mental health service was started through Winnunga Nimmityjah, a community controlled Aboriginal health service. The process of starting the clinic and some clinical themes are described.

The COVID-19 ‘lockdown’ and multiple school closures disrupted the daily lives and routines of the entire UK population. However, adolescents were likely particularly impacted by such measures due to this time being key for social and educational development. This qualitative study explored young people’s experiences of lockdowns and school closures. Fifteen secondary schools within south-west England were initially contacted and three schools participated in recruitment efforts. From December 2020 to March 2021, 25 students aged 14–15 participated in a combination of individual interviews (n = 5) and focus groups (n = 3). Findings revealed diverse experiences of the pandemic and highlighted the complexity of experiences according to individual student contexts. Three main themes were identified: (1) Learning environments; (2) Connection to peers; (3) Transition, adaptation and coping. These findings highlight the value young people place on face-to-face social contact with close friends, and the sense of structure provided by school, with implications for future home-based learning. Further in-depth qualitative research is needed to continue to understand the varied experiences during the course of the pandemic, particularly longer-term impacts on mental health and learning.

School closures and social distancing measures during the pandemic have disrupted young people’s daily routines and social relationships. We explored patterns of change in adolescent mental health and tested the relationship between pre-pandemic levels of school and peer connectedness and changes in mental health and well-being between the first lockdown and the return to school. This is a secondary analysis of a longitudinal 3-wave panel survey. The study sample included 603 students (aged 13–14) in 17 secondary schools across south-west England. Students completed a survey pre-pandemic (October 2019), during lockdown (May 2020) and shortly after returning to school (October 2020). Multilevel models, with random effects, were conducted for anxiety, depression and well-being outcomes with school and peer connectedness as predictor variables. Symptoms of anxiety decreased from pre-pandemic to during the first UK lockdown and increased on the return to school; anxious symptoms decreased the most for students reporting feeling least connected to school pre-pandemic. Students reporting low levels of school and peer connectedness pre-pandemic experienced poorer mental health and well-being at all time points. Low school connectedness pre-pandemic was associated with a greater increase in anxious and depressive symptoms between lockdown and the return to school when compared to students with medium levels of school connectedness. No associations were found with high school connectedness or with low/high peer connectedness. For adolescents with poor school connectedness, the enforced time away from school that the pandemic caused led to reduced anxiety. Going forwards, we need to consider ways in which to promote connection with school as a way of supporting mental health and well-being.

Tuning the chain-end functionality of a short-chain cationic homopolymer, owing to the nature of the initiator used in the atom transfer radical polymerization (ATRP) polymerization step, can be used to mediate the formation of a gel of this poly(electrolyte) in water. While a neutral end group gives a solution of low viscosity, a highly homogeneous gel is obtained with a phosphonate anionic moiety, as characterized by rheometry and diffusion nuclear magnetic resonance (NMR). This novel type of supramolecular control over poly(electrolytic) gel formation could find potential use in a variety of applications in the field of electro-active materials.

People experiencing homelessness have higher rates of mental ill-health and substance use and lower access to health services compared to the general population. The COVID-19 pandemic led to changes in service delivery across health and social care services, with many adopting virtual or telephone support for service users. This paper explores the experiences of access to community-based mental health and substance use support for people experiencing homelessness during the COVID-19 pandemic. Qualitative telephone interviews were conducted with 10 women and 16 men (ages 25 to 71) who self-identified as experiencing homelessness in North East England between February and May 2021. With five individuals with lived experience, results were analysed using inductive reflexive thematic analysis. Reactive changes to support provision often led to inadvertent exclusion. Barriers to access included: physical locations, repetition of recovery stories, individual readiness, and limited availability. Participants suggested creating services reflective of need and opportunities for choice and empowerment. Community mental health and substance use support for people experiencing homelessness should ensure the support is personalised, responsive to need, inclusive, and trauma-informed. The findings of this research have important implications for mental health and substance use policy and practice for individuals who experience homelessness during a public health crisis.