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The role of macro‐level processes in determining the effectiveness or otherwise of micro‐level initiatives is a theme that is developed in this paper. Based on efforts to tackle division between Protestants and Catholics in Northern Ireland through cross‐community contact, the paper will argue that the structural context within which contact occurs has important implications for the extent to which achievements of particular encounters are extrapolated to the wider community.

This paper – the final paper of a series of three – aims to discuss the implications of the findings from a service user needs assessment of people experiencing homelessness in the Northwest of England. It will expand on the previous paper by offering a more detailed analysis and discussion of the identified key themes and issues. The service user needs assessment was completed as part of a review of local service provision in the Northwest of England against the backdrop of the COVID-19 pandemic.

Semi-structured questionnaires were administered and used by health-care professionals to collect data from individuals accessing the Homeless and Vulnerable Adults Service (HVAS) in Bolton. The questionnaires included a section exploring Adverse Childhood Experiences. Data from 100 completed questionnaires were analysed to better understand the needs of those accessing the HVAS.

Multiple deprivations including extensive health and social care needs were identified within the cohort. Meeting these complex needs was challenging for both service users and service providers. This paper will explore key themes identified by the needs assessment and draw upon further comments from those who participated in the data-gathering process. The paper discusses the practicalities of responding to the complex needs of those with lived experience of homelessness. It highlights how a coordinated partnership approach, using an integrated service delivery model can be both cost-effective and responsive to the needs of those often on the margins of our society.

Data collection during the COVID-19 pandemic presented a number of challenges. The collection period had to be extended whilst patient care was prioritised. Quantitative methods were used, however, this limited the opportunity for service user involvement and feedback. Future research could use qualitative methods to address this balance and use a more inclusive approach.

This study illustrates that the needs of the homeless population are broad and varied. Although the population themselves have developed different responses to their situations, their needs can only be fully met by a co-ordinated, multi-agency, partnership response. An integrated service model can help identify, understand, and meet the needs of the whole population and individuals within it to improve healthcare for a vulnerable population.

This study highlighted new and important findings around the resilience of the homeless population and the significance of building protective factors to help combat the multiplicity of social isolation with both physical and mental health problems.

The discussion provides an opportunity to reflect on established views in relation to the nature and scope of homelessness. The paper describes a contemporary approach to tackling current issues faced by those experiencing homelessness in the current context of the COVID-19 pandemic. Recommendations for service improvements will include highlighting established good practices including embedding a more inclusive/participatory approach.

The purpose of this paper – the second of three – is to report the findings from a service user needs assessment in those who have contact with a local homelessness service in the North-West of England.

Data were collected using a semi-structured questionnaire that included a section exploring Adverse Childhood Experiences. Aggregated data from a total of 100 completed questionnaires were analysed to understand the nature and scope of those accessing the Homelessness and Vulnerable Adults Service (HVAS).

Homeless people accessing HVAS face a number of challenges, which reflect their upbringing and chaotic and complex lifestyles. Reports of multiple disadvantage, social isolation, physical and mental health problems were common among the cohort.

This was a small cohort study, and the authors accept that this may potentially limit the scope of the findings. Themes identified are, however, reflected in wider research and official data collection sources. Future research may seek to widen the data collection methods to offer a more representative cohort.

The provision of co-ordinated multi-agency support is essential to tackle health inequalities experienced by those who are homeless.

The complex issues often experienced by those who are homeless can further compound the impact of social exclusion on health and well-being. The reduction of statutory support and increased emphasis on self-reliance can further impact those people on the margins of society.

This study identifies how multiple deprivations and social isolation impacts upon health and well-being, further compounding a person’s ability and willingness to engage with services. It raises the question of the systems failure to respond effectively.

There is evidence that students’ experiences in higher education can be adversely affected by mental health issues, whilst well-being can be bolstered through a sense of belonging. This study aims to draw from Student Minds research into student mental health to consider the importance of peers to constructing a sense of belonging.

This paper draws from a thematic review of 12 focus groups – involving student services staff in six UK universities (69 participants) – conducted as part of the consultation and creation of the Student Minds University Mental Health Charter. The schedule considered student support, service structures and developments to enhance student well-being and manage mental health risks.

A significant theme explored here is the positionality of student peers in terms of relatability, and the importance of orientation and belonging for student mental health and well-being. The findings also consider types of peer involvement (formal/informal) and the influence of structure, training and boundaries in interventions.

Findings reveal the importance of feeling a sense of belonging in the university community to achieve well-being and good mental health. Peer support is an important contributor that supports transitions into university and creates a sense of belonging, which is important to all students, but more so to those less familiar with university, who lack role models and more easily feel isolated.

The research has implications for higher education providers, which should inform the promotion of peer support within student services, based on the recognised contribution to well-being and mental health. This is important for student success and related opportunities.

Success in higher education will open opportunities and create improved future prospects for individuals. This will not be realised for individuals who face boundaries and barriers to successful transition through university. The importance of belonging and role of peer support has implications for those who find themselves excluded in society.

This is a qualitative study which gives voice to individuals in universities across the UK. The theme of peer support within this context and linked with mental health and well-being is underexplored.

This paper – the first of three – aims to explore some of the complex physical and mental health needs of those experiencing homelessness. It will act as a leader to the other articles by establishing the nature of the problem and offer a rationale for carrying out a service user needs assessment as part of a review of local service provision in the North West of England against the backdrop of the current COVID-19 epidemic.

There are a number of complex social and health inequalities often experienced by those who are homeless. Effectively tackling these requires a co-ordinated multi-agency response to both prevent and tackle the harms associated with being and becoming homeless.

Partnership working offers the best opportunity to meet the complex needs of those experiencing homelessness. The current delivery model being actioned in the North West of England highlights the importance of the links between statutory and non-statutory services. An ongoing service user needs assessment will further help to highlight contemporary issues faced by those experiencing homelessness and those providing services in the context of the COVID-19 epidemic.

Future papers as part of this series of three will consider the implications of social exclusion and barriers to accessing services faced on a day-to-day basis by those experiencing homelessness.

The opportunity to reflect on established views in relation to the nature and scope of homelessness. It will consider the implications exclusion from society and service provision that this group face on a day-to-day basis. The paper will describe a contemporary approach to tackling current issues faced by those experiencing homelessness in the current context of the COVID-19 epidemic.

Small and medium-sized enterprises (SMEs) use networks to overcome knowledge deficiencies in pursuing innovation. However, balancing the cost and risk of growing networks, especially internationally, with potential gains in knowledge remains a critical challenge. Searching for innovation knowledge in international and domestic networks can be complementary when learning is compressed or as competing when the SMEs capacity to use the new knowledge is exceeded. This paper aims to investigate whether knowledge searches in domestic and international networks are complementary or conflicting in pursuit of innovation.

This study is based on firm-level data set comprising 426 SMEs located in New Zealand, an advanced small and open economy. Using multi-level modelling, this study tests competing hypotheses, asking whether domestic and international network searches are complements or substitutes when seeking ambidexterity.

The research finds that, in contrast to earlier research, which shows increasing network breadth drives innovation activity, SMEs benefit less from knowledge search across combined domestic and international networks for exploration innovation and ambidexterity. In contrast, exploitation shows no effect, suggesting that combined networks could support exploitation.

This paper highlights how SMEs mitigate the influence resource constraints have on the partnerships they form and how this translates to ambidexterity. Specifically, recognising that an opportunistic approach to network development may impose future constraints on SME ambidexterity. From a management perspective, the paper recognises that balancing knowledge search across domestic and international networks can facilitate ambidexterity; however, to prevent spreading resources too thinly, this likely requires exit from early domestic innovation network partnerships.

Adolescence and emerging adulthood are key developmental stages with high risk for trauma exposure and the development of mental and substance-use disorders (SUDs). This study aims to compare the clinical profiles of adolescents (aged 12–17 years) and emerging adults (aged 18–25 years) presenting for treatment of posttraumatic stress disorder (PTSD) and SUD.

Data was collected from the baseline assessment of individuals (n = 55) taking part in a randomized controlled trial examining the efficacy of an integrated psychological therapy for co-occurring PTSD and SUDs (PTSD+SUD) in young people.

Both age groups demonstrated complex and severe clinical profiles, including high-frequency trauma exposure, and very poor mental health reflected on measures of PTSD, SUD, suicidality and domains of social, emotional, behavioral and family functioning. There were few differences in clinical characteristics between the two groups.

Similarity between the two groups suggests that the complex problems seen in emerging adults with PTSD + SUD are likely to have had their onset in adolescence or earlier and to have been present for several years by the time individuals present for treatment.

To the best of the authors’ knowledge, this is the first study to compare the demographic and clinical profiles of adolescents and emerging adults with PTSD + SUD. These findings yield important implications for practice and policy for this vulnerable group. Evidence-based prevention and early intervention approaches and access to care are critical. Alongside trauma-focused treatment, there is a critical need for integrated, trauma-informed approaches specifically tailored to young people with PTSD + SUD.

This paper reports on a pilot study on how women with a learning disability access a mainstream rape crisis centre, used by women who had been sexually abused at any time during their lives. It examines how the pilot was set up, criteria for inclusion, monitoring and evaluation, the outcomes for the women who accessed it and its benefits. The paper also looks at issues raised by the work and future ways of helping other providers to make their services inclusive and open to this group, and makes general recommendations.