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The COVID-19 pandemic resulted in immense pressure on healthcare workers (HCWs) and healthcare systems worldwide. The current multi-centre evaluation sought to explore the association between coping behaviours and levels of psychological distress among HCWs working during the initial onset of COVID-19.

Between April and July 2020 HCWs at three urban hospitals in England were invited to complete an online survey measuring personal and professional characteristics, psychological distress and coping. A principal component analysis (PCA) identified components of coping and structural equation modelling (SEM) was used to test the relationship between components of coping and psychological distress.

A total of 2,254 HCWs participated (77% female, 67% white, 66% in clinical roles). Three components for coping were retained in the PCA analysis: external strategies, internal strategies and self-criticalness/substance use. SEM indicated that internally based coping was associated with lower levels of psychological distress, whereas externally based coping and self-criticalness were associated with greater psychological distress. The final model accounted for 35% of the variance in psychological distress.

This multi-centre evaluation provides unique insight into the level of psychological distress among HCWs during the initial onset of the COVID-19 pandemic (2020) and associated coping strategies. Addressing self-criticalness and supporting cognitive-based internal coping strategies among HCWs may protect against prolonged exposure to psychological distress. Findings highlight the importance of developing a culture of professional resilience among this vital workforce as a whole rather than placing pressure on an individual's personal resilience.

The purpose of this paper is to provide a profile of Rachel Taylor.

Rachel provides a short biographical account and is then interviewed by Jerome. In the biography the search for happiness and belonging is discussed.

Rachel talks about focusing on what we are good at, what we love and how discovery can light that spark of hope that there can be better than what has gone before.

Rachel’s story shows the potential that lies not just within some of us, but all of us. It is but one story, but its message is sure to touch many.

How do services promote hope and build resilience and wellbeing? While another service user said recovery was about “coping with your illness and having a meaningful life” (McManus et al., 2009), services have perhaps focused too much on symptom reduction and not enough on helping people find meaning and purpose.

Rachel asks the question is Positive Psychology a movement for all or is it just for the elite?

Rachel is someone who has discovered for herself the benefits of Positive Psychology. Hopefully Rachel’s own discovery will lead to bringing this promising approach to people with mental health problems.

Evidence suggests high rates of psychiatric disorders in bariatric surgery candidates (e.g. Mitchell et al., 2012), although no rigorous studies have examined the prevalence in a Canadian sample. Improved understanding of the prevalence of psychopathology among female patients is an important area of study, as females comprise approximately 80 percent of surgical candidates (Martin et al., 2010; Padwal, 2005). The purpose of this paper is to assess the prevalence of Axis I disorders and associations with quality of life in a Canadian sample of female bariatric surgery candidates.

Female patients (n=257) were assessed using a structured psychodiagnostic interview and completed a health-related quality of life questionnaire.

Results indicated that 57.2 percent of patients met DSM-IV-TR criteria for a lifetime psychiatric disorder and 18.3 percent met criteria for a current psychiatric disorder. Major depressive disorder was the most common lifetime psychiatric disorder (35.0 percent) and binge eating disorder was the most prevalent current psychiatric disorder (6.6 percent). Patients scored significantly lower than Canadian population norms on all domains of the SF-36 (all p's<0.001). Patients with a current Axis I disorder also reported significantly worse functioning on four mental health domains and one physical health domain (p's<0.01) compared to patients without a current Axis I disorder.

Results confirm high rates of psychiatric disorders in Canadian female bariatric surgery candidates and provide evidence for associated functional health impairment. Further study is needed to elucidate how pre-operative psychopathology may impact female patients’ post-operative outcomes.

The purpose of this paper is to review the 20 remarkable lives of student accounts published in this journal. These recovery narratives (RNs) are examined first in terms of whether they meet the five elements of the connectedness, hope, identity, meaning and empowerment (CHIME) model of recovery and then in terms of what makes each account remarkable.

Two Excel spreadsheets were created. One had each author’s name and the five elements of the CHIME model, the other the features of a remarkable life.

All 20 accounts fulfilled the criteria for the CHIME model, independently validating this model of recovery. Hence, each account showed evidence of connectedness, hope, identity, meaning and empowerment. A number of additional characteristics stood out from the accounts such as the importance of motherhood and of education.

All 20 accounts were only reviewed by the two authors, who may be subject to bias. To reduce this, the first author did the bulk of the ratings. This paper shows the importance of education for recovery.

Some 15/20 accounts reported problems with mental health services, mainly around waiting lists. Must mental health always remain a Cinderella service?

This is the first attempt to synthesise this particular set of recovery narratives, entitled remarkable lives. These accounts show the richness of the recovery journeys embarked on by many sufferers and these are just drawn from one University. Like the authors of these stories, we too as recovery specialists have much to learn from their inspiring accounts.

A pilot project commissioned to assess feasibility and impact of peer support in an Early Intervention in Psychosis (EIP) service highlighted the importance of team readiness. The purpose of this paper is to reflect on the lessons learned in recognising and facilitating team readiness in an NHS setting.

The literature suggests that mental health teams need to be ready to implement peer support, if this is to be done successfully. The authors describe the process of preparing for peer support, obstacles that arose and ways that the team found to address these.

The team had actively sought to develop peer support for some time, and negotiated with Trust managers to agree these roles in principle. However, initially unspoken concerns about duty of care emerged as a key obstacle. An arguably paternalistic desire to protect potential peer worker colleagues from stress and distress could have resulted in unnecessary risk aversion and a narrowing of the role. Willingness and opportunity to reflect on the change in relationship from service user/professionals to colleagues enabled these concerns to be aired, and practical solutions agreed.

Team enthusiasm is not the same as team readiness. The team’s willingness to identify and reflect on implicit concerns facilitated an acceptance of the change in relationship with peer workers, which in turn enabled the development of standard operating procedures to ensure safe and effective peer support as “business as usual.”

This paper considers the process of welcoming peer workers in an EIP team and offers practical suggestions that may be of value to other teams seeking to implement peer support in similar adult mental health settings.

This study explored the feasibility of developing scaled inspection tools for use during external inspection of health and social care facilities to give improved accuracy in identifying facilities “at risk”, a tool for risk-adjusted frequency of inspection, and greater consistency of judgements.

This paper summarises the development through working groups and workshops involving 20 experienced inspectors (nurses and social workers) of the Regulation and Quality Improvement Authority who inspect the 206 nursing and 182 residential care homes in Northern Ireland. A brief evaluation survey, including response to a case vignette, gathered inspectors' views after using the tools for six months.

Eight two-dimensional Scaled Inspection Tools were created, each embodying a scale of performance (seriousness of risk issue) and a scale of the ability of the facility to manage that issue, each axis comprising four points. The Scaled Inspection Tools were used for on-site inspections during 2017–18. Evaluative comments were generally positive. The case vignette seemed to highlight greater risk aversion amongst newer inspectors.

The creation of scaled inspection tools adds credibility to the potential for developing risk-based governance in service regulation. Further testing of domains and their scope is required.

Prompts for each domain were found essential to guide inspectors. Despite the challenge of change, inspectors became enthusiastic about use for evaluating risks, and managers about improvements in consistency of inspection.

Knowledge derived from statistical approaches needs to be incorporated into inspection and regulation, just as in other aspects of professional practice.

Scaled inspection tools, with two orthogonal axes corresponding to seriousness of risk and ability to manage the risk (inverse of likelihood of harm), proved acceptable and intuitive in use. The study gives credibility to the possibility of developing screening and surveillance approaches to risk-based governance in service regulation.

The purpose of this paper is to explore the experiences of academic staff who are committed to embedding sustainability within tertiary curricula and pedagogy.

The focus of this paper is on a New Zealand university. A survey of staff was undertaken and in-depth interviews conducted with 11 sustainability “champions”. A narrative variant of thematic analysis was used to examine the ways these sustainability “champions” made sense of the work they do. Through an analysis of their metaphors and metaphorical language, a sense of the identities that they held as educators of sustainability was gained.

Three types of identities emerged – the sustainability “saviour”, “nurturer” and “struggler”. These identities reflected the champion’s experiences, disciplinary affiliations and pedagogical approaches. Interdisciplinarity emerged as a key tenet and challenge for such sustainability champions.

This paper provides rare insights into the experiences, identities and teaching approaches of sustainability champions within higher education. It highlights the need for university-wide conversations and cross-discipline support for such academics.

There is evidence that music programmes can have a positive impact on people in contact with the criminal justice system. However, little attention has been paid to the potential role of music programmes as people leave prison and re-enter the community. Providing support for former prisoners “through-the-gate” is important to aid resettlement and reduce the risk of reoffending. This paper aims to present research on a programme called Sounding Out: a two-year, London-based programme providing ex-prisoners with longer-term rehabilitative opportunities upon their release to bridge the gap between life inside and outside of prison.

The study aimed to understand the impact of the Sounding Out programme on ex-prisoners from the perspective of participants, staff and family members. Semi-structured interviews took place with 17 people: ten participants across two Sounding Out projects; six members of staff – three from the Irene Taylor Trust, two musicians and one former prison worker; and one family member of a participant.

The research provides an understanding of the impact of involvement in a carefully designed programme of music creation, skills development and work placements. Thematic analysis of the data resulted in three key themes: personal impact, focus and direction and interpersonal relationships. The findings are consistent with the body of research that demonstrates the impact of music programmes on prisoners.

The current study adds to the relatively limited body of evidence on the role of music programmes in the reintegration of former prisoners into the community.

The purpose of this paper is to outline the development, piloting and evaluation of the Who’s Challenging Who? (WCW) training intervention for social care staff to improve their empathy and attitudes towards people with learning disabilities (LD) and challenging behaviour (CB).

A phased approach was taken to the development and testing of the intervention. Initially, the existing literature was reviewed, the theoretical background of the intervention was developed, and then the intervention was designed. A pilot study was undertaken, followed by further development, and a large-scale randomised controlled trial (RCT).

WCW had a small positive effect on staff empathy 20 weeks after the intervention, and small to moderate effects for other staff reported outcomes (e.g. positive empowerment attitudes and positive work motivation). Being trained by people with LD and CB encouraged staff to reflect on the impact they have on the people they support. The trainers with LD valued their role, and saw benefits beyond this (e.g. friendships).

It is possible to carry out high-quality RCT evaluations of social care practice, and research should continue to generate evidence in this way, as in healthcare settings. However, there were difficulties in retaining participants.

People with LD can be actively involved in the co-production and delivery of social care training.

Employment and a fair wage can increase the confidence and empowerment of people with LD.

This is the first large-scale RCT of an intervention that aimed to improve empathy/change attitudes in social care staff who work with people with LD and CB.

The purpose of this paper is to investigate how entrepreneurial behaviors support small and medium-sized enterprise (SME) resilience, refine the concept of entrepreneurial resilience, and identify how SME resilience might be promoted.

Qualitative data were collected in the UK via 11 focus groups which provided a sub-sample of 19 SME participants.

Because of their experience operating in uncertain environments, their direct experience of adversity, and the informal organizational settings they inhabit, entrepreneurs are often highly resilient and possess capabilities that enable SMEs to be resilient. Entrepreneurial resilience provides a basis for SME resilience that differs significantly from best practices as understood in larger firms.

Exploratory qualitative research on a small sample (n=19) limits the generalizability of this work. Further research could quantitatively test the paper’s findings and/or examine the link between entrepreneurial resilience and the resilience of larger firms.

Rather than encouraging formal planning and redundancy, policy and practice designed to promote the resilience of SMEs should pay greater attention to building capacities to cope with uncertainty, generating and leveraging personal relationships, and activating the ability to experiment and think creatively in response to crises.

This paper draws on organizational psychology research to refine understanding of entrepreneurial resilience and to empirically examine and inductively theorize the multi-level relationships between entrepreneurial resilience and SME resilience.