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This paper aims to discuss current work and further steps of the psychological hotline launched by the National Psychological Association of Ukraine (NPA), along with a call for action to mental health professionals worldwide.

This paper describes the training and support of the NPA’s hotline staff as well as reflections on the hotline’s work from June 2022 to April 2023.

With broad international support, the NPA’s psychological hotline currently operates in 21 countries providing psychological assistance and referrals to other service providers within Ukraine and abroad. The authors propose further steps of its work, including international collaboration.

Providing citizens of Ukraine with broad public access to evidence-based remote psychological support through NPA’s hotlines is a high priority considering the war’s negative impact on mental health diverse and the limited capacity of the state mental health system.

Staff in secure mental health-care settings face unique occupational challenges that may conflict with their personal or professional moral code. Initial research has established the presence of moral injury in this population, though insight into the specific sources and driving factors at the root of this syndrome is limited. The purpose of this study was to identify potentially morally injurious events and associated risk factors for secure mental healthcare staff.

To address this gap, a three-round expert Delphi survey was conducted to gain consensus on the conceptualisation, types and drivers of potentially morally injurious experiences (PMIEs) for secure mental health-care workers. Health-care professionals and academics in the field were recruited.

A high level of consensus (= 80%) was achieved on several sources of moral injury, which related to aspects of the health-care system, the secure context, relational dynamics and individual practices, behaviours and attitudes. Experts also agreed on several items relating to the definition of a PMIE, the factors driving the occurrence of PMIEs and the factors increasing risk for the subsequent development of moral injury.

The findings suggest that current definitions of PMIEs may, in isolation, be too narrow, prompting the need to attend to the broad range of PMIEs experienced by secure mental health-care staff. In addition, recommendations for the primary and secondary prevention of moral injury in secure mental health-care staff are offered, recognising the particular need for intervention at a systemic level.

To the best of the authors’ knowledge, this study is the first to consider the range of sources of moral injury faced by staff providing for people with complex forensic and mental health needs.

This study aims to examine whole service effectiveness using a secure version of the Health of the Nation Outcome Scales (HoNOS-Secure), further supplemented in some services by the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM) and the Patient Reported Experience and Outcome Measure (PREOM).

The utility of these measures were considered across the full remit of forensic services within a single NHS Trust. A total of 1,038 service users were included (male, n = 876), with the majority of these presenting with HoNOS-Secure ratings. It was predicted that there would be differences pre and post therapy indicated using these measures, that there would be further differences in relation to period of contact with services, and an association was also noted in relation to aggression within services.

Results indicated that HoNOS-Secure scores decreased following treatment and as a function of time spent in secure care. However, no statistically significant improvement or deterioration was observed on patient-reported outcome measures (CORE-OM and PREOM).

The paper concludes with a comparative examination evaluating potential arguments regarding why low levels of distress are observed within forensic populations and why discrepancies exist between clinician-rated and patient-reported routine outcome measures.

Research into this area is limited and yet the HoNOS is a widely implemented tool, without consideration of the core value of this measure.

This preliminary investigation aims to examine the psychological impact of the COVID-19 pandemic on patients and staff within a high secure service.

To discern the connection between COVID-19-related distress and multiple factors, the study involved 31 patients and 34 staff who completed assessments evaluating coping strategies, resilience, emotional reactivity, ward atmosphere and work-related aspects.

Results demonstrated that around a third of staff (31.2%) experienced COVID-19-related distress levels that met the clinical cut-off for possible post-traumatic stress disorder. Emotional reactivity, staff shortages, secondary traumatic stress and coping strategies were all positively correlated with COVID-19-related-distress. Resilience was negatively associated with distress, thus acting as a potential mitigating factor. In comparison, the prevalence of distress among patients was low (3.2%).

The authors postulate that increased staff burdens during the pandemic may have led to long-term distress, while their efforts to maintain minimal service disruption potentially shielded patients from psychological impacts, possibly lead to staff “problem-focused coping burnout”. This highlights the need for in-depth research on the enduring impacts of pandemics, focusing on mechanisms that intensify or alleviate distress. Future studies should focus on identifying effective coping strategies for crisis situations, such as staff shortages, and strategies for post-crisis staff support.

The authors postulate that the added burdens on staff during the pandemic might have contributed to their distress. Nonetheless, staff might have inadvertently safeguarded patients from the pandemic’s psychological ramifications by providing a “service of little disruption”, potentially leading to “problem-focused coping burnout”. These findings underscore the imperative for further research capturing the enduring impacts of pandemics, particularly scrutinising factors that illuminate the mechanisms through which distress is either intensified or alleviated across different groups. An avenue worth exploring is identifying effective coping styles for pandemics.

The current review aims to focus on how risk and protective factors for self-harm in secure mental health hospitals are captured in the literature.

Fifty-seven articles were included in a systematic review, drawn from an initial 1,119 articles, post duplicate removal. Databases included Psycinfo, Psycarticles, Psycnet, Web of Science and EBSCO host. A thematic analysis was used, which included a meta-ethnographic approach for considering qualitative papers.

There was a clear focus on risk factors, with eight identified (in order of occurrence): raised emotional reactivity and poor emotion regulation; poor mental health; traumatic experiences; personality disorder diagnosis and associated traits; increased use of outward aggression – dual harm; constraints of a secure environment and lack of control; previous self-harm and suicide attempts; and hopelessness. Protective factors featured less, resulting in only three themes emerging (in order of occurrence): positive social support and communication; positive coping skills; and hope/positive outlook.

This includes a proposal to move focus away from “risk” factors, to incorporate “needs”, in terms of individual and environmental factors. There is also a need for more attention to focus on developing high quality research in this area.

The research captures an area where a synthesis of research has not been comprehensively undertaken, particularly with regards to capturing protective as well as risk factors.

This chapter delves into the enhancement of the tourism industry through strategic entrepreneurship (SE) and digital transformation. The potential of these methodologies in revolutionizing tourism development and management is emphasized. The Fourth Industrial Revolution, characterized by technologies such as the Internet of Things, big data, artificial intelligence (AI), cloud computing, augmented and virtual reality, and 3D printing, has permeated various sectors including governance and commerce.

This paradigm shift has also seeped into tourism, dubbed as Tourism 4.0 by Korze (2019). As highlighted by Peceny et al. (2019), the infusion of critical communication and information technologies, particularly augmented reality (AR) and virtual reality (VR), into the tourism sector can provide tourists with vivid previews or simulations of attractions. Such immersive experiences can influence travel decisions.

There's an evident rise in the integration of the Fourth Industrial Revolution's technologies in tourism. A prominent example is the adoption of these innovations in digital marketing strategies, especially on social media platforms (Zeng & Gerritsen, 2014; Leung et al., 2013). Given the profound impact of digital tech in molding a network-driven consumer behavior (Rogers, 2016), it becomes imperative for the tourism sector to undergo a comprehensive digital metamorphosis, paying heed to value chains and systems (Ismail et al., 2017).

Furthermore, the importance of SE cannot be overlooked (Ireland et al., 2003; Ireland & Webb 2007). It encapsulates an entity's prowess in seizing opportunities with apt strategies, ensuring the tourism industry remains resilient and thriving.

Individual Placement and Support (IPS) is an evidence-based employment model, effective in supporting individuals with severe mental health difficulties to gain competitive employment. Irish mental health policy recognises its value and IPS is being rolled out in a national programme. Employment is recognised an important contributor to mental health recovery and social inclusion. However, research on IPS has tended to focus on competitive job outcomes. The purpose of this study was to explore the non-vocational outcomes of IPS in an Irish context.

A qualitative research approach was used to interview participants taking part in IPS within community mental health teams. Twelve interviews were included in the data analysis process which was informed by a thematic analysis approach.

Participants experienced increased confidence and positivity, both within a work context and whilst job seeking. More purposeful time use, participation in activities and engagement with society were also experienced by those employed and those at the job search stage of IPS.

This study contributes to the literature about the non-vocational benefits of IPS within an Irish context, highlights the mental health recovery benefits of taking part in IPS and supports the need for ongoing development of IPS throughout mental health services in Ireland.

The aim of this study was to explore and understand the leadership experiences of medical consultants prior to a major hospital move. Health and care is becoming increasingly complex and there is no greater challenge than the move to a new hospital. Effective leadership has been identified as being essential for successful transition. However, there is very little evidence of how medical consultants experience effective leadership.

A qualitative methodology was utilized with one-to-one semi-structured interviews conducted with ten medical consultants. These were transcribed verbatim and analyzed using inductive thematic analysis. The research complied with the consolidated criteria for reporting qualitative research (COREQ).

Four themes were found to influence medical consultants’ experience of leadership: collaboration, patient centredness, governance and knowledge mobilization. Various factors were identified that negatively influenced their leadership effectiveness. The findings suggest that there are a number of factors that influence complexity leadership effectiveness. Addressing these areas may enhance leadership effectiveness and the experience of leadership in medical consultants.

This study provides a rich exploration of medical consultants’ experience of collective leadership prior to a transition to a new hospital and provides new understandings of the way collective leadership is experienced in the lead up to a major transition and makes recommendations for future leadership research and practice.

The findings suggest that there are a number of factors that influence complexity leadership effectiveness. Addressing these areas may enhance leadership effectiveness and the experience of leadership in medical consultants.

Clinical leadership is associated with better outcomes for patients therefore any interventions that enhance leadership capability will improve outcomes for patients and therefore benefit society.

This is the first research to explore medical consultants’ experience of collective leadership prior to a transition to a new hospital.