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The purpose of this paper is to describe the development, implementation, delivery and evolution of a community-led, comprehensive, peer support service, including co-production approaches, peer support worker role development, outcomes, acceptability and lessons learnt over a five-year timeframe.

This case study presents a reflection on a charity’s peer support service development along with outcomes to highlight client progress.

Improvement in well-being as measured through the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) was evidenced along with demonstrating that the peer support service offers complementary support to Improving Access to Psychological Therapies (IAPT) services.

There was limited quantitative data, and that which existed was analysed on a service-wide basis as opposed to looking at individual components of the service.

This paper demonstrates the value of peer support provision as part of an overall primary care, community-based mental health service, including findings that suggest that for some individuals, where IAPT services did not help them as much, a peer-based service appeared to be more suitable.

The peer support service provided a complementary and alternative service to conventional primary care mental health services whilst offering individuals with lived experience to gain volunteering, employment and development opportunities.

Whilst peer support services have been well documented in the literature for clients experiencing serious mental illness, research on the use of such approaches in the management of common mental health difficulties including anxiety and depression is not as well established. The aim of this paper is to detail the experiences of a user-led charity in developing and delivering peer support services, including challenges encountered. Furthermore, this paper describes a peer support service that has been integrated with a co-existing low intensity IAPT service, reporting recovery rates for clients that have accessed both peer support and IAPT services.

The efficacy of supported computerised therapy (eTherapy) for anxiety and depression is established; however, questions remain regarding supporter type. This paper aims to examine differences in client outcomes between clinician- (Psychological Wellbeing Practitioner) and non-clinician-supported, low intensity eTherapy. Standardised outcome measures were collected and analysed pre- and post-intervention in two eTherapy services as part of National Health Service (NHS) commissioned, Improving Access to Psychological Therapy provision – now known as NHS Talking Therapies for anxiety and depression (TT).

This study is a routine service evaluation comparing two eTherapy services. In total, 494 clients (including 455 clients meeting caseness) accessed the service over a year as part of routine care for anxiety and depression. The Patient Health Questionnaire and Generalised Anxiety Disorder Questionnaire scales were administered pre- and post-treatment as part of the TT data set (NHS England, 2024).

Following adjustment for demographics, baseline assessment scores and clinical variables, the authors found no evidence to support differences in the likelihood of recovery between clients in the non-clinician-supported site and clients referred to the clinician-supported site: OR = 1.24 [95%CI: 0.71 to 2.17] for TT recovery, OR = 0.83 [95%CI: 0.47 to 1.49] for TT reliable improvement and OR = 1.11 [95%CI: 0.65 to 1.92] for TT reliable recovery.

Non-clinician-supported eTherapy is as effective as clinician-supported eTherapy. This finding supports the case for expansion of non-clinician-supported eTherapy services in TT services.

Securing a job in an industry is a boon for most of the slum dwellers. When the primary earner of a slum household suffers from occupational illness and injuries, without insurance coverage or partial coverage of insurance, this boon may become a curse in the long run. The occupational security and safety along with the fact that whether such workers are insured is an important aspect and has a close link with the expenditure on illness. Thus, the accessibility to employees’ insurance in the risky industrial occupation, particularly for slum dwellers, is crucial to protect them from falling into poverty. Studies on occupational health of the poor workers are either limited to informal sectors or remain industry specific and the analysis of their accessibility to job insurance is rarely done. The paper aims to discuss these issues.

The research questions are framed to analyze the types of insurance accessible to workers across various industries; the accessibility to insurance, however, varying across risk intensities of various industries; and the determinants of insurance accessibility of the industrial workers living in slums. The determinants of accessibility of job insurance are analyzed with a binary Logit model. A multi-stage random sampling technique is used to collect the primary data from 320 industrial workers living in the slums of the Indian state of West Bengal.

The industrial workers, irrespective of the types of industries, are exposed to a high-risk category without proper job insurance. The higher industrial income is not adequate to prevent financial hardships. Access to insurance is more likely for the respondents with job tenure of more than two years and less likely for the workers who are working for more than eight hours per day.

This study provides a significant insight to the policymakers concerning health dynamics of the slum dwellers, which can improve their livelihood.

The analysis of the industry-specific risk intensities with accessibility to insurance contributes to understanding the coverage of the insurance scheme for the workers in slums.