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The process of ending mental health support is often not well-attended to in practice or research, and clinicians in UK mental health services lack focused clinical guidance in this area. This paper aims to report on a service evaluation that sought to understand from clinicians working in a single adult community mental health team (CMHT) their experiences of discharge and issues arising in the process, factors considered in decision-making and what constitutes “good” endings and what support could be helpful to them in navigating this with clients.

Semi-structured interviews were completed with six members of the multi-disciplinary team and analysed thematically.

Clinicians described a range of criteria considered in discharge decision-making. Collaboration, planning and preparation were represented as key ingredients for “good” endings. Factors viewed as complicating discharge included complexity and changes in presentation, psychosocial contexts and re-referrals. Perceptions of clients’ feelings (resistance and dependence, fear and anger, relief and gratitude) and varying feelings evoked for clinicians (from little or no reported impact, to pride and confidence, sadness and worry) at the ending of the working relationship were reported. Suggested organisational supports for clinicians with endings and discharges involved opportunities to consult with colleagues, psychological formulation and advice and reflective supervision.

There has been limited empirical attention to practitioner experiences of discharge in the work of CMHTs in a UK context; this practitioner-led evaluation explored clinician perspectives.

This paper contributes to a dialogue about the psychoanalytic concept of free association and its application in the context of qualitative research interviewing. In doing so, it also adds to wider discussion regarding the relationship between clinical psychoanalysis, psychoanalytic psychotherapy and qualitative research.

Critical consideration of different perspectives on the application of free association in the qualitative research interview, extending earlier work addressing this issue. Differences and similarities in the way the concept of free association is articulated are examined regarding its framing in psychoanalysis and psychoanalytically oriented psychotherapy.

Whether researchers see themselves as borrowing, applying or drawing inspiration from free association, there is scope for muddling distinct ways of viewing it as it is conceived in psychoanalysis.

Considerations are outlined for researchers interested in psychoanalytically informed methods to be mindful of.

This paper is concerned with what intensive family intervention professionals reveal to the parents with whom they work about whether they themselves are parents or not, as a form of professional self-disclosure in child welfare work. This paper also addresses the act of lying in professional self-disclosure.

The paper draws on material from a series of narrative interviews completed with practitioners from one family intervention programme in an English local authority as part of a study looking at how children’s services professionals experience the suffering of parents. The study was based on a psychoanalytically informed methodological approach, which is represented in the analysis provided in the paper.

The overall team ethos regarding parental status disclosure is considered briefly first then two participants’ accounts are explored in depth. These involved, what can be considered as, questionable or unorthodox stances regarding parental status disclosure (and self-disclosure more generally). The exploration illustrates the role that practitioners’ personal lives and histories can play in influencing how the act of professional parental status disclosure is experienced and how particular positions are invested in regarding the role of self-disclosure in working relationships with parents.

Child welfare and family intervention professionals are often asked personal questions by the parents and carers they work with, including questions about whether they are a parent or not. These questions can be difficult to answer and there is a need for dedicated empirical analysis into the ways in which professionals experience, think about and respond to them and what they disclose about themselves when working with families.

The purpose of this paper is to report an analysis of arrangements in English mental health trusts to meet the needs of adult service users who are homeless. Homelessness is associated with various forms of mental ill-health, yet homeless people are not always well-served by statutory mental health services. In recent years, practice guidance seeking to improve health outcomes for the homeless has emphasised the need for NHS services to improve care pathways and professional provision for this service user group, in part by collaborating more closely with homelessness organisations.

Responses to freedom of information requests sent to trusts were analysed. The requests asked trusts for information concerning partnerships with external agencies, particular projects/staff, training available to trust professionals, referral pathways, and intervention models/approaches informing work with homeless service users.

In total, 49 trusts provided information that could be used in the analysis. Just under half of these had dedicated arrangements or resources, including outreach teams and clinical staff co-located in accommodation and support services for the homeless. The remaining trusts indicated that they either had some limited specific arrangements, such as links between local agencies working with the homeless and existing services, or no dedicated arrangements in place. Training to improve staff awareness around, and knowledge in, working with homeless service users tended to be minimal if provided at all.

This analysis further evidences gaps in the way the needs of the homeless population are addressed by statutory mental health services and adds support to concerns about the homeless having equitable access to care and treatment.

The purpose of this paper is to report findings from a service evaluation of a training initiative in participatory practice with children and young people (CYP) for early help (EH) professionals. The training was based on the Lundy model of child participation.

A questionnaire-based survey was undertaken of staff completing the training. Within the sample of professionals surveyed, various work contexts were represented.

Reported benefits arising from the training included increased understanding of the utility of the tenets of the Lundy model, as well as changes in practice with CYP. Barriers and issues encountered in seeking to work in a participatory way were identified in relation to time for relationship-building, resources and interprofessional and interagency working.

The evaluation findings provide insight into ways training in participatory practice with CYP is experienced by EH professionals. The role of networks of practitioner champions in influencing participatory practice is also addressed, as well as the interface between participatory and relationship-based practice.

The purpose of this paper is to report findings from a service evaluation undertaken within a single specialist child and adolescent mental health service (CAMHS) team. The team works closely with local authority children’s services to serve specific populations recognised as experiencing higher levels of mental health need, including children living in alternative care and with adoptive families. The evaluation sought to better understand the experience of this provision during the COVID-19 pandemic and concomitant increase in remote and digitally mediated care delivery.

Analysis of the accounts of 38 parents, carers and professionals involved with the team gathered via telephone interviews and email and postal questionnaires.

Similar views were expressed from participants involved with the team before and following the onset of the pandemic. Overall, satisfaction was high; however, changes in care appeared more challenging for those already involved with the team before the pandemic. Differences in experience between groups were also evident. Whereas foster carers’ accounts were generally appreciative of the involvement of clinicians, particularly regarding clinician–patient relationships, amongst adoptive parents and members of children’s birth families there were more mixed and negative impressions.

Locally based service evaluations can help inform care pathway planning in specialist CAMHS provision as part of wider quality improvement initiatives. This is especially relevant considering the repercussions of the COVID-19 pandemic and as the longer-term acceptability of remote working practices is appraised.

The purpose of this study was to explore early help provision to children and families not reaching the Children Act (1989) child in need threshold, across all 152 English local authorities in 2017.

A freedom of information request was used, in September 2017, to obtain information regarding recorded numbers, attributes and referral reasons for Early Help cases, case categorisation, professional groups involved in this provision and models of practice.

Responses revealed there are no common protocols categorising referrals and identified needs of children and young people. Child behavioural issues were the most frequently occurring category followed by parenting issues and child emotional well-being. The numbers of children engaged by Early Help services varied with a range between Barnsley with 7.8% of children under 18 years old and Richmond on Thames with 0.33% and only exceeded children in need in a 7 out of 71 reporting authorities. Models of practice used were most commonly based on the assessment framework, which operates at all social work thresholds including child protection. The enquiry found a diverse workforce involved in Early Help and sets it within a context of local thresholds for dealing with large increases in referral rates to children’s services departments in recent years.

The study provides a unique insight into the nature and scope of Early Help provision across England. The relationship between existing thresholds of intervention in the child welfare system is underexplored in the social work literature.

This paper aims to examine the role of bullying victimization in predicting psychopathology, encompassing post-traumatic stress disorder (PTSD), risk of developing prodromal psychosis and emotional and behavioural problems, among in-school Nigerian adolescents.

A total of 351 junior secondary students (n = 173 males, 178 females; age range: 9–17 years) were recruited from five randomly selected public secondary schools in Nigeria. Students completed a variety of self-report measures, including a socio-demographic questionnaire, the prodromal questionnaire – brief version, the strengths and difficulties questionnaire (SDQ) and the multidimensional peer victimization scale. They were also interviewed using the PTSD module of the Mini International Neuropsychiatric Interview-Kid Version.

Although bullying victimization was not found to predict the presence of PTSD, it predicted the risk of developing prodromal psychosis. All SDQ subscales also held significant positive associations with bullying victimization. This indicates that higher levels of victimization are associated with increased behavioural and emotional difficulties among adolescents.

The study findings add support to whole system approaches involving relevant stakeholders in health, education, social and criminal justice sectors via protective policies to address the problems of bullying in schools.

The study contributes to evidence demonstrating a need for improved understanding regarding the role of exposure to bullying victimization in predicting various forms of psychopathology. Furthermore, there is specifically a need for research with this focus in developing countries in sub-Saharan Africa and the Nigerian education system.