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This paper aims to introduce the concept of using the well-established Shared Lives approach to support survivors of domestic abuse with complex needs including those with learning and physical disabilities, older people and carers.

Survivors with complex needs are often excluded from traditional domestic abuse support services thus increasing their risk and making recovery impossible. Using the Shared Lives approach in suitable cases could address gaps in provision and improve the outcomes for survivors with disabilities, older survivors and carers.

The paper draws on evidence from reports and research about the experiences of these cohorts of survivors to explain how the Shared Lives approach could increase support options for specific categories of survivors.

Using the Shared Lives approach to support cohorts of victims/survivors who experience barriers to accessing support could improve outcomes for these people, reduce risk of serious harm and improve quality of life.

With the recent recommendation from Association of Directors of Adult Social Services around increasing use of Shared Lives, this paper provides one potential way to meet this recommendation.

Spoken service language is critical for service experiences and human welfare in many service settings. However, little is known about how spoken service language can enhance customer well-being in transformative service contexts. This paper explores spoken service language and well-being for customers experiencing vulnerability in a transformative service context, informed by an empirical account of the human welfare service of residential aged care.

Situated within transformative service research (TSR), this study was guided by a theoretical framework of service language and adopts a strengths-based approach to customer experiences of vulnerability. A qualitative multiple case study methodology was applied to explore carers’ perspectives on spoken service language and well-being from three residential aged care homes in Australia.

The findings demonstrate five spoken service language practices and four principles of spoken service language for well-being that co-create customer well-being and support the alleviation of customer experiences of vulnerability. Conceptualised as transformative spoken service language, the spoken service language practices and principles collectively recognise, support and leverage residents’ capabilities and uplift customer well-being, by enacting a process of mattering highly salient to transformative service contexts.

This study is the first to conceptualise how employee spoken service language can be used to support customer well-being and enhance transformative value for customers experiencing vulnerability to align with the goals of TSR. Practically, the study advocates for a greater awareness and more considered use of transformative spoken service language in human welfare and other transformative service contexts.

The purpose of this paper is to provide a literature review on what is known about unpaid family carers who are at risk of or have experienced abuse from the people they provide care for and relevant policy/legal and practice responses for affected family carers.

A literature search was carried out to locate literature relating to unpaid family carers who are at risk of or have experienced abuse from the people they provide care for. This also incorporated grey literature, including policy guidance and law, to determine the existing knowledge base, gaps in practice and areas that might require further research.

The findings suggest that although carer harm is serious, it is under-researched. In addition, the unique needs of unpaid family carers who are at risk of or have experienced abuse, violence and harm from the people they provide care for are subsumed in safeguarding policy/law processes and practice under the auspices of the protection of “adults at risk” rather than the protection of “carers at risk”.

It is important that those who support unpaid family carers who are at risk of abuse and harm know about their unique safeguarding needs and concerns to offer appropriate support. It is also apparent that policy and law need to address the gap in provision relating to the unique safeguarding concerns involving the abuse of unpaid family carers by the people they provide care for. This paper is based on this literature review and not on other types of research.

The paper provides insights into what is known about the abuse of unpaid family carers by the people they provide care for, and the policy/legal and practice responses to affected unpaid family carers. It contributes to the body of knowledge on carer abuse and safeguarding carers from abuse and harm.

The purpose of this study is to describe peer support work in a men’s mental health unit from a lived experience and service user’s perspective. The intertwining of process (a lived experience perspective) and subject (the therapeutic value of peer support) leads to greater knowledge and insight into peer support for people with mental health problems.

This service user narrative draws on the extracts from a reflective journal of interactions and conversations with people with mental health problems as well as feedback from service users and staff about the value of peer support. These methods allow a first-person, service user’s, reflective and narrative account of peer support work.

Peer support work, particularly hearing voices sessions, are found to be highly therapeutic and worthwhile. They promote insight and create feelings of safety and hope in what can sometimes be a frightening and hostile ward environment. Peer support provides emotional and practical support. Sharing stories and experiences of mental illness with people leads to trust, feelings of being valued, heard and accepted as well as better experiences of care and being seen as a person first. Due to their shared experiences, peer support workers are able to befriend people with mental health problems on the ward. Peer support work bridges the gap and vacuum of care between people with mental health problems and staff. It compensates for understaffing to provide more holistic and person-centred care and support.

Lived experience/ service user perspectives and narratives on peer support are rare, particularly in a hospital setting. This article provides a rich, perhaps overlooked and hidden narrative on the nature of peer support work. People with mental health problems, like Ben, are often excluded from society, health and social care, education, employment and research. This narrative opens up a pathway to understanding peer support from a service user perspective.

Obesity and associated morbidity and mortality are major challenges for people with severe mental illness, particularly in secure (forensic) mental health care (patients who have committed a crime or have threatening behaviour). This study aims to explore experiences of weight management in secure mental health settings.

This study used a mixed-methods approach, involving thematic analysis. A survey was delivered to secure mental health-care staff in a National Health Service (NHS) mental health trust in Northern England. Focus groups were conducted with current and former patients, carers and staff in the same trust and semi-structured interviews were undertaken with staff in a second NHS mental health trust.

The survey received 79 responses and nine focus groups and 11 interviews were undertaken. Two overarching topics were identified: the contrasting perspectives expressed by different stakeholder groups, and the importance of a whole system approach. In addition, seven themes were highlighted, namely: medication, sedentary behaviour, patient motivation, catered food and alternatives, role of staff, and service delivery.

Secure care delivers a potentially “obesogenic environment", conducive to excessive weight gain. In future, complex interventions engaging wide-ranging stakeholders are likely to be needed, with linked longitudinal studies to evaluate feasibility and impact.

To the best of the authors’ knowledge, this is the first study to involve current patients, former patients, carers and multidisciplinary staff across two large NHS trusts, in a mixed-methods approach investigating weight management in secure mental health services. People with lived experience of secure services are under-represented in research and their contribution is therefore of particular importance.

Recognising current, significant rates of youth sexual violence and abuse (YSVA) and the need for more comprehensive prevention approaches to combat this social issue, new approaches are required to ensure that agency is given to the people who are most affected and who know their lives the best. This paper aims to report a youth-led (Young Voices United [YVU] Committee) participatory design approach aimed at delivering the highest level of engagement to understand what people agree is needed to reduce YSVA in their own communities.

The seven-step co-design (Trischler et al., 2019) process was implemented following ethical clearance. Over five months, 13 group co-design sessions involving 102 young people aged 12–25 years, 17 parents/caregivers (including young mums) and 9 teacher/guidance officers were conducted. Purposive sampling was undertaken to ensure that young people who had previously experienced YSVA or were most at risk of experiencing YSVA were overrepresented. Convenience sampling was used to gain wider community involvement in co-design. Four sessions were facilitated by YVU members, who were aged between 12 and 25 years, and more than 66 people helped the design team. Inductive thematic analysis identified emergent themes across completed co-design sessions.

New ideas and solutions to prevent YSVA can be identified by young people who have previously experienced violence, carers, other young people and community members. A core finding in this study is the need for positive relationship role models and an enhanced understanding of consent. Education and training, a community promotional campaign, sector involvement, capacity-building and consideration of the unique needs of different target audiences were key ideas emerging from youth-led co-design. The YVU Committee provided recommendations for resource prioritisation.

This youth-led co-design process empowered the community. Project stakeholders have since formed partnerships won funding and used that funding to co-design and trial a new programme aiming to provide a safe haven for young people at risk of YSVA. The pilot programme delivers a safe and supportive environment for young people delivered at a time when it is needed most. Other geographical areas are now seeking to replicate the programme. The co-design processes and tools detailed in this study can be adapted to the design of programmes for those already engaged with the youth justice system and should be considered as part of a public health approach to effectively prevent and respond to YSVA and other youth crimes.

This paper advances understanding, providing a practical approach that ensures youth views are given weight [audience and influence described in Lundy’s (2007) participatory framework]. This paper explains how the YVU Committee, established at the commencement of the project, oversaw the community co-design effort, which followed Trischler et al.’s (2019) seven-step co-design process. Ideas were generated, and consensus views were consolidated, delivering the highest level of engagement according to Willmott et al.’s (2022) methodology, agent of change, training and engagement taxonomy. The participatory design method led to high levels of community engagement, and the success of the project is attributed to the establishment of the YVU Committee and stakeholder support.

The ageing and disabled population is fast growing, which emphasises the need to effectively modify current homes and environments to support healthy ageing and increasingly diverse health needs. This paper aims to bring together findings and analyses from three adaptations-focussed projects, drawing on perspectives from key stakeholders alongside the lived experiences of service users acquiring adaptations.

Following an Adaptations Framework developed from interviews and focus groups with older people and key stakeholders, the paper discusses barriers experienced by older people and front-line workers in receiving and delivering adaptations through all stages of the process.

This paper reveals how experiences around adaptations might diverge with unseen, hidden investment and need amongst individuals, and how conceptual and cost-focussed evidence gaps impact wider understandings of adaptations delivery. In so doing, this paper highlights how the adaptations process is perceived as a “fight” that does not work smoothly for either those delivering or receiving adaptations services.

The paper suggests a systematic failure such that the adaptations process needs to be rehauled, reset and prioritised within social and public policy if the housing, health and social care sectors are to support healthy ageing and prepare for the future ageing population.

The paper brings together insights from key stakeholders alongside service users' experiences of adaptations to highlight key policy drivers and barriers to accessing and delivering adaptations.

Literature regarding recovery has focussed on diagnoses such as schizophrenia, with few papers focussing on borderline personality disorder (BPD). This is a significant area in need of change because a lack of research concentrating on recovery from BPD could be seen to perpetuate the view that recovery from this condition may not be possible. Recovery Colleges (RCs) in the UK began in 2009and aim to offer co-produced and co-facilitated psychoeducational courses to encourage recovery and enable people to develop skills and knowledge so they become experts in the self-management of their difficulties. Given the gaps within the recovery literature, it is unclear how Recovery Colleges can support recovery for people diagnosed with BPD. The purpose of this study was to explore the impact of a Recovery College course for people diagnosed with BPD.

Using participatory methods, this paper aims to explore the question of what personal recovery looks like for people with BPD and how this may prove useful in developing future practice in RCs. Qualitative feedback data was collected from 51 managing intense emotions courses delivered to 309 students using a patient reported experience measure between Autumn 2015 and Autumn 2021.

The results of this study indicate that people with BPD can experience recovery, whilst still experiencing symptoms, as long as they receive appropriate co-produced, recovery-orientated support and services.

Further research in this area could help shape future clinical practice by embedding a recovery-focussed programme into community services.

Literature regarding recovery has focussed on diagnoses such as schizophrenia withfew papers focussing on BPD. This is an area in need of change because a lack of research on recovery from BPD could be seen to perpetuate the view that recovery from this condition may not be possible. RCs offer co-produced and co-facilitated psychoeducational courses around recovery, enabling people to develop skills and knowledge to become experts in the self-management of their difficulties. Given the gaps within the recovery literature it is unclear how RCs can support recovery for this group of service users.

Engaging with heritage to support mental health and wellbeing has become a focus of research and policy, more recently moving towards social prescription of heritage interventions. While there are benefits to active participation, there are potential risks to those taking part and to the non-renewable historic remains and landscape that form the core of these projects. The purpose of the current research paper was to develop best practice guidelines for organisations offering heritage projects as interventions for people who live with mental health issues to protect both participants and heritage.

There were two research phases; a Sandpit with World Café discussions to produce a set of research priorities, and a Delphi Consultation, using three questionnaires distributed over six months, to develop best practice guidelines. The panel in both phases comprised experts through lived experience, policy, practice and research.

The Authentic and Meaningful Participation in Heritage or Related Activities (AMPHORA) guidelines cover three stages: project development, project delivery and project follow-up, with a set of action points for each stage. Of particular importance was authentic participation and expertise to ensure appropriate management of heritage/ historic environment assets and support for participants.

The AMPHORA guidelines can assist all organisations in the delivery of safe projects that support the mental health of those involved, as well as enhancing and protecting the historic environment.

To the best of the authors’ knowledge, these are the first research-led guidelines that help heritage organisations support those living with mental health issues.

This service evaluation aims to understand the experiences of service users (SUs) who accessed an early intervention in psychosis (EIP) service during the Coronavirus pandemic using qualitative and quantitative methodologies and compare these to a previous pre-pandemic study conducted within the same service (Watkins et al., 2018).

This paper collated experiences of individuals accessing an EIP service to inform service development. Questionnaires and individual interviews were conducted to provide quantitative and qualitative data. Descriptive statistics and T-test confidence intervals were created from the results and compared to findings of Watkins et al. (2018). Interviews were transcribed verbatim and analysed using Braun and Clarke’s (2006) thematic analysis.

Data showed participants were largely satisfied with all areas of the service with “work or education”, “living skills”, and “addictions” scoring highest. Though participants reported no overall dissatisfaction, satisfaction levels dropped in “social activities” compared to the findings of Watkins et al. (2018), perhaps due to the national restrictions put in place to manage the spread of Coronavirus during this time. Interview analysis identified three themes of importance consistent with prior literature, highlighting the importance of relationships and validation during recovery.

This evaluation did not consider whether participants had accessed the service prior to the pandemic or only during, meaning that some participants could have a point of comparison with the service pre-pandemic, whereas others might not. Similarly, the participants were not the same as those of the Watkins et al.’s (2018) evaluation, meaning that direct comparisons of pre- and post-pandemic experiences were not possible. In addition, this evaluation collected data at only one time point early in the pandemic; therefore, it is unknown if client experiences of services differed as the pandemic and restrictions continued over time.

The Covid-19 pandemic has been an unprecedented challenge for health services, and the effects of this are becoming widely reported. This evaluation of clinical services offers a valuable perspective of service user experience of receiving mental health services during a global health crisis further offering a comparison to pre-pandemic services and the experiences of those who used them.