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In recent years, in research and policy circles, there is growing interest in the subject of speaking up (and silence) within the health sector, and there is a consensus that it is a major issue that needs to be addressed. However, there remain gaps in our knowledge and while scholars talk of a voice system – that is the existence of complementary voice channels designed to allow employees to speak up – empirical evidence is limited. We seek to explore the notion of a voice system in a healthcare organisation as comprising structures and cultures as seen from different stakeholder perspectives. What do they see and how do they behave and why? To what extent do the users see a voice system they can access and easily navigate?

Interviews and focus groups were conducted with a voice stakeholder group (e.g. designers of the system from senior management and HR, which comprised 23 staff members) as well as those who have to use the system, with 13 managers and 26 employees from three units within a metropolitan hospital: an oncology department, an intensive care unit and a community health service. Overall, a total of 62 staff members participated and the data were analysed using grounded theory to identify key themes.

This study revealed that although a plethora of formal voice structures existed, these were not always visible or accessible to staff, leading to confusion as to who to speak up to about which issues. Equally other avenues which were not designated voice platforms were used by employees to get their voices heard.

This papers looks at the voice system across the organisation rather than examining a specific scheme. In doing so it enables us to see the lived perceptions and experiences of potential users of these schemes and their awareness of the system as a whole.

Knowledge of how social movements move, diffuse, and expand collective action events is central to movement scholarship and activist practice. Our purpose is to extend sociological knowledge about how movements (sometimes) diffuse and amplify insurgent actions, that is, how movements move. We extend movement diffusion theory by drawing a conceptual analogue with military theory and practice applied to the case of the organized and highly disciplined nonviolent Nashville civil rights movement in the late 1950s and early 1960s. We emphasize emplacement in a base-mission extension model whereby a movement base is built in a community establishing a social movement school for inculcating discipline and performative training in cadre who engage in insurgent operations extended from that base to outlying events and campaigns. Our data are drawn from secondary sources and semi-structured interviews conducted with participants of the Nashville civil rights movement. The analytic strategy employs a variant of the “extended case method,” where extension is constituted by movement agents following paths from base to outlying campaigns or events. Evidence shows that the Nashville movement established an exemplary local movement base that led to important changes in that city but also spawned traveling movement cadre who moved movement actions in an extensive series of pathways linking the Nashville base to events and campaigns across the southern theater of the civil rights movement. We conclude with theoretical and practical implications.

This final chapter draws together the key findings presented in the preceding pages and considers emergent conclusions and implications for mental health and wellbeing in schools. The author draws upon the evidence presented by the book’s eclectic range of contributors and the health promoting schools’ (HPSs) framework to provide a road map of what an effective whole school approach (WSA) might look like moving forward. Crucially, lessons from recent crises in education, including COVID-19-driven changes in pathways to support, are highlighted as pivotal factors in a future vision which sees schools as an effective and sustainable frontline force to help tackle the global burden of child and adolescent mental health through a proactive, preventive stance. With this future focus in mind, next steps are considered in terms of developing effective and sustainable mental health and wellbeing support for all within healthy school settings.

A growing body of research finds a consistently negative relationship between medical cannabis access and aggregate measures of opioid use. Nothing is currently known about the types of opioids that are being most impacted by cannabis access. Using the Callaway and Sant’Anna (2021) difference-in-differences (DID) estimator for the main analysis and data on all opioid shipments to every United States (US) pharmacy from 2006 to 2014, the authors found no evidence of overall change in the total number of morphine milligram equivalent (MME) units of opioids shipped to pharmacies, following the opening of medical cannabis dispensaries. However, across all opioids, the authors found a reduction in the highest MME dosage strengths (8.8% decrease in 50–89 MME doses and 11.3% decrease in 90+ MME doses). This decrease appears to be driven predominantly by commonly diverted opioids, where the authors found a reduction in the highest MME dosage strengths (12.2% in 50–89 MME doses and 13.8% in 90+ MME doses). Further, the authors see a 6.0% increase in low-to-moderate dose opioids (0–49 MMEs). This is consistent with patients using cannabis concomitantly with opioids in order to achieve a lower opioids dose.

Social movement organizations are concerned and cognizant of their public image and typically need to maintain positive public perception to gain and sustain support. White supremacist organizations believe that they are highly stigmatized, reviled, and surveilled groups and go to great lengths to protect their desired self-representation. Through a qualitative analysis of close to 2 million Discord chat messages from white supremacist organizations, I find that white nationalist groups attempt to cater their public appearances through three primary axes: organizational, activism, and individual/membership. This chapter uses concepts from Goffmanian sociology, such as Stigma, Impression Management, and Frontstage/Backstage, to highlight how political movements discuss, argue, and debate the public image they wish to deploy. Studies on right-wing movements tend to be “externalist” in the sense that they look at publicly available documents which privilege the views of leadership. This chapter uses a dataset which delves into the social movement “backstage,” enabling us to view white supremacists' private conversations, their impression management strategies, and how they wish to appear on the “frontstage.”

Racially and ethnically minoritized (REM) women continue to be underrepresented in science, technology, engineering and mathematics (STEM) programs and careers. Peer mentoring is one strategy that can support their participation. This study explores the experiences of Black women peer mentors in an online peer mentoring program at two historically Black institutions.

A qualitative case study approach was utilized to explore the impact of an online peer mentoring program on peer mentors' STEM self-efficacy, sense of community, STEM identity and intent to persist in STEM.

Analysis identified five themes relating to peer mentors' experiences in the program: (1) an “I can do this” approach: confidence and self-efficacy; (2) utility of like others; (3) “beacons of light”: intersecting and malleable identities; (4) skills development and (5) motivation and reciprocity. Further, challenges of the online relationship were shared.

The study contributes to the body of knowledge by demonstrating the utility of an online peer mentoring model among women mentors enrolled in STEM programs at two historically Black institutions. The findings support those who are historically marginalized in participating in and remaining in STEM.

This chapter introduces the topic of mental health and wellbeing in schools and the overarching theoretical framework for the book. The evolving role of schools from nurturing environments to frontline support for pupils’ mental health and wellbeing is scrutinised in the context of demand, capacity and constraints in a post-pandemic world. Alongside this is a critical consideration of schools’ and education staff’s role, responsibilities and boundaries. The disparate mental health needs of pupils within the school population are discussed, as well as key risk and protective factors to help facilitate timely identification and appropriate support pathways for vulnerable pupils. Key topics and case studies which comprise the remainder of the book are introduced to navigate the reader, and this concludes the chapter.