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The purpose of this paper is to offer an opinion piece that documents the experience of losing an adult sibling to suicide and explores the experience of personal and family grief.

This narrative is written from an autoethnographic perspective and uses the current evidence base to support a personal reflection.

This paper identifies the complex nature of bereavement following death from suicide and considers those factors that support more positive outcomes for those grieving.

This piece focuses on autoethnographic data but is supported by findings from the wider evidence base.

The importance of seeking positives as part of the healing process when processing complex grief.

Disclosure has been identified as an important part of processing complex grief associated with suicide bereavement and yet suicide remains a taboo subject for many.

This autoethnographic piece details the experience of dealing with a sibling suicide and the importance of creating the opportunity for positive reflection to process complex grief.

Mental well-being is associated with positive outcomes throughout the life course. This study aims to examine interventions delivered by allied health professionals (AHPs) to alleviate community stressors adversely impacting public mental health and well-being.

Review inclusion criteria comprised experimental and qualitative process evaluations of public mental health interventions delivered by AHPs. Electronic searches in Cinahl, Embase, Medline, PsycINFO and the Cochrane Library, were combined with grey literature searches of National Institute for Health and Care Excellence public health guidance. A narrative synthesis and the Effective Public Health Practice Project appraisal tool were used to evaluate the evidence.

A total of 45-articles were included in the review describing AHP-delivered interventions addressing social disadvantage, trauma, bullying, loneliness, work-related stress, transitional stress, intersectionality, pain and bereavement. No articles were identified evaluating interventions delivered by operating department practitioners or orthoptists. A conceptual map was developed summarising the stressors, and a typology of public mental health interventions defined including: place-based interventions, discrete/one-off interventions, multi-component lifestyle and social connector interventions and interventions targeting groups at risk of mental health conditions.

Many mental health conditions begin in childhood, and a strength of the review is the life course perspective. A further strength is compiling a compendium of public mental health outcome measures used by AHPs to inform future research. The authors excluded many articles focussed on clinical interventions/populations, which did not meet review inclusion criteria. While playing a key role in delivering public mental health interventions, clinical psychologists are not defined as AHPs and were excluded from the review, and this may be construed a limitation. Given heterogeneity of study designs and interventions evaluated numerical analyses of pooled findings was not appropriate.

The review highlights the breadth of community stressors on which AHPs can intervene and contribute in public mental health contexts, stressors which correspond to those identified in UK Government guidance as currently important and relevant to address. The findings can inform developing community public mental health pathways that align with the UK National Health Service (NHS) Long Term Plan, on prevention and early intervention to protect community mental health and well-being. Further can inform the NHS strategic direction for AHPs including informing ways of increasing utilisation of core AHP skills to optimise contributions in public mental health agendas.

It is surprising there were not more AHP delivered evaluations of interventions for other stressors important to address in public mental health settings, for example gambling, domestic violence or that used digital technology, and these are areas for future research. Future research should identify the most active/effective dimensions of multi-component interventions which could be informed by frameworks to guide complex intervention development. The relative paucity of research identified, highlights the predominant focus of research to date on interventions for clinical mental health conditions and populations. The lack of preventative approaches is evident, and an important area for future research to align with UK health and social care priorities.

The review highlights AHP-delivered interventions impacting diverse community stressors across the life course. The findings can inform developing public mental health pathways aligned with government health service priorities to protect mental health and well-being, prioritise prevention and early intervention and increase utilisation of AHP skills across public mental health settings.

This paper aims to explore the links between being lonely and isolated, and increased risks of abuse for adults with care and support needs.

Thematic analysis was used to explore features of loneliness and social isolation present in South Yorkshire Safeguarding Adults Reviews (SARs) published since 2014.

Ten out of fifteen SARs indicated there had been issues of loneliness and/or social isolation for the person who was the subject of the SAR.

The limitations of this paper are that it only included SARs from the South Yorkshire area. Future research should explore national and international perspectives on these issues.

Safeguarding Boards should include actions to address loneliness and social isolation as part of prevention strategies and services to develop approaches that can minimise or prevent abuse before it occurs. Practitioners should routinely explore whether the people they work with feel lonely and/or isolated and support people to take appropriate action to mitigate these risks.

This paper uses the existing body of literature about loneliness and social isolation to explore the risks of abuse and neglect for adults with care and support needs.

This chapter provides an overview of the role of technology and policy in shaping care plans for patients. Historically, healthcare has lagged behind other industry sectors in adopting and deploying useful technologies, and policy surrounding use is an important component of establishing a long-term strategy. This chapter evaluates the current state of technology in the clinical setting and extends the widely adopted policy-based approaches into the palliative care context.

This chapter more clearly identifies the distinction between Electronic Health Record (EHR) and Electronic Medical Record (EMR), and states their value in obtaining individual-level data. Synthetic medical records may be used as a surrogate for EHR data in order to ensure digital data privacy is maintained during the development of the LHS. Synthea is an open-source simulation tool available through GitHub.¹ Extensive descriptive analysis of synthesized data is provided as a foundation for the analysis in Chapter 7.

Miscarriage is the most common adverse pregnancy outcome, with an estimated one in four pregnancies ending in loss. Despite its prevalence, and significant effects, early pregnancy loss is commonly unacknowledged by organizations, and the intersect of miscarriage experiences while navigating work remains sparsely researched. Available literature, and preliminary research from my Ph.D., reveal stark findings, notably that women commonly conceal miscarriage at work, and when they do disclose, they often experience inconsistent support, or none at all. Minimization, and even discriminatory practice, are commonly witnessed (including inappropriate absence reporting, formal warnings, jeopardization of promotional opportunities, and redundancy). Effective support is often due to empathetic line managers, who sometimes have first-hand experience. Partners are commonly assigned to the “supporter role”, resulting in insufficient leave and support. The absence of formal initiatives, including policy and training, exacerbate the issue. Workplaces that fail to address miscarriage likely face reduced engagement and productivity, and increased absenteeism, presenteeism, and staff turnover. Key recommendations are presented, emphasizing the need for organizations to (i) implement a pregnancy loss policy; (ii) train managers, HR, and colleagues; (iii) provide specialist support; and (iv) tackle pro-natal cultures. Avenues for future research are explored, notably the need to adopt an intersectional lens, and to obtain management/HR and partner perspectives.