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The purpose of this paper is to present insights into the way in which system change can be activated around the provision of services and support for people experiencing multiple disadvantages in an urban setting.

This paper is informed by a thematic analysis of reflections, reports, learning logs, interviews and experiences of those “activating” system change in the Golden Key partnership in Bristol between 2014 and 2021.

Four themes are identified, including “creating the conditions for change”, “framing your involvement”, “investing in relationships” and “reflective practice and learning”. For each of these, an illustrative vignette is provided.

Practical recommendations and reflective questions are provided with suggestions of further considerations for applying this approach in different contexts.

This paper describes an original approach of activating and supporting people to do system change to improve the lives of people facing multiple disadvantages.

The purpose of this paper is to present a case study tracking the development and engagement of a group of experts by experience (The Independent Futures (IF) Group) who provided a lived experience voice to the Bristol Golden Key (GK) partnership within the Fulfilling Lives programme. The case study reports the genesis and impact of the group, as well as the facilitators of impact and experiences of the group members and those they worked in partnership with.

The research adopted an iterative approach drawing on multiple data sources over an eight-year period. An inductive ethnographic analysis of stakeholder and partnership meetings was combined with documentary analysis and thematic analysis of interviews with experts by experience and service providers.

The voice of lived experience provided by the IF group contributed to the GK partnership through various channels. Evidence of this contribution and its impact was found at programme, city-wide and national levels of the service ecosystem. Furthermore, IF members recognised the value of the group in contributing to systems change and service improvement, but also for themselves.

This case study serves to illustrate the impact of the lived experience voice on services and systems change, specifically the provision of that voice from a formalised advisory group. The successes and challenges of the group and the experiences of its members are reported with a view to sharing learning that may influence future co-production initiatives with experts by experience and service provision for those experiencing multiple disadvantage.

The insights provided by the longitudinal observation of the group as it was formed and evolved, coupled with insights provided by the experts by experience, have important implications for facilitating and supporting sustainable lived experience input.

This study aims to examine the emotional and cognitive responses of frontline homelessness service support staff to the highly insecure attachment styles (AS) exhibited by people experiencing multiple exclusion homelessness (MEH), that is, a combination of homelessness and other forms of deep social exclusion.

Focus groups were conducted with frontline staff (N = 19) in four homelessness support services in Scotland. Hypothetical case vignettes depicting four insecure AS (enmeshed, fearful, withdrawn and angry-dismissive) were used to facilitate discussions. Data is analysed thematically.

Service users with AS characterised by high anxiety (enmeshed or fearful) often evoked feelings of compassion in staff. Their openness to accepting help led to more effective interactions between staff and service users. However, the high ambivalence and at times overdependence associated with these AS placed staff at risk of study-related stress and exhaustion. Avoidant service users (withdrawn or angry-dismissive) evoked feelings of frustration in staff. Their high need for self-reliance and defensive attitudes were experienced as hostile and dismissing. This often led to job dissatisfaction and acted as a barrier to staff engagement, leaving this group more likely to “fall through the net” of support.

Existing literature describes challenges that support staff encounter when attempting to engage with people experiencing MEH, but provides little insight into the causes or consequences of “difficult” interactions. This study suggests that an attachment-informed approach to care can promote more constructive engagement between staff and service users in the homelessness sector.

This study aims to explore the experiences of living through the COVID-19 pandemic for people who faced homelessness and dealt with mental health and/or substance use challenges.

This qualitative study was comprised of 26 1:1 interviews (16 men and 10 women), conducted between February and May 2021 with people who experienced homelessness in North East England during the COVID-19 pandemic. An inductive reflexive thematic analysis was undertaken, with input from individuals with lived experience who were involved throughout the study.

Four themes were developed. The first theme, lack of support and exacerbation of mental health and substance use difficulties, highlighted how the lack of in-person support and increased isolation and loneliness led to relapses or new challenges for many people’s mental health and substance use. The second theme, uncertainty and fear during the pandemic, explored how the “surreal” experience of the pandemic led to many people feeling uncertain about the future and when things would return to normal. The third theme, isolation and impacts on social networks, discussed how isolation and changes to relationships also played a role in mental health and substance use. Finally, opportunity for reflection and self-improvement for mental health and substance use, explored how some people used the isolated time to re-evaluate their recovery journey and focus on self-improvement.

The experiences shared within this study have important implications for planning the future delivery and commissioning of health and social care services for people facing homelessness, such as sharing information accessibly through clear, consistent and simple language.

As one of the few papers to involve people with lived experience as part of the research, the findings reflect the unique narratives of this population with a focus on improving services.

Privilege is often silent, invisible and not made explicit, and silence is a key question for theorizing on organizations. This paper examines interrelations between privilege and silence for relatively privileged professionals in high-intensity knowledge businesses (KIBs).

This paper draws on 112 interviews in two rounds of interviews using the collaborative interactive action research method. The analysis focuses on processes of recruitment, careers and negotiation of boundaries between work and nonwork in these KIBs. The authors study how relative privilege within social inequalities connects with silences in multiple ways, and how the invisibility of privilege operates at different levels: individual identities and interpersonal actions of privilege (micro), as organizational level phenomena (meso) or as societally constructed (macro).

At each level, privilege is reproduced in part through silence. The authors also examine how processes connecting silence, privilege and social inequalities operate differently in relation to both disadvantage and the disadvantaged, and privilege and the privileged.

This study is relevant for organization studies, especially in the kinds of “multi-privileged” contexts where inequalities, disadvantages and subordination may remain hidden and silenced, and, thus, are continuously reproduced.

This study aims to explore the effect of mental health in terms of depression, anxiety, stress, fear of COVID-19 and quality of life (QoL) on the reluctance to be vaccinated in a population of Palestinian adults living in occupied Palestinian territories and Israel.

The authors recruited 1,122 Palestinian adults who consented to participate in the study; 722 were females, and the mean age of the sample was 40.83 (SD 8.8). Depression, anxiety, and stress scale (DASS), World Health Organization QoL-BREF, FCov-19 and reluctance to the vaccine scale were administered; hierarchical regression analysis was applied to test vaccine reluctance as a dependent variable, and mental health, fear of COVID-19 and QoL as independent variables. This study hypothesized influence of such variables on the vaccine choice with differences due to the participants’ geographical locations.

Findings showed an effect of mental health, particularly depression, QoL and fear of COVID on vaccine reluctance, with depression and fear of COVID in the West Bank and Gaza, while in Israel, QoL played a role in vaccination choices.

The future needs to be comprehended more thoroughly to discover mutations and fluctuations over time in vaccine hesitancy and the increasing role of psychological distress, diminished QoL and fear of Covid-19. Online recruitment might not have allowed the study to include the most disadvantaged strips of the Palestinian population.

Human rights perspectives must be considered in public health and public mental health policies to ensure the QoL and well-being for the Palestinian population during and following the pandemic.

The crumbling of the Palestinian health-care system exacerbated the sense of dread among the population and made them less likely to vaccinate. The pandemic-like spread of Covid-19 prompts a plea for the global community to actively advocate for the urgent re-establishment of equity, autonomy and durability of the medical infrastructure in the occupied territories and equal entitlements for the Palestinians in Israel.

The results demonstrated the importance for public mental health to consider the multiple levels implied in the vaccine refusal in Palestine and Israel among the Palestinian population.

The purpose of this paper is to consider the social turn in contemporary capitalism and contemporary art through the lens of art-based social enterprises (ASEs) that aim to create positive social benefits for young people experiencing forms of marginalisation, and which trade creative products or services to help fulfil that mission. A growth in ASEs demonstrates a growing interest in how the arts can support social and economic development, and the ways new economic models can generate employment for individuals excluded from the labour market; extend opportunities for more people to participate in art markets; and challenge dominant market models of cultural production and consumption.

This paper considers a number of challenges and complexities faced by ASEs that embrace a co-dependence of three goals, which are often in tension and competition – artistic practice, social purpose and economic activity. It does so by analysing interviews from staff working with 12 ASE organisation’s across Australia.

While the external forces that shape ASEs – including government policy, markets, investors and philanthropy – are interested in the “self-sufficient” economic potential of ASEs, those working in ASEs tend to prioritise social values and ethical business over large financial returns and are often ambivalent about their roles as entrepreneurs. This ambivalence is symptomatic of a position that is simultaneously critical and affirmative, of the conditions of contemporary capitalism and neoliberalism.

This paper addresses a gap in social enterprise literature presenting empirical research focussing on the lived experience of those managing and leading ASEs in Australia.