Social Care Professionals Research Articles

Objects of hope: using object elicitation to open up conversations about hope for people affected by rarer forms of dementia

AbstractBackgroundHope is an essential component of the human experience and can play a critical role in sustaining wellbeing and a good quality of life. It can seem somewhat at odds however with the dominant societal discourses around dementia, which, stemming from a biomedical perspective, are often (naturally) focused on deficits and decline. With recent promising developments in the field of therapeutic interventions, it is of timely importance to explore the concept of hope for those affected by rarer forms of dementia, charactersised by atypical symptoms and associated with unique challenges, for whom emerging treatments may be too late. Here, we explored the use of an innovative methodology – object elicitation – to facilitate conversations on this complex and sensitive topic with these underrepresented groups.Method17 people affected by dementia and primary caregivers took part in 3 facilitated discussions using object elicitation to explore the concept of hope within the context of rarer forms of dementia, including: familial Alzheimer’s disease, behavioural variant frontotemporal dementia, and posterior cortical atrophy. Transcripts of the discussions were analysed thematically.ResultFindings were organised into 4 themes: (i) Reframing and reconceptualising hope in the context of dementia; (ii) Temporality: from hopes for the future to finding hope in the moment; (iii) Hope for the individual and hope for the collective; and (iv) The other side of the coin: lost hope, false hope and barriers to hope.ConclusionThe findings of this study shed light on some of the challenges to sustaining hope for people affected by lesser known forms of dementia and importantly, their resilience and resourcefulness in finding ways to continue to cultivate a sense of hope during difficult times within their everyday lives. These findings have implications for others living with these conditions and the unpaid carers and health and social care professionals supporting them, and are of particular relevance in the context of current treatment developments. This study has also demonstrated the utility and accessibility of the object elicitation method for opening up and facilitating conversations about emotionally charged topics for people living with and supporting people with different diagnoses of dementia.

Professionals Evaluating Clients' Suitability for Digital Health and Social Care: Scoping Review of Assessment Instruments.

Increased digital health and social care services are generally considered to improve people's access to services. However, not everyone can equally access and use these resources. Health and social care professionals should assess clients' suitability for digital solutions, but to succeed, they need information about what to evaluate and how. This scoping review aimed to identify evaluation tools that professionals can use when assessing clients' suitability for digital health and social care. We summarized the dimensions and the practical usefulness of the instruments. The MEDLINE (Ovid), CINAHL, Web of Science, and ASSIA databases were searched in February 2023 following the Joanna Briggs Institute's Manual for Evidence Synthesis. Studies were included if they focused on health and social care clients and professionals, examined clients' suitability for using digital health or social care, and applied related assessment methods in the direct client work of professionals. Studies focusing primarily on instruments intended for research use without clear applicability to professionals' practical contexts were excluded. Details of the eligible studies were extracted, and qualitative content analysis according to the research objectives was performed. A total of 19 articles introducing 12 different assessment instruments intended for the health care context were included in the review. No instruments were found for evaluating the suitability for digital social care. The instruments contained 60 dimensions of the client's suitability for digital health, which reflected four perspectives: (1) skill-based suitability, (2) suitability based on general ability to maintain health, (3) suitability based on attitude and experience, and (4) suitability based on practical matters. The described practical usefulness of the instruments included professionals' possibility to (1) identify clients most in need of education and support, (2) direct and recommend the right clients for the right digital services, (3) ensure that clients can use digital health, (4) improve effectiveness and maximize the provision of digital health, (5) develop and redesign services, and (6) empower clients. Based on the diverse assessment instruments available and the dimensions they measure, there seems to be no comprehensive evaluation tool for assessing clients' prerequisites to use digital solutions. It is important to further develop comprehensive screening tools applicable to professionals' busy work (both in health and social care) with defined threshold values for suitability.

The development of an integrated neighborhood approach for health promotion and prevention: a qualitative exploration of stakeholders' views.

Although the promise of integrated neighborhood approaches, including the essential roles of communities and collaboration between the medical and social domains, has been widely acknowledged, the realization of such approaches in practice often remains difficult. To gain insight into the development of integrated neighborhood approaches, this case study describes the experiences of stakeholders involved in such an approach for health promotion and prevention in Rotterdam. Interviews with 18 stakeholders (including health and social care professionals, health insurance employees, and policymakers) were conducted, and stakeholders' statements were analyzed thematically. The results reveal a lack of alignment among the professional, organizational, and system levels. Elements needed for collaboration between health and social care professionals are not supported at the organizational and system levels. The lack of integration at the policy and organizational levels encourages competition and self-interest instead of stimulating collaboration. Intersectoral collaboration and coordination must take place not only between professionals, but also at the organizational and policy levels. As long as integration at the organizational and system levels is lacking, professionals' ability to collaborate and provide coordinated support to neighborhood residents will be compromised.

A Digital Microintervention Supporting Evidence-Based Parenting Skills: Development Study Using the Agile Scrum Methodology.

Conduct disorder increases risks of educational dropout, future mental illness, and incarceration if untreated. First-line treatment of conduct disorder involves evidence-based parenting skills programs. Time-outs, a frequent tool in these programs, can be effective at improving behavior, and recent apps have been developed to aid this process. However, these apps promote the use of time-outs in inconsistent or developmentally inappropriate ways, potentially worsening behavior problems. Digital microinterventions like these apps could guide parents through high-quality time-outs in the moment, but current time-out apps lack features promoting adherence to the evidence-based best practice. Agile scrum is a respected approach in the software development industry. We aimed to explore the feasibility of using the agile scrum approach to build a digital microintervention to help parents deliver an evidence-based time-out. The agile scrum methodology was used. Four sprints were conducted. Figma software was used for app design and wireframing. Insights from 42 expert stakeholders were used during 3 sprint reviews. We consulted experts who were identified from councils around the Midlands region of the United Kingdom and charities through personal contacts and a snowballing approach. Over 4 development sprints from August 2022 to March 2023, the app was iteratively designed and refined based on consultation with a diverse group of 42 experts who shared their knowledge about the content of common parenting programs and the challenges parents commonly face. Modifications made throughout the process resulted in significant app enhancements, including tailored timer algorithms and enhanced readability, as well as an onboarding zone, mindfulness module, and pictorial information to increase inclusivity. By the end of the fourth sprint, the app was deemed ready for home use by stakeholders, demonstrating the effectiveness of our agile scrum development approach. We developed an app to support parents to use the evidence-based time-out technique. We recommend the agile scrum approach to create mobile health apps. Our experience highlights the valuable role that frontline health and social care professionals, particularly those working with vulnerable families, can play as experts in scrum reviews. There is a need for research to both evaluate the impact of digital microinterventions on child behavioral change and also create digital microinterventions that cater to non-English speakers and individuals who participate in parenting programs in settings outside the United Kingdom.

Implementation of Blended Learning in Tertiary Education of Health and Social Care Professionals During Covid-19 Pandemic

Blended learning is a relatively new e-learning method that combines traditional classroom learning with computer-mediated instruction. Its roots can be traced back to the 1840s when Sir Isaac Pitman sent tasks to his students on postcards for evaluation. It represents a new way of teaching, employing modern technologies and the online environment, whilst simultaneously emphasizing the importance of traditional teaching methods and personal contact between students and teachers. Blended learning has proven to be an effective way to combine scheduled and self-paced classwork, ensuring its better accessibility and flexibility. This article discusses the implementation and effectiveness of a blended-learning course designed to train communication skills in students studying healthcare-related programmes at the Faculty of Health and Social Sciences of the University of South Bohemia, Czech Republic. The course uses a combination of face-to-face instruction, individual student work, and multimedia online materials. It is divided into modules specific to the student's field of study, such as nursing, nutritional therapy, and civil protection. Each module includes theoretical and practical sections, and the course covers communication skills with seniors, adults, children, and disabled clients. A questionnaire survey was conducted to assess the effectiveness of the course and student satisfaction in order to obtain feedback for further development and improvement of the course. The data obtained from the survey were analysed using descriptive statistics and the Gini index. The results show that the blended-learning course was effective in training communication skills and reducing the number of failures.

Acceptability, feasibility and perceived effectiveness of online and remote mental health and wellbeing interventions during the COVID-19 pandemic: A qualitative study with care-experienced young people, carers and professionals

The COVID-19 pandemic, and associated lockdowns, saw numerous services move to online and remote delivery. This included mental health and wellbeing interventions for care-experienced young people. To date there has been limited consideration of how different stakeholders experienced the receipt or delivery of remote provision during this period. We conducted online one-to-one and small group interviews with: young people with experience of care (n = 3); a young person whose biological parents were foster carers (n = 1); foster and kinship carers (n = 10); and social care and affiliated professionals (n = 9). We further engaged with relevant stakeholder consultation groups to refine and confirm study findings. Five central themes were generated, that reflected participants’ experience of a range of services, while also serving as recommendations for the future development and optimisation of provision: 1) Awareness: there is a lack of general awareness of mental health provision and understanding of what is available to support care-experienced young people, and a specific lack of knowledge regarding online support; 2) Choice and tailoring: young people need choice and flexibility in identifying provision that best suits their needs, and this includes the decision to receive online, blended or in-person services; 3) Training: carers and professionals need training on how to foster relationships with young people online and how to ensure safety and child protection; 4) Safety, protection and risk: young people need to have safe and private spaces when accessing online services; and 5) Access and resources: care-experienced young people don’t always have access to online support, and need appropriate technological devices that don’t have prohibitive restrictions. Taken together, the study findings offer insight into how interventions and services may be developed and optimised moving forward to ensure that they are meeting the needs of young people in care, and maximize likely effectiveness.

Preconceito contra pessoa idosa LGBTQIA+ em Instituições de Longa Permanência para Idosos (ILPI): uma revisão de escopo

Abstract Among older people, LGBTQIA+ persons represent one of the groups most likely to depend on formal care services because of socio-economic vulnerability. However, the prejudice rooted in society, including health and social care professionals, result in a cis-heteronormative model of care delivery in Long-Term Care Facilities for older persons (LTC). The aim of this article is to investigate, describe and analyse the scientific production on prejudice against the older LGBTQIA+ population in LTC. Scoping review based on searches in the following databases: AgeLine, Portal de Periódicos CAPES, SciELO, Portal USP and HeinOnline. No time limit was set. Of the initial 642 articles, 31 were selected to comprise the sample. Four categories and 11 subcategories were identified. These covered agents, causes, effects, and solutions found in the research. The lack of preparation of the LTC staff and the history of prejudice during life leads the LGBTQIA+ community to fear institutionalisation, when the desire is to have a friendly or exclusive environment. Training of LTC staff is essential, in addition to the need to create legislation to protect this population based on local surveys.

Promoting sexual health in older adults: Findings from two rapid reviews.

Sexual health throughout the life course is increasingly recognised as important to maintaining one's overall health, wellbeing, and relationships. We aimed to provide an overview of the evidence on sexual health needs and sexual health promotion in later life. We undertook two rapid reviews, drawing on systematic review evidence. Searches were conducted in Epistemonikos. Studies were eligible if they reported evidence about the sexual health needs of, or sexual health promotion interventions for, people aged 50+ years. Evidence was quality assessed and summarised in a narrative synthesis. Fifteen systematic reviews were included in Review 1 (sexual health needs) and 12 in Review 2 (interventions). Key concerns and needs of older adults included the impacts of cultural stigma/misperceptions, barriers to sexual expression, and a need for tailored support in a welcoming environment. Key concerns and needs of health and social care professionals included mixed attitudes towards and knowledge of later-life sexuality and a need for more training and education. Approaches to promoting sexual health in later life included training and workshops for care home professionals, education for older people at risk of/living with HIV, and interventions to address sexual health-related symptoms of menopause. Gaps in the evidence from current reviews and methodological issues in primary studies were identified. Older people have specific needs relating to their sexual health. Health and social care professionals working with older people may benefit from education/training around sexuality in later life. Evidence on effective interventions and strategies is limited.

Experiences of health and social professionals using care technologies with older adults during the COVID-19 pandemic: A qualitative study.

To investigate the perceptions and experiences of health and social care professionals concerning the use of technology for the care of older adults during the COVID-19 pandemic. A phenomenological qualitative, exploratory, and descriptive design using semi-structured interviews. Twenty Spanish health and social care workers in six Spanish cities between February and July 2021, during the COVID-19 pandemic. During the COVID-19 pandemic care workers have become more familiar with technology devices, but they also recognize certain barriers for the implementation of technology, mainly in nursing homes and homecare, related to concerns of lack of humanization and difficulties in accessing and using these devices. Politicians and social and healthcare managers should be aware of the benefits of techno-care, reducing the difficulties in implementing it and making more funding and further training available to care providers.

Mental health and wellbeing interventions for care-experienced children and young people: Systematic review and synthesis of process evaluations

BackgroundThe mental health and well-being of care-experienced children and young people remains a concern. Despite a range of interventions, the existing evidence base is limited in scope, with a reliance on standalone outcome evaluations which limits understanding of how contextual factors influence implementation and acceptability. The Care-experienced cHildren and young people’s Interventions to improve Mental health and wEll-being outcomes Systematic review (CHIMES) aimed to synthesise evidence of intervention theory, outcome, process and economic effectiveness. This paper reports the process evaluation synthesis, exploring how system factors facilitate and inhibit implementation and acceptability of mental health and wellbeing interventions for care-experienced children and young people. MethodsSixteen databases and 22 websites were searched between 2020 and 2022 for studies published from 1990 and May 2022. This was supplemented with contacting experts in the field, citation tracking, screening of relevant systematic reviews and stakeholder consultations. We drew on framework synthesis of qualitative data and incorporated a systems lens, taking account of contextual influences across socio-ecological domains. Quality appraisal assessed reliability and usefulness. Confidence in synthesised findings was assessed with the GRADE-CERQual tool. We report the review in accordance with relevant elements of both the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) checklist. ResultsSearches retrieved 15,068 unique study reports, and 23 of these were eligible for process evaluation synthesis, reporting on sixteen interventions. Studies were published between 2003 and 2021. Nine interventions were from the UK and Ireland, six interventions were from the USA, and one was from Australia. They were largely classified as interpersonal, where the aim was to modify carer-child relationships. Five key context factors were identified that supported and prohibited intervention delivery: (1) lack of system resources; (2) intervention burden, which encompasses the time, cognitive, and emotional burden associated with implementation and participation; (3) interprofessional relationships between health and social care professionals; (4) care-experienced young people’s identity; and (5) carer identity. ConclusionWe identified several supportive and restrictive factors across social and health care systems that may impact intervention implementation and acceptability. Key implications include: the importance of involving diverse stakeholders in intervention development and delivery; the need to better resource and support those involved in interventions, particularly training and support for carers; and ensuring future evaluations integrate process evaluations in order to optimise interventions.

Skills4 Health Literacy– Nordic project promoting capacity building on health literacy and dementia

Abstract Background An increasing proportion of the population is living with dementia and need health- and social care. People with limited health literacy have difficulties with accessing, understanding, appraising, and applying health information to promote and maintain health. Knowledge about how to promote health literacy is limited among health- and social care providers although such knowledge is important to be able to work person-centered and to reduce the risk of unequitable health and health care. As a response to this, the Erasmus+ project Skills 4 Health Literacy is conducted in the period 2022-2025. The project's overall aim is to meet the needs of higher education institutions in training future and current health and social care professionals, through digital education technologies, to promote health literacy capacity-building when supporting persons at risk of dementia to deliver relevant and personalized interventions. Methods A review of research, policies, and curriculums, and four focus group discussions and 14 individual interviews with experts from with a wide range of social and health care sites in Denmark, Finland, Norway, and Sweden. Results We developed a competence profile for health- and social care workers highlighting which knowledge, skills, and abilities they need to promote and take health literacy into account when working with people at risk of dementia and relatives to those. Thereafter, we developed, and pilot tested health literacy courses (1 classroom-based, 1 traditional online and 1 MOOC) based on this competence profile, in three of the Nordic countries. Conclusions There is a need for health literacy training among health- and social care workers in the Nordic countries. This project suggests a consensus-build competency profile to further develop the capacity building within health and social care and dementia with regards to health literacy training. Key messages • Health- and social care workers in the Nordics who meet elderly need training in health literacy. • A competence profile and health literacy courses have been developed to meet those needs.

Sustaining treatment of vulnerable people: assessing needs for integrated care in mental health

Abstract Background About half the population in Denmark will experience mental health challenges during their lives. Among them a group of vulnerable people often experiences higher unmet needs and lack of coherence between sectors. They therefore require cross-sectoral initiatives. The Flexible Assertive Community Treatment (FACT) model offers integrated healthcare access to people with severe mental illness, through interprofessional teams across health and social services. The model is implemented in Central Denmark Region between the specialist (regional) and the (municipal) community mental health services. This study aimed to explore the pathways through the healthcare system of citizens with severe mental illness, and to analyze the abilities of provider organizations to meet the needs of the target group. Methods The study draws on interviews and observations with participants of FACT that suffer from severe mental illness, interviews with the health and social care professionals involved, and observations of interactions between the two groups of informants. Results The participants of FACT experienced smoother pathways between the regional and municipal sectors and more integrated access to services, as they had only one gateway instead of several. They further experienced closer relations with and between the professionals in the FACT teams (e.g., psychiatrists, community and social workers, nurses). These professionals to a larger extent understood and pursued the participants’ individual needs. This created for example higher levels of trust and contributed to the sustainment of the participants in treatment. Conclusions People with severe mental illness struggle to cope with many different aspects of life, including navigating the health system and sustaining treatment. To retain this vulnerable group in treatment it is key that health systems provide continuous and integrated treatment that meets individual needs. Key messages • The current study finds that FACT provides valuable tools to offer integrated and person-centered care for people suffering from severe mental illness. • The current study finds that FACT provides valuable tools to offer integrated and person-centered care for people suffering from severe mental illness.

Perceived Roles and Barriers in Delivering Community-Based Care: A Qualitative Study of Health and Social Care Professionals.

As healthcare systems increasingly embrace population health management, the integration of health and social care to improve the health and well-being of individuals is crucial. Thus, we conducted a qualitative study in Singapore to understand health and social care professionals' (HCPs and SCPs) perception of the roles they played in delivering community-based care. A descriptive phenomenological research design was adopted. HCPs and SCPs (n = 53) providing services in community settings were recruited purposefully and interviewed through eleven focus group discussions. Each session was recorded and transcribed. Thematic analysis was applied. Our results revealed eight themes in three main categories describing the roles played by HCPs and SCPs, including: (1) delivering needs-based care in community settings; (2) activating and empowering clients in health care, and (3) fostering community-based sustainable support networks. Six barriers encountered while performing these roles were also identified. Our results highlight that the roles of HCPs and SCPs go beyond the provision of direct medical and social care. They were involved in activating and empowering clients to take care of their health, and importantly, fostering community-based sustainable support networks to better empower individuals in coping with health challenges. The identified barriers shed light on areas for potential improvements for integrated community care.

Communication partner training for student health and social care professionals engaging with people with stroke acquired communication difficulties: A protocol for a realist review.

Stroke acquired communication impairments impede effective communication. Consequently, in stroke care, communicative interactions can be challenging for both patients and staff and can predispose patients to increased risk of preventable adverse events. Communication partner training (CPT) can mitigate such negative outcomes by optimising communicative interactions. Providing CPT to student health and social care professionals (SH&SCPs) has the potential to enhance their clinical expertise and experiences and enhance the future clinical care of patients with stroke acquired communication impairments. This research aims to expand our understanding of how CPT is operationalised for SH&SCPs in higher education institutions and determine: what works; for whom; in what contexts; how and why? This review is Phase 1 of a research project employing a realist approach with public and patient involvement (PPI). It incorporates five iterative steps: 1.) Clarifying the scope; 2.) Searching for evidence; 3.) Selecting and appraising evidence; 4.) Data extraction; 5.) Synthesising data and developing a middle range theory explaining how CPT is expected to work for SH&SCPs. An advisory panel, including PPI advisors, content advisors, student advisors, realist advisors and educationalist advisor has been set up to consult throughout the review and collaboratively agree the middle range theory. While there is an evolving evidence base for CPT, including stroke specific CPT for SH&SCPs, it is acknowledged that there are challenges to its implementation in complex real-world settings. In combining empirical evidence with theoretical understanding, realist review permits synthesis of data from diverse sources and goes beyond determining efficacy to explore generative causation and solutions for real world practice. A middle range realist programme theory that coherently explains how CPT is expected to work when teaching SH&SCPs to communicate with people with stroke acquired communication impairments will provide educators with new insights into CPT development and implementation in their higher education institutions.

Barriers and facilitators to palliative care for patients with non-curable cancer in Colombia: perspectives of allied health and social care professionals

BackgroundPalliative care aims to improve the quality of life of people with life-limiting illness and their families by addressing physical, psychological, social and spiritual suffering. Allied Health and Social Care Professionals (AHSCP) are key to delivering comprehensive, high quality palliative care. In recent years, Colombia has developed changes in the legal, and regulatory framework for access to palliative care but barriers and facilitators to palliative care for patients with non-curable cancer have not been explored from the perspective of AHSCP.MethodThis study aims to address this knowledge gap in two cities in Colombia: one in a medium-sized city in a rural area (Popayan) and one in a highly urbanized area (Bogota). Two focus groups with AHSCP were conducted using the World Cafe method, and a subsequent thematic analysis was performed to establish the main barriers and facilitators.ResultsA wide range of 18 AHSCPs attended the two World Cafe groups in Popayan and Bogota. As a result of this iterative process, we established five thematic areas: (i) Humanizing care, (ii) Normalizing palliative care: referral at the time of diagnosis, (iii) Misunderstandings related to palliative care, (iv) Barriers within the health system, and (v) Geographic barriers.ConclusionThis study provided the perspectives of AHSCPs in Colombia in relation to barriers and facilitators in the framework of comprehensive palliative care attention. Participants identified misconceptions about palliative care, which are explained by the lack of inclusion of this area in the educational programs of health professionals and AHSCPs, along with the limited supply and access to palliative care, especially in rural areas.

Barriers and facilitators to health care access for people experiencing homelessness in four European countries: an exploratory qualitative study

BackgroundPeople experiencing homelessness (PEH) are known to be at higher risk of adverse health outcomes and premature mortality when compared to the housed population and often face significant barriers when attempting to access health services. This study aimed to better understand the specific health care needs of PEH and the barriers and facilitators associated with their timely and equitable access to health services in the European context.MethodsWe conducted an exploratory cross-national qualitative study involving people with lived experience of homelessness and health and social care professionals in Austria, Greece, Spain, and the UK. A total of 69 semi-structured interviews comprising 15 social care professionals, 19 health care professionals, and 35 PEH were completed, transcribed, and analysed thematically.ResultsFindings were organised into three overarching themes relating to the research question: (a) Health care needs of PEH, (b) Barriers to health care access, and (c) Facilitators to health care access. Overall, the general health of PEH was depicted as extremely poor, and mainstream health services were portrayed as ill-equipped to respond to the needs of this population. Adopting tailored approaches to care, especially involving trusted professionals in the delivery of care, was identified as a key strategy for overcoming existing barriers.ConclusionsThe results of this study indicate there to be a high degree of consistency in the health care needs of PEH and the barriers and facilitators associated with their access to health care across the various European settings. Homelessness in itself is recognized to represent an essential social determinant of health, with PEH at risk of unequal access to health services. Changes are thus required to facilitate PEH’s access to mainstream primary care. This can also be further complemented by investment in ‘in-reach’ services and other tailored and person-centred forms of health care.Trial registrationThis study was registered retrospectively on June 6, 2022, in the registry of ClinicalTrials.gov under the number NCT05406687.

CN_LBA3 Providing support for families when an adult with dependent children is at end-of-life with cancer: A systematic review of educational interventions for health and social care professionals

CN_LBA3 Providing support for families when an adult with dependent children is at end-of-life with cancer: A systematic review of educational interventions for health and social care professionals

Identifying, synthesising and appraising existing evidence relating to myalgic encephalomyelitis/chronic fatigue syndrome and pregnancy: a mixed-methods systematic review

ObjectivesTo identify, synthesise and appraise evidence relating to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and pregnancy.DesignMixed-methods systematic review, using convergent segregated design.Data sourcesMEDLINE, EMBASE, Scopus, PsycINFO, CINAHL, MedRxiv, PROSPERO and grey...

'I probably wouldn't want to talk about anything too personal': A qualitative exploration of how issues of privacy, confidentiality and surveillance in the home impact on access and engagement with online services and spaces for care-experienced young people.

This paper draws on a qualitative interview-based study that explored online mental health and wellbeing interventions and services for care-experienced young people. The study involved young people (n = 4), foster carers (n = 8), kinship carers (n = 2) and social care professionals (n = 9) in Wales, UK. The paper reflects on the complexities of online communication in the space of 'the home'. It documents the ways in which care-experienced young people's living arrangements can restrict access to services and complicate confidentiality within portals to the virtual world, creating an environment where young people and their carers 'wouldn't want to talk about anything too personal'. Drawing on data generated in a study focused on services and interventions to support the mental health and wellbeing of care-experienced children and young people, the paper considers privacy, confidentiality and surveillance in the home and reflects on how associated relational practices impact on care-experienced young people. While the data discussed in this paper was generated during the Covid-19 pandemic, its findings have implications for how care-experienced young people and their carers can be supported to engage with the digital world in the future.

Pilot study: design, delivery and evaluation of a co-produced multi-agency mental health simulation-based education programme

Research shows inequity of access and provision of Simulation-Based Education (SBE) globally, perhaps especially for Simulation for Mental Health (S4MH). Integrated approaches to education improve outcomes, despite this, there is a lack of multi-agency education and service user/carer involvement. This innovative work involves service users and carers in the design, delivery and evaluation of an experiential, mental health, SBE programme for health and social care professionals, and multi-agencies. Highlighting important areas of inclusivity, equality and diversity provides valuable insight into the unique patient perspective and experience of their interactions with services and professionals, and knowledge, perspective, and role of the practitioner, considering the transition of the service user between services. In a mixed approach, data was collected between November 2021 and March 2022 by pre- and post-participation survey of participants’ thoughts, beliefs, attitudes, behaviours and experiences of the programme. A thematic method was used for qualitative data analysis. Completed survey response rate = 64%. Analyses constructed themes around safety, responsiveness, empathy, stigma and experience. Findings show increased confidence and understanding of roles following participation in the programme. Positive changes in empathy and respondents’ perspectives and behaviours were also reported. Findings inform better integrated, co-ordinated systems and practices, demonstrating mutual benefits of service user and carer involvement, and value of multi-agency learning; increased knowledge, safety, empathy, mutual appreciation of roles and recognition in the value of lived experience integrated into learning. Implications for practice and mental health care are relevant to multi-agency professionals, service providers, service users, carers and families. Simulation, Hybrid, Mental Health, Co-Production, Multi-Agency, Psychosis, Depression, Personality Disorder