Background: Establishing and maintaining relationships and ways of connecting and being with others is an important component of health and wellbeing. Harnessing the relational within caring, supportive, educational, or carceral settings as a systems response has been referred to as relational practice. Practitioners, people with lived experience, academics and policy makers, do not yet share a well-defined common understanding of relational practice. Consequently, there is potential for interdisciplinary and interagency miscommunication, as well as the risk of policy and practice being increasingly disconnected. Comprehensive reviews are needed to support the development of a coherent shared understanding of relational practice. Method: This study uses a scoping review design providing a scope and synthesis of extant literature relating to relational practice focussing on organisational and systemic practice. The review aimed to map how relational practice is used, defined and understood across health, criminal justice, education and social work, noting any impacts and benefits reported. Searches were conducted on 8 bibliographic databases on 27 October 2021. English language articles were included that involve/discuss practice and/or intervention/s that prioritise interpersonal relationships in service provision, in both external (organisational contexts) and internal (how this is received by workers and service users) aspects. Results: A total of 8010 relevant articles were identified, of which 158 met the eligibility criteria and were included in the synthesis. Most were opinion-based or theoretical argument papers (n = 61, 38.60%), with 6 (3.80%) critical or narrative reviews. A further 27 (17.09%) were categorised as case studies, focussing on explaining relational practice being used in an organisation or a specific intervention and its components, rather than conducting an evaluation or examination of the effectiveness of the service, with only 11 including any empirical data. Of the included empirical studies, 45 were qualitative, 6 were quantitative, and 9 mixed methods studies. There were differences in the use of terminology and definitions of relational practice within and across sectors. Conclusion: Although there may be implicit knowledge of what relational practice is the research field lacks coherent and comprehensive models. Despite definitional ambiguities, a number of benefits are attributed to relational practices. Systematic review registration: PROSPERO CRD42021295958

The aim of this study was to examine patterns of social media use across age groups in four countries (Norway, USA, UK, and Australia) two years after the COVID-19 pandemic outbreak, and whether types of use and time spent using social media was related to health worries. A cross-sectional online survey was completed by 1578 adult participants. The data were analysed with one-way analyses of variance and a linear regression analysis. Younger people spent more time on and were more likely to be passive users of social media than older people. Motives for social media use, and perceived effects of using social media, varied by participants’ age. Passive social media use and more time spent using social media were related to higher levels of health worries. Thus, an age perspective is relevant for understanding patterns of social media use, and different types of social media use appear to be differently related to health worries.

We aimed to gain knowledge of possible sociodemographic predictors of long COVID and whether long COVID was associated with health outcomes almost two years after the pandemic outbreak. There were 1649 adults who participated in the study by completing a cross-sectional online survey disseminated openly in Norway, the UK, the USA, and Australia between November 2021 and January 2022. Participants were defined as having long COVID based on self-reports that they had been infected by COVID-19 and were experiencing long-lasting COVID symptoms. Logistic regression analyses were used to examine possible sociodemographic predictors, and multivariate analysis of variance was used to examine whether long COVID status was associated with health outcomes. None of the sociodemographic variables was significantly associated with reporting long COVID. Having long COVID was associated with higher levels of psychological distress, fatigue, and perceived stress. The effect of long COVID on health outcomes was greater among men than among women. In conclusion, long COVID appeared across sociodemographic groups. People with long COVID reported worsened health outcomes compared to those who had had COVID-19 but without long-term symptoms. Men experiencing long COVID appear to be particularly vulnerable to experiencing poorer health outcomes; health services may pay extra attention to potentially unnoticed needs for support among men experiencing long COVID.

Purpose: – An innovative training initiative to raise the awareness of personality disorder and enable more effective working with people with personality disorder who come into contact with the wider multi-agency system has been developed. For the purpose of the training initiative the nationally recognised Knowledge and Understanding Framework (KUF, awareness-level programme) has been employed. An overview of the comprehensive multi-agency training initiative will be outlined with reporting and discussion of the outcome data provided within this paper. The paper aims to discuss these issues. Design/methodology/approach: – This paper outlines the development and outcomes of a service evaluation study. The utilised outcome measures were carried out at pre-, post- and three-month follow-up measures. The Personality Disorder-Knowledge Attitude and Skills Questionnaire was utilised on the recommendation of the central team. Additionally a Visual Analogue Scale was developed for the purpose of this study was also employed. Findings: – Data findings are positive particularly when comparing pre- and post-results and the pre- and follow-up results. There appears to be an apparent peak in results post-training which could be attributed to the fact that knowledge and understanding is recent and fresh in the delegates mind, however positive results are still reported at follow-up there does appear to be decline in results and durability of the effect when three-month follow-up is compared against the post-training results. Research limitations/implications: – Follow-up was at three months, which is a relatively short-time span post-training it would be of great interest to see in the future if the decline in the three areas continues. If this was followed up and if this pattern continued this could provide us with evidence to support the development of refresher courses. In the future, due to the multi-agency design of this service evaluation, comparisons of the different sectors, agencies and occupations involved, could also be explored further to establish what multi-agency areas the training has had the most effect and impact. Practical implications: – High levels of demand from multi-agencies to receive training in personality disorder is reported. Our findings and experience provide evidence that multi-agencies partners from a variety of professional backgrounds can effectively work in partnership with people with lived experience to effectively deliver the KUF training. Social implications: – This innovative roll-out of KUF training provides evidence that with a little investment, a comprehensive multi-agency roll-out of KUF is achievable and can provide statistically significant positive results displaying the effectiveness and change brought about via the KUF training. Originality/value: – The originality of this sustainable and low-cost approach to educating the wider system is reported in this paper. This has lead to the strategy receiving national recognition winning a nursing times award in 2011 and a model of innovative practice nationally.

Purpose: Personality disorder is reported to elicit strong emotional responses and negative attitudes in mental health staff (Bodner et al., 2015). The purpose of this paper is to provide an overview of the design and development of a co-produced e-learning training package for personality disorder awareness and an evaluation of its effectiveness. This study was carried out to explore if e-learning is an effective mode of training delivery for raising personality disorder awareness. Design/methodology/approach: The e-learning was uniquely developed by subject matter experts working in co-production with people with lived experience. Self-reported measures were completed at three separate intervals to evaluate the effectiveness of the training: at pre-, post- and three-month follow up. Quantitative data were collected via these questionnaires. Findings: The results from this evaluation show that e-learning is an effective mode of delivery for raising the awareness of personality disorder among mental health professionals, achieving similar outcomes to those reported following face-to-ace training. Research limitations/implications: Attrition at follow-up phase was high which was consistent with other similar studies. The evaluation was led by the lead contributors and in the geographical area of its development. The study was relatively small and the participants were self-selected, therefore findings should be treated with caution. Practical implications: E-learning can provide flexible training to compliment and act as an alternative to face-to-face personality disorder training. E-learning may provide an alternative refresher course to knowledge and understanding framework or other face-to-face methods. Co-produced training can be mirrored within an e-learning programme, careful planning to ensure the service user voice is heard and that their lived experience is embraced is required. Originality/value: This is the first evaluation of a co-produced e-learning only personality disorder awareness training. It is also the first paper to carry out a review of the published evaluations of personality awareness training in the UK with comparisons explored across the studies.

Purpose: Carers of people with mental health problems present with high levels of burden, poor mental well-being and feelings of disempowerment by mental health services. The purpose of this paper is to establish whether providing a psychoeducation skill programme for carers would lead to an improvement of mental well-being, reduce the levels of burden that carers sometimes feel while caring for someone with mental illness and also to increase empowerment. This paper provides a service evaluation study of an innovative carer-led psychoeducational intervention that was undertaken. Design/methodology/approach: This programme was initiated and led by a carer who had experienced a lack of service provision to support carers and families in understanding and caring for a relative with severe and enduring mental health diagnoses. A model of co-production was adopted with the carer who led this initiative working closely with an occupational therapist and consultant psychologist in its development and delivery. Data were collected to measure the impact of the training at five different time points. The measures employed to measure outcomes were the Warwick-Edinburgh Mental Well-being Scale, the Burden Assessment Scale and Family Empowerment Scale. Findings: Results indicated improved well-being, reduced burden and increased family empowerment in carers who completed this peer-led carer initiative psychoeducational programme. Research limitations/implications: This service evaluation study was conducted in a single site and in the site in which it was developed. The carer consultant who led this evaluation and development of the intervention was also the peer worker who delivered the interventions. Hence, the authors are unable to ascertain if the results reported are unique to the individual peer worker. The transferability of this programme and generalisability of the result should therefore be treated with caution and further replication of this model and research is required. This would be beneficial to be conducted in an alternative site from where it was developed, delivered by different facilitators and include a control group. Practical implications: The evidence from this study indicates that carers are able and willing to attend a group psychoeducational programme. A high number of referrals to the programme in a relatively short timeframe indicates that there is significant demand for such a service. The implementation of the programme is relatively straightforward. The key challenges for practical implementation are to have the right carer to lead and deliver the programme and the right support system in place for them (financial and supervision). Co-production also is not without challenges, the peer worker and occupational staff need to ensure that mutually valued and respected working relationship should develop. Originality/value: This is the first evaluation of the impact of a carer-led psychoeducation intervention for carers of people with mental health difficulties in secondary mental health services.