John Goodwin

Background: First responders are categorised as those who are the first to respond to emergency calls and attend the site of an emergency. They include, but are not limited to police, emergency medical technicians, firefighters, and water safety personnel. First responders play a critical role in suicide postvention, supporting those bereaved by suicide and preventing adverse outcomes. However, many responders feel uncertain about how to effectively support those bereaved by suicide and often lack formal postvention training. This study aimed to explore and understand the experiences and training needs of first responders when attending the scene of a suspected suicide. Methods: A mixed-method approach was adopted. A national quantitative survey with first responders was conducted. The impact of previous suicide-related training on suicide literacy, attitudes, and postvention knowledge was analysed using multivariate ANOVA, adjusting for sociodemographic factors. Qualitative data were collected through focus groups and analysed using reflexive thematic analysis. Results: A total of 1587 first responders completed surveys. Participants demonstrated positive and non-stigmatising attitudes towards suicide prevention and suicidal individuals, though lower scores were achieved for suicide literacy, postvention knowledge, organisation support, and preparedness. Previous suicide-related training was significantly associated with higher literacy, attitudes, and postvention knowledge, although effect-sizes were small. Qualitative findings from 10 focus groups revealed substantial gaps in training and confidence when responding to suspected suicides. Participants also described the considerable emotional toll of attending the scene and emphasised the need for support in the aftermath. Conclusion: Attending the scene of a suspected suicide has an impact on first responders. Limited suicide prevention and postvention training creates challenges, particularly in communicating with the bereaved. These findings underscore the need for comprehensive suicide prevention and postvention training and the allocation of adequate support.

Background: Trauma-informed care (TIC) is a framework that embeds safety, trust, choice, collaboration, and empowerment into practice. Although training improves TIC attitudes, implementation in European residential child and adolescent settings remains inconsistent, and immersive technologies such as virtual reality (VR) are underevaluated for this purpose. Objective: This study aims to evaluate whether a VR-enhanced training program improves TIC attitudes among staff and trainees in residential child and adolescent care across European sites and to examine site-level heterogeneity. Methods: We conducted a multisite pre-post evaluation within the European Union–co-funded Safe4Child project. Participants completed a standardized online TIC module followed by a mentor-facilitated VR simulation. Attitudes were measured using the ARTIC-10 (10-item version of the Attitudes Related to Trauma-Informed Care; 7-point) scale immediately before the online module and immediately after the VR simulation; the design, therefore, evaluates the combined program rather than VR in isolation. Analyses included Wilcoxon signed-rank tests, multivariable regression, and Bayesian models with skeptical priors. Results: Among 79 matched participants from Bulgaria, Finland, and Germany, mean (SD) ARTIC-10 scores increased from 5.33 (1.05) to 5.57 (1.20; P <.001; Cohen d =0.22). Effects varied by site. Germany showed significant improvement (Cohen d =0.56), whereas Bulgaria and Finland did not reach significance. Bayesian estimation yielded a mean change of 0.24 points (95% CI 0.11‐0.37) with P ( Δ >0) ≈ 1.00. Prior trauma-related training showed a probable but uncertain additional benefit. Conclusions: The VR-enhanced TIC program produced a small overall improvement in attitudes, with a moderate effect in Germany, suggesting that immersive training can strengthen TIC learning when aligned with local contexts. The absence of a control group precludes attributing effects specifically to VR. Larger comparative trials are needed to determine whether VR confers advantages over conventional training approaches.

Aims: Healthcare providers need access to evidence‐based knowledge to deliver interventions effectively within clinical settings. This paper aims to provide an overview of umbrella reviews (URs) conducted in an oncology healthcare context. In this review, the oncology healthcare context relates to focusing on care delivery systems, supportive care, supportive care needs, and supportive care interventions, systems, and models of care for cancer survivorship care and support. Methods: This overview followed the Preferred Reporting Items for Overviews of Reviews (PRIOR) statement. The literature search was performed in seven databases including PubMed, CINAHL, APA PsycArticles, APA PsycInfo, SocINDEX with Full Text, Embase, and Cochrane Database from 2012 to 2023. The search terms and eligibility criteria were organized around the PCC framework. The JBI Critical Appraisal Checklist for Systematic Reviews and Research Synthesis was used for quality assessment. Results: Seventy‐six umbrella reviews were included in this review. Only four reviews demonstrated low quality. Tables and bubble maps helped to outline the key findings of included URs. Recommendations to aid future studies and reviews were summarized into five overarching themes. Conclusions: In conclusion, we outlined the range and gaps in topics covered, as well as the key features of umbrella reviews examining oncological supportive care systems and models of care over the past decade. Future research should address the multidimensional nature and complexity of clinical implementation and methodological concerns; consider underrepresented populations and be more targeted to inform policy development.

Since the first suicide helpline was established in 1953, telephone support helplines have expanded globally. One such helpline is Samaritans. Previous studies on Samaritans have explored volunteers' perspectives and examined the number of calls users make. The aim of this study was to capture the users' experiences of Samaritans' helpline in Ireland. A mixed methods methodology, incorporating quantitative (cross-sectional) and qualitative (qualitative descriptive) elements was adopted. Participants accessed surveys via Samaritans' website. At the end of the survey, participants could self-select to partake in 1:1 online interviews. Quantitative data were analysed using descriptive statistics; qualitative data were analysed using reflexive thematic analysis. A total of 395 respondents completed the survey. Telephone was the most prominent format of contact with Samaritans, at 88.6% (n = 350). Mental health was cited as the main reason callers connected with Samaritans. Almost half of respondents felt supported a lot (47.3%, n = 187). Qualitative analysis identified three themes: Availability, Accessibility, Anonymity; Connecting with Volunteers; and Expectations of Samaritans' Services. Samaritans' services are highly valued by those who engage with them. However, there is a need to enhance public awareness about the specific supports Samaritans provide, and the formats of contact that are available.

In 2025, the film One Flew Over the Cuckoo's Nest turned 50 years old. Although the film has been subject to analysis over the years, its role in shaping the perceptions of professionals working in mental health has not yet been fully explored. The aim of this paper is to explore mental health staff's perspectives on One Flew Over the Cuckoo's Nest on its 50th anniversary. Semi‐structured interviews were conducted with 15 participants. The study was guided by a qualitative descriptive approach. Reflexive thematic analysis was used to analyse data. Five Themes were identified: Personal Reflections on First Viewing One Flew Over the Cuckoo's Nest , Consolidating Stereotypes and Reinforcing Stigma, The Shadow of Nurse Ratched, We Have Come a Long Way but We Still Have a Long Way to Go and The Legacy of One Flew Over the Cuckoo's Nest Today. Although the film's direct influence is waning, it still has some hold over the public's negative views of mental health care. Media campaigns, similar to those used to dispel myths about mental health challenges, should be used to promote better images of mental health staff and care environments, reducing stigma. While mental health care has come a long way since the release of One Flew Over the Cuckoo's Nest , further improvements are warranted, with an emphasis on reducing power dynamics and more focused mental health education.

UNSTRUCTURED Background: Trauma-informed care (TIC) is an organisational and clinical framework that embeds safety, trust, choice, collaboration, and empowerment into routine practice. Although training improves TIC attitudes, implementation in European residential child and adolescent settings is uneven. Immersive technologies such as virtual reality (VR) may accelerate experiential learning but remain under-evaluated for TIC. Objective: To evaluate whether a VR-enhanced training programme improves attitudes toward TIC among staff and trainees in residential child and adolescent care (including a child psychiatric ward) across multiple European sites, and to examine site-level heterogeneity and participant factors associated with change. Methods: We conducted a multi-site pre–post evaluation within the EU-co-funded Safe4Child project. Participants completed a standardised online TIC module (4 ECTS) followed by a mentor-facilitated VR simulation (1 ECTS). Attitudes were measured immediately pre- and post-intervention using the ARTIC-10 (7-point scale; higher scores indicate stronger TIC alignment). Analyses included descriptive statistics, Wilcoxon signed-rank tests, Cohen’s d, centre-specific comparisons, multivariable linear/logistic regression, and Bayesian models with sceptical priors. Internal consistency (Cronbach’s α) was assessed. Only matched cases were analysed (n = 79) from Bulgaria, Finland, and Germany. Results: Cronbach’s α increased overall from 0.839 (95% CI 0.792–0.886) pre- to 0.894 (0.863–0.926) post-intervention. Mean ARTIC-10 rose from 5.33 (SD 1.05) to 5.57 (SD 1.20); the change was significant (p < 0.001) with a small effect (d = 0.22). Centre-specific effects differed: Germany showed a significant improvement (p < 0.001; d = 0.56), whereas Bulgaria (p = 0.796) and Finland (p = 0.186) did not. The proportion with increased scores was 80% in Germany (95% CI 61.4–92.3%), 60% in Bulgaria (38.7–78.9%), and 54.2% in Finland (32.8–74.4%). In multivariable models, the German centre remained associated with greater gain (β ≈ 0.46). Bayesian estimation yielded a mean paired change Δ = 0.24 (95% CrI 0.11–0.37); P(Δ > 0) ≈ 1.00 and P(Δ > 0.20) = 0.73. Prior trauma-related training showed a probable but uncertain additional benefit. Conclusion: A VR-enhanced TIC programme produced a small overall improvement in TIC attitudes with a moderate, context-dependent effect in Germany, suggesting that immersive training can strengthen TIC learning when aligned with local educational and practice contexts. Results highlight site heterogeneity and the likely value of foundational training before VR. Limitations include single-group pre–post design, immediate post-assessment, reliance on self-report, and modest, predominantly female sample. Larger, longitudinal, and implementation-focused studies are warranted to test durability and translate attitudinal gains into practice change.

The aim of this review was to synthesise and appraise the evidence on the impact of media on career decisions. Academic databases were searched for papers that investigated the link between media and career choice. There was some evidence that audiovisual media (i.e., movies, TV, video games) impacted career choice, with further evidence that print media was influential. Males and those from racial minority groups were more influenced by media than others. There was a limited focus on specific careers, although it is evident that people are influenced to pursue career pathways in STEM, the criminal justice system, and marketing owing to media exposure. Overall, there is some evidence that media influences career choice, with audiovisual approaches more effective over print/text. However, this evidence is limited to a narrow range of careers. More rigorous research is warranted to develop our understanding of how media can influence career choice.