Catherine Robinson

On release from prison, many people re-enter the community with social care needs that are not appropriately addressed. This group is at risk of homelessness, unemployment, and self-harm. In England and Wales, the Care Act clarified that the responsibility for social care on release from prison lies with the local authority into which people return, but there is no universal, systematic way of monitoring and supporting individuals with these needs. Against this background, we sought insights regarding the planning and provision of social care for people in four ‘good practice’ local authority sites. Semi-structured interviews were conducted with sixteen staff. The thematic framework technique was used to code and analyse the data. Three key themes were identified: problematic policies and systems (including confusion over the ‘grey’ Care Act; siloed working), collaboration (including building relationships; engaging staff; specialist teams/roles), and person-centred approaches (including empowering service users; wrapping services around people; innovative commissioning). In conclusion, interviewees highlighted a palpable need to embrace person-centredness (including greater understanding of how people’s needs in prison may differ from their needs on release), to adopt creative commissioning strategies, and to equip people with the skills to cope in the community rather than being ‘set up to fail’.

Prison peer support schemes can offer social care for people who require help with activities such as self-care, fetching meals, getting around safely, taking part in meaningful activities, and/or forming or maintaining relationships. Little is known about how best to deliver and monitor prison peer support schemes. Peer supporters do not always receive appropriate training or supervision, leaving them and the support recipient vulnerable to exploitation and/or distress or harm. We conducted a mixed studies review to co-develop guidance on peer support schemes for social care in prison and developed an initial programme theory and logic model. We synthesised findings/evidence from stakeholder workshops, six of our previous projects on social care in/on release from prison, and an umbrella review of the literature. The co-developed guidance provides structure for some aspects of the peer support process while allowing for flexibility. We make recommendations about recruitment, training, roles, support plans, and supervision of and support for peer supporters themselves. Better structured/formalised processes which espouse a peer-led approach would empower peer supporters to optimise their capacity to be the “eyes and ears on the ground” and to become recognised, respected and valued as integral to the running of the prison. In turn, this could provide individuals with a sense of purpose, self-efficacy, and self-confidence. The correct balance between risk-management and allowing some flexibility within the peer support role needs to be determined. Our guidance will be implemented and evaluated in at least one prison and disseminated across England and Wales.

Low and lower-middle income countries (LMICs) account for 79% of all worldwide deaths by suicide (Kasaju et al., 2021). In India, an LMIC, the suicide rate for women is 14.7 per 100,000, which is 2...

Background: Newspapers can highlight sociocultural assumptions of acceptable gender behavior that are used to frame suicide, with males depicted as aggressive and independent, and females portrayed as dependent and submissive. Aims: This mixed-methods study builds on existing research by examining how female suicide is reported in Indian newspapers. Method: The database Pressreader was used to identify English-language newspaper articles in India that covered suicides between May 2021 and May 2022. In total, 205 articles were identified. Descriptive statistics and critical discourse analysis were used to explore the data in the articles. Results: Themes such as the possible misclassification of the death of minors, the use of euphemism to describe certain relationships, and attribution of blame through the criminal charge of abetment to suicide were identified. Women’s suicides were usually framed as a result of interpersonal problems and viewed sympathetically. Limitations: Analyzing traditional broadsheets and local language newspapers, as well as comparing gender differences would allow for more robust conclusions to be drawn about reporting styles in India. Conclusion: This study provides recommendations, such as the use of reporting guidelines that are country-specific, and the need for further research that focuses on newspaper reporting and perception of suicide in India.

Moral injury is the long-term effect of the experience of events that violate deeply held moral beliefs. Social workers in adult care settings are tasked with managing morally complex situations and make decisions that impact the lives of service users. Simultaneously, they adhere to their professional ethical code and organisational standards, potentially giving rise to moral injury. Little is known about these experiences. This qualitative descriptive study aimed to explore social workers' experiences of moral injury. Remote interviews were conducted with ten social work professionals, in adult services in England. Data were inductively analysed using reflexive thematic analysis. Three themes were identified: a) System-related impacts; b) Service-related impacts; c) Individual psychological impacts. Social worker moral injury can arise from efforts to uphold professional values whilst navigating limited resources, interprofessional conflicts, and working within a constrained system. Witnessing dehumanising, low-quality, and impersonal care is a major source of moral injury. This is marked by professional disempowerment, sadness, guilt, betrayal, and helplessness. Recognising these experiences is important. Building psychosocial resilience through formal support is essential for moral repair. Application of the concept for social work, alongside further research, is paramount to adequately support staff.

People living with dementia face a disproportionately high risk of abuse and neglect, yet safeguarding responses remain underexplored, particularly within the context of English legal and care systems. This realist review investigates how safeguarding practices for people with dementia operate in England, examining what works, for whom, in what circumstances, and why. Drawing on 44 studies published between 2014 and 2024, supplemented by extensive stakeholder engagement with individuals with lived experience, carers, practitioners, and community representatives, the review synthesizes evidence through Context–Mechanism–Outcome configurations. Five core domains emerged: stakeholder roles, conceptualization of abuse and neglect, safeguarding processes and diversity, safeguarding law and policy, and partnership working. Findings reveal that effective safeguarding depends not only on statutory frameworks like the Care Act 2014 and Mental Capacity Act 2005, but also on professional judgement, relational dynamics, and inter-agency collaboration. Significant barriers include inconsistent training, conceptual ambiguity, cultural stigma, and systemic under-resourcing. Importantly, safeguarding outcomes improves in environments where legal literacy, trust, and communication are strong, and services are culturally competent and person-centered. The review highlights the need for integrated, rights-based approaches and greater inclusivity in safeguarding systems to better protect diverse populations of people living with dementia.

Background: With a rising prison population, a substantial portion of whom are identified as substance misusers, it is important to understand the availability of treatment pathways, their successes and areas for improvement. Given the likely importance of national factors in criminal justice and substance use service provision, we chose to focus on one country. Aim: To review substance misuse treatment and outcomes for such treatments as implemented in British prisons for men. Methods: We conducted a mixed‐methods systematic review, searching Ovid MEDLINE, Ovid Embase, APA PsycINFO, CINAHL Plus, Sociology Collection, Web of Science Core Collection and Social Science Premium Collection between 1 January 2000 and 5 June 2024. Included were empirical, peer‐reviewed studies of processes and outcomes of UK male prison‐based substance misuse programmes. Primary outcomes included changes in substance use, withdrawal symptoms and experiences of interventions, whereas secondary outcomes encompassed quality of life, locus of control and mental health. Because of study design heterogeneity, meta‐analysis was not possible. Analysis followed JBI methodology with a convergent synthesis. Results: Fourteen studies were included: 8 qualitative, 5 quantitative studies of which 3 were randomised control trials (RCTs) and 1 mixed‐methods study, with a combined sample of 4037 participants engaged in opioid substitute treatment (OST) and/or psychosocial interventions. Four key themes emerged: the power of purposeful activity, strengthening support systems, bridging patient needs with treatment plans and, for those in opiate programmes, experiences and engagement with opioid substitution treatments. Conclusions: Participants articulated diverse treatment needs, highlighting the necessity of individualised and tailored reduction or maintenance plans. Treatment requires a comprehensive approach with the aim of facilitating effective social integration.

Introduction: Intentional injuries can be broadly classified into those that are self-inflicted (eg, suicide, self-harm), and those that are inflicted by others (eg, homicide, assault). Many risk factors are the same for all intentional injuries. It is widely accepted that there needs to be a public health approach to self-harm and interpersonal violence prevention, including surveillance of presentations to emergency departments. Self-harm and interpersonal violence are important causes of morbidity and mortality in Wales. Interpersonal violence surveillance is already operationalised in Wales, but variables are limited and case ascertainment may not be complete. There is no self-harm register. The aim of this study is to understand the utility of existing systems in North Wales that collect data about self-harm and interpersonal violence, and how a registry could be implemented to address any unmet needs. Methods and analysis: The project consists of five work packages. First, process mapping will be used to understand the pathways by which patients access emergency care, and how data are collected about patients. Second, routinely collected data will be explored to understand the burden of disease, and the strengths and limitations of existing data collection systems. Third, semi-structured interviews will be completed with stakeholders to understand their needs and experiences. Fourth, semi-structured interviews with third sector organisations which work with people with lived experience of self-harm or interpersonal violence will explore the acceptability of data collection. Fifth, a method will be developed that would enable economic evaluation of a self-harm and interpersonal violence register. Ethics and dissemination: Results will be used to understand whether a self-harm and interpersonal violence registry is required in Wales. The results have the potential to influence local and national strategy on intentional injury prevention. Results will be disseminated to local services, regional and national programme teams, and published as a peer-reviewed journal article.

Context: The COVID-19 pandemic presented unprecedented challenges for the adult social care sector, necessitating rapid changes in service delivery. Understanding the factors influencing the well-being of staff beyond the pandemic’s initial crisis response phase is crucial. Objective: The article examines the mental well-being, burnout, and the morally injurious experiences of the adult social care workforce in Greater Manchester during the UK’s ’Living with COVID’ phase, initiated in February 2022. Methods: An online survey collected responses from 251 social care staff. Regression analyses, employing a job-demands and resources framework (JD-R), considered demographic, occupational, and COVID-19-related factors to predict psychological outcomes. Findings: Significant levels of low mental well-being (34%) and burnout (31% likely experiencing burnout, 36% at risk) were observed. Additionally, 40% reported experiencing events that were potentially morally injurious. COVID-19-related factors had a significant impact on these outcomes. Satisfaction with infection control measures and access to sufficient resources were associated with more favourable outcomes. Considerable changes in daily activities and dissatisfaction with infection control measures were associated with increased levels of burnout and exposure to morally injurious experiences. Demographic and occupational factors had a lesser influence. Limitations: The study was conducted in a single geographic region of England with non-probability sampling methods and recruitment, potentially impacting the generalisability of the findings. Implications: The findings highlight the importance of adequate resources and infection control measures in reducing harm in the adult social care workforce and building resilience for future sector pressures.