Many of the newspaper reports highlighted the need for protection of the general public from the mentally ill, and that the mentally ill were in some way different to the general public. In particular, both the words "violence" and "drugs" were linked to mental health/mental illness in these articles.

This article outlines the introduction and development of a team of like-minded people utilizing family interventions (FIs) in a NHS Trust. FIs can be described as therapy sessions for families of people experiencing psychosis, which involve the family, client and therapist. The sessions focus on key elements, such as engagement and assessment, psycho-education, communication skills, problem-solving and relapse prevention. Through this focus, problems are analysed and ultimately the interventions are decided and agreed upon. The analysis of the team utilizing FIs in a NHS Trust raises many questions, identifies problems encountered in its conception and highlights managerial difficulties that occurred when trying to balance caseload demands and something envisaged as resource- and time-hungry. The Trust, however, views FIs as one of the ways of addressing part of the National Institute for Health and Clinical Excellence (2002) guidelines, Schizophrenia: Core Interventions in the Treatment of Schizophrenia in Primary and Secondary Care, and lately, Organising and Delivering Psychological Therapies (Department of Health, 2004), and are keen to improve the quality of the service user and carer experience.

Globally, an increasing number of people who Self-Harm (SH) are being treated in mental health hospitals. Incidences of SH are common in secure hospitals, with those using the behaviour being highly dependent on staff for care and support but impacting on often limited resources. While literature related to the lived experiences of people who SH exists, this is in its infancy in African countries. The aim of this study was to explore the lived experiences of people who SH in two secure mental health hospitals in Ghana. Interpretive Phenomenological Analysis (IPA) was used to explore the experiences of people who SH in two secure mental hospitals in Ghana. A convenience sample of nine participants were recruited and face-to-face in-depth semi structured interviews were used to collect data. With the permission of each participant, all interviews were audio recorded and notes were made by the researcher (first author). Each interview was transcribed and analysed using the IPA seven-step approach, with three superordinate and 11 subordinate themes being identified. The superordinate themes were: Being let down; Living with the negative self; Forces of the supernatural and religion. Findings demonstrate that there is a need to develop a collaborative health care package if appropriate care and support is to be offered to people in secure settings who use high-risk behaviours, such as SH. To ensure care is holistic, culturally, and temporally relevant research is needed, particularly in Sub-Saharan Africa.

This paper provides reflection on the journey of completing a PhD by using emergent themes that occurred in supervision sessions as recorded in a reflective journal. The paper highlights the need to reflect and accept decisions that can be challenging. The paper also indicates examples where past understandings are questioned and newer insights have to be explored. A conclusion related to accepting responsibility for what happens as a consequence of supervision sessions is debated.Finally a new insight into identity is arrived at.

Advanced clinical practitioners are in demand in primary care. This study looked at the experiences of participants in a hub and spoke training model using a qualitative approach Background: Advanced clinical practitioners (ACPs) have been fundamental in ensuring the provision of expert care, resulting in an increase in demand in primary care. This demand has incentivised innovation in approaches to education, to maximise the benefits of training with limited resources and harnessing the expertise in the workforce. Aim: To develop a method of educating and supervising advanced clinical practitioners in training (ACPiTs) in primary care settings situated in a novel hub and spoke environment. Methods: A qualitative approach with close methodological links to the philosophical work of Heidegger was used to capture the nature of existence and reality in the hub and spoke environment. Results: Three main themes emerged from the study: support; supervision; and vision. Conclusion: The hub and spoke format of training is a useful alternative to traditional methods in developing practitioners who work in a bespoke yet broad practice environment, such as primary care.