Output list
Journal article
First online publication 16/08/2025
Criminal behaviour and mental health
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.
To review substance misuse treatment and outcomes for such treatments as implemented in British prisons for men.
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.
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.
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.
Journal article
Knowledge, Attitudes, and Experiences of Self-Harm and Suicide in Low- and Middle-Income Countries
Published 07/2025
Crisis : the journal of crisis intervention and suicide prevention, 46, 4, 232 - 242
Background: Over three-quarters of suicides occur in low- and middle-income countries (LMICs) and a better understanding of this behavior within these settings is crucial. Aim: To investigate stakeholders’ knowledge, attitudes, and experiences of self-harm and suicide in LMICs. Method: A systematic search was conducted using British Nursing Index, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase, MEDLINE, PsycINFO, and Social Sciences electronic databases from inception to March 2022, combined with hand-searching reference lists. The search was updated using the PubMed Similar Articles function in February 2024. Analysis followed a modified narrative synthesis approach. Results: One hundred and fifty-four articles met the inclusion criteria, of which 60 included relevant quantitative data. Attitudes toward suicide were often contradictory although, overall, were negative and suicide literacy was poor. Healthcare staff reported lacking training in this area. Willingness to seek help was linked to suicide literacy and attitudes toward suicide. Limitations: Heterogeneity of included studies. Conclusion: Tackling stigma and improving awareness of suicide and self-harm in LMICs are needed to facilitate suicide prevention. Training should include people with lived experience of suicide and self-harm. The complex and contradictory influences of age, gender, religious, and cultural beliefs and lived experience must be considered.
Journal article
Published 02/06/2025
Journal of long-term care, 2025, 168 - 181
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.
Journal article
First online publication 22/05/2025
Journal of further and higher education, 1 - 20
Disruption to higher education during the COVID-19 pandemic caused several challenges for university students, as they were forced to adjust to new teaching and learning styles. Therefore, this study aimed to investigate how the COVID-19 pandemic impacted university students' learning experiences and education. This study took a phenomenological methodological approach in an attempt to understand students' experiences from their own perspective. Semi-structured interviews were then carried out with 19 university students from the UK between 9 May 2022 - 26 June 2022. The main themes that emerged through thematic analysis were: (1) A lack of engagement with online learning; (2) Changes in attitudes towards learning; (3) A lack of practical learning opportunities; (4) Changes to academic support; (5) Limited interaction with peers; (6) Implications for health and well-being. This study provides a deeper student-centred understanding of university students' lived experiences with online learning during the pandemic, revealing underexplored contextual, emotional and relational dimensions of online learning. These rich qualitative findings not only enhance current understanding of higher education during the pandemic but can be drawn upon to shape digitised learning moving forward. As we are progressing in an era of increasing digitised learning, these findings contribute towards laying the groundwork for future policy and practice within higher education.
Journal article
First online publication 19/02/2025
Journal of Health Psychology, 13591053251314989
Men who have sex with men (MSM) living with HIV tend to experience a range of mental health issues, in particular generalised anxiety disorder (GAD), often caused and maintained by psychosocial variables including HIV stigma, discrimination, self-esteem issues, substance abuse and loneliness. This is particularly problematic in countries like Nigeria where same sex activity is illegal and can result in up to 14 years imprisonment. An important psychological variable that may contribute to the experience of GAD are metacognitive beliefs. Participants (
= 311) completed measures to examine the relationship between these variables. Results indicated that metacognition was associated with, and significantly predicted, GAD in this population. Moderation analysis showed that the effect of HIV stigma on GAD was explained by the proposed interaction with metacognition. Findings suggest that metacognition may be an important variable in explaining GAD symptoms in MSM living with HIV in Nigeria.
Journal article
Published 01/12/2024
Behavioral sciences, 14, 12, 1146
Longitudinal research into the impact of COVID-19 on university students' mental health beyond the pandemic is lacking. This study aims to address the gap in the literature by tracking the mental health of university students over a two-year period, spanning the COVID-19 pandemic and its aftermath. A two-year longitudinal study surveyed a sample of university students (n = 302) three times between May 2020 and May 2022. Students' psychological distress, generalised anxiety, flourishing, and personal wellbeing were assessed at each time point. It was found that students' psychological distress levels spiked in May 2021 (T1) during the first year of the pandemic but reverted back to similar levels seen in May 2020 (T0) at the two-year follow-up (T2). While generalised anxiety gradually improved, both students' psychological distress and generalised anxiety remained considerably worse than pre-pandemic norms obtained in other studies. Students' flourishing scores remained very low, while their life satisfaction and state happiness improved slightly between May 2021 (T1) and May 2022 (T2). These findings clearly demonstrate that students' mental health is still in crisis, even after the COVID-19 pandemic. More needs to be done to support students beyond the pandemic generally, including this particularly unique cohort of students who endured unprecedented challenges for prolonged periods, and who are now transitioning into the working world. Practical implications and recommendations are discussed.
Journal article
Evaluating the impact of employability skill training on the self-efficacy of disadvantaged adults
Published 09/07/2024
Mental health and social inclusion
PurposeEmployability skills training programmes are an effective means for reducing unemployment rates. Such programmes also have the potential to improve the general well-being (e.g. self-efficacy) of disadvantaged individuals, however, reliable longitudinal evaluations of the psychological benefits of such programmes are limited. The present study evaluated the impact of an employability programme offered to disadvantaged adults in North-West England on self-efficacy. Additionally, the study aimed to identify risk factors for programme disengagement to identify at-risk groups that require further support.Design/methodology/approachSecondary longitudinal data pertaining to the background characteristics, programme engagement and self-efficacy scores (repeatedly measured on a monthly basis) of 308 programme users were analysed.FindingsResults demonstrated that employability programme engagement significantly increased self-efficacy scores. Additionally, the findings suggested that individuals with mental health and learning difficulties were more likely to disengage from the programme. The findings demonstrate that employability programmes can have a positive impact on the well-being of individuals from disadvantaged backgrounds, however, prolonged engagement is needed for which some individuals require further support with.Originality/valueThe present study analysed longitudinal data from a diverse sample of disadvantaged individuals to reliably evaluate psychological outcomes from employability training programmes.
Book chapter
Positive Education in Higher Education
Published 13/02/2024
Positive Education at All Levels: Learning to Flourish, 65 - 86
Abstract The aim of this chapter is to provide an overview of the student mental health crisis in Higher Education (HE), and how resilience and grit, two important positive psychological constructs, can be beneficial for university students’ success and wellbeing. As part of a discussion around some of the current approaches to intervening in wellbeing in universities, the chapter provides evidence for the use of PPIs for wellbeing in university students, alongside some of the challenges of implementing these in HE. It also provides an overview of the Thriving Students Framework and presents a case for a multicomponent approach to monitoring and improving educational success. In particular, a wellbeing framework that, alongside resilience, also recognises the importance of strengths, persistence in the face of difficulty, a growth mindset, self-control and mental wellbeing; Academic Tenacity. The implications of utilising this framework for educational attainment in university students are discussed. The Bolton Uni-Stride Scale (BUSS), a single short measure of academic tenacity that combines the attributes enabling measurement and intervention to support university students to thrive, is also presented for educators to use.
Journal article
Published 02/11/2023
British Journal of Educational Studies, 71, 6, 585 - 608
University students in the UK have encountered many challenges as a result of the COVID-19 pandemic. This research aimed to track the mental well-being of a large sample of British university students (n = 554) over a one-year period of the COVID-19 pandemic, capturing data at four time points between May 2020 and May 2021. Overall retention after 12 months was 34.73%. Findings showed the COVID-19 pandemic has caused a significant, negative impact on the well-being of British university students. Students are suffering from prolonged and high levels of psychological distress and anxiety. Levels of flourishing in students are still very low. The different phases of the pandemic appear to have played an influential role in student mental health. The practical implications for higher education and recommendations for future research are discussed.
Journal article
Published 08/2023
Current psychology, 42, 23, 20165 - 20178
The effects of Covid-19 have been felt worldwide and one population that are of increasing concern are university students. University students have endured unique and drastic changes to their everyday and academic lives. It is important to understand how university students in different parts of the world have been affected by the Covid-19 pandemic and how it has affected their mental health? A cross-sectional study was conducted during the first wave of Covid-19, in May 2020 with 2,006 university students from the UK, Italy, Germany and Spain. Participants were recruited online and were asked to complete a series of standardised measures of psychological distress, anxiety, flourishing and wellbeing. Attitudes towards Covid-19 were measured using a new scale. The factor structure and reliability of this new scale was confirmed using this European sample. Results indicated that all university students were suffering from poor mental health, considerably below pre-pandemic norms. There were many geographical differences in the way that university students perceived the Covid19 pandemic, in terms of their fears, anxieties, loneliness and positivity. There were also significant mental health comparisons between students from the UK, Italy, Germany and Spain. Student beliefs that their government had provided effective leadership during the Covid-19 pandemic were strongly related to numerous mental health outcomes. A picture of university students' mental health is provided and discussed. Geographical comparisons are discussed, as are the implications for practice and future directions.