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Background: Strategies for coping with the burdens of living with a depressed person affect a family's psychosocial environment. Aim: The aim of this qualitative study was to explore how relatives make personal sense of living with a depressed family member. Methods: Thirteen cohabitant relatives were interviewed either individually or in a focus group. The transcribed interviews were interpreted thematically. Results: Relatives went through a psychosocial transformation process driven by the twin challenges of their attitudes towards the depressed family member and of stigma. Conclusions: More could be done to resolve families' need for information and for emotional and practical support promoting recovery.

In healthcare, occupational groups have adopted tactics to maintain autonomy and control over their areas of work. Witz described a credentialist approach to occupational closure adopted by nursing in the United Kingdom during the 19th and early 20th centuries. However, the recent advancement of assistant, 'non-qualified' workers by governments and managers forms part of a reconfiguration of traditional professional work. This research used focus groups with three cohorts of healthcare support workers undertaking assistant practitioner training at a London university from 2011-13 (6 groups, n=59). The aim was to examine how these workers positioned themselves as professionals and accounted for professional boundaries. A thematic analysis revealed a complex situation in which participants were divided between articulating an acceptance of a subordinate role within traditional occupational boundaries and a usurpatory stance towards these boundaries. Participants had usually been handpicked by managers and some were ambitious and confident in their abilities. Many aspired to train to be nurses claiming that they will gain recognition that they do not currently get but which they deserve. Their scope of practice is based upon their managers' or supervisors' perception of their individual aptitude rather than on a credentialist claim. They 'usurp' nurses claim to be the healthcare worker with privileged access to patients, saying they have taken over what nursing has considered its core work, while nurses abandon it for largely administrative roles. We conclude that the participants are the not unwilling agents of a managerially led project to reshape the workforce that cuts across existing occupational boundaries.

Service user involvement in mental health research is on the international political agenda, for example mirrored by an emphasis on user involvement in funding of research. The idea is that service users contribute with their lived experiences of mental distress to the research process and thereby heighten the quality and relevance of the research. The purpose of this scoping review was to identify and evaluate empirical research of how mental health service users actually partake in collaborative research processes and to summarize this research in dialogue with mental health user-researchers. The review included 32 studies. Main findings indicated that actual involvement of service user-researchers in research processes encompassed a complex set of precarious negotiation practices, where academics and service user-researchers were positioned and positioned themselves in alternative ways. The review accounts for how mental health service users were involved in collaborative research processes. The extracted themes concerned: (i) Expectations of research processes, (ii) Contribution to research processes, and (iii) Training and learning from research processes. The study reveals that collaborative research in mental health requires changes to traditional research practices to create and support genuine collaborative partnerships and thereby avoid tokenism and power inequalities.

Objective: The aim of this study was to examine changes in the distribution of causes of death and mortality rates among psychiatric patients visiting a psychiatric emergency room (PER), to determine clinically useful predictors for avoiding premature mortality among these patients and to discuss possible interventions. Method: The study was designed as a historical prospective record linkage study of patients with at least one visit to a Danish PER in 1995–2007. Five consecutive 3-year cohorts of individuals aged 20 to <80 years were identified. Data from the Danish Civil Registration System were linked to the Cause of Death Register and the Central Psychiatric Research Register, and logistic predictor analyses for premature death were performed. Results: The standardised mortality ratio (SMR) of all visitors compared to the general Danish population was approximately 5. Overall, patients with drug and/or alcohol use disorder experienced at least a twofold increase in SMR compared to patients without substance use disorder. In the case of patients with schizophrenia and a concurrent substance use disorder, the SMR increased considerably. During the period, substance use disorder was the strongest predictor of premature death among visitors to a PER (odds ratio (OR) = 1.8; 95% confidence interval (CI) = 1.5, 2.2). Conclusion: Persons visiting the PER had an increased SMR and substance use disorders were the strongest predictor of premature death within 3 years. However, death caused by substance use disorder is preventable, and PERs are ideal points of early intervention. Systematic screening for substance use disorder at the PER and/or crisis intervention teams may be effective intervention strategies.

The aim of this paper is to describe a novel form of qualitative inquiry, dialogical inquiry, which allows for multiple investigators from different positions or traditions to collaboratively interpret qualitative data, engaging in a process of mutual influence to enrich both themselves and the process of analysis. We provide a clearly operationalized method, which is inspired by the philosophy of Bakhtin, as reimagined through practices from Open Dialogue, a social network–based approach to dialogical psychotherapy. Drawing on a specific text analysis of Jay Neugeboren's novel "Imagining Robert," we demonstrate how our dialogical inquiry approach can bring reflexive practice in qualitative research to life through mutual reflections among investigators. We show how dialogical inquiry can generate appreciation for multiple perspectives, awareness of affective and epistemic positions, and new knowledge production. This approach could be particularly suited for research teams that wish to actively generate new kinds of knowledge, or to privilege the voices of coresearchers from diverse social, political, and epistemic positions.