Main Research Project AbstractBackground – Psychosis is one of the most stigmatised mental health problems. Individuals who experience psychosis can internalise this stigma, resulting in self-stigma where an individual’s self-concept is eroded with a negative impact on recovery. Conversely, peer support has been shown to impact positively on recovery and theory suggests that this may be achieved through challenging stigmatising attitudes. Aims – The aim of this study is to further investigate one potential mechanism underpinning peer support, that is the impact of peers on challenging self-stigmatising attitudes.Methodology – 20 people with first episode psychosis were recruited and randomised to watch a psycho-educational video delivered either by an individual with experience of psychosis (a peer) or a health professional. Levels of self-stigma were measured before and after the video.Results – The findings of this study did not support the hypothesis that psycho-education delivered by a peer reduces internalised stigma to a greater degree than someone without this, however, the results are underpowered and require a larger sample before conclusions can be drawn.Conclusions – Further research is needed to better understand the effective components of peer support and to better understand the relationship between peer support and internalised stigma. Service Improvement Project AbstractPulmonary Arterial Hypertension (PAH) is a chronic disease, which is monitored by a series of complex treatments including cardiac catheterisation (CATH). Evidence suggests that patients can experience CATH as anxiety provoking, however, most undergo this procedure without any formal psychological support. The current study aimed to explore patients’ beliefs about the CATH procedure and to better understand adaptive coping and self-management skills. It was hoped that this knowledge would inform recommendations to improve the psychological experience and coping resources of those undertaking CATH. Ten participants were recruited through purposive sampling and completed a qualitative interview, which explored their beliefs about CATH and factors which enhanced coping resilience. Findings suggest that factors which increase an individual’s understanding of CATH and sense of control were associated with positive coping. The results also suggest that whilst perceptions of the CATH procedure are very individual, the importance of relationships with health professionals and trust in their expertise was highlighted across participants. The findings informed service recommendations, including the introduction of a patient experience leaflet aimed at promoting positive coping in those attending the CATH procedures.Critical Literature Review AbstractBackground – Stigma is a global phenomenon affecting many health conditions. Stigmatised attitudes can become internalised (internalised stigma), a process that can negatively impact on an individual’s sense of self, their emotional wellbeing and wider life. Recently interventions have been developed to reduce internalised stigma, including interventions led by people with personal experience of health conditions (peers). Aim – This review aimed to draw together literature on peer-led interventions for stigmatised health conditions, which have included internalised stigma as an outcome. The review aimed to synthesis interventions and their components; relate the findings to social identity theory and summarise what is known and not known about the relationship between peers and internalised stigma. Method – Using specific search terms and inclusion criteria, this review yielded 13 papers in total. The papers were examined in terms of their methodology and findings, and common components of the interventions were collated across the papers. Results – The results revealed methodological limitations amongst the papers and highlighted the need for replication. However, the findings suggest there is evidence that peer led interventions can impact positively on internalised stigma, if designed in the right way for the people who receive it. The key components include sharing experiences, narrative components, information provision and problem-solving.Conclusions – Peer-led interventions present an empowering way of countering the stigma surrounding certain conditions through role-modelling recovery, sharing hopeful experiences and enhancing positive identity. Current evidence shows promise, however, more high quality research is needed to better understand this relationship and to develop effective, accessible interventions.