{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T02:18:58Z","timestamp":1787797138496,"version":"build-2784847793"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Psychological therapies are rarely available for UK suicidal prisoners. A pilot feasibility clinical trial of Cognitive Behavioural Suicide Prevention therapy showed that it was possible to deliver therapy offering the potential to improve outcomes for suicidal prisoners. However, there were challenges to engaging male prisoners in therapy as many experienced difficulties in accessing and talking about their emotions. Difficulty in talking about emotions is common amongst male prisoners, yet this is essential for successful engagement in a talking therapy. The current co\u2010production study aimed to further understand the contextual influences that impact male prisoners' ability to engage with a psychological intervention focused on suicide prevention and to explore user\u2010generated solutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Community\u2010residing male ex\u2010prisoners with past experience of suicidal thoughts or behaviour during imprisonment participated in individual qualitative interviews followed by a series of six focus groups. Due to COVID\u201019 restrictions in place at that time, recruitment and data collection were conducted by remote methods. Data were analysed according to the principles of reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifteen individuals participated: twelve completed individual interviews, ten participated in the focus groups, with seven individuals participating in both.<\/jats:p>\n                    <jats:p>Three main themes were formed.<\/jats:p>\n                    <jats:p>\n                      1.\n                      <jats:bold>Negotiating prison personas and identities<\/jats:bold>\n                      \u2013 Pressures to hide emotions, act tough, and distrust professionals.\n                    <\/jats:p>\n                    <jats:p>\n                      2.\n                      <jats:bold>Command and control in prison<\/jats:bold>\n                      \u2013 Prison regimes impact on interpersonal relationships with staff and other prisoners to worsen suicide risk, with prisoner's healthcare needs often neglected.\n                    <\/jats:p>\n                    <jats:p>\n                      3.\n                      <jats:bold>Making therapy accessible and acceptable<\/jats:bold>\n                      \u2013 Prisoners must be able to trust a compassionate therapist for engagement to be successful.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study epitomises the feasibility and value of meaningful co\u2010production in research involving populations from marginalised groups such as ex\u2010prisoners. Our results reveal how the combination of individual prisoner and prison institution socio\u2010cultural contextual influences impact suicidal prisoners' engagement in psychotherapy. User\u2010defined suggestions are provided to promote development of potential remedies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Co\u2010production was achieved by the leading role of a salaried peer\u2010researcher co\u2010investigator in liaison with members of our Suicide Risk and Safety Research Group (SSRG) comprised of Experts\u2010by\u2010Experience (EbEs). Co\u2010decision making featured throughout all stages of the research, influencing the protocol design and interview schedule. The personal experience knowledge of the peer\u2010researcher\/co\u2010investigator enabled targeted recruitment strategies and successful engagement of participants. Shared past experiences of prison life and language positively influenced rapport and engagement of participants during data collection, enabling attainment of rich data. Similarly, the peer researcher\/co\u2010investigator's unique personal experiential knowledge ensured a \u2018real\u2010world\u2019 perspective to analysis and co\u2010authorship of publications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70821","type":"journal-article","created":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T12:09:36Z","timestamp":1786882176000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Qualitative Co\u2010Production Study of a Solutions\u2010Focused Approach to Understanding the Barriers and Facilitators to Engagement of Male Suicidal Prisoners in Psychological Therapy for Suicide Prevention"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0767-4994","authenticated-orcid":false,"given":"Yvonne","family":"Awenat","sequence":"first","affiliation":[{"name":"Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester Academic Health Science Centre, MAHSC University of Manchester Manchester Lancashire UK"},{"name":"Greater Manchester Mental Health NHS Foundation Trust, Suicide Risk and Safety Research Unit, Manchester, Manchester Academic Health Science Centre, MAHSC University of Manchester Manchester Lancashire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3557-5731","authenticated-orcid":false,"given":"Rebecca","family":"Crook","sequence":"additional","affiliation":[{"name":"Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester Academic Health Science Centre, MAHSC University of Manchester Manchester Lancashire UK"},{"name":"Department of Public Health, Policy &amp; Systems, Institute of Population Health University of Liverpool, Pembroke Place Liverpool Merseyside UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5719-178X","authenticated-orcid":false,"given":"David","family":"Honeywell","sequence":"additional","affiliation":[{"name":"Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester Academic Health Science Centre, MAHSC University of Manchester Manchester Lancashire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9014-9965","authenticated-orcid":false,"given":"Charlotte","family":"Lennox","sequence":"additional","affiliation":[{"name":"Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester Academic Health Science Centre, MAHSC University of Manchester Manchester Lancashire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1139-6613","authenticated-orcid":false,"given":"Dawn","family":"Edge","sequence":"additional","affiliation":[{"name":"Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester Academic Health Science Centre, MAHSC University of Manchester Manchester Lancashire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7458-4462","authenticated-orcid":false,"given":"Patrcia","family":"Gooding","sequence":"additional","affiliation":[{"name":"Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester Academic Health Science Centre, MAHSC University of Manchester Manchester Lancashire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6234-5774","authenticated-orcid":false,"given":"Gillian","family":"Haddock","sequence":"additional","affiliation":[{"name":"Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester Academic Health Science Centre, MAHSC University of Manchester Manchester Lancashire UK"},{"name":"Greater Manchester Mental Health NHS Foundation Trust, Suicide Risk and Safety Research Unit, Manchester, Manchester Academic Health Science Centre, MAHSC University of Manchester Manchester Lancashire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2157-0200","authenticated-orcid":false,"given":"Helen","family":"Brooks","sequence":"additional","affiliation":[{"name":"Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Centre University of Manchester Manchester Lancashire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1176-5231","authenticated-orcid":false,"given":"Caroline","family":"Hendricks","sequence":"additional","affiliation":[{"name":"Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester Academic Health Science Centre, MAHSC University of Manchester Manchester Lancashire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8843-1224","authenticated-orcid":false,"given":"Daniel","family":"Pratt","sequence":"additional","affiliation":[{"name":"Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester Academic Health Science Centre, MAHSC University of Manchester Manchester Lancashire UK"},{"name":"Greater Manchester Mental Health NHS Foundation Trust, Suicide Risk and Safety Research Unit, Manchester, Manchester Academic Health Science Centre, MAHSC University of Manchester Manchester Lancashire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,16]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(24)00134-2"},{"key":"e_1_2_13_3_1","unstructured":"Safety in Custody Statistics. 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