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Evidence on the impact of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.
To systematically review evidence on presentations to health services following self-harm during the COVID-19 pandemic.
A comprehensive search of databases (WHO COVID-19 database; Medline; medRxiv; Scopus; PsyRxiv; SocArXiv; bioRxiv; COVID-19 Open Research Dataset, PubMed) was conducted. Studies published from 1 January 2020 to 7 September 2021 were included. Study quality was assessed with a critical appraisal tool.
Fifty-one studies were included: 57% (29/51) were rated as ‘low’ quality, 31% (16/51) as ‘moderate’ and 12% (6/51) as ‘high-moderate’. Most evidence (84%, 43/51) was from high-income countries. A total of 47% (24/51) of studies reported reductions in presentation frequency, including all six rated as high-moderate quality, which reported reductions of 17–56%. Settings treating higher lethality self-harm were overrepresented among studies reporting increased demand. Two of the three higher-quality studies including study observation months from 2021 reported reductions in self-harm presentations. Evidence from 2021 suggests increased numbers of presentations among adolescents, particularly girls.
Sustained reductions in numbers of self-harm presentations were seen into the first half of 2021, although this evidence is based on a relatively small number of higher-quality studies. Evidence from low- and middle-income countries is lacking. Increased numbers of presentations among adolescents, particularly girls, into 2021 is concerning. Findings may reflect changes in thresholds for help-seeking, use of alternative sources of support and variable effects of the pandemic across groups.
The Afterword addresses the historical dominance of white voices in British nature writing, and the marginality of race, class and gender politics in the genre. This tendency matches continuing inequalities in the social and ethnic composition of British environmentalist movements. Contemporary nature writing also reflects regional inequalities, with many of its leading figures clustering around East Anglia. Nonetheless, Elizabeth-Jane Burnett’s recent book The Grassling exemplifies British nature writing that stands out not only through the unconventional background of its author, but also through its experimental techniques. At the same time, platforms such as The Willowherb Review suggest that the genre and the critical culture around it are gradually changing to allow room for more diverse voices. However, nature writers of colour venturing into rural environments still find themselves contending with the stark racial divide between Britain’s cities and countryside. Similarly, a growing range of LGBTQ* nature writers are becoming increasingly visible in the genre and challenging heteronormative codings of the rural. In the aftermath of Brexit and a global pandemic, Britain’s nature writers confront a nation highly divided and isolated, and a literary heritage permeated by elitist elements which need to be reckoned with.
British nature writing is a conflict-ridden mode that speaks to contradictions in the modern condition, and a crisis-ridden mode that addresses the modern crises of the environment, of representation and of the alienated self. It returns repeatedly to problems of mimesis and the non-transparency of language, and to the slippages between ecological facts and the cultural imagination. ‘Nature writing’ is a problematic category, and classifications of earlier literature as such must be qualified, recognising the historical overlapping of environmental literature with natural history and other genres. Although British nature writing grew in dialogue with its American equivalent, it has always been less concerned than the latter with the wilderness, addressing more cultivated environments in which wildlife intermingles with human social and economic activity. The genre has long sought spiritual renewal and significance in wildlife and engaged in conservation movements, although its environmentalist ethics have not been consistent. British nature writing has also been deeply shaped by the pastoral and georgic traditions, causing it to waver between the foci of leisurely contemplation and laborious activity.
Chapter 4 examines contemporary nature writing, initially focusing on the ‘new nature writing’ of the past few decades. It argues that this writing, ostensibly an attempt to engage with the ‘post-natural’ conditions of the Anthropocene, is haunted by a feeling of inadequacy in relation to its predecessors and marked by the frustrations of ‘late style’. Indeed, many British writers of the period are best seen as ‘late Moderns’, expressing deep-seated anxieties about themselves, their writing, and their position in a rapidly diminishing natural world. This thesis is examined in relation to writers whose work simultaneously attempts to recall the wild and reflects on the impossibility of that exercise; other writers are then brought in to examine those contemporary post-industrial landscapes that might create the conditions of possibility for a ‘new wild’. The second half of the chapter pursues this line of argument, but in relation to another popular subgenre, animal writing, which is seen as containing regenerative potential but also as communicating unsettling insights into the always unstable relationship between animal others and human selves. The chapter then concludes with some reflections on a different kind of violence, the violence of the elements, which in today’s era of accelerated climate change is both significantly influenced by human beings and beyond the bounds of human control.
Chapter 1 reveals the complexity and self-consciousness of Romantic nature writing, bringing together authors who share an interest in nonhuman nature as a dynamic process. It also addresses the porousness of Romantic nature writing as a mode of engagement across different kinds of texts. A key claim is that, while Gilbert White’s localism and close field observations were influential on later nature writing, so was the strand of confessional autobiography pioneered by Jean-Jacques Rousseau. Romantic nature writing is often represented as a self-aggrandising masculine mode. But women writers such as Dorothy Wordsworth and Charlotte Smith were significant, particularly in their portrayals of nonhuman nature as entangled with everyday human life. The chapter also addresses labouring-class writers, bringing John Clare’s natural history prose into dialogue with the work of the artist Thomas Bewick and the novelist and poet James Hogg. All three resisted and lamented the forces of modernisation, but did so through developing innovative modes of representation. Even at its most backward-looking, Romantic nature writing engaged with the contradictions and conflicts of modernity. And, while influenced by natural theology, it also dared to speculate about deep time and the transience of human species.
Chapter 3 addresses the Modern period. As good a way as any of designating the period is via Eric Hobsbawm’s moniker the Short Twentieth Century (1914–91), which he sees as an age of extremes marked, especially in its first half, by a sequence of potentially world-ending catastrophes bookended by the two world wars. Much nature writing of the time evidences this apocalyptic trend, though it also takes heart in the regenerative properties of nature, which is viewed, via the lenses of such fast-developing disciplines as ecology and ethology, with an increasingly scientific eye. The first part of the chapter draws accordingly on writing which, informed by evolving ecological understandings, also debates the protectionist measures needed to combat species extinction in an ecologically threatened world. These ecological threats are then brought to bear on early- to mid-twentieth-century rural writing, which is often all too hastily viewed as reacting against the modern forces of industrialisation and urbanisation, but is better seen as belonging to a complex machinery of rural representation adapted to the cultural needs of post-war England as well as to the new technological demands of a rapidly modernising world.
Victorian nature writing vacillated between escapist pastoral idealism and hands-on georgic realism. Its narrators were at once labourers and idlers, scientists and aesthetes. The genre’s hybridity allowed it to mediate between mechanistic paradigms of nature and religious beliefs and experiences. Natural environments were constructed as realms of both Darwinian struggle and spiritual revelation. Imagining nature appreciation as a form of self-culture sometimes encouraged a nascent ecological and humanitarian sensibility. However, Victorian nature writing remained generally anthropocentric, centring the human mind. Yet, some authors, particularly later in the period, also framed wild environments and organisms as radically alien and unknowable. These different tendencies were often expressed through rhetoric of strangeness and estrangement, which dovetailed with ambivalences about identity, place and belonging. While authors classified objects, creatures and plants as alternately native or foreign, these categories frequently became blurred or uncertain. Authors also equivocated on where to locate ‘nature’, tracing it through rural, coastal and urban areas, in the great outdoors and human homes. Authors discussed include John Ruskin, Charles Kingsley, Philip Henry Gosse, Margaret Gatty, Hugh Miller, Eliza Brightwen, Richard Jefferies and W. H. Hudson.
Why do we speak so much of nature today when there is so little of it left? Prompted by this question, this study offers the first full-length exploration of modern British nature writing, from the late eighteenth century to the present. Focusing on non-fictional prose writing, the book supplies new readings of classic texts by Romantic, Victorian and Contemporary authors, situating these within the context of an enduringly popular genre. Nature writing is still widely considered fundamentally celebratory or escapist, yet it is also very much in tune with the conflicts of a natural world under threat. The book's five authors connect these conflicts to the triple historical crisis of the environment; of representation; and of modern dissociated sensibility. This book offers an informed critical approach to modern British nature writing for specialist readers, as well as a valuable guide for general readers concerned by an increasingly diminished natural world.
We examine the Scotch Whisky Association’s (SWA) role in protecting “Scotch whisky” between c. 1945 and c. 1990. Using new archival evidence, we demonstrate that the SWA intensively lobbied the UK government to achieve coordination between domestic and European regulations governing Scotch whisky and whisky. The SWA’s nonmarket activities were consonant with some trade associations but in other respects they were atypical. The SWA extended its activities to supranational bodies and engaged in extensive domestic and foreign litigation. The key message from this article is that the SWA built the world-renowned appellation “Scotch whisky” even though this marque was not registered as an appellation until the late twentieth century.
Over the past two centuries, apocalypse and extinction have become powerful secular tropes, and have been given new urgency in the context of escalating global heating and biodiversity loss. This chapter examines how the environmental humanities can analyse, complicate, democratise, and challenge these tropes. It addresses present-day speculations about the future of the biosphere, both within the field, and in wider culture through the activities of groups such as Extinction Rebellion. It explores the entanglements of these speculations with questions of justice, and offers an analysis of relationships humanity, inequality, and catastrophe in Mary Shelley’s novels Frankenstein (1818) and The Last Man (1826). The chapter ends with some suggestions about the role of the environmental humanities in an ecological emergency. In particular, it addresses how the field might contribute to the communal task of finding urgent solutions for social-environmental problems, while at the same time maintaining focus on issues of justice and rigorous critique of totalising narratives, including the language of solutions and of apocalypse itself.
Romantic nature writing emerges at roughly the same time as the industrial innovations that will eventually lead to global carbon capitalism and therefore is for some scholars coeval with the birth of the Anthropocene. This chapter takes a genealogical approach to the Anthropocene by suggesting that there are significant continuities between Romantic literature and contemporary discourses on environmental catastrophe. Focusing on two case studies – William Cowper’s The Task and Mary Shelley’s Frankenstein, both of which responded to climate change caused by volcanic eruptions – this chapter shows how Romantic writers address what it means to be alive at a catastrophic turning point in planetary history. They are concerned with the power of the human imagination to shape its environments, yet also with our vulnerability to elemental forces that we may affect but that we cannot control.
SUMMARY: The destruction of Jamestown, Nevis, in 1690 by a tidal wave, or tsunami, has been the subject of hurried reports in contemporary news broadsheets, Victorian romantic legend, enthusiastic local histories, and even quick assessment by reality-TV archaeologists. Documentary and archaeological research has revealed the location, extent, and details of this early English colonial settlement, which have proved to be often at odds with previous assertions and assumptions. Evidence of destruction by natural forces corroborates the story of Jamestown's fate, but exposed walls lying on the ocean floor must be dismissed as fanciful. The human tragedy of the 1690 earthquake and tsunami can now be presented as fact, stripped of fiction and fable.
This paper summarizes archaeological investigations conducted from 2003 to 2006 at the site of Jamestown, a ‘lost’ commercial settlement on the leeward shore of the island of Nevis. According to local legend and lore, Jamestown vanished in 1690, destroyed by a tsunami. The town's end came, without warning, on April 5, 1690, ‘about five of the Clock in the Afternoon,’ an eyewitness would remember in a letter to a friend in London. ‘We heard a rumbling Noise, like that of distant Thunder,’ the eyewitness wrote, ‘from the Bowels of the great Mountain, … in the very Navil of the island.’ This earthquake was different from trembles that had rattled the island before. ‘So strong was the Motion,’ the eyewitness recounted, ‘that … [a] few Moments after the Noise began, … a … Earth Quake, which shook the whole island to that degree, that all the Houses in Charles Town that were built of Brick or Stone, dropt of a sudden down from the Top to the Bottom.’ The sea then suddenly receded, ‘for a time forfeit the Shoar for about three quarters of a Mile together, and left a great Number of Fish of a large size to lye gaping upon the Sand, till it returned again.’ This ‘violent Motion of the Water’ repeated ‘diverse times’, and we can imagine that when the sea ‘returned again’ it lifted and then slammed mats of debris against walls, houses, and anything else that lay in its path. No other reports of this earthquake or its effects survive (Fig. 9.1).
Despite the critical role families play in the care and recovery journeys of people who experience enduring mental distress, they are often excluded by the mental health services in the care and decision-making process. International trends in mental health services emphasise promoting a partnership approach between service users, families and practitioners within an ethos of recovery.
This paper evaluated the acceptability of and initial outcomes from a clinician and peer co-led family information programme.
A sequential design was used involving a pre-post survey to assess changes in knowledge, confidence, advocacy, recovery and hope following programme participation and interviews with programme participants. Participants were recruited from mental health services running the information programme. In all, 86 participants completed both pre- and post-surveys, and 15 individuals consented to interviews.
Survey findings indicated a statistically significant change in family members’ knowledge about mental health issues, recovery attitudes, sense of hope and confidence. In addition, the interviews suggested that the programme had a number of other positive outcomes for family members, including increased communication with members of the mental health team and increased awareness of communication patterns within the family unit. Family members valued the opportunity to share their experiences in a ‘safe’ place, learn from each other and provide mutual support.
The evaluation highlights the importance of developing information programmes in collaboration with family members as well as the strength of a programme that is jointly facilitated by a family member and clinician.