Dr Felicity Thomas
Associate Professor
4249
01392 724249
Overview
I am an Associate Professor in the College of Humanities, and a Director of the Wellcome Centre for Cultures and Environments of Health and the WHO Collaborating Centre for Culture and Health at the University of Exeter.
My work is focused on understanding how cultures - encompassing societal values and norms, working practice, and regulatory and research cultures – intersect to impact on health and social care delivery, particularly for marginalised population groups. I have a particular interest in the intersections between poverty, mental health, and medicalisation, and in improving social care practice to support families with complex needs. I work in collaboration with service users, patients and health and social care providers to understand the cultural contexts that shape their experiences, and to design and lead impactful studies that shift working practice to create more ethical and sustainable health and social care.
Research
Current/recent research:
Implementing effective primary care responses to poverty-related mental distress (2021-2023, NIHR ARC Health Inqualities Consortium)
Research team: Felicity Thomas (PI), Katrina Wyatt (Exeter), Richard Byng (Plymouth), Susanne Hughes (Exeter), Jane Horrell (Exeter), Ilse Lee (UCL Partners), Kathryn Berzins (UcLan)
Understanding the high number of children in statutory care in Torbay: an engaged approach to supporting families (2021-2023, Torbay Medical Research Fund)
Research team: Felicity Thomas (PI), Felix Gradinger (Plymouth), Susanne Hughes (Exeter), Tom El-Hoss (Exeter), Torbay Council Public Health and Children's Services teams
Health and wellbeing in the Belarusian diaspora (2022-2024, WCCEH)
Research team: Felicity Thomas (PI), Aliaksandr Kazakou (Exeter)
Poverty, pathology and pills: moral narratives and the medicalisation of distress (2016 - 2019, ESRC ref: ES/N018281/1) http://destressproject.org.uk/
The provision of effective treatment and support for mental distress is a stated aim of the British Government and many civil society organisations. Within low-income communities, use of antidepressant medications is relatively high. However, current strategies frame mental distress as a psychological problem that lies within the individual concerned. This not only suggests that such distress can be 'corrected' through medical treatment, but also masks the factors that often underlie the root causes of suffering e.g. poor living conditions, unemployment. At the same time, policies in place to restrict welfare support, and popular media e.g. Benefits Street, draw on moralising narratives that promote the idea that people should take responsibility for their actions and circumstances. This research is exploring how people in low-income communities perceive and respond to mental distress caused by material deprivation and social disadvantage. Addressing key knowledge gaps, attention will be given to understanding: i) the role of moral narratives in influencing decisions to seek medical support for mental distress; ii) how these narratives manifest within GP consultations and influence treatment decisions and patient wellbeing.
Research team: Felicity Thomas (PI), Katrina Wyatt (Exeter), Rose McCabe (Exeter) and Richard Byng (Plymouth).
Cultural contexts of health (on-going collaboration with WHO Regional Office for Europe)
Our experiences of health, and our interactions with those who care for us, are strongly influenced by the cultural contexts we inhabit. Yet whilst there has been a recent drive to understand the social determinants of health, the ways in which societal norms, value systems, working practice, traditions and beliefs impact on health pathways and outcomes are often ignored, as is the frequently positive, protective impact that culture can have in the face of certain health challenges. We are working with WHO to systematically investigate the cultural contexts of health and well-being across the European Region, and to embed humanities and social sciences research and methodological approaches into the public health sector. Current work here includes on-going collaborations relating to the culture and reform of mental health care in Central and Eastern Europe; reporting on the cultural aspects of antibiotic resistance; the development of a model for reporting on wellbeing across the WHO Europe Region; development of a toolkit on intercultural competence and diversity sensitivity within healthcare.
Mental health outcomes of early life trauma in Belarus and Ukraine (MRC TrACES fund 2018 - 2019)
Early life trauma (ELT) is known to be a key determinant of later life health and wellbeing. Within Belarus and Ukraine, high levels of ELT have been associated with some of the highest levels of suicide and substance abuse amongst young people and adults in the world. Whilst this situation has been widely linked to the significant social, political and economic upheavals experienced in the Central and Eastern European Region over the past three decades, there is a dearth of detailed analysis of the causes of early life trauma in Belarus or Ukraine, or the socio-cultural context in which it is experienced, understood and responded to. This is due in large part to the continuing dominance of psychiatric and biomedical models of understanding, which pay little attention to the socio-cultural factors underpinning people’s lives, and to the lack of funding that has been available for non-clinical research. This project involves running a series of workshops with partner organisations (Ukrainian Catholic University and Minsk Regional Centre for Psychiatry and Addiction) to bring together key stakeholders from diverse disciplinary and service provider backgrounds in Belarus and Ukraine in order to i) support key stakeholders and service providers working with those affected by early life trauma to better understand its causes and the ways that multiple traumas interact to establish risk for negative mental health, substance abuse and suicide; ii) identify the factors and mechanisms which promote resilience amongst those affected by ELT and protect against negative mental health, substance abuse and suicide.
Research team: Felicity Thomas (PI), Dzmitry Krupchenka, Olga Kazakova, Orest Suvalo
Reducing inequalities in psychological support for people affected by cancer (Engaged Reearch Exploratory Award, 2018)
High levels of cancer exist within low-income communities in the UK. Since the publication of best practice guidance (National Cancer Equality Initiative 2010), efforts have been made to increase parity of cancer healthcare and treatment. Yet whilst people’s medical needs are increasingly well met, little attention has focused on supporting their mental health and emotional wellbeing, crucial when over half now live for ten years or more following diagnosis (Macmillan 2014). People diagnosed with cancer often report feeling overwhelmed with despair, grief and depression, factors that can be vastly exacerbated when they and their families are living concurrently with material hardship and deprivation.
The NHS Cancer Strategy (2016) calls for accelerated commissioning of support services, such as those provided through specialist counselling and psychological support. However, this is not provided routinely within NHS care, and little is known about the factors that influence referral to, or awareness of, this kind of service, or the long-term impact counselling has on service users. Working with partner organisations We Hear You (WHY); Wessex Cancer Trust and The Harbour, this project sekes to: identify lived experiences and gaps in current service provision for low-income groups; ii) provide a forum for low-income communities to feed in to the development and implementation of local Sustainability and Transformation Plans (STPs); iii) identify research priorities to help reduce inequalities in the provision of psychological support for people affected by cancer.
Research team: Felicity Thomas (PI), Lorraine Hansford
Co-creating strategies to address child poverty (Engaged Research Exploratory Award, 2017)
Working with Barnardo's, a Children's Centre and parents from low-income backgrounds, this work provided a forum for parents to voice their experiences, needs and priorities relating to child poverty. This work fed into the Plymouth Child Poverty Action Plan and has played an influential role in the development of the City Council's approach to co-creating strategy and commissioning with service users from low-income backgrounds.
Research team: Felicity Thomas, Lorraine Hansford
Supervision
I am open to discussing research proposals on any subject area relevant to my expertise. I am especially happy to consider working with candidates with interests in the following areas:
- health inequalities
- mental health
- medicalisation and pharmaceuticalisation
- cultural contexts of health and well-being
- migration and health
Publications
Copyright Notice: Any articles made available for download are for personal use only. Any other use requires prior permission of the author and the copyright holder.
| 2024 | 2023 | 2022 | 2021 | 2020 | 2019 | 2018 | 2017 | 2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 |
2024
- El-Hoss T, Thomas F, Gradinger F, Hughes MS. (2024) Child protection and family support: Experiences in a seaside resort, Geoforum, volume 148, pages 103943-103943, article no. 103943, DOI:10.1016/j.geoforum.2024.103943. [PDF]
2023
- Montenegro C, Irarrázaval Dominguez M, González Moller J, Thomas F, Urrutia Ortiz J. (2023) Moving psychiatric deinstitutionalization forward: A scoping review of barriers and facilitators – CORRIGENDUM, Cambridge Prisms: Global Mental Health, volume 10, article no. e82, DOI:10.1017/gmh.2023.87. [PDF]
- El‐Hoss T, Thomas F, Gradinger F, Hughes S. (2023) The role of the voluntary, community and social enterprise sector in Early Help: Critical reflections from embedded social care research, Child & Family Social Work, volume 28, no. 4, pages 1150-1162, DOI:10.1111/cfs.13034. [PDF]
- Montenegro C, Irarrázaval Dominguez M, González Moller J, Thomas F, Urrutia Ortiz J. (2023) Moving psychiatric deinstitutionalization forward: A scoping review of barriers and facilitators, Cambridge Prisms: Global Mental Health, volume 10, article no. e29, DOI:10.1017/gmh.2023.18. [PDF]
- Montenegro Cortés C, González Moller J, Dominguez MI, Thomas F, Urrutia Ortiz J. (2023) Moving psychiatric deinstitutionalisation forward: A scoping review of barriers and facilitators, DOI:10.1101/2023.03.28.23287810. [PDF]
- Jack-Kadioglu T. (2023) Power and Polycentric Coastal Governance: Livelihoods, Equity, and Environmental Change in the Philippines.
2022
- Hansford L, Thomas F, Wyatt K. (2022) How does housing affect end-of-life care and bereavement in low-income communities? A qualitative study of the experiences of bereaved individuals and service providers in the United Kingdom, Palliative Care and Social Practice, volume 16, DOI:10.1177/26323524221110248.
- Green J, Fischer EF, Fitzgerald D, Harvey TS, Thomas F. (2022) The publics of public health: learning from COVID-19, Critical Public Health, volume 32, no. 5, pages 592-599, DOI:10.1080/09581596.2022.2077701. [PDF]
- Heney V. (2022) Our stories, our selves: Fictional representations of self-harm.
- Hansford L, Thomas F, Wyatt K. (2022) Poverty, choice and dying in the UK: a call to examine whether public health approaches to palliative care address the needs of low-income communities, Mortality, volume 28, no. 4, pages 610-626, DOI:10.1080/13576275.2022.2044299. [PDF]
2021
- Kazakova O, Thomas F, Suvalo O. (2021) Building resilience to early life trauma in belarus and Ukraine, EUROPEAN PSYCHIATRY, volume 64, pages S68-S68, DOI:10.1192/j.eurpsy.2021.211. [PDF]
- Kazakova O, Thomas F, Zrazikova V. (2021) Impact of relative mental illness on caregivers, EUROPEAN PSYCHIATRY, volume 64, pages S369-S370, DOI:10.1192/j.eurpsy.2021.990. [PDF]
- Thomas F. (2021) Medicalisation, Routledge International Handbook of Critical Issues in Health and Illness, 23-33.
- Ford J, Thomas F, Byng R, McCabe R. (2021) Asking about self-harm and suicide in primary care: Moral and practical dimensions, Patient Education and Counseling, volume 104, pages 826-835, DOI:10.1016/j.pec.2020.09.037.
2020
- Marais JM, Kazakova O, Krupchanka D, Suvalo O, Thomas F. (2020) Understanding and building resilience to early life trauma in Belarus and Ukraine, WHO Regional Office for Europe, WHO Regional Office for Europe, 54 pages.
- Thomas F. (2020) Migration and Health: Enhancing Intercultural Competence and Diversity Sensitivity, WHO Europe, WHO Europe, 74 pages.
- Thomas F, Fietje N. (2020) Capturing the cultural narratives of well-being, Well-Being: Expanding the Definition of Progress Insights From Practitioners, Researchers, and Innovators From Around the Globe, 67-82, DOI:10.1093/oso/9780190080495.003.0005.
- Kazakova O, Thomas F, Suvalo O, Krupchanka D, Fietje N. (2020) Understanding and building resilience to early life trauma in belarus and ukraine, EUROPEAN PSYCHIATRY, volume 63, pages S160-S160. [PDF]
- Kazakova O, Thomas F, Zrazikova V, Gvazdzeuskaya M. (2020) Factors influencing family decisions to institutionalize or care for a relative with mental illness at home, EUROPEAN PSYCHIATRY, volume 63, pages S139-S139. [PDF]
- Thomas F. (2020) Mental health disorders: an anthropological perspective, EUROPEAN PSYCHIATRY, volume 63, pages S590-S590. [PDF]
- Thomas F, Hansford L, Wyatt K, Byng R, Coombes K, Finch J, Finnerty K, Ford J, Guppy K, Guppy R. (2020) An engaged approach to exploring issues around poverty and mental health: A reflective evaluation of the research process from researchers and community partners involved in the DeStress study, Health Expectations, volume 24, no. S1, pages 113-121, DOI:10.1111/hex.13065. [PDF]
- Ford J, Thomas F, Byng R, McCabe R. (2020) Use of the Patient Health Questionnaire (PHQ-9) in practice? Interactions between patients and physicians, Qualitative Health Research, DOI:10.1177/1049732320924625.
- Thomas F, Wyatt K, Hansford L. (2020) The violence of narrative: embodying responsibility for poverty-related distress, Sociology of Health and Illness: a journal of medical sociology, DOI:10.1111/1467-9566.13084.
2019
- Thomas F, Hansford L, Ford J, Wyatt K, McCabe R, Byng R. (2019) How accessible and acceptable are current GP referral mechanisms for IAPT for low-income patients? Lay and primary care perspectives, Journal of Mental Health, volume 29, no. 6, pages 706-711, DOI:10.1080/09638237.2019.1677876. [PDF]
- Ford J, Thomas F, Byng R, McCabe R. (2019) Exploring how patients respond to GP recommendations for mental health treatment: an analysis of communication in primary care consultations, BJGP Open, DOI:10.3399/bjgpopen19X101670.
- Hansford L, Thomas F, Wyatt K. (2019) The impact of the Work Capability Assessment on mental health: Claimants’ lived experiences and GP perspectives in low-income communities, Journal of Poverty and Social Justice, volume 27, no. 3, pages 351-368, DOI:10.1332/175982719X15637716050550.
- Thomas F, Hansford L. (2019) Supporting mental health in low-income communities: Implications for justice and equity, Practical Justice: Principles, Practice and Social Change, 54-68.
- Higgins S, Thomas F. (2019) Urban freshwaters, biodiversity and human health and wellbeing: setting an interdisciplinary research agenda, WIREs Water, volume 6, DOI:10.1002/wat2.1339.
2018
- Thomas F. (2018) Health education and migration, Health Education Journal, DOI:10.1177/0017896918813592.
- Hinchliffe S, Jackson M, Wyatt K, Barlow A, Barreto M, Clare L, Deplege M, Durie R, Fleming L, Groom N. (2018) Healthy publics: Enabling cultures and environments for health, Palgrave Communications, volume 4, pages n/a-n/a, article no. 57 (2018), DOI:10.1057/s41599-018-0113-9.
- Thomas F, Hansford L, Ford J, Wyatt K, McCabe R, Byng R. (2018) Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform, Palgrave Communications, volume 4, article no. 39, DOI:10.1057/s41599-018-0091-y.
2017
- Napier D, Depledge MH, Knipper M, Lovell R, Ponarin E, Sanabria E, Thomas F. (2017) Culture matters: using a cultural contexts of health approach to enhance policy-making, World Health Organisation, World Health Organisation.
- Thomas F. (2017) Pharmaceutical waste in the environment: a cultural perspective, Public Health Panorama.
2016
- Wyatt K, Durie R, Thomas F. (2016) Asset Based Approaches for Community Engagement, Oxford Research Encyclopedia of Environmental Science, Oxford University Press (OUP), DOI:10.1093/acrefore/9780199389414.013.348.
- Thomas F, Hoyez A. (2016) Socio-spatial dimensions of healthcare for newly arrived migrants, Handbook of Migration and Health, Edward Elgar, 158-172.
- Thomas F. (2016) Cultural competence in migrant healthcare, Handbook of Migration and Health, Edward Elgar, 459-476.
- Thomas F. (2016) Migration and health: an introduction, Handbook of Migration and Health, Edward Elgar Publishing, 3-18.
- Thomas F. (2016) Handbook of Migration and Health, Edward Elgar Publishing.
- Thomas F. (2016) Climate change and health, Reference Module in Earth Systems and Environmental Science, DOI:10.1016/B978-0-12-409548-9.09791-8.
- Thomas F. (2016) Climate change and health, Encyclopedia of the Anthropocene, Elsevier.
- Thomas F. (2016) Young people's use of medicines: pharmaceuticalised governance and illness management within household and school settings, Social Science and Medicine, volume 165, pages 150-158, DOI:10.1016/j.socscimed.2016.07.032.
- Thomas F, Aggleton P. (2016) School-Based Sex and Relationships Education: Current Knowledge and Emerging Themes, Global Perspectives and Key Debates in Sex and Relationships Education: Addressing Issues of Gender, Sexuality, Plurality and Power, 13-29, DOI:10.1057/9781137500229_2.
2015
- Aggleton P, Parker R, Thomas F. (2015) From sex to sexuality, Culture, Health and Sexuality, Taylor & Francis, 1-6, DOI:10.4324/9781315794259-1.
- Thomas F, Depledge M. (2015) Medicine ‘misuse’: Implications for health and environmental sustainability, Social Science & Medicine, volume 143, pages 81-87, DOI:10.1016/j.socscimed.2015.08.028. [PDF]
- Aggleton P, Parker R, Thomas F. (2015) From Sex to Sexuality: Sexual Cultures and Sexual Selves, Culture, Health and Sexuality: an introduction, Routledge.
- Aggleton P, Parker R, Thomas F. (2015) Culture, health and sexuality: an introduction, Routledge.
- Thomas F, Aggleton P. (2015) School-based sex and relationships education: current knowledge and emerging themes, Global Perspectives and Key Debates in SRE: Addressing Issues of Gender, Sexuality, Plurality and Power, Palgrave.
- Thomas F. (2015) The role of natural environments within women's everyday health and wellbeing in Copenhagen, Denmark, Health Place, volume 35, pages 187-195, DOI:10.1016/j.healthplace.2014.11.005. [PDF]
2014
- Thomas F, Sabel CE, Morton K, Hiscock R, Depledge MH. (2014) Extended impacts of climate change on health and wellbeing, ENVIRONMENTAL SCIENCE & POLICY, volume 44, pages 271-278, DOI:10.1016/j.envsci.2014.08.011. [PDF]
2013
- Bennett C, Thomas F. (2013) Seeking asylum in the UK: lesbian perspectives, Forced Migration Review, volume 42, pages 25-28.
- Thomas F. (2013) Multiple medicaments: looking beyond structural inequalities in migrant healthcare, Migration, Health and Inequality, Zed Books, 137-149.
2012
- Aggleton P, Thomas F. (2012) Diversity in School, Latin American Center in Sexuality and Human Rights. [PDF]
2011
- Drew R, Aggleton P, Boyce P, Chalmers H, Maxwell C, Pachauri S, Thomas F, Warwick I, Wood K. (2011) Social Network Analysis to evaluate organisational networks on sexual health and rights, Development in Practice, volume 21, no. 8, pages 1062-1079, DOI:10.1080/09614524.2011.590884.
2010
- Schifter J, Thomas F. (2010) Fantasies, dependency and denial: HIV and the sex industry in Costa Rica, Mobility, Sexuality and AIDS, Routledge.
- Chase E, Chalmers H, Thomas F, Hollingworth K, Aggleton P. (2010) Shifting Policies and Enduring Themes in School Nursing, British Journal of School Nursing, volume 5, pages 492-500.
- Wood K, Aggleton P, Thomas F. (2010) Developing sexual health programmes: a framework for action, World Health Organisation, WHO. [PDF]
- Thomas F, Haour-Knipe M, Aggleton P. (2010) Mobility, Sexuality and AIDS, Routledge. [PDF]
- Thomas F, Aggleton P, Anderson J. (2010) 'Experts', 'partners' and 'fools': exploring agency in HIV treatment seeking among African migrants in London, Social Science and Medicine, volume 70, pages 736-743. [PDF]
- Thomas F, Aggleton P, Anderson J. (2010) If I cannot access services then there is no need for me to test." The impacts of health service charges on HIV testing and treatment amongst migrants in England, volume 22(4), pages 526-531. [PDF]
- Thomas F. (2010) Transnational health and treatment networks: meaning, value and place in health seeking amongst southern African migrants in London, Health and Place, volume 16(3), pages 606-612. [PDF]
2009
- Evans R, Thomas F. (2009) Emotional interactions and an ethic of care: caring relations in families affected by HIV and AIDS', Emotions, Space and Society, volume 2(2), pages 111-119. [PDF]
2008
- Thomas F. (2008) ‘Our Families are Killing Us’: HIV/AIDS, Witchcraft and Social Tensions in the Caprivi Region, Namibia, Anthropology and Medicine, volume 14, no. 3, pages 279-291, DOI:10.1080/13648470701612679.
- Thomas F. (2008) Remarriage after spousal death: options facing widows and implications for livelihood security, Gender & Development, volume 16, no. 1, pages 73-83, DOI:10.1080/13552070701876235.
- Thomas F. (2008) Remarriage after spousal death: options facing widows and implications for livelihood security, Gender and Development, volume 16(1), pages 75-85.
- Thomas F. (2008) Indigenous narratives of HIV/AIDS: morality and blame in a time of change, Medical Anthropology, volume 27(3), pages 227-256.
2007
- Thomas F. (2007) Eliciting emotions in HIV/AIDS research: a diary‐based approach, Area, volume 39, no. 1, pages 74-82, DOI:10.1111/j.1475-4762.2007.00723.x.
- Thomas F. (2007) Global rights, local realities: negotiating gender equality and sexual rights in the Caprivi Region, Namibia, Culture, Health and Sexuality, volume 9(6), pages 599-614. [PDF]
- Thomas F. (2007) Eliciting emotions: using solicited text and photo diary methods in HIV/AIDS research, Area, volume 39(1), pages 74-82. [PDF]
- Thomas F. (2007) Our families are killing us": witchcraft narratives and social tensions in the Caprivi Region, Namibia, Anthropology and Medicine, volume 14(3), pages 279-291. [PDF]
2006
- Thomas F. (2006) Stigma, fatigue and social breakdown: exploring the impacts of HIV/AIDS on patient and carer well-being in the Caprivi Region, Namibia, Social Science and Medicine, volume 63, pages 3174-3187. [PDF]