Mental health, social inclusion and the development of vocational services in the NHS – what can be learnt?

2019 ◽  
Vol 24 (2) ◽  
pp. 133-143 ◽  
Author(s):  
Mark Bertram
Keyword(s):  
Mental Health ◽  
Social Inclusion ◽  
Health Impact ◽  
Service Development ◽  
Service Users ◽  
Policy Makers ◽  
Content Type ◽  
Descriptive Case Study ◽  
Personal Bias ◽  
Vocational Goals

Purpose The purpose of this paper is to describe the learning from a historical NHS vocational service development that focused on: mental health, employment and social inclusion – in an inner city area – involving service users, staff and commissioners. Design/methodology/approach It is a descriptive case study. A range of historical documents was content analysed and described through a first-person narrative: service user consultations, service specifications, audit records, outcome frameworks, internal service evaluations and published literature. Findings When vocational NHS service developments are grounded in what service users say helps them (person-centred, networked and co-ordinated approaches) the evidence indicates people can achieve their vocational goals. Research limitations/implications The range of documents described is factual, although the learning insights from some of the service developments are based on personal judgements. The author was the responsible manager – personal bias is high. There is not enough robust evidence to warrant generalisation. Practical implications When employment and social inclusion are prioritised, as core business in NHS, outcomes and health impact can increase. Greater detail is needed from healthcare policy makers – focusing on who exactly should undertake this work and what the key commissioning social inclusion performance indicators are. Originality/value The bulk of literature on employment support focuses on promoting evidence from one model: individual placement and support. Evidence here indicates a broader range of activity (education, training and volunteering) can have value and health impact.

scholarly journals Foregrounding the perspectives of mental health services users during the COVID-19 pandemic

2020 ◽  
Vol 24 (3) ◽  
pp. 131-133
Author(s):  
Hannah Zeilig ◽  
Brioney Gee ◽  
Bonnie Teague ◽  
Jonathan Wilson ◽  
Corinna Hackmann
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Design Methodology ◽  
Lead Author ◽  
Service Development ◽  
Service Users ◽  
Service Strategy ◽  
Content Type ◽  
Strategy Design

Purpose This paper aims to highlight the critical importance of the perspectives of mental health service-users during the COVID-19 pandemic. Design/methodology/approach This viewpoint is based on a review of recent research and literature and draws on consultations with experts by experience, including the lead author. Findings The authors argue that expertise-by-experience is critical to policy, service development and research; but there is a risk it will be neglected at a time of rapid and reactive clinical development. Research limitations/implications Understanding and responding to the nuances of individual need can only be achieved through coproducing service strategy design, delivery and research with mental health service users. The consultation outlined in this viewpoint gives some indication of the type of valuable insights that can be gained through seeking and listening to the perspectives of experts by experience. Originality/value The discussions revealed that experience of managing severe and complex mental health conditions can actually be advantageous when facing a crisis such as COVID-19.

The recovery-orientation of three mental health units

2014 ◽  
Vol 19 (3) ◽  
pp. 163-175 ◽  
Author(s):  
Hollie Bass ◽  
Anna Tickle ◽  
Nicholas Lewis
Keyword(s):  
Mental Health ◽  
Service User ◽  
Service Development ◽  
Service Improvement ◽  
Service Users ◽  
Cross Sectional ◽  
Content Type ◽  
Staff Members ◽  
Recovery Orientation ◽  
Cross Sectional Design

Purpose – The purpose of this paper is to measure service user and staff views of the recovery orientation of three mental health rehabilitation units; two “open” and one “locked”. It identified elements of recovery that were important to service users. It measured the units’ performance on domains of recovery, attending to differences between staff members’ and service users’ perceptions and between the locked and open units. Design/methodology/approach – A cross-sectional design was used. Staff and service users completed the “Developing Recovery Enhancing Environment Measure (DREEM)”. Findings – Findings revealed some differences between staff and service user views. Service users in the locked unit reported the organisational climate to be more recovery oriented on some domains than those in the open units. Service users’ responses highlighted potential areas for service improvement. Research limitations/implications – The sample was small but reflected the applied setting. Some service users were not invited to participate because of significant communication or cognitive difficulties and it is recognised that they may have had alternative views that remain unrepresented. Practical implications – The DREEM provided valuable information about current practice and potential for service development. Both locked and open units can provide recovery-oriented environments. Services should be aware of discrepant views between staff and service users. Originality/value – To the knowledge, this is the first study to use the DREEM to evaluate the recovery orientation of a locked recovery unit and to compare locked and unlocked units.

Vocational rehabilitation in mental health services: evaluating the work of a social and therapeutic horticulture community interest company

2014 ◽  
Vol 18 (3) ◽  
pp. 155-163 ◽  
Author(s):  
Jon Fieldhouse ◽  
Vanessa Parmenter ◽  
Alice Hortop
Keyword(s):  
Mental Health ◽  
Vocational Rehabilitation ◽  
Social Inclusion ◽  
Local Community ◽  
Service Development ◽  
Small Scale ◽  
Content Type ◽  
Skill Sets ◽  
Community Interest ◽  
Therapeutic Horticulture

Purpose – The purpose of this paper is to report on an action inquiry (AI) evaluation of the Natureways project, a time-limited collaboration between an NHS Trust Vocational Service and a voluntary sector horticulture-based community interest company (CIC). Design/methodology/approach – Natureways produced positive employment outcomes and an AI process – based on co-operative inquiry with trainees, staff, and managers – explored how these had been achieved. Findings – Natureways’ efficacy was based on features of the setting (its supportiveness, rural location, and workplace authenticity), on its embeddedness (within local care-planning pathways, the horticultural industry, and the local community), and on effective intersectoral working. The inquiry also generated actionable learning about creative leadership and adaptability in the changing landscape of service provision, about the benefits of the CIC's small scale and business ethos, about the links between trainees’ employability, social inclusion and recovery, about horticulture as a training medium, and about the role of AI in service development. Practical implications – The inquiry highlights how an intersectoral CIC can be an effective model for vocational rehabilitation. Social implications – Community-embeddeness is an asset for mental health-orientated CICs, facilitating social inclusion and recovery. Social and therapeutic horticulture settings are seen to be conducive to this. Originality/value – This case study suggests that AI methodology is not only well-suited to many practitioners’ skill sets, but its participatory ethos and focus on experiential knowledge makes it suitable for bringing a service user voice to bear on service development.

Religion in inpatient mental health: a narrative review

2014 ◽  
Vol 19 (4) ◽  
pp. 221-236 ◽  
Author(s):  
Suzanne Heffernan ◽  
Sandra Neil ◽  
Stephen Weatherhead
Keyword(s):  
Mental Health ◽  
Traditional Healers ◽  
Service Users ◽  
Topic Area ◽  
Policy Makers ◽  
Content Type ◽  
Spiritual Assessment ◽  
Inpatient Mental Health ◽  
Inpatient Services ◽  
Informed Group

Purpose – The purpose of this paper is to explore the extent to which inpatient mental health services attend to the religious needs of service-users. Literature is presented to argue that whilst the importance of religion is highlighted in consumer accounts, research and policy; inpatient services continue to neglect religion and service-users consistently report insufficient attention to religious needs during hospitalisation. Design/methodology/approach – This review adopts a narrative approach to the literature, drawing upon published journal articles, book chapters and policy documentation. Findings – Literature into the topic area is reviewed and discussed within three themes. First, the extent to which religious needs are currently met is explored. Second, potential reasons for neglect of religion are considered. Finally, examples of religiously informed group programmes, individual psychotherapy and the use of traditional healers are detailed. Practical implications – Findings of the review point towards the requirement for inpatient services to more adequately meet religious needs in terms of available facilities. The need for spiritual assessment and collaboration with hospital chaplains is also highlighted, along with the call for increased staff training. Originality/value – It is expected that this review will be of interest to a range of stakeholders including professionals, policy makers and service users. It highlights the void in clinical attention to religious needs and offers practical suggestions for meeting this need.

Appreciating collaborative service improvement – a case study on using appreciative inquiry methodology in co-production in mental health

2019 ◽  
Vol 23 (3) ◽  
pp. 105-111
Author(s):  
Nicholas Dent
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Appreciative Inquiry ◽  
Service Development ◽  
Service Improvement ◽  
Health Staff ◽  
Service Users ◽  
Content Type ◽  
Health Service Improvement

Purpose The purpose of this paper is to examine the value of appreciative inquiry (AI) methodology in enabling co-productive work within mental health service development. Design/methodology/approach The methodology of AI is described and observations on its use in mental health service improvement are considered. Findings AI is a really helpful tool in supporting service improvement and is particularly applicable in mental health discussions involving service users and carers. Many service users and carers engaging with service development discussions have had adverse past experiences which can inhibit their successful contribution to planning discussions. AI allows a more positive reflection on how services can be improved which can help achieve positive results. Research limitations/implications AI methodology is a really useful tool in supporting improvement discussions across health, and other public, services, and is particularly valuable in engaging mental health service users and carers in such activity. Practical implications The method is useful across service development needs and could be developed to support mental health service improvement locally, regionally and nationally. Developing the use of this method could make a real contribution to improving relations between service users, carers and health staff and support meaningful and positive change in the delivery of mental health services. Social implications Helping to overcome dissonance between service users and carers, and health staff and commissioners; and developing the use of appreciative enquiry could enhance the value of co-production as a key driver for service improvement. Originality/value The author is aware of little discussion of the value of appreciative enquiry in the growing literature around co-production in mental health.

Research watch: is social inclusion for service users increased when mental health professionals “come out” as service users?

2017 ◽  
Vol 21 (2) ◽  
pp. 73-79 ◽  
Author(s):  
Sue Holttum
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Social Inclusion ◽  
Mental Distress ◽  
Service Users ◽  
Australian Study ◽  
Content Type ◽  
The Usa ◽  
Seeking Help

Purpose This paper discusses two recent studies of mental health professionals who have experience of mental distress, one in the USA and one in Australia. The purpose of this paper is to highlight different experiences, first of largely concealing their experience, and second of disclosing and using it. Design/methodology/approach The Australian study examined the barriers experienced by mental health professionals, including trainees, in relation to seeking help. The USA study reported on a sample of mental health professionals who were doing well, including leaders of services, despite current or past mental distress. Findings Both studies included more psychologists than other mental health professionals. Australian mental health professionals reported similar fears and barriers to those found in other studies, in addition to concern about their colleagues’ duty to report impairment to the regulating body. Professionals in the USA-based study were described as potentially helpful in reducing stigma about mental distress because their achievements demonstrated that recovery is possible. However, many of them were also cautious about who they disclosed to, and wanted further reduction in stigma and discrimination. Originality/value The Australian study highlighted specifically that the requirement to report impairment to the regulator deterred people from disclosing distress at work, making it less likely that they would get help. The USA-based study was ground-breaking in documenting achievements of a substantial sample of mental health professionals with experience of mental distress. Potentially more professionals being “out and proud” might help increase recovery and social inclusion for service users more generally.

Now they’re listening: involvement in clinical psychology training

2019 ◽  
Vol 23 (1) ◽  
pp. 23-29
Author(s):  
Laura Lea ◽  
Sue Holttum ◽  
Victoria Butters ◽  
Diana Byrne ◽  
Helen Cable ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Clinical Psychology ◽  
Health Professionals ◽  
Service User ◽  
Health Workers ◽  
Psychology Training ◽  
Service Users ◽  
Clinical Psychology Training ◽  
Content Type

PurposeThe 2014/2015 UK requirement for involvement of service users and carers in training mental health professionals has prompted the authors to review the work of involvement in clinical psychology training in the university programme. Have the voices of service users and carers been heard? The paper aims to discuss this issue.Design/methodology/approachThe authors update the paper of 2011 in which the authors described the challenges of inclusion and the specific approaches the authors take to involvement. The authors do this in the context of the recent change to UK standards for service user and carer involvement, and recent developments in relation to partnership working and co-production in mental healthcare. The authors describe the work carried out by the authors – members of a service user involvement group at a UK university – to ensure the voices of people affected by mental health difficulties are included in all aspects of training.FindingsCareful work and the need for dedicated time is required to enable inclusive, effective and comprehensive participation in a mental health training programme. It is apparent that there is a group of service users whose voice is less heard: those who are training to be mental health workers.Social implicationsFor some people, involvement has increased. Trainee mental health professionals’ own experience of distress may need more recognition and valuing.Originality/valueThe authors are in a unique position to review a service-user-led project, which has run for 12 years, whose aim has been to embed involvement in training. The authors can identify both achievements and challenges.

An outcomes study of eTherapy for dual diagnosis using Breaking Free Online

2014 ◽  
Vol 7 (2) ◽  
pp. 52-62 ◽  
Author(s):  
Sarah Elison ◽  
Jonathan Ward ◽  
Glyn Davies ◽  
Nicky Lidbetter ◽  
Daniel Hulme ◽  
...  
Keyword(s):  
Mental Health ◽  
Dual Diagnosis ◽  
Substance Dependence ◽  
Clinical Effectiveness ◽  
Outcome Data ◽  
Post Treatment ◽  
Service Users ◽  
Original Cohort ◽  
Content Type ◽  
Self Help

Purpose – In recent years there has been a proliferation of computer-based psychotherapeutic interventions for common mental health difficulties. Building on this, a small number of such interventions have now been developed to address substance dependence, one of which is Breaking Free Online (BFO). A new “eTherapy” self-help service, which was set up by the UK mental health charity Self-Help Services, has provided access to BFO to service users presenting with comorbid mental health and substance misuse difficulties. The purpose of this paper is to evaluate a range of clinical outcomes in the first cohort of service users accessing this dual diagnosis service. Design/methodology/approach – A number of standardised psychometric assessments were conducted with service users at baseline and post-treatment at discharge from the service. Outcome data were available for 47 service users out of an original cohort of 74. Findings – Statistically significant improvements were found in terms of measures of social functioning, depression, anxiety, alcohol and drug use and social anxiety. Clinically relevant gains were also identified, with fewer service users reaching threshold scores for depression and anxiety at post-treatment compared to baseline. Effect sizes also indicated that the identified improvements across the psychometric measures were robust and significant. Research limitations/implications – These findings provide further support for the clinical effectiveness of BFO, and also provide evidence that an eTherapy self-help service may be appropriate for some individuals presenting with dual diagnosis. Further research is underway with larger and alternative clinical populations to examine the effectiveness of BFO and also this novel eTherapy self-help approach. Originality/value – This paper has provided initial data to support effectiveness of a novel eTherapy service for dual diagnosis.

Is co-production working well in recovery colleges? Emergent themes from a systematic narrative review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Karen Louise Bester ◽  
Anne McGlade ◽  
Eithne Darragh
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Social Care ◽  
The Body ◽  
Bibliographic Databases ◽  
Service Users ◽  
Content Type ◽  
Practitioner Attitudes ◽  
Health And Social Care ◽  
The Impact

Purpose “Co-production” is a process in health and social care wherein service users and practitioners work in partnership. Recovery colleges (RCs) are educational establishments offering mental health education; a cornerstone feature is that courses are designed and delivered in parity by both mental health practitioners and “peers” – people with lived experience of mental illness. This paper aims to consider, through the identification of key themes, whether co-production within RCs is operating successfully. Design/methodology/approach The paper is a systematic review of qualitative literature. Relevant concept groups were systematically searched using three bibliographic databases: Medline, Social Care Online and Scopus. Articles were quality appraised and then synthesised through inductive thematic analysis and emergent trends identified. Findings Synthesis identified three key themes relating to the impact of co-production in RCs: practitioner attitudes, power dynamics between practitioners and service users, and RCs’ relationships with their host organisations. As a result of RC engagement, traditional practitioner/patient hierarchies were found to be eroding. Practitioners felt they were more person-centred. RCs can model good co-productive practices to their host organisations. The review concluded, with some caveats, that RC co-production was of high fidelity. Originality/value RC research is growing, but the body of evidence remains relatively small. Most of what exists examine the impact of RCs on individuals’ overall recovery and mental health; there is a limited empirical investigation into whether their flagship feature of parity between peers and practitioners is genuine.

Creating a culture of employability in mental health

2014 ◽  
Vol 18 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Naomi Boycott ◽  
Justine Schneider ◽  
Michael Osborne
Keyword(s):  
Mental Health ◽  
Supported Employment ◽  
Implementation Process ◽  
Lessons Learned ◽  
Service Development ◽  
Content Type ◽  
The Individual ◽  
The Uk ◽  
Early Intervention In Psychosis ◽  
The Impact

Purpose – The purpose of this paper is to draw out the lessons learned from the implementation of the Individual Placement and Support (IPS) approach to supported employment in two contrasting adult mental health teams; one “standard” CMHT, and one early intervention in psychosis (EIP) team. Design/methodology/approach – These inferences are based on the evidence from a four-year study of IPS in one mental health care provider in the UK, which began by setting up a new service, and went on to run a RCT looking at the impact of psychological input as an adjunct to IPS alone. Findings – In attempting to introduce IPS to mental health teams in Nottingham the authors came across numerous barriers, including service reorganisation, funding cuts and the wider context of recession. Differences were observed between mental health teams in the willingness to embrace IPS. The authors argue that this variability is due to differences in caseload size, recovery priorities and client profiles. The authors have learnt that perseverance, strenuous efforts to engage clinical staff and the use of IPS fidelity reviews can make a positive difference to the implementation process. Practical implications – The experience suggests that setting up an IPS service is possible even in the most challenging of times, and that EIP services may be a particularly fertile ground for this approach. The authors also discuss potential barriers to implementing new services in mental health teams. Originality/value – This paper will be of value to service development and the science of implementation in mental health.

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