Research, recovery and mental health: challenges and opportunities

2016 ◽  
Vol 20 (3) ◽  
pp. 174-179
Author(s):  
Padraig Collins ◽  
Sarah Crowe
Keyword(s):  
Mental Health ◽  
Research Methodology ◽  
Traditional Approach ◽  
Research Process ◽  
Service Users ◽  
Research Paradigm ◽  
Content Type ◽  
Traditional Research ◽  
Challenges And Opportunities ◽  
Oriented Approach

Purpose – The purpose of this paper is to explore the limitations of the current research paradigm in mental health, particularly from a recovery perspective, and to suggest an alternative approach to clinical research which may be more in line with recovery principles. Design/methodology/approach – The paper will first review the dominant research methodology utilised by the mental health disciplines, discussing some of the limitations of this approach, particularly from a recovery perspective. Existing research methodologies which embody recovery principles will then be outlined, before an alternative, more recovery-oriented, approach to research is discussed. Findings – The findings from this paper suggest that the current research paradigm utilised by the mental health disciplines may not be producing the most optimal results, and that a more recovery-oriented approach could help add to the value of this research, while also involving service users and their carers in the research process in a more meaningful way. Research limitations/implications – This paper will explore possibilities for undertaking recovery-informed research, which has implications, not only for researchers, service users and their families, but also for the practice of mental health disciplines more broadly. Originality/value – This paper will introduce a critique of traditional research methodology in mental health and will present an alternative recovery-oriented approach which could help to overcome some of the limitations of the more traditional approach.

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.

Linking the past and the present: service users’ perspectives of how adverse experiences relate to their admission to forensic mental health services

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jessica Cartwright ◽  
Daniel Lawrence ◽  
Christopher Hartwright
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Service Users ◽  
Forensic Mental Health ◽  
Discussion Section ◽  
Content Type ◽  
The Past ◽  
Secure Care ◽  
Adverse Experiences

Purpose This study aimed to explore how forensic mental health service users make sense of their past adverse experiences. Secondly, it aimed to explore whether service users considered their adverse experiences to be related to their current stay in a forensic mental health setting. Design/methodology/approach Interpretative phenomenological analysis was used to analyse interviews with eight service users in low and medium secure care. Six of the participants were male and two were female. Findings Four super-ordinate themes emerged from the data: “Living amongst adversity”; “Managing adverse experiences”; “Making sense of going into secure care”; and “Coping with the past in the present”. All participants referred to multiple adverse experiences throughout their lives and used harmful coping strategies to manage these. Individual differences in how they related their past experiences to their detention in secure care were evident. Practical implications Author guidelines state that this section is optional. Implications for clinical practice are discussed at length in the discussion section. Originality/value This study offers an insight into the way in which forensic mental health service users make sense of their past traumas in relation to their current admission to secure services. To the best of the authors’ knowledge, no research has previously addressed this from the perspective of service users.

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.

Research watch: what really helps recovery in relation to severe mental health difficulties?

2020 ◽  
Vol 24 (1) ◽  
pp. 6-12
Author(s):  
Sue Holttum
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Design Methodology ◽  
Support Service ◽  
Health Condition ◽  
Service Users ◽  
Content Type ◽  
Inpatient Settings ◽  
Mental Health Difficulties

Purpose The purpose of this paper is to examine three recent papers on mental health services and how they support recovery following a diagnosis of a severe mental health condition. Design/methodology/approach A search was carried out for recent papers on mental health and recovery. The author selected three papers that seemed to advance understanding of not only whether, but also how recovery of a meaningful life may be best supported in mental health services. Findings One paper suggested how staff were able to support service users’ personal goals and focus on recovery in acute inpatient settings, and what got in the way. The author suggests practical ways to address the barriers. A second paper reported the testing of a new model for supporting staff in primary and secondary care to work together so that service users with a diagnosis of bipolar or schizophrenia were better supported to work towards valued goals. A third paper reviewed 40 studies of how people can experience positive change after a first diagnosis of psychosis, and how change happened. Originality/value By studying the issues in detail, all three papers show how improved support for recovery and inclusion can be implemented against the backdrop of many years of service shortcomings.

Job creation through income generation: an evaluation of Re-Cover, a decorating project developed with forensic mental health service users

2018 ◽  
Vol 13 (3) ◽  
pp. 148-156
Author(s):  
Sarah McDonald ◽  
Mark Bertram
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Job Creation ◽  
Operating Costs ◽  
Service Users ◽  
Income Generation ◽  
Forensic Mental Health ◽  
Commercial Activity ◽  
Content Type

Purpose The purpose of this paper is to explore and describe the effectiveness, achievements and challenges of a job creation project that was developed with people in contact with forensic mental health services. Design/methodology/approach This evaluation (case study) used a mixed methods approach: a range of quantitative and qualitative data were gathered, analysed and interpreted. Findings There were economic and health benefits. The income generation was sufficient to fund a large chunk of the projects operating costs. Service users reported improvements in mental health, wellbeing, confidence, skill development and earning capacity. Research limitations/implications The sample size was too small to be generalised and no validated measures were used. Further research is required into the long-term benefits of job creation in mental health services and providing a continuum of employment support. Practical implications A range of commercial activity can form the basis for job creation and work training projects in mental health services. Substantial operating costs can be generated, to re-invest in job creation/enterprises. Social implications Social value can be enhanced within NHS public sector procurement procedures. Agreement between a range of internal NHS departments is necessary: finance, commercial, estates and facilities, and procurement. Originality/value Public sector procurement has the potential to act as a catalyst to support the inclusion agenda by funding commercial activity that job creation projects can undertake.

The experience of learning from mental health service users and carers

2019 ◽  
Vol 14 (2) ◽  
pp. 119-130
Author(s):  
Charlotte Wilson
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Online Survey ◽  
User Involvement ◽  
Emotional Arousal ◽  
Student Experiences ◽  
Service Users ◽  
Content Type ◽  
Cognitive Experience

Purpose The purpose of this paper is to explore student experiences of learning from mental health service users and carers. Design/methodology/approach In total, 30 clinical psychology trainees and ex-trainees took part in an online survey (n=21) or focus group (n=9). Responses were analysed using interpretative thematic analysis. Findings A number of themes were identified. There were two pre-conditions of learning: valuing the teaching and emotional arousal. Participants’ learning experiences were characterised by cognitive and meta-cognitive processes: active learning, reflection, increased attention and vivid memories. Furthermore, participants might have a meta-cognitive experience of having learned something, but being unsure what that something was. Participants reported learning about the lives of service users, about themselves and about the wider societal context for people with mental health difficulties. Practical implications In order to facilitate learning students should value the input of service users. This allows them to contain and use the emotional arousal the teaching produces. Furthermore, leaving students with a feeling that something has been learned but not being exactly sure what that has been may facilitate students seeking out further opportunities for service user involvement. Originality/value Few studies have explored the process of learning from mental health service users and carers. In the current study, the emotion aroused in participants was primary. Furthermore, a new meta-cognitive experience, namely, the experience of having learned something, but not being sure what has been learned, has been identified.

Owning one’s epistemology in religious studies research methodology

Kybernetes ◽  
2019 ◽  
Vol 49 (8) ◽  
pp. 2057-2071 ◽  
Author(s):  
Philip Baron
Keyword(s):  
Social Justice ◽  
Research Methodology ◽  
Research Process ◽  
Religious Studies ◽  
Research Approach ◽  
Research Activity ◽  
Content Type ◽  
Observer Effect ◽  
Temporal Coupling ◽  
The Relationship

Purpose There is a lack of epistemological considerations in religious studies methodologies, which have resulted in an on-going critique in this field. In addressing this critique, the researcher’s observer effect needs to be actively accounted for owing to the influence of the researcher’s epistemology in the author’s research. This paper aims to answer the question of why a researcher should address one’s epistemology in the research. Design/methodology/approach Using second-order cybernetics as an approach, observer dependence is exemplified and justified in the context of religious studies research methodology. The research activity is shown as a relational temporal coupling that introduces inter-subjective aspects to the research. The research process is analysed showing the need to provide scope for the researcher’s epistemology in one’s research. Findings A relational observer-dependent approach to research embraces the epistemology of the researcher and the participants providing equality in the relationship. The research results are thus framed according to the nature of the relationship and are thus not detached. This addresses social justice and reduces troubling truth claims. Research limitations/implications This first paper focuses on the question of why epistemology should be included in scholarly research. A detailed framework for how scholars may achieve this goal is to be part of the future study and is not presented in this paper. Practical implications In many positivist approaches there is a motivation to hide the researcher; however, recently there has been a move towards including authors in the first person, realising that science is tied to politics, which does not reach its ideals of objectivity. Cybernetics is presented as an approach to addressing the move from “objective” to “subjective” research. Social implications Researchers cannot get into the minds of their participants and thus an authorial privileged presentation by the researcher of the participant’s experiences is fraught with epistemological weaknesses. Attempting to own one’s own epistemology could address social justice in research by personalising the research and accounting for the observer effect and the inter-subjective attributes of the research relationship. Originality/value The principle of observer dependence in cybernetics is not new; however, a research approach that focuses on the nature of knowing and how this may influence one’s research in religious studies is uncommon. It is thus presented here as a viable option to address the critique of epistemologically weak research methodology in religious studies.

scholarly journals Therapeutic institutions of violence: conceptualising the biographical narratives of mental health service users/survivors accessing long term “treatment” in England

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Stephen J. Macdonald
Keyword(s):  
Mental Health ◽  
Family Members ◽  
Psychiatric Hospitals ◽  
Term Treatment ◽  
Service Users ◽  
Content Type ◽  
Criminal Violence ◽  
Long Term Treatment ◽  
Forms Of Violence

Purpose This paper aims to conceptualise the residential and psychiatric hospital as a space where criminality and social harms can emerge. Because of recent media scandals over the past 10 years concerning privately-owned hospitals, this study examines the lived experiences of service users/survivors, family members and practitioners to examine historic and contemporary encounters of distress and violence in hospital settings. Design/methodology/approach The study consists of 16 biographical accounts exploring issues of dehumanising and harmful practices, such as practices of restraint and rituals of coercive violence. A biographical methodology has been used to analyse the life stories of service users/survivors (n = 9), family members (n = 3) and professional health-care employees (n = 4). Service users/survivors in this study have experienced over 40 years of short-term and long-term periods of hospitalisation. Findings The study discovered that institutional forms of violence had changed after the deinstitutionalisation of care. Practitioners recalled comprehensive experiences of violence within historic mental hospitals, although violence that may be considered criminal appeared to disappear from hospitals after the Mental Health Act (1983). These reports of criminal violence and coercive abuse appeared to be replaced with dehumanising and harmful procedures, such as practices of restraint. Originality/value The data findings offer a unique interpretation, both historical and contemporary, of dehumanising psychiatric rituals experienced by service users/survivors, which are relevant to criminology and MAD studies. The study concludes by challenging oppressive psychiatric “harms” to promote social justice for service users/survivors currently being “treated” within the contemporary psychiatric system. The study intends to conceptualise residential and psychiatric hospitals as a space where criminality and social harms can emerge. The three aims of the study examined risk factors concerning criminality and social harms, oppressive and harmful practices within hospitals and evidence that violence occurs within these institutionalised settings. The study discovered that institutional forms of violence had changed after the deinstitutionalisation of care. These reports of violence include dehumanising attitudes, practices of restraint and coercive abuse.

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