Identifying research priorities for older people’s mental health services

2019 ◽  
Vol 23 (2) ◽  
pp. 89-100 ◽  
Author(s):  
Luke Emrich-Mills ◽  
Laura Louise Hammond ◽  
Emma Rivett ◽  
Tom Rhodes ◽  
Peter Richmond ◽  
...  

PurposeIncluding the views of service users, carers and clinical staff when prioritising health research can ensure future projects are meaningful and relevant to key stakeholders. One National Health Service Foundation Trust in England, UK undertook a project to identify the top 10 research priorities according to people with experience using or working in services for dementia and older adult mental health. The paper aims to discuss these issues.Design/methodology/approachService users with dementia and mental health difficulties; informal carers, family and friends of service users; clinical staff working in the Trust. Participants were surveyed for research ideas. Ideas were processed into research questions and checked for evidence. Participants were then asked to prioritise their personal top 10 from a long list of research questions. A shortlist of 26 topics was discussed in a consensus workshop with a sample of participants to decide on the final top 10 research priorities.FindingsA total of 126 participants provided 418 research ideas, leading to 86 unique and unanswered research questions. In total, 58 participants completed interim prioritisation, 11 of whom were invited to the consensus workshop involving service users, carers and clinical staff. The final top 10 priorities were dominated by topics surrounding care, psychosocial support and mental health in dementia.Research limitations/implicationsFuture research from the Trust and collaborating organisations can use these results to develop relevant projects and applications for funding.Originality/valueThis project has demonstrated the possibility of including key stakeholders in older adult mental health research priority setting at the local level.

2020 ◽  
Vol 25 (3) ◽  
pp. 281-294
Author(s):  
Joanna Fox

Purpose User involvement in research is entering the mainstream of traditional mental health research. In practice, there are diverse ways in which the process of involvement is experienced by mental health service user researchers. This paper aims to explore two diverse experiences of involvement by the researcher. Design/methodology/approach Auto-ethnography is the research methodology used in this study; it combines a process of reflective writing and critical analysis which enables the author to explore experiences of being both a service user and academic researcher. Two accounts of the author’s involvement in mental health research are presented: one which builds on a consultation model and the other based on co-production principles. Findings Experiences of power-sharing and collaborative decision-making, alongside disempowerment, are discussed, leading to exploration of the theoretical and practical processes for promoting participation of users in research. Research limitations/implications The research is limited because it is undertaken by one individual in a local setting, and is therefore is not generalisable; however, it provides useful insights into the diverse processes of involvement that many service users experience. Practical implications Recommendations are presented to support the involvement of service users in research, with final remarks offered considering the possible future implementation of this still emerging tradition. Originality/value This paper reflects on the experiences of one service user academic involved in research and highlights diverse experiences of both empowering and disempowering involvement, providing recommendations for best practice.


2019 ◽  
Vol 24 (3) ◽  
pp. 171-182
Author(s):  
Diane Beattie ◽  
Síle Murphy ◽  
John Burke ◽  
Hester O’Connor ◽  
Sarah Jamieson

Purpose The purpose of this paper, a qualitative study, is to explore service users’ experiences of attending clinical psychology within a public community adult mental health service. Design/methodology/approach Six individuals who had completed at least 16 sessions of psychotherapy participated in semi-structured interviews. Data were transcribed and analysed using interpretative phenomenological analysis. Findings The results showed the following overarching domains: the relationship and its impacts, structure and focus, and participant factors – timing/readiness. The importance of the use of language was also identified. Participants appeared to value a sense of humanity within the relationship. Interestingly, the personal impact of therapy as perceived by the participants was not focussed on symptom reduction, but on broader changes. The results are discussed in relation to the relevant literature. Practical implications Suggested principles for practice include maintaining attentiveness to relational factors, to client factors such as readiness for change and to the use of structure and flexibility. The use of recovery focussed and alliance measures are recommended. Originality/value For clinical psychologists providing psychotherapy within the public system, there are valuable lessons we can learn from asking the service users directly about their experiences, in terms of focussing on the human element of the relationship, and striking a balance between professionalism and humanity.


2019 ◽  
Vol 23 (1) ◽  
pp. 23-29
Author(s):  
Laura Lea ◽  
Sue Holttum ◽  
Victoria Butters ◽  
Diana Byrne ◽  
Helen Cable ◽  
...  

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.


2014 ◽  
Vol 7 (2) ◽  
pp. 52-62 ◽  
Author(s):  
Sarah Elison ◽  
Jonathan Ward ◽  
Glyn Davies ◽  
Nicky Lidbetter ◽  
Daniel Hulme ◽  
...  

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.


2017 ◽  
Vol 27 (2) ◽  
pp. 608-618 ◽  
Author(s):  
Emily Dodd ◽  
Richard Cheston ◽  
Charlie Procter ◽  
Sarah Heneker ◽  
Richard Gray ◽  
...  

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Karen Louise Bester ◽  
Anne McGlade ◽  
Eithne Darragh

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.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jessica Cartwright ◽  
Daniel Lawrence ◽  
Christopher Hartwright

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.


2019 ◽  
Vol 24 (2) ◽  
pp. 133-143 ◽  
Author(s):  
Mark Bertram

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.


2020 ◽  
Vol 24 (1) ◽  
pp. 6-12
Author(s):  
Sue Holttum

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.


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