scholarly journals Shifting neurotypical prevalence in knowledge production about the mentally diverse: A qualitative study exploring factors potentially influencing a greater presence of lived experience-led research

2019 ◽  
Vol 8 (3) ◽  
pp. 66-94
Author(s):  
Damian Mellifont

Research which is led by mentally diverse persons offers a variety of benefits.  Crucially, this research holds potential to target wide-ranging social inclusion issues.  Recognizing that these studies cannot lay claim to be commonplace, the aim of this investigation is to inform and improve policy supportive of lived experience-led studies by critically investigating evidence-based factors influencing a greater presence of this genuinely inclusive style of research.  Following purposive sampling, thematic analysis was applied to twelve articles meeting with inclusion criteria and retrieved from Scopus, Medline, PsycINFO and ProQuest databases.  This investigation reveals three key findings.  First, this exploratory study identifies factors supporting and resisting lived experience-led research across micro, meso and macro levels.  Second, investment in future research is needed to identify evidence-based measures with capacity to redress factors constraining opportunities for mentally diverse persons to develop research careers and to potentially lead the way in reforming mental health and other services.  Finally, any assertions of neurodiverse researchers as necessarily being lacking in professional qualifications or reliant upon the assistance of neurotypical colleagues should be critically questioned.  

2021 ◽  
pp. 107780122110145
Author(s):  
Belinda Nixon ◽  
Elly Quinlan

The literature on sexual abuse indicates low rates of inquiry by mental health professionals. This study explores early career psychologists’ experiences of inquiry into their clients’ sexual abuse histories. Twelve Australian psychologists participated in semi-structured interviews with transcripts analyzed using thematic analysis. The vast majority of participants reported that they did not routinely inquire about sexual abuse with barriers including not knowing what to do, discomfort, stigma, and fear of negative outcomes. Participants asserted that their university training in sexual abuse inquiry was inadequate. Findings emphasize the need for the development of an evidence-based framework for sexual abuse training.


2021 ◽  
Author(s):  
Melissa Voth ◽  
Shannon Chisholm ◽  
Hannah Sollid ◽  
Chelsea Jones ◽  
Lorraine Smith-MacDonald ◽  
...  

BACKGROUND Globally, military members (MM) and public safety personnel (PSP) are vulnerable to occupational stress injuries (OSIs) due to their job demands. Consequently, when MM and PSP transition out of these professions, they may continue to experience mental health challenges. In response to this, resilience building programs are being developed and implemented with the goal of promoting empowerment and primary stress regulation. The development of mobile health (mHealth) applications (apps) as an emergent mental health intervention platform has allowed for targeted, cost effective, and easily accessible treatment when in-person therapy may be limited or unavailable. However, current mHealth app development is not regulated, and often lacks both clear evidence-based research and the input of healthcare professionals. OBJECTIVE The purpose of this manuscript is to evaluate the evidence-based quality, efficacy, and effectiveness of resilience building mobile apps targeted towards MM, PSP, and veteran populations via: (1) a scoping literature review of the current evidence-base regarding resilience apps for these populations, and; (2) evaluation of free resilience apps designed for use amongst these populations. METHODS Studies were selected using a comprehensive search of MEDLINE, CINAHL Plus, PsycINFO, SocINDEX, Academic Search Complete, Embase, and Google and was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis for scoping reviews (PRISMA-ScR). The Alberta Rating Index for Apps (ARIA) was utilized to conduct a review of each of the identified apps. Inclusion criteria consisted of apps: 1) free to download in either Google Play or the App Store; 2) updated within the last 3 years; 3) available in English and in Canada; and 4) intended for use by MM and/or PSP. RESULTS Twenty-two apps met the inclusion criteria for evaluation. The resilience strategies offered by the majority of apps included psychoeducation, mindfulness, Cognitive Behavioural Therapy (CBT), and Acceptance and Commitment Therapy (ACT). Eleven apps (50%) had been tested with randomized controlled trials, seven (31.8%) were evaluated using other research methods, and five (22.7%) had not been researched. Using the ARIA, apps scores ranged from 37 to 56 out of 72 with higher rated apps demonstrating increased useability and security features. CONCLUSIONS The mHealth apps reviewed are well suited to providing resilience strategies for MMs, PSP and veterans. They offer easy accessibility to evidence-based tools while working to encourage the use of emotional and professional support with safety in mind. While not intended to function as a substitute for professional services, research has demonstrated that mHealth apps have the potential to foster a significant reduction in symptom severity for PTSD, depression, anxiety, and other stress-induced concerns. Within clinical practice, apps can be utilized to supplement treatment as well as provide clients with population-specific, confidential tools to increase engagement in the treatment process. CLINICALTRIAL N/A


2008 ◽  
Vol 6 (4) ◽  
pp. 26-33 ◽  
Author(s):  
John Owen ◽  
Alexia Papageorgiou

Aim: This small−scale, exploratory, qualitative study was conducted to investigate how the experiences of having a stoma and subsequent stoma reversal affected the lives of the participants.Method: Five participants were interviewed about their experiences. Manual thematic analysis, using Interpretive Phenomenological Analysis (IPA), was employed to interpret the data. Results: Common themes were identified as emerging from the data. Themes before reversal were: acceptance and coping; social impact; and anticipation of returning to normal. Post−reversal themes were: returning to normal; interference with anticipated return to normal; and ongoing social impact. Conclusion: This exploratory study provides a rich account of the experiences of stoma patients who underwent reversal operations. It enhances our understanding of the transition encountered when changing from a person with a stoma into someone without one. This research has found that the anticipated return to normal can be hampered by a mix of physical and psychological processes.


2020 ◽  
Author(s):  
Eric Badu ◽  
Anthony Paul O’Brien ◽  
Rebecca Mitchell ◽  
Akwasi Osei

Abstract Background Evidence-based clinical practice is an inherent component of developed countries mental health professional practice, however, little is known about Ghana mental health professional perspectives on evidence-based practice. This paper outlines the processes involved in the delivery of best practice in Ghana. The paper describes a realistic evaluation of mental health nurses and allied health opinions regarding the evidenced-based therapeutic process in Ghana mental health facilities. Methods A purposive sample of 30 Mental Health Professionals (MHPs) was recruited to participate in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. A programme theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two CMO configurations: 1) technical competency stimulates evidence-based mental health services; and, 2) therapeutic alliance-building ensures effective interaction. The study demonstrated that contextual factors (technical competencies and therapeutic alliance building) together with mechanisms (intentional and unintentional) help to promote the quality of mental health services. However, contextual factor such as the lack of sign language interpreters yielded an unintended outcome such as consumer-provider communication barrier for consumers with hearing impaired and those from linguistically minority background. Conclusion We conclude that government stakeholders and policymakers should prioritize policy documents, periodic monitoring and adequate financial incentives to support the on-going mechanisms that promote mental health professional technical competence and therapeutic alliance building.


2021 ◽  
Author(s):  
Laura Martinengo ◽  
Anne-Claire Stona ◽  
Konstadina Griva ◽  
Paola Dazzan ◽  
Carmine Maria Pariante ◽  
...  

BACKGROUND Mental health disorders affect one in ten people globally, of which around 300 million are affected by depression. At least half of affected people remain untreated. Cognitive behavioral therapy (CBT) is an effective treatment but access to specialized providers, habitually challenging, has worsened with COVID-19. Internet-based CBT (iCBT) is effective and a feasible strategy to increase access to treatment for people with depression. Mental health apps may further assist in facilitating self-management for people affected by depression but accessing the right app might be cumbersome given the large number and wide variety of apps offered by public app marketplaces. OBJECTIVE To systematically assess features, functionality, data security and congruence with evidence of self-guided CBT-based apps available in major app stores, suitable for users suffering from depression. METHODS A systematic assessment of self-guided CBT-based apps available in Google Play and Apple’s App Store was conducted. Apps launched or updated since August 2018 were identified through a systematic search in 42matters using CBT-related terms. Apps meeting inclusion criteria were downloaded and assessed using a Samsung Galaxy J7 Pro (Android 9) and iPhone 7 (iOS 13.3.1). Apps were appraised using a 182-question checklist developed by the research team, comprising apps’ general characteristics, CBT-related features, including six evidence-based CBT techniques as informed by a CBT manual, CBT competences framework and a literature review of iCBT clinical trial protocols (psychoeducation, behavioral activation, cognitive restructuring, problem solving, relaxation, and exposure for comorbid anxiety), and technical aspects and quality assurance. Results were reported as a narrative review, using descriptive statistics. RESULTS The initial search yielded 3006 apps, of which 98 apps met inclusion criteria and were systematically assessed. There were 20 wellbeing apps, 65 mental health apps and 13 depression apps. Twenty-eight apps offered at least four evidence-based CBT techniques, particularly depression apps. Cognitive restructuring was the most common technique, offered by 77/98 apps. Only a third of apps offered suicide- risk management resources while less than 20% of apps offered COVID-19-related information. Most apps included a privacy policy, but only a third of apps presented it before account creation. Eighty percent of privacy policies stated sharing data with third party service providers. Half of app development teams included academic institutions or healthcare providers. CONCLUSIONS Only few self-guided CBT-based apps offer comprehensive CBT programs or suicide risk management resources. Sharing of users’ data is widespread, highlighting shortcomings in the health app market governance. To fulfill their potential, self-guided CBT-based apps should follow evidence-based clinical guidelines, be patient-centered and enhance users’ data security. CLINICALTRIAL NA


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paulina Daw ◽  
Thomas M. Withers ◽  
Jet J. C. S. Veldhuijzen van Zanten ◽  
Alexander Harrison ◽  
Colin J. Greaves

Abstract Background There is a longstanding research-to-practice gap in the delivery of cardiac rehabilitation for patients with heart failure. Despite adequate evidence confirming that comprehensive cardiac rehabilitation can improve quality of life and decrease morbidity and mortality in heart failure patients, only a fraction of eligible patients receives it. Many studies and reviews have identified patient-level barriers that might contribute to this disparity, yet little is known about provider- and system-level influences. Methods A systematic review using narrative synthesis. The aims of the systematic review were to a) determine provider- and system-level barriers and enablers that affect the delivery of cardiac rehabilitation for heart failure and b) juxtapose identified barriers with possible solutions reported in the literature. A comprehensive search strategy was applied to the MEDLINE, Embase, PsycINFO, CINAHL Plus, EThoS and ProQuest databases. Articles were included if they were empirical, peer-reviewed, conducted in any setting, using any study design and describing factors influencing the delivery of cardiac rehabilitation for heart failure patients. Data were synthesised using inductive thematic analysis and a triangulation protocol to identify convergence/contradiction between different data sources. Results Seven eligible studies were identified. Thematic analysis identified nine overarching categories of barriers and enablers which were classified into 24 and 26 themes respectively. The most prevalent categories were ‘the organisation of healthcare system’, ‘the organisation of cardiac rehabilitation programmes’, ‘healthcare professional’ factors and ‘guidelines’. The most frequent themes included ‘lack of resources: time, staff, facilities and equipment’ and ‘professional’s knowledge, awareness and attitude’. Conclusions Our systematic review identified a wide range of provider- and system-level barriers impacting the delivery of cardiac rehabilitation for heart failure, along with a range of potential solutions. This information may be useful for healthcare professionals to deliver, plan or commission cardiac rehabilitation services, as well as future research.


2018 ◽  
Vol 23 (4) ◽  
pp. 601-613 ◽  
Author(s):  
Michelle O’Reilly ◽  
Nisha Dogra ◽  
Natasha Whiteman ◽  
Jason Hughes ◽  
Seyda Eruyar ◽  
...  

Despite growing evidence of the effects of social media on the mental health of adolescents, there is still a dearth of empirical research into how adolescents themselves perceive social media, especially as knowledge resource, or how they draw upon the wider social and media discourses to express a viewpoint. Accordingly, this article contributes to this scarce literature. Six focus groups took place over 3 months with 54 adolescents aged 11–18 years, recruited from schools in Leicester and London (UK). Thematic analysis suggested that adolescents perceived social media as a threat to mental wellbeing and three themes were identified: (1) it was believed to cause mood and anxiety disorders for some adolescents, (2) it was viewed as a platform for cyberbullying and (3) the use of social media itself was often framed as a kind of ‘addiction’. Future research should focus on targeting and utilising social media for promoting mental wellbeing among adolescents and educating youth to manage the possible deleterious effects.


2020 ◽  
Vol 30 (7) ◽  
pp. 1033-1044
Author(s):  
Alexis M. Fabricius ◽  
Andrea D’Souza ◽  
Vanessa Amodio ◽  
Angela Colantonio ◽  
Tatyana Mollayeva

Despite recognizing that women have worse outcomes after traumatic brain injury (TBI), little is known about how gender influences their experiences of this critical injury. Past research has been dominated by androcentrism and quantitative approaches, leaving the lived experience of women with TBI insufficiently examined. To gain insight into their experiences, this qualitative study interviewed 19 Canadian women with mild and moderate-to-severe TBIs. Applying a thematic analysis, we discerned three themes: Gender prevails considers choosing to do gender over complying with physician advice; Consequences of TBI impeding performativity explores how women frame themselves as terrible people for being unable to do gender post-TBI; and Perceptions of receiving care looks at gendered caregiving expectations. These results broadly align with research on how doing gender influences recovery and health outcomes. We discuss the implications of our findings for knowledge translation, future research on women’s TBI recovery, and clinical practice.


Author(s):  
Katherine M. Boydell ◽  
Anne Honey ◽  
Helen Glover ◽  
Katherine Gill ◽  
Barbara Tooth ◽  
...  

Mental health lived-experience research illuminates the perspectives and experiences of people who live with mental illness. However, little is known about how useful people with lived experience of mental illness/distress might find lived-experience research, nor what the best formats are to bring it to their attention. This paper describes the STELLER study (Supporting the Translation into Everyday Life of Lived-Experience Research), which explores the translation of lived-experience research in the lives of people living with mental illness. Our aim was to use a design thinking approach to develop a range of user-friendly formats to disseminate lived-experience research. A staged design thinking approach was used to develop a translation strategy for lived-experience research. We explored empathy via consumer consultation to understand their perspectives on lived-experience research, refined the design aim, research questions and generated ideas with consumers and mental health professionals, identified the evidence based on lived experience-authored journal articles, worked with design students and peer workers to create a suite of resources and developed prototypes tailored to individual settings and clients. Participatory design thinking strategies are essential to identify the best ways to translate evidence-based lived-experience research via accessible, lay-friendly resources targeted to individuals impacted by mental illness. This study is the first to investigate the feasibility and usefulness of bringing the findings of lived-experience research to individuals impacted by mental illness/distress. It provides evidence about a potentially important source of information that can be used to facilitate their recovery.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eric Badu ◽  
Anthony Paul O’Brien ◽  
Rebecca Mitchell ◽  
Akwasi Osei

Abstract Background Evidence-based clinical practice is an inherent component of mental health professional practice in developed countries. However, little is known about professional perspectives of evidence-based practice in mental in developing countries such as Ghana. This paper describes the processes involved in the delivery of best practice in Ghana. The paper reports on a realistic evaluation of mental health nurses and allied health professionals’ views on the evidence-based therapeutic process in Ghana. Methods A purposive sample of 30 mental health professionals (MHPs) was recruited to participate in semi-structured, in-depth interviews. Thematic analysis was used to analyse the data. A program theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two contexts, mechanism and outcome configurations (themes): 1) technical competency stimulates evidence-based mental health services, and 2) therapeutic relationship building ensures effective interaction. The study demonstrates that contextual factors (technical competencies and therapeutic relationship building) together with mechanisms (intentional and unintentional) help to promote quality in mental health service provision. However, contextual factors such as a lack of sign language interpreters yielded unintended outcomes including barriers to communication with providers for consumers with hearing impairment and those from linguistic minority backgrounds. Conclusion Government stakeholders and policymakers should prioritise policies, periodic monitoring and adequate financial incentives to support the mechanisms that promote technical competence in MHPs and the building of therapeutic relationship.


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