scholarly journals Reflections on my role as a mental health service user co-applicant in a randomized control trial

2020 ◽  
Vol 4 (1) ◽  
pp. 33-46
Author(s):  
Laura Lea ◽  
Sarah Byford ◽  
Yve Coney ◽  
Rebecca Crane ◽  
Natalia Fagabemi ◽  
...  

This is not a research paper but a personal and collective reflection of patient and public involvement (PPI) for the LIGHTMind 2 randomized control trial (www. isrctn. com/ISRCTN13495752). This trial compares two guided self-help psychological interventions for depression, and is delivered in the UK NHS Improving Access to Psychological Therapy services. The paper is the result of my reviewing our PPI 18 months into the trial. The PPI includes myself as a research team member and co-applicant, with lived experience of depression, mindfulness and cognitive behaviour therapy. There is a Lived Experience Advisory Panel of six people with lived experience of depression or mindfulness, who advise the researchers. Two people with lived experience of mental health difficulties and knowledge of PPI attend the Trial Steering Committee. This paper includes comments from some of the other people with lived experience and from researchers involved in the trial, included as co-authors. I offer the Johari window (Luft, 1970) and the 4Pi National Involvement Standards (NSUN, 2018) as a way of positioning the value of PPI. Developing relationships within PPI is identified as a way of moderating the fear that some people experience as they work with researchers. I describe the importance of principles that incorporate explicit statements about the value of PPI.

Author(s):  
Andrew Beck

AbstractExperiences of racism can be a cumulative risk factor for developing mental health problems. Cognitive Behaviour Therapists working with Black and Minority Ethnic (BME) service users should be confident in their ability to establish the necessary rapport to ask about these experiences and be able to incorporate this information into longitudinal formulations and as part of maintenance cycles. This paper sets out guidelines as to how to do this as part of a wider engagement process.


2018 ◽  
Author(s):  
Julian Edbrooke-Childs ◽  
Chloe Edridge ◽  
Phoebe Averill ◽  
Louise Delane ◽  
Michael P Craven ◽  
...  

BACKGROUND Digital tools have the potential to support patient activation and shared decision making in the face of increasing levels of mental health problems in young people. There is a need for feasibility trials of digital interventions to determine the usage and acceptability of interventions. In addition, there is a need to determine the ability to recruit and retain research participants to plan rigorous effectiveness trials and therefore, develop evidence-based recommendations for practice. OBJECTIVE To determine the feasibility of undertaking a cluster randomized control trial to test the effectiveness of a smartphone app, Power Up, co-designed with young people to support patient activation and shared decision making for mental health. METHODS Overall, 270 young people were screened for participation and 53% (N = 142) were recruited and completed baseline measures across eight specialist child mental health services (n = 62, mean (SD) age = 14.66 (1.99) years, 52% female) and two mainstream secondary schools (n = 80; mean (SD) age = 16.88 (0.68) years, 46% female). Young people received Power Up in addition to management as usual or received management as usual only. Post-trial interviews were conducted with 11 young people from the intervention arms (specialist services n = 6; schools n = 5). RESULTS Usage data showed that there were an estimated 50 (out of 64) users of Power Up in the intervention arms. Findings from the interviews indicated that young people found Power Up to be acceptable. Young people reported: 1) their motivation for use of Power Up, 2) the impact of use, and 3) barriers to use. Out of the 142 recruited participants, 45% (64/142) completed follow up measures, and the approaches to increase retention agreed by the steering group are discussed. CONCLUSIONS The findings of the present research indicate that the app is acceptable and it is feasible to examine the effectiveness of Power Up in a prospective cluster randomized control trial. CLINICALTRIAL ISRCTN: ISRCTN77194423, ClinicalTrials.gov NCT02552797


2017 ◽  
Vol 46 (1) ◽  
pp. 115-120 ◽  
Author(s):  
Judith Gellatly ◽  
Leanne Chisnall ◽  
Nic Seccombe ◽  
Kathryn Ragan ◽  
Nicola Lidbetter ◽  
...  

Background: Ensuring rapid access to psychological interventions is a priority of mental health services. The involvement of peer workers to support the delivery of more accessible treatment options such as computerized cognitive behaviour therapy (CCBT) is recognized. Aims: To evaluate the implementation of a third sector remote CCBT @Home eTherapy service for people experiencing common mental health problems supported by individuals with lived experience. Method: Supported CCBT packages with telephone support were delivered over a 30-month period. Self-complete measures identifying levels of depression, anxiety and functioning were administered at each treatment appointment. Results: Over 2000 people were referred to the @Home eTherapy service; two-thirds attended an initial assessment and 53.4% of referrals assigned to CCBT completed treatment. Statistically significant improvements in anxiety, depression and functioning were found, with 61.6% of treated clients meeting recovery criteria. Conclusions: The service meets Improving Access to Psychological Therapies (IAPT) key performance targets, and is comparable to other IAPT services using CCBT. Evidence for the successful implementation of such a service by a third sector organization is provided.


2018 ◽  
Vol 16 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Mostafa Dianatinasab ◽  
Mohammad Fararouei ◽  
Valiollah Padehban ◽  
Aria Dianatinasab ◽  
Yousef Alimohamadi ◽  
...  

Medicina ◽  
2020 ◽  
Vol 56 (8) ◽  
pp. 404
Author(s):  
Akihiko Katayama ◽  
Kanae Kanda ◽  
Ayako Hase ◽  
Nobuyuki Miyatake

Background and objectives: The purpose of this study is to clarify the effects on the mental health of face-to-face exercise performed by an instructor (lesson-style Group: Group L) and exercise using machines (program-style Group: Group P) by randomized control trial. Materials and Methods: Among 120 subjects, 117 subjects were allocated to two groups with stratified randomization by sex (Group P: 58 subjects; Group L: 59 subjects). A 60-min health exercise class was held once per week for 12 consecutive weeks. The measurement items were mental health as a primary evaluation item and self-efficacy as a secondary evaluation item. Physical fitness was also measured using a new physical fitness test used in Japan. The 12-item general health questionnaire (GHQ-12) was used to measure mental health and the general self-efficacy scale (GSES) was used to measure self-efficacy. Results: After the intervention, 102 subjects were analyzed. The changes in mental health evaluated by GHQ-12 scores were significantly lower in Group L −0.7 (95% CI, −1.2 to −0.3) than Group P −0.1 (95% CI, −0.4 to 0.2) (p = 0.03). The changes in self-efficacy evaluated by GSES scores were significantly higher in Group P 5.3 (95% CI, 3.1 to 7.5) than Group L 1.3 (95% CI, −0.4 to 3.1) (p < 0.01). Conclusions: Compared with program exercises mainly using machines, face-to-face exercises performed by instructors improved mental health.


1992 ◽  
Vol 9 (4) ◽  
pp. 246-253 ◽  
Author(s):  
Gavin Andrews

The treatment of persons with mental disorders is advancing rapidly. New epidemiological information has allowed the magnitude of the task to be specified. A census of mental health professionals has allowed the workloads to be determined and organisational models which focus on treatment in the community established. As diagnosis is the first step in treatment it is timely that new, computerised structured diagnosis interviews are available. Treatment evaluation likewise is able to suggest that medication and cognitive behaviour therapy backed by good clinical care are the keys to good patient treatment. The two major problems that follow mainstreaming of the treatment of persons with mental disorders are the reallocation of money to treatment in the community, and the education of mental health staff to diagnose and deliver the proven effective treatments.


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