scholarly journals Trajectories of loneliness and objective social isolation and associations between persistent loneliness and self- reported personal recovery in a cohort of secondary mental health service users in the UK

2021 ◽  
Author(s):  
Ruimin Ma ◽  
Jingyi Wang ◽  
Brynmor Lloyd-Evans ◽  
Louise Marston ◽  
Sonia Johnson
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Los Angeles ◽  
Health Service ◽  
Social Isolation ◽  
Mental Health Problems ◽  
Service Users ◽  
Personal Recovery ◽  
Time Points

Abstract Background: Loneliness is a frequent and distressing experience among people with mental health problems. However, few longitudinal studies have so far investigated the trajectories of loneliness and objective social isolation, and the extent to which both issues may impact mental health outcomes among mental health service users. Therefore, this study aims to describe the trajectories of loneliness and objective social isolation and their associations with self-rated personal recovery among people leaving crisis resolution teams (CRTs). Methods: A total of 224 participants receiving care from CRTs (recruited for a large multi-site randomised controlled trial) were included in this longitudinal cohort study. They completed the eight-item University of California at Los Angeles Loneliness Scale (ULS-8), Lubben-Social Network Scale (LNSN-6), and the Questionnaire about the Process of Recovery (QPR) (primary outcome) at baseline, 4- and 18-month follow-up, as well as baseline sociodemographic and clinical variables. Results: We compared groups who were persistently lonely (at all time points), intermittently lonely (at one or two time points) and never lonely. After adjusting for all potential confounders and baseline predictive variables, persistent severe loneliness was associated with worse personal recovery at 18-month follow-up compared with the never lonely (reference group) (coef. = -12.8, 95% CI -11.8, -3.8, p<.001), as was being intermittently lonely (coef. = -7.8, 95% CI -18.8, -6.8, p<.001). The persistently objectively social isolated group (coef. = -9.8, 95% CI -15.7, -3.8, p=.001) also had poorer self-rated recovery at 18-month follow-up than those who were not socially isolated at any timepoint (i.e., reference category). Conclusion: Results suggest that both persistent loneliness and objective social isolation are associated with poorer self-rated recovery following a crisis, compatible with a causal relationship. These findings suggest a potential role for interventions aimed at alleviating loneliness and objective social isolation in improving recovery outcomes for people with mental health symptoms. Increased awareness of both issues among health practitioners is also warranted.

scholarly journals Trajectories of loneliness and objective social isolation and associations between persistent loneliness and self-reported personal recovery in a cohort of secondary mental health service users in the UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruimin Ma ◽  
Jingyi Wang ◽  
Brynmor Lloyd-Evans ◽  
Louise Marston ◽  
Sonia Johnson
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Los Angeles ◽  
Health Service ◽  
Social Isolation ◽  
Mental Health Problems ◽  
Service Users ◽  
Personal Recovery ◽  
Time Points

Abstract Background Loneliness is a frequent and distressing experience among people with mental health problems. However, few longitudinal studies have so far investigated the trajectories of loneliness and objective social isolation, and the extent to which both issues may impact mental health outcomes among mental health service users. Therefore, this study aims to describe the trajectories of loneliness and objective social isolation and their associations with self-rated personal recovery among people leaving crisis resolution teams (CRTs). Methods A total of 224 participants receiving care from CRTs (recruited for a large multi-site randomised controlled trial) were included in this longitudinal cohort study. They completed the eight-item University of California at Los Angeles Loneliness Scale (ULS-8), Lubben-Social Network Scale (LNSN-6), and the Questionnaire about the Process of Recovery (QPR) (primary outcome) at baseline, 4- and 18-month follow-up, as well as baseline sociodemographic and clinical variables. Results We compared groups who were persistently lonely (at all time points), intermittently lonely (at one or two time points) and never lonely. After adjusting for all potential confounders and baseline predictive variables, persistent severe loneliness was associated with worse personal recovery at 18-month follow-up compared with the never lonely (reference group) (coef. = − 12.8, 95% CI -11.8, − 3.8, p < .001), as was being intermittently lonely (coef. = − 7.8, 95% CI -18.8, − 6.8, p < .001). The persistently objectively social isolated group (coef. = − 9.8, 95% CI -15.7, − 3.8, p = .001) also had poorer self-rated recovery at 18-month follow-up than those who were not socially isolated at any timepoint (i.e., reference category). Conclusion Results suggest that both persistent loneliness and objective social isolation are associated with poorer self-rated recovery following a crisis, compatible with a causal relationship. These findings suggest a potential role for interventions aimed at alleviating loneliness and objective social isolation in improving recovery outcomes for people with mental health symptoms. Increased awareness of both issues among health practitioners is also warranted.

scholarly journals Experience of stigma among mental health service users in Hong Kong: Are there changes between 2001 and 2017?

2018 ◽  
Vol 65 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Ka-Fai Chung ◽  
Samson Tse ◽  
Chit-Tat Lee ◽  
Michael Ming-Cheuk Wong ◽  
Wing-Man Chan
Keyword(s):  
Mental Health ◽  
Hong Kong ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Health Problems ◽  
Cross Sectional Study ◽  
Baseline Survey ◽  
Service Users ◽  
Cross Sectional ◽  
Over Time

Background: Public expenditure on mental health education has grown exponentially in the past two decades. Does the experience of stigma among people with mental health problems improve over time? Our study aims to compare the levels of perceived stigmatization, rejection experiences and stigma–coping among mental health service users in Hong Kong between 2001 and 2017 using longitudinal and repeated cross-sectional study design. Method: The baseline survey was completed by 193 psychiatric outpatients in 2001. They were traced for re-assessment in 2017. Another sample of 193 outpatients matched in age, gender and psychiatric diagnosis was recruited in 2017 for cross-sectional comparison. Participants completed a 39-item questionnaire on stigma experiences, Beck Depression Inventory and Disability Assessment Schedule at both time points. Results: In total, 109 of 193 participants (56.5%) of the 2001 survey were re-assessed. No significant change in perceived stigmatization, rejection experiences and stigma–coping was found among the 109 participants interviewed in 2001 and 2017. For cross-sectional comparison, significant differences in two perceived stigma items were observed upon Bonferroni correction (chi-square test, p < .005) and remained significant after controlling for confounding factors by regression analysis. Improvements in perceived stigmatization were on marriage and friendship, while viewpoints on trustworthiness, dangerousness, devaluation, avoidance and personal failure remained unchanged, and there was no improvement in rejection experiences and stigma–coping. Conclusion: Positive attitude changes over time are unlikely to occur if there is no targeted intervention on stigma. Our findings highlight that evidence-based antistigma interventions are urgently needed.

An evaluation of peer-led self-management training for people with severe psychiatric diagnoses

2015 ◽  
Vol 10 (1) ◽  
pp. 3-13 ◽  
Author(s):  
Eva Cyhlarova ◽  
David Crepaz-Keay ◽  
Rachel Reeves ◽  
Kirsten Morgan ◽  
Valentina Iemmi ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Management Training ◽  
Self Management ◽  
Psychiatric Diagnoses ◽  
Service Users ◽  
Content Type ◽  
Time Points ◽  
Health Promoting

Purpose – The purpose of this paper is to establish the effectiveness of self-management training as an intervention for people using secondary mental health services. Design/methodology/approach – A self-management and peer support intervention was developed and delivered by secondary mental health service users to 262 people with psychiatric diagnoses living in the community. Data on wellbeing and health-promoting behaviour were collected at three time points (baseline, six, and 12 months). Findings – Participants reported significant improvements in wellbeing and health-promoting lifestyle six and 12 months after self-management training. Peer-led self-management shows potential to improve long-term health outcomes for people with psychiatric diagnoses. Research limitations/implications – Due to the lack of a control group, the positive changes cannot definitively be attributed to the intervention. Other limitations were reliance on self-report measures, and the varying numbers of completers at three time points. These issues will be addressed in future studies. Practical implications – The evaluation demonstrated the effectiveness of self-management training for people with psychiatric diagnoses, suggesting self-management training may bring significant wellbeing gains for this group. Social implications – This study represents a first step in the implementation of self-management approaches into mental health services. It demonstrates the feasibility of people with psychiatric diagnoses developing and delivering an effective intervention that complements existing services. Originality/value – This is the first study to investigate the effectiveness of a self-management training programme developed and delivered by mental health service users in the UK.

scholarly journals Coping with stigma and discrimination: evidence from mental health service users in England

2017 ◽  
Vol 27 (6) ◽  
pp. 577-588 ◽  
Author(s):  
A. Isaksson ◽  
E. Corker ◽  
J. Cotney ◽  
S. Hamilton ◽  
V. Pinfold ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Health Problems ◽  
Health Problems ◽  
Mental Health Stigma ◽  
Service Users ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Stigma And Discrimination

Aims.Mental health stigma and discrimination are significant problems. Common coping orientations include: concealing mental health problems, challenging others and educating others. We describe the use of common stigma coping orientations and explain variations within a sample of English mental health service users.Methods.Cross-sectional survey data were collected as part of the Viewpoint survey of mental health service users’ experiences of discrimination (n = 3005). Linear regression analyses were carried out to identify factors associated with the three stigma coping orientations.Results.The most common coping orientation was to conceal mental health problems (73%), which was strongly associated with anticipated discrimination. Only 51% ever challenged others because of discriminating behaviour, this being related to experienced discrimination, but also to higher confidence to tackle stigma.Conclusions.Although stigma coping orientations vary by context, individuals often choose to conceal problems, which is associated with greater anticipated and experienced discrimination and less confidence to challenge stigma. The direction of this association requires further investigation.

scholarly journals Disclosure of a mental health problem in the employment context: qualitative study of beliefs and experiences

2013 ◽  
Vol 23 (3) ◽  
pp. 289-300 ◽  
Author(s):  
E. Brohan ◽  
S. Evans-Lacko ◽  
C. Henderson ◽  
J. Murray ◽  
M. Slade ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Health Problem ◽  
Health Problem ◽  
Mental Health Problems ◽  
Public Understanding ◽  
Service Users ◽  
Voluntary Work ◽  
Personal Impact

Aims.Decisions regarding disclosure of a mental health problem are complex and can involve reconciling conflicting needs and values. This article provides a qualitative account of the beliefs and experiences of mental health service users regarding disclosure in employment contexts.Methods.Total sample of 45 individuals were interviewed in two study phases. In phase one, semi-structured interviews were carried out with 15 mental health service users. The transcripts were analysed using interpretative phenomenological analysis (IPA). In phase two, identified themes were further explored through interviews with mental health service users (n = 30) in three employment contexts: in paid employment (n = 10); in study or voluntary work (n = 10); and currently unemployed (n = 10). These were analysed using directed content analysis.Results.Four super-ordinate themes were drawn from phase one analysis: (1) public understanding of mental health problems; (2) the employment context; (3) personal impact of labelling and (4) disclosure needs. These themes were reflective of the content of phase two interviews.Conclusions.Greater emphasis needs to be placed on considering the societal, employment and interpersonal influences which form the basis for disclosure beliefs and experiences.

scholarly journals Introducing the Needs in Recovery Assessment (NiRA) into clinical practice: protocol for a pilot study investigating the formal and systematic assessment of clinical and social needs experienced by service users at a tertiary, metropolitan mental health service

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ellen L. Davies ◽  
Andrea L. Gordon ◽  
Kenneth J. Hooper ◽  
Robert E. Laing ◽  
Elizabeth A. Lynch ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Mental Health Service ◽  
Health Service ◽  
Quantitative Data ◽  
Assessment Tool ◽  
Service Users ◽  
Validity And Reliability ◽  
Recovery Assessment

Abstract Background The Needs in Recovery Assessment (NiRA) is a newly developed needs assessment tool, designed to identify the needs of people recovering from mental illness. This tool has been evaluated outside of the clinical context for validity and reliability. The aim of this study is to introduce the NiRA into clinical practice and to evaluate the value of the NiRA as an adjunct to service delivery from the perspectives of stakeholders and to evaluate the barriers and facilitators of embedding the NiRA in a mental health service. Methods The establishment of the NiRA in a tertiary mental health unit over a 6-month period will be evaluated using a multi-methods approach. Quantitative data will be collected using the NiRA itself and the Recovery Self-Assessment (RSA). Face-to-face interviews with service users and clinicians will be conducted following the initial completion of the NiRA, with a follow-up interview for service users on discharge from the service. Regular informal follow-up with clinicians throughout the study will support the introduction of the NiRA. Descriptive statistics will be used to analyse quantitative data, and descriptive qualitative methods will be used to analyse data from interviews. Discussion Aligning mental health services with recovery-oriented frameworks of care is imperative. The NiRA is a tool that has been designed in accordance with recovery principles and may assist services to be more recovery-oriented. If the NiRA is able to achieve the aims and objectives of this project, a larger implementation study will be conducted. Trial registration Australian and New Zealand Clinical Trial Registry (ANZCTR), ACTRN12621000316808

scholarly journals Suicide: can we identify and manage those at risk more effectively?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S345-S346
Author(s):  
Emily Roberts ◽  
Anne-Marie Grew ◽  
T Everett Julyan
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Health Problems ◽  
Small Sample Size ◽  
Primary Diagnosis ◽  
Small Sample ◽  
Public Health Issue ◽  
Service Users ◽  
Emotional Instability

AimsThis study aimed to conduct longitudinal analysis of suicide reviews for mental health service users in Ayrshire to improve local practice and outcomes. Traditional risk factors – middle-age, male and alcohol misuse – were hypothesised to convey greater risk of completing suicide.BackgroundSuicide is an important public health issue in Scotland, with potentially devastating impacts. Practice and policy may lag behind emerging evidence. Mental health problems are associated with an increased suicide risk, and care provided to those who take their own lives is reviewed to identify recommendations and learning points to improve practice and outcomes. However, these reviews and their conclusions are often considered individually, when studying them collectively over time it is necessary to characterise common themes and highlight factors that could be addressed to reduce suicide. Moreover, national averages can obscure local patterns.MethodAccess to reviews of suicides for mental health service users in Ayrshire was granted by the Adverse Event Review Group. Relevant data were extracted for the 35 General Adult service users completing suicide between 2013 and 2015, including details of the act, demographics and clinical factors, and analysed for trends. Those with and without emotional instability as a primary diagnosis or significant problem were dichotomised to facilitate identification of statistically significant factors specific to these symptoms.ResultThere were 35 completed suicides including three inpatients. Suicide was most common in the 25-29 and 45-54 age ranges, and over 68.6% were male. Hanging accounted for 60.0% of deaths, and self-poisoning for 8.6%. Up to 62.9% of patients did not appear to have ongoing scheduled appointments on a regular basis. Diagnoses were difficult to identify – 48.6% had no clear primary diagnosis specified in the reviews, and features of depressive, anxiety, psychotic, substance misuse and personality disorders frequently overlapped and co-occurred. 22.9% had problems with emotional instability; their median age was 14 years younger, and 87.5% were female.ConclusionSmall sample size precluded detailed analysis. The traditional risk profile remains relevant. However, almost 25% of those completing suicide were younger females with emotional instability, despite frequent contact with services. Given the challenges in predicting suicide, we should continue to consider how best to prevent this tragic outcome in all service users, especially in younger females with emotional instability; middle-aged males who misuse alcohol, and those with ill-defined diffuse psychological difficulties who do not fit into discrete categories or are reviewed infrequently.

On becoming a student mental health nurse

2009 ◽  
Author(s):  
Victoria Clarke ◽  
Frances Byrne
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Service User ◽  
Mental Health Problems ◽  
Service Users ◽  
Mental Health Nursing ◽  
Mental Health Nurses ◽  
Health Nurse ◽  
Health Nursing

This chapter is all about helping you to understand what mental health nursing is. To this end, we will consider what you must know and do when you first meet people with mental health problems. We will introduce a personal account from a mental health service user early in the chapter in order to help you begin to understand what working with people with mental health problems is like and what service users want from mental health nurses. In an effort to help you become familiar with what mental health nursing is, we will explore the following issues: what is a profession; what is nursing; what beliefs and values inform nursing; why is it important for mental health nurses to be self-aware; and what do mental health nurses need to know? In the final part of this chapter we explore the nature of boundaries in professional relationships and the implications of this for practice as a mental health nurse. Before you read any further we would encourage you to recognize that mental health service users are, quite rightly, the real experts in their care and needs. It is vitally important that you listen and really attend to what they are saying to you. We have asked a service user, Deborah Living, to represent for you some of the important issues that she would like mental health nurses to be aware of, and Deborah is going to tell you part of her own life story. I consider myself to be a survivor…not just a survivor of mental health difficulties but also a survivor of mental health services. I feel I am a survivor because I have reclaimed my life after more than ten years of mental health diagnoses and treatments: diagnoses from clinical depression to cyclothymia (described as a ‘milder’ form of manic depression); antidepressants and mood stabilisers from prozac to lithium; and interventions from counselling to psychiatry, through ECT to being an inpatient. It took me over a decade and a 12-month stay in a residential therapeutic community to stop the ‘revolving door’ approach within the mental health service, whereby I would gain short-term stability only to relapse yet again.

scholarly journals Mental health recovery and arts engagement

2018 ◽  
Vol 13 (3) ◽  
pp. 157-166 ◽  
Author(s):  
Anita Jensen
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Meaning In Life ◽  
Mental Health Problems ◽  
Service Users ◽  
Structured Interviews ◽  
Content Type ◽  
Arts Engagement ◽  
Creating Meaning

PurposeArts and cultural activities have been illustrated to be beneficial for mental health service users. The purpose of this paper is to explore the benefits of museum visits and engage in arts activities for mental health service users.Design/methodology/approachSemi-structured interviews were conducted with 17 mental health service users in Denmark. A thematic approach was used to analyse the data and theoretical lens of sociological theories of institutional logics was employed to explore the findings.FindingsThese benefits are perceived to include empowerment and meaning in life, which are two of the core principles of recovery; arts engagement can, therefore, be a useful tool in recovery. The findings also show that the experience of visiting a museum was not always positive and depended upon the interaction with the museum educators.Originality/valueThe service users identified arts engagement as creating meaning in life and empowerment, which are two element in the conceptual framework, CHIME (an acronym for: Connectedness, Hope and optimism, Identity, Meaning in life and Empowerment), that describes the human process of recovery. The findings also highlighted that if museums want to engage positively with people with mental health problems and contribute to their recovery then the training of staff and the improvement of institutional approaches to support working with vulnerable people are essential.

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