The unique contribution of older people with a lived experience of mental illness to the peer workforce: observations from older peer workers

2018 ◽  
Vol 6 (1) ◽  
pp. 78
Author(s):  
Dominiek Coates ◽  
Patrick Livermore ◽  
Raichel Green
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Older People ◽  
Focus Groups ◽  
Lived Experience ◽  
Sense Of Self ◽  
Work Practice ◽  
Unique Contribution ◽  
Implementation Barriers ◽  
Work Model

Background: The development of peer work models that are integrated into health systems is at the heart of national and international reform agenda in mental health. Peer work differs from other mental health roles as it is provided by people who have a lived experience of mental illness and recovery and does not assume a medical model. Peer work in mental health services for older people is not well established and to address this gap we developed, implemented and evaluated a peer work model for older patients of a specialist mental health service.Method: The findings discussed in this paper are part of a broader evaluation and consist of qualitative observations made by the peer workers during focus groups. Three focus groups were conducted during the first year of the project to identify the peer workers’ perspectives, feelings and thoughts around the developing peer work model and how they were impacted by the work. Data collection and analysis was inductive and informed by grounded theory principles. Observations from peer workers are discussed in relation to the literature as well as observations made by the researchers during project implementation.Results: Analysis suggests that older peer workers have a level of maturity and experience with recovery that benefit the peer workforce in a number of ways namely (a) significant experience with recovery to draw on when helping others; (b) a well-established sense of identity and coping strategies that support wellbeing and (c) ability to cope with ambiguity and uncertainty inherent in peer work practice. We propose that having a strong sense of self or personal identity may be important in peer work, particularly as the peer work role is often challenged, questioned and unclear.Conclusion: Older peer workers provide a valuable contribution to the peer workforce and bring with them an array of strengths that can help overcome some of the common peer work implementation barriers.

scholarly journals The development and implementation of a peer support model for a specialist mental health service for older people: lessons learned

2018 ◽  
Vol 23 (2) ◽  
pp. 73-85
Author(s):  
Dominiek Coates ◽  
Patrick Livermore ◽  
Raichel Green
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Older People ◽  
Implementation Barriers ◽  
Content Type ◽  
Specialist Mental Health Service ◽  
Work Model

Purpose There has been a significant growth in the employment of peer workers over the past decade in youth and adult mental health settings. Peer work in mental health services for older people is less developed, and there are no existing peer work models for specialist mental health services for older people in Australia. The authors developed and implemented a peer work model for older consumers and carers of a specialist mental health service. The purpose of this paper is to describe the model, outline the implementation barriers experienced and lesson learned and comment on the acceptability of the model from the perspective of stakeholders. Design/methodology/approach To ensure the development of the peer work model met the needs of key stakeholders, the authors adopted an evaluation process that occurred alongside the development of the model, informed by action research principles. To identify stakeholder preferences, implementation barriers and potential solutions, and gain insight into the acceptability and perceived effectiveness of the model, a range of methods were used, including focus groups with the peer workers, clinicians and steering committee, consumer and carer surveys, field notes and examination of project documentation. Findings While the model was overall well received by stakeholders, the authors experienced a range of challenges and implementation barriers, in particular around governance, integrating the model into existing systems, and initial resistance to peer work from clinical staff. Originality/value Older peer workers provide a valuable contribution to the mental health sector through the unique combination of lived experience and ageing. The authors recommend that models of care are developed prior to implementation so that there is clarity around governance, management, reporting lines and management of confidentiality issues.

Assessing students’ mental health crisis skills via consumers with lived experience: a qualitative evaluation

2019 ◽  
Vol 14 (5) ◽  
pp. 361-371
Author(s):  
Claire L. O’Reilly ◽  
Rebekah J. Moles ◽  
Evelyn Boukouvalas ◽  
Sarira El-Den
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Focus Groups ◽  
Lived Experience ◽  
Structured Interview ◽  
Pharmacy Students ◽  
Simulated Patients ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Content Type

Purpose Suicide is a major cause of preventable mortality and primary healthcare professionals, including pharmacists, require appropriate training to communicate with and support people at risk of suicide. Mental Health First Aid (MHFA) training teaches participants how to communicate with and support people experiencing suicidal thoughts. The purpose of this paper is to use a novel MHFA assessment approach involving simulated role-plays enacted by people with a lived experience of mental illness and explore MHFA participants’ and simulated patients’ views of participating in simulated role-plays of mental health crises. Design/methodology/approach MHFA is embedded into the Sydney School of Pharmacy curriculum. Post-MHFA training, pharmacy students were randomly allocated to participate in or observe a simulated role-play of one of three suicide crisis scenarios, with a person with a lived experience of mental illness. Two purpose-designed, semi-structured interview guides were used to conduct student focus groups and interviews with simulated patients to explore their views. Focus groups and interviews were digitally recorded, transcribed verbatim and thematically content analysed using a constant comparison approach. Findings In total, 22 pharmacy students participated in two focus groups and three simulated patients participated in interviews. Five themes emerged including: the benefits of participating; the value of having a lived experience; challenges with suicide assessment; communication; and the value of immediate feedback and debrief. Originality/value Students and simulated patients both benefited from participating in the role-plays. Students valued practicing their MHFA skills post-training with simulated patients with lived experiences. This unique approach to post-training assessment provides an opportunity to practice skills realistically and authentically, in a safe, learning environment.

scholarly journals Older Adults’ Subjective Well-being Following an Exergame Intervention “Bandit the Dolphin”: Focus Group Findings

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 169-170
Author(s):  
Brittany Drazich ◽  
Breanna Crane ◽  
Kyle Moored ◽  
Karl Shieh ◽  
Janiece Taylor ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Illness ◽  
Focus Groups ◽  
Well Being ◽  
Community Dwelling ◽  
Mental Illness Stigma ◽  
Subjective Well Being ◽  
Future Health ◽  
Adult Participants

Abstract Due to generational mental illness stigma and under diagnosis of mental illness, older adults do not always receive the mental health help that they need. One unique technology that has the potential to improve mood in older adults is exergames, or exercise video games. The objective of this sub-study (main study: Stimulation With Intricate Movements “SWIM” Study) was to explore older adults’ mood following an exergame intervention called “Bandit the Dolphin,” created by the Johns Hopkins KATA Studio. Researchers conducted three focus groups with 14 community-dwelling older adult participants who took part in the SWIM Study exergame intervention. The semi-structured focus groups were transcribed, coded, and analyzed using deductive and inductive techniques described by Ray Maietta’s “sort and sift, think and shift” method. Three themes related to playing “Bandit the Dolphin” and mood emerged. First, participants described their perceived association between activity and mood. Participants felt that both active and passive activities, “Bandit the Dolphin” and otherwise, improved their mood through the “fun” factor, and through feelings of achievement. Second, the participants described that the competition and frustration of playing “Bandit the Dolphin” increased eventual feelings of achievement. Third, participants described how feelings of immersion, or being absorbed in the game, helped them forget their other life concerns. These findings provide a better understanding of older adults’ perceived relationship between an exergame intervention, “Bandit the Dolphin,” and short-term improved mood. Future health and engineering researchers should explore exergames as a potential tool to improve the mental health of older adults.

scholarly journals Centering Social Justice in Mental Health Practice: Epistemic Justice and Social Work Practice

2021 ◽  
pp. 104973152110109
Author(s):  
Marjorie Johnstone
Keyword(s):  
Mental Health ◽  
Social Justice ◽  
Social Work ◽  
Lived Experience ◽  
Medical Model ◽  
Work Practice ◽  
Social Work Practice ◽  
Policy Advocacy ◽  
Health Practice ◽  
Epistemic Justice

This article examines how mental health social work practice can move outside the hegemony of the medical model using approaches that honor the centering of social justice. By using the philosophical analysis of epistemic injustice and the ethics of knowing, I move out of the traditional psychiatric and psychological conceptual frameworks and discuss new guiding principles for practice. In the context of the radical tradition in social work and the impetus to blend theory with practice, I consider the use of narrative and anti-oppressive approaches to center social justice principles in individual dyadic work as well as in wider systems family and community work and policy advocacy. I evaluate these approaches through the principles of epistemic justice and discuss the importance of a relational collaborative approach where honoring the client and exploring lived experience are central to both the concepts of testimonial justice, hermeneutic justice and anti-oppressive practice.

Dental health of community-living older people attending secondary healthcare: a cross-sectional comparison between those with and without diagnosed mental illness

2009 ◽  
Vol 22 (3) ◽  
pp. 417-425 ◽  
Author(s):  
Nitin Purandare ◽  
Eva Woods ◽  
Sue Butler ◽  
Julie Morris ◽  
Martin Vernon ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Older People ◽  
Dental Treatment ◽  
Dental Health ◽  
Oral Pathology ◽  
Community Living ◽  
Health Examination ◽  
Medical Group ◽  
Cross Sectional

ABSTRACTBackground: Mental illness and cognitive impairment are risk factors for poor dental health.Methods: We conducted a cross-sectional study to compare the dental health of older patients attending out-patient clinics and day hospitals of old age psychiatry services (the psychiatry group, n = 103) with those attending general/geriatric medical services (the medical group; n = 99). Those living in care homes, and those with diagnosed mental illness (in the medical group) were excluded. A registered mental health nurse assessed mental and general health using validated and previously published instruments. A registered dentist made an independent assessment of dental health (examination to assess oral pathology, status of remaining teeth, and dentures) and made an overall judgment about whether the patient needed any dental treatment (a “normative” need).Results: The normative need for dental treatment was significantly higher among the psychiatry group compared to the medical group (85% vs 52%; p<0.001); even after taking account of the effect of age, gender, teeth status, physical comorbidity, cognition, depressive symptoms, and overall mental and social health [adjusted odds ratio, OR (95% confidence interval): 4.32 (2.09, 8.91)]. The presence of any natural remaining teeth [OR: 4.44 (2.10, 9.42)] and Barthel Index [OR: 0.96 (0.93, 0.99)] were the two other independent predictors of the need for treatment.Conclusion: Dental problems are common in community-living older people, especially those with some natural remaining teeth and those with mental illness. There is a need to develop integrated mental health and dental care services for older people with emphasis on prevention of dental problems.

scholarly journals Storytelling, Safeguarding, Treatment, and Responsibility: attributes of recovery in psychiatric intensive care units

2014 ◽  
Vol 11 (02) ◽  
pp. 105-118 ◽  
Author(s):  
Karleen Gwinner ◽  
Louise Ward
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Illness ◽  
Intensive Care ◽  
Lived Experience ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Review Of Literature ◽  
Psychiatric Distress ◽  
Nurse Knowledge

AbstractBackground and aimIn recent years, policy in Australia has endorsed recovery-oriented mental health services underpinned by the needs, rights and values of people with lived experience of mental illness. This paper critically reviews the idea of recovery as understood by nurses at the frontline of services for people experiencing acute psychiatric distress.MethodData gathered from focus groups held with nurses from two hospitals were used to ascertain their use of terminology, understanding of attributes and current practices that support recovery for people experiencing acute psychiatric distress. A review of literature further examined current nurse-based evidence and nurse knowledge of recovery approaches specific to psychiatric intensive care settings.ResultsFour defining attributes of recovery based on nurses’ perspectives are shared to identify and describe strategies that may help underpin recovery specific to psychiatric intensive care settings.ConclusionThe four attributes described in this paper provide a pragmatic framework with which nurses can reinforce their clinical decision-making and negotiate the dynamic and often incongruous challenges they experience to embed recovery-oriented culture in acute psychiatric settings.

scholarly journals Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations

2017 ◽  
Vol 41 (1) ◽  
pp. 38 ◽  
Author(s):  
Ana Fernandez ◽  
James A. Gillespie ◽  
Jennifer Smith-Merry ◽  
Xiaoqi Feng ◽  
Thomas Astell-Burt ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Lived Experience ◽  
Critical Analysis ◽  
Local Health ◽  
Adult Mental Health ◽  
Local Evidence ◽  
Integrated Mental Health

Objective Australian mental health care remains hospital centric and fragmented; it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence. Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD. Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care; (2) an absence of services providing acute day care and non-acute day care; (3) low availability of specific employment services for people with a lived experience of mental ill-health; and (4) a lack of comprehensive data on the availability of supported housing. Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care. What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system. What does this paper add? This paper provides a critical analysis of the pattern of adult mental health care provided within the boundaries of the Western Sydney LHD using a standard, internationally validated tool to describe and classify the services. This provides a good picture of the availability of adult mental health care at the local level that was hitherto lacking. What are the implications for practitioners? The data presented herein provide a better understanding of the context in which mental health practitioners work. Managers and planners of services providing care for people with a lived experience of mental illness can use the information herein for better planning informed by local evidence.

scholarly journals The Needs of Older People with Mental Health Problems: A Particular Focus on Dementia Patients and Their Carers

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Joaquim Passos ◽  
Carlos Sequeira ◽  
Lia Fernandes
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Psychological Distress ◽  
Older People ◽  
Unmet Needs ◽  
Mental Health Problems ◽  
Clinical Manifestations ◽  
Health Problems ◽  
Association Analyses ◽  
Dementia Patients

The problems and needs of older people are often associated with mental illness, characterized by a set of clinical manifestations, which constitute important domains for investigation and clinical practice. This paper presents the results of a pilot study whose main purpose was to identify met and unmet needs and to analyze the relationship between those needs, psychopathology and functionality in older people with mental health problems. A sample of 75 patients aged 65 or over, of both sexes, diagnosed with mental illness using ICD-9. The main diagnoses were depression (36%) and dementia (29.3%). Most patients had cognitive impairment (MMSE, 52%; CDT, 66.7%), depression (GDS, 61.3%), anxiety (ZAS, 81.3%), and moderate dependence (BI, 49.3% and LI, 77.3%). The main unmet needs found were daytime activities (40%), social benefits (13.3%), company (10.7%), psychological distress (9.3%), and continence (8%). The majority of these unmet needs occur with dementia patients. The majority of the carers of these patients had global needs (met and unmet) in terms of psychological distress. Findings also reveal that a low level of functionality is associated with dementia diagnoses. The association analyses suggest that dementia is an important determinant of the functional status and needs.

Beyond the counter-narrative

2007 ◽  
Vol 17 (2) ◽  
pp. 157-178 ◽  
Author(s):  
Alexandra L. Adame ◽  
Roger M. Knudson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Psychological Distress ◽  
Lived Experience ◽  
Medical Model ◽  
Master Narrative ◽  
Interpretive Interactionism ◽  
Psychiatric Survivor ◽  
Counter Narrative ◽  
Psychiatric Survivors

The discourse of the medical model of mental illness tends to dominate people’s conceptions of the origins and treatments of psychopathology. This reductionistic discourse defines people’s experiences of psychological distress and recovery in terms of illnesses, chemical imbalances, and broken brains. However, the master narrative does not represent every individual’s lived experience, and alternative narratives of mental health and recovery exist that challenge our traditional understandings of normality and psychopathology. Guided by the method of interpretive interactionism, we examined how psychiatric survivors position themselves in relation to the medical model’s narrative of recovery. In its inception, the psychiatric survivor movement created a counter-narrative of protest in opposition to the medical model’s description and treatment of psychopathology. Since then, the movement has moved beyond the counter-narrative and has constructed an alternative narrative; one that is not defined in opposition to the master narrative but instead participates in an entirely different discourse.

scholarly journals Promoting the Mental Health of University Students in China: Protocol for Contextual Assessment to Inform Intervention Design and Adaptation (Preprint)

2020 ◽  
Author(s):  
Josephine Pui-Hing Wong ◽  
Cun-Xian Jia ◽  
Mandana Vahabi ◽  
Jenny Jing Wen Liu ◽  
Alan Tai-Wai Li ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
University Students ◽  
Focus Groups ◽  
Health Knowledge ◽  
Service Providers ◽  
Self Report ◽  
Mental Illness Stigma ◽  
Contextual Assessment ◽  
Mental Health Knowledge

BACKGROUND Chinese students are extremely vulnerable to developing mental illness. The stigma associated with mental illness presents a barrier to seeking help for their mental health. OBJECTIVE The <i>Linking Hearts—Linking Youth and ‘Xin’ (hearts)</i> project is an implementation science project that seeks to reduce mental illness stigma and promote the mental health of university students in Jinan, China. The Linking Hearts project consists of 3 components. In this paper, we outline the protocol for the first component, that is, the contextual assessment and analysis of the mental health needs of university students as the first step to inform the adaptation of an evidence-based intervention to be implemented in Jinan, China. METHODS Six local universities will participate in the Linking Hearts project. A total of 100 students from each university (n=600) will engage in the contextual assessment through self-report surveys on depression, anxiety, stress, mental health knowledge, and mental health stigma. Quantitative data will be analyzed using several descriptive and inferential analyses via SPSS. A small number of participants (144 students and 144 service providers) will also be engaged in focus groups to assess the socio-environmental contexts of university students’ health and availability of mental health resources. Qualitative data will be transcribed verbatim and NVivo will be used for data management. Social network analysis will also be performed using EgoNet. RESULTS Linking Hearts was funded in January 2018 for 5 years. The protocol of Linking Hearts and its 3 components was approved by the research ethics boards of all participating institutions in China in November 2018. Canadian institutions that gave approval were Ryerson University (REB2018-455) in January 2019, University of Alberta (Pro00089364), York University (e2019-162) in May 2019, and University of Toronto (RIS37724) in August 2019. Data collection took place upon ethics approval and was completed in January 2020. A total of 600 students were surveyed. An additional 147 students and 138 service providers took part in focus groups. Data analysis is ongoing. Results will be published in 2021. CONCLUSIONS Findings from this contextual assessment and analysis will generate new knowledge on university students’ mental health status, mental health knowledge, and resources available for them. These findings will be used to adapt and refine the <i>Acceptance and Commitment to Empowerment-Linking Youth N’ Xin</i> intervention model. The results of this contextual assessment will be used to inform the adaptation and refinement of the mental health intervention to promote the mental health of Chinese university students in Jinan. INTERNATIONAL REGISTERED REPORT RR1-10.2196/25009

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