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Recovery Research Network (RRN)

2022 RRN Emails

January 2022

Recovery Research Network eBULLETIN

January 2022

RRN Meetings
Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time. However, the current suspension arrangements are under constant review by the RRN Collective and it is possible that a webinar-style meeting may provide an interim measure to coalesce our membership prior to the resumption of face-face networking when it becomes safe to do so. More information about this possibility will be circulated in due course.

The national and international responses to Covid-19 are under constant review, and particularly so following the identification of a variant of concern named Omicron by the World Health Organisation in late November. We would encourage our readers to keep safe and follow relevant guidance as appropriate.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:

Shula:     s.ramon@herts.ac.uk
Tony:      a.sparkes@bradford.ac.uk

Coronavirus and Mental Health
The impact of coronavirus, and government measures to restrict its transmission, means that we have to pay particular attention to our mental health and wellbeing. There is a considerable amount of advice and information available online. We continue to include examples at the end of the e-bulletin.

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:
https://www.researchintorecovery.com/events/rrn/join/

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research. Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers
In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world. As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.

i) International Shared Decision Making Conference 2022.
The 11th International Shared Decision Making Conference takes place June 20-22 2022 with a pre-conference June 19. The venue for the conference is Comwell Kolding (Denmark) – just next to the site of Lillebaelt University Hospital – Kolding site.

Conference registration for the above event opened on Monday 1st November 2021. For further details, please see here
https://www.isdm2022.com

ii) 14th European Network on Mental Health Services Evaluation

https://targetconferences.com EMNESH2022.com
ENMESH2022.com/program-at-a-glance:
Focus on: Collectivism and Individualism in Mental Health

June 27-29, 2022, Tel Aviv, Israel.

iii) Dr Stefan Rennick-Egglestone draws attention to the following Special Issue:
Special Issue of Perspectives in Public Health on “Recovery outside of mental health services”

Recovery Research Network members Dr Stefan Rennick-Egglestone and Dr Theo Stickley will co-edit a special issue of the journal Perspectives in Public Health, to be published in May 2023, with submission due by end of September 2022.

The theme for the special issue is “Recovery outside of mental health services: what can public health contribute?”. The editors would particularly like to hear about practice and research that focuses on increasing wellbeing as it relates to mental health, and which is not necessarily situated in statutory mental health services. They welcome contributions covering the entire age-span from childhood through to end-of-life, both national and international, and they can include articles that draw on the author’s experience of mental health problems to make recommendations for public health policy and practice.

Details of the special issue will be published on the journal website https://journals.sagepub.com/home/rsh soon, or contact Stefan Rennick-Egglestone through stefan.egglestone@nottingham.ac.uk

Papers and Publications
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i) Vergallo, G. M. and Gulino, M. (2022) Physical restraint in psychiatric care: soon to fall out of use? Psychiatry and Clinical Psychopharmacology 31(4) 468-473
https://doi.org/10.5152/pcp.2021.21237

Abstract
International directives all recommend that using restraints on psychiatric patients should be avoided, yet scientific literature shows that such practices are still largely in use. This article aims to lay out strategies that could be put in place in order to gradually discard the use of restraints, particularly through a “restraint-free” approach, nursing, logistic–environmental pathways, and locally centered health care provision. All such tools have proven valuable for the purpose of safeguarding the health of psychiatric patients. Hence, the failure to put in place such measures may lead to litigation and lawsuits against physicians and particularly health care facilities. Undoubtedly, the ability to effectively implement such methods largely depends on the financial resources available, which in countries such as Italy are poorer than in others. Still, the risk of being sued and held professionally liable may constitute a factor in raising awareness among operators, facilities, and public health care management, leading to the implementation of policy changes aimed at minimizing the use of restraints.

RRN e-bulleting Editor’s note: we would have considered that the human rights aspect is at least as important, if not more than the motivation to stop the use of restraints due to fear of being sued? Furthermore, the use of restraint creates justified antagonism in service users, and de-motivates them to collaborate with their service providers.

ii) Skar Fröding, R., Clausen, H., Benth, J. S., Ruud, T., Slade, M. and Heiervang, K. S. (2022) Associations between personal recovery and service user-rated versus clinician-rated clinical recovery, a cross-sectional study. BMC Psychiatry 22:42
https://doi.org/10.1186/s12888-022-03691-y

Abstract
Background: This study examined the relationship between service user-rated personal recovery and clinician-rated and service user-rated clinical recovery. The relationships between different subdomains of clinical recovery and personal recovery were also assessed.
Methods: In total, 318 mental health service users with a psychosis diagnosis and their clinicians from 39 sites across Norway completed standardized questionnaires regarding personal recovery, clinical symptoms and psychosocial functioning. Regression models were used to investigate the relationship between personal and clinical recovery.
Results: Overall, clinical recovery was positively associated with personal recovery, when rated both by service users and by clinicians. Personal recovery was associated with lower levels of depression, self-harm and problems with relationships when rated by the service users. Among the subdomains rated by the clinicians, personal recovery was associated with fewer problems with relationships and higher aggressiveness.
Conclusions: These findings suggest that affective symptoms are associated with personal recovery, indicating the need for greater focus on depression treatment among people with psychosis. Improving social connections is of importance for personal recovery, and might be an area where clinicians and service users can meet and find agreement on important treatment goals.

iii) Charles, A.., Korde, P., Newby, C. et al. (2022) Proportionate translation of study materials and measures in a multinational global health trial: methodology development and implementation. BMJ Open 2022;12:e058083
https://doi.org/10.1136/bmjopen-2021-058083

Abstract
Objectives: Current translation guidelines do not include sufficiently flexible translation approaches for different study materials. We aimed to develop a proportionate methodology to inform translation of all types of study materials in global health trials.
Design: The design included three stages: (1) categorisation of study materials, (2) integration of existing translation frameworks and (3) methodology implementation [in different countries] (Germany, India, Israel, Tanzania and Uganda), and refinement.
Participants: The study population comprised 27 mental health service users and 27 mental health workers who were fluent in the local language in stage 7 (pretesting), and 54 bilingual mental health service users, aged 18 years or over, and able to give consent as judged by a clinician for step 9 (psychometric evaluation).
Setting: The study took place in preparation for the Using Peer Support in Developing Empowering Mental Health Services (UPSIDES) randomised controlled trial (ISRCTN26008944).
Primary outcome measure: The primary outcome measure was the Social Inclusion Scale (SIS). Results: The typology identifies four categories of study materials: local text, study-generated text, secondary measures and primary measure. The UPSIDES Proportionate Translation Methodology comprises ten steps: preparation, forward translation, reconciliation, back translation, review, harmonisation, pretesting, finalisation, psychometric evaluation and dissemination. The translated primary outcome measure for the UPSIDES Trial (SIS) demonstrated adequate content validity (49.3 vs 48.5, p=0.08), convergent validity and internal consistency (0.73), with minimal floor/ceiling effects.
Conclusion: This methodology can be recommended for translating, cross-culturally adapting and validating all study materials, including standardised measures, in future multisite global trials. The methodology is particularly applicable to multi-national studies involving sites with differing resource levels. The robustness of the psychometric findings is limited by the sample sizes for each site. However, making this limitation explicit is preferable to the typical practice of not reporting adequate details about measure translation and validation.

iv) Stuen, H. K., Landheim, A., Rugkåsa, J. and Wynn, R. (2018) Responsibilities with conflicting priorities: a qualitative study of ACT providers’ experiences with community treatment orders.
BMC Health Services Research 18:290
https://doi.org/10.1186/s12913-018-3097-7

Abstract
Background: Patients with severe mental illness may be subjected to Community Treatment Orders (CTOs) in order to secure that the patients adhere to treatment. Few studies have investigated the use of CTOs within an Assertive Community Treatment (ACT) setting, and little is known about how the tension between the patients’ autonomy and the clinicians’ responsibility to act in the patients’ best interest are resolved in practice. The aim of this study was to explore the service providers’ experiences with CTOs within an ACT setting.
Methods: The study was based on reviews of case files of 15 patients, eight individual qualitative in depth interviews and four focus group interviews with service providers involved in ACT and decisions related to CTOs. A modified grounded theory approach was used to analyse the data.
Results: The main theme ‘responsibility with conflicting priorities’ emerged from data analysis. The balance between coercive approaches and the emphasis on promoting patient autonomy was seen as problematic. The participants saw few alternatives to CTOs as long-term measures to secure ongoing treatment for some of the patients. However, participants perceived the ACT model’s comprehensive scope as an opportunity to build rapport with patients and thereby better meet their needs. The team approach, the ACT providers’ commitment to establish supportive relationships and the frequent meetings with patients in their home environment were highlighted. The ACT approach gave them insight into patients’ everyday lives and, in some cases a greater sense of security when considering whether to take patients off CTOs.
Conclusions: Many of the participants viewed CTOs as helpful in securing long-term treatment for patients. CTO decision-making was described as challenging and complex and presented the providers with many dilemmas. The ACT approach was considered as helpful in that it afforded comprehensive, patient-centered support and opportunities to build rapport.

v) Dreyer, R. P., Pavlo, A. J., Horne, A., Dunn, R., Danvers, K., Brush, J., Slade, M. and Davidson, L. (2021) Conceptual framework for personal recovery in patients with acute myocardial infarction. Journal of the American Heart Foundation. 10:e022354.
https://doi.org/10.1161/JAHA.121.022354

Abstract
Background: Although there has been movement in cardiology to advance patient-centered approaches to postacute myocardial infarction (AMI) care, work remains to be done in aligning patient preferences with clinical care. Our objective was to characterize patients’ experience of AMI and treatment to develop a new conceptual framework of patient-centered recovery in cardiology.
Methods and results: We conducted in-depth interviews with people who previously experienced an AMI (2016–2019). The interview focused on participants’ experiences of their recovery, which were audio-recorded, transcribed verbatim, and analyzed using a phenomenological framework. The overarching theme described by the 42 participants was feeling like a “different person” after the AMI. This shift manifested itself in both losses and gains, each of which posed new challenges to everyday life. The experience appeared to be an active process requiring people to take responsibility for their health. In terms of loss, participants describe how the AMI threatened their sense of safety and security and led to social isolation, fragility, uncertainty about the future, and difficulty expressing emotions accompanied this new fear. A conceptual framework describing the relationship between AMI, identity change, and functioning was developed.
Conclusions: Participants experienced the AMI as an unexpected disruption in their lives that had far-reaching effects on their daily functioning, and were resolved in numerous ways. The conceptual framework may assist in providing a theoretical basis for future interventions in cardiology that not only engage and retain patients in care but also improve long-term adherence to secondary prevention and other aspects of self-care.

vi) Griffiths, C., Walker, K. and Leathlean, C. (2022) Wearable physical activity and sleep tracker based healthy lifestyle intervention in Early Intervention Psychosis (EIP) Service: patient experiences. Open Journal of Psychiatry 12, 115-127
https://doi.org/10.4236/ojpsych.2022.121010

Abstract
Background: Physical activity, sleep, mental health, physical health, wellbeing, quality of life, cognition, and functioning in people who experience psychosis are interconnected factors. People experiencing psychosis are more likely to have low levels of physical activity, high levels of sedation, and sleep problems.
Intervention: An eight-week intervention; including the provision of a Fitbit and its software apps, sleep hygiene and physical activity guidance information, as well as three discussion and feedback sessions with a clinician.
Participants: Out of a sample of 31 using an early intervention psychosis (EIP) service who took part in the intervention, fifteen participants consented to be interviewed—9 (60%) males and 6 (40%) females, age range: 19 – 51 years, average age: 29 years.
Method: In-depth interviews investigating patient experience of the intervention and its impact on sleep, exercise, and wellbeing were undertaken. Thematic analysis was applied to analyse the qualitative data and content analysis was used to analyse questions with a yes/no response.
Results: Most of the participants actively used the Fitbit and its software apps to gain information, feedback, and set goals to make changes to their lifestyle and daily routines to improve quality of sleep, level of physical activity, and exercise.
Conclusion: The intervention was reported to be beneficial, and it is relatively easy and low cost to implement and therefore could be offered by all EIP services. Furthermore, there is potential value for application in services for other psychiatric disorders, where there is often a need to promote healthy lifestyle, physical activity, and effective sleep.

vii) Chu, M. H., Lau, B., Leung, J., Chan, C. S., Tang, B., Lau, C., Newby, Chiu, R., Lo, W. T., Schrank, B. and Slade, M. (2022) Positive psychotherapy for psychosis in Hong Kong: A randomized controlled trial. Schizophrenia Research 240 175-183
https://doi.org/10.1016/j.schres.2021.12.044

Abstract
Recovery-oriented practice has been advocated in mental health services in Hong Kong since 2009. Well-being has become an important area of focus for mental health services. Positive psychotherapy for Psychosis (PPP) is a well-being-focused intervention for use in psychosis, with preliminary evidence from a randomized controlled trial in the United Kingdom of impact on well-being and symptomatology. The aim of this study was to test the effectiveness of PPP on the well-being of people with psychosis in Hong Kong.
The study was a randomized controlled trial with two-arm parallel groups. Both groups received treatments as usual, and in addition the intervention group received a 13-session intervention based on a Cantonese Chinese translation of the PPP manual. Intention-to-treat analysis was used. The trial was registered (ANZCTR:ACTRN12620000464965).
A total of 154 participants (78 intervention, 76 control) were recruited. As compared to control group, intervention group participants showed significant changes over time on the primary outcome of well-being assessed using the Chinese Short Warwick-Edinburgh Mental Well-being Scale (p = 0.001) and on secondary outcomes of hope (Agency subscale: p = 0.029) and self-efficacy (p = 0.001).
Positive Psychotherapy for Psychosis was found to be an effective treatment in improving the well-being and other mental health outcomes for people with psychosis. It can be recommended for use in mental health services to promote recovery.

viii) Rennick-Egglestone, S., Elliott, R., Newby, C., Robinson, C. and Slade, M. (2022) Impact of receiving recorded mental health recovery narratives on quality of life in people experiencing non-psychosis mental health problems (NEON-O Trial): updated randomised controlled trial protocol. Trials. 23:90
https://doi.org/10.1186/s13063-022-06027-z

Abstract
Background: Mental health recovery narratives are first-person lived experience accounts of recovery from mental health problems, which refer to events or actions over a period of time, and which include elements of adversity or struggle, and also self-defined or observable strengths, successes, or survival. Recorded recovery narratives are those presented in invariant form, including text, audio, or video. In a previous publication, we presented a protocol for three pragmatic trials of the Narrative Experiences Online (NEON) Intervention, a web application recommending recorded recovery narratives to participants. The aim of the definitive NEON Trial was to understand whether the NEON Intervention benefitted people with experience of psychosis. The aim of the smaller NEON-O and NEON-C trials was to evaluate the feasibility of conducting definitive trials of the NEON Intervention with people (1) experiencing non-psychosis mental health problems and (2) who informally care for others experiencing mental health problems. An open recruitment strategy with a 60-week recruitment period was developed. Recruitment for the NEON Trial and NEON-O Trial targeted mental health service users and people not using mental health services. The NEON Trial
recruited to time and target. The NEON-O Trial achieved its target in 10 weeks. Analysis considered by a Programme Steering Committee after the target was achieved demonstrated a definitive result could be obtained if the trial was adapted for recruitment to continue. The UK Health Research Authority approved all needed amendments following ethical review.
Purpose of this article: To describe the decision-making process for amending the NEON-O Trial and to describe amendments made to the NEON-O Trial to enable a definitive result. The article describes amendments to the aims, objectives, design, power calculation, recruitment rate, process evaluation design, and informed consent documents. The extended NEON-O Trial adopts analysis principles previously specified for the NEON Trial. The article provides a model for other studies adapting feasibility trials into definitive trials

ix) Yeo, C., Rennick-Egglestone, S. and Armstrong, V. et al (2022) Uses and misuses of recorded mental health lived experience narratives in healthcare and community settings: systematic review. Schizophrenia Bulletin 48:1 134-144
https://doi.org/10.1093/schbul/sbab097

Abstract
Mental health lived experience narratives are first-person accounts of people with experience of mental health problems. They have been published in journals, books and online, and used in healthcare interventions and anti-stigma campaigns. There are concerns about their potential misuse. A four-language systematic review was conducted of published literature characterizing uses and misuses of mental health lived experience narratives within healthcare and community settings. 6531 documents in four languages (English, Danish, Swedish, Norwegian) were screened and 78 documents from 11 countries were included. Twenty-seven uses were identified in five categories: political, societal, community, service level and individual. Eleven misuses were found, categorized as relating to the narrative (narratives may be co-opted, narratives may be used against the author, narratives may be used for different purpose than authorial intent, narratives may be reinterpreted by others, narratives may become patient porn, narratives may lack diversity), relating to the narrator (narrator may be subject to unethical editing practises, narrator may be subject to coercion, narrator may be harmed) and relating to the audience (audience may be triggered, audience may misunderstand). Four open questions were identified: does including a researcher’s personal mental health narrative reduce the credibility of their research?: should the confidentiality of narrators be protected?; who should profit from narratives?; how reliable are narratives as evidence?)

x). Roe, D., Slade, M. and Jones, N. (2022) The utility of patient reported outcome measures in mental health. World Psychiatry 21:1. 56-57
https://doi.org/10.1002/wps.20924

Abstract
For decades, clinician-rated outcome measures have been the central source of data informing clinical practice and policy. Patient reported outcome measures (PROMs) more directly assess the lived experiences of service users, capturing their perspectives on their health status and essential subjective constructs such as goal attainment, quality of life and social inclusion. Patient reported experience measures (PREMs) assess their experiences of using health services, including communication, responsiveness and recovery orientation. Here we argue for the systematic implementation of co-developed, user-selected PROMs and PREMs; identify implementation challenges; and propose future priorities.

xi) Piat, M., Wainwright, M., Cherkas, D. et al. (2021) Identifying and understanding the contextual factors that shaped mid-implementation outcomes during the COVID-19 pandemic in organizations implementing mental health recovery innovations into services. Implementation Science Communications 2:101
https://doi.org/10.1186/s43058-021-00206-w

Abstract
Background: Seven housing and health services organizations were guided through a process of translating Chapter Six of the Canadian Guidelines for Recovery-Oriented Practice into a recovery-oriented innovation and plan for its implementation. At the time of the COVID-19 outbreak and lockdown measures, six of the seven organizations had begun implementing their chosen innovation (peer workers, wellness recovery action planning facilitator training, staff training and a family support group). This mid-implementation study used the Consolidated Framework for Implementation Research (CFIR) to identify contextual factors that influenced organizations to continue or postpone implementation of recovery-oriented innovations in the early months of the COVID-19 pandemic.
Methods: Twenty-seven semi-structured 45-min interviews were conducted between May and June 2020 (21 implementation team members and six providers of the innovation (trainers, facilitators, peer workers). Interview guides and analysis were based on the CFIR. Content analysis combined deductive and inductive approaches. Summaries of coded data were given ratings based on strength and valence of the construct’s impact on implementation. Ratings were visualized by mid-implementation outcome and recovery innovation to identify constructs which appear to distinguish between sites with a more or less favourable mid-implementation outcomes.
Results: Four mid-implementation outcomes were observed at this snapshot in time (from most to least positive): continued implementation with adaptation (one site), postponement with adaptation and estimated relaunch date (four sites), indefinite postponement with no decision on relaunch date (one site), and no implementation of innovation yet (one site). Two constructs had either a negative influence (external policies and incentives—renamed COVID-19-related external policy for this study) or a positive influence (leadership engagement), regardless of implementation outcome. Four factors appeared to distinguish between more or less positive mid-implementation outcome: adaptability, implementation climate and relative priority, available resources, and formally appointed internal implementation leaders (renamed “engaging implementation teams during the COVID-19 pandemic” for this study).
Conclusions: The COVID-19 pandemic is an unprecedented outer setting factor. Studies that use the CFIR at the mid-implementation stage are rare, as are studies focusing on the outer setting. Through robust qualitative analysis, we identify the key factors that shaped the course of implementation of recovery innovations over this turbulent time.

xii) Piat, M., Wainwright, M., Sofouli, E. et al. (2021) Factors influencing the implementation of mental health recovery into services: a systematic mixed studies review. Systematic Reviews 10:134
https://doi.org/10.1186/s13643-021-01646-0

Abstract
Background: Countries around the world have committed in policy to transforming their mental health services towards a recovery orientation. How has mental health recovery been implemented into services for adults, and what factors influence the implementation of recovery-oriented services?
Methods: This systematic mixed studies review followed a convergent qualitative synthesis design and used the best-fit framework synthesis method. Librarians ran searches in Ovid- MEDLINE, Ovid-EMBASE, Ovid-PsycInfo, EBSCO- CINAHL Plus with Full Text, ProQuest Dissertations and Theses, Cochrane Library, and Scopus. Two reviewers independently screened studies for inclusion or exclusion using DistillerSR. Qualitative, quantitative, and mixed methods peer-reviewed studies published since 1998 were included if they reported a new effort to transform adult mental health services towards a recovery orientation, and reported findings related to implementation experience, process, or factors. Data was extracted in NVivo12 to the 38 constructs of the Consolidated Framework for Implementation Research (CFIR). The synthesis included a within-case and a cross-case thematic analysis of data coded to each CFIR construct. Cases were types of recovery-oriented innovations.
Results: Seventy studies met our inclusion criteria. These were grouped into seven types of recovery-oriented innovations (cases) for within-case and cross-case synthesis. Themes illustrating common implementation factors across innovations are presented by CFIR domain: Intervention Characteristics (flexibility, relationship building, lived experience); Inner Setting (traditional biomedical vs. recovery-oriented approach, the importance of organizational and policy commitment to recovery-transformation, staff turnover, lack of resources to support personal recovery goals, information gaps about new roles and procedures, interpersonal relationships), Characteristics of Individuals (variability in knowledge about recovery, characteristics of recovery-oriented service providers); Process (the importance of planning, early and continuous engagement with stakeholders). Very little data from included studies was extracted to the outer setting domain, and therefore, we present only some initial observations and note that further research on outer setting implementation factors is needed.

xiii) Piat, M., Wainwright, M., Sofouli, E. et al. (2021) The CFIR card game: A new approach for working with implementation teams to identify challenges and strategies. Implementation Science Communications. 2:1
https://doi.org/10.1186/s43058-020-00099-1

Abstract
Background: The Consolidated Framework for Implementation Research (CFIR) and the ERIC compilation of implementation strategies are key resources for identifying implementation barriers and strategies. However, their respective density and complexity make their application to implementation planning outside of academia challenging. We developed the CFIR Card Game as a way of working with multi-stakeholder implementation teams that were implementing mental health recovery into their services, to identify barriers and strategies to overcome them. The aim of this descriptive evaluation is to describe how the game was prepared, played, used and received by teams and researchers and their perception of the clarity of the CFIR constructs.
Methods: We used the new CFIR-ERIC Matching Tool v.1 to design the game. We produced a deck of cards with each of the CFIR-ERIC Matching Tool barrier narratives representing all 39 CFIR constructs. Teams played the game at the pre-implementation stage at a time when they were actively engaged in a planning process for implementing their selected recovery-oriented innovation. The teams placed each card in either the YES or NO column of the board in response to whether they anticipated experiencing this barrier in their setting. Teams were also asked about the clarity of the barrier narratives and were provided with plain language versions if unclear. Researchers completed a reflection form following the game, and participants completed an open-added questionnaire that included questions specific to the CFIR Card Game. We applied a descriptive coding approach to analysis.
Results: Four descriptive themes emerged from this analysis: (1) the CFIR Card Game as a useful and engaging process, (2) difficulties understanding CFIR construct barrier narratives, (3) strengths of the game’s design and structure and room for improvement and (4) mediating factors: facilitator preparation and multi-stakeholder dynamics. Quantitative findings regarding the clarity of the barrier narratives were integrated with qualitative data under theme 2. Only seven of the 39 original barrier narratives were judged to be clear by all teams.
Conclusions: The CFIR Card Game can be used to enhance implementation planning. Plain language versions of CFIR construct barrier narratives are needed. Our plain language versions require further testing and refining.

Other News / Resources

i)  Prof. Shula Ramon draws attention to the online MSc Mental Health Recovery and Social Inclusion Programme at the University of Hertfordshire.  

In addition to the above link a promotional video can be found here:
VideoMHRSI –

ii) Coronavirus and Mental Health (information)

The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19. It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation
Gov.uk
Social Care Institute for Excellence
Centre for Mental Health
Mental health Foundation
Mind
Rethink
Carers UK
National Service User Network
British Psychological Society
British Association of Social Workers
Royal College of Psychiatrists
Royal College of Nursing
Royal College of Occupational Therapists

iii) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:

Shula:     s.ramon@herts.ac.uk
Tony:      a.sparkes@bradford.ac.uk

February 2022

Recovery Research Network eBULLETIN

February 2022

RRN Meetings
Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time. Nationally however, the current move towards the easing of restrictions represents an optimistic turn to the possibility of resuming face-to-face meetings. The current arrangements are under constant review by the RRN Collective and more information about this possibility will be circulated in due course. In the meantime, we would encourage our readers to keep safe and follow relevant guidance as appropriate.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk

Coronavirus and Mental Health
The impact of coronavirus, and government measures to restrict its transmission, means that we have to pay particular attention to our mental health and wellbeing. There is a considerable amount of advice and information available online. We continue to include examples at the end of the e-bulletin.

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:
https://www.researchintorecovery.com/events/rrn/join/

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research. Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers
In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world. As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.

i) International Shared Decision Making Conference 2022.
The 11th International Shared Decision Making Conference takes place June 20-22 2022 with a pre-conference June 19. The venue for the conference is Comwell Kolding (Denmark) – just next to the site of Lillebaelt University Hospital – Kolding site.

Conference registration for the above event opened on Monday 1st November 2021. For further details, please see here
https://www.isdm2022.com

ii) 14th European Network on Mental Health Services Evaluation

https://targetconferences.com EMNESH2022.com
ENMESH2022.com/program-at-a-glance:
Focus on: Collectivism and Individualism in Mental Health

June 27-29, 2022, Tel Aviv, Israel.

iii) Dr Stefan Rennick-Egglestone draws attention to the following Special Issue:
Special Issue of Perspectives in Public Health on “Recovery outside of mental health services”

Recovery Research Network members Dr Stefan Rennick-Egglestone and Dr Theo Stickley will co-edit a special issue of the journal Perspectives in Public Health, to be published in May 2023, with submission due by end of September 2022.

The theme for the special issue is “Recovery outside of mental health services: what can public health contribute?”. The editors would particularly like to hear about practice and research that focuses on increasing wellbeing as it relates to mental health, and which is not necessarily situated in statutory mental health services. They welcome contributions covering the entire age-span from childhood through to end-of-life, both national and international, and they can include articles that draw on the author’s experience of mental health problems to make recommendations for public health policy and practice.

Details of the special issue will be published on the journal website https://journals.sagepub.com/home/rsh soon, or contact Stefan Rennick-Egglestone through stefan.egglestone@nottingham.ac.uk

Papers and Publications
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i) Ramon, S., Zisman-IIani, Y. and Quirk, A. (ed) (2022) Shared decision making in mental health: international perspective on implementation. Frontiers in Psychiatry.

This E-book includes a summary editorial and twelve articles on updated developments in implementing shared decision making in mental health with different service users groups, a range of providers, tools, and countries.

The e-book and all individual articles are also available for download on the Research Topic homepage. The homepage also contains a detailed overview of this research topic, the opening paragraph is reproduced below:

The application of shared decision making (SDM) to mental health issues and services is a recent development. An increased range of different styles of SDM in mental health exists, reflecting varieties concerning the power differential of clinicians vs. service users, and the place allocated to experiential knowledge vs. scientific knowledge. Yet, current evidence highlights that compulsory interventions are still very common in the context of mental illnesses compared with physical-somatic illnesses; and in some situations the threat of compulsion is overt or barely concealed. Although more decision-making aids exist, these tools are not always equally validated, and their application does not necessarily ensure that the principles of SDM are either applied in practice or contributes to SDM and health outcomes.

ii) Stone, M., Kokanovic, R., Callard, F. and Broom, A. F. (2020) Estranged relations: coercion and care in narratives of supported decision-making in mental healthcare. Medical Humanities 46(1) 62-72.

Abstract
Supported decision-making has become popular among policymakers and mental health advocates as a means of reducing coercion in mental healthcare. Nevertheless, users of psychiatric services often seem equivocal about the value of supported decision-making initiatives. In this paper we explore why such initiatives might be rejected or ignored by the would-be beneficiaries, and we reflect on broader implications for care and coercion. We take a critical medical humanities approach, particularly through the lens of entanglement. We analyse the narratives of 29 people diagnosed with mental illness, and 29 self-identified carers speaking of their experiences of an Australian mental healthcare system and of their views of supported decision-making. As a scaffolding for our critique we consider two supported decision-making instruments in the 2014 Victorian Mental Health Act: the advance statement and the nominated person. These instruments presuppose that patients and carers endorse a particular set of relationships between the agentic self and illness, as well as between patient, carer and the healthcare system. Our participant narratives instead conveyed ’entangled’ relations, which we explore in three sections. In the first we show how ideas about fault and illness often coexisted, which corresponded with shifting views on the need for more versus less agency for patients. In the second section, we illustrate how family carers struggled to embody the supported decision-making ideal of the independent yet altruistic nominated person, and in the final section we suggest that both care and coercion were narrated as existing across informal/formal care divisions. We conclude by reflecting on how these dynamic relations complicate supported decision-making projects, and prompt a rethink of how care and coercion unfold in contemporary mental healthcare.

iii) Knight, F., Kokanović, R., Ridge, D., Brophy, L., Hill, N., Johnston-Ataata, K. and Herrman, H. (2018) Supported decision-making: The expectations held by people with experience of mental illness. Qualitative Health Research. 28(6) 1002 – 1015

Abstract
Supported decision-making (SDM) is a principle guiding mental health service provision, which aims to improve people’s ability to make informed decisions about their care. Understanding diverse individual needs is vital to its success. Based on 29 narrative interviews with people diagnosed with mental illness in Australia, we examine how participants reflected on their own experiences of SDM. We find that participants’ conceptualization of mental health expertise, their own experiences and sense of agency, and their varying needs for dependence and independence influenced their relationships with mental health practitioners. These factors in turn shaped their expectations about SDM. Four narrative positions emerged: the “Inward Expert,” the “Outward Entrustor,” the “Self-Aware Observer,” and the “Social Integrator.” These positionings influenced the type or style of support that participants expected and considered most useful. Our findings are relevant to developing effective approaches to SDM that take into account service users’ needs and preferences.

iv) Kusdemir, S., Oudshoorn, A. and Ndayisenga, J. P. (2022) A critical analysis of the Tidal Model of Mental Health Recovery. Archives of Psychiatric Nursing. 36. 34 – 40.

Abstract
The purpose of this paper is to critically analyze the Tidal Model of Mental Health Recovery. This examination consolidates the existing knowledge used in developing and implementing this model in order to add clarity and explores how its theory relates to practice, research, and educational activities. This paper follows Chinn and Kramer’s theory analysis framework, which includes the following criteria: clarity, simplicity, generalizability, importance, and accessibility. While the Tidal Model theory meets the criterion of clarity, simplicity is impeded due to the complexity of its concepts. That being said, Barker’s theory is applicable across different psychiatric nursing settings because it is general and accessible. To enhance simplicity and make this a more actionable midrange theory, an illustration is offered to demonstrate how the theory could be utilized and empiricized with a potential population of women who use substances. It is concluded that the Tidal Model appeals not only to mental health practice, but as the literature indicates, it also supports everyone who needs shelter where they feel safe at some point in their lives

v) Carr, E. R. and Ponce, A. N. (2022) Supporting mental health recovery, citizenship, and Social Justice. Community Mental Health Journal 58:11–19. Online:
https://doi.org/10.1007/s10597-021-00900-y

Abstract
Individuals with serious mental illness (SMI) have historically experienced stigma and marginalization. Mental health providers are well positioned to engage in social justice agendas geared at supporting the civil rights of those with SMI, and ultimately helping open doors to the full rights of participation in the community. By engaging and partnering in a mental health recovery and strengths-based orientation, leaders in these settings have the capacity to influence micro-, meso, and macro-systems. This can shed light on mechanisms to build on the strengths, capabilities, and hopes of individuals to live lives of meaning as they so define, with equal access to resources and rights, within communities of their choice. The article articulates an integrated application of these concepts for embracing and utilizing the concepts of mental health recovery, citizenship, and social justice in public mental health. Additionally, specific examples and practical applications are offered within the context of an inpatient setting and a community setting.

vi) Senneseth, M., Pollak, C., Urheim, R., Logan, C. and Palmstierna, T. (2022) Personal recovery and its challenges in forensic mental health: systematic review and thematic synthesis of the qualitative literature. BJPsych Open 8, e17, 1–15.
Https://doi.org/10.1192/bjo.2021.1068

Abstract
Background: There has been a call for a framework to guide recovery-oriented practices in forensic mental health services.
Aims: This study aims to examine personal recovery and its challenges in forensic mental health settings in relation to the established framework for personal recovery in mental illness: connected- ness, hope, identity, meaning and empowerment (CHIME).
Method: This study is an updated and expanded systematic review and thematic synthesis of the qualitative literature. A systematic search of six electronic databases (Web of Science, Medline, PsycINFO, CINAHL, EMBASE and SocIndex) was carried out in January 2019, using the terms [Recover*] AND [Forensic OR Secure] AND [Patient* OR Offend* OR Service User*]. Only studies that included service user’s own perceptions and were published from 2014 onward were included in the review. Data were examined with thematic synthesis and subsequently ana- lysed in relation to the CHIME framework.
Results: Twenty-one studies were included in the review. Findings suggest that some adjustments to the original CHIME framework are needed for it to be more relevant to forensic populations, and
that an additional recovery process regarding feeling safe and being secure (safety and security) could be added to CHIME, providing the CHIME-Secure framework (CHIME-S). Specific challenges and barriers for forensic recovery were identified and found to represent the opposite of the recovery processes defined by CHIME (e.g. hopelessness).
Conclusions: We present the CHIME-S as a framework for the personal recovery processes of forensic mental health service users. The CHIME-S may guide the recovery-oriented work of forensic mental health services.

 

Other News / Resources

i) Prof. Mike Slade has announced an exciting job opportunity to co-ordinate the RECOLLECT Programme – for further details about the post and the RECOLLECT Programme, a link is provided below:
https://jobs.kcl.ac.uk/gb/en/job/040529/Post-Doctoral-Research-Associate-Research-Fellow

Please note the closing date of 3.3.22

ii) Prof. Shula Ramon draws attention to the online MSc Mental Health Recovery and Social Inclusion Programme at the University of Hertfordshire.

An informative short video on the Programme is available here:
https://www.youtube.com/watch?v=urg9l3Zw1rQ

 

iii) Coronavirus and Mental Health (information)

The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19. It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation
Gov.uk
Social Care Institute for Excellence
Centre for Mental Health
Mental health Foundation
Mind
Rethink
Carers UK
National Service User Network
British Psychological Society
British Association of Social Workers
Royal College of Psychiatrists
Royal College of Nursing
Royal College of Occupational Therapists

iii) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:

Shula:     s.ramon@herts.ac.uk
Tony:      a.sparkes@bradford.ac.uk

March 2022

Recovery Research Network eBULLETIN

March 2022

RRN Meetings
Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time. Nationally however, the current move towards the easing of restrictions represents an optimistic turn to the possibility of resuming face-to-face meetings. The current arrangements are under constant review by the RRN Collective and more information about this possibility will be circulated in due course. In the meantime, we would encourage our readers to keep safe and follow relevant guidance as appropriate.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk

Coronavirus and Mental Health
The impact of coronavirus, and government measures to restrict its transmission, means that we have to pay particular attention to our mental health and wellbeing. There is a considerable amount of advice and information available online. We continue to include examples at the end of the e-bulletin.

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:
https://www.researchintorecovery.com/events/rrn/join/

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research. Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers
In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world. As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.

i) The World Health Organisation invite you to the Global Launch of the WHO QualityRights e-training to advance mental health, eliminate stigma and promote community inclusion, on Tuesday 12 April 2022, 15.00 to 16.30 CEST.

There is global consensus that prevailing attitudes and practices need to be transformed on a massive scale to advance mental health. However, in countries across the world, whether low, medium or high-income, the collective response has been inadequate. A sea change in mental health is needed. Stigma and discrimination need to be replaced with hope, acceptance and inclusion in the community. In addition, services, policies and laws in the area of mental health need to reflect a person-centered, rights-based, holistic approach.

We are pleased to collaborate with WHO for the launch and rollout of its innovative QualityRights e-training programme to transform attitudes and practices in mental health will be launched globally reaching all people in all countries. The e-training is a key tool for tackling stigma and discrimination and promoting mental health, recovery and community inclusion. It offers the opportunity for hundreds of thousands of people to also learn how to look after their own mental health, how to support others and how to build responsive mental health services. In doing so, the world will be on a better path to achieving good mental health outcomes. This global launch and rollout has an ambitious target – 1 million learners to have completed the e-training by the end of 2024.

Join us on 12 April at 15.00 CEST to learn more about the QualityRights e-training and its strategic rollout over the next 3 years. You will hear from high level policy-makers and thought leaders in governments, UN agencies, humanitarian agencies and civil society about their plans to implement the e-training. Through personal testimonies you will also hear how the programme has already positively impacted the personal and professional lives of those who have completed it.

The launch event will include interpretation in Arabic, Chinese, French, Russian and Spanish. International signing and captioning will also be available.

Please register now for the 12 April launch event here:
https://who.zoom.us/webinar/register/WN_swLxocnvRwOwCDcgWjacmQ

ii) International Shared Decision Making Conference 2022.
The 11th International Shared Decision Making Conference takes place June 20-22 2022 with a pre-conference June 19. The venue for the conference is Comwell Kolding (Denmark) – just next to the site of Lillebaelt University Hospital – Kolding site.

Conference registration for the above event opened on Monday 1st November 2021. For further details, please see here
https://www.isdm2022.com

iii) 14th European Network on Mental Health Services Evaluation

https://targetconferences.com EMNESH2022.com
ENMESH2022.com/program-at-a-glance:
Focus on: Collectivism and Individualism in Mental Health

June 27-29, 2022, Tel Aviv, Israel.

iv) Dr Stefan Rennick-Egglestone draws attention to the following Special Issue:
Special Issue of Perspectives in Public Health on “Recovery outside of mental health services”

Recovery Research Network members Dr Stefan Rennick-Egglestone and Dr Theo Stickley will co-edit a special issue of the journal Perspectives in Public Health, to be published in May 2023, with submission due by end of September 2022.

The theme for the special issue is “Recovery outside of mental health services: what can public health contribute?”. The editors would particularly like to hear about practice and research that focuses on increasing wellbeing as it relates to mental health, and which is not necessarily situated in statutory mental health services. They welcome contributions covering the entire age-span from childhood through to end-of-life, both national and international, and they can include articles that draw on the author’s experience of mental health problems to make recommendations for public health policy and practice.

Details of the special issue will be published on the journal website https://journals.sagepub.com/home/rsh soon, or contact Stefan Rennick-Egglestone through stefan.egglestone@nottingham.ac.uk

Papers and Publications
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i) Ng, F., Newby, C., Robinson, C., Llewellyn-Beardsley, J., Yeo, C., Roe, J., Rennick-Egglestone, S., Smith, R., Booth, S., Bailey, S., Castelein, S., Callard, F., Arbour, S. and Slade, M. (2022) How do recorded mental health recovery narratives create connection and improve hopefulness. Journal of Mental Health 31(2) 273-280
https://doi.org/10.1080/09638237.2021.2022627

Abstract
Background: Mental health recovery narratives are an active ingredient of recovery-oriented interventions such as peer support. Recovery narratives can create connection and hope, but there is limited evidence on the predictors of impact.
Aims: The aim of this study was to identify characteristics of the narrator, narrative content and participant which predict the short-term impact of recovery narratives on participants.
Method: Independent studies were conducted in an experimental (n¼40) and a clinical setting
(n¼13). In both studies, participants with mental health problems received recorded recovery narratives and rated impact on hopefulness and connection. Predictive characteristics were identified using multi-level modelling.
Results: The experimental study found that narratives portraying a narrator as living well with mental health problems that is intermediate between no and full recovery, generated higher self-rated levels of hopefulness. Participants from ethnic minority backgrounds had lower levels of connection with narrators compared to participants from a white background, potentially due to reduced visibility of a narrator’s diversity characteristics.
Conclusions: Narratives describing partial but not complete recovery and matching on ethnicity may lead to a higher impact. Having access to narratives portraying a range of narrator characteristics to maximise the possibility of a beneficial impact on connection and hopefulness

ii) Williams, L. and Armitage, C. (2022) Assessing the Value of a Novel “Recovery and Collaborative Care Planning Café” Initiative for Co-designing Improvements Through a Shared Learning Experience with Service Users, Carers, and Practitioners. Journal of Recovery in Mental Health. 5(2) 5-10. Online:
https://jps.library.utoronto.ca/index.php/rmh/article/view/37968

Abstract
Objective: This paper ascertains the value of a novel approach to creating a participative social learning space with service users, carers, and practitioners to develop recovery-oriented conversations and the experience of collaborative care planning.
Methods: A participatory method “World Café” was utilized with taught masterclasses on recovery principles. Evidenced-based practice was a central feature drawn from service user research. The Model for Improvement: Plan-Do-Study-Act (PDSA) framed the sessions to generate and test ideas.
Results: Service user and carer attendance was low at the start, although this increased after testing ideas using PDSA cycles to improve this. Shared learning grew over time, which led to ideas to create improved participation in care planning. Conversations also developed towards becoming more recovery oriented after participants incorporated a framing set of recovery concepts into the sessions.
Conclusions: The café design proved it was possible to both create a social learning space and change conversations leading to a greater focus on recovery through using CHIME (a conceptual framework incorporating connectedness, hope, identity, meaning, and empowerment). The café successfully

iii) Roe, D., Slade, M. and Jones, N. (2022) The utility of patient-reported outcome measures in mental health. World Psychiatry 21(1) 56-57.
https://doi.org/10.1002/wps.20924

Summary
in a short perspective piece for World Psychiatry, Roe et al discuss the usefulness of patient reported outcome measures (PROMs), and patient reported experience measures (PREMs). The authors make a cogent case for the systematic implementation of co-developed measures, particularly those that emerge out of substantive involvement from people with lived experience. The routine use of such measures are supported by ethical, clinical and institutional justifications. Going forward, the authors conclude by asserting that PROMs/PREMs may be better utilised if they are co-developed, offer enhanced levels of service user choice, capitalise upon the increasing use of mental health apps, and more fully embrace cultural and geopolitical differences.

iv) Griffiths, C., Maravic da Silva, K., Leathlean, C., Jiang, H., Ang, C. S. and Searle, R. (2022) Investigation of physical activity, sleep, and mental health recovery in treatment resistant depression (TRD) patients receiving repetitive transcranial magnetic stimulation (rTMS) treatment. Journal of Affective Disorders Reports. Online:
https://doi.org/10.1016/j.jadr.2022.100337

Abstract
Background: Repetitive transcranial magnetic stimulation (rTMS) is effective in treating depression; however, the effect on physical activity, sleep and recovery is unclear. This study investigated rTMS effect on physical activity and sleep through providing patients with a Fitbit and software apps; and reports the impact of rTMS on depression, anxiety and mental health recovery.
Methods: Study design was a pre and post data collection without a control, with twenty-four participants with treatment-resistant depression (TRD). Measures used were Fitbit activity and sleep data, and patient-rated Recovering Quality of Life (ReQoL-20), Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder (GAD-7).
Results: Response and remission rates were, respectively: 34.8% and 39% for PHQ-9; 34.8% and 47.8% for GAD-7. ReQoL-20 response and reliable improvement were 29.4% and 53%. PHQ-9, GAD-7 and ReQol-20 scores significantly improved, with large effect sizes. Analysis of Fitbit activity and sleep data yielded non-significant results. The Fitbit data machine learning model classified two levels of depression to 82% accuracy.
Limitations: rTMS treatment was open-label and adjunct to existing antidepressant medication. No control group. Female patients were overrepresented.
Conclusions: Improvements on the ReQoL-20 and aspects of sleep and activity indicate the positive impact of rTMS on the individual’s real world functioning and quality of life. A wearable activity tracker can provide feedback to patients and clinicians on sleep, physical activity and depression levels. Further research could be undertaken through a sufficiently powered RCT comparing rTMS versus rTMS with use of a Fitbit, its software applications, and sleep and physical activity advice.

v) de Wet, A., Sunkel, C. and Pretorius, C. (2022) Opportunities and challenges: a case for formal peer support work in mental health in a South African context. Advances in Mental Health. Online:
https://doi.org/10.1080/18387357.2022.2032776

Abstract
Objective: Peer support in mental health has gained much attention especially in high income countries (HICs). Peer support can be delivered informally or formally. Both informal peer support and formal peer support work in mental health (PSWMH) hold promise for service users’ recovery and increasingly delivered in low- and middle-income countries (LMICs) too, to overcome large treatment gaps between mental health care needs and limitations in services.
Method: 37 semi-structured interviews and 3 focus groups with 14 service users, 12 service providers and 12 carers of service users at three tertiary psychiatric hospitals in the Western Cape, South Africa, were conducted. Data were analysed using reflexive thematic analysis.
Results: Support as facilitator to recovery was generated as a theme, including peer support; described as beneficial for both service users and peer support workers.
Discussion: The benefits lead to the exploration of the opportunities and challenges for PSW-MH in the study context. While there is still a long way to go to the successful inclusion of formal peer support within health care services in South African contexts, we have discussed the possible ways in which such inclusion can be beneficial on various levels, if the challenges to PSW-MH are heeded.

vi) Fox, J. (2022) Experiences of being cared-for: The perspective of an Expert-by-Experience in Mental Health. Front. Psychiatry 13(824542). Online:
https://doi.org/10.3389/fpsyt.2022.824542

Abstract
It is difficult to understand what it feels like for people with mental ill-health to be cared-for and supported by family members; this experience is often little-explored. Narratives about caring have been increasingly written alongside first-person accounts of recovery, however, there is a dearth of literature written to gain the perspective of being cared-for because of mental distress. Thus, using autoethnography, I present three critical incidents occurring at different points in my recovery to enable exploration of experiences of being cared-for. Firstly, a critical incident at the point of acute unwellness is introduced, secondly an incident during a consultation with a health professional is highlighted, and finally a moment of transition when embarking on an independent life with my husband-to-be is described. I use autoethnography to connect “the autobiographical and personal to the cultural, social, and political”. I consider how the identity of a carer is continually negotiated in a relationship with the service user in both the “private” and the “public” worlds during recovery. I reflect on how professionals can support both service users and carers in a triangle of care, by providing information and support, alongside promoting the development of independence and agency for the service user whilst in the caring relationship. Finally, I introduce a service model which promotes a family network approach to empower the service user and highlight training programs on recovery that enable carers. I conclude by suggesting the potential of both approaches to support carers to promote the recovery of the service user.

vii) Nixdorf, R., Nugent, L., Aslam, R., Barber, S., Charles, A., Meir, L. G., Grayzman, A., Hiltensperger, R., Kalha, J., Korde, P., Mtei, R., Niwemuhwezi, J., Ramesh, M., Ryan, G., Slade, M., Wenzel, L. and Mahlke, C. (2022) A multi-national peer support intervention: the UPSIDES pilot phase, Advances in Mental Health 20(1) 2-14. Online:
https://doi.org/10.1080/18387357.2021.2020140

Abstract
Objective: Using Peer Support in Developing Empowering Mental Health Services (UPSIDES) is evaluating implementation of a peer support worker (PSW) intervention at six recruiting sites (Germany, India, Israel, Tanzania, and Uganda) (ISRCTN26008944). The aim of this study is to evaluate the pre-trial pilot phase.
Method: The initial training to prepare individuals for the PSW role and the implementation of the peer support (PS) intervention was evaluated using a multi-method design comprising six focus groups (FG; n = 22) and questionnaires capturing the perspectives of service users, PSWs, peer trainers, and mental health staff members (n = 21).
Results: Findings were organised across eleven key implementation themes: organisational culture, PSW training, PSW role definition, staff willingness and ability to work with PSWs, resource availability, financial arrangements, support for PSW well-being, PSW access to a peer network, acceptance, preparation, and other challenges.
Discussion: The following recommendations are made, based on this pilot phase: the PS training should train on practical skills using role- playing exercises; PSWs should work in teams, including role reflection with colleagues (intervision) or with a highly experienced coach (supervision); necessary resources and tools for networking should be provided; and continuous awareness-raising about PS is needed.

Other News / Resources
i) Prof. Shula Ramon draws attention to the online MSc Mental Health Recovery and Social Inclusion Programme at the University of Hertfordshire.

An informative short video on the Programme is available here:
https://www.youtube.com/watch?v=urg9l3Zw1rQ

 

ii) Coronavirus and Mental Health (information)

The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19. It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation
Gov.uk
Social Care Institute for Excellence
Centre for Mental Health
Mental health Foundation
Mind
Rethink
Carers UK
National Service User Network
British Psychological Society
British Association of Social Workers
Royal College of Psychiatrists
Royal College of Nursing
Royal College of Occupational Therapists

iii) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:

Shula:     s.ramon@herts.ac.uk
Tony:      a.sparkes@bradford.ac.uk

April 2022

Recovery Research Network eBULLETIN

April 2022

RRN Meetings
Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time. Nationally however, the current move towards the easing of restrictions represents an optimistic turn to the possibility of resuming face-to-face meetings. The current arrangements are under constant review by the RRN Collective and more information about this possibility will be circulated in due course. In the meantime, we would encourage our readers to keep safe and follow relevant guidance as appropriate.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk

Coronavirus and Mental Health
The impact of coronavirus, and government measures to restrict its transmission, means that we have to pay particular attention to our mental health and wellbeing. There is a considerable amount of advice and information available online. We continue to include examples at the end of the e-bulletin.

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:
https://www.researchintorecovery.com/events/rrn/join/

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research. Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers
In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world. As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.

i) International Shared Decision Making Conference 2022.
The 11th International Shared Decision Making Conference takes place June 20-22 2022 with a pre-conference June 19. The venue for the conference is Comwell Kolding (Denmark) – just next to the site of Lillebaelt University Hospital – Kolding site.

Conference registration for the above event opened on Monday 1st November 2021. For further details, please see here
https://www.isdm2022.com

ii) 14th European Network on Mental Health Services Evaluation

https://targetconferences.com EMNESH2022.com
ENMESH2022.com/program-at-a-glance:
Focus on: Collectivism and Individualism in Mental Health

June 27-29, 2022, Tel Aviv, Israel.

iii) Dr Stefan Rennick-Egglestone draws attention to the following Special Issue:
Special Issue of Perspectives in Public Health on “Recovery outside of mental health services”

Recovery Research Network members Dr Stefan Rennick-Egglestone and Dr Theo Stickley will co-edit a special issue of the journal Perspectives in Public Health, to be published in May 2023, with submission due by end of September 2022.

The theme for the special issue is “Recovery outside of mental health services: what can public health contribute?”. The editors would particularly like to hear about practice and research that focuses on increasing wellbeing as it relates to mental health, and which is not necessarily situated in statutory mental health services. They welcome contributions covering the entire age-span from childhood through to end-of-life, both national and international, and they can include articles that draw on the author’s experience of mental health problems to make recommendations for public health policy and practice.

Details of the special issue will be published on the journal website https://journals.sagepub.com/home/rsh soon, or contact Stefan through stefan.egglestone@nottingham.ac.uk

Papers and Publications
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery

i) Ibrahim, N., Ng, F., Selim, A., Ghallab, E., Ali, A. and Slade, M. (2022) Posttraumatic growth and recovery among a sample of Egyptian mental health service users: a phenomenological study. BMC Psychiatry 22(555). Online:
https://doi.org/10.1186/s12888-022-03919-x

Abstract
Background: Delivery of recovery-oriented mental health practice is fundamental to personal recovery. Yet, there is lack of service users’ accounts on what constitutes mental health recovery in Egypt.
Objectives: The aim of this study was to explore mental health recovery meaning informed by people with personal experience of recovery.
Methods: A phenomenological research design was used. Semi-structured qualitative interviews were conducted with 17 adult community-dwelling individuals who identified as recovered/recovering from mental health issues. An inductive thematic analysis approach was used to analyses participants’ responses.
Results: Participants predominately reported personal and functional definitions of mental health recovery. Posttraumatic growth was the strongest theme comprising: relation to others, spirituality, new possibilities, identity & strengths, and appreciation of life. Themes of acceptance and forgiveness, functional and clinical recovery, and finding hope were also identified.
Conclusions: This is the first study to explore mental health recovery meaning among a sample of people with lived experience of mental health issues in Egypt. Findings suggest that developing and implementing psychosocial interventions to support posttraumatic growth among people with mental health issues is a priority.

ii) Carpenter-Song, E., Acquilano, S. C., Noel, V., Al-Abdulmunem, M., Torous, J. and Drake, R. E. (2022) Individualized intervention to support mental health recovery through implementation of digital tools into clinical care: feasibility study. Community Mental Health Journal 58 99–110. Online:
https://doi.org/10.1007/s10597-021-00798-6

Abstract
Myriad digital tools exist to support mental health but there are multiple barriers to using these tools in routine care. This study aimed to assess the feasibility of an intervention incorporating a support role to help the clinical team identify and use technology to promote recovery. The technology specialist intervention is 3 months in duration and comprises four stages: goal setting, researching and evaluating tools, demonstrating and selecting tools, and ongoing support. We implemented the intervention in a community mental health center and a dual diagnosis treatment program, working with eight clients and their case managers. Clients and case managers willingly engaged with the technology specialist and found the intervention beneficial. Integration and collaboration with the care team facilitated implementation of the technology specialist in these real-world settings. Clients reported that the intervention made it easy to try a digital tool. Six of the eight participants stated that they made substantial progress toward their goals. The technology specialist is a promising new role for mental health care delivery to augment traditional services and enhance individualized recovery.

iii) Piat, M., Sofouli, E., Wainwright, M., Albert, H., Rivest, M-P., Casey, R., LeBlanc, S., Labonté, L., O’Rourke, J. and Kasdorf, S. (2022) Translating mental health recovery guidelines into recovery-oriented innovations: A strategy combining implementation teams and a facilitated planning process. Evaluation and Program Planning. 91 102054. Online:
https://doi.org/10.1016/j.evalprogplan.2022.102054

Abstract
Recovery is the focus of mental health strategies internationally. However, little translation of recovery knowledge has occurred in mental health services. The purpose of this research is to bridge the gap between recovery guidelines and practice by developing a new implementation strategy involving the formation of implementation teams made up of different stakeholders (service users, service providers, managers, knowledge users) and facilitating a 12-meeting implementation planning process. Seven mental health organizations across Canada successfully completed the process of translating the guidelines into a recovery-oriented innovation that was implemented. Fifty-five implementation team members were interviewed upon completion of the 12-meeting process. Findings indicate that implementation team members perceived the structured planning process as positive. Nevertheless, the language of implementation science remains difficult to understand for a non-academic audience. Key elements of the 12-meeting process included the value of consensus building among implementation team members and the subsequent shifting power relationships. While working with diverse stakeholders came with certain challenges, the process in itself was a form of system transformation. This type of engaged planning process was a significant departure from the more top-down approaches to organizational change that staff were used to.

iv) Jatta, S., Brunton-Smith, I. and Meadows, R (2022) Inequalities in recovery or methodological artefact? A comparison of models across physical and mental health functioning. SSM – Population Health 17 101067. Online:
https://doi.org/10.1016/j.ssmph.2022.101067

Abstract
Considerable attention has been paid to inequalities in health. More recently, focus has also turned to inequalities in ‘recovery’; with research, for example, suggesting that lower grade of employment is strongly associated with slower recovery from both poor physical and poor mental health. However, this research has tended to operationalise recovery as ‘return to baseline’, and we know less about patterns and predictors when recovery is situated as a ‘process’. This paper seeks to address this gap. Drawing on data from the UK Household Longitudinal Study, we operationalise recovery as both an ‘outcome’ and as a ‘process’ and compare patterns and predictors across the two models. Our analysis demonstrates that the determinants of recovery from poor health, measured by the SF-12, are robust, regardless of whether recovery is operationalised as an outcome or as a process. For example, being employed and having a higher degree were found to increase the odds of recovery both from poor physical and mental health functioning, when recovery was operationalised as an outcome. These variables were also important in distinguishing health functioning trajectories following a poor health episode. At one and the same time, our analysis does suggest that understandings of inequalities in recovery will depend in part on how we define it. When recovery is operationalised as a simple transition from poor health state to good, it loses sight of the fact that there may be inequalities (i) within a ‘poor health’ state, (ii) in how individuals are able to step into the path of recovery, and (iii) in whether health states are maintained over time. We therefore need to remain alert to the additional nuance in understanding which comes from situating recovery as a process; as well as possible methodological artefacts in population research which come from how recovery is operationalised.

v) Murphy, J., Mulcahy, H., O’ Mahony, J. and Bradley, S. (2022) Exploring individuals’ experiences of hope in mental health recovery: An interpretative phenomenological analysis. Journal of Psychiatric and Mental Health Nursing(Early View). Online:
https://doi.org/10.1111/jpm.12833

Abstract
Introduction: Mental health services have embraced the philosophy and practice of recovery. Research has confirmed hope as a micro-process of recovery. The lived experience of hope has received scant attention. This is required to improve understanding and optimize its therapeutic potential
Aim: To explore how individuals describe and make sense of their experience of hope in mental health recovery.
Method: A qualitative interpretative phenomenological analysis (IPA) approach was used. The sample was accessed via email networks. Data were generated through semi-structured interviews and analysed using an IPA framework.
Results: Three superordinate themes emerged: “Without it we would wither up and die”—Hope as intrinsic to life; “I will be ok”—Having a sense of possibility and “Making it happen”—Moving forward. Individuals referenced hope by its absence when attempts were made to end life, and as present but hidden in tortuous circumstances.
Discussion: Individuals were more familiar with the concept of hopelessness, had a ready-to-hand vocabulary of “having no hope” and used this by default to inform what hope meant.
Implications for Practice: It is important that all stakeholders appreciate the context specific interpretation of hope and cultivate dialogue and understanding to harness its therapeutic potential.

vi) Damsgaard, J. B. and Brinkmann, S. (2022) Me and us: Cultivating presence and mental health through choir singing. Scandinavian Journal of Caring Sciences. (early View) Online:
https://doi.org/10.1111/scs.13078

Abstract
Background: An increasing body of qualitative and quantitative research suggests that choir singing can improve mental and physical health and wellbeing. A recurring phenomenon is social agency and social and emotional competences. However, there is little consensus about the underlying impact mechanisms and the special nature of music as a medium for music-based social–emotional
competence.
Aim: This research was carried out to explore how the participants experienced engaging and singing in the choir A Song for the Mind in order to understand the social and emotional aspects in relation to choir singing and mental health.
Method: Six women and two men were interviewed. The study involved open-ended interviews and applied Paul Ricoeur’s phenomenological–hermeneutic theory of interpretation in processing the collected data.
Findings: Two themes emerged—The Singing Me and Cultivating Us. Joining the choir, singing and engaging with the lyrics, helped the participants get in contact with complex feelings and visualise and express challenges. This formed feelings of connecting to oneself and opening up to become aware of the world such as nature, the other person and the choir. Songs, melodies, tones, lyrics—singing together—formed a relation between the participants and the other and the group. This was a meaningful, and to some, a life-changing experience, and an important learning process to the professionals. As the participants are sensing and connecting to themselves, there is an opening for growing a nascent presence and awareness.
Conclusion: Joining the initiative A Song for the Mind instils an attention to the other person(s). The singing process seems to evoke presence, leading to awareness towards relational aspects and solidarity. In a choir singing perspective, and health care practice in general, this can be seen as a budding and ground-breaking formation of cultural activities holding learning and empowering potentials instilling mental health.

vii) Thoits, P. A. (2022) Mental health treatment histories, recovery, and well-being. Society and Mental Health 12(1) 1-16

Abstract
Epidemiological and sociological research on recovery from mental disorder is based on three rarely tested medical model assumptions: (1) recovery without treatment is the result of less severe illness, (2) treatment predicts recovery, and (3) recovery and well-being do not depend on individuals’ treatment histories. I challenge these assumptions using National Comorbidity Survey-Replication data for individuals with any disorder occurring prior to the current year (N = 2,305). Results indicated that (1) untreated remissions were fully explained by less serious prior illness, (2) treated individuals were less likely to recover due to more serious illness, and (3) people who had past-only treatment were more likely to recover than the never-treated, while those in recurring and recently initiated care were less likely to recover. Treatment histories predicted greater well-being only if recovery had been attained. Histories of care help to explain recovery rates and suggest new directions for treatment-seeking theory and research.

viii) Trustam, E., Chapman, P. and Shanahan, P. (2022) Making recovery meaningful for people with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities. 35(1) 252–260.

Abstract
Background: A recovery approach within mental health services has gained momentum. Its meaning for adults with intellectual disabilities recovering from mental health disorders is less understood. Peoples’ experiences of recovery were explored to help inform recovery-focused recommendations for clinical practise.
Method: A qualitative design using interpretative phenomenological analysis was applied. Nine interviews with people with intellectual disabilities who had experienced mental health disorders were conducted.
Results: Two themes that emerged focusing on entry to service and the recovery experience. Subthemes for entry to service included unfair treatment, valuing information and managing expectations. The recovery experience subthemes were therapeutic alliance, self-management, emotional development, autonomy, connectedness, positive identity and a belief in recovery.
Conclusions: Hearing peoples’ experiences directly allowed the current themes to emerge in the context of living with lifelong disabilities. This article adds to the sparse literature and highlights considerations for recovery-based interventions for people with intellectual disabilities.

Other News / Resources
i) Prof. Shula Ramon draws attention to the online MSc Mental Health Recovery and Social Inclusion Programme at the University of Hertfordshire.

An informative short video on the Programme is available here:
https://www.youtube.com/watch?v=urg9l3Zw1rQ

ii) Coronavirus and Mental Health (information)

The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19. It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation
Gov.uk
Social Care Institute for Excellence
Centre for Mental Health
Mental health Foundation
Mind
Rethink
Carers UK
National Service User Network
British Psychological Society
British Association of Social Workers
Royal College of Psychiatrists
Royal College of Nursing
Royal College of Occupational Therapists

iii) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:

Shula:     s.ramon@herts.ac.uk
Tony:      a.sparkes@bradford.ac.uk

May 2022

Recovery Research Network eBULLETIN

May 2022

RRN Meetings
Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time. Nationally however, the current move towards the easing of restrictions represents an optimistic turn to the possibility of resuming face-to-face meetings. The current arrangements are under constant review by the RRN Collective and more information about this possibility will be circulated in due course. In the meantime, we would encourage our readers to keep safe and follow relevant guidance as appropriate.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk

Coronavirus and Mental Health
Both nationally and internationally, the impact of coronavirus is an ongoing concern, and it remains important that we continue to pay particular attention to our mental health and wellbeing. There is a considerable amount of advice and information available online. We continue to include examples at the end of the e-bulletin.

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:
https://www.researchintorecovery.com/events/rrn/join/

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research. Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers
In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world. As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.

i) International Shared Decision Making Conference 2022.
The 11th International Shared Decision Making Conference takes place June 20-22 2022 with a pre-conference June 19. The venue for the conference is Comwell Kolding (Denmark) – just next to the site of Lillebaelt University Hospital – Kolding site.

Conference registration for the above event opened on Monday 1st November 2021. For further details, please see here
https://www.isdm2022.com

ii) 14th European Network on Mental Health Services Evaluation

https://targetconferences.com EMNESH2022.com
ENMESH2022.com/program-at-a-glance:
Focus on: Collectivism and Individualism in Mental Health

June 27-29, 2022, Tel Aviv, Israel. A comprehensive and detailed programme covering the three days is available from the ENMESH website, along with a range information pertinent to the event.
https://www.enmesh2022.com

iii) Dr Stefan Rennick-Egglestone draws attention to the following Special Issue:
Special Issue of Perspectives in Public Health on “Recovery outside of mental health services”

Recovery Research Network members Dr Stefan Rennick-Egglestone and Dr Theo Stickley will co-edit a special issue of the journal Perspectives in Public Health, to be published in May 2023, with submission due by end of September 2022.

The theme for the special issue is “Recovery outside of mental health services: what can public health contribute?”. The editors would particularly like to hear about practice and research that focuses on increasing wellbeing as it relates to mental health, and which is not necessarily situated in statutory mental health services. They welcome contributions covering the entire age-span from childhood through to end-of-life, both national and international, and they can include articles that draw on the author’s experience of mental health problems to make recommendations for public health policy and practice.

Details of the special issue will be published on the journal website https://journals.sagepub.com/home/rsh soon, or contact Stefan Rennick-Egglestone through stefan.egglestone@nottingham.ac.uk

iv) Centre for Mental Health.
A Year in Our Lives: Honouring our stories of the pandemic
Tuesday 7 June 2022. 11:00 – 12:00

In June 2020, Centre for Mental Health set out to hear from people across the UK and beyond about how the Covid-19 pandemic was affecting their mental health.

Two years and over eighty submissions later, we have an incredible picture of diverse experiences, highlighting the shared sorrows and stark inequalities over this most difficult of times.

You are warmly invited to join us at this online event where we will be honouring the voices we’ve heard from over the course of this project. We will be launching a reflective piece by poet and activist, David Gilbert, which explores the stories as a diverse collective and the golden threads running through them, alongside the A Year in Our Lives anthology.

Hear from David Gilbert and some of the writers sharing their reflections on the pandemic, and talking about the impact of writing on mental health.

Join us by registering below!

Register here

 

Papers and Publications
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i) Griffiths, C., Walker, K., and Leathlean, C. (2022). An exploration of patient experience of sleep, physical activity, and exercise in early psychosis. Psychosis. Online: https://doi.org/10.1080/17522439.2022.2064907

Abstract
Background: Compared to the general population, people with experience of psychosis have poorer physical fitness, higher levels of sedation, lower levels of physical activity, more sleep problems, and higher incidence of insomnia.
Methods: Thirty-one early intervention psychosis (EIP) service patients took part in an eight-week intervention: provision of a Fitbit, Fitbit software apps, sleep and physical activity guidance, and three discussion sessions with clinicians. Fifteen participants consented to be interviewed, 9 males and 6 females, age range 19–51, average age 29. In-depth interviews investigating patient experiences of sleep and physical activity were conducted. Thematic analysis was employed.
Results: Patients using an EIP service experience particular issues, problems, and barriers to engaging in effective and healthy sleep and physical activity/exercise; these can have a negative effect on mental and physical health, wellbeing, recovery, and sociability. Patients used factors such as medication, social support, practical strategies, and motivation enhancement to overcome issues, problems, and barriers.
Discussion: Healthy effective sleep and physical activity/exercise is important to EIP service patients’ wellbeing and mental and physical health. EIP services should consider and assess sleep and physical activity/exercise issues, and promote healthy effective sleep and physical activity/exercise within recovery focused practice

ii) Griffiths, C., Hina, F., Pollard, L., and Reid, I. (2022). Effectiveness of online mindfulness training for people experiencing mental illness. Open Journal of Depression 11(2) Online:
https://doi.org/10.4236/ojd.2022.112002

Abstract
Background: Evidence has shown that self-guided web application mindfulness training can improve mental health. In this study, the “Be Mindful” online-based mindfulness training software application was offered through a United Kingdom (UK) universal community healthcare provider to patients with a mental illness diagnosis. Be Mindful is an online course providing instruction on mindfulness theories and practice training, progress tracking, integrated guidance/feedback, and motivational emails.
Objective: The aim of this paper is to present feasibility findings and outcomes on anxiety, depression, and stress of an intervention offering Be Mindful. Participants were adults who had a mental illness diagnosis and were under the care of community mental health services.
Methods: Open-label patient cohort design, with no control group. Pre- and post-intervention assessment using participant self-report measures: Generalised Anxiety Disorder-7 (GAD-7); Perceived Stress Scale (PSS-10); and Patient Health Questionnaire-9 (PHQ-9; a measure of depression severity).
Results: Two hundred and seventy-four started and thirty-one patients completed the Be Mindful programme and outcome measures. PSS scores at baseline significantly improved from 24.6 (1.79) to 18.7 (2.05) at the end (p < 0.001), with a large effect size of 0.498. GAD-7 scores at baseline significantly improved from 11.4 (1.3) to 8.00 (1.35) at end (p < 0.001), with a medium effect size of 0.354. PHQ-9 scores at baseline significantly improved from 13.7 (1.42) to 9.09 (1.76) to 9.81 (1.77) at end (p < 0.001), with a medium effect size of 0.378.
Limitations: There was no control group, and the intervention was adjunct to existing treatment. Conclusions: Be Mindful can be offered through a UK community NHS Trust and can have a significant positive impact on the reduction of symptoms of anxiety, depression, and stress in patients with experience of mental illness. Roll-out through community mental health providers to people with experience of mental illness is justified. Well-designed and sufficiently powered randomised controlled trials of theory-driven online mindfulness training for mental illness patient populations are required.

iii) Åsbø, G., Ueland., T., Haatveit, B., Bjella, T., Flaaten, C. B., Wold, K. F., Widing, L., Engen, M. J., Lyngstad, S. H., Gardsjord, E., Romm, K. L., Melle, I., Simonsen, C. (2022) The Time is ripe for a consensus definition of clinical recovery in first-episode psychosis: Suggestions based on a 10-Year follow-up study. Schizophrenia Bulletin. Sbac035
https://doi.org/10.1093/schbul/sbac035

Abstract
Objectives: A consensus definition of clinical recovery in first-episode psychosis (FEP) is required to improve knowledge about recovery rates in this population. To propose criteria for a future consensus definition, this study aims to investigate rates of clinical recovery when using a standard definition (full psychotic symptom remission and adequate functioning for minimum one year) across both affective and nonaffective FEP groups (bipolar spectrum and schizophrenia spectrum disorders). Second, we aim to explore changes in rates when altering the standard definition criteria. Third, to examine the extent to which healthy controls meet the functioning criteria.
Study design: In total, 142 FEP participants and 117 healthy controls preselected with strict criteria, were re-assessed with structured clinical interviews at 10-year follow-up.
Study results: A total of 31.7% were in clinical recovery according to the standard definition, with significantly higher recovery rates in bipolar (50.0%) than in schizophrenia spectrum disorders (22.9%). Both groups’ recovery rates decreased equally when extending duration and adding affective symptom remission criteria and increased with looser functioning criteria. In healthy controls, 18.8% did not meet the standard criteria for adequate functioning, decreasing to 4.3% with looser criteria.
Conclusions: Findings suggest that clinical recovery is common in FEP, although more in bipolar than in schizophrenia spectrum disorders, also when altering the recovery criteria. We call for a future consensus definition of clinical recovery for FEP, and suggest it should include affective symptom remission and more reasonable criteria for functioning that are more in line with the general population.

iv) The following blog from Dina Poursanidou offers some reflections on the questions raised from undertaking ethnographic work. In the spirit of a ‘blog’ then Dina’s words are reproduced here and speak from themselves. The blog is taken from Asylum magazine in 2017 and the link here also includes Dina’s powerpoint.
https://asylummagazine.org/2017/06/doing-critical-ethnographic-research-on-violence-in-inpatient-mental-health-care-as-a-service-user-researcher-reflections-on-methodology-relational-ethics-and-politics/#more-3484

Doing Critical Ethnographic Research on Violence in Inpatient Mental Health Care as a Service User Researcher: Reflections on Methodology, Relational Ethics and Politics by Dina Poursanidou

I am a service user researcher. Since February 2015 I have been working at the Service User Research Enterprise (SURE), a research group at the Institute of Psychiatry at King’s College London.

The uniqueness of SURE lies in the fact that all of its members are both mental health service users (ex-service users or current service users) and academic researchers.

I have a 3-year postdoctoral research fellowship and as part of this fellowship I have been conducting an evaluation of how a violence reduction programme has been implemented on inpatient psychiatric wards in London and in Devon (that is, I have been doing a process evaluation).
For the evaluation I have been using ethnography, a research approach that is well suited to the study of cultures and institutions – in my case, to the study of inpatient psychiatric wards and their cultures.
In the context of this ethnographic evaluation, I have spent long periods of time on a number of different inpatient wards in London and in Devon, observing what was going on in the wards, the interactions between ward staff and service users, service user group activities and key staff meetings. I have also spent hours talking informally (‘chatting’) with ward staff and service users, as well as doing formal interviews with them.Since April 2016 (when I started the ethnography) I have been reflecting a lot on and speaking (at conferences and research meetings) about the methodological, ethical and political challenges and dilemmas I have encountered in the process of carrying out service user-led critical ethnographic research on violence in inpatient mental health care. Some of the questions I have been interrogating are:

1. How to negotiate the need to constantly oscillate between being immersed in the settings I observed, on the one hand, and ‘making the familiar strange’ by adopting a critical distance and problematising what could be taken for granted (including my own lived experience and experiential knowledge of inpatient care), on the other?

2. How can I manage the emotional labour and profound emotional cost of using my own lived experience/subjectivity as ‘an instrument of knowing’ and understanding (expected of me as a service user researcher) in my mental health ethnography?

3. How to reconcile the political and ethical position of being an ‘engaged’ (intellectually, emotionally, sensorily, relationally and politically engaged with the subject of my inquiry) researcher and (dare I say) a service user ally with the need to be dispassionate, detached and critically distant for a large part of my ethnographic work?

4. How to use my lived experience of acute inpatient care and my experiential knowledge of coercive/violent practices constructively in my ethnographic work – without being overwhelmed by the feelings associated with this knowledge , i.e. anger, grief and terror?

5. To what extent can I claim that I have been doing ‘non participant observation’ on my study wards when I have often-albeit unintentionally on my part-been pulled into the dramas that take place on these wards, which raised acutely difficult issues of ethical responsibility for me?

v) Ng. F., Newby, C., Robinson, C., Llewellyn-Beardsley, J., Yeo, C., Roe, J., Rennick-Egglestone, S., Smith, R., Booth, S., Bailey, S., Castelein, S., Callard, F., Arbour, S. and Slade, M (2022) How do recorded mental health recovery narratives create connection and improve hopefulness? Journal of Mental Health. 31(2) 273-280,

Abstract
Background: Mental health recovery narratives are an active ingredient of recovery-oriented interventions such as peer support. Recovery narratives can create connection and hope, but there is limited evidence on the predictors of impact.
Aims: The aim of this study was to identify characteristics of the narrator, narrative content and participant which predict the short-term impact of recovery narratives on participants.
Method: Independent studies were conducted in an experimental (n1⁄440) and a clinical setting (n1⁄413). In both studies, participants with mental health problems received recorded recovery narratives and rated impact on hopefulness and connection. Predictive characteristics were identified using multi-level modelling.
Results: The experimental study found that narratives portraying a narrator as living well with mental health problems that is intermediate between no and full recovery, generated higher self-rated levels of hopefulness. Participants from ethnic minority backgrounds had lower levels of connection with narrators compared to participants from a white background, potentially due to reduced visibility of a narrator’s diversity characteristics.
Conclusions: Narratives describing partial but not complete recovery and matching on ethnicity may lead to a higher impact. Having access to narratives portraying a range of narrator characteristics to maximise the possibility of a beneficial impact on connection and hopefulness.

vi) Ibrahim, N., Ghallab, E., Ng, F., Eweida, R., and Slade, M. (2022) Perspectives on mental health recovery from Egyptian mental health professionals: A qualitative study. Journal of Psychiatric Mental Health Nursing. 29(3) 484–492

Abstract
Introduction: Recovery-oriented mental health practice is an emerging approach that aims to empower individuals to define their goals and take responsibility for their own recovery. However, mental health practice in Egypt is still custodial.
Aim: To explore perspectives of Egyptian mental health professionals on recovery. Method: Semi-structured interviews were conducted with 15 mental health professionals identified through snowball sampling.
Results: The current study identified that functional recovery outweighed other definitions. Four facilitators of mental health recovery were identified: therapeutic relationship; family engagement; cultural sensitivity; and professionals’ self-awareness. Six barriers to recovery were found, comprising mental health stigma and lack of awareness, seeking traditional healers, shortage of psychiatrists, cost of treatment, lack of training and effective rehabilitation programs.
Discussion: The concept of functional recovery predominates among nurses and other mental health professionals, which may be due to limited training and the historical lack of service user involvement in Egypt. Lack of support from family and society, inadequate training MHPs and perceived system inefficiencies are also major impeding factors for recovery.
Implications for Practice: There is a need for nurses to be involved in designing intervention programs targeting the general public and to support increased involvement of people with mental health issues.

vii) Walker, K., Yates, J. and Dening, T. (2022) Staff perspectives on barriers to and facilitators of quality of life, health, wellbeing, recovery and reduced risk for older forensic mental-health patients: A qualitative interview study. Journal of Health Services Research and Policy. Online:
https://doi.org/10.1177/13558196221094512

Abstract
Objectives: There is a lack of research informing service delivery for older forensic mental health patients. This study explored service provision in forensic mental health inpatient and community services in England, investigating what is required for progress in terms of quality of life, health, wellbeing, recovery and reduced risk, and the barriers and facilitators associated with this.
Methods: Semi-structured interviews were undertaken with 48 members of staff working with older forensic mental health patients in secure inpatient units or the community in England. Data were analysed using thematic analysis.
Results: Two global themes ‘What works’ and ‘What doesn’t work’ were identified comprising themes representing environmental, interpersonal and individual factors. ‘What works’ included: positive social support and relationships; individualised holistic patient-centred care; hub and spoke approach to patient care; and suitable environments. ‘What doesn’t work’ included: absence of/or maladaptive relationships with family and friends; gaps in service provision; and unsuitable environments.
Conclusions: For older patients to progress to improved quality of life, health, wellbeing and reduced risk, multilevel and comprehensive support is required, comprising a range of services, interventions, and multidisciplinary input, and individualised to each patient’s needs. The physical environment needs to be adapted for older patients and provide a social environment that seeks to include supportive families, friends and expert professional input. A clear patient progression pathway is required; this must be reflected in policy and provision.

viii). Charles, A., Hare-Duke, L., Nudds, H., Franklin, D., Llewellyn-Beardsley, L., Rennick-Egglestone, S., Gust, O., Ng, F., Evans, E., Knox, E., Townsend, E., Yeo, C. and Slade, M. (2022) Typology of content warnings and trigger warnings: Systematic review. PLoS ONE 17(5): e0266722. Online:
https://doi.org/10.1371/journal.pone.0266722

Abstract
Content and trigger warnings give information about the content of material prior to receiving it. Different typologies of content warnings have emerged across multiple sectors, including health, social media, education and entertainment. Benefits arising from their use are contested, with recent empirical evidence from educational sectors suggesting they may raise anxiety and reinforce the centrality of trauma experience to identity, whilst benefits relate to increased individual agency in making informed decisions about engaging with content. Research is hampered by the absence of a shared intersectoral typology of warnings. The aims of this systematic review are to develop a typology of content warnings and to identify the contexts in which content warnings are used. The review was pre-registered ( ID: CRD42020197687, URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020197687 ) and used five sources: electronic databases covering multiple sectors (n = 19); table of contents from multi-sectoral journals (n = 5), traditional and social media websites (n = 53 spanning 36 countries); forward and backward citation tracking; and expert consultation (n = 15). In total, 6,254 documents were reviewed for eligibility and 136 documents from 32 countries were included. These were synthesised to develop the Narrative Experiences Online (NEON) content warning typology, which comprises 14 domains: Violence, Sex, Stigma, Disturbing content, Language, Risky behaviours, Mental health, Death, Parental guidance, Crime, Abuse, Socio-political, Flashing lights and Objects. Ten sectors were identified: Education, Audio-visual industries, Games and Apps, Media studies, Social sciences, Comic books, Social media, Music, Mental health, and Science and Technology. Presentation formats (n = 15) comprised: education materials, film, games, websites, television, books, social media, verbally, print media, apps, radio, music, research, DVD/video and policy document. The NEON content warning typology provides a framework for consistent warning use and specification of key contextual information (sector, presentation format, target audience) in future content warning research, allowing personalisation of content warnings and investigation of global socio-political trends over time.

ix). Kelly, C., Sharma, S., Jieman. A-T. and Shulamit Ramon (2022): Sense-making narratives of autistic women diagnosed in adulthood: a systematic review of the qualitative research. Disability & Society. Online:
https://doi.org/10.1080/09687599.2022.2076582

Abstract
Few qualitative studies have explored the lives of autistic women diagnosed in adulthood, despite this knowledge being essential to inform awareness of the intersection of autism and gender. This systematic review was undertaken to synthesise available qualitative evidence on the lived experience of autistic women diagnosed in adulthood. The accounts of 50 women from nine qualitative studies were synthesised using thematic analysis and four super-ordinate themes were identified: wanting to ‘fit in’; making sense of past experiences; developing a new ‘autistic identity’; and barriers to support. The autistic women spent many years without a diagnosis or autism-specific support, felt misunderstood, and experienced social exclusion. Following their diagnosis, they reframed these experiences into new ‘sense-making narratives’, used social media to contact other autistic people, and developed neurodiverse-affirming autistic identities. The studies suggested that health and social care professionals were not always able to recognise, refer, diagnose, and support autistic women effectively.

x) Barnett, P., Steare, T., Dedat, Z., Pilling, S., McCrone, P., Knapp, M., Cooke, E., Lamirel, D., Dawson, S., Goldblatt, P., Hatch, S., Henderson, C., Jenkins, R., Machin, K., Simpson, A., Shah, P., Stevens, M., Webber, M., Johnson, S. and Lloyd‐Evans, B. (2022) Interventions to improve social circumstances of people with mental health conditions: a rapid evidence synthesis. BMC Psychiatry. 22:302 Online:
https://link.springer.com/article/10.1186/s12888-022-03864-9

Abstract
Background: Poor social circumstances can induce, exacerbate and prolong symptoms of mental health conditions, while having a mental health condition can also lead to worse social outcomes. Many people with mental health conditions prioritise improvement in social and functional outcomes over reduction in clinical symptoms. Interventions that improve social circumstances in this population should thus be considered a priority for research and policy.
Methods: This rapid evidence synthesis reports on randomised controlled trials of interventions to improve social circumstances across eight social domains (Housing and homelessness; money and basic needs; work and education; social isolation and connectedness; family, intimate and caring relationships; victimisation and exploitation; offending; and rights, inclusion and citizenship) in people with mental health conditions. Economic evaluations were also identified. A comprehensive, stepped search approach of the Cochrane library, MEDLINE, Embase, PsycINFO, Web of Science and Scopus was conducted.
Results: One systematic review and 102 randomised controlled trials were included. We did not find RCT evidence for interventions to improve family, intimate and caring relationships and only one or two trials for each of improving money and basic needs, victimisation and exploitation, and rights, inclusion and citizenship. Evidence from successful interventions in improving homelessness (Housing First) and employment (Individual Placement and Support) suggests that high‐intensity interventions which focus on the desired social outcome and provide comprehensive multi‐ disciplinary support could influence positive change in social circumstances of people with mental health conditions. Objective social isolation could be improved using a range of approaches such as supported socialisation and social skills training but interventions to reduce offending showed few benefits. Studies with cost and cost‐effectiveness components were generally supportive of interventions to improve housing and vocational outcomes. More research is needed to ensure that social circumstances accompanied by high risks of further exacerbation of mental health conditions are adequately addressed.

Other News / Resources
i) Writing out of the Mental Health Policy Research Unit at University College London, Dr Becky Appleton draws attention to a national research study (linked to the above paper by Barnett et al) and writes:

Dear…
We are contacting you as you may be able to provide us with some information around models of support which can help people living with severe mental illness across various life domains (money and debt, housing, work, family relationships, social isolation, crime victimisation, offending and citizenship). This is for a research study entitled “Approaches to improve social circumstances of people with mental health conditions: a stakeholder consultation” (approved by UCL Research Ethics Committee: 22343.001). It has been requested by policymakers in the Department of Health and Social Care and findings will inform the development of DHSC’s “Living Well with Mental Illness” strategy, which is due to be published in Autumn 2022. This work is being conducted by a team of researchers working for DHSC at University College London, in the NIHR Mental Health Policy Research Unit.

A link to the survey can be found here: https://opinio.ucl.ac.uk/s?s=77500

If you have any questions, please do get in touch. Thank you for your support with this national survey.

Best wishes,

Dr. Becky Appleton
r.appleton@ucl.ac.uk
Mental Health Policy Research Unit

 

ii)  Coronavirus and Mental Health (information)
The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19.  It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation
Gov.uk
Social Care Institute for Excellence
Centre for Mental Health
Mental health Foundation
Mind
Rethink
Carers UK
National Service User Network
British Psychological Society
British Association of Social Workers
Royal College of Psychiatrists
Royal College of Nursing
Royal College of Occupational Therapists

iii) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:

Shula:     s.ramon@herts.ac.uk
Tony:      a.sparkes@bradford.ac.uk

June 2022

Recovery Research Network eBULLETIN

June 2022

RRN Meetings
Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time. Nationally however, the current move towards the easing of restrictions represents an optimistic turn to the possibility of resuming face-to-face meetings. The current arrangements are under constant review by the RRN Collective and more information about this possibility will be circulated in due course. In the meantime, we would encourage our readers to keep safe and follow relevant guidance as appropriate.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk

Coronavirus and Mental Health
Both nationally and internationally, the impact of coronavirus is an ongoing concern, and it remains important that we continue to pay particular attention to our mental health and wellbeing. There is a considerable amount of advice and information available online. We continue to include examples at the end of the e-bulletin.

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:
https://www.researchintorecovery.com/events/rrn/join/

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research. Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers
In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world. As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.

i) Dr Stefan Rennick-Egglestone draws attention to the following Special Issue:
Special Issue of Perspectives in Public Health on “Recovery outside of mental health services”

Recovery Research Network members Dr Stefan Rennick-Egglestone and Dr Theo Stickley will co-edit a special issue of the journal Perspectives in Public Health, to be published in May 2023, with submission due by end of September 2022.

The theme for the special issue is “Recovery outside of mental health services: what can public health contribute?”. The editors would particularly like to hear about practice and research that focuses on increasing wellbeing as it relates to mental health, and which is not necessarily situated in statutory mental health services. They welcome contributions covering the entire age-span from childhood through to end-of-life, both national and international, and they can include articles that draw on the author’s experience of mental health problems to make recommendations for public health policy and practice.

Details of the special issue will be published on the journal website https://journals.sagepub.com/home/rsh soon, or contact Stefan Rennick-Egglestone through stefan.egglestone@nottingham.ac.uk

 

Papers and Publications
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i) Kelly, C., Sharma, S., Jieman, A-T. and Ramon, S. (2022): Sense-making narratives of autistic women diagnosed in adulthood: a systematic review of the qualitative research. Disability and Society. Online:
https://doi.org/10.1080/09687599.2022.2076582

Abstract
Few qualitative studies have explored the lives of autistic women diagnosed in adulthood, despite this knowledge being essential to inform awareness of the intersection of autism and gender. This systematic review was undertaken to synthesise available qualitative evidence on the lived experience of autistic women diagnosed in adulthood. The accounts of 50 women from nine qualitative studies were synthesised using thematic analysis and four super-ordinate themes were identified: wanting to ‘fit in’; making sense of past experiences; developing a new ‘autistic identity’; and barriers to support. The autistic women spent many years without a diagnosis or autism-specific support, felt misunderstood, and experienced social exclusion. Following their diagnosis, they reframed these experiences into new ‘sense-making narratives’, used social media to contact other autistic people, and developed neurodiverse-affirming autistic identities. The studies suggested that health and social care professionals were not always able to recognise, refer, diagnose, and support autistic women effectively.

ii) Lauzier-Jobin, F. and Houle, J. (2022) A comparison of formal and informal help in the context of mental health recovery. International Journal of Social Psychiatry. 68(4) 729-737.

Abstract
Background: People in recovery from anxiety, depressive or bipolar disorders can receive both formal (from practitioners) and informal help (from family and friends). These two types of helping relationships have often been studied separately as either therapeutic relationships or social support. Yet, the mechanisms of these two forms of help have not been empirically compared in the context of mental health recovery.
Aims: The purpose of this study is to compare the mechanisms of informal help and formal help in recovery by combining the perspectives of individuals in recovery, their informal helper and their practitioner.
Method: Individual interviews were conducted with 15 triads (N = 45 participants) comprising a person in recovery, their most significant informal helper and their most significant practitioner to compare the two forms of help through a mixed method approach. Based on the paradigm of critical realism, the research puts the emphasis on the triangulation of data sources and types.
Results: The informal and formal helping relationships serve multiple functions some can be found in both, often in different ways (communication, presence and availability). Informal helpers tend to serve a broader array of functions than practitioners do. Regarding differences, formal help is characterised by scheduling, time limitations and professional competencies. Informal help is characterised by emotional closeness, companionship and reciprocity. Also, people in recovery are active when it comes to determining the role that their helpers play (agency).
Conclusions: Social support from family members and friends, as well as help from professionals can contribute to recovery in different ways. Attesting to the agency of people in recovery, the two forms of help are not only perceived as complementary, they are deliberately kept so.

iii) Erdoğan, E. and Demir, S. (2022) The Effect of Solution Focused Group Psychoeducation Applied to Schizophrenia Patients on Self-Esteem, Perception of Subjective Recovery and Internalized Stigmatization. Issues in Mental Health Nursing. Online:
https://doi.org/10.1080/01612840.2022.2083735

 

Abstract
The study examined the effect of Solution-Focused Group Psychoeducation on self-esteem, subjective perception of recovery, and internalized stigma among patients with schizophrenia 39 patients with schizophrenia were recruited based design of the randomized control-group with pre-test and post-test. The patients completed the “Rosenberg Self-Esteem Scale (RSES)”, “Subjective Recovery Assessment Scale (SubRAS)”, and “Internalized Stigma of Mental Illness (ISMI) Scale” in pre-test and post-test. After the psychoeducation, ISMI scores decreased in the intervention group (p < 0.001) but increased in the control group (p = 0.599). The post-test RSES score was lower in the intervention group compared to the control group (p = 0.001). A statistically significant difference was found between the pre-test and post-test SRAS scores of the intervention group when compared to the control group (p = 0.018). After the psychoeducation, intervention group’ self-esteem and subjective perception of recovery increased, while the severity of internalized stigma decreased.

iv) Campbell, K., Massey, D and Lakeman, R. (2022) Working with People Presenting with Symptoms of Borderline Personality Disorder: The Attitudes, Knowledge and Confidence of Mental Health Nurses in Crisis Response Roles in Australia. Issues in Mental Health Nursing. Online:
https://doi.org/10.1080/01612840.2022.2087011

Abstract
Many people diagnosed with or presenting with borderline personality disorder (BPD) attend the emergency department (ED) when in crisis, and are often referred to mental health nurses for further assessment, and to arrange appropriate follow-up (MHNs). Little is known about the knowledge, skills, confidence and competence of MHNs working with this group in these specialist roles. This study sought to describe the attitudes of MHNs working in EDs and crisis services towards people who present with symptoms characteristic of BPD and to explore their knowledge of the diagnostic criteria of BPD. A descriptive survey tool comprised of 23 questions was adapted from a previously used survey with clinicians in a mental health service in Australia. Fifty-four nurses who identified as MHNs and were currently employed in EDs or crisis settings completed the survey online. These MHNs were found to hold positive attitudes towards people with BPD including being optimistic about recovery and treatment. The experience and education of MHNs now employed in EDs may have contributed to positive attitudes and self-reported confidence relative to other nurses. Further research ought to focus on how MHNs assist people with a diagnosis of BPD who present in crisis meet immediate needs and facilitate access to effective ongoing care and treatment.

v) Murphy, O., Looney, K., McNulty, M. and O’Reilly, G. (2022) Exploring the factors that predict quality of life, and the relationship between recovery orientation and quality of life in adults with severe mental health difficulties. Current Psychology. Online:
https://doi.org/10.1007/s12144-022-03296-4

Abstract
Integration of intrapersonal, interpersonal and environmental factors has been proposed to enhance understanding of psychological quality of life (QOL) in adults with severe and enduring mental illness (SMI). This study examined the contribution of factors such as self-stigma, coping style and personal recovery orientation to psychological QOL in SMI; compared QOL outcomes to norms from the general population; and examined the association between personal recovery orientation and overall QOL. 70 participants with SMI completed measures of QOL (including psychological QOL), personal recovery orientation, coping, perceived stigma, psychological distress and demographic variables. Regression analysis found that only adaptive coping and psychological distress contributed significantly to psychological QOL. Personal recovery orientation was significantly associated with overall subjective QOL. Participants had lower QOL in the psychological and social relationships domains compared to the general population. Findings support the positive contribution of adaptive coping to psychological QOL, and the positive association between personal recovery orientation and overall QOL.

vi) The World Association for Psychosocial Rehabilitation (WAPR) have published their latest bulletin (No.48. June 2022) entitled: Human Rights in Mental Health: WHO Quality Rights implementation wordwide. Framed by an informative editorial, the bulletin contains a number of engaging articles written by an inclusive range of authors who are experts in their respective fields. The broad theme brings together the experience of QualityRights in different parts of the world. Collectively, the writings find connection with personal recovery narratives, and recovery research more generally. The bulletin goes on to discuss experiences from the WAPR network.

The bulletin is available here:
http://www.wapr.org/wapr-bulletin-no-48/

Please note: In the first article (Funk et al. 2022) it may work better to cut and paste the WHO QualityRights e-training on page 9 directly into a web-browser rather than simply clicking the link.

Other News / Resources
i) Coronavirus and Mental Health (information)
The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19. It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation
Gov.uk
Social Care Institute for Excellence
Centre for Mental Health
Mental health Foundation
Mind
Rethink
Carers UK
National Service User Network
British Psychological Society
British Association of Social Workers
Royal College of Psychiatrists
Royal College of Nursing
Royal College of Occupational Therapists

ii) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:

Shula:     s.ramon@herts.ac.uk
Tony:      a.sparkes@bradford.ac.uk

July 2022

Recovery Research Network eBULLETIN

July 2022

RRN Meetings
Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time. Nationally however, the current move towards the easing of restrictions represents an optimistic turn to the possibility of resuming face-to-face meetings. The current arrangements are under constant review by the RRN Collective and more information about this possibility will be circulated in due course. In the meantime, we would encourage our readers to keep safe and follow relevant guidance as appropriate.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk

Coronavirus and Mental Health
Both nationally and internationally, the impact of coronavirus is an ongoing concern, and it remains important that we continue to pay particular attention to our mental health and wellbeing. There is a considerable amount of advice and information available online. We continue to include examples at the end of the e-bulletin.

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:
https://www.researchintorecovery.com/events/rrn/join/

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research. Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers
In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world. As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.

i) Dr Stefan Rennick-Egglestone draws attention to the following Special Issue:
Special Issue of Perspectives in Public Health on “Recovery outside of mental health services”

Recovery Research Network members Dr Stefan Rennick-Egglestone and Dr Theo Stickley will co-edit a special issue of the journal Perspectives in Public Health, to be published in May 2023, with submission due by end of September 2022.

The theme for the special issue is “Recovery outside of mental health services: what can public health contribute?”. The editors would particularly like to hear about practice and research that focuses on increasing wellbeing as it relates to mental health, and which is not necessarily situated in statutory mental health services. They welcome contributions covering the entire age-span from childhood through to end-of-life, both national and international, and they can include articles that draw on the author’s experience of mental health problems to make recommendations for public health policy and practice.

Details of the special issue will be published on the journal website https://journals.sagepub.com/home/rsh soon, or contact Stefan Rennick-Egglestone through stefan.egglestone@nottingham.ac.uk

 

Papers and Publications
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

Papers and Publications
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

We start this section of the July edition of the ebulletin with two publications (an article and a book) authored by Dr Prateeksha Sharma. Dr Sharma has kindly shared a little information about the origins of both publications. The first item (i) offers some background context, whilst the second item (ii) reports the abstract from Dr Sharma’s thesis.

i) Calendars mark important dates and coming November marks a landmark in mine. Looking back three decades my path is defined by a long trail of patient-hood (bipolar disorder) spanning 18 years. And suddenly then exiting the role, for various reasons including comorbid conditions. That led to a quest for mapping recovery, via many autoethnographic writings, which further led to an unexpected opening: doctoral research. So now my recovery research that started in 2010 brings me to two closures: a Ph.D. in October 2020, and a book around November 2022.

RRN encourages sharing about doctoral research and though I could not when I completed the degree, due to a burnout which debilitated me for weeks, I do so now. Once recovered, I felt the urgency to present my findings as a book, based on my thesis though far from a replica. I welcome the RRN community to explore further via these links.

The two links referred to above are listed below as items (iii) and (iv).

ii) (Abstract) In the mental health community around the world ‘recovery’ is increasingly recognized as an important development in conditions such as schizophrenia and bipolar disorder. The phenomenon of ‘recovery’ has significant implications for both clinical intervention and policy formulation. However, in the mental health community in India, ‘recovery’ is cautiously recognized. This research is an attempt to investigate such claims on the ‘impossibility of recovery’ and present evidence to counter the assertion that psychiatric patient-hood is a permanent category. In fact, this study present arguments, developed out of interviews with individuals and their families/caregivers to show how these very labels are first arrived at, and then fixed for perpetuity in the minds of those ‘labelled’ and family/caregivers. Evidently the role of close family members would constitute an important area of investigation, especially in any resource starved country since public infrastructure is often overburdened and poorly equipped to support any person who is undergoing an emotional meltdown/crisis.

Findings from this research indicate that family/caregivers will often be the decisive agents hindering or supporting ‘recovery’. Based on these findings some the key determining factors of scenarios where psychiatric patient-hood is likely to be permanent and conditions which would support a recovery, free of any psychiatric drug are arrived at. This research attempts to inform the policy making community about the necessity of appropriate legislation, which will enable not only the referral of people in mental/emotional distress to get opportunities for humane treatment (when they are in violation of the law) but also for the larger populations of school & university students, women, employees in private and public incorporated enterprises, elderly and increasingly the people on the margins of society to not be funneled into psychiatric systems through early referrals by institutional counsellors/social workers. In fact, these institutions can aid and support ‘mental health’ and well being in the first place and guide people to a variety of resources, making the psychiatric option only one among several alternatives which include traditional medicine systems such as ayurveda, unani, homeopathy, siddha and so forth. More importantly support can be offered by nurturing an attitude of empathy and support for the one in mental distress. This process will be an important first step in building a community to support someone taking tiny but important steps towards recovering selfhood.

This thesis is an attempt to understand the barriers that disable the phenomenon of ‘recovery’ becoming more widespread. Three interlinked streams of inquiry converge to constitute the outcomes of this research. The first of these is the position of the researcher, as someone who has personally experienced both ‘psychosis’ and ‘recovery’, and her experiential perspectives. Due to that this researcher may be seen as an ‘insider’ to the phenomena she studies and the qualitative component of this study as constituting ‘peer’ research.

In the second component of the dissertation, a qualitative research, ‘patient’ and caregiver narratives are analysed to understand both catalysts and barriers to ‘recovery’. Even in the absence of suitable enabling mechanisms from the macro environment people ‘recover’. One of the main goals here is to centralize the voices of people who have gone through the ‘mental’ health system, and to acknowledge that they are capable of contributing meaningfully to the discussion about what works or does not work in the wider context of ‘recovery’.

In the third part of the dissertation the macro aspects of existing Indian laws are studied to comprehend whether they contribute to any aspect of ‘recovery’ or what impede patients from ‘recovering’ from this domain. As part of this the ontological assumption of ‘mental illness’ being a permanent versus a transient condition is discussed and what parts of the existing legal system reflect the former, or what needs to be changed in order to make the system more ‘patient’-oriented and less normative is analysed. This change may help in coinciding with India’s compliance with the United Nations Convention of Rights for People with Disabilities (UN-CRPD), as being a signatory India is obligated to harmonize its laws in accordance with it

iii) Prateeksha, S. (2019) Shades of Silence: Doing Mental Health Research as an ‘Insider’. Journal of Ethics in Mental Health. Special Theme Issue VI: Disordering Social Inclusion: Ethics, Critiques, Collaborations, Futurities. Online:
https://jemh.ca/issues/v9/documents/JEMH%20Inclusion%20xiii.pdf

Abstract
This article traces my endeavours to enlist research participants in my doctoral research. I interviewed both people who, like me, hold a ‘psychosis’ history, as well as their direct caregivers, who were most often family members. My research is embedded in an emancipatory episteme, and focuses on understanding the barriers to recovery in the psy-medico-legal landscape prevalent in India. During my participant recruitment process, I encountered ‘silence’ of diverse sorts and, with this article, I attempt to deconstruct that silence. At the individual level, I was met with silence by individuals and their caregivers who were reluctant to be interviewed due to various forms of stigma, paternalism, and their hesitancy to question psychiatric authority. At the organizational level, non-governmental organizations (NGOs) were largely unsupportive of my work because my research queries psychiatry and its motives, and this undermines the powers of dominant psychiatric discourses. Central to my argument is that as a ‘peer researcher,’ my position destabilizes common held truths about ex-patients. Thus, being an ‘insider’ researcher actually hindered my access to some potential participants because I was understood as an ‘exception’ who should not be engaged with. I end by exploring the asymmetrical power relations between researchers and those we research, and the potential that emancipatory approaches bring to mental health social change.

iv) Sharma, P. (2023). Barriers to recovery from psychosis: A peer investigation of psychiatric subjectivation. Routledge (forthcoming)

From the publisher’s website, Routledge write:

This book inaugurates the field of Mad Studies in the Indian subcontinent investigating the barriers to recovery from the perspective of “patients” and caregivers.

Offering a radical critique of the mental health system, it questions why the phenomenon of recovery from serious mental health issues is not more widespread. Drawing from narratives of “patients”, evidence from lived experiences around the globe and literature on recovery in psychiatry, mental health legislations and policies, it establishes the hitherto silenced voice of the “patient” as having testimonial viability, via an emancipatory scholarship. It highlights the repeated marginalization of “patients” and the identity prejudice they experience in day-to-day situations as a form of epistemic violence. The book examines the barriers to recovery through an interdisciplinary investigation, scrutinizing relationships between individuals and institutions at interpersonal, intersocial and global levels.

The book will be of interest to researchers and scholars of psychiatry, psychology, anthropology, sociology, disability studies, Mad Studies, law and policy, cultural studies, mental health, medicine as well as general readers.

v) Moore, T. and Zeeman, L. (2022) A psychosocial exploration of resistances to service user involvement in United Kingdom National Health Service (NHS) mental health services’. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine. Online:
https://doi.org/10.1177/13634593221099103

Abstract
Policy promotes the active participation of those with lived experience of mental health difficulties in UK NHS mental health services, from the level of collaborative care-planning to service delivery, leadership and development. However, research indicates different forms of resistance to the implementation of such service user involvement. This article reports the findings of a qualitative, interview-based study which used Foucauldian discourse analysis and psychoanalytic theory to understand how resistances are produced through the interplay of clinical mental health professionals’ subjectivity and their organisational context. Service user involvement was found to highlight conflicts within clinicians’ roles. Central to this conflict was an ambivalent relationship to the power associated with these roles. Power could protect professionals from work related stresses, but could also be used to dominate, silence and coerce service users in ways that conflicted with the core function of providing care. Whilst important, raising awareness of such conflict will arouse discomfort and resistance where psychological defences are challenged. A parallel is drawn with psychotherapeutic change, in which resistance must be understood and worked with as part of meaningful change.

vi) Damsgaard, J. B., Overgaard, C. M. L., Dürr, D. W., Lunde, A., Thybo, P. and Birkelund, R. (2022) Psychiatric care and education understood from a student perspective: Enhancing competences empowering personal and social recovery. Scandinavian Journal of Caring Sciences. 00:1–10: Online:
https://doi-org.brad.idm.oclc.org/10.1111/scs.13097

Abstract
Background: During the last decades, a recovery-based approach has called for a change in mental health care services. Several programmes have been presented, and the need to develop student and professional competences in education and clinical practice has been documented.
Aim: The aim of this study was to explore how psychiatric care is understood seen from a student perspective (nursing students, masters nurses and a master in applied philosophy) with focus on their personal competences and the educational interventions empowering processes for users’ personal and social recovery.
Method: A qualitative design with a phenomenological–hermeneutic approach based on the French philosopher Paul Ricoeur’s theory of interpretation. Data were collected through semi-structured interviews.
Findings: All interviewees expressed that both theoretically and clinically students did not experience a recovery-oriented approach empowering users’ personal and social recovery process. On the contrary, they experienced that both education and practice were dominated by a biomedical approach providing clinical recovery. However, several students were aware of their need of developing personal and relational competences to be able to support the users’ personal and social recovery journey. The students expressed that there is a need for educational processes targeting personal competences in ‘becoming a professional’ supporting ‘presentness and awareness’ and thereby the development of relational abilities and the courage to engage. The results relate to two nursing schools and two universities.
Conclusion: A biomedical approach dominates and makes it difficult to develop students’ personal competences during education in practice and theory vital to the development of personal and social recovery-oriented practices. It is recommended that educators — in practice and in school — accentuate presentness, awareness and creativity as crucial relational capabilities and incorporate this in their teaching and supervision method, supporting the education and formation of the students’ (and teachers’ and supervisors’) personal development processes.

vii) Lauzier-Jobin, F. and Houle, J. (2022) A comparison of formal and informal help in the context of mental health recovery. International Journal of Social Psychiatry. 68(4) 729–737

Abstract
Background: People in recovery from anxiety, depressive or bipolar disorders can receive both formal (from practitioners) and informal help (from family and friends). These two types of helping relationships have often been studied separately as either therapeutic relationships or social support. Yet, the mechanisms of these two forms of help have not been empirically compared in the context of mental health recovery
Aims: The purpose of this study is to compare the mechanisms of informal help and formal help in recovery by combining the perspectives of individuals in recovery, their informal helper and their practitioner.
Method: Individual interviews were conducted with 15 triads (N = 45 participants) comprising a person in recovery, their most significant informal helper and their most significant practitioner to compare the two forms of help through a mixed method approach. Based on the paradigm of critical realism, the research puts the emphasis on the triangulation of data sources and types.
Results: The informal and formal helping relationships serve multiple functions some can be found in both, often in different ways (communication, presence and availability). Informal helpers tend to serve a broader array of functions than practitioners do. Regarding differences, formal help is characterised by scheduling, time limitations and professional competencies. Informal help is characterised by emotional closeness, companionship and reciprocity. Also, people in recovery are active when it comes to determining the role that their helpers play (agency).
Conclusions: Social support from family members and friends, as well as help from professionals, can contribute to recovery in different ways. Attesting to the agency of people in recovery, the two forms of help are not only perceived as complementary, they are deliberately kept so.

viii) Sreeram, A., Cross, W. M., and Townsin, L. (2022). Anti-stigma initiatives for mental health professionals — A systematic literature review. Journal of Psychiatric and Mental Health Nursing. 29(4) 512–528.
https://doi.org/10.1111/jpm.12840

Abstract
Introduction: Despite an increasing focus on stigma, evidence shows prejudicial attitudes towards mental illness among mental health professionals still exist. It is suggested that anti-stigma initiatives can aid in enhancing the attitudes of mental health professionals. However, research on initiatives targeting stigma of mental illness among mental health professionals is limited.
Aim: To identify and analyse scientific literature pertaining to the effectiveness of anti-stigma initiatives regarding mental ill health among mental health professionals.
Method: A systematic literature review was performed using the databases MEDLINE, CINAHL, PsycINFO, PubMed, Scopus, Google Search engine and Google Scholar. The papers were limited to English language, published in peer-reviewed journals with full-text articles available and published between the years 2008 and 2020 to understand the most recent trends in the attitudes of mental health professionals including nurses. The Population, Intervention, Comparison and Outcome (PICO) strategy was used to identify papers meeting the inclusion criteria.
Results: A total of 439 papers were identified. However, papers not meeting the inclusion criteria were excluded from selection. Three appraisers reviewed the selected papers individually using the Joanna Briggs Institute [JBI] critical appraisal tool. Finally, eight unanimously accepted papers were included in the systematic review. Several effective anti-stigma initiatives were identified through the review, and these had positive impacts on mental health professionals’ attitudes towards mental illness, for at least a short period. It was identified that contact-based interventions are relevant and effective although the involvement of consumers and caregivers in the design and delivery of interventions was not explicitly addressed in detail in studies included in the review. Education strategies tailored for specific mental illness may be more appropriate, rather than approaches that refer to mental illness in general.
Conclusions: This review shows the evidence of pessimistic attitudes towards mental illness persists among mental health professionals. Anti-stigma initiatives identified in the selected papers were effective in changing these attitudes. Future research should be focused on the effectiveness of contact-based

ix) Tseris, E. J., Eve, B. H. and Franks, S. (2022) “My Voice Was Discounted the Whole Way Through”: A Gendered Analysis of Women’s Experiences of Involuntary Mental Health Treatment. Affilia: Feminist Inquiry in Social Work. Online:
https://doi.org/10.1177/08861099221108714

Abstract
Although it is well established that women experience significant gendered oppressions when accessing mental health services, research exploring the impacts of involuntary mental health services is frequently conducted without attending specifically to gender. This article reports on a qualitative study that explored women’s experiences of compulsory mental health treatment in Australia. In-depth interviews revealed substantial gendered harms experienced by women within involuntary mental health treatment settings. Themes identified were: involuntary treatment replicates the dynamics and tactics of gendered violence; treatment involves profound deprivation and losses, with potential implications across the life-course; mental health services disrupt and undermine mothering; and recovery is found outside of coercive mental health systems. The study reveals the heightened harms experienced by women within involuntary mental health contexts, as well as women’s strategic resistances to psychiatric oppression. It demonstrates the relevance of a conceptual lens that is attuned to gender, in order to develop a deeper understanding of women’s experiences of intersecting oppressions within involuntary mental health settings. Implications include the need for alliance-building across feminist and critical mental health movements, and the need for a much more robust engagement by the social work profession in challenging the widespread acceptance of involuntary mental health treatment.

x) Moyo, N., Jones, M. and Gray, R. (2022) What are the core competencies of a mental health nurse? A concept mapping study involving five stakeholder groups. International Journal of Mental Health Nursing. 31(4) 933–951

Abstract
Mental health nurses aim to provide high-quality care that is safe and person-centred. Service users require individualized care, responsive to their preferences, needs, and values. The views of service users, mental health nurses, nurse academics, psychiatrists, and nurse managers about the core competencies of mental health nurses have not been explored. Our study aimed to describe and contrast the views of multiple stakeholder groups on the core competencies of mental health nurses. Concept mapping is a six-step mixed-methods study design that combines qualitative data with principal component analysis to produce a two-dimensional concept map. Forty-eight people participated in the study from five stakeholder groups that included service users and clinicians. The final concept map had eight clusters: assessment and management of risk; understanding recovery principles; person- and family-centred care; good communication skills; knowledge about mental disorders and treatment; evaluating research and promoting physical health; a sense of humour; and physical and psychological interventions. There were important differences in how service users and health professionals ranked the relative importance of the clusters. Service users reported the understanding recovery principles cluster as the most important, whilst health professionals ranked the assessment and management of risk group the most important. There may be a disconnect between what service users and other stakeholders perceive to be the core competencies of mental health nurses. There is a need for more research to examine the differing perspectives of service users and health professionals on the core competencies of mental health nurses.

Other News / Resources
i) 3-year PhD Studentship at University of Nottingham (UK)
Writing out of Nottingham University, Research Fellow Dr Fiona Ng, calls for applications for the following opportunity:

Applications are invited for a 3-year PhD Studentship to investigate positive changes/posttraumatic growth in experiences conceptualised as psychosis. The successful candidate will be given the opportunity to develop the scope and approach to the doctoral thesis, however the focus of the project should fall within the area of positive change/posttraumatic growth in psychosis. This is a full-time studentship funded for three years, which will cover UK home fees and a stipend. The successful candidate will be supervised by Dr Fiona Ng and join the world-renowned Recovery Research Team (led by Professor Mike Slade). The studentship will be based at the Institute of Mental Health and School of Health Sciences (University of Nottingham). For more information, please see: https://tinyurl.com/yuu76ad6

Many thanks,
Fiona

ii) Request for peer-reviewed intervention studies that target identity or self-concept

From the Department of Clinical and Developmental Neuropsychology at the University of Groningen, PhD candidate Elske Kronemeijer makes the following request for peer-reviewed intervention studies:

Researchers from the University of Groningen are currently writing a transdiagnostic exploratory scoping review on identity interventions. With this review the researchers aim to give an overview of interventions that target identity or self-concept in people with a severe mental illness, intellectual disability or acquired brain injury. In addition to a systematic search of the literature, we would like to consult researchers in the field to identify additional relevant intervention studies.

We are looking for intervention-studies that:
* Target identity, self-concept, ‘illness-engulfment’ or related concepts.
* For any one of the following populations: severe mental illness; schizophrenia, psychosis; bipolar disorder; severe psychotic depression; acquired brain injury ( (traumatic or non-traumatic); or intellectual disability.
* Studies should include an evaluation of the intervention (qualitative or quantitative).

Do you know a study that could be relevant? Please contact us at u.e.kronemeijer@rug.nl Feel free to forward this question to other researchers that may want to submit a (reference of) paper.

Other News / Resources
iii) Coronavirus and Mental Health (information)
The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19. It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation
Gov.uk
Social Care Institute for Excellence
Centre for Mental Health
Mental health Foundation
Mind
Rethink
Carers UK
National Service User Network
British Psychological Society
British Association of Social Workers
Royal College of Psychiatrists
Royal College of Nursing
Royal College of Occupational Therapists

iv) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:

Shula:     s.ramon@herts.ac.uk
Tony:      a.sparkes@bradford.ac.uk

August 2022

Recovery Research Network eBULLETIN

August 2022

RRN Meetings
Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time. Nationally however, the current move towards the easing of restrictions represents an optimistic turn to the possibility of resuming face-to-face meetings. The current arrangements are under constant review by the RRN Collective and more information about this possibility will be circulated in due course. In the meantime, we would encourage our readers to keep safe and follow relevant guidance as appropriate.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk

Coronavirus and Mental Health
Both nationally and internationally, the impact of coronavirus is an ongoing concern, and it remains important that we continue to pay particular attention to our mental health and wellbeing. There is a considerable amount of advice and information available online. We continue to include examples at the end of the e-bulletin.

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:
https://www.researchintorecovery.com/events/rrn/join/

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research. Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

Conferences, Events and Calls for Papers
In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world. As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.

i) Dr Stefan Rennick-Egglestone draws attention to the following Special Issue:
Special Issue of Perspectives in Public Health on “Recovery outside of mental health services”

Recovery Research Network members Dr Stefan Rennick-Egglestone and Dr Theo Stickley will co-edit a special issue of the journal Perspectives in Public Health, to be published in May 2023, with submission due by end of September 2022.

The theme for the special issue is “Recovery outside of mental health services: what can public health contribute?”. The editors would particularly like to hear about practice and research that focuses on increasing wellbeing as it relates to mental health, and which is not necessarily situated in statutory mental health services. They welcome contributions covering the entire age-span from childhood through to end-of-life, both national and international, and they can include articles that draw on the author’s experience of mental health problems to make recommendations for public health policy and practice.

Details of the special issue will be published on the journal website https://journals.sagepub.com/home/rsh soon, or contact Stefan Rennick-Egglestone through stefan.egglestone@nottingham.ac.uk

 

Papers and Publications

In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

Chisholm, J. and Petrakis, M. (2022) Clinician perspectives and sense of efficacy about the implementation of recovery-oriented practice in mental health. British Journal of Social Work. 52(3) 1380-1397

Abstract
Recovery-oriented practice (ROP) is being steadily adopted worldwide. The current research examined the perspectives of clinicians about ROP pre-implementation at a clinical mental health service. The method was a survey consisting of fourteen questions regarding implementation of ROP and clinicians reported self-efficacy about work within a ROP framework. The research design was mixed methods couched within a narrative approach. It was exploratory and social constructivist in nature. This article explores quantitative data. Participants were 203 mental health clinicians from multidisciplinary backgrounds—including social work, nursing, occupational therapy, psychiatry, psychology, other medical and other allied health. There were 142 females, 46 males; 15 did not specify their sex. Results showed that clinicians perceived their practice was recovery-oriented 83.6 per cent of the time. Overall, 81 per cent chose the most recovery-oriented statement prior to formal training in ROP. This study concludes that clinicians are committed to the implementation of ROP. They do not believe ROP is easy to implement; however, they do believe it can be successfully implemented in the clinical treatment setting. With the support of stakeholders, these findings may be used to aid the ongoing implementation of ROP into the study service, and add to social work literature.

ii) Dupuis, M. and Castillo, M-C. (2022) Empowerment: a step in the (r)evolution of recovery. Journal of Recovery in Mental Health. 5(2) 47-61.

Abstract
We are witnessing a revolution in the field of mental health in France. The notions of recovery, empowerment, and social inclusion drive us to transform our care practices. New care and support schemes are being devised throughout the entire French territory. In France, however, the concrete application of empowerment in the field is rather slow, as the notion’s theoretical complexity and promotion are significant moot points. In this article, we aim to address these French difficulties in order to suggest means of implementing empowerment-centred support methodologies. We demonstrate how this notion is correlated with other theoretical movements and how it overlaps with new notions with the aim of leading an ethical reflection. We also illustrate our reflection with clinical observations from the Un chez soi d’abord (equivalent of the US Housing First scheme) scheme.

iii) Ibrahim, N., Selim, A., Ng, F., Kasaby, M., Ali, A. M. Eweida, R., Almakki, D., Elaagib, A. and Slade, M. (2022) Experiences of peer support workers supporting individuals with substance use disorders in Egypt: phenomenological analysis. BMC Health Services Research. 22, 1012 https://doi.org/10.1186/s12913-022-08393-5

Abstract
Background: Peer support work for substance use disorders is widely implemented in high-income countries. More research is still needed to understand its applicability in settings which have proportionately low budgets allocated to mental health. Peer Support Workers are individuals who managed to achieve recovery from substance use disorders and help people remain engaged in their recovery and prevent relapse through shared understanding.
Aim: To investigate the experience of peer support workers providing recovery support to people with substance use disorders in Egypt.
Methods: A qualitative phenomenological design was used in which 17 adults working as peer support workers for substance use disorders were recruited by means of purposive and snowball sampling. A semi-structured interview with participants was conducted by phone or video-call. Interviews were transcribed and thematically analysed based on descriptive phenomenology.
Results: Three superordinate themes were identified: role responsibility, Peer Support Workers’ need for organizational and stakeholders’ support, and challenges to the role integrity.
Conclusion and recommendations: The findings indicate the need for national and governmental support to peer support workers engaged with people with substance use disorders in Egypt and educating families and the public about the role of peer support workers in substance use disorders.

iv) Llewellyn-Beardsley, J., Rennick-Egglestone, S., Pollock, K., Ali, Y., Watson, E., Franklin, D., Yeo, C., Ng, F., McGranahan, R., Slade, M. and Edgley, A. (2022) ‘Maybe I shouldn’t talk’: The role of power
in the telling of mental health recovery stories. Qualitative Health Research. 0(0) 1-16
https://doi.org/10.1177/10497323221118239

Abstract
Mental health ‘recovery narratives’ are increasingly used within teaching, learning and practice environments. The mainstreaming of their use has been critiqued by scholars and activists as a co-option of lived experience for organisational purposes. But how people report their experiences of telling their stories has not been investigated at scale. We present accounts from 71 people with lived experience of multiple inequalities of telling their stories in formal and informal settings. A reflexive thematic analysis was conducted within a critical constructivist approach. Our overarching finding was that questions of power were central to all accounts. Four themes were identified: (1) Challenging the status quo; (2) Risky consequences; (3) Producing ‘acceptable’ stories; (4) Untellable stories. We discuss how the concept of narrative power foregrounds inequalities in settings within which recovery stories are invited and co-constructed, and conclude that power imbalances complicate the seemingly benign act of telling stories of lived experience

v) Ørjasæter, K. B. and Almvik, A. (2022) Challenges in adopting recovery-oriented practices in specialized mental health care: ‘‘How far should self-determination go; should one be allowed to perish?’’ Journal of Psychosocial Rehabilitation and Mental Health.
https://doi.org/10.1007/s40737-022-00276-6

Abstract
Abstract Mental health services need to transform from a primary focus on symptom reduction to a recovery-oriented delivery. Research on recovery-oriented practices is mainly based in community mental health settings, while research on specialized mental health care remains scarce. In this article, we aim to identify and explore the experiences faced by professionals working in specialized mental health care units that aim to be recovery-oriented. Data were collected during seven focus group interviews with 45 professionals from four psychiatric hospitals and district psychiatric centres in Norway. We used reflexive thematic analysis to interpret the data. Three main themes emerged from the analysis: (a) disease-oriented structures, (b) negotiating roles and (c) risk management. This study identified the many tensions professionals face as they try to shift specialized mental health care toward a recovery-oriented paradigm. Specifically, professionals must balance managing risks and promoting self-determination. To succeed, it is not sufficient to implement practices that are characterized as recovery-oriented without also changing existing systems, structures, and frameworks. We suggest approaching recovery orientation through shared decision-making. This could contribute to the promotion of self-determination and increased inpatient safety in specialized mental health care.

vi) Thapar, A., Eyre, O., Patel, V. and Brent, D. (2022). Depression in young people. Lancet. 400(10352). 617-631

Abstract
Depression rates in young people have risen sharply in the past decade, especially in females, which is of concern because adolescence is a period of rapid social, emotional, and cognitive development and key life transitions. Adverse outcomes associated with depression in young people include depression recurrence; the onset of other psychiatric disorders; and wider, protracted impairments in interpersonal, social, educational, and occupational functioning. Thus, prevention and early intervention for depression in young people are priorities. Preventive and early intervention strategies typically target predisposing factors, antecedents, and symptoms of depression. Young people who have a family history of depression, exposure to social stressors (eg, bullying, discordant relationships, or stressful life events), and belong to certain subgroups (eg, having a chronic physical health problem or being a sexual minority) are at especially high risk of depression. Clinical antecedents include depressive symptoms, anxiety, and irritability. Evidence favours indicated prevention and targeted prevention to universal prevention. Emerging school-based and community-based social interventions show some promise. Depression is highly heterogeneous; therefore, a stepwise treatment approach is recommended, starting with brief psychosocial interventions, then a specific psychological therapy, and then an antidepressant medication

vii) Wyder, M., Barratt, J., Jonas, R. and Bland, R. (2022) Relational recovery for mental health carers and family: relationships, complexity and possibilities. British Journal of Social Work. 52(3) 1325-1340

Abstract
Whilst recovery theory in mental health has become increasingly influential, much of the focus has been on individualistic understandings. This study aimed to explore the relevance of a family-based recovery framework developed by the authors. This framework explored the CHIME (Connectedness, Hope, Identity, Meaning and Purpose, and Empowerment) tenants of recovery from the perspectives of the consumer, the family role of providing recovery-oriented support and own recovery. Two Action Learning Sets (ASLs) were conducted with Family Peer Workers: the first ASL focused on presenting and receiving feedback on the framework and this feedback was integrated into a new model, which was represented and refined at a second ASL. The results highlight that recovery processes are strongly embedded within family networks, which can be composed of different individuals, relationships, roles and experiences. Furthermore, recovery processes are not static and individual family members can be at different stages. Whilst CHIME provides a useful framework, it did not encapsulate the experiences of loss and complicated grief many families face. A relational framework that encapsulates the interaction of recovery experiences between different family members as well as grief and loss can guide clinicians to support family’s capacity to encourage recovery of individual members as well as ameliorating the family’s psychological distress.

Other News / Resources

i) Writing out of the University of Nottingham, Dr Olamide Todowede makes a call for participation in the following study:

We are conducting an interview study to learn the views of key stakeholders about citizen science in mental health. The study is being conducted as part of the UKRI-funded Citizen Science To Achieve Coproduction at Scale (C-STACS) study, and we hope that the findings from C-STACS will improve the lives of people with mental health issues. The study participants must fit into any of the following categories:
• Academic expert with experience of conducting a citizen science project.
• A public contributor with experience of taking part in a citizen science project.
• Person who has personal experience of mental health issues. You do not need to know anything about citizen science to take part.
• Someone who is a carer (e.g. family, friend) of someone who has experience of mental health issues. You do not need to know anything about citizen science to take part.
• Mental health worker, You do not need to know anything about citizen science to take part.

Taking part would involve one 60-minute interview to discuss your views. More information about what is involved, including how to express interest in participation, is on the study’s website: https://www.researchintorecovery.com/research/c-stacs/

ii) Request for peer-reviewed intervention studies that target identity or self-concept

From the Department of Clinical and Developmental Neuropsychology at the University of Groningen, PhD candidate Elske Kronemeijer makes the following request for peer-reviewed intervention studies:

Researchers from the University of Groningen are currently writing a transdiagnostic exploratory scoping review on identity interventions. With this review the researchers aim to give an overview of interventions that target identity or self-concept in people with a severe mental illness, intellectual disability or acquired brain injury. In addition to a systematic search of the literature, we would like to consult researchers in the field to identify additional relevant intervention studies.

We are looking for intervention-studies that:
• Target identity, self-concept, ‘illness-engulfment’ or related concepts.
• For any one of the following populations: severe mental illness; schizophrenia, psychosis; bipolar disorder; severe psychotic depression; acquired brain injury (traumatic or non-traumatic); or intellectual disability.
• Studies should include an evaluation of the intervention (qualitative or quantitative).

Do you know a study that could be relevant? Please contact us at u.e.kronemeijer@rug.nl Feel free to forward this question to other researchers that may want to submit a (reference of) paper.

iii) Coronavirus and Mental Health (information)
The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19. It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation
Gov.uk
Social Care Institute for Excellence
Centre for Mental Health
Mental health Foundation
Mind
Rethink
Carers UK
National Service User Network
British Psychological Society
British Association of Social Workers
Royal College of Psychiatrists
Royal College of Nursing
Royal College of Occupational Therapists

iv) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:

Shula:     s.ramon@herts.ac.uk
Tony:      a.sparkes@bradford.ac.uk

September 2022

Recovery Research Network eBULLETIN

September 2022

RRN Meetings
Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time. Nationally however, the current move towards the easing of restrictions represents an optimistic turn to the possibility of resuming face-to-face meetings. The current arrangements are under constant review by the RRN Collective and more information about this possibility will be circulated in due course. In the meantime, we would encourage our readers to keep safe and follow relevant guidance as appropriate.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk

Coronavirus and Mental Health
Both nationally and internationally, the impact of coronavirus is an ongoing concern, and it remains important that we continue to pay particular attention to our mental health and wellbeing. There is a considerable amount of advice and information available online. We continue to include examples at the end of the e-bulletin.

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:
https://www.researchintorecovery.com/events/rrn/join/

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research. Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

 

Conferences, Events and Calls for Papers
In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world. As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.

i)

Please book via this Eventbrite link – https://www.eventbrite.co.uk/e/411129939717 and be prepared to join the conference via MS Teams. We will make a recording of the event available to anyone who is not able to join for any reason. Copies of the Recovery Newsletter will similarly be available.

Please address any queries to Leigh Heaps at: leigh.heaps@nhs.net / 07812 785533

Papers and Publications
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i) Milasan, L. H. (2022) “Mending fractured personalities”: A photography-based cultural study of
recovery from mental distress in Romania. Transcultural Psychiatry. 1-18. Online:
https://doi.org/10.1177/13634615221119373

Abstract
This study explored the lived experiences and meanings of recovery from mental distress from the perspective of mental health service users in Romania, along with investigating cultural particularities of recovery in this country. Research in this area is essential in the context of Romania’s mental health reform marked by a transition from institutionalised mental health services to a recovery-based approach, and profound social and economic changes during the post-communist era. Subscribing to the recovery framework, this study employed a qualitative phenomenological design involving 15 adults with mental health problems purposively recruited from a community day centre in Romania. The phenomenological background was enriched with elements of participatory photography to elicit subjective experiences and meanings of recovery. The outcome of this study was a better understanding of recovery in Romanian adults living with mental distress, as a complex and multi-layered phenomenon. Three key themes were identified through Interpretative Phenomenological Analysis: awakening, healing, and reconstructing life. The findings add to the current recovery models by showing that recovery cannot be fully understood unless situated in a socio-political, cultural, and historical context. Implications for mental health practice in Romania are discussed and directions for future research are recommended.

ii) Milasan, L. H., Bingley, A. F. and Fisher, N. R. (2022) The big picture of recovery: a systematic review on the evidence of photography-based methods in researching recovery from mental distress. Arts & Health, 14(2), 165-185. Online:
https://doi.org/10.1080/17533015.2020.1855453

Abstract
Background: In the context of a growing body of literature on incorporating visual media in researching well-being and mental health, this systematic review examined the evidence of using photography-based research methods in exploring recovery from mental distress, their outcomes, but also limitations and challenges encountered by researchers.
Methodology: Six cross-disciplinary electronic databases (CINAHL, MEDLINE, Web of Science, Scopus, PsycINFO, Arts & Humanities) were systematically searched resulting in a total of 15 qualitative and mixed-methods studies included in a thematic synthesis.
Results: Photo-elicitation and photovoice were identified as the main photographic methods employed in recovery research along with less common, but nonetheless creative, techniques. Four key themes were identified through thematic analysis in photography-based recovery studies: enhanced understanding, collaboration and empowerment, situatedness, and storytelling. The results of this review revealed photography as a valuable methodological tool with potential to contribute to conceptualising recovery from the stance of research participants, but also facilitate and support their recovery processes.
Conclusions: Recovery research can benefit from the use of photographic methods that are widely accessible, versatile, and interactive. They may offer mental health researchers alternative ways to explore individuals’ perspective on recovery in ways that are creative, empowering, and supportive of their recovery.

iii) Hayes, D., Henderson, C., Bakolis, I., Lawrence, V., Elliott, R. A., Ronaldson, A., Richards, G., Repper, J., Bates, P., Brewin, J., Meddings, S., Winship, G., Bishop, S., Emsley, R., Elton, D., McNaughton, R., Whitley, R., Smelson, D., Stepanian, K., McPhilbin, M., Dunnett, D., Hunter Brown, H., Yeo, C., Jebara, T. and Slade, M. (2022) Recovery Colleges Characterisation and Testing in England (RECOLLECT): rationale and protocol. BMC Psychiatry. 22(627), 1-14
https://doi.org/10.1186/s12888-022-04253-y

Abstract
Background: Recovery Colleges are a relatively recent initiative within mental health services. The first opened in 2009 in London and since then numbers have grown. They are based on principles of personal recovery in mental health, co-production between people with lived experience of mental health problems and professionals, and adult learning. Student eligibility criteria vary, but all serve people who use mental health services, with empirical evidence of benefit. Previously we developed a Recovery College fidelity measure and a preliminary change model identifying the mechanisms of action and outcomes for this group, which we refer to as service user students. The Recovery Colleges Characterisation and Testing (RECOLLECT) study is a five-year (2020–2025) programme of research in England. The aim of RECOLLECT is to determine Recovery Colleges’ effectiveness and cost-effectiveness, and identify organisational influences on fidelity and improvements in mental health outcomes.
Methods: RECOLLECT comprises i) a national survey of Recovery Colleges, ii) a prospective cohort study to establish the relationship between fidelity, mechanisms of action and psychosocial outcomes, iii) a prospective cohort study to investigate effectiveness and cost-effectiveness, iv) a retrospective cohort study to determine the relationship between Recovery College use and outcomes and mental health service use, and v) organisational case studies to establish the contextual and organisational factors influencing fidelity and outcomes. The programme has been developed with input from individuals who have lived experience of mental health problems. A Lived Experience Advisory Panel will provide input into all stages of the research.
Discussion: RECOLLECT will provide the first rigorous evidence on the effectiveness and cost effectiveness of Recovery Colleges in England, to inform their prioritising, commissioning, and running. The validated RECOLLECT multilevel change model will confirm the active components of Recovery Colleges. The fidelity measure and evidence about the

iv) Karbouniaris, S., Boomsma-van Holten, M., Oostindiër, A., Raats, P., Prins-Aardema, C. C., Weerman, A., Wilken, J. P. and Abma, T. A. (2022) Explorations on the use of lived experiences by psychiatrists: facilitators and barriers. Mental Health and Social inclusion. Online:
https://doi.org/10.1108/MHSI-07-2022-0049

Abstract
Purpose: This study aims to explore the perspectives of psychiatrists with lived experiences and what their considerations are upon integrating the personal into the professional realm.
Design/methodology/approach: As part of a qualitative participatory research approach, participant observations during two years in peer supervision sessions (15 sessions with 8 psychiatrists with lived experiences), additional interviews as part of member feedback and a focus group were thematically analysed.
Findings: Although the decision to become a psychiatrist was often related to personal experiences with mental distress and some feel the need to integrate the personal into the professional, the actual use of lived experiences appears still in its early stages of development. Findings reveal three main considerations related to the personal (3.1), professionality (3.2) and clinical relevance (3.3) comprising 11 facilitators and 9 barriers to harness lived experiences.
Research limitations/implications: This study was conducted locally and there are no similar comparable studies known. It was small in its size due to its qualitative nature and with a homogeneous group and therefore may lack generalisability.
Practical implications: Future directions to further overcome shame and stigma and discover the potential of lived experiences are directed to practice, education and research.
Originality/value: Psychiatrists with lived experiences valued the integration of experiential knowledge into the professional realm, even though being still under development. The peer supervision setting in this study was experienced as a safe space to share personal experiences with vulnerability and suffering rather than a technical disclosure. It re-sensitised participants to their personal narratives, unleashing its demystifying, destigmatising and humanising potential.

v) Mezzina, R., Gopikumar, G., Jenkins, J., Saraceno, B., and Sashidharan, S.P. (2022) Social vulnerability and mental health inequalities in the “Syndemic”: call for action. Frontiers in Psychiatry. 13(894370) 1-14.
https://doi.org/10.1108/MHSI-07-2022-0049

Abstract
Covid-19 is referred to as a “syndemic,” i.e., the consequences of the disease are exacerbated by social and economic disparity. Poor housing, unstable work conditions, caste, class, race and gender based inequities and low incomes have a profound effect on mental health and wellbeing. Such disparities are increasing between, among and within countries and are exacerbated by human rights violations, in institution and in society, stigma and discrimination. Social capital can mediate health outcomes, through trust and reciprocity, political participation, and by mental health service systems, which can be coercive or more open to demand of emancipation and freedom. Societal inequalities affect especially vulnerable groups, and Covid itself had a wider impact on the most socially vulnerable and marginalized populations, suffering for structural discrimination and violence. There are complex relations among these social processes and domains, and mental health inequalities and disparity. Participation and engagement of citizens and community organizations is now required in order to achieve a radical transformation in mental health. A Local and Global Action Plan has been launched recently, by a coalition of organizations representing people with lived experience of mental health care; who use services; family members, mental health professionals, policy makers and researchers, such as the International Mental Health Collaborating Network, the World Federation for Mental Health, the World Association for Psychosocial Rehabilitation, the Global Alliance of Mental Illness Advocacy Networks (GAMIAN), The Mental Health Resource Hub in Chennai, India, The Movement for Global Mental Health (MGMH) and others. The Action Plan addresses the need for fundamental change by focusing on social determinants and achieving equity in mental health care. Equally the need for the politics of wellbeing has to be embedded in a system that places mental health within development and social justice paradigm, enhancing core human capabilities and contrasting discriminatory practices. These targets are for people and organizations to adopt locally within their communities and services, and also to indicate possible innovative solutions to Politics. This global endeavour may represent an alternative to the global mental discourse inspired by the traditional biomedical model.

vi) Kouvaras, S., Guiotto, M., Schrank, B., Slade, M. and Riches, S. (2022). Character strength–focused positive psychotherapy on acute psychiatric wards: a feasibility and acceptability study. Psychiatric Services. 73(9), 1051-1055.
https://doi.org/10.1176/appi.ps.202100316

Abstract
Objective: A manualized single-session positive psychotherapy intervention was developed and tested on acute psychiatric wards.
Methods: Participants were invited in 2018–2019 to identify positive experiences, link them to a personal character strength, and plan a strengths-based activity. The intervention’s feasibility was evaluated through fidelity to session components, character strengths identification, and activity completion. Acceptability was evaluated with self-reported pre- and post-session mood ratings, a post-session helpfulness rating, and narrative feedback.
Results: Participants (N570) had complex and severe mental health conditions. In 18 group sessions, 89% of components were delivered with fidelity; 80% of the participants identified a character strength, of whom 71% identified a strengths-based activity, and 58% completed the activity. The mean6SD helpfulness rating (N523) was 8.561.5 (on a 10-point Likert scale), and positive mood significantly increased post-session (5.9 presession vs. 7.2 post-session).
Conclusions: Positive psychotherapy is feasible in challenging inpatient settings, and service users with severe and complex mental health conditions find it helpful.

vii) Tomlin, J., Walker, K., Yates, J., Dening, T., Völlm, B. and Griffiths, C. (2022) Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive
ability and quality of life [version 2; peer review: 2 approved]. NIHR Open Research. 2(9), 1-29.
https://doi.org/10.3310/nihropenres.13248.2

Abstract
Background: Older individuals (e.g., 55 years and over) constitute a growing proportion of the forensic mental health patient population. As a group, they are vulnerable to health outcomes similar to other individuals with serious mental disorders of the same age; however, these concerns can be compounded by complex forensic-related care backgrounds and clinical presentations, lengthy periods of time spent in prison or psychiatric hospitals, substance use histories, and crime perpetration or victimisation. The healthcare needs and strengths of this group are not well understood. The aim of this study was to identify and describe the demographic, physical health, mental wellbeing, cognitive ability, and quality of life profiles of older forensic patients in community, low, medium, and high security settings in England.
Methods: A cross-sectional quantitative study design was used. N=37 forensic patients aged 55 years and over completed six questionnaires. Data were also collected from patient records.
Results: Most patients were male and were diagnosed with psychosis. The most frequently committed index offence types were violent offences. Patients were prescribed 7.6 medications on average and had average anticholinergic effect on cognition scores of 2.4. Nearly half the sample had diabetes, with an average BMI score of 31.7 (indicating obesity). Possible cognitive impairment was identified in 65% of the sample. Patients’ assessments of their recovery-related quality of life and mental wellbeing were comparable to published UK general population values. Assessments of quality of life were positively correlated with the ability to undertake everyday activities and cognitive performance.
Conclusions: We suggest that forensic services are well-placed to provide holistic mental and physical care to this group but that they should co-develop with patients a greater range of age-appropriate meaningful activities that are mindful of mobility issues and consider implementing more cognition-based and physical health interventions.

viii) Grey, B. (2022) Lived experience research: a guide to the barriers and facilitators from a service user’s perspective. Mental Health Today (22/09/2022)

The publisher’s introduction to Ben’s article reads:
In this article, Dr Ben Gray (a Research Ambassador and Service User Researcher at Healthwatch Essex who has schizophrenia and Asperger’s syndrome – also referred to as Autism) describes the barriers and facilitators to successful lived experience research, service user involvement and co-production. Ben has over 20 years of experience as a service user researcher. This comes at a time when Patient and Public Involvement (PPI) and service user involvement are required in research proposals, research funding bids and broader and more inclusive research projects and methods/ methodologies. This article should also help and guide other service users who are involved or considering becoming involved in lived experience/ service user research.

The barriers and facilitators noted here are not exhaustive or complete but offer a guide to the main issues that might be encountered by service user researchers.

Other News / Resources
i) Earlier in September, one of our readers emailed the ebulletin commenting upon their experience of caring for their son, who had been diagnosed with paranoid schizophrenia many years earlier. As co-producers of the ebulletin we thought we would share an anonymised version of this with you, and ask for your comments. We shall of course forward these onwards.

As a mother/carer I look on the RRN emails for enlightenment as to how far I can expect my son to recover from his original diagnosis of paranoid schizophrenia 21 years ago at the age of 21.

James shows no joy in life and seems unable to smile and unable to make friends. He appears to be preoccupied with voices (mumbles inaudibly with moving lips and sometimes jaw movements). Probably because of this he often doesn’t appear to hear what is being said to him. I attend his Reviews, when it seems he has no need to attend to ‘voices’ and has denied hearing voices, (I believe this is dissociation rather than lying) He comes home to me for 3 nights over the weekend and spends time watching television, sometimes it seems it doesn’t matter to him what is on, and he appreciates home cooking. He eats more than he needs.

James is resident with a Mental health Service in the South of England during the week. There are many positives. He attends organised groups, Art, drama, music when available, sows seeds at an inner-city farm, goes to the allotment and to a swimming pool on his own most weeks. He has a large room and there are 5 or 6 others in the house. He has meals delivered by a ‘meal kit’ service which he cooks. He has a TV in his room. The house is staffed during weekdays in the daytime.

So maybe this is as far as he can get in Recovery. He has returned to clozapine which he takes without needing to be reminded. This seems to be the medication that suits him best, and he indicates no wish for change. I am 82 and am concerned that when I die his sisters will not be able to offer what I do as his mother. When I speak with other carers who attend group walks I feel I have reason to be thankful, so maybe I should accept that this is as good as it gets

 

ii) Coronavirus and Mental Health (information)
The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19. It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation
Gov.uk
Social Care Institute for Excellence
Centre for Mental Health
Mental health Foundation
Mind
Rethink
Carers UK
National Service User Network
British Psychological Society
British Association of Social Workers
Royal College of Psychiatrists
Royal College of Nursing
Royal College of Occupational Therapists

iii) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:

Shula:     s.ramon@herts.ac.uk
Tony:      a.sparkes@bradford.ac.uk

October 2022

Recovery Research Network eBULLETIN

October 2022

RRN Meetings
Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time. Nationally however, the current move towards the easing of restrictions represents an optimistic turn to the possibility of resuming face-to-face meetings. The current arrangements are under constant review by the RRN Collective and more information about this possibility will be circulated in due course. In the meantime, we would encourage our readers to keep safe and follow relevant guidance as appropriate.

Please can we urge our readership to continue to submit material to the e-bulletin using the detail below. As ever, comments are welcome from the readership about articles included in the e-bulletins.

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk

Coronavirus and Mental Health
Both nationally and internationally, the impact of coronavirus is an ongoing concern, and it remains important that we continue to pay particular attention to our mental health and wellbeing. There is a considerable amount of advice and information available online. We continue to include examples at the end of the e-bulletin.

RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:
https://www.researchintorecovery.com/events/rrn/join/

A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.

Recovery Research: We would like to learn from your experience of conducting recovery research. Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.

 

Conferences, Events and Calls for Papers
In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world. As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.

i) The current issue of the European Social Work Research Association newsletter includes a call for abstracts from the Mental Health Special interest Group. The call reads:

Our SIG will be meeting at the ECSWR 2023 Milan conference on Wednesday 12th April 2023 13:00 to 15:30. We would welcome abstracts for the Mental Health SIG to be sent to us by 20th January 2023 to Sarah Vicary sarah.vicary@open.ac.uk Pearse McCusker pearse.mccusker@ed.ac.uk

The final outline of the SIG will be published early 2023 but we have time for:
• 4-5 conference papers,
• Progress of the Mental Health Social Workbook
• The Annual General Meeting
• Any other business
Please contact us if you have any business, you would like the SIG committee to consider for the conference session on Wednesday 12th April 2023

Papers and Publications
In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.

i) Ali, I., Benkwitz, A., and McDonald, P. (2022) Setting up a Recovery College: exploring the experiences of mental health service-users, staff, carers and volunteers. Journal of Psychosocial Rehabilitation and Mental Health. Online:
https://doi.org/10.1007/s40737-022-00295-3

Abstract
Following the first recovery college being established in 2009, there has been considerable growth in the number of colleges internationally as they have become established features of service transformations. This is the first study that has holistically explored setting up a recovery college from the combined perspectives of service-users, staff, carers and volunteers involved in the development process. An interpretative phenomenological analysis was undertaken following 25 semi-structured interviews. Results included three key themes of ‘Challenges in the early stages of development’; ‘Having a shared understanding of recovery’; and the ‘Conceptualisation of Recovery Colleges’. This study demonstrated that, as well as future groups seeking to set up a recovery college having clear conceptualisations of personal recovery and the underpinning approach of their recovery college, they should actively manage the level of integration between the college and its host organisation, with open conversations about the power imbalances and roles of service-users, staff, carers and volunteers involved. Those planning to develop a college should also be mindful that although there will be the early challenges as outlined in this study, there are broader benefits for both individuals and the wider organisation via the process of planning and discussions of how to implement co-produced, recovery-oriented practice such as a recovery college.

ii) Ali, I., Benkwitz, A., McDonald, P., Allen, K., and Glover, A. (2022) Reflections on co-production, lived experience and the shared learning environment within the development and early delivery of a Recovery College. Journal of Recovery in Mental Health, 5(2) 19-33
https://doi.org/10.33137/jrmh.v5i2.37890

Abstract
Objective: This study sought to explore and value the experiences of the service users, staff, carers and volunteers who were involved in the development and early establishment of a recovery college in a large mental health Trust in the United Kingdom.
Research Design and Methods: This qualitative study used Interpretative Phenomenological Analysis (IPA) to explore the experiences of 25 participants who were involved in the design, development and early delivery phases of the recovery college. Data was collected using face-to-face semi-structured interviews.
Results: The findings discuss a number of key features relating to participants’ experiences of the development of the recovery college, with the central themes being: 1) co-production; 2) lived experience; and 3) the shared learning environment.
Conclusions: Key recommendations for those seeking to develop their own recovery college include: i) co-production is essential, but there are both philosophical and practical considerations; ii) lived experience is valuable, but it needs to be valued and supported within both the recovery college and the host organisation; and iii) the shared learning environment and educational approach of the college is vital and needs equity of opportunity between the service users, staff, carers and volunteers involved.

iii) Kotera, Y., Llewellyn-Beardsley, J., Charles, A. and Slade, M. (2022) Common humanity as an under-acknowledged mechanism for mental health peer support. International Journal of Mental Health and Addiction. Online:
https://doi.org/10.1007/s11469-022-00916-9

Abstract
Mental health peer support (PS) is a relational approach to recovery. Service users are helped through a relationship focused on connection with a PS worker who shares similar experiences. Despite the strong evidence base, the mechanisms of action for mental health PS are under-researched. Several theories have been proposed to explain the mechanisms, including social comparison theory (SCT). SCT highlights the benefits arising from emphasising differences between a service user and the PS worker. An unintended consequence is that connection between them may be reduced. We propose common humanity (CH) as an under-acknowledged mechanism of action. CH is an experience recognising that there are other people living with similar suffering and helps us regulate emotions. A CH-informed connection-based PS relationship may help a service user in different ways from a SCT-informed comparison-based PS relationship. Future PS research can investigate emotional self-regulation to establish whether CH-related outcomes arise from PS.

iv) Kotera, Y., Young, H., Marybury, S. and Aledeh, M. (2022) Mediation of self-compassion on pathways from stress to psychopathologies among Japanese workers. International Journal of Environmental Research and Public Health.
https://doi.org/10.3390/ijerph191912423

Abstract
As awareness of mental health increases worldwide, how to improve mental health has begun to be discussed in many countries. Stress is known to cause diverse physical and mental health problems, including psychopathologies. On the other hand, our previous studies identified that self-compassion, kindness and understanding towards oneself are key components for good mental health in many populations, including Japanese workers. The government reports that Japanese workers suffer from high rates of mental health problems. However, the mechanism of how self-compassion helps their mental health remains to be evaluated. Accordingly, this study aimed to elucidate how self-compassion intervenes in pathways from stress to psychopathologies, namely depression and anxiety. One hundred and sixty-five Japanese workers completed an online survey regarding self-compassion, depression, anxiety and stress. Correlation and path analyses were conducted. These four variables were significantly inter-related. While self-compassion mediated the pathway from stress to depression, it did not mediate the pathway from stress to anxiety. These exploratory insights assist in understanding the mechanism of how self-compassion improves mental health and inform effective methods to implement self-compassion interventions to the Japanese workforce.

v) Kotera, Y., Aledeh, M., Barnes, K., Annabel, R., Habib, A. and Riswani, R. (2022) Academic motivation of Indonesian university students: Relationship with self-compassion and resilience. Healthcare. 10(2092). Online:
https://doi.org/10.3390/healthcare10102092

Abstract
Academic motivation is an important construct for university students, associated with student wellbeing and academic performance. Students who are motivated tend to feel and perform well. Self-compassion, that is kindness and understanding towards oneself in difficult times, and resilience, an ability to bounce back from difficulties, are also associated with student wellbeing and academic achievement. However, how these variables are related to each other has not been evaluated in Indonesian university students. Indonesian higher education has rapidly developed, focusing on student achievement while their wellbeing suffers. Understanding how academic motivation is linked with self-compassion and resilience can inform an effective way to augment their motivation. Accordingly, this cross-sectional study evaluated the relationship among these three variables. An opportunity sample of 156 students in Indonesia completed measures about those three constructs. Correlation, regression and moderation analyses were used. Intrinsic motivation was positively associated with extrinsic motivation and resilience. Amotivation was negatively associated with self-compassion and resilience. Self-compassion was positively associated with resilience. Both self-compassion and resilience predicted all three types of motivation apart from self-compassion for intrinsic motivation. Lastly, self-compassion nor resilience moderated the pathway from extrinsic motivation to intrinsic motivation. Resilience interventions are recommended for Indonesian students to maintain intrinsic motivation. Our findings will help educators and wellbeing staff to identify helpful ways to support healthful motivation in this student population that is undergoing drastic changes.

vi) Colman, R., Vione, K. and Kotera, Y. (2022). Psychological Risk Factors for Depression in the UK General Population: Derailment, Self-Criticism and Self-Reassurance. British Journal of Guidance and Counselling. Online:
https://doi.org/10.1080/03069885.2022.2110214

Abstract
UK depression prevalence is increasing. In this study we appraised the relationships between psychological factors of derailment, self-criticism, self-reassurance and depression, to identify individual differences within the UK general population indicating those at higher risk. Participants completed self-report measures regarding these constructs. Relationships were assessed using correlation and path analyses. Derailment and self-criticism predicted depression positively, whereas self-reassurance predicted depression negatively. Self-criticism mediated derailment’s relation to depression. Self-reassurance moderated derailment’s relation to depression, with low self-reassurance indicating greater depression, though self-reassurance was not found to moderate the effect of derailment-associated self-criticism on depression. In depression treatment therefore derailment should be considered as a target factor to be reduced, since derailment indicates a risk of depression for individuals with high self-criticism or low self-reassurance

vii) Kuek, J. H. L., Raeburn, T., Chow, M. Y. Z. and Wand, T. (2022) Lived experience perspectives of factors
that influence mental health recovery in Singapore: a thematic analysis. Mental Health and Social Inclusion. Online:
https://doi.org/10.1108/MHSI-09-2022-0063

Abstract
Purpose: Contemporary interpretations of mental health recovery emphasize the need to understand better the lived experience of people with mental health conditions and how they define the idea of recovery. While traction for such ideas has been building in many western countries, the recovery movement is still in its early stages within most Asian countries. Hence, this study aims to add to this growing effort by understanding various factors that influence the recovery of people with mental health conditions in Singapore.
Design/methodology/approach: Braun and Clarke’s thematic analysis was used on the qualitative data provided by 21 participants.
Findings: Four themes were revealed: double-edged nature of social support, challenges accessing mental health support, personalized coping strategies and societal influences. As a result, the authors could better understand various factors that influenced the recovery process of people with mental health conditions in Singapore, such as the high costs and low levels of literacy regarding pathways to mental health services. In addition, the importance of societal influences on mental health recovery was highlighted, and their impact could be seen through the participants’ sharing.
Research limitations/implications: These findings form a foundation from which future research and recovery-oriented interventions can work from to provide more tailored approaches to supporting people with mental health conditions.
Originality/value: This study identified cultural nuances to notions of recovery that are commonly found in personal recovery constructs that need to be considered when working within culturally diverse populations.

vii) Thompson, E. J., Stafford, J., Moltrecht, B., Huggins, C. F., Kwong, A. S. F., Shaw, R. J. et al (2022) Psychological distress, depression, anxiety, and life satisfaction following COVID-19 infection: evidence from 11 UK longitudinal population studies. The Lancet, 9(11) 894-906.

 

Abstract
Background: Evidence on associations between COVID-19 illness and mental health is mixed. We aimed to examine whether COVID-19 is associated with deterioration in mental health while considering pre-pandemic mental health, time since infection, subgroup differences, and confirmation of infection via self-reported test and serology data.
Methods: We obtained data from 11 UK longitudinal studies with repeated measures of mental health (psychological distress, depression, anxiety, and life satisfaction; mental health scales were standardised within each study across time) and COVID-19 status between April, 2020, and April, 2021. We included participants with information available on at least one mental health outcome measure and self-reported COVID-19 status (suspected or test-confirmed) during the pandemic, and a subset with serology-confirmed COVID-19. Furthermore, only participants who had available data on a minimum set of covariates, including age, sex, and pre-pandemic mental health were included. We investigated associations between having ever had COVID-19 and mental health outcomes using generalised estimating equations. We examined whether associations varied by age, sex, ethnicity, education, and pre-pandemic mental health, whether the strength of the association varied according to time since infection, and whether associations differed between self-reported versus confirmed (by test or serology) infection.
Findings: Between 21 Dec, 2021, and July 11, 2022, we analysed data from 54 442 participants (ranging from a minimum age of 16 years in one study to a maximum category of 90 years and older in another; including 33 200 [61·0%] women and 21 242 [39·0%] men) from 11 longitudinal UK studies. Of 40 819 participants with available ethnicity data, 36 802 (90·2%) were White. Pooled estimates of standardised differences in outcomes suggested associations between COVID-19 and subsequent psychological distress (0·10 [95% CI 0·06 to 0·13], I²=42·8%), depression (0·08 [0·05 to 0·10], I²=20·8%), anxiety (0·08 [0·05 to 0·10], I²=0·0%), and lower life satisfaction (–0·06 [–0·08 to –0·04], I²=29·2%). We found no evidence of interactions between COVID-19 and sex, education, ethnicity, or pre-pandemic mental health. Associations did not vary substantially between time since infection of less than 4 weeks, 4–12 weeks, and more than 12 weeks, and were present in all age groups, with some evidence of stronger effects in those aged 50 years and older. Participants who self-reported COVID-19 but had negative serology had worse mental health outcomes for all measures than those without COVID-19 based on serology and self-report. Participants who had positive serology but did not self-report COVID-19 did not show association with mental health outcomes.
Interpretation: Self-reporting COVID-19 was longitudinally associated with deterioration in mental health and life satisfaction. Our findings emphasise the need for greater post-infection mental health service provision, given the substantial prevalence of COVID-19 in the UK and worldwide.

 

Other News / Resources
i)  Writing out of the University of Bath, Lorna Hogg draws attention to a current study and looking to recruit participants.  Lorna writes:

Hi
I would be extremely grateful if you could advertise this study to your membership. Please find a poster for circulation. The study has University of Bath Psychology Research Ethical Approval (reference number: 21-266)

The study is a qualitative investigation of the concept of social identity in people employed in research on the basis of their identity as someone who experiences psychosis. I believe such participants will be well placed to speak to the concepts being investigated. Essentially, I am interested in investigating the recovery benefits of developing a positive social identity as someone with psychosis.

I’m looking for people who are:

  • Aged over 18 years
  • Able to participate in an interview conducted in English
  • Able to consent, and not currently too distressed to participate
  • Employed in a UK University or NHS Trust in a paid or voluntary capacity as a researcher with lived experience
  • Currently have, or historically have had, experiences consistent with psychosis e.g., hearing voices, other unusual perceptual experiences, distressing beliefs that others don’t agree with e.g., that your personal safety may be at risk
  • Have at some point accessed mental healthcare support and received a diagnosis consistent with psychosis

Taking part will involve a 60-90 minute interview with myself conducted online using the MS Teams platform. Anonymised transcripts will be analysed using Thematic Analyses. There will also be opportunity to join a focus group with other participants at the end of the study to receive the results and discuss dissemination and next steps. I can offer £15 as a thank you for participating in each aspect, interview and focus group. I appreciate this is a small token, however, I hope those taking part will find the process interesting in itself.

I hope you will be able to help. I would be happy to discuss in more detail or provide other study materials as helpful.

With best wishes, Lorna Hogg
PhD researcher, consultant clinical psychologist and Clinical Director of the Oxford Doctorate in Clinical Psychology Training Programme, University of Bath, Claverton Down, Bath, BA2 7AY

ii) Dr Lucian Milasan advertises an exciting opportunity for a fully funded PhD in mental health recovery at Nottingham Trent University.

A multi-disciplinary exploration of mental health recovery in a cultural context
A fully funded PhD studentship opportunity has arisen in the area of mental health recovery with Nottingham Trent University (Institute of Health and Allied Professions). The project aims to explore cultural nuances of recovery in mental health in the UK and/or other countries through the use of creative arts and digital technologies. The proposed interdisciplinary research seeks to inform mental health practice to promote culturally appropriate avenues to support the recovery of people with mental health problems from diverse ethnic and cultural backgrounds. The project is methodologically and epistemologically versatile, and is open to UK, EU, and international applicants from various professional backgrounds: mental health nurses, psychiatrists, social workers, occupational therapists, psychologists, psychotherapists, and people with lived experiences of mental distress, with interest in, and passion for, mental health recovery.

More details are available by accessing the project page below. Alternatively, you can make enquiries with the Director of Studies for this project (Dr Lucian Milasan, lucian.milasan@ntu.ac.uk).

https://www.ntu.ac.uk/research/find-a-phd-opportunity/studentship-projects/a-multi-disciplinary-exploration-of-mental-health-recovery-in-a-cultural-context

Deadline for applications: 12th January 2023
Best wishes, Lucian

iii) Prof. Shula Ramon includes a presentation from Michele O’Grady and Rebecca Murray (University of Herefordshire) on the topic of Schwartz rounds for postgraduate students in health and social work.

iv) The McPin Foundation publish a quarterly supporter newsletter that is available via free subscription. The most recent issue (Autumn 2022) embraces a number of topics relevant to personal recovery research and mental health research more generally.
https://mailchi.mp/02410a9b57bb/coproduction-tips-storytelling-and-a-year-of-change-14217609?e=076a26b21e

v) Coronavirus and Mental Health (information)
The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19. It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation
Gov.uk
Social Care Institute for Excellence
Centre for Mental Health
Mental health Foundation
Mind
Rethink
Carers UK
National Service User Network
British Psychological Society
British Association of Social Workers
Royal College of Psychiatrists
Royal College of Nursing
Royal College of Occupational Therapists

vi) Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:

Shula:     s.ramon@herts.ac.uk
Tony:      a.sparkes@bradford.ac.uk