Recovery Research Network (RRN)

2020 RRN Emails

January 2020

Recovery Research Network eBULLETIN

January 2020

RRN Meetings

The 23rd meeting of the RRN will be taking place in London, and details will be announced shortly.

All RRN events are free and administrated through Eventbrite.  The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly.  We do kindly ask that you notify the RRN if, for whatever reason, you are unable to attend on the day. This allows us to offer your place to someone else.

If you would like to present at a future meeting of the RRN please email either Shula Ramon or Tony Sparkes. Their contact details are:

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

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/rrn

Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk

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 and Events

i) Presented by Kate Lucre and Petr Ord, The Compassionate Mind Foundation are hosting a one-day event on the topic of: Compassion Focused Therapy for people with attachment trauma and personality disorder

The one-day event will explore the science, clinical applications and latest research findings of Compassion Focused Therapeutic work with people with a personality disorder diagnosis

Date/Time: 24th February 2020 at 9:30am until 4:30pm

Venue: The Ridgeway Centre, Featherstone Road

Location: Wolverton

For more information please click here

ii) A One-day International Conference on Shared Decision Making in Mental Health is due to take place at Addenbrooke’s Hospital, Cambridge, on Tuesday, May 12th 2020.

For more information and registration, please click here

iii)  Organised by Ajuda, The Mental Health and Wellbeing Show is to be held on Thursday 21st May 2020 at Cardiff City Stadium, Leckwith Road, Cardiff (08:00am – 16:00pm).  For more information please see:

https://www.ajuda.org.uk/shop/courses/mental-health/mhwshow/

iv) A number of international conferences are set out by the International Society for Psychological and Social Approaches to Psychosis (ISPS) during 2020:

ISPS Norway Conference

Norway Thursday, 06 February 2020 – Friday 07 February 2020 Hamar

“Back to the Future: Psychotherapy for Psychosis anno 2020”

Further information (in Norwegian)

ISPS Suomi Conference

Finland Tuesday, 11 February 2020 – Wednesday, 12 February 2020 Helsinki

“Psychosis 2020”

Keynote speakers include Jan Olav Johannessen and Amy Hardy

Further information (in Finnish)

ISPS Perugia 2021

Italy Wednesday, 01 September 2021 – Sunday, 05 September 2021 Perugia

The 22nd International Conference of the ISPS will take place in Perugia, Italy in 2021.

www.isps2021.it

v)  International Resilience Revolution Conference Blackpool, 8-11 September 2020

A conference and a call-for-action, recognising the importance of resilience focused, co-produced research and action to achieve equality and social justice for all.

Organised by the Centre of Resilience for Social Justice at the University of Brighton with Boingboing and HeadStart Blackpool. Come and learn from local communities, practitioners and academics who are developing ideas we want to share and grow.

For more information click here

Papers and Publications

In addition to peer-reviewed literature and work of a purely academic nature, the ebulletin 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)  Meadows, G. N., Prodan, A., Patten, S., Shawyer, F., Francis, S., Enticott, J., Rosenberg, S., Atkinson, J., Fossey, E. and Kakuma, R. (2019) Resolving the paradox of increased mental health expenditure and stable prevalence. Australian and New Zealand Journal of Psychiatry. 53(9) 844-850.

Abstract

A doubling of Australian expenditure on mental health services over two decades, inflation-adjusted, has reduced prevalence of neither psychological distress nor mental disorders. Low rates of help-seeking, and inadequate and inequitable delivery of effective care may explain this partially, but not fully. Focusing on depressive disorders, drawing initially on ideas from the work of philosopher and socio-cultural critic Ivan Illich, we use evidence-based medicine statistics and simulation modelling approaches to develop testable hypotheses as to how iatrogenic influences on the course of depression may help explain this seeming paradox. Combined psychological treatment and antidepressant medication may be available, and beneficial, for depressed people in socioeconomically advantaged areas. But more Australians with depression live in disadvantaged areas where antidepressant medication provision without formal psychotherapy is more typical; there also are urban/non-urban disparities. Depressed people often engage in self-help strategies consistent with psychological treatments, probably often with some benefit to these people. We propose then, if people are encouraged to rely heavily on antidepressant medication only, and if they consequently reduce spontaneous self-help activity, that the benefits of the antidepressant medication may be more than offset by reductions in beneficial effects as a consequence of reduced self-help activity. While in advantaged areas, more comprehensive service delivery may result in observed prevalence lower than it would be without services, in less well-serviced areas, observed prevalence may be higher than it would otherwise be. Overall, then, we see no change. If the hypotheses receive support from the proposed research, then implications for service prioritisation and delivery could include a case for wider application of recovery-oriented practice. Critically, it would strengthen the case for action to correct inequities in the delivery of psychological treatments for depression in Australia so that combined psychological therapy and antidepressant medication, accessible and administered within an empowering framework, should be a nationally implemented standard.

ii)  Ibrahim, N., Thompson, D., Nixdorf, R., Kalha, J., Mpango, R., Moran, G., Mueller‑Stierlin, A., Ryan, G., Mahlke, C., Shamba, D., Puschner, B., Repper, J. and Slade, M. (2019) A systematic review of influences on implementation of peer support work for adults with mental health problems.  Social Psychiatry and Psychiatric Epidemiology.  Online:

https://doi.org/10.1007/s00127-019-01739-1

Abstract

Purpose: The evidence base for peer support work in mental health is established, yet implementation remains a challenge. The aim of this systematic review was to identify influences which facilitate or are barriers to implementation of mental health peer support work.

Methods: Data sources comprised online databases (n = 11), journal table of contents (n = 2), conference proceedings (n = 18), peer support websites (n = 2), expert consultation (n = 38) and forward and backward citation tracking. Publications were included if they reported on implementation facilitators or barriers for formal face-to-face peer support work with adults with a mental health problem, and were available in English, French, German, Hebrew, Luganda, Spanish or Swahili. Data were analysed using narrative synthesis. A six-site international survey [Germany (2 sites), India, Israel, Tanzania, Uganda] using a measure based on the strongest influences was conducted. The review protocol was pre-registered (Prospero:CRD42018094838).

Results: The search strategy identified 5813 publications, of which 53 were included. Fourteen implementation influences were identified, notably organisational culture (reported by 53% of papers), training (42%) and role definition (40%). Ratings on a measure using these influences demonstrated preliminary evidence for the convergent and discriminant validity of the identified influences.

Conclusion: The identified influences provide a guide to implementation of peer support. For services developing a peer support service, organisational culture including role support (training, role clarity, resourcing and access to a peer network) and staff attitudes need to be considered. The identified influences provide a theory base to prepare research sites for implementing peer support worker interventions.

iii)  Coloni-Terrapon, C., Favrod, J., Clément-Perritaz, A., Gothuey, I. and Rexhaj, S. (2020) Optimism and the psychological recovery process among informal caregivers of inpatients suffering from depressive disorder: A descriptive exploratory study. Frontiers in Psychiatry.  10:972  Online:

https://www.frontiersin.org/articles/10.3389/fpsyt.2019.00972/full

Abstract

Background: Informal caregivers of people suffering from depressive disorders go through a psychological recovery process. This process is dynamic, deep, catalyzed by hope and optimism and characterized by stages from which specific needs ensue. This study aimed to describe the stages of the psychological recovery process and the level of optimism among informal caregivers of psychiatric inpatients suffering from depressive disorders in order to provide adapted nursing support and psychoeducation and facilitate a patient’s own recovery.

Methods: A descriptive exploratory study was conducted using a convenience sample of 29 informal caregivers. Participants filled out a sociodemographic questionnaire, a specially adapted Stages of Recovery Instrument (STORI) and the Life Orientation Test–Revised (LOT–R).

Results: A mean optimism score of 16.41 showed that informal caregivers are close to the level of the general European population. The sample included all the stages of the recovery process, with 34.5% of participants being in the growth stage. Informal caregivers’ stages in the recovery process were negatively associated with the patient’s length of illness (Rho = -.683, p = .000) and positively associated with the caregivers’ level of optimism (Rho = .564, p = .001).

Conclusion: During the inpatient treatment of a close relative suffering from a depressive disorder, informal caregivers go through an individual psychological recovery process involving several stages. In addition to caring for inpatients, nurses are encouraged to meet and support caregivers as soon as possible in their individual recovery process. Furthermore, the development of a suitably adapted clinical tool would facilitate the assessment of the informal caregiver’s stage in the recovery process within care units. A multidisciplinary approach is needed in this domain.

iv)  Winsper, C., Crawford Docherty, A., Weich, S., Fenton, S-J. and Singh S. P. (2020) How do recovery-oriented interventions contribute to personal mental health recovery? A systematic review and logic model.  Clinical Psychology Review. Online:

https://doi.org/10.1016/j.cpr.2020.101815

Abstract

The emergent recovery paradigm prioritises adaption to serious mental illness and a move towards personally meaningful goals. In this review, we combine a theory driven logic model approach with systematic review techniques to forward understanding of how recovery-oriented interventions can help service users in their personal recovery journey. We identified 309 studies meeting our inclusion criteria. Our logic model mapped out intervention typologies and their recovery outcomes, the mechanisms of action underpinning these links, and the contextual moderators of these mechanisms and outcomes. Interventions were associated with recovery outcomes (functional, existential and social) directly and through a sequence of processes, which were underpinned by four common mechanisms: 1) providing information and skills; 2) promoting a working alliance; 3) role modelling recovery; and 4) increasing choice. Moderators of these mechanisms were observed at the service user (e.g., motivation), mental health service (e.g., professional attitudes) and wider environmental (e.g., unemployment rates) level. Recovery-oriented interventions share common critical mechanisms, which can help propel service users towards recovery especially when delivered within pro-recovery and non-stigmatising contexts. Future studies should further examine ways to reduce (or remove) barriers preventing individuals with mental health problems from experiencing the same citizenship entitlements as everyone else.

v)  Karpetis, G. (2020) How experienced social workers apply recovery- oriented mental health policies in everyday practice.  European Journal of Social Work.  23(1)  106-117

https://doi.org/10.1080/13691457.2018.1474855

Abstract

In the wider mental health literature, there is a shortage of empirical studies elaborating on how exactly the recovery principle is effectively operationalised in everyday practice. This study explores how statutory mental health social workers implement recovery policies in Australia. Adopting the interpretative phenomenology framework, the researcher  conducted in-depth interviews with six experienced statutory mental health social workers. The data were thematically analysed to identify the participants’ perspectives on how they experience the recovery practice phenomenon and, thus, how exactly they apply recovery policies in their everyday practice. The study contributes new knowledge to the literature by means of translating the main aspects of recovery policies into identifiable practice behaviours and demonstrates that the terminology the practitioners adopt considerably aligns with the critical and humanistic theoretical perspectives that similarly underpin the majority of the current recovery-oriented policy documents. The study concludes that there is a need for further research on how exactly personal and clinical recovery are effectively operationalised in statutory mental health practice, under different theoretical perspectives.

Other News

i)  Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. 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 2020

Recovery Research Network eBULLETIN

February 2020

RRN Meetings

The 23rd meeting of the Recovery Research Network (RRN) will be hosted by Camden and Islington NHS Foundation Trust.  The theme of the meeting will be implementation challenges for a recovery-orientated NHS. A provisional agenda and registration details will follow shortly.

Date:               Thursday 28th May 2020

Time:               09:30 – 16:00

Venue:            St Pancras Hospital

4 St. Pancras Way

London

NW1 0PE

Travel

St Pancras Hospital Telephone:  020 3317 3500

Tube:  Mornington Crescent

Train:  St Pancras International/ Kings Cross

From St Pancras International (Kings Cross) station allow 15 min walking time.  From Mornington Crescent: turn right from the station to Crowndale Road. Continue down Crowndale Road. The entrance to the hospital is on St Pancras Road. The conference hall is next to main reception in West Wing building.

All RRN events are free and administrated through Eventbrite.  The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly.  We do kindly ask that you notify the RRN if, for whatever reason, you are unable to attend on the day. This allows us to offer your place to someone else.

If you would like to present at a future meeting of the RRN please email either Shula Ramon or Tony Sparkes. Their contact details are:

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

 

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/rrn

Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk

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 and Events

i)  The 3rd Meeting of the International Open Dialogue Research Collaboration (IODRC.  Developed as a multicentre, international extension of the ODEDESSI trial) will take place in Rome 4th – 5th May 2020.

For further details and registration, please click here.

ii) A One-day International Conference on Shared Decision Making in Mental Health is due to take place at Addenbrooke’s Hospital, Cambridge, on Tuesday, May 12th 2020.

For more information and registration, please click here

iii)  Organised by Ajuda, The Mental Health and Wellbeing Show is to be held on Thursday 21st May 2020 at Cardiff City Stadium, Leckwith Road, Cardiff (08:00am – 16:00pm).  For more information please see:

https://www.ajuda.org.uk/shop/courses/mental-health/mhwshow/

iv)  International Society for Psychological and Social Approaches to Psychosis (ISPS) international conference 2021:

ISPS Perugia 2021

Italy Wednesday, 01 September 2021 – Sunday, 05 September 2021 Perugia

The 22nd International Conference of the ISPS will take place in Perugia, Italy in 2021.

www.isps2021.it

v)  International Resilience Revolution Conference Blackpool, 8-11 September 2020

A conference and a call-for-action, recognising the importance of resilience focused, co-produced research and action to achieve equality and social justice for all.

Organised by the Centre of Resilience for Social Justice at the University of Brighton with Boingboing and HeadStart Blackpool. Come and learn from local communities, practitioners and academics who are developing ideas we want to share and grow.

For more information click here

Papers and Publications

In addition to peer-reviewed literature and work of a purely academic nature, the ebulletin 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)  De Wet, A., Parker, J. and Pretorius, C. (2019) The Spring Foundation: a recovery approach to institutional public mental health services in South Africa. Perspectives in Public Health. 139(3)  123-124.  Online:

https://doi.org/10.1177/1757913919838767

Summary

Recent change in mental healthcare policy in South Africa has promoted a recovery approach to support people with mental health problems within communities and institutions. In this article, Anneliese De Wet and her co-authors share the progress and early successes of The Spring Foundation, one of the first interventions to be developed and based in Cape Town.

ii)  Bartram, M. (2020)  ‘It’s really about wellbeing’: a Canadian Investigation of harm reduction as a bridge between mental health and addiction recovery.  International Journal of Mental Health and Addiction.  Online:

https://doi.org/10.1007/s11469-020-00239-7

Abstract

Recovery is a key concept driving system transformation in both the addiction and mental health sectors, with shared roots in advocacy and a shared focus on hope in the face of stigma, self-determination and meaningful lives. Nevertheless, while mental health recovery is possible even with on-going symptoms, addiction recovery generally starts with or leads to abstinence. This disconnection undermines coherence at the policy level and exacerbates fragmentation between services and supports in the mental health and addiction sectors in Canada and internationally. At the same time, harm reduction, which does not require abstinence, has been gaining ground in the Canadian addiction sector. This qualitative policy study explores the potential for harm reduction to bridge the gap between mental health recovery and addiction recovery in the Canadian context, drawing on diverse experiences from the mental health and addiction sectors. The findings could be adapted internationally to address similar policy challenges.

iii)   Hui, A., Latif, A., Hinsliff-Smith, K. and Chen, T. (2020) Exploring the impacts of organisational structure, policy and practice on the health inequalities of marginalised communities: Illustrative cases from the UK healthcare system.  Health Policy.  124(3) 298-302.

Abstract

This paper explores how organisational structure, policies and practices in healthcare can inadvertently disadvantage marginalised populations (e.g. individuals from ethnic minority backgrounds) and reinforce health inequalities. We draw upon three diverse UK healthcare settings (long term care institutions, high security hospitals and community pharmacies) to illustrate how systemic injustices negatively impact on access to care, treatment and health outcomes. The first case study considers the care of older people within nursing homes; specifically the disempowering effects of this service structure and impacts of choice reduction upon health and their access to health provision. The second case study explores the impact of security restrictions upon patients within high security hospitals, focusing particularly on the maintenance of relationships and support networks outside of the hospital. The third and final case study, draws upon a national community pharmacy medicine management service to illustrate ways in which policies and guidelines inadvertently obstruct patients’ engagement with the service within a community setting. We draw upon these settings to highlight inequalities within different contexts and to illustrate the ways in which well-intended services can inadvertently disadvantage marginalised communities in multiple ways.

iv)  Petros, R. and Solomon, L. (2020) Social Workers’ propensity to endorse recovery-oriented service provision: a randomised factorial design.  British Journal of Social Work. 50(1) 42-61.

Abstract

Providers inconsistently provide recovery-oriented services to adults with serious mental illness despite US federal mandate. An online randomised factorial survey was used to identify and evaluate predictors of social workers’ degree of endorsement of recovery-oriented service provision. Respondents (N ¼ 107) each rated scale items indicating support for recovery-oriented services for four client vignettes (n ¼ 398) and completed standardised measures of recovery knowledge and expectations. The final predictive model was significant (p < 0.0001), accounting for 61 per cent of the variance of the degree of endorsement of recovery-oriented services. Recovery knowledge explains the largest portion of the variance, followed by psychotic symptoms. The finding that client characteristics predict endorsement of recovery-oriented services suggests a fundamental misunderstanding of recovery. Recommendations include training and supervision to enhance application of recovery-oriented principles to service provision.

v)  Rosmarin, D.H., Pargament, K.I. and Koenig, H.K. (2020) Spirituality and mental health: challenges and opportunities (commentary).  Lancet Psychiatry.  S2215-0366(20)30048-1.  Online: https://doi.org/10.1016/

Couched in terms of challenges and opportunities, Rosmarin et al offer a brief commentary of the relevance of spirituality to contemporary mental health care.  Relevance is expressed in terms of personal meaning and ‘connection’, and in terms of service provision.  The authors argue that greater levels of research funding would greatly contribute to the knowledge base in this domain.

vi)  K, L.E. Peteet, J.R. and Cook, C.C.H. (2020) Spirituality and mental health.  Journal for the Study of Spirituality.  Online:

https://doi.org/10.1080/20440243.2020.1726048

Abstract

In many contexts, emotional ailments have been considered problems of religious or spiritual origin. Historically, religious groups were often the primary providers of mental health care. This changed over time with advances in medicine and Freud’s writings framing religion/spirituality (R/S) as a sign of neurosis. In the early- to mid-twentieth century, mental health and R/S were often viewed by Western clinicians and patients as separate and antithetical. Recent decades have been marked by another shift in thought, with increased interest in the overlap between mental health and R/S, and recognition that R/S may in fact serve protective and healing roles in the face of emotional suffering. There has been a concomitant increase in research investigating the connections between R/S and mental health, along with increased development and application of clinical interventions addressing the two in combination. In this narrative review, we summarize the history of how mental health and R/S have been viewed as relating to one another, recent research evidence on the effects of R/S on mental health, and clinical implications of these findings. We conclude with a discussion of ongoing challenges and opportunities in the study and application of how mental health and R/S affect one another.

vii)  Llewellyn‑Beardsley, J., Rennick‑Egglestone, S., Bradstreet, S., Davidson, L., Franklin, D., Hui, A., McGranahan, R., Morgan, K., Pollock, K., Ramsay, A., Smith, R., Thornicroft, G. and Slade, M. (2020) Not the story you want? Assessing the fit of a conceptual framework characterising mental health recovery narratives.  Social Psychiatry and Psychiatric Epidemiology.  55.  295-308.

https://doi.org/10.1007/s00127-019-01791-x

Abstract

Purpose: Narratives of recovery have been central to the development of the recovery approach in mental health. However, there has been a lack of clarity around definitions. A recent conceptual framework characterised recovery narratives based on a systematic review and narrative synthesis of existing literature, but was based on a limited sample. The aims of this study were to assess the relevance of the framework to the narratives of more diverse populations, and to develop a refined typology intended to inform narrative-based research, practice and intervention development.

Method: 77 narrative interviews were conducted with respondents from four under-researched mental health sub-populations across England. Deductive and inductive analysis was used to assess the relevance of the dimensions and types of the preliminary typology to the interview narratives.

Results: Five or more dimensions were identifiable within 97% of narratives. The preliminary typology was refined to include new definitions and types. The typology was found not to be relevant to two narratives, whose narrators expressed a preference for non-verbal communication. These are presented as case studies to define the limits of the typology.

Conclusion: The refined typology, based on the largest study to date of recovery narratives, provides a defensible theoretical base for clinical and research use with a range of clinical populations. Implications for practice include ensuring a heterogeneous selection of narratives as resources to support recovery, and developing new approaches to supporting non-verbal narrative construction.

viii)  Ibrahim, N., Thompson, d., Nixdorf, R., Kalha, J., Mpango, R., Moran, G., Mueller‑Stierlin, A., Ryan, G., Mahlke, C.,  Shamba, D., Puschner, B., Repper, J. and Slade, M. (2020) A systematic review of influences on implementation of peer support work for adults with mental health problems.  Social Psychiatry and Psychiatric Epidemiology.  55. 285-293

Abstract

Purpose: The evidence base for peer support work in mental health is established, yet implementation remains a challenge.  The aim of this systematic review was to identify influences which facilitate or are barriers to implementation of mental health peer support work.

Methods: Data sources comprised online databases (n = 11), journal table of contents (n = 2), conference proceedings (n = 18), peer support websites (n = 2), expert consultation (n = 38) and forward and backward citation tracking. Publications were included if they reported on implementation facilitators or barriers for formal face-to-face peer support work with adults with a mental health problem, and were available in English, French, German, Hebrew, Luganda, Spanish or Swahili. Data were analysed using narrative synthesis. A six-site international survey [Germany (2 sites), India, Israel, Tanzania, Uganda] using a measure based on the strongest influences was conducted. The review protocol was pre-registered (Prospero: CRD42018094838).

Results: The search strategy identified 5813 publications, of which 53 were included. Fourteen implementation influences were identified, notably organisational culture (reported by 53% of papers), training (42%) and role definition (40%). Ratings on a measure using these influences demonstrated preliminary evidence for the convergent and discriminant validity of the identified influences.

Conclusion: The identified influences provide a guide to implementation of peer support. For services developing a peer support service, organisational culture including role support (training, role clarity, resourcing and access to a peer network) and staff attitudes need to be considered. The identified influences provide a theory base to prepare research sites for implementing peer support worker interventions.

ix)  Cooper, R.E., Grünwald, L.M. and Horowitz, M. (2020) The  case for including antipsychotics in the UK NICE guideline: “Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults”.  Psychosis.  12(1)  89-93.

Abstract

The UK’s National Institute for Health and Care Excellence (NICE) is in the process of writing guidelines for “Medicines Associated with Dependence or Withdrawal Symptoms: Safe Prescribing and Withdrawal Management for Adults”. NICE has excluded antipsychotics, despite inclusion having been requested by all four groups participating in the guideline scoping workshop, as well as the Royal College of Psychiatrists, the All-Party Parliamentary Group for Prescribed Drug Dependence, the International Institute for Psychiatric Drug Withdrawal (IIPDW), Bangor University, Grünenthal Ltd, Pfizer and Mind (the UK’s largest mental health non-profit organisation). The IIPDW subsequently submitted the following request, drafted on their behalf by three researchers with expertise in this field, that NICE review its decision to exclude antipsychotics. The request draws on the recently updated German National Guideline for Schizophrenia. Two additional studies published since the submission, adding weight to the case, are also summarised.

x)  Dawson, S., Muller, J., Renigers, V., Varona, L. and Kernot, J. (2020). Consumer, health professional and employment specialist experiences of an individual placement and support programme.  Scandinavian Journal of Occupational Therapy  24.  1-13. Online:

https://doi.org/10.1080/11038128.2020.1714719

Abstract

Background: Individuals with severe mental illness (SMI) are under-represented in the workforce. The Individual Placement and Support (IPS) programme is an evidence-based intervention that co-locates an Employment Specialist in a community mental health team to support individuals with a SMI with their goal of finding work. Previous research predominantly explored IPS programme outcomes rather than stakeholder experiences.

Aim: To explore programme stakeholder perspectives and experiences during the early stages of IPS programme implementation.

Methods: Qualitative descriptive methodology explored consumers (n = 11), health professionals and employment specialist (n = 11) perceptions and experiences of the IPS programme. Semi-structured interviews were conducted and thematically analysed.

Results: Three main themes emerged: enacting core care philosophies, IPS programme process and catalyst for supportive environments and relationships. The combination of IPS programme relationships, enactment of core care philosophies, and programme process promoted development of supportive environments and relationships for consumers participating in the programme.

Conclusion: Findings suggest IPS processes promoted the enactment of person-centred and recovery-oriented care approaches and positively influenced care planning practices and service culture.

Significance: IPS directly tackles the compounding disadvantage resulting from unemployment for people with a SMI. At a service level, IPS can foster positive changes to care practices and service culture.

xi)  Kemp, H., Bellingham, B., Gill, K., McCloughen, A., Roper, C., Buus, N. and River, J. (2020) Peer support and open dialogue: possibilities for transformation and resistance in mental health services.  In Rhodes, P. (ed.) Beyond the psychology industry: how else might we heal?  Springer Nature Switzerland.  Chapter 6.

Abstract

This chapter is about peer support and open dialogue (OD). Peer support workers (PSWs) purposefully bring to their work knowledge and wisdom gained through lived experience of emotional distress and/or extreme states of mind (distress/extreme states) to establish connections with service users and engage in mutually transformative dialogue. The transformative power of peer support is often curtailed in health service cultures that are resistant to change and continue to privilege biomedical responses to distress/extreme states. Open dialogue is a social network–based approach to mental healthcare that came out of ‘psy’ (psychiatry and psychology) disciplines, and radically challenged clinicians to put aside their disciplinary expertise, diagnoses and clinical judgements to see distress/extreme states in a relational context. Using a co-production framework, which aims to yield new forms of knowledge through a collaborative, exploratory and reflective process of interaction between people with lived experience and researchers, we explore the histories and possibilities of each practice and the potential for transformation and resistance in mental health services by the pairing of the two.

https://link.springer.com/chapter/10.1007%2F978-3-030-33762-9_6

xii)  Crawford, P., Brown, B. and Charise, A. (eds.) (2020) The Routledge companion to health humanities.  Abingdon, Routledge.

Description

The health humanities is a rapidly rising field, advancing an inclusive, democratizing, activist, applied, critical, and culturally diverse approach to delivering health and well-being through the arts and humanities. It has generated new kinds of interdisciplinary research, knowledge, and communities of practice globally. It has also acted to bring greater coherence and political force to contributions across a range of related disciplines and traditions.

In this volume, a formidable set of authors explore the history, current state, and future of the health humanities, in particular how its vision of the arts and humanities:

  • Promotes creative public health.
  • Opens new routes to health and well-being.
  • Informs and drives better health care.
  • Interrogates relationships between ill health and social equality.
  • Develops humanist theory in relation to health and social care practice.
  • Foregrounds cultural difference as a resource for positive change in society.
  • Tests the humanity of an increasingly globalized health-care system.
  • Looks to overcome structural and process obstacles to cross-disciplinary ventures.
  • Champions co-construction, co-design, and mutuality in solving health and well-being challenges.
  • Showcases less familiar, prominent, or celebrated creative practices.
  • Includes multiple perspectives on the value and health benefits of the arts and humanities not limited to or dominated by medicine.

Divided into two main sections, the Companion looks at “Reflections and Critical Perspectives,” offering current thinking and definitions within health humanities, and “Applications,” comprising a wide selection of applied arts and humanities practices from comedy, writing, and dancing to yoga, cooking, and horticultural display.

https://www.routledge.com/The-Routledge-Companion-to-Health-Humanities-1st-Edition/Crawford-Brown-Charise/p/book/9781138579903

Other News

i)  Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. 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 2020

Recovery Research Network eBULLETIN

March 2020

RRN Meetings

The 23rd meeting of the Recovery Research Network (RRN) was due to be hosted by Camden and Islington NHS Foundation Trust.  Due to the current developments with regard to Covid-19, this event has been cancelled.

The coronavirus pandemic is having unprecedented effects both nationally and internationally.  During this time of social distancing and self-isolation, remaining connected to our networks is important.  Please can we encourage our readership to continue to submit material to e-bulletin using the detail below.

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.  Some advice about this is available herehere and here.  Information from the World Health Organisation is available here.

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/rrn

Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk

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 and Events 

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 almost certain that traditional face-face conferencing/events will not be taking place in their ‘traditional’ format, please check with the organisers.  It may be that alternative or innovative platforms are being utilised to deliver such events going forward.

Papers and Publications 

In addition to peer-reviewed literature and work of a purely academic nature, the ebulletin 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)  Carey, B. (2020) After answering the voices, what’s next.  The New York times.  February 25th 2020.

In a recent article in the New York Times, Benedict Cary engages an editorial piece by Larry Davidson (Davidson 2019) to provide commentary upon a recent study looking at the utility of the Recovery Assessment Scale (RAS) as a clinical outcome measure of personal recovery. Discussion builds towards a conclusion suggesting that situating the RAS as a clinical measure, may be lack the sensitivity to address the lived experience of personal recovery.

References

Davidson, L. (2019) Is ‘personal recovery’ a useful measure of clinical outcome?  Psychiatric services.  Online:  https://doi.org/10.1176/appi.ps.701204

Van der Krieke, L., Bartels-Velthuis, A. and Sytema S. (2019) Personal recovery among service users compared with siblings and a control group: a critical note on recovery assessment.  Psychiatric Services.  Online: https://doi.org/10.1176/appi.ps.201900049

ii)  Jordan, G., Iyer, S.N., Malla, A. and Davidson, L. (2020) Posttraumatic growth and recovery following a first episode of psychosis: a narrative review of two concepts. Psychosis.  Online:  https://doi.org/10.1080/17522439.2020.1736610

Abstract

A first episode of psychosis is often a traumatic experience that leads to significant life disruptions. However, many young people recover following a first episode of psychosis. Two types of recovery from psychosis have been described in the literature: clinical recovery (i.e. the resolution of symptoms and resumption of social, occupational or educational goals) and personal recovery (i.e. finding a way to live a meaningful life despite the limitations of having a mental illness). Further, some young people may experience posttraumatic growth (i.e. positive psychological changes following the struggle with psychosis). It is unclear how posttraumatic growth and recovery are similar or distinct. This conceptual ambiguity may limit both theoretical and empirical work in the field. The purpose of this narrative review is to help resolve this ambiguity by describing similarities and differences in the historical roots, phenomenology, and predictors of recovery (both clinical and personal) and posttraumatic growth within the context of a first episode of psychosis. Our review concludes that personal recovery may be best understood as a broader construct under which clinical recovery is subsumed, and that posttraumatic growth may be a phenomenon that is related to, yet distinct from, personal recovery. Future empirical studies are needed to disentangle these phenomena

iii)  Sapouna, L. (2020) Service-user narratives in social work education; Co-production or co-option?  Social Work Education.  Online:  https://doi.org/10.1080/02615479.2020.1730316

Abstract

As a social work lecturer I have, over the years, developed strong links with service-user/survivor groups in an effort to contribute to a more context-focused and democratic approach to mental health education and practice. User narratives of psychiatric survival have been central in organizing resistance toward dominant constructions of ‘mental illness’. Within education, user narratives have created spaces for co-production with a transformative potential, as traditionally silenced voices can be heard and affirmed. However, recent debates suggest that such narratives are often used by mental health and educational systems to promote their own agendas. In this context, user narratives are no longer considered a transformative act of co-production or resistance. They are a commodity servicing primarily the interests of these systems. This paper adds to these debates through a self-reflexive discussion on my experience of including user/survivor narratives in Irish social work education, as user narratives remain insufficiently critiqued in this context. I consider the significance of power operations in the contexts where narratives are shared and heard and argue for the need to honour what has been achieved while problematizing what may be lost through the inclusion of service-user narratives in social work education.

iv)  Deegan, P. (2020)  The journey to use medication optimally to support recovery.  Psychiatric Services. 71(4)  401-402.

Building upon her previous work in this field, Pat Deegan’s short piece discusses a number of challenges regarding the use of medication as a tool within personal recovery.  She writes about the potential shift from passive to active engagement with medicine before considering the challenge of redefining a sense of self and the construction of a ‘new normal’.  Deegan discusses the need to balance the pros and cons of taking medicine in order to make an informed choice about its use.  The way medicine is used over time, including decisions to reduce or stop using it altogether are further challenges in the process of personal recovery. Deegan also writes about the development of personal understanding and motivation about medication use within her analysis.  In keeping with her earlier writings, Deegan situates the above challenges within a process that is non-linear, dynamic and quintessentially individual; not all challenges are encountered and what one person considers challenging, another person may not.

v)  Richardson, K. and Barkham, M. (2020) Recovery from depression: a systematic review of perceptions and associated factors. Journal of Mental Health. 29(1) 103-115.

Abstract

Background: Despite extensive literature examining perceptions of recovery from severe mental illness, literature focusing on recovery from depression in adults is limited. Aim: Systematically review the existing literature investigating patients’ and clinicians’ perceptions of, and factors associated with, recovery from depression.

Method: Studies investigating perceptions of, and factors associated with, recovery from depression in adults were identified through database searches. Studies were assessed against inclusion criteria and quality rating checklists.

Results: Fourteen studies met the inclusion criteria. Recovery from depression is perceived as a complex, personal journey. The concept of normalised, biomedical definitions of recovery is not supported, with the construction of self and societal gender expectations identified by women as central to recovery. Recovery from depression was associated with higher levels of perceived social support and group memberships. A range of factors are identified as influencing recovery. However, physicians and patients prioritise different factors assessing what is important in being ‘‘cured’’ from depression.

Conclusions: Recovery from depression is perceived by patients as a complex, personal process, influenced by a range of factors. However, greater understanding of clinicians’ perceptions of client recovery from depression is essential to inform clinical practice and influence future research.

vi)  Holttum, S. (2020) Research watch: what really helps recovery in relation to severe mental health difficulties?  Mental Health and Social Inclusion.  24(1) 6-12

Abstract

Purpose:  The purpose of this paper is to examine three recent papers on mental health services and how they support recovery following a diagnosis of a severe mental health condition.

Design/methodology/approach:  A search was carried out for recent papers on mental health and recovery. The author selected three papers that seemed to advance understanding of not only whether, but also how recovery of a meaningful life may be best supported in mental health services

Findings:  One paper suggested how staff were able to support service users’ personal goals and focus on recovery in acute inpatient settings, and what got in the way. The author suggests practical ways to address the barriers. A second paper reported the testing of a new model for supporting staff in primary and secondary care to work together so that service users with a diagnosis of bipolar or schizophrenia were better supported to work towards valued goals. A third paper reviewed 40 studies of how people can experience positive change after a first diagnosis of psychosis, and how change happened.

Originality/value:  By studying the issues in detail, all three papers show how improved support for recovery and inclusion can be implemented against the backdrop of many years of service shortcomings.

vii)  Milton, D., Ridout, S., Kourti, M., Loomes, G. and Martin, N. (2019), A critical reflection on the development of the Participatory Autism Research Collective (PARC). Tizard Learning Disability Review. 24(2) 82-89

Abstract

Purpose:  The Participatory Autism Research Collective (PARC) was initially set up with the purpose of bringing autistic people, including scholars and activists (but not exclusively), together with early career researchers and practitioners who work with autistic people, with the aim being to build a community where those who wished to see more significant involvement of autistic people in autism research could share knowledge and expertise. This paper aims to discuss this issue.

Design/methodology/approach:  This paper explores the development of the PARC network, reflecting upon its activities and ethos within current higher education practices and structures.

Findings:  In supporting autistic individuals in their attempts to establish themselves within academic systems that may not always be considerate or accommodating, the existence of PARC creates a structure with which autistic people can influence social change. PARC serves as a network of support, strengthening the presence of autistic scholars in academia. It also provides a structure through which autistic people are able to demonstrate helpful practices with which to engage more broadly.

Originality/value:  The PARC network is the first autistic-led venture of its kind in the UK to have a sustained impact. PARC is growing to become an important element in the field of autism studies both by supporting emerging autistic academics and by promoting ethical and participatory research methods and practices.

Other News

i)  Out of the University of Nottingham, Dr Fiona Ng writes about current research with mental health recovery stories:

NEON (Narrative Experiences Online) is a new interactive website which provides online access to mental health recovery stories. We have collected hundreds of stories from around the world, in text, video and audio form, and preliminary evidence suggests that these stories can help people feel connected to others including the storyteller.

We are now starting three online trials of this website, and looking to recruit people with experience of psychosis, other kinds of mental health problems, and informal carers. People can find out more and sign up for free at www.recoverystories.uk.  

  • These trials don’t require any face to face contact
  • There is no need to visit the health service
  • People can take part from home, purely online
  • Usage is self-guided, done any time – people can use it as little or as much as they want

Would you help us to promote the www.recoverystories.uk website through your networks? You can use any of the publicity materials available at www.researchintorecovery.com/neontrials/promotion or just tweet:

Can real-life mental health recovery stories help you with your own mental health? Access hundreds of recovery stories in the NEON Trial. Help researchers @InstituteMH understand the benefits of accessing other people’s recovery narratives. See recoverystories.uk

If you would like printed promotional materials (e.g. posters, postcards) do let us know (neon@nottingham.ac.uk), and many thanks for your help.

ii)  Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. 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 2020

Recovery Research Network eBULLETIN

April 2020

RRN Meetings

The 23rd meeting of the Recovery Research Network (RRN) was due to be hosted by Camden and Islington NHS Foundation Trust.  Due to the current developments with regard to Covid-19, this event has been cancelled.

The coronavirus pandemic is having unprecedented effects both nationally and internationally.  During this time of social distancing and self-isolation, remaining connected to our networks is important.  Please can we encourage our readership to continue to submit material to e-bulletin using the detail below.  As ever, comments are welcome from the readership about articles included in the ebulletins.

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.  Some advice about this is available herehere and here.  Information from the World Health Organisation is available here.

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/rrn

Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk

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 and Events 

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 almost certain that traditional face-face conferencing/events will not be taking place in their ‘traditional’ format, please check with the organisers.  It may be that alternative or innovative platforms are being utilised to deliver such events going forward.

Papers and Publications 

In addition to peer-reviewed literature and work of a purely academic nature, the ebulletin 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)  Gerino, E., Rollè, L., Sechi, C. and Brustia, P. (2017) Loneliness, resilience, mental health, and quality of life in old age: A structural equation model.  Frontiers in Psychology.  Nov 2017 Vol8  Article 2003.  Online:

https://www.frontiersin.org/articles/10.3389/fpsyg.2017.02003/full

Abstract

Objectives: In the scientific literature on aging, a recent core issue has been the role of individuals’ internal and external resources, which are considered intrinsically connected, in contributing synergistically to physical and psychological quality of life (QoL). The current study investigates the way in which psychological factors—such as, loneliness, resilience, and mental states, in terms of depression and anxiety symptoms—affect the perceived QoL among elderly individuals.

Method: Data from 290 elderly Italian participants were used to study the mediation effects of both mental health and resilience to elucidate the relationship between loneliness and psychophysical QoL.

Results: The best model we obtained supports the mediation effect of both resilience and mental health between loneliness and mental and physical QoL. These results highlight that loneliness influences mental and physical QoL via two pathways, with the impact of loneliness mediated by mental health and resilience dimensions.

Conclusions: The findings suggest the importance of the support that elderly people receive from social relationships. In terms of clinical interventions, the reduction of loneliness could be an important factor in primary prevention or the recovery process. A way to reduce levels of mental distress could be represented by the increasing of resilience and self-efficacy and reduction of loneliness dissatisfaction. A high degree of resiliency contributes to increasing perceived life quality at the physical and psychological levels, and at the same time, reducing anxiety and depressive symptoms.

ii)  Waddingham, R. (2020) COVID-19: How can we support each other (and ourselves)?“  Psychosis.  Online: https://doi.org/10.1080/17522439.2020.1759678

Abstract

The Chair of The National Hearing Voices Network (http://www.hearing-voices.org/HVN)

prepared this document, on behalf of the HVN Board, to provide some sources of information and support for its members, and others, during the Covid-19 pandemic. At the request of the journal Editor (also a member of the HVN Board), the document is published here, verbatim, for Psychosis readers around the world. Although targeted at people in the UK who hear voices or see visions, much of the information is potentially also relevant for other people, including mental health professionals. Like HVN, neither the journal nor ISPS endorse or recommend specific mental health services or practitioners. We recognise that different things are helpful for different people. The document is published merely to increase the range of options for people to choose from if they feel the need for additional support or information. All at HVN, Psychosis and ISPS wish readers a safe passage though the current stormy waters, which, despite all the fears and losses, are providing us all with opportunities to take care of one another like many of us have never experienced before.

iii)  Hardy, K. V., Dickens, C. E., Roach, E. L., Harrison, V., Desai, A., Flynn, L, Noordsy, D. L., Dauberman, J. and Adelsheim, S. (2020) Lived experience perspectives on reducing the duration of untreated psychosis: the impact of stigma on accessing treatment.  Psychosis.  Online:  https://doi.org/10.1080/17522439.2020.1754890

Abstract

Introduction: Prolonged duration of untreated psychosis (DUP) has long-term deleterious effects on outcomes. Research has focused on identifying factors contributing to prolonged DUP and initiatives to reduce the time it takes individuals to access treatment. Stigma may contribute to extended DUP, but there has been little exploration of the experience of stigma and its impact on accessing care.

Objectives: The aim of this study was to explore the impact of stigma on decisions to seek care from the perspective of individuals with lived experience of psychosis and their caregivers.

Methods: A survey, developed by a group consisting of individuals with lived experience of psychosis, and distributed online, was designed to elicit quantitative and qualitative data relating to the experience of accessing care at the onset of psychosis. Qualitative data were analysed using Thematic Analysis.

Results: 193 respondents completed the survey. Qualitative analysis yielded themes including “perception of stigma” and “outcomes associated with stigma”.

Conclusions: There is a need to address stigma at the outset of treatment, and wider dissemination of information about psychosis is necessary. Future research should address cultural differences in individuals’ experiences of psychosis, as well as the role siblings play in the care of affected individuals.

iv)  Holmes, E. A., O’Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., Ballard, C., Christensen, H., Cohen Silver, R., Everall, I., Ford, T., John, A., Kabir, T., King, K., Madan, I., Michie, S., Przybylski, A. K., Shafran, R., Sweeney, A., Worthman, C. M., Yardley, L., Cowan, K., Cope, C., Hotopf, M. and Bullmore, E. (2020) Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. Lancet Psychiatry.  Online:

https://doi.org/10.1016/S2215-0366(20)30168-1

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK’s world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.

v)  Hornstein, G. A., Robinson Putnam, E. and Branitsky, A.  (2020): How do hearing voices peer-support groups work? A three-phase model of transformation. Psychosis.  Online:

https://doi.org/10.1080/17522439.2020.1749876

Abstract

Despite decades of research and the development of many psychiatric medications, widespread suffering remains among people who hear voices. Hearing voices groups (HVGs) encourage an in-depth exploration of the meaning of voices and use peer support to develop coping strategies. Although HVGs continue to spread around the world, their effectiveness remains unknown and only a few studies have examined members’ experiences. To understand the mechanisms by which these groups operate, we recruited a diverse sample of 113 participants from across the US, who completed detailed qualitative questionnaires describing their voice-hearing histories, experiences in HVGs and changes in their lives outside the group. A subset also participated in follow-up interviews. A collaborative team of researchers and voice hearers used phenomenological, grounded theory and thematic analyses to identify a distinctive set of elements that make HVGs unique: in their style of interaction (non-judgmental, curious, reciprocal and unstructured dialogue among people regarded as equals, in a shared community); and in the content of meetings (welcoming multiple perspectives and exploring coping strategies in non-prescriptive ways, with a focus on expertise by experience). We propose a three-phase model to explain how these elements interact within HVGs to enable significant transformation to occur.

vi)  Empson, L. A. and Conus, P. (2020) Video ethnography: introducing a new tool from research to psychiatric practice?  Psychosis.  Online: https://doi.org/10.1080/17522439.2020.1745874

Abstract

Ongoing progress in psychiatric research calls for interdisciplinary approaches and use of novel methodologies. After discussing theoretical advantages of the use of video ethnography in psychiatric research in the context of urbanicity/psychosis studies, the present article explores the representations of first line practitioners regarding its use in psychiatric research and, by extrapolation, in general practice based on qualitative analysis of case-managers feedbacks. Video ethnography was found sufficiently acceptable and tolerable tool within our research cohort. Both patients and case managers were positive about assets provided by this approach. Nevertheless, more research is warranted to supplement reported results and conceptualize further implementation of video ethnography as a research tool. Further developments in this area may profit to psychiatric care beneficiaries by enabling a user inclusive approach and enriching therapists’ appreciation of the impact of psychotic symptoms on patient’s daily life. While the use of video ethnography in psychiatric research and practice with patients suffering from psychosis remains scarce, ever changing attitudes of the society towards self-exposure and availability of non-professional video recording material may further shape both research and clinical practice.

vii)  Bowen, A. L., Maguire, T. and Newman-Taylor, K. (2020) Do recovery outcome measures improve clinical practice? A linguistic analysis of the impact of the Hope, Agency and Opportunity measure in community mental health teams. Perspectives in Public Health. 140(2)  102-107

https://doi.org/10.1177%2F1757913919852121

Abstract

Aims:  Recovery approaches are identified as the overarching framework for improving mental health services for people with severe and enduring conditions. These approaches prioritise living well with long-term conditions, as evidenced by personal recovery outcomes. There is little research demonstrating how to support busy mental health teams, work in this way. This study assessed the impact of introducing a brief measure of recovery, the Hope, Agency and Opportunity (HAO), on the attitudes and behaviours of staff working in community mental health teams, to test whether routine use of such measures facilitates recovery-based practice.

Methods:  Linguistic analysis assumes that language is indicative of wider attitudes and behaviours. Anonymised clinical notes recorded by community mental health team clinicians were analysed for recovery and non-recovery language, over 30 months. This covered periods before, during and after the introduction of the recovery measure. We used a single-case design (N = 1 community mental health team) and hypothesised that clinicians would use recovery-focused language more frequently, and non-recovery-focused language less frequently, following the introduction of the measure, and that these changes would be maintained at 18-month follow-up.

Results:  Visual inspection of the data indicated that recovery-focused language increased following the introduction of the HAO, though this was not maintained at follow-up. This pattern was not supported by statistical analyses. No clear pattern of change was found for non-recovery-focused language.

Conclusions:  The introduction of a brief measure of recovery may have influenced staff attitudes and behaviours temporarily. Any longer-term impact is likely to depend on ongoing commitment to the use of the measure, without which staff language, attitudes and behaviours return to previous levels.

viii)   NSPCC (2020) What children are saying to Childline about coronavirus.  NSPCC.  Online:

https://learning.nspcc.org.uk/research-resources/2020/childline-briefing-coronavirus

From the author’s webpage:

Our briefing provides an overview of the main concerns that children and young people have been talking to Childline counsellors about during the coronavirus pandemic (COVID-19). Gaining an insight into these worries can help adults think about what support needs to be put in place for young people at this time.  Between 21 January 2020 and 8 April 2020, Childline delivered 2,209 counselling sessions to children and young people who expressed concerns about coronavirus. Issues discussed included: mental health, family relationships, schoolwork and bullying

ix)  The following three items are blogs.  The first is written by Andy Bell, Deputy Chief Executive at the Centre for Mental Health (available here).   Andy starts by reminding us that both mental health problems and Covid-19 do not discriminate; at least rhetorically.  Whilst there may be some grain of truth in such statements, a much deeper analysis (re)confirms that social and structural inequalities serve to construct a different reality for many.  A reality that is discriminatory, affecting disproportionally more people, families and communities who are already disadvantaged, on many levels.  Moreover, Andy points to the distinct possibility of even further disadvantage and injustice as Covid-19 joins the plethora of factors that contribute to the intersectionalities between Covid-19 and poor mental health.  Whilst we are in this together he adds, the inequalities that divide us are as great as ever.

x)  The second blog is written by Barney Cullum (available here).  Writing out of Mental Health Today, Barney draws attention to the injustices that are experienced by some people who find themselves detained within medium-secure mental health hospitals in England and Wales.  His blog draws upon the experience of ‘Adam’, an interviewee, who talks about his much longer incarceration in a secure unit for pleading ‘not guilty’, than a much shorter prison sentence had he pleaded ‘guilty’.  The concept of diagnostic overshadowing is introduced, which concerns the lasting impact of a person’s diagnosis rather than what they actually did.  Barney’s blog captures a very real sense of the multi-layered ambivalence that runs in parallel to the indeterminate nature of Adam’s experience.

xi)  Writing out of the National Survivor User Network (NSUN), the third blog, authored by Diana Rose, considers the paradox that is inherent in the government’s strategy to ‘Shield’ those people it considers to be (more) vulnerable.  Grounded in, although not exclusive to, personal experience Diana grapples with the contradiction that on the one hand she is receiving special attention due to the vulnerabilities brought about by her ‘underlying health conditions’, whilst on the other hand, those same health conditions are not receiving any attention due to the impositions brought about by Covid-19.  An insightful and informative read, available here.

Other News / Resources

i)  MHPRU survey: Impact of COVID-19 on mental health services and mental health service users#COVIDMentalHealth

Out of University College London, Prof. Alan Simpson draws attention to an important survey targeting people who work in mental health care in the UK in any sector or any speciality.  The survey is intended to:

… help us better understand how the COVID-19 pandemic is impacting on mental health services and the people who use these services, and what is being done to manage these impacts, both in the NHS and the voluntary sector. We appreciate this is a very busy period for you but believe this survey can quickly inform the national response to the pandemic.

It is being carried out by the NIHR Mental Health Policy Research Unit (MHPRU) for England, whose core team is based at University College London and Kings’ College London. We are independent university-based researchers, including many researchers with lived experience, who will be feeding back results from the study rapidly to policy makers, including the Department of Health and Social Care and NHS England, to study participants and to the wider public. The survey is intended for people who work in mental health care in the UK in any sector or any speciality.

We are also keen to interview people about interesting developments and innovations – please see this section on the survey if you would like to be interviewed.

The survey should take around 20 minutes to complete and the responses you provide are confidential. Full details about the survey can be found here: https://opinio.ucl.ac.uk/s?s=67377

Finally, we would like to take this opportunity to thank you for all your hard work in continuing to provide mental health care during these very challenging times.

Please click on the link below to take part in the survey. Please forward this email to colleagues that may be interested. Or see us on Twitter: @MentalHealthPRU #COVIDMentalHealth

https://opinio.ucl.ac.uk/s?s=67377

ii)  The British Association of Social Workers (BASW)

As with several other professional associations connected to mental health work, BASW include updates and guidance concerning Covid-19 on their website.  Please see here

In addition to the above, BASW have also issued information and support for Approved Mental Health Professionals, AMHP leads and Principal Social Workers on the role of Approved Mental Health Professionals during the Covid-19 Pandemic.  This is an important resource and can be found here

iii)  MadCovid  https://madcovid.com

On its ‘about’ page MadCovid states that:

MadCovid is a shared space for survivor / service user led projects and initiatives that started during the COVID-19 pandemic.

Please explore the above site to find a wealth of testimony and resources that intersect survivor / service user experience during the Covid-19 pandemic.

iv)  Centre for Mental Health

In its April 2020 update, the Centre for Mental Health (CMH) set out a range of useful links and information to support mental health equality through the Covid-19 pandemic. Please see the following link

CMH organise their work in this area across three domains, (1) supporting people and services, (2) a platform for lived experience and (3) research and analysis.  For more information, please see: Supporting mental health equality through the pandemic

v)  The Social Care Institute for Excellence (SCIE)

On their website, SCIE host a range of material that is relevant to social care provision at a time of Covid-19.  Please see the following link

vi)  Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. 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 2020

Recovery Research Network eBULLETIN

May 2020

RRN Meetings

The 23rd meeting of the Recovery Research Network (RRN) was due to be hosted by Camden and Islington NHS Foundation Trust.  Due to the current developments with regard to Covid-19, this event has been cancelled.

The coronavirus pandemic is having unprecedented effects both nationally and internationally.  During this time of social distancing and self-isolation, remaining connected to our networks is important.  Please can we encourage our readership to continue to submit material to e-bulletin using the detail below.  As ever, comments are welcome from the readership about articles included in the ebulletins.

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.  In this edition, we have included some examples at the end of the ebulletin.

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/rrn

Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk

  

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 and Events 

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 almost certain that traditional face-face conferencing/events will not be taking place in their ‘traditional’ format, please check with the organisers.  It may be that alternative or innovative platforms are being utilised to deliver such events going forward.

Papers and Publications 

In addition to peer-reviewed literature and work of a purely academic nature, the ebulletin 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)  Moran, G.S., Kalha, J., Mueller-Stierlin, A.S., Kilian, R., Krumm, S, Slade, M., Ashleigh, C., Mahlke, C., Nixdorf, R., Basangwa, D., Nakku, J., Mpango, R., Ryan, G., Shamba, D., Ramesh, M., Ngakongwa, F., Grayzman, A., Pathare, S., Mayer, B. and Puschner, B. (2020)  Peer support for people with severe mental illness versus usual care in high-, middle- and low-income countries: study protocol for a pragmatic, multicentre, randomised controlled trial (UPSIDES-RCT)  Trials.  21:371.  1-15

https://doi.org/10.1186/s13063-020-4177-7

Abstract

Background: Peer support is an established intervention involving a person recovering from mental illness supporting others with mental illness. Peer support is an under-used resource in global mental health. Building upon comprehensive formative research, this study will rigorously evaluate the impact of peer support at multiple levels, including service user outcomes (psychosocial and clinical), peer support worker outcomes (work role and empowerment), service outcomes (cost-effectiveness and return on investment), and implementation outcomes (adoption, sustainability and organisational change).

Methods: UPSIDES-RCT is a pragmatic, parallel-group, multicentre, randomised controlled trial assessing the effectiveness of using peer support in developing empowering mental health services (UPSIDES) at four measurement points over 1 year (baseline, 4-, 8- and 12-month follow-up), with embedded process evaluation and cost-effectiveness analysis. Research will take place in a range of high-, middle- and low-income countries (Germany, UK, Israel, India, Uganda and Tanzania). The primary outcome is social inclusion of service users with severe mental illness (N = 558; N = 93 per site) at 8-month follow-up, measured with the Social Inclusion Scale. Secondary outcomes include empowerment (using the Empowerment Scale), hope (using the HOPE scale), recovery (using Stages of Recovery) and health and social functioning (using the Health of the Nations Outcome Scales). Mixed-methods process evaluation will investigate mediators and moderators of effect and the implementation experiences of four UPSIDES stakeholder groups (service users, peer support workers, mental health workers and policy makers). A cost-effectiveness analysis examining cost-utility and health budget impact will estimate the value for money of UPSIDES peer support.

Discussion: The UPSIDES-RCT will explore the essential components necessary to create a peer support model in mental health care, while providing the evidence required to sustain and eventually scale-up the intervention in different cultural, organisational and resource settings. By actively involving and empowering service users, UPSIDES will move mental health systems toward a recovery orientation, emphasising user-centredness, community participation and the realisation of mental health as a human right.

ii)  Milner, K., Crawford, P., Edgley, A., Hare-Duke, L. and Slade, M. (2020)  The experiences of spirituality among adults with mental health difficulties: a qualitative systematic review.  Epidemiology and Psychiatric Sciences.  29  e34 1-10

https://doi.org/10.1017/S2045796019000234

Abstract

Aims. Despite an increasing awareness of the importance of spirituality in mental health contexts, a ‘religiosity gap’ exists in the difference in the value placed on spirituality and religion by professionals compared with service users. This may be due to a lack of understanding about the complex ways people connect with spirituality within contemporary society and mental health contexts, and can result in people’s spiritual needs being neglected, dismissed or pathologised within clinical practice. The aim of this qualitative systematic review is to characterise the experiences of spirituality among adults with mental health difficulties in published qualitative research.

Methods. An electronic search of seven databases was conducted along with forward and backward citation searching, expert consultation and hand-searching of journals. Thirty- eight studies were included from 4944 reviewed papers. The review protocol was pre-registered (PROSPERO:CRD42017080566).

Results. A thematic synthesis identified six key themes: Meaning-making (sub-themes: Multiple explanations; Developmental journey; Destiny v. autonomy), Identity, Service-provision, Talk about it, Interaction with symptoms (sub-themes: Interactive meaning-making; Spiritual disruption) and Coping (sub-themes: Spiritual practices; Spiritual relationship; Spiritual struggles; Preventing suicide), giving the acronym MISTIC.

Conclusions. This qualitative systematic review provides evidence of the significant role spirituality plays in the lives of many people who experience mental health difficulties. It indicates the importance of mental health professionals being aware of and prepared to support the spiritual dimension of people using services. The production of a theory-based framework can inform efforts by health providers to understand and address people’s spiritual needs as part of an integrated holistic approach towards care.

iii)  Charles, A., Thompson, D., Nixdorf, R., Ryan, G., Shamba, D., Kalha, J., Moran, G., Hiltensperger, R., Mahlke, C., Puschner, B., Repper, J., Slade, M. and Mpango, R. (2020) Typology of modifications to peer support work for adults with mental health problems: systematic review.  British Journal of Psychiatry. 216(6)  301-307

https://doi.org/10.1192/bjp.2019.264

Abstract

Background:  Peer support work roles are being implemented internationally, and increasingly in lower-resource settings. However, there is no framework to inform what types of modifications are needed to address local contextual and cultural aspects.

Aims:  To conduct a systematic review identifying a typology of modifications to peer support work for adults with mental health problems.

Method:  We systematically reviewed the peer support literature following PRISMA guidelines for systematic reviews (registered on PROSPERO (International Prospective Register of Systematic Reviews) on 24 July 2018: CRD42018094832). All study designs were eligible and studies were selected according to the stated eligibility criteria and analysed with standardised critical appraisal tools. A narrative synthesis was conducted to identify types of, and rationales for modifications.

Results:  A total of 15 300 unique studies were identified, from which 39 studies were included with only one from a low-resource setting. Six types of modifications were identified: role expectations; initial training; type of contact; role extension; workplace support for peer support workers; and recruitment. Five rationales for modifications were identified: to provide best possible peer support; to best meet service user needs; to meet organisational needs, to maximise role clarity; and to address socioeconomic issues.

Conclusions:  Peer support work is modified in both pre-planned and unplanned ways when implemented. Considering each identified modification as a candidate change will lead to a more systematic consideration of whether and how to modify peer support in different settings. Future evaluative research of modifiable versus non-modifiable components of peer support work is needed to understand the modifications needed for implementation among different mental health systems and cultural settings.

iv)  Karban, K. Sparkes, T., Benson, S., Kilyon, J. and Lawrence, J.  (2020)  Accounting for social perspectives: an exploratory study of approved mental health professional practice.  British Journal of Social Work.  bcca037

https://doi.org/10.1093/bjsw/bcaa037

Abstract

The role of the Approved Mental Health Professional (AMHP) in England and Wales was intended to provide a social perspective as a ‘counterweight’ to a medical perspective when compulsory detention to psychiatric care is being considered as part of an assessment under the 1983 Mental Health Act (MHA). However, with few exceptions, there is relatively little written about AMHPs’ understandings of a social perspective and their experiences of applying this in practice. This article will discuss the findings of a small-scale qualitative study involving twelve AMHPs, highlighting the different accounts of how social perspectives may be understood and implemented. Some of the tensions that may arise when undertaking MHA assessments and the challenges of implementing a social perspective in practice will be considered. The conclusion highlights the complexity of AMHP practice and the diverse ways in which AMHPs attempt to apply a social perspective. It is clear, however, that an understanding of social perspectives is firmly embedded in the practice of the AMHPs involved in this study.

v)  Nappo, N. and Fiorillo, D. (2020) Volunteering and self-perceived individual health: cross-country evidence from nine European countries.  International Journal of Social Economics.  47(3) 285-314

Abstract

Purpose:  The paper studies the simultaneous effect of formal and informal volunteering on self-perceived individual health across nine European countries while controlling, among other things, for socioeconomic characteristics and social and cultural participation.

Design/methodology/approach:  This paper employs the 2006 wave of the EU-SILC dataset for estimating recursive trivariate probit models using instrumental variables.

Findings:  The paper finds that although formal volunteering and informal volunteering are correlated with each other, they have different impacts on health. Formal volunteering is never correlated with higher self-perceived individual health except in the Netherlands. In contrast, informal volunteering is related to lower self-perceived individual health in Austria, Finland, France, the Netherlands, Spain, and Italy.

Research limitations/implications:  The first limitation concerns the absence of other measures of volunteering, such as volunteering hours that are not available in the employed dataset. The second limitation is that the dataset collection on social and cultural variables in EU-SILC is cross-sectional while the optimal dataset should be a panel data. The third limitation is that instrumental variables are observed in the same year of declaring self-perceived individual health while the optimal timing would be at least one year before.

Practical implications:  Findings of the paper show that formal volunteering has no effect on self-perceived individual health while informal volunteering has negative consequences.

Social implications:  Volunteering is performed because of an individual decision and could be considered a consequence of how social responsibilities are distributed within countries. Our results show that informal volunteering has a negative effect on health; this is likely to depend on how people manage stress coming from performing this altruistic activity. It is likely that a more cautious distribution of social responsibilities could prevent the negative effects of informal volunteering on health.

Originality/value:  The originality of the present paper is in simultaneously examining the impact of formal and informal volunteering on self-perceived individual health. Furthermore, most of the existing studies on formal volunteering and health focus on a single country; this paper compares nine European countries characterized by different social, cultural, economic, and institutional features. Finally, the paper addresses the issue of reverse causation.

vi)  Gibbs, M., Griffiths, M. and Dilks, S. (2020) A grounded theory of how service users experience and make use of formulation in therapy for psychosis.  Psychosis.  Online:

https://doi.org/10.1080/17522439.2020.1742198

Abstract

Objectives: This study set out to explore service user experiences of formulation during individual therapy for psychosis, and develop a grounded theory of the processes involved.

Method: Semi-structured interviews were undertaken with 11 service users and two clinical psychologists with experience of formulation in therapy for psychosis.

Design: Grounded theory was used to examine the qualitative data collected.

Results: An emerging model was constructed to conceptualise the processes that occur during the sharing of a formulation. “Linking previous experiences with current ways of being” and “Building the therapeutic relationship” emerged as core, reciprocally influential processes. “Making use of new understandings” was also identified as an important process.

Conclusions: The findings suggest that formulations should be developed collaboratively and progressively with service users, and that care should be given to the emotions that arise as a result. Further research is necessary to elaborate our understanding of formulation given the importance placed on it in United Kingdom clinical psychology.

vii)  From the author of the critically acclaimed 2018 book Start, Graham Morgan writes in Mental Health Knowledgeabout his experience of living under a compulsory treatment order.  See:

Morgan, G. (2020) Winning or Losing?  The irreconcilable realities of life under a compulsory treatment order.  Mental Health Knowledge.  20th January 2020.  Online here

Other News / Resources

i)  Released on the 19th May, and along with over 30 organisations, YoungMinds issued an open letter to the Government to encourage them to take necessary measures to mitigate the impact of Covid-19 upon the mental health of children and young people.  The letter can be accessed via the following link:

https://youngminds.org.uk/about-us/media-centre/press-releases/our-open-letter-to-government-on-young-peoples-mental-health-during-lockdown/

ii)  Dr Juliana Onwumere, senior lecturer and consultant clinical psychologist, writes out of Kings College London to encourage participation in a new survey exploring carers’ experiences during covid-19.  More information and the survey itself can be found here:

https://kcliop.eu.qualtrics.com/jfe/form/SV_2bFquevHV5up8PP

Note:  Please click the blue button at the bottom left to access the next page.

iii)  Recovery stories

Mike Slade’s Narrative Experiences Online (NEON) study has launched www.recoverystories.uk a new interactive website which provides online access to mental health recovery stories. We have collected hundreds of stories from around the world, in text, video and audio form, and preliminary evidence suggests that these stories can help people feel connected to others including the storyteller. We are now running three trials using this website, the largest of which is called the NEON Trial.

RRN members can help us in two ways:

1.     Recruitment and participation

The NEON Trial is currently recruiting people who:

  • Have experienced psychosis or psychosis-like experiences in the past 5 years
  • Have experienced mental health distress in the past 6 months
  • Live in England
  • Aged over 18 years
  • Have access to the internet
  • Can provide informed consentIf you or someone else you know meet the inclusion criteria, more information and eligibility checking can be accessed here www.recoverystories.ukWe would also like to recruit people who have cared for others experiencing mental health problems.

2.     Promotion of the Trial

Would you help us to promote the NEON Trial through your networks? You can use any of the publicity materials available at www.researchintorecovery.com/neontrials/promotion or just tweet:

Can real-life mental health recovery stories help you with your own mental health? Access hundreds of recovery stories in the NEON Trial. Help researchers @InstituteMH understand the benefits of accessing other people’s recovery narratives. See recoverystories.uk

Follow us on Twitter (@neontrials), Instagram (@neontrials) and Facebook today!

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

ii)  Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. 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 2020

Recovery Research Network eBULLETIN

June 2020

RRN Meetings

The 23rd meeting of the Recovery Research Network (RRN) was due to be hosted by Camden and Islington NHS Foundation Trust.  Due to the current developments with regard to Covid-19, this event has been cancelled.

The coronavirus pandemic is having unprecedented effects both nationally and internationally.  During this time of social distancing and self-isolation, remaining connected to our networks is important.  Please can we encourage our readership to continue to submit material to e-bulletin using the detail below.  As ever, comments are welcome from the readership about articles included in the ebulletins.

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.  In this edition, we have included some examples at the end of the ebulletin.

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/rrn  If you would like to leave the RRN and have your details removed from our database, please email:  researchintorecovery@nottingham.ac.uk

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 and Events 

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 almost certain that traditional face-face conferencing/events will not be taking place in their ‘traditional’ format, certainly in the immediate future, please check with the organisers.  It may be that alternative or innovative platforms are being utilised to deliver such events going forward.

Looking ahead, the University of South-Eastern Norway are hosting a rescheduled seminar with the title: The Politics of Recovery: controversy and co-option in the era of austerity.  Originally scheduled for later this month, the new date will be:  16th June 2021.  For more information please click here.

Papers and Publications 

In addition to peer-reviewed literature and work of a purely academic nature, the ebulletin 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)  Mazor, Y., Gelkopf, M., and Roe, D. (2020). Posttraumatic growth in psychosis: Challenges to the assumptive world. Psychological Trauma: Theory, Research, Practice, and Policy, 12(1) 3–10.

https://doi.org/10.1037/tra0000443

Abstract

Objective: Research has shown high rates of exposure to trauma among people with serious mental illness (SMI). In addition, studies suggest that psychosis and mental illness-related experiences can be extremely traumatic and may lead to significant symptomatology. Indeed, overwhelming traumatic experiences may shatter people’s core beliefs about themselves, the world, and others. However, coping with adversity may also foster a unique outcome; namely posttraumatic growth (PTG). The experience of PTG is contingent on people’s ability to re-examine their core beliefs after trauma. Little is known about whether and how such core-belief re-examination is related to PTG among people with SMI and psychosis, specifically people who experience positive, negative, and general psychopathological symptoms (PANSS).

Method: For the purpose of this study, 121 participants were recruited from community mental health rehabilitation centers and administered trauma- and psychiatry-oriented questionnaires.

Results: In addition to high levels of traumatic exposure, we observed that people with SMI can experience PTG, which is mediated by re-examination of core beliefs, contingent on low levels of illness-related psychopathological symptoms.

Conclusion: The ability to challenge one’s world assumptions and re-establish a functional set of assumptions is critical to the development of PTG. In light of the high levels of posttraumatic comorbidity found in this population, psychiatric facilities should place greater emphasis on treating the traumatic aspects of SMI and on teaching and practicing effective strategies to re-evaluate life after trauma.

ii)  Diers, L., Rydell, S.A., Watts, A. and Neumark-Sztainer, D.  (2020) A yoga-based therapy program designed to improve body image among an outpatient eating disordered population: program description and results from a mixed-methods pilot study. Eating

Disorders.  Online, 18th May 2020

https://doi.org/10.1080/10640266.2020.1740912

Abstract

Poor body image is a critical barrier to eating disorder recovery. This pilot project was designed as a feasibility study to examine a novel group-based, therapeutic yoga and body image program (YBI) for addressing negative body image in those clinically diagnosed with an eating disorder (anorexia, bulimia nervosa, and other specified feeding or eating disorder) receiving outpatient level treatment at an eating disorder treatment center located in Minneapolis–St. Paul, Minnesota. Self-administered questionnaires were completed by 67 participants at the beginning and end of the 8-week series, to better understand the acceptability of the YBI program and its potential effects on body image and self-worth during outpatient eating disorder treatment. Quantitative survey questions assessed participants’ body image concerns, while open-ended questions probed participants’ experiences and the perceived impact of the yoga program on their body image. After completion of the yoga program, mean item scores on the body image concern survey improved: increases ranged from 0.3 to 0.8 points on a 5-point scale. In open-ended questions, participants described many positive changes to their body image. Participants reported that the yoga program improved their self-acceptance, self-awareness, confidence, emotional and physical strength, and was a positive form of release. Participants also discussed physical and emotional challenges of the yoga program and how they contributed to self-judgment, vulnerability, and confrontation of uncomfortable feelings. The results of this pilot study are promising and warrant consideration of more rigorous study designs to explore the potential of a body image specific therapeutic yoga program to aid those in eating disorder treatment to improve body image disturbances.

iii)  Brinchmann, B., Widding-Havneraas, T., Modini, M., Rinaldi, M., Moe, C.F.,

McDaid, D., Park, A-L., Killackey, E., Harvey, S.B., Mykletun, A.,  (2020)  A meta-regression

of the impact of policy on the efficacy of individual placement and support.  Acta Psychiatrica Scandinavica. 141(3)  206–220

Abstract

Objective: Individual placement and support (IPS) has shown consistently better outcomes on competitive employment for patients with severe mental illness than traditional vocational rehabilitation. The evidence for efficacy originates from few countries, and generalization to different countries has been questioned. This has delayed implementation of IPS and led to requests for country-specific RCTs. This meta‐analysis examines if evidence for IPS efficacy can be generalized between rather different countries.

Methods: A systematic search was conducted according to PRISMA guidelines to identify RCTs. Overall efficacy was established by meta‐analysis. The generalizability of IPS efficacy between countries was analysed by random‐effects meta‐regression, employing country‐ and date‐specific contextual data obtained from the OECD and the World Bank.

Results:  The systematic review identified 27 RCTs. Employment rates are more than doubled in IPS compared with standard vocational rehabilitation (RR 2.07 95% CI 1.82–2.35). The efficacy of IPS was marginally moderated by strong legal protection against dismissals. It was not moderated by regulation of temporary employment, generosity of disability benefits, type of integration policies, GDP, unemployment rate or employment rate for those with low education.

Conclusions:  The evidence for efficacy of IPS is very strong. The efficacy of IPS can be generalized between countries.

iv)  Kopelovich, S.L., Monroe‑DeVita, M., Buck, B.E., Brenner, C., Moser, L., Jarskog, L.F., Harker, S. and Chwastiak, L.A.  (2020)  Community mental health care delivery during the COVID‑19 pandemic: practical strategies for improving care for people

with serious mental illness.  Community Mental Health Journal. Online 19th June 2020

https://doi.org/10.1007/s10597-020-00662-z

Abstract

The COVID-19 pandemic has presented a formidable challenge to care continuity for community mental health clients with serious mental illness and for providers who have had to quickly pivot the modes of delivering critical services. Despite these challenges, many of the changes implemented during the pandemic can and should be maintained. These include offering a spectrum of options for remote and in-person care, greater integration of behavioural and physical healthcare, prevention of viral exposure, increased collaborative decision-making related to long-acting injectable and clozapine use, modifying safety plans and psychiatric advance directives to include new technologies and broader support systems, leveraging natural supports, and integration of digital health interventions. This paper represents the authors’ collaborative attempt to both reflect the changes to clinical practice we have observed in CMHCs across the US during this pandemic and to suggest how these changes can align with best practices identified in the empirical literature.

Whilst not explicit in the abstract, (although evident in the key words) the following article specifically targets mental health recovery as an example of a values-based approach within human service organisations (HSOs).  A case is made for the relevance of leaders with social work training to the success of HSOs

v)  Choy-Brown, M., Stanhope, V., Wackstein, N. and Cole, H.D. (2020)  Do Social Workers lead differently?  Examining associations with leadership style and organisational factors.  Human Service Organisations: Management, Leadership and Governance.  Online, 7th June 2020.

https://doi.org/10.1080/23303131.2020.1767744

Abstract

What training leaders need to successfully shepherd high quality human service delivery remains less understood. This study aims to evaluate associations between social work training, leadership style, and organizational factors. Participants included leaders (N = 49) and employees (N = 224) working in 10 behavioural health organizations who completed a survey.  Hierarchical linear models were used to analyse multilevel associations. Analyses indicated that leaders with social work training were rated higher in transformational leadership and organizational factors (e.g., lesser stress) on average within both samples. Findings begin an empirical argument for the value of social work leaders for the success of human service organizations.

Other News / Resources

i)  Dr Juliana Onwumere, senior lecturer and consultant clinical psychologist, writes out of Kings College London to encourage participation in a new survey exploring carers’ experiences during covid-19.  More information and the survey itself can be found here:

https://kcliop.eu.qualtrics.com/jfe/form/SV_2bFquevHV5up8PP

Note:  When following the above link, please click the blue button at the bottom left to access the next page.

ii)  Recovery stories

Mike Slade’s Narrative Experiences Online (NEON) study has launched www.recoverystories.uk a new interactive website which provides online access to mental health recovery stories. We have collected hundreds of stories from around the world, in text, video and audio form, and preliminary evidence suggests that these stories can help people feel connected to others including the storyteller. We are now running three trials using this website, the largest of which is called the NEON Trial.

RRN members can help us in two ways:

1.     Recruitment and participation

The NEON Trial is currently recruiting people who:

  • Have experienced psychosis or psychosis-like experiences in the past 5 years
  • Have experienced mental health distress in the past 6 months
  • Live in England
  • Aged over 18 years
  • Have access to the internet
  • Can provide informed consentIf you or someone else you know meet the inclusion criteria, more information and eligibility checking can be accessed here www.recoverystories.ukWe would also like to recruit people who have cared for others experiencing mental health problems.

2.     Promotion of the Trial

Would you help us to promote the NEON Trial through your networks? You can use any of the publicity materials available at www.researchintorecovery.com/neontrials/promotion or just tweet:

Can real-life mental health recovery stories help you with your own mental health? Access hundreds of recovery stories in the NEON Trial. Help researchers @InstituteMH understand the benefits of accessing other people’s recovery narratives. See recoverystories.uk

Follow us on Twitter (@neontrials), Instagram (@neontrials) and Facebook today!

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 ebulletin. 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 2020

Recovery Research Network eBULLETIN 

July 2020 

RRN Meetings 

The 23rd meeting of the Recovery Research Network (RRN) was due to be hosted by Camden and Islington NHS Foundation Trust.  Due to the current developments with regard to Covid-19, this event has been cancelled.

The coronavirus pandemic is having unprecedented effects both nationally and internationally.  During this time of social distancing and self-isolation, remaining connected to our networks is important.  Please can we encourage our readership to continue to submit material to e-bulletin using the detail below.  As ever, comments are welcome from the readership about articles included in the ebulletins.

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.  In this edition, we have included some examples at the end of the ebulletin.

 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/rrn  If you would like to leave the RRN and have your details removed from our database, please email:  researchintorecovery@nottingham.ac.uk

 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 and Events  

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 almost certain that traditional face-face conferencing/events will not be taking place in their ‘traditional’ format, certainly in the immediate future, please check with the organisers.  It may be that alternative or innovative platforms are being utilised to deliver such events going forward.

Looking ahead, the University of South-Eastern Norway are hosting a rescheduled seminar with the title: The Politics of Recovery: controversy and co-option in the era of austerity.  Originally scheduled for later this month, the new date will be:  16th June 2021.  For more information please click here.

 Papers and Publications  

In addition to peer-reviewed literature and work of a purely academic nature, the ebulletin 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)  Cheli, S., Cavalletti, V. and Petrocchi, N. (2020): An online compassion-focused crisis intervention during COVID-19 lockdown: a cases series on patients at high risk for psychosis, Psychosis.  Online:

https://doi.org/10.1080/17522439.2020.1786148

Abstract 

Aim: To pilot-test the effectiveness of an online compassion-focused crisis intervention for persons who were diagnosed with brief psychotic disorder and were still at high risk for a psychotic episode at the Italian announcement of lockdown on March 9th, 2020.

Methods: Six patients who, at the moment of the lockdown, were treated through different psychotherapy approaches and antipsychotic drugs for a first brief psychotic episode accessed a 4-week online compassion-focused intervention comprising a weekly individual video-call session, and an open messenger service with audio-recorded compassion-focused practices. Primary outcome (general symptomatology) was assessed one week before and at the end of the intervention. Secondary outcomes (depression, anxiety and stress symptoms) were assessed daily during the intervention, for a total of 28 days.

Results: Five of six participants demonstrated a reliable change in both primary and secondary outcomes, and no one reported acute psychotic episodes during the lockdown. All participants reported a stable or increased working alliance.

Conclusion: These data provide the preliminary feasibility and effectiveness of a brief online compassion-focused crisis intervention for patients diagnosed with a brief psychotic disorder, in situations where the telepsychology is offered, unplanned, as the only possible treatment option.

ii)  Moreno, C., Wykes, T., Galderisi, S., Nordentoft, M., Crossley, N., Jones, N., Cannon, M., Correll, C.U., Byrne, L., Carr, S., Chen, E.Y.H., Gorwood, P., Johnson, S., Kärkkäinen, H., Krystal, J.H., Lee, J., Lieberman, J., López-Jaramillo, C., Männikkö, M., Phillips, M.R., Uchida, H., Vieta, E., Vita, A. and Arango, C. (2020) How mental health care should change as a consequence of the COVID-19 pandemic.  The Lancet.  July 16 2020. Online:

https://doi.org/10.1016/S2215-0366(20)30307-2

Abstract 

The unpredictability and uncertainty of the COVID-19 pandemic; the associated lockdowns, physical distancing, and other containment strategies; and the resulting economic breakdown could increase the risk of mental health problems and exacerbate health inequalities. Preliminary findings suggest adverse mental health effects in previously healthy people and especially in people with pre-existing mental health disorders. Despite the heterogeneity of worldwide health systems, efforts have been made to adapt the delivery of mental health care to the demands of COVID-19. Mental health concerns have been addressed via the public mental health response and by adapting mental health services, mostly focusing on infection control, modifying access to diagnosis and treatment, ensuring continuity of care for mental health service users, and paying attention to new cases of mental ill health and populations at high risk of mental health problems. Sustainable adaptations of delivery systems for mental health care should be developed by experts, clinicians, and service users, and should be specifically designed to mitigate disparities in health-care provision. Thorough and continuous assessment of health and service-use outcomes in mental health clinical practice will be crucial for defining which practices should be further developed and which discontinued. For this Position Paper, an international group of clinicians, mental health experts, and users of mental health services has come together to reflect on the challenges for mental health that COVID-19 poses. The interconnectedness of the world made society vulnerable to this infection, but it also provides the infrastructure to address previous system failings by disseminating good practices that can result in sustained, efficient, and equitable delivery of mental health-care delivery. Thus, the COVID-19 pandemic could be an opportunity to improve mental health services

iii)  Rennick-Egglestone, S., Elliott, R., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, K., Llewellyn-Beardsley, J., Ng, F., Yeo, C., Roe, J., Hui, A.,  van der Krieke, L., Walcott, R. and Slade, M. (2020)  Impact of receiving recorded mental health recovery narratives on quality of life in people experiencing psychosis, people experiencing other mental health problems and for informal carers: Narrative Experiences Online (NEON) study protocol for three randomised controlled trials.  Trials 21, 661 (2020). Online: https://doi.org/10.1186/s13063-020-04428-6

Abstract 

Background: Mental health recovery narratives have been defined as 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 strengths, successes or survival. They are readily available in invariant recorded form, including text, audio or video. Previous studies have provided evidence that receiving recorded recovery narratives can provide benefits to recipients. This protocol describes three pragmatic trials that will be conducted by the Narrative Experiences Online (NEON) study using the NEON Intervention, a web application that delivers recorded recovery narratives to its users. The aim of the NEON Trial is to understand whether receiving online recorded recovery narratives through the NEON Intervention benefits people with experience of psychosis. The aim of the NEON-O and NEON-C trials is to evaluate the feasibility of conducting a definitive trial on the use of the NEON Intervention with people experiencing non-psychosis mental health problems and those who care for others experiencing mental health problems respectively.

Methods: The NEON Trial will recruit 683 participants with experience of psychosis. The NEON-O Trial will recruit at least 100 participants with experience of non-psychosis mental health problems. The NEON-C Trial will recruit at least 100 participants with experience of caring for others who have experienced mental health problems. In all three trials, participants will be randomly allocated into one of two arms. Intervention arm participants will receive treatment as usual plus immediate access to the NEON Intervention for 1 year. Control arm participants will receive treatment as usual plus access to the NEON Intervention after 1 year. All participants will complete demographics and outcome measures at baseline, 1 week, 12 weeks and 52 weeks. For the NEON Trial, the primary outcome measure is the Manchester Short Assessment of Quality of Life at 52 weeks, and secondary outcome measures are the CORE-10, Herth Hope Index, Mental Health Confidence Scale and Meaning in Life Questionnaire. A cost-effectiveness analysis will be conducted using data collected through the EQ-5D-5 L and the Client Service Receipt Inventory.

Discussion: NEON Trial analyses will establish both effectiveness and cost-effectiveness of the NEON Intervention for people with experience of psychosis, and hence inform future clinical recommendations for this population.

iv)  Barrenger, S.L., Maurer, K., Moore, K.L. and Hong, Inhwa.  (2020)  Mental health recovery: peer specialists with mental health and incarceration experiences.  American Journal of Orthopsychiatry 90(4) 479-488.

Abstract 

Mental health recovery has not been examined widely in individuals with mental illnesses re-entering the community from correctional settings. An important component of mental health recovery is engaging in work and many with lived mental health experiences become peer support specialists, yet little is known how this process unfolds for individuals who also have incarceration histories. Using life history phenomenological interviewing, this study investigates recovery pathways for peer support specialists with incarceration histories. Findings show that experiences of hope, connectedness, identity, meaningfulness, and empowerment were evident in individuals’ recovery pathways of activating change, getting into recovery, integrating past and present, and living recovery every day. Notably, establishing a peer identity and drawing on past experiences were particularly salient. Training and working as a peer supported the recovery process through experiencing hope, facilitating connections, and witnessing disclosure. These findings can be applied to recovery-oriented services for those with experiences of mental illness and incarceration.

v)  Chan, S. and Weich, S. (2020) Mental well-being and recovery in serious mental illness: associations between mental well-being and functional status in the Health Survey for England 2014.  BJPsych Open 6(4) 1-7.  Online:

https://doi.org/10.1192/bjo.2020.46

Abstract 

Background:  Mental illness and mental well-being are independent but correlated dimensions of mental health. Both are associated with social functioning (in opposite directions), but it is not known whether they modify the effects of one another. New treatment targets might emerge if improving mental well-being in people with serious mental illness improved functional outcomes independent of clinical status.

Aims:  To describe associations between mental well-being and functioning in people classified according to mental illness status.

Method:  Cross-sectional data from 5485 respondents to the Health Survey for England 2014 were analysed. Mental illness status (including whether diagnosed by a professional) was by self-report and grouped into four categories, including ‘diagnosis of serious mental illness’. Mental well-being was measured using the Warwick-Edinburgh Mental Well-Being Scale, and functioning by items from the EQ-5D. Mental distress was assessed using General Health Questionnaire (GHQ-12) items. Associations were examined using moderated regression models with group membership as an interaction term.

Results:  Mental well-being score was associated with (higher) functioning score (P < 0.05). This association varied between mental illness groups, even after adjusting for age, gender, ethnicity, physical health and symptoms of mental distress (F(3) = 14.60, P < 0.001). The gradient of this association was greatest for those with diagnosed serious mental illness.

Conclusions:  Mental well-being was associated with higher functional status in people with mental illness, independent of the symptoms of mental distress and other confounders. The association was strongest in the diagnosed serious mental illness group, suggesting that mental well-being may be important in recovery from mental illness.

vi)  Perski, M., Wilton, R. and Evans, J. (2020)  An ambivalent atmosphere: employment training programs and mental health recovery.  Health and Place.  62.  1-7.

Online:  https://doi.org/10.1016/j.healthplace.2019.102266

Abstract 

This article critically examines the role of employment training programs in the personal recovery of adults living with mental illness in community settings. Using Cameron Duff’s (2014) notion of ‘assemblages of recovery,’ we explore how, and to what extent, employment training programs provide the supportive resources linked to personal recovery. Using an ethnographic case study, we describe the ambivalent atmospheres associated with one program. This ambivalence expresses the fundamental tension between the genuine aspirations of personal recovery and the realities of the capitalist labour process.

vii)  Although the editors are clear to point out that their newsletters do not necessarily reflect endorsement of the World Association of Psychosocial Rehabilitation (WAPR), the recent series of newsletters provide insightful testimony about the ways in which Coronavirus is experienced ‘from the ground’  There are three newsletters to date, each containing a collection of storied accounts sent in by WAPR members, their colleagues and friends.  The first two newsletters are available here:

Newsletter 1  March 16 – April 1 2020

Newsletter 2  March 15 – April 26 2020

We are anticipating that the third edition will be available on the World Association for Psychosocial Rehabilitation website (http://www.wapr.org) in due course.

Other News / Resources 

i)  Dr Juliana Onwumere, senior lecturer and consultant clinical psychologist, writes out of Kings College London to encourage participation in a new survey exploring carers’ experiences during covid-19.  More information and the survey itself can be found here:

https://kcliop.eu.qualtrics.com/jfe/form/SV_2bFquevHV5up8PP

Note:  When following the above link, please click the blue button at the bottom left to access the next page.

ii)  Recovery stories

Mike Slade’s Narrative Experiences Online (NEON) study has launched www.recoverystories.uk a new interactive website which provides online access to mental health recovery stories. We have collected hundreds of stories from around the world, in text, video and audio form, and preliminary evidence suggests that these stories can help people feel connected to others including the storyteller. We are now running three trials using this website, the largest of which is called the NEON Trial.

RRN members can help us in two ways:

1.     Recruitment and participation

The NEON Trial is currently recruiting people who:

  • Have experienced psychosis or psychosis-like experiences in the past 5 years
  • Have experienced mental health distress in the past 6 months
  • Live in England
  • Aged over 18 years
  • Have access to the internet
  • Can provide informed consent

If you or someone else you know meet the inclusion criteria, more information and eligibility checking can be accessed here www.recoverystories.ukWe would also like to recruit people who have cared for others experiencing mental health problems.

2.     Promotion of the Trial

Would you help us to promote the NEON Trial through your networks? You can use any

of the publicity materials available at www.researchintorecovery.com/neontrials/promotion or just tweet:

Can real-life mental health recovery stories help you with your own mental health

Access hundreds of recovery stories in the NEON Trial. Help researchers @InstituteMH

understand the benefits of accessing other people’s recovery narratives. See

recoverystories.uk

Follow us on Twitter (@neontrials), Instagram (@neontrials) and Facebook today!

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 ebulletin. 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 2020

Recovery Research Network eBULLETIN 

August 2020 

RRN Meetings 

The 23rd meeting of the Recovery Research Network (RRN) was due to be hosted by Camden and Islington NHS Foundation Trust.  Due to the current developments with regard to Covid-19, this event has been cancelled.

The coronavirus pandemic is having unprecedented effects both nationally and internationally.  During this time of social distancing and self-isolation, remaining connected to our networks is important.  Please can we encourage our readership to continue to submit material to e-bulletin using the detail below.  As ever, comments are welcome from the readership about articles included in the ebulletins.

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.  In this edition, we have included some examples at the end of the ebulletin.

 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/rrn  If you would like to leave the RRN and have your details removed from our database, please email:  researchintorecovery@nottingham.ac.uk

 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 and Events  

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 almost certain that traditional face-face conferencing/events will not be taking place in their ‘traditional’ format, certainly in the immediate future, please check with the organisers.  It may be that alternative or innovative platforms are being utilised to deliver such events going forward.

Looking ahead, the University of South-Eastern Norway are hosting a rescheduled seminar with the title: The Politics of Recovery: controversy and co-option in the era of austerity.  Originally scheduled for later this month, the new date will be:  16th June 2021.  For more information please click here.

 Papers and Publications  

In addition to peer-reviewed literature and work of a purely academic nature, the ebulletin 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)  Llewellyn-Beardsley, J., Skye, B., Rennick-Egglestone, S., Ng, F., Roe, J., Hui, A., Franklin, D., Deakin, E., Hare-Duke, L. and Slade, M. (2020) INCRESE: Development of an inventory to characterize recorded mental health recovery narratives.  Journal of Recovery in Mental Health 3(2) 25-44. 

Abstract 

Objective: Mental health recovery narratives are increasingly used in clinical practice, public health campaigns, and as directly accessed online resources. No instrument exists to describe characteristics of individual recovery narratives. The aims were to develop and evaluate an inventory to characterize recorded recovery narratives.

Research Design and Methods: A preliminary version of the Inventory of Characteristics of Recovery Stories (INCRESE) was generated from an existing theory base. Feasibility and acceptability were evaluated by two coders each rating 30 purposively selected narratives.  A refined version was produced and a formal evaluation conducted.  Reliability was assessed by four coders each rating 95 purposively selected narratives.  Inter-coder reliability was assessed using Fleiss’s kappa coefficients; test-retest reliability was assessed using intra-class correlation coefficients (ICCs).

Results: Multiple refinements to description, coding categories, and language were made. Data completeness was high, and no floor or ceiling effects were found. Inter-coder reliability ranged from moderate (k=0.58) to perfect (k=1.00) agreement. Test-retest reliability ranged from moderate (ICC=0.57) to complete (ICC=1.00) agreement. The final INCRESE comprises 77 items spanning five sections: Narrative Eligibility; Narrative Mode; Narrator Characteristics; Narrative Characteristics; Narrative Content.

Conclusion:  INCRESE is the first evaluated tool to characterize mental health recovery narratives.  It addresses current concerns around normative recovery narratives being used to promote compulsory wellness, e.g. by identifying narratives that reject diagnosis as an explanatory model and those with non-upward trajectories. INCRESE can be used to establish the diversity of a narrative collection and will be used in the NEON trials (ISRCTN11152837, ISRCTN63197153, ISRCTN76355273) to allow a recommender system to match narratives to participants.

ii)  Luciano. M., Sampogna, G., Del Vecchio, V., Loos, S., Slade, M., Clarke, E., Nagy, M., Kovacs, A., Munk‑Jørgensen, P., Krogsgaard Bording, M., Kawohl, W., Rössler, W., Puschner, B., Fiorillo, A., For the CEDAR Study Group.  (2019)  When does shared decision making is adopted in psychiatric clinical practice? Results from a European multicentric study. European Archives of Psychiatry and Clinical Neuroscience  270  645-653

NB: there seems to be a grammatical mistake in the above title which we suggest should read: When is shared decision making adopted in psychiatric clinical practice? Results from a European multicentric study.

Abstract 

To identify factors associated with the use of shared decision making in routine mental health care in a large multicenter European study. Data have been collected within the study “Clinical decision making and outcome in routine care for people with severe mental illness” (CEDAR), which is a naturalistic, longitudinal, observational study carried out in six European countries. Patients with a severe mental illness attending outpatient units and their treating clinicians have been recruited.  Clinicians’ Clinical Decision Making (CDM) styles have been explored through the Clinical Decision Making Style Scale.  Patients’ clinical and social outcomes have been assessed through validated assessment instruments. The sample consisted of 588 patients and 213 professionals. Professionals were mainly psychiatrists (35.7%), nurses (21.6%), support workers, social workers or occupational therapists (24.9%), psychologists (9.9%) or trainees in psychiatry (4.7%). In the majority of cases, clinicians adopted a shared CDM style. Shared CDM was more frequently adopted with patients with psychotic disorders, with a better quality of life and social functioning. At multivariate analyses, the likelihood of adopting shared decision making increased in patients with higher levels of interpersonal relationships’ skills (p < 0.05) and global functioning (p < 0.01).  On the contrary, being a trainee in psychiatry reduced the likelihood of adopting shared CDM (p < 0.008). Shared decision making has been adopted mainly when patients have a better functioning and less severe clinical symptomatology and by less trained clinicians, differently from national and international recommendations. More efforts should be made to implement interventions to promote shared CDM, with a specific focus for trainees in psychiatry.

iii)  Barlott, T., Shevellar, L., Turpin, M. and Setchell, J. (2020)  Destabilising social inclusion and recovery, and pursuing ‘lines of flight’ in the mental health sector.  Sociology of Health and Illness.42(6)  1328-1343

Abstract 

People who have been diagnosed with serious mental illness have a long history of confinement, social stigma and marginalisation that has constrained their participation in society. Drawing upon the work of Gilles Deleuze and Felix Guattari, we have used the concepts of: assemblagesmajor and minor and deterritorialisation to critically analyse two pervasive and ‘taken-for-granted’ assemblages in mental health: recovery (including clinical recovery, social recovery andrecovery-oriented practice) and social inclusion. Our analysis explores how dominant and oppressive forces have been entangled with liberating and transformative forces throughout both of these assemblages – with dominant forces engaging in ongoing processes of capture and control, and transformative forces resisting and avoiding capture. In pursuit of social transformation for people categorised with serious mental illness, deterritorialisation is posited as a potential way forward. To have transformation in the lives of mental health service users, we present the possibility that ongoing, disruptive movements of deterritorialisation can unsettle majoritarian practices of capture and control – producing liberating lines of flight.

iv)  Lee, M.Y., Eads, R., Yates, N. and Liu, C. (2020) Lived experiences of a sustained mental health recovery process without ongoing medication use.  Community Mental Health Journal.  Online:  https://doi.org/10.1007/s10597-020-00680-x

Abstract 

Serious mental health conditions have historically been considered lifelong conditions, with substantial literature supporting pharmaceutical approaches to remission. More recently, the recovery movement has emphasized lasting recovery, which can occur through a variety of pathways. With the traditional focus on medication, less is known about the recovery process of persons who achieve sustained recovery without ongoing medication use. This qualitative study used a grounded theory approach to explore the recovery process of 19 participants with diagnoses of schizophrenia, bipolar disorder, or major depression who were in recovery and not taking medications for at least twelve months. Participants identified internal recovery processes (cognitive changes, emotional processes, and spirituality/faith) leading to a perspective change about self and symptoms. Participants also identified external recovery processes including both support received and productive ways of giving back. The study findings highlight the importance of self-efficacy, emotion management, and social giving in mental health recovery.

v)  Gyamfi, N., Bhullar, N.,  Islam, M.S. and Usher, K. (2020)  Knowledge and attitudes of mental health professionals and students regarding recovery: A systematic review.  International Journal of Mental Health Nursing.  29(3)  322-347

Abstract 

This review was conducted to synthesize and critically appraise the literature on knowledge, attitudes, understanding, perceptions, and expectations of mental health professionals (MHPs) and mental health professional (MHP) students’ regarding recovery. A systematic search in Scopus, CINAHL, PsycINFO, Web of Science, Medline, and Embase as well as Google scholar and web-based repositories was conducted. The searches were conducted using a combination of key terms: “mental health professionals”, “students’’, ’knowledge’, “understanding”, “perception” “attitude”, “expectation”, “recovery”. After screening and quality assessment, the review included 29 studies (18 quantitative, 8 qualitative, and 3 mixed-method studies) published in English, from January 2006 to June 2019, and was analysed systematically using a mixed-method synthesis. The findings revealed that there is increasing evidence (especially among MHPs) of knowledge, attitudes, understanding, perceptions, and expectations regarding recovery. However, there are disparities in how MHPs perceive and understand recovery. While some understood it to mean a personal process, others explained it as a clinical process. In addition, there was limited knowledge among the MHPs and MHP students regarding the nonlinearity nature of the recovery process and expectations regarding recovery. The implications from these findings are the need for more in-service training for MHPs, and examination of the curriculum used to educate MHP students. In particular, they should be sufficiently informed about the nonlinearity nature of the recovery process and how to develop hopeful and realistic expectations for consumers throughout the recovery process. The review was preregistered with PROSPERO (Registration No:CRD42019136543).

vi)  Following on from the July edition of the ebulletin where we included links to the first and second editions of ‘from the ground’, a link to the third edition is included here.  Hosted by the World Association for Psychosocial Rehabilitation website (http://www.wapr.org), the newsletters provide insightful testimony about the ways in which Coronavirus is experienced ‘from the ground’  The newsletters contain a collection of storied accounts sent in by WAPR members, their colleagues and friends.

Other News / Resources 

i)  Led by Rai Waddingham, The National Survivor User Network (NSUN) is currently co-ordinating a mapping exercise on the subject of Lived Experience Leadership.  To find out more about this initiative, please see:

https://www.nsun.org.uk/lived-experience-leadership

ii)  Dr Juliana Onwumere, senior lecturer and consultant clinical psychologist, writes out of Kings College London to encourage participation in a new survey exploring carers’ experiences during covid-19.  More information and the survey itself can be found here:

https://kcliop.eu.qualtrics.com/jfe/form/SV_2bFquevHV5up8PP

Note:  When following the above link, please click the blue button at the bottom left to access the next page.

iii)  Recovery stories

Mike Slade’s Narrative Experiences Online (NEON) study has launched www.recoverystories.uk a new interactive website which provides online access to mental health recovery stories. We have collected hundreds of stories from around the world, in text, video and audio form, and preliminary evidence suggests that these stories can help people feel connected to others including the storyteller. We are now running three trials using this website, the largest of which is called the NEON Trial.

RRN members can help us in two ways:

1.     Recruitment and participation

The NEON Trial is currently recruiting people who:

  • Have experienced psychosis or psychosis-like experiences in the past 5 years
  • Have experienced mental health distress in the past 6 months
  • Live in England
  • Aged over 18 years
  • Have access to the internet
  • Can provide informed consent

If you or someone else you know meet the inclusion criteria, more information and eligibility checking can be accessed here www.recoverystories.ukWe would also like to recruit people who have cared for others experiencing mental health problems.

2.     Promotion of the Trial

Would you help us to promote the NEON Trial through your networks? You can use any of the publicity materials available at www.researchintorecovery.com/neontrials/promotion or just tweet:

Can real-life mental health recovery stories help you with your own mental health? Access hundreds of recovery stories in the NEON Trial. Help researchers @InstituteMH understand the benefits of accessing other people’s recovery narratives. See recoverystories.uk

Follow us on Twitter (@neontrials), Instagram (@neontrials) and Facebook today!

iv)  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

v)  Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. 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 2020

Recovery Research Network eBULLETIN

September 2020

RRN Meetings

The 23rd meeting of the Recovery Research Network (RRN) was due to be hosted by Camden and Islington NHS Foundation Trust.  Due to the current developments with regard to Covid-19, this event has been cancelled.

The coronavirus pandemic is having unprecedented effects both nationally and internationally.  During this time of social distancing and self-isolation, remaining connected to our networks is important.  Please can we encourage our readership to continue to submit material to e-bulletin using the detail below.  As ever, comments are welcome from the readership about articles included in the ebulletin.

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.  In this edition, we have included some examples at the end of the ebulletin.

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/rrn  If you would like to leave the RRN and have your details removed from our database, please email:  researchintorecovery@nottingham.ac.uk

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) Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge University Hospitals Trust R&D and the University of Hertfordshire will be hosting an online conference entitled:  Shared Decision Making 2020 and Beyond.  Prof. Shula Ramon, the conference organiser writes:

It is rare to have a conference on mental health shared decision making in the UK, one that is focused on co-production of experts by lived experience with clinicians and with family members.

The conference attempts to look at innovation in mental health shared decision making and how the barriers to implementing it in everyday practice can be faced and often overcome with the right approach and skills from all participants.

Presenters include people from the UK, Israel and the US, who offer a wide range of life changing strategies as well as a respectful and trusting relationships between the different partners to the endeavour of shared decision making.

Due to the Covid-19 pandemic the conference takes place online, and on two half days, as we are aware that participants become very tired from a whole day Zoom attendance. The  first half day will take place on Tuesday, 17th November 2020 a.m., and the second half day will take place on Wednesday, 25th November p.m.

My personal reading of the Covid-19 context is that we need to apply shared decision making even more than before, as EbEs (experts by lived experience of mental ill health) and practitioners meet much less often either face-to-face or via the phone and online, and EbE have to make decisions more on their own, and with family members or voluntary organisations if they have a good relationships with them. Such good relationships depend on developing a workable shared decision making method.

If you wish to participate in this conference, please contact Prof. Ramon on s.ramon@herts.ac.uk

ii)  The University of South-Eastern Norway are hosting a rescheduled seminar with the title: The Politics of Recovery: controversy and co-option in the era of austerity.  Originally scheduled for later this month, the new date will be:  16th June 2021.  For more information please click here.

iii)  Writing out of the International Journal of Environmental Research and Public Health, the guest editors invite papers that orientate towards promoting a better understanding of the processes of recovery and concepts of citizenship and wellbeing for young people who live with substance use and mental health problems.  The deadline for manuscript submissions is: 1st September 2021.  For more information please click here.

Papers and Publications

In addition to peer-reviewed literature and work of a purely academic nature, the ebulletin 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)  Hurley, J., Jolley, S., Gibbons, O., Williams, A., Nath Varma, S., Bhandari, S., Mukherjee, K., Garraway, H., Jones, C., Aker, N., Appiah-Kusi, E. and Weaver, T.  (2020) A five-year prospective evaluation of a new community psychosis service in North London: introducing the Recovery and Enablement Track.  Psychosis.  Online:

https://doi.org/10.1080/17522439.2020.1803954

Abstract

Background and aims: United Kingdom mental healthcare guidelines recommend recovery-focused services for people with psychosis. We evaluated a “Recovery and Enablement Track” (RET) aiming to promote recovery and well-being, reduce distress and maintain independence from secondary care following discharge, for people with established psychosis and long histories of secondary care.

Method: From March 2015 to December 2019, 214 individuals entered the RET and were followed up 12 months’ post-discharge. Recovery, wellbeing, and distress were measured at assessment, review, and discharge. Of 214 total people, 86 consented to inclusion for this evaluation.

Results: Well-being and recovery significantly improved from assessment to discharge – distress did not. Distress improved from review to discharge, suggesting improvement during service contact. 79% (68/86) of individuals were discharged to the care of their family doctor, and 22% of these (15/68) re-presented before 12-month follow-up.

Conclusion: Recovery and well-being improved from assessment to discharge, distress improved from review to discharge. Half of consenting participants were successfully discharged from secondary care following the RET, suggesting potential to promote recovery. Comparison to a formal control condition with systematic analysis of any biasing effect of missing data (i.e. through refusal to participate) is now indicated.

ii)  Moernaut, N. and Vanheule, S. (2020): Experiencing negative symptoms in psychosis: a systematic qualitative review. Psychosis. Online:

https://doi.org/10.1080/17522439.2020.1784257

Abstract

Although negative symptoms of psychosis are frequently researched, the subjective experience of these symptoms is not often studied in detail. This paper addresses this shortcoming by reviewing qualitative research about first-person perspectives on negative symptoms. A systematic literature search using Web of Science, Scopus, PsychArticles, PubMed, CiNAHL and Embase revealed 12 relevant studies. Our review yields a model with five clusters: failing social interactions; experiences of disconnection; overwhelming psychotic experiences; an eroded self-image; and detrimental side effects of psychotropic medication. In the discussion, the authors conclude that disturbances underlying negative symptoms should be studied in greater detail, starting explicitly from theoretical frameworks like phenomenology or psychoanalysis

iii)  Slade, M. and Sweeney, A. (2020) Rethinking the concept of insight.  World Psychiatry.  19(3) 389-390

In this engaging commentary, Slade and Sweeney draw upon survivor research and the associated field of Mad Studies to unsettle the dominant, biomedical approach to understanding the psychiatric concept of insight. Citing the recent work of Beth Filson, they focus attention upon the ways in which being labelled as lacking insight can serve to undermine personal sense-making, and personal claims to knowledge.  Slade and Sweeney argue a rights-based case for privileging the person’s own narrative insight as a legitimate alternative.  Whilst acknowledging the tensions and debates in this area, they tread a thought-provoking path in their short, but interesting, analysis.

iv)  Yeo, C., Hare-Duke, L., Rennick-Egglestone, S., Bradstreet, S., Callard, F., Hui, A., Llewellyn-Beardsley, J., Longden, E., McDonough, T., McGranahan, R., Ng, F., Pollock, K., Roe, J. and Slade, M. (2020)  The VOICES typology of curatorial decisions in narrative collections of the lived experiences of mental health service use, recovery, or madness: Qualitative study.  JMIR Mental Health. 7(9) e16290.  Online:

https://mental.jmir.org/2020/9/e16290/

Abstract

Background: Collections of lived experience narratives are increasingly used in health research and medical practice. However, there is limited research with respect to the decision-making processes involved in curating narrative collections and the work that curators do as they build and publish collections.

Objective: This study aims to develop a typology of curatorial decisions involved in curating narrative collections presenting lived experiences of mental health service use, recovery, or madness and to document approaches selected by curators in relation to identified curatorial decisions.

Methods: A preliminary typology was developed by synthesizing the results of a systematic review with insights gained through an iterative consultation with an experienced curator of multiple recovery narrative collections. The preliminary typology informed the topic guide for semi-structured interviews with a maximum variation sample of 30 curators from 7 different countries. All participants had the experience of curating narrative collections of the lived experiences of mental health service use, recovery, or madness. A multidisciplinary team conducted thematic analysis through constant comparison.

Results: The final typology identified 6 themes, collectively referred to as VOICES, which stands for values and motivations, organization, inclusion and exclusion, control and collaboration, ethics and legal, and safety and well-being. A total of 26 subthemes related to curation decisions were identified.

Conclusions: The VOICES typology identifies the key decisions to consider when curating narrative collections about the lived experiences of mental health service use, recovery, or madness. It might be used as a theoretical basis for a good practice resource to support curators in their efforts to balance the challenges and sometimes conflicting imperatives involved in collecting, organizing, and sharing narratives. Future research might seek to document the use of such a tool by curators and hence examine how best to use VOICES to support decision making

v)  Langlois, T., Bourcier, A., Lamy, P., Lhermine, M., Callahan, S. and Lecomte, T. (2020) Narrative changes about “voices” following a contextual group therapy for people with psychosis.  Psychosis.  Online:

https://doi.org/10.1080/17522439.2020.1801817

Abstract

Objective of the study: To determine the impact of a contextual group CBT intervention for voices on the narratives of people with psychosis

Method: Narratives from 10 participants with psychosis and hearing auditory hallucinations, who participated in a group intervention for voices, were collected and analysed, before and after the intervention.

Results: Four main themes emerged from the phenomenological analysis of the participant’s narratives regarding their voices: ‘representation of voices’, ‘explanations given to hearing voices’, ‘unfolding and appearance of voices, and ’reactions and emotional management of voices’. It was possible to isolate sub-categories within the four main (or superordinate) themes that evolved following the intervention, reflecting the psychological and behavioural processes at work involved in response to the voices. The identification of these processes made it possible to understand how a contextual group CBT intervention for voice management could concretely help those who receive it.

Conclusion: A contextual group intervention for the management of auditory hallucinations in people with psychosis seems to improve the ability to describe, accept, and manage voices, as well as to encourage participants to relate differently, in a more peaceful way, with them.

vi)  Sips, R., Van Duppen, Z., Kasanova, Z., De Thurah, L., Teixeira, A., Feyaerts, J., and Myin-Germeys, I.  (2020): Psychosis as a dialectic of aha- and antiaha-experiences: a qualitative study, Psychosis.  Online:

https://doi.org/10.1080/17522439.2020.1798492

Abstract

Experiences of sudden and abrupt insight, sometimes termed aha-experiences, are often reported during psychosis. The aha-experience is described as a radical and sudden restructuring, realization or change in understanding. Based on personal experience, we argued that alongside this ahaexperience exists the anti-aha-experience. The anti-aha-experience refers to an experience of sudden insight that does not fit within one’s framework, convictions or worldview and has an undermining effect. We have conceptualized psychosis as a dialectic of aha- and anti-aha-experiences and argue that a dialectic tension between aha- and anti-aha experiences undermines a stable personal perspective. In this study, we set out to investigate whether individuals with lived experience of psychosis do indeed report forms of sudden insight, and particularly if they report aha- and anti-ahaexperiences, and the dialectic between them. We therefore conducted 21 in-depth interviews and 6 focus groups with individuals with lived experience

of psychosis and analysed the transcripts using Interpretative Phenomenological Analysis. The findings show that these phenomena are indeed often reported and could play a significant role in psychosis. Integrating these phenomena into our understanding of psychosis could help to better grasp the lived experience of individual patients and additionally inform other forms of research on psychosis.

vii)  Florence, A.C., Miller, R., Bellamy, C., Bernard, P., Bien, C., Atterbury, K., Bragg, C., Diaz, A., Gardien, E., Guy, K., Hansen, C., Maclean, K., Milton, B., Nelson, L., Samoskevich, J.J., Smith, S., Stanojlovic, M., Wexler, T., Zorzanelli, R. and Davidson, L. (2020) When reality breaks from us: lived experience wisdom in the Covid-19 era.  Psychosis. Online:

https://doi.org/10.1080/17522439.2020.1817138

Abstract

The emergence of Covid-19 disrupted most aspects of life, creating a high degree of uncertainty and unpredictability about the future. Knowledge from a place of lived experience offers insights and strategies to better understand how to live, grow and thrive through the difficulties that people who experience mental health challenges, other disabling health conditions, people of color, and people from lower socio-economic backgrounds have overcome. We report on a programmatic effort to investigate how lessons learned through lived experience could be useful to persons who are dealing with a destabilizing situation like this pandemic for the first time, especially mental health providers. Three listening sessions over Zoom were conducted to gather information, views and personal accounts related to the current pandemic. Twenty four people with experience of mental health challenges and people living with disabilities, of various ethnic and racial backgrounds, participated in the sessions. We suggest that the recovery framework can be helpful to address the current crisis; we challenge traditional notions of normality; and finally, we recommend that providers and systems of care adopt a framework that addresses health inequities and human rights.

viii)  Grundman, S.H., Edri, N. and Stanger Elran, R.  (2020) From lived experience to experiential knowledge: a working model.  Mental Health and Social Inclusion. Online:

https://doi.org/10.1108/MHSI-06-2020-0041

Abstract

Purpose:  This paper aims to present a working model for using experiential knowledge in the work of lived experience practitioners within the mental health field.

Design/methodology/approach: The working model is constructed from three key elements, namely, components of lived experience, the Library of Life Experiences and the NISE technique for sharing experiential knowledge (NISE: need identification; inner identification; sharing experiential knowledge and interpersonal encounter).

Findings: The model will be described, followed by central themes that emerged from a pilot course that was taught in Israel in 2019 to a group of peers working in the mental health system. The central themes were: developing peer identity; sharing peer language; internalizing the working model; understanding the peer role; and awakening social consciousness.

Originality/value: The original working model and training course were co-produced and co-conducted by peer specialists and mental health professionals, for the use of lived experience practitioners

x)  Goldberg, M., Stanger Elran, R., Mayer, Y. and Lurie, I.  (2020) The treatment of a patient who is also a mental health practitioner: special considerations and recommendations.  Academic Psychiatry.  44(5)  624-628.

Goldberg et al open their article with the following paragraph:  The first time we met (MG & IL, authors) was as guest speakers at a seminar for social work students at an Israeli university, intended to expose them to the field of mental health. The next time we met was in an inpatient psychiatric department, as a patient (MG) and the head of the department (IL). About a year later, we decided, with colleagues (RSE, YM), to put our previous interactions, perspectives, personal, and professional knowledge into a joint paper regarding the treatment of colleagues within the mental health system.  Drawing upon the term ‘therapatient’ to describe a person who is at the same time a therapist and a patient, the authors present an insightful account of the complexities and challenges from the therapatient’s therapist and the therapatient’s point of view.  The authors discuss a number of recommendations going forward, before concluding that the experience of therapatient can potentially counter the ‘us and them’ divide, whilst at the same time promoting the lived experience of personal recovery.

Other News / Resources

i)  Led by Rai Waddingham, The National Survivor User Network (NSUN) is currently co-ordinating a mapping exercise on the subject of Lived Experience Leadership.  To find out more about this initiative, please see:

https://www.nsun.org.uk/lived-experience-leadership

ii)  Recovery stories

Mike Slade’s Narrative Experiences Online (NEON) study has launched www.recoverystories.uk a new interactive website which provides online access to mental health recovery stories. We have collected hundreds of stories from around the world, in text, video and audio form, and preliminary evidence suggests that these stories can help people feel connected to others including the storyteller. We are now running three trials using this website, the largest of which is called the NEON Trial.

RRN members can help us in two ways:

  1. Recruitment and participation

The NEON Trial is currently recruiting people who:

  • Have experienced psychosis or psychosis-like experiences in the past 5 years
  • Have experienced mental health distress in the past 6 months
  • Live in England
  • Aged over 18 years
  • Have access to the internet
  • Can provide informed consent

If you or someone else you know meet the inclusion criteria, more information and eligibility checking can be accessed here www.recoverystories.ukWe would also like to recruit people who have cared for others experiencing mental health problems.

  1. Promotion of the Trial

Would you help us to promote the NEON Trial through your networks? You can use any of the publicity materials available at www.researchintorecovery.com/neontrials/promotion or just tweet:

Can real-life mental health recovery stories help you with your own mental health? Access hundreds of recovery stories in the NEON Trial. Help researchers @InstituteMH understand the benefits of accessing other people’s recovery narratives. See recoverystories.uk

Follow us on Twitter (@neontrials), Instagram (@neontrials) and Facebook today!

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 ebulletin. 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