Recovery Research Network (RRN)

2012 RRN Emails

June 2012

Sent 12 June

1. RRN meetings
The date for the next meeting is Wednesday 7 November 2012 and the theme will be Research about peer working. Please book into your diary now! Minutes of the 21 May 2012 and previous meetings, as well as some presentations from meetings, are available in the RRN meeting and presentation section of this website.

2. RRN membership profile
If you would like to update your entry, please email researchintorecovery@kcl.ac.uk. The membership profile will be circulated with each RRN monthly email, but not put on our website.

3. Requests from members
Wendy Bryant writes: ‘We are looking for written commentaries from service users who have had a direct experience of occupational therapy. I am one of the editors of the forthcoming 5th edition of Creek’s Occupational Therapy in Mental Health and we hope that most of the 29 chapters in the book will have service user commentaries.’ Flyer attached with more information.

4. Conferences and events
i) King’s College London is running a new Summer School called Recovery: from research evidence to clinical practice and organisational transformation in London, 25 to 29 June 2012.

ii) 10th ENMESH Conference, Verona, 26 to 28 September 2013. Theme: Recovery-oriented mental health services: therapeutic, organisational and economic challenges. Flyer attached.

5. Papers
The monthly email includes new publications by RRN members that may be of wider interest. Please send us the reference and abstract for a new publication you would like included.

i) Empowerment, Lifelong Learning and Recovery in Mental Health. Ryan P, Ramon S, Greacen T (ed). Basingstoke: Palgrave Macmillan (978-0-230-2985-7). 2012.

ii) ‘I know how to look after myself a lot better now’: Service user perspectives on mental health in-patient rehabilitation. Notley J, Pell H, Bryant W, Croucher A, Cordingley K, Blank A, Grove M. International Journal of Therapy and Rehabilitation. 2012, 19, 5, 288-298. Email Wendy.Bryant@brunel.ac.uk for a copy.

iii) Recovery grows up. Slade M, Williams J, Bird V, Leamy M, Le Boutillier C. Journal of Mental Health. 2012, 21, 99-104.

Please let us know if there is anything you would like included in the next monthly email, by emailing us at researchintorecovery@kcl.ac.uk.

page updated 27 September 2013

July 2012

Sent 17 July

1. RRN meetings
The next meeting will be held on Wednesday 7 November 2012 and the theme will be Research about peer working – please book into your diary now!

2. RRN membership profile
If you would like to update your entry, please email researchintorecovery@kcl.ac.uk. The membership profile will be circulated with each RRN monthly email, but not put on our website.

3. Conferences and events
i) 10th ENMESH Conference, Verona, 3 to 5 October 2013. Theme is Recovery-oriented mental health services: therapeutic, organisational and economic challenges. Flyer attached.

4. Papers
The monthly email includes new publications by RRN members that may be of wider interest. Please send us the reference and abstract for a new publication you would like included.

i) The thesis (2010) of Emma Sierakowski (University of Melbourne) looks at peer workers’ experience of role and terms of employment. Peer support in mental health: an exploratory study of PHaMs in Victoria was submitted as part of a Masters of Social Work.

ii) Everyday solutions for everyday problems: how mental health systems can support recovery. Mike Slade. Psychiatric Services. 2012, 63(7), 702-704.

People who experience mental illness can be viewed as either fundamentally different than, or fundamentally like, everyone else in society. Recovery-oriented mental health systems focus on commonality. In practice, this involves an orientation toward supporting everyday solutions for everyday problems rather than providing specialist treatments for mental illness-related problems. This change is evident in relation to help offered with housing, employment, relationships, and spirituality. Interventions may contribute to the process of striving for a life worth living, but they are a means, not an end. Mental health systems that offer treatments in support of an individual’s life goals are very different than those that treat patients in their best interests. The strongest contribution of mental health services to recovery is to support everyday solutions to everyday problems.

Please let us know if there is anything you would like included in the next monthly email by emailing us at researchintorecovery@kcl.ac.uk.

page updated 27 September 2013

August 2012

Sent 13 August

1. RRN meetings
The next meeting will be held on Wednesday 7 November 2012, 10am to 4pm, at the David Goldberg Centre Seminar Room, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF. The theme will be Research about peer working. Please book into your diary now!

2. RRN membership profile
If you would like to update your entry, please email researchintorecovery@kcl.ac.uk. The membership profile will be circulated with each RRN monthly email, but not put on our website.

3. Conferences and events
i) One day conference, Rumours of Happiness, How to Thrive in a Mad World in Oldham on Friday 14 September 2012. Organised by CLEO, Oldham and Elemental Wellbeing, UK. Poster attached.

ii) Ethnic Health Initiative present Psychiatric labels on a multi-ethnic society, a London conference on 15 October 2012. The conference aims to bring together academics, researchers, practitioners – including health and social care workers – and mental health clinicians who have researched in this field and/or have experience in providing medical, psychological and social care interventions across fields. Brochure available.

iii) 10th ENMESH Conference, Verona, 3 to 5 October 2013. Theme is Recovery-oriented mental health services: therapeutic, organisational and economic challenges. Flyer attached.

4. Papers
The monthly email includes new publications by RRN members that may be of wider interest. Please send us the reference and abstract for a new publication you would like included.

a) Journal of Mental Health Training Education and Practice Peer Support special edition. Guest editors: Thurstine Basset and Peter Ryan. Journal of Mental Health Training Education and Practice, 2012, 7.2.

Alison Faulkner and Thurstine Basset examine informal, naturally occurring peer support. Allen Daniels and his colleagues report on the Pillars of Peer Support across many states in the USA. Julie Repper and Emma Watson reflect on lessons learned over a year in which their local NHS Trust employed peer support workers. They also explore the individual work that peer support workers did with their clients. Emma Watson reflects on her individual journey as one of these workers. David Crepaz-Keay and Eva Cyhlarova review the work of the Mental Health Foundation, working with Bipolar UK, in running self-management courses across Wales. Clare Ockwell reports on a peer support scheme centred on her organisation CAPITAL, which is a service user led body in West Sussex.

Please let us know if there is anything you would like included in the next monthly email, by emailing us at researchintorecovery@kcl.ac.uk.

page updated 27 September 2013

September 2012

Sent 16 October

1. RRN meetings
The next meeting will be held on Wednesday 7 November 2012, 10am to 4pm (refreshments from 9.30am), at the David Goldberg Centre Seminar Room, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF. The theme will be Research about peer working. Please book into your diary now and see attached agenda.

2. RRN membership profile
If you would like to update your entry, please email researchintorecovery@kcl.ac.uk. The membership profile will be circulated with each RRN monthly email, but not put on our website.

3. Conferences and events
i) One day conference, Rumours of Happiness, How to Thrive in a Mad World in Oldham on Friday 14 September 2012. Organised by CLEO, Oldham and Elemental Wellbeing, UK. Poster, programme and conference booking form attached.

ii) Ethnic Health Initiative present Psychiatric labels on a multi-ethnic society, a London conference on 15 October 2012. The conference aims to bring together academics, researchers, practitioners – including health and social care workers – and mental health clinicians who have researched in this field and/or have experience in providing medical, psychological and social care interventions across fields. Brochure available.

iii) 10th ENMESH Conference, Verona, 3 to 5 October 2013. Theme is Recovery-oriented mental health services: therapeutic, organisational and economic challenges. Flyer attached.

4. Papers
The monthly email includes new publications by RRN members that may be of wider interest. Please send us the reference and abstract for a new publication you would like included.

i) There are a series of articles on recovery in World Psychiatry October 2012, including two by RRN members. They are Consumer models of recovery: can they survive operationalism? by Jan Wallcraft and Recovery research: the empirical evidence from England by Mike Slade.

5. London based research request
Hannah Duncan is a Trainee Clinical Psychologist at the University of East London who is looking for participants in her research and would be grateful if you could circulate this around your networks. Hannah’s ethical approval from the university allows her to recruit from the public, service user/survivor and voluntary groups and networks but not via the NHS. Hannah writes:

‘Would you like to take part in a study that is looking at mental health service users’ experiences of treatment pressures? This study is exploring times when service users have felt pressured by others with regards to their mental health treatment(s) and how they have made sense of these experiences. I am interested in hearing about a whole range of experiences – for example; being persuaded to have psychotherapy, being pressurised to take medication or being compulsorily admitted to hospital. I am happy to meet with people one-to-one or in small groups to hear about their experiences. Depending on the number of people who want to be involved I will offer women only and men only groups if possible. The meetings will last between 1 and 2 hours. You will be paid £15 for your time and your travel expenses will be reimbursed if you are able to provide tickets or receipts. If you are interested in taking part and would like to find out more about the study please email me, Hannah Duncan, at treatmentpressures@gmail.com.’

Please let us know if there is anything you would like included in the next monthly email, by emailing us at researchintorecovery@kcl.ac.uk.

page updated 27 September 2013

October 2012

Sent 16 October

1. RRN meetings
The next meeting will be held on Wednesday 7 November 2012, 10am to 4pm (refreshments from 9.30am), at the David Goldberg Centre Seminar Room, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF. The theme will be Research about peer working. Please book into your diary now and see attached agenda.

2. RRN membership profile
If you would like to update your entry, please email researchintorecovery@kcl.ac.uk. The membership profile will be circulated with each RRN monthly email, but not put on our website.

3. Conferences and events
i) One day conference, Rumours of Happiness, How to Thrive in a Mad World in Oldham on Friday 14 September 2012. Organised by CLEO, Oldham and Elemental Wellbeing, UK. Poster, programme and conference booking form attached.

ii) Ethnic Health Initiative present Psychiatric labels on a multi-ethnic society, a London conference on 15 October 2012. The conference aims to bring together academics, researchers, practitioners – including health and social care workers – and mental health clinicians who have researched in this field and/or have experience in providing medical, psychological and social care interventions across fields. Brochure available.

iii) 10th ENMESH Conference, Verona, 3 to 5 October 2013. Theme is Recovery-oriented mental health services: therapeutic, organisational and economic challenges. Flyer attached.

4. Papers
The monthly email includes new publications by RRN members that may be of wider interest. Please send us the reference and abstract for a new publication you would like included.

i) There are a series of articles on recovery in World Psychiatry October 2012, including two by RRN members. They are Consumer models of recovery: can they survive operationalism? by Jan Wallcraft and Recovery research: the empirical evidence from England by Mike Slade.

5. London based research request
Hannah Duncan is a Trainee Clinical Psychologist at the University of East London who is looking for participants in her research and would be grateful if you could circulate this around your networks. Hannah’s ethical approval from the university allows her to recruit from the public, service user/survivor and voluntary groups and networks but not via the NHS. Hannah writes:

‘Would you like to take part in a study that is looking at mental health service users’ experiences of treatment pressures? This study is exploring times when service users have felt pressured by others with regards to their mental health treatment(s) and how they have made sense of these experiences. I am interested in hearing about a whole range of experiences – for example; being persuaded to have psychotherapy, being pressurised to take medication or being compulsorily admitted to hospital. I am happy to meet with people one-to-one or in small groups to hear about their experiences. Depending on the number of people who want to be involved I will offer women only and men only groups if possible. The meetings will last between 1 and 2 hours. You will be paid £15 for your time and your travel expenses will be reimbursed if you are able to provide tickets or receipts. If you are interested in taking part and would like to find out more about the study please email me, Hannah Duncan, at treatmentpressures@gmail.com.’

Please let us know if there is anything you would like included in the next monthly email, by emailing us at researchintorecovery@kcl.ac.uk.

page updated 27 September 2013

November 2012

Sent 26 November

1. RRN meetings
The date for the next meeting is being decided but will be Spring 2013. Minutes of the 7 November and previous meetings, as well as some presentations from this and previous meetings, are available in the RRN meeting and presentation section of this website.

2. RRN membership profile
If you would like to update your entry, please email researchintorecovery@kcl.ac.uk. The membership profile will be circulated with each RRN monthly email, but not put on our website.

3. Conferences and events
i) 10th ENMESH Conference, Verona, 3 to 5 October 2013. Theme is Recovery-oriented mental health services: therapeutic, organisational and economic challenges. Flyer attached.

4. Papers
The monthly email includes new publications by RRN members that may be of wider interest. Please send us the reference and abstract for a new publication you would like included.

i) Can we risk recovery? A grounded theory of clinical psychologists’ perceptions of risk and recovery-oriented mental health services. Tickle A, Brown D, Hayward, M. Psychology and Psychotherapy: Theory, Research and Practice. 2012, 26 September.

This study sought to explore the views of clinical psychologists towards the concepts of ‘risk’ and ‘recovery’ and to set those views against the context of mental health services. Participants’ ability to work in a recovery-oriented manner seemed to be limited by the way in which services perceived and responded to risk. Participants did not discuss risks arising from stigma, social exclusion, racism, sexism, or iatrogenic effects of psychiatric treatment. Narrow conceptualisations of risk as related to harm and danger seen in this study contribute to a sense of needing to be risk averse. However, the implications for practice included ideas about what might increase the possibilities for adopting recovery approaches across disciplines.

ii) Recovery: Past progress and future challenges. Slade M, Adams N, O’Hagan M. International Review of Psychiatry. 2012, 24(1) p1-4.

The idea of ‘ recovery ’ now permeates a great deal of international mental health policy. In opening this themed issue on recovery, we address three related international issues.

First, what does recovery mean, both for individuals experiencing mental illness and for mental health systems? The conceptual foundations and the practice implications of a recovery orientation have become much clearer in the past decade.

Second, what are the key policy implementation challenges? Lessons from countries which are implementing pro-recovery mental health policy identify several issues: socio-political expectations on the mental health system; how to advance positive attitudes within organisational culture through workforce planning and performance management strategies; and the extent to which choice and power can be exercised by the consumer.

Finally, we identify future research and practice priorities. Empirical research is needed to identify the contribution that mental health services can make to recovery. Also, and perhaps more importantly, research is needed to identify where problems (and therefore solutions) lie outside the traditional service delivery system such as disability rights, stigma, and societal responses to suffering. Maximising recovery support will likely involve incorporation of new types of evidence into mental health services, including research on wellbeing and positive psychology research.

iii) Determinants, self-management strategies and interventions for hope in people with mental disorders: systematic search and narrative review. Schrank B, Bird V, Rudnick A, Slade M. Social Science & Medicine. 2012, 74, 554-564.

Developing a recovery focus in mental health services is a policy goal internationally, and hope is a central component of recovery. Yet determinants of hope of people with mental disorders are not well known, nor are strategies and interventions that increase hope. This study aims to systematically summarise the available evidence to fill four relevant knowledge gaps: (1) hope scales used in psychiatric research, (2) determinants of hope, (2) hope-fostering self-management strategies, and (3) interventions to increase hope for people with mental disorders.

We conducted a systematic literature search in April 2011 and a narrative synthesis of publications including qualitative and quantitative studies. Results for the first time provide a comprehensive overview of existing evidence and identify important scientific knowledge gaps. (1) Hope scales used do slightly vary in focus but are overall comparable. (2) Most published research used cross-sectional designs resulting in a high number of potential determinants of hope. No studies prospectively investigated the influence of these determinants. (3) Hope fostering self-management strategies of people with mental disorders were described in qualitative studies only with experimental studies completely missing. (4) While some recovery-oriented interventions were shown to increase hope as a secondary outcome, there are no successful interventions specifically aimed at increasing hope.

This review provides the basis for both practical and research recommendations. The five most promising candidate interventions to improve hope in people with mental disorders are (i) collaborative strategies for illness management, (ii) fostering relationships, (iii) peer support, (iv) helping clients to assume control and to formulate and pursue realistic goals, and (v) specific interventions to support multiple positive factors such as self-esteem, self-efficacy, spirituality and wellbeing. These may serve to directly improve care and to develop theory-based models and testable interventions to improve hope in mental health as well as in allied fields.

iv) Recovery in England: transforming statutory services? Perkins R, Slade M. International Review of Psychiatry. 2012, February; 24(1): 29–39.

English mental health policy has explicitly supported a focus on recovery since 2001. More recently, this has been elaborated through policy support for social inclusion, employment and wellbeing.

We review several drivers for this political orientation, including a refocusing of the role of health services as a whole from treating illnesses to helping people to make the most of their lives, the shift to greater power for the individual, reflected in personal social care and personal health budgets, and the evidence informing clinical guidelines issued by the National Institute for Health and Clinical Excellence (NICE).

A disjunction remains between policy and practice, with organisational policies espousing a recovery orientation and teams re-branding as ‘recovery and support ’ teams whilst pursuing clinical practices which prioritise symptomatic treatment rather than recovery support.

The next phase of development in English statutory mental health services is therefore bridging this gap through organisational transformation in mental health services towards a focus on recovery. We describe two funded initiatives to support this process of organisational transformation. The first (ImROC) is a national initiative to develop a pro-recovery organisational climate. The second (REFOCUS) is a multi-site cluster randomised controlled trial (ISRCTN02507940) investigating a team-level pro-recovery intervention.

v) Measures of the recovery orientation of mental health services: systematic review. Williams J, Leam, M, Bird V, Harding C, Larsen J, Le Boutillier C, Oades L, Slade M. Social Psychiatry and Psychiatric Epidemiology. 2012, 47: 1827–1835.

The review aimed to (1) identify measures that assess the recovery orientation of services; (2) discuss how these measures have conceptualised recovery, and (3) characterise their psychometric properties.

A systematic review was undertaken using seven sources. The conceptualisation of recovery within each measure was investigated by rating items against a conceptual framework of recovery comprising five recovery processes: connectedness; hope and optimism; identity; meaning and purpose; and empowerment. Psychometric properties of measures were evaluated using quality criteria.

Thirteen recovery orientation measures were identified, of which six met eligibility criteria. No measure was a good fit with the conceptual framework. No measure had undergone extensive psychometric testing and none had data on test–retest reliability or sensitivity to change.

Many measures have been developed to assess the recovery orientation of services. Comparisons between the measures were hampered by the different conceptualisations of recovery used and by the lack of uniformity on the level of organisation at which services were assessed. This situation makes it a challenge for services and researchers to make an informed choice on which measure to use. Further work is needed to produce measures with a transparent conceptual underpinning and demonstrated psychometric properties.

vi) Social factors and recovery from mental health difficulties: a review of the evidence. Tew J, Ramon S, Slade M, Bird V. Melton J, Le Boutillier C. British Journal of Social Work. 2012, 42:3, 443–460.

Although there is now increasing evidence as to the role played by social factors in contributing to the onset of mental health difficulties, there has been little systematic examination of the role that social factors can play in enabling (or impeding) recovery.

This paper provides a review of the emerging international literature in this area, and is linked to a wider conceptual review undertaken as part of a major project researching recovery practice in the UK. Research findings are explored in detail in relation to three areas that had been identified by the wider review as central to recovery: empowerment and control over one’s life; connectedness (including both inter-personal relationships and social inclusion); and rebuilding positive identities (often within the context of stigma and discrimination).

Out of this emerges a clearer picture of the importance of particular social factors, which starts to define a more broad-based and proactive agenda for mental health social work – with an emphasis not just on working with individuals, but also on engaging with families and communities. However, there is a need for further research and development work in order to determine how to intervene most effectively in order to influence specific social factors.

Please let us know if there is anything you would like included in the next monthly email, by emailing us at researchintorecovery@kcl.ac.uk.

page updated 27 September 2013

December 2012

Sent 17 December

1. RRN meetings
The date for the next meeting is being decided but will be Spring 2013.

2. RRN membership profile
If you would like to update your entry, please email researchintorecovery@kcl.ac.uk. The membership profile will be circulated with each RRN monthly email, but not put on our website.

3. Conferences and events
i) 10th ENMESH Conference, Verona, 3 to 5 October 2013. Theme is Recovery-oriented mental health services: therapeutic, organisational and economic challenges. Flyer attached.

4. Papers
The monthly email includes new publications by RRN members that may be of wider interest. Please send us the reference and abstract for a new publication you would like included.

i) International differences in understanding recovery: systematic review. M Slade, M Leamy, F Bacon, M Janosik, C Le Boutillier, J Williams, V Bird. Epidemiology and Psychiatric Sciences. 2012, 21, 353-364.

Mental health policy internationally varies in its support for recovery. The aims of this study were to validate an existing conceptual framework and then characterise by country the distribution, scientific foundations and emphasis in published recovery conceptualisations.

Update and modification of a previously published systematic review and narrative synthesis of recovery conceptualisations published in English.

A total of 7431 studies were identified and 429 full papers reviewed, from which 105 conceptualisations in 115 papers were included and quality assessed using established rating scales.

Recovery conceptualisations were identified from 11 individual countries, with 95 (91 per cent) published in English-speaking countries, primarily the USA (47 per cent) and the UK (25 per cent). The scientific foundation was primarily qualitative research (53 per cent), non-systematic literature reviews (24 per cent) and position papers (12 per cent). The conceptual framework was validated with the 18 new papers. Across the different countries, there was a relatively similar distribution of codings for each of five key recovery processes.

Recovery as currently conceptualised in English-language publications is primarily based on qualitative studies and position papers from English-speaking countries. The conceptual framework was valid, but the development of recovery conceptualisations using a broader range of research designs within other cultures and non-majority populations is a research priority.

Please let us know if there is anything you would like included in the next monthly email, by emailing us at researchintorecovery@kcl.ac.uk.

page updated 27 September 2013