Recovery Research Network (RRN)

Recovery Research Network eBULLETIN

January 2017

As many of you will know, our colleague Ruth Chandler sadly passed away in December of last year and the Network celebrated Ruth’s life with an obituary in the December edition of the ebulletin.  Ruth undoubtedly touched many lives, and we continued to receive the kind words of others. We welcome you to the first ebulletin of 2017 with the remainder of those words:

Claire Warrington, Doctoral Student: Section 136 of the Mental Health Act, University of Brighton

Talking about Ruth using past tense seems so wrong, not only because of the horrible shock that she’s not physically with us anymore but also because she is, and I hope always will be, such a huge part of the work the department does. Ruth taught me and I’m sure so many others such a huge amount. She was so generous with her time and so passionate about making sure the voices of people who are too often not heard were placed at the heart of what we do. I think all of us who worked with her are better for the experience. To say I’ll miss her is an understatement, but what I mean is I’ll miss spending time with her because I will do my best to always honour her memory in my research and to never forget her voice, and her wonderful laugh.

Philippa Case, Research Manager, Research and Development Team, Sussex Partnership

Ruth and I started in the department within one month of each other and we first met at our annual research conference, where I was in awe of her ability to articulate the perfect questions and ask them fearlessly!  Over the seven-and-a-half years that we worked together, the awe has remained as I saw the passion and drive to her role in patient and public involvement.  On a personal level, I liked Ruth immensely and have learnt so much from her through her approach to work and to life.  It will not be the same in the department without her, but we will work to ensure that the values she brought to the team are maintained in the work we do.

Jean Southey, Co-ordinator for Service User and Carer Involvement, Sussex Partnership NHS Foundation Trust

We all relied on Ruth to be our figurehead, flying the flag for Involvement in LEAF and the Involvement team. However she also had the wisdom to delegate, ensuring we were constantly building our own skills and confidence by guiding us in the right direction.  Ruth rewarded us with her trust in our thinking and beliefs.  She was such a role model; assertively speaking her mind to all and encouraging others to do the same, whilst respecting difference.   Anyone who got to know Ruth realised she had rare gifts and was able to offer each one of us a wider world of understanding around how the health system works and how we can build a network of voices to become equal partners in research with our experience. Ruth’s political astuteness was immense and yet she could speak in the most available language at so many different levels. Whilst there is no way we individually can replicate Ruth’s charismatic approach we need to be guided by her example; keeping on message, keeping together and keeping all the initiatives alive to move onwards with Ruth’s vision. I feel privileged to have worked with Ruth for four years. She taught me so much about life and overcoming adversity.  I will always remember her cheeky grin, her mischievousness and her great sense of fun. I will really miss her.

Paula Bellers, Communications Officer, Research and Development, Sussex Partnership NHS Foundation Trust

I’ve known Ruth since I joined the department five years ago and I was impressed by her drive, passion for involving people with lived experience in research, honesty, open-heartedness and sense of humour. She was a supportive and protective colleague and a real champion of me personally who was always quick to say ‘thank you’. We worked closely together preparing articles about involvement for our research magazines and several events and she was always enthusiastic, tenacious and keen to get her message across. Ruth’s network stretched far and wide and when I look back over the magazines, you can see that Ruth’s work in involvement runs throughout. I was always proud of her at events – when she spoke, it was always with clarity and honesty and the room sat up and listened! We also shared many conversations about her grandchildren, as well as a similar taste in music. Ruth was an exceptional person; she was a force of nature who liked get things done. I have learned so much from her and will miss her. 

Hugo Critchley, Chair in Psychiatry, Brighton and Sussex Medical School

I wish to express my personal condolences to Ruth’s family and friends and express my appreciation and gratitude for the wonderful opportunity to have worked with Ruth.  She was an inspiration to myself my colleagues and my team. She enthusiastically supported our work in psychiatry research at Brighton and Sussex Medical School.  Her input in shaping and advising on our research has been invaluable. For a period Ruth was also an active member of the Research Ethics and Governance Committee, providing a fresh, insightful and highly-valued input into decision-making about sponsoring and approving research at the University.  Recently I had been working with Ruth who led the PPI voice on an external ethics advisory for committee for one of my Research grants and was a collaborator on another, in which we sought to embed patient involvement throughout the delivery of the research.  Myself and my colleagues at Brighton and Sussex are deeply saddened by Ruth’s death.  She has left a lasting impression.  Ruth’s local and national championing of patient involvement in clinical research and practice will have a lasting impact.

Sara Meddings, Psychology and Psychological Therapies Consultant Lead for Recovery and Wellbeing, Sussex Partnership NHS Foundation Trust

Ruth is an inspiration. Her work with LEAF and making lived experience involvement an essential part of all research projects makes me proud to work for Sussex Partnership. She has been a service user leader standing up for people’s rights. She has been a huge supporter of the Recovery College from the start. She has encouraged me to put in research proposals about recovery and lived experience. She has also been a huge support to me especially in my thinking about using my own lived experience. I will miss her. She has been at the forefront of recovery focused research both locally and nationally.  I am confident that she has left such an impression that her legacy will live on.

Victoria Hare, Manager Centre for Dementia Studies

Dear Ruth, your contribution to dementia research, is unforgettable. Thank you, much love.

Clara Strauss, Research Fellow, Research and Development Team, Sussex Partnership NHS Foundation Trust

I can’t remember a time when Ruth wasn’t here – when I think of the R&D department, I think of Ruth – her kind hearted, passionate and challenging presence. Quite simply, the R&D department wouldn’t be what it is today without Ruth, it would be poorer and more one-dimensional. There were many times when I agreed with Ruth – and many times when Ruth helped me to change my mind and really see the value of lived experience involvement, opening my eyes to issues and perspectives I wasn’t aware of. There were times when I didn’t agree with Ruth, and she always responded with respect and understanding – but also held her ground – which I respected her for, and which I think was needed. On a personal level I feel so sad to have lost such a unique and valued colleague, and I still half expect to see Ruth walking down the corridor. I will miss her.

Dr Kay Macdonald  – Executive Lead for Research, Sussex Partnership NHS Foundation Trust

Our dear Ruth  – we will miss her so much. On behalf of the Board and Executive team at Sussex Partnership Trust we would like acknowledge just how much she has helped us develop our research. She was a leading light in helping us understand and be curious about mental health. She leaves a great legacy – her shoes will never be adequately filled. 

Duncan Barron, NIHR Research Design Service South East & Brighton & Sussex University Hospital Trust (BSUH) University of Brighton

Ruth Chandler: My ‘Critical Friend’

Ruth first introduced me to an approach to service user feedback and consultation in health research modelled on the Critical Friend Model.  This has proved invaluable in my own work.  In many ways Ruth was the embodiment of a ‘critical friend’: she was a “trusted person who asks provocative questions…”; she always examined situations through “another lens” and offered her critique “as a friend.” She took time to “fully understand the context” of whatever was set before her and she was always “an advocate for the success” of projects she believed in or people in her life.  She didn’t find your flaws; she saw your strengths.  She wanted to help and move projects and people forward.  Ruth was intellectually challenging and stimulating.  Her contributions to discussions were provocative but pertinent.  Often she changed your mind.  Despite challenges in her own life Ruth  was compassionate and caring and took the time to find out about others and offer support and advice that was always apposite.  Thanks Ruth; I was fortunate to know you as a ‘critical friend’.  You will be greatly missed.

Dr Clio Berry, Research Fellow, University of Sussex and Sussex Partnership NHS Foundation Trust. 

Ruth was a true inspiration to me and so many others; both in how she challenged the systems surrounding us and the work we do and how she used her own life experiences in such a remarkably constructive way. She made a real difference to service user and carer involvement both locally and nationally. She motivated and inspired her colleagues, peers and the many students who came into contact with her and her teaching. She was passionately dedicated to improving the lives and experiences of service users and carers.

Ruth had a tremendous amount of bravery and integrity. She was a powerful woman with a powerful presence. She was almost intimidatingly intelligent but open and willing to share her thoughts and ideas with others. She worked hard to include, support and encourage all her colleagues and was a mentor and role model to so many. I and many others benefitted hugely both personally and professionally from working with and learning from Ruth. Most of all, Ruth was honest, funny and human – and she will be so missed.

For Ruth

RRN Meetings

The next meeting of the RRN will be held on:

Tuesday, April 18^th in London

(venue to be confirmed and advertised in due course)

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

                        shula.ramon@anglia.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

Conferences and Events

i) ImROC: What is the Role of Peer Support. Note change of date

Unfortunately a significant number of people are unable to make the Peer Worker Critical Debate; what is the role of peer support? planned for 31 January but are interested in the content. We agree that this is an important issue for us to dedicate time to and explore as a national group of thought leaders. We welcome your attendance on 1 June 2017, one year on from our last peer worker critical debate, to reflect on changes over the last year and set out our expectations and ambitions for the future.

Together we can unpick this challenging issue and consider what this means for our practical locally and collectively. Peer support is a crucial element of supporting recovery for all. At ImROC we are passionate about sharing positive experiences and practice, challenges ourselves to be better and supporting one another to make recovery a reality. This conference is relevant to whole communities including NHS funded mental health providers, commissioners, user led organisations and forums.

The programme chaired by Julie Repper, ImROC Director, includes:

• The debate: what is the role of peer support? It’s not what we do, it’s the way that we do it (Jane Rennison & Sue Williams, Central & North West London  NHS Foundation Trust) vs distinct & dedicated peer support (Steve Gillard, St George’s University of London)
• Presentation: developments in the role of peer support (Emma Watson, Peer Support Development Lead, Nottinghamshire Healthcare NHS Foundation Trust)
• Presentation: Peer Support development for substance misuse services (Jon Roberts, Dear Albert, Drug Rehabilitation, Nottingham)
• Interactive workshops led by Rachel Perkins, ImROC Senior Consultant

To book your place please click on this link https://www.surveymonkey.co.uk/r/PGDJZQF

Delegate rates:

£100 plus VAT for ImROC sites

£150 plus VAT for non ImROC sites.

http://www.imroc.org/

ii) Making Real Change Happen. The 20^th International Congress of the ISPS will take place in the city of Liverpool, UK August 30^th – September 3^rd, 2017

Plenary Speakers will include: Alison Brabban, Jacqui Dillon, Grainne Fadden, Jim van Os Other speakers will include: Richard Bentall, Jim Geekie, Peter Kinderman, Eleanor Longden, Brian Martindale, John Read, Rai Waddingham

See more at: http://tinyurl.com/isps-change

Contact: isps@isps.org or visit www.isps2017uk.org

Twitter: #isps2017uk

iii) Registration and abstract submission are now open for Refocus on Recovery 2017, being held in Nottingham from 18th to 20th September 2017. The event will comprise expert workshops, an international conference and a Mad Celebration event. Conference themes will be Recovery for different groups, Re-situating mental health, Prevention of mental ill-health, Allocating resources.

See more at: https://www.researchintorecovery.com/ror2017

See also the flyers circulated with this edition of the ebulletin.

iv) The 12th ENMESH Conference will be held in Groningen, Netherlands from 5^th to the 7^th October 2017. Conference themes are Assessment:  Understanding the context; Epidemiology:  Methodological approaches supporting personalised care; Approaches:  Novel approaches using the patient’s own context; and Policy:  Societal challenges for community mental health. Further information at http://enmesh2017groningen.com/home/

Papers and Publications

i) Hart, A., Gagnon, E., Eryigit-Madzwamuse, S., Cameron, J., Aranda, K., Rathbone, A. and Heaver, B. (2016) Uniting resilience research and practice with an inequalities approach. SAGE Open 6(4) 1-15.

http://journals.sagepub.com/doi/abs/10.1177/2158244016682477

Abstract

The concept of resilience has evolved, from an individual-level characteristic to a wider ecological notion that takes into account broader person–environment interactions, generating an increased interest in health and well-being research, practice and policy. At the same time, the research and policy-based attempts to build resilience are increasingly under attack for responsibilizing individuals and maintaining, rather than challenging, the inequitable structure of society. When adversities faced by children and young people result from embedded inequality and social disadvantage, resilience-based knowledge has the potential to influence the wider adversity context. Therefore, it is vital that conceptualizations of resilience encompass this potential for marginalized people to challenge and transform aspects of their adversity, without holding them responsible for the barriers they face. This article outlines and provides examples from an approach that we are taking in our research and practice, which we have called Boingboing resilience. We argue that it is possible to bring resilience research and practice together with a social justice approach, giving equal and simultaneous attention to individuals and to the wider system. To achieve this goal, we suggest future research should have a co-produced and inclusive research design that overcomes the dilemma of agency and responsibility, contains a socially transformative element, and has the potential to empower children, young people, and families.

ii) Cameron, J., Sadlo, G., Hart, A. and Walker, C. (2016) Return-to-work support for workers with mental health problems: identifying and responding to key challenges of sick leave

British Journal of Occupational Therapy. 79(5) 275-283.

http://journals.sagepub.com/doi/abs/10.1177/0308022615627176

Abstract

Introduction:  This research explored return-to-work and sick leave experiences of workers with mental health issues in contact with acute or community mental health services.

Method: Using a critical realist methodology with a comparative case study and collaborative design, 21 employed participants recovering from mental health problems participated in semi-structured interviews. Data were analysed using inductive and deductive thematic and constant comparative analysis.

Findings: While on sick leave, despite a range of challenges, participants treasured their work identities. They were sustained by positive and troubled by negative memories of work. People missed the routine of work and felt isolated. To varying degrees of success, they searched for alternative activities to fill this gap and promote recovery.

Conclusion:  The need for sick leave was not disputed, but an important discovery was its iatrogenic (‘side-’) effects, whereby isolation and reduced activity levels could exacerbate mental health problems. Negative impacts of sick leave need to be mitigated by support to maintain worker identity and orientation and by opportunities and encouragement to sustain routine, activities and social contacts. A new concept of ‘occupational capital’ emerged, comprising accessible external opportunities and supports for occupational participation, and internal capacities and skills required to access these.

iii) Loos, S., Clarke, E., Jordan, H., Puschner, B., Fiorillo, A., Luciano, M., Ivánka, T., Magyar, E., Krogsgaard-Bording, M., Østermark-Sørensen, H., Rössler, W., Kawohl, W., Mayer, B., Slade, M. and CEDAR Study Group. (2017) Recovery and decision-making involvement in people with severe mental illness from six countries: a prospective observational study. BioMed Central.

DOI: 10.1186/s12888-017-1207-4

Abstract

Background:  Clinical decision-making is the vehicle of health care provision, and level of involvement predicts implementation and satisfaction. The aim of this study was to investigate the impact of decision-making experience on recovery.

Methods:  Data derived from an observational cohort study “Clinical decision making and outcome in routine care for people with severe mental illness” (CEDAR). Adults (aged 18–60) meeting standardised criteria for severe mental illness were recruited from caseloads of outpatient and community mental health services in six European countries. After consenting, they were assessed using standardised measures of decision-making, clinical outcome and stage of recovery at baseline and 1 year later. Latent class analysis was used to identify course of recovery, and proportional odds models to investigate predictors of recovery stage and change.

Results:  Participants (n = 581) clustered into three stages of recovery at baseline: Moratorium (N = 115; 19.8%), Awareness/Preparation (N = 145; 25.0%) and Rebuilding/Growth (N = 321; 55.2%). Higher stage was cross-sectionally associated with being male, married, living alone or with parents, and having better patient-rated therapeutic alliance and fewer symptoms. The model accounted for 40% of the variance in stage of recovery. An increased chance of worse outcome (change over 1 year to lower stage of recovery) was found for patients with active involvement compared with either shared (OR = 1.84, 95% CI 1.15–2.94) or passive (OR = 1.71, 95% CI = 1.00–2.95) involvement. Overall, both process (therapeutic relationship) and outcome (symptomatology) are cross-sectionally associated with stage of recovery.

Conclusions: Patient-rated decision-making involvement and change in stage of recovery are associated. Joint consideration of decision practice within the recovery process between patient and clinician is supposed to be a useful strategy to improve clinical practice (ISRCTN registry: ISRCTN75841675. Retrospectively registered 15 September 2010).

iv) Sweeney, A., Clement, S., Filson, B. and Kennedy, A. (2016) Trauma-informed mental healthcare in the UK: what is it and how can we further its development? Mental Health Review Journal. 21(3) 174 – 192.

http://dx.doi.org/10.1108/MHRJ-01-2015-0006

Abstract

Purpose: The purpose of this paper is to describe and explain trauma-informed approaches (TIAs) to mental health. It outlines evidence on the link between trauma and mental health, explains the principles of TIAs and their application in mental health and explores the extent to which TIAs are impacting in the UK.

Design/methodology/approach: The approach is a conceptual account of TIAs including a consideration of why they are important, what they are and how they can become more prevalent in the UK. This is supported by a narrative overview of literature on effectiveness and a scoping of the spread of TIAs in the UK.

Findings: There is strong and growing evidence of a link between trauma and mental health, as well as evidence that the current mental health system can retraumatise trauma survivors. There is also emerging evidence that trauma-informed systems are effective and can benefit staff and trauma survivors. Whilst TIAs are spreading beyond the USA where they developed, they have made little impact in the UK. The reasons for this are explored and ways of overcoming barriers to implementation discussed.

Originality/value: This paper – authored by trauma survivors and staff – describes an innovative approach to mental health service provision that, it is argued, could have immense benefits for staff and service users alike.

v) McWade, B. (2016) Recovery-as-policy as a form of neoliberal state making. Intersectionalities. 5(3) 62-79.

Abstract

In this paper I provide an analysis of the implementation of “recovery” as a policy object and commitment in the United Kingdom. This can be situated as part of the New Labour government’s (1997–2010) reform of the NHS during the 2000s. Through a textual analysis of policy and legislation from this time I draw out a tension between contemporary ideals of choice and autonomy in health care and the specificities of a mental health care system in which psychiatrists are legislatively empowered to treat patients without their consent. In the United Kingdom, evidence continues to show that the most economically and socially disadvantaged members of British society are most likely to be detained under the Mental Health Act (2007). This paper provides an intersectional analysis of the ways in which policy, legislation and psychiatrization enact particular subjects as “failed” citizens. Following Tyler (2010, 2013), I argue that these practices of exclusion and detainment are constituent elements of neoliberal state making, which are discriminatory and unjust.

New Book

i) Slade, M., Bronwell, T., Rashad, T. and Schrank, B. (2017) Positive psychotherapy for psychosis: a clinician’s guide and manual. Routledge.

About the Book (Publisher information)

Positive Psychotherapy for Psychosis describes a new psychological intervention, which for the first time applies emerging research from the field of positive psychology specifically to psychosis. The book contains guidance on adapting the approach for use in individual treatments, and on providing part of the intervention, either as individual sessions or by integrating Positive Psychotherapy for Psychosis sessions into other treatments.

https://www.routledge.com/Positive-Psychotherapy-for-Psychosis-A-Clinicians-Guide-and-Manual/Slade-Brownell-Rashid-Schrank/p/book/9781138182875

Discussion

Last month we promoted discussion on the topic of:

Given the contemporary issues surrounding mental health and young people, this edition of the ebulletin focuses upon the Munson et al. (2016) paper, based on a US pilot, to ask the readership about how they see the viability of a Cornerstone-type project within other contexts?

We have had no responses on this topic.

This month we would welcome readers’ comments on two interconnected papers whose summaries appear above – Uniting resilience research and practice with an inequalities approach, and Recovery-as-policy as a form of neoliberal state making.  Both raise the value of the social justice approach vis-a-vis recovery key components; one concluding that it is possible to bring social justice and recovery together, the other that this cannot be the case. What is your view?

Other News

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

                        shula.ramon@anglia.ac.uk

Tony                a.sparkes@bradford.ac.uk

page updated 8 February 2017

Recovery Research Network eBULLETIN

February 2017

 

RRN Meetings

The next meeting of the RRN will be held on:

Tuesday, April 18^th 10am – 4pm

at

The McPin Foundation

32-36 Loman Street, London SE1 0EH

The event will be themed around ‘mental health and identity’

For further details (including description, provisional speakers, map of venue and so on) please see:

https://www.eventbrite.co.uk/e/recovery-research-network-spring-2017-tickets-31708245215

 

The agenda for the day has yet to be finalised and will be confirmed in due course

 

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

                        shula.ramon@anglia.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

An opportunity to join the Recovery Research Network (RRN) Collective 

We have three vacancies on the RRN Collective. The role and current Collective members are on the RRN website (researchintorecovery.com/rrn) under the RRN Collective tab. RRN Collective members co-ordinate the monthly e-bulletins, and organise and regularly attend the six-monthly meetings. If this (un-funded) role might be of interest then feel free to contact Mike Slade (m.slade@nottingham.ac.uk) to discuss.

Please can we encourage members to forward their peer-reviewed articles and book publications to us in a timely manner in order that we can best disseminate their literary efforts to the broader membership.

Conferences and Events

i) ImROC: What is the Role of Peer Support. Note change of date

Unfortunately a significant number of people are unable to make the Peer Worker Critical Debate; what is the role of peer support? planned for 31 January but are interested in the content. We agree that this is an important issue for us to dedicate time to and explore as a national group of thought leaders. We welcome your attendance on 1 June 2017, one year on from our last peer worker critical debate, to reflect on changes over the last year and set out our expectations and ambitions for the future.

Together we can unpick this challenging issue and consider what this means for our practical locally and collectively. Peer support is a crucial element of supporting recovery for all. At ImROC we are passionate about sharing positive experiences and practice, challenges ourselves to be better and supporting one another to make recovery a reality. This conference is relevant to whole communities including NHS funded mental health providers, commissioners, user led organisations and forums.

The programme chaired by Julie Repper, ImROC Director, includes:

• The debate: what is the role of peer support? It’s not what we do, it’s the way that we do it (Jane Rennison & Sue Williams, Central & North West London  NHS Foundation Trust) vs distinct & dedicated peer support (Steve Gillard, St George’s University of London)
• Presentation: developments in the role of peer support (Emma Watson, Peer Support Development Lead, Nottinghamshire Healthcare NHS Foundation Trust)
• Presentation: Peer Support development for substance misuse services (Jon Roberts, Dear Albert, Drug Rehabilitation, Nottingham)
• Interactive workshops led by Rachel Perkins, ImROC Senior Consultant

To book your place please click on this link https://www.surveymonkey.co.uk/r/PGDJZQF

Delegate rates:

£100 plus VAT for ImROC sites

£150 plus VAT for non ImROC sites.

http://www.imroc.org/

ii) Making Real Change Happen. The 20^th International Congress of the ISPS will take place in the city of Liverpool, UK August 30^th – September 3^rd, 2017

Plenary Speakers will include: Alison Brabban, Jacqui Dillon, Grainne Fadden, Jim van Os Other speakers will include: Richard Bentall, Jim Geekie, Peter Kinderman, Eleanor Longden, Brian Martindale, John Read, Rai Waddingham

See more at: http://tinyurl.com/isps-change

Contact: isps@isps.org or visit www.isps2017uk.org

Twitter: #isps2017uk

iii) Registration and abstract submission are now open for Refocus on Recovery 2017, being held in Nottingham from 18th to 20th September 2017. The event will comprise expert workshops, an international conference and a Mad Celebration event. Conference themes will be Recovery for different groups, Re-situating mental health, Prevention of mental ill-health, Allocating resources.

See more at: https://www.researchintorecovery.com/ror2017

See also the flyers circulated with this edition of the ebulletin.

iv) The 12th ENMESH Conference will be held in Groningen, Netherlands from 5^th to the 7^th October 2017. Conference themes are Assessment:  Understanding the context; Epidemiology:  Methodological approaches supporting personalised care; Approaches:  Novel approaches using the patient’s own context; and Policy:  Societal challenges for community mental health. Further information at http://enmesh2017groningen.com/home/

Papers and Publications

i) Mezzich, J. E., Kirisci, L., Salloum, I., Trivedi, J., Kar, S. J., Adams, N. and Wallcraft, J. (2016) Systematic Conceptualization of Person Centered Medicine and Development and Validation of a Person-centered Care Index.  The International Journal of Person Centred Medicine. 6(4) 219-247. 

Abstract

Background: A world-wide movement is emerging for person centered medicine and healthcare collaboratively developed by the International College of Person Centered Medicine and a number of global institutions through annual Geneva Conferences and International Congresses as well as scholarly publications. While frequently quoted definitional notes have been advanced through this maturational process, efforts are needed to conceptualize and measure systematically person-centered care.

Objectives: These included the elucidation of the core concepts of person centered medicine and healthcare, the design of a prototype measuring instrument, and the study of its metric structure, acceptability, reliability and validity.

Methods: The following methodological approaches were employed: A systematic review of the literature, consultation exercises with broad international panels composed of health professionals and representatives of patient and family organizations, and quantitative and qualitative data analyses.

Results: The following key concepts underlying person centered medicine were elucidated: 1) Ethical Commitment, 2) Cultural Sensitivity, 3) Holistic scope, 4) Relational Focus, 5) Individualized Care, 6) Common Ground for Collaborative Diagnosis and Care, 7) People-centered Systems of Care, and 8) Person-centered Education and Research. On this basis, a Person-centered Care Index was developed composed of 8 broad items and 33 sub-items, each measured on a 4-point scale. The study of its metric structure revealed high Cronbach internal consistency (0.95), scale unidimensionality through factor analysis (69 % of the variance accounted for by the first factor), and interesting inter-correlations such as the sub-item attaining the highest correlation with the global average score being “fulfillment of the person’s life project” (0.88). Validation studies in California, London and Lucknow (India) showed quite high levels of inter-rater reliability (above 0.80 intra-class correlations for most items) and substantial content validity.

Discussion: The elucidated core concepts of person centered medicine appear to be consistent with those of international studies on the bases of person- and people-centeredness in primary care and on research and implementation of person centered care. The concepts are also consistent with the key domains of person-centered diagnostic approaches. Further validation studies with larger samples in diverse settings and cultures seem to be warranted.

Conclusions. The emerging core concepts of person centered medicine appear to be robust. The Person-centered Care Index built on such concepts appears to have suitable metrics and substantial acceptability, reliability and content validity. Further empirical research is recommended.

ii) Stead, U., Morant, N. and Ramon, S. (2017) Shared decision-making in medication management: development of a training intervention. BJPsych Bulletin. January 2017. 1-7

doi: 10.1192/pb.bp.116.053819

Summary: Shared decision-making is a collaborative process in which clinicians and patients make treatment decisions together. Although it is considered essential to patient-centred care, the adoption of shared decision-making into routine clinical practice has been slow, and there is a need to increase implementation. This paper describes the development and delivery of a training intervention to promote shared decision-making in medication management in mental health as part of the Shared Involvement in Medication Management Education (ShIMME) project. Three stakeholder groups (service users, care coordinators and psychiatrists) received training in shared decision-making, and their feedback was evaluated. The programme was mostly well received, with all groups rating interaction with peers as the best aspect of the training. This small-scale pilot shows that it is feasible to deliver training in shared decision-making to several key stakeholders. Larger studies will be required to assess the effectiveness of such training.

Discussion

Last month we promoted discussion on the following topics:

Uniting resilience research and practice with an inequalities approach, and Recovery-as-policy as a form of neoliberal state making.

We suggested that both topics raised the value of the social justice approach vis a vis recovery key components; one concluding that it is possible to bring social justice and recovery together, the other that this cannot be the case. Shula has kindly posted the following response:

The two papers recognise the importance of a social justice perspective when focusing on mental health recovery. The paper by Hart et al does so in terms of the relationships between resilience and social justice; while the paper by McWade looks at the issue of social justice in the implementation of the UK Mental Health Act (2007).

 

Social justice is a wide area, covering many aspects. The aspect focused upon in the Hart et al paper is that of service users’ responsibility vs. the responsibility of the wider social system. The recovery approach has been recently criticised for expecting people with lived experience of mental ill health to take responsibility for their lives and decisions, arguing that this is an attempt by a neo-liberal system to shift burden and failure to this group, ignoring the contribution of social structural elements and in particular of state structural elements.

 

The recovery approach does indeed aim for people to take control over their lives as much as possible, but without an expectation that the state, representing society at large, should not contribute its share in taking responsibility for enhancing social justice and contributing to the welfare of its citizens, especially those vulnerable.

 

McWade is looking at a legislation aimed a-priori to make decisions about people in crisis, even against their will, which does not indicate an interest (or an investment) in encouraging people to take more personal responsibility, or to genuinely participate in decision making. Furthermore, it focuses primarily on symptoms reduction, and is not aligned to recovery principles.

 

It is therefore not surprising that this Act does not pay attention to the fact that those more deprived of social support and living in poverty constitute a larger group among those detained by the application of the Act then those who are less deprived.

 

The impact of living in poverty by people with lived experience of mental ill health has been noted in a number of studies (e.g. Topor et al, 2013, Mills, 2015) highlighting the ingenuity required to manage to maintain one’s quality of life while living in poverty on the one hand and on the other hand of the harm done by a neoliberal welfare regime to this group of people.

 

Shula Ramon February 28^th 2017

Topor, A. et al (2014) Psychosis and Poverty: coping with poverty and severe mental illness in every day life. Psychosis, 6, 117-127.

Mills, C. (2015) The Psychiatrization of Poverty@ Rethinking the Mental Health-Poverty Nexus. Social and Personality Psychology Compass, 9,5, 213-222.

Other News

Recovery College Research

If you are involved in Recovery College research, you may be interested to know that a list of research groups with current or planned studies investigating Recovery Colleges is being created at www.researchintorecovery.com/rcrg. In order to foster collaboration and connection, feel free to add your details to the list.

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

                        shula.ramon@anglia.ac.uk

Tony                a.sparkes@bradford.ac.uk

page updated 10 March 2017

Recovery Research Network eBULLETIN

March 2017

RRN Meetings 

The previously advertised RRN meeting on the 18^th of April 2017 is now fully booked.  Please do not journey to the venue on the day as there is only capacity to allow entry to those people who have reserved a place.  In the best RRN tradition, we shall seek to make presentations available on the RRN website soon after the meeting.

For information, the theme of the meeting will be around Identity and mental health and invite presentations from the following speakers:

Alison Faulkner: Some complexities of identity and power in relation to survivor research 

Colin King: Surviving research – racialisation from a black perspective 

Rhiannon Foster, Kati Turner and Lucy Goldsmith: The importance of personal, social and political identity in mental health recovery

Jessica Worner and Natalie Koussa: Who am I? Peer identities in mental health 

Sheena Foster: When survival means losing your identity 

Ruth Sayers: – Repairing “spoiled identity”: Using therapy in bipolar recovery

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

shula.ramon@anglia.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

An opportunity to join the Recovery Research Network (RRN) Collective

We have three vacancies on the RRN Collective. The role and current Collective members are on the RRN website (researchintorecovery.com/rrn) under the RRN Collective tab. RRN Collective members co-ordinate the monthly e-bulletins, and organise and regularly attend the six-monthly meetings. If this (un-funded) role might be of interest then feel free to contact Mike Slade (m.slade@nottingham.ac.uk) to discuss.

Please can we encourage members to forward their peer-reviewed articles and book publications to us in a timely manner in order that we can best disseminate their literary efforts to the broader membership.

Conferences and Events

i) ImROC: What is the Role of Peer Support. Note change of date

Unfortunately a significant number of people are unable to make the Peer Worker Critical Debate; what is the role of peer support? planned for 31 January but are interested in the content. We agree that this is an important issue for us to dedicate time to and explore as a national group of thought leaders. We welcome your attendance on 1 June 2017, one year on from our last peer worker critical debate, to reflect on changes over the last year and set out our expectations and ambitions for the future.

Together we can unpick this challenging issue and consider what this means for our practical locally and collectively. Peer support is a crucial element of supporting recovery for all. At ImROC we are passionate about sharing positive experiences and practice, challenges ourselves to be better and supporting one another to make recovery a reality. This conference is relevant to whole communities including NHS funded mental health providers, commissioners, user led organisations and forums.

The programme chaired by Julie Repper, ImROC Director, includes:

• The debate: what is the role of peer support? It’s not what we do, it’s the way that we do it (Jane Rennison & Sue Williams, Central & North West London  NHS Foundation Trust) vs distinct & dedicated peer support (Steve Gillard, St George’s University of London)
• Presentation: developments in the role of peer support (Emma Watson, Peer Support Development Lead, Nottinghamshire Healthcare NHS Foundation Trust)
• Presentation: Peer Support development for substance misuse services (Jon Roberts, Dear Albert, Drug Rehabilitation, Nottingham)
• Interactive workshops led by Rachel Perkins, ImROC Senior Consultant

To book your place please click on this link https://www.surveymonkey.co.uk/r/PGDJZQF

Delegate rates:

£100 plus VAT for ImROC sites

£150 plus VAT for non ImROC sites.

http://www.imroc.org/

ii) Making Real Change Happen. The 20^th International Congress of the ISPS will take place in the city of Liverpool, UK August 30^th – September 3^rd, 2017

Plenary Speakers will include: Alison Brabban, Jacqui Dillon, Grainne Fadden, Jim van Os Other speakers will include: Richard Bentall, Jim Geekie, Peter Kinderman, Eleanor Longden, Brian Martindale, John Read, Rai Waddingham

See more at: http://tinyurl.com/isps-change

Contact: isps@isps.org or visit www.isps2017uk.org

Twitter: #isps2017uk

iii) Registration is open for Refocus on Recovery 2017, being held in Nottingham from 18th to 20th September 2017. The event will comprise expert workshops, an international conference and a Mad Celebration event. Conference themes will be Recovery for different groups, Re-situating mental health, Prevention of mental ill-health, Allocating resources.

See more at: https://www.researchintorecovery.com/ror2017

iv) The 12th ENMESH Conference will be held in Groningen, Netherlands from 5^th to the 7^th October 2017. Conference themes are Assessment:  Understanding the context; Epidemiology:  Methodological approaches supporting personalised care; Approaches:  Novel approaches using the patient’s own context; and Policy:  Societal challenges for community mental health. Further information at http://enmesh2017groningen.com/home/

Papers and Publications

i) Burmeister, O. K. and Marks, E. (2016) Rural and remote communities, technology and mental health recovery. Journal of Information, Communication and Ethics in Society. 14(2) 170-181

Abstract

Purpose: This study aims to explore how health informatics can underpin the successful delivery of recovery-orientated healthcare, in rural and remote regions, to achieve better mental health outcomes. Recovery is an extremely social process that involves being with others and reconnecting with the world. 

Design/methodology/approach: An interpretivist study involving 27 clinicians and 13 clients sought to determine how future expenditure on ehealth could improve mental health treatment and service provision in the western Murray Darling Basin of New South Wales, Australia. 

Findings: Through the use of targeted ehealth strategies, it is possible to increase both the accessibility of information and the quality of service provision. In small communities, the challenges of distance, access to healthcare and the ease of isolating oneself are best overcome through a combination of technology and communal social responsibility. Technology supplements but cannot completely replace face-to-face interaction in the mental health recovery process. 

Originality/value: The recovery model provides a conceptual framework for health informatics in rural and remote regions that is socially responsible. Service providers can affect better recovery for clients through infrastructure that enables timely and responsive remote access whilst driving between appointments. This could include interactive referral services, telehealth access to specialist clinicians, GPS for locating clients in remote areas and mobile coverage for counselling sessions in “real time”. Thus, the technology not only provides better connections but also adds to the responsiveness (and success) of any treatment available 

ii)  Collins, P. and Crowe, S. (2017) Recovery and practice-based evidence: reconnecting the diverging discourses in mental health. Mental Health and Social Inclusion. 21(1) 34-42

doi: 10.1108/MHSI-09-2016-0028

Abstract

Purpose: The purpose of this paper is to explore the discourses which exist around the alleviation of mental distress, from the different perspective of mental health professionals and service users. It then looks at the use of “practice-based evidence” as a means of bringing together these two diverging discourses.

Design/methodology/approach: Literature on the discourses which exist around the cause and treatment of mental distress, from the perspective of professionals and service users, is first explored. Differences between these two discourses are identified, as are theoretical and practical limitations of current professional diagnostic and treatment paradigms. Finally the use of practice-based evidence as a means of bridging the gap between these two discourses is outlined.

Findings:  This paper highlights marked differences between the discourse which exists for professionals, and that for service users, around alleviating mental distress. The use of practice-based evidence is explored, not only as a means of bringing these two varying discourses together, but also as a tool which could help to improve treatment outcome in a way which is more inclusive of service users and fits with both empiricism and a broader recovery ethos.

Originality/value:  This paper applies a “practice-based evidence” approach to bringing together the divergent perspectives regarding mental health of service providers and users. In doing so it provides a practical and pragmatic approach to true collaborative working.

iii)  Zisman-Ilani, Y., Roe, D., Scholl, I. Härter M. and Karnieli-Miller, O. (2016)  Shared Decision Making During Active Psychiatric Hospitalization: Assessment and Psychometric Properties. Health Communication. 32(1) 126-130

Abstract

Encouraging patients to be involved in their care and enhancing shared decision making (SDM) have been advocated over the past two decades as means to enhance patient-centered care. However, one of the barriers to implementing SDM in medical consultations is the need to adapt this approach to various populations and medical settings, including mental health, and developing reliable and practical methods for measuring and assessing SDM. This article presents the psychometric properties and validity of a revised scale, SDM-Q-9-Psy, that assesses SDM in routine care among psychiatric inpatients. Psychiatric inpatients were included in a SDM intervention cohort (n = 46) or a control cohort (n= 40). The adapted scale was administered after a decision-making process. The scale was subsequently psychometrically tested via factor and reliability analyses. It was also tested for convergent validity and for its ability to distinguish the degree of SDM between the intervention and control groups (construct validity). The SDM-Q-9-Psy scale yielded a Cronbach’s α of .94. Convergent and construct validity parameters were good. The SDM-Q-9-Psy scale can be used to evaluate SDM from psychiatric inpatients’ perspective and to provide rapid feedback to mental health professionals, enabling them to monitor their decision-making practice in real-time clinical consultations.

Discussion

In September of last year we included a paper by Lynn Tang.  Our discussion section this month draws upon Tang’s (2016) paper and raises an important issue not only for those working with members of the Chinese community , but also for anyone else working with members of ethnic minorities in the context of mental health. Our question encourages a response from the readership to consider:

What are the elements that would help us to create a constructive conceptual way of making sense of the likely connections between understanding cultural fluidity, transformative community development approach and the intersecting structural inequality members of such minority groups are likely to meet?

Other News

Scottish Recovery Network

The Scottish Recovery Network (SRN) produces an e-update and present a number of interesting features and developments on the subject of mental health recovery. Further information can be found at:

https://www.scottishrecovery.net

https://www.scottishrecovery.net/news/

Recovery College Research

If you are involved in Recovery College research, you may be interested to know that a list of research groups with current or planned studies investigating Recovery Colleges is being created at www.researchintorecovery.com/rcrg  In order to foster collaboration and connection, feel free to add your details to the list.

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

shula.ramon@anglia.ac.uk

Tony:                     a.sparkes@bradford.ac.uk

page updated 13 April 2017

Recovery Research Network eBULLETIN

April 2017

Please can we remind the readership about our standing invitation to respond to a key question related to articles summarised in the ebulletin (see details in the Discussion section later in the ebulletin)

RRN Meetings 

The last meeting of the Recovery Research Network was held on the 18^th April at the McPin Foundation, London.  This was a well-attended and thought-provoking day.  Thank you to all who organised the event, including Vanessa Pinfold, and to all those individuals and agencies who contributed to the day.

Thank you to everyone who attended our ’Identity and Mental Health’ meeting, and for our speakers who left us with so much to ponder and reflect upon. This short report was compiled by Vanessa Pinfold. It is written to give a flavour of the session, and is not a full write up of the talks.

We started the meeting with a minute pause to remember our friend Ruth Chandler who helped set up the network and who died in December 2016. This particular discussion on identity would have been something she would have relished.

Dr Alison Faulkner who spoke first really helped us get into the topic quickly. Key areas discussed included changing identities over time, the concept of the “spoiled identity” from Goffman, survivor research using narrative methods, identity judgements including viewpoints of rationality versus irrationality, low versus high status positionalities considering experiential and research expertise, and the role of emotionality in research. Alison also stressed how we must remain aware of privilege in the research sector; some voices remain marginalised both in research teams and the topics investigated. This provided a useful Link to Dr Colin King’s talk – Surviving research: racialisation from a black perspective.

Colin asked whether current mental health practices were fit for purpose taking on board transcultural differences in the needs of people across society? He discussed values based practice, considering historic and current perspectives. The emphasise was on how research often provides too narrow a perspective (particularly white and western) and does not do what it is supposed to do – challenge established practices with new and innovative thinking.

The final session of the morning was delivered by Lucy Goldsmith and Rhiannon Foster from St George’s, University of London, drawing upon personal reflections from their roles as service user researchers.

 

All the speakers showed how they were ‘far more than a mental health identity’, but being reduced to one thing or another by the judgements or behaviour of others was far too easy. And those judgements were sometimes your own.

Our discussion before lunch drew us towards conversations around recovery, poverty and mental health. This provided an idea for the focus of our next meeting which will be in Oxford: Poverty, social inequalities and mental health.

Our afternoon session started with a presentation from Natalie Koussa at National Voices talking about their work on personalised care and Jessica Worner and Rhianna Blanchard from Together looking at peer identities from delivering peer support in the community. A key point was how peer identities mean different things to different people and should not be used to box or constrain people in peer support projects.  Assumptions should not be imposed, such as those linked to race or gender or diagnosis or age.

Our session moved in our next talk to secure care settings. Sheena Foster shared her experiences. The talk title “when survival means losing your identity” gives a strong sense of the journey Sheena and her family have been on through the prison system, high secure and medium secure care. She reflected on the challenges for:

• service users in a system that “strips away” identity;
• families that are unrecognised and side-lined by the system;
• staff that can become victims of institutionalisation.

Sheena’s personal analysis of two care systems (high and medium care) provided an example of hope that things can change for the better. She was clear that she is continuing to campaign for change.

The final session at the meeting was delivered by Ruth Sayers, who works with the McPin Foundation. The title “I live with three people, but I don’t like two of them very much” – my bipolar ID, came from a chance discussion with a local business owner who disclosed their own experiences of living with bipolar. Themes in Ruth’s talk included:

• Identity change points – such as losing paid occupation through mental ill-health or taking psychiatric medication;
• Reconciling multiple identities – finding balance where no one identity overruns another;

The topic – identity and mental health – is vast. That was clear when we started putting the agenda together. We could not do justice to it in a few hours. The idea was to invite a range of speakers to start the conversation that others could follow-up, and surface issues the network could host other meetings around. We thank everyone who attended and hope you found it a useful space for critical thinking.

The next meeting will take place in November, in Oxford. The specific date and time of this  meeting of the Recovery Research Network will be advertised in due course. The provisional topic will be around: Poverty and Social Inequality.

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

An opportunity to join the Recovery Research Network (RRN) Collective

We have three vacancies on the RRN Collective. The role and current Collective members are on the RRN website (researchintorecovery.com/rrn) under the RRN Collective tab. RRN Collective members co-ordinate the monthly e-bulletins, and organise and regularly attend the six-monthly meetings. If this (un-funded) role might be of interest then feel free to contact Mike Slade (m.slade@nottingham.ac.uk) to discuss.

Please can we encourage members to forward their peer-reviewed articles and book publications to us in a timely manner in order that we can best disseminate their literary efforts to the broader membership.

Conferences and Events

i) ImROC: What is the Role of Peer Support. Note change of date

Unfortunately a significant number of people are unable to make the Peer Worker Critical Debate; what is the role of peer support? planned for 31 January but are interested in the content. We agree that this is an important issue for us to dedicate time to and explore as a national group of thought leaders. We welcome your attendance on 1 June 2017, one year on from our last peer worker critical debate, to reflect on changes over the last year and set out our expectations and ambitions for the future.

Together we can unpick this challenging issue and consider what this means for our practical locally and collectively. Peer support is a crucial element of supporting recovery for all. At ImROC we are passionate about sharing positive experiences and practice, challenges ourselves to be better and supporting one another to make recovery a reality. This conference is relevant to whole communities including NHS funded mental health providers, commissioners, user led organisations and forums.

The programme chaired by Julie Repper, ImROC Director, includes:

• The debate: what is the role of peer support? It’s not what we do, it’s the way that we do it (Jane Rennison & Sue Williams, Central & North West London NHS Foundation Trust) vs distinct & dedicated peer support (Steve Gillard, St George’s University of London)
• Presentation: developments in the role of peer support (Emma Watson, Peer Support Development Lead, Nottinghamshire Healthcare NHS Foundation Trust)
• Presentation: Peer Support development for substance misuse services (Jon Roberts, Dear Albert, Drug Rehabilitation, Nottingham)
• Interactive workshops led by Rachel Perkins, ImROC Senior Consultant

To book your place please click on this link https://www.surveymonkey.co.uk/r/PGDJZQF

Delegate rates:

£100 plus VAT for ImROC sites

£150 plus VAT for non ImROC sites.

http://www.imroc.org/

ii) Making Real Change Happen. The 20^th International Congress of the ISPS will take place in the city of Liverpool, UK August 30^th – September 3^rd, 2017

Plenary Speakers will include: Alison Brabban, Jacqui Dillon, Grainne Fadden, Jim van Os Other speakers will include: Richard Bentall, Jim Geekie, Peter Kinderman, Eleanor Longden, Brian Martindale, John Read, Rai Waddingham

See more at: http://tinyurl.com/isps-change

Contact: isps@isps.org or visit: www.isps2017uk.org

Twitter: #isps2017uk

iii) Registration is open for Refocus on Recovery 2017, being held in Nottingham from 18th to 20th September 2017. The event will comprise expert workshops, an international conference and a Mad Celebration event. Conference themes will be Recovery for different groups, Re-situating mental health, Prevention of mental ill-health, Allocating resources.

See more at: https://www.researchintorecovery.com/ror2017

iv) The 12th ENMESH Conference will be held in Groningen, Netherlands from 5^th to the 7^th October 2017. Conference themes are Assessment: Understanding the context; Epidemiology: Methodological approaches supporting personalised care; Approaches: Novel approaches using the patient’s own context; and Policy: Societal challenges for community mental health. Further information at: http://enmesh2017groningen.com/home/

Papers and Publications

i) McGrath, L., Griffin, V. and Mundy E. (2015) The Psychological Impact of Austerity: A Briefing Paper. PAA. London

https://psychagainstausterity.files.wordpress.com/2015/03/paa-briefing-paper.pdf

Executive Summary (introduction)

This report directly links cuts to public services with mental health problems. Well-established psychological research that explains these links already exists. However, this knowledge has been missing from the debate on austerity so far. Psychologists are often in a position to see the effects that social and economic changes have on people. We also occupy a relatively powerful position as professionals and therefore have an ethical responsibility to speak out about these effects.

ii) Psychologists for Social Change (2017) Universal Basic income: A Psychological Impact Assessment. PAA. London

http://www.psychchange.org/uploads/9/7/9/7/97971280/ubi_briefing_low_res.pdf

Executive Summary (introduction)

This briefing paper is the beginning of a psychological impact assessment of the universal basic income policy (UBI), which would guarantee a regular, unconditional basic income for all citizens of a nation, whatever their employment status, throughout their lifetime.

iii) Slobodin, O. and de Jong, Joop TVM (2015) Mental health interventions for traumatised asylum seekers and refugees: what do we know about their efficacy?  International Journal of Social Psychiatry. 61(1) 17-26.

DOI: 10.1177/0020764014535752

Abstract

Background: The prevalence of trauma-related problems among refugees and asylum seekers is extremely high due to adverse experiences associated with forced migration. Although the literature presents a considerable number of guidelines and theoretical frameworks for working with traumatized refugees and asylum seekers, the efficacy, feasibility and applicability of these interventions have little empirical evidence.

Aims: The purpose of this article is to critically review the literature to provide a rationale for developing culturally sensitive, evidence-based interventions for refugees and asylum seekers.

Methods: A literature review integrating research findings on interventions designed especially for traumatized asylum seekers and refugees was conducted. Retained studies had to use some quantitative measurements of post-traumatic stress and to have pre- and post-measurements to evaluate the efficacy of the intervention. Studies included in this review cover a wide variety of interventions, including trauma-focused interventions, group therapy, multidisciplinary interventions and pharmacological treatments.

Results: The majority of studies with traumatized refugees and asylum seekers reported positive outcomes of the intervention in reducing trauma-related symptoms. There is evidence to support the suitability of cognitive-behavioral therapy (CBT) and narrative exposure therapy (NET) in certain populations of refugees. Other intervention studies are limited by methodological considerations, such as lack of randomization, absence of control group and small samples.

Conclusions: This review has again highlighted the shortage of guiding frameworks available to investigators and clinicians who are interested in tailoring interventions to work with refugees and asylum seekers. Theoretical, ethical and methodological considerations for future research are discussed.

iv) Væggemose, U., Lou, S., Frumer, M., Christiansen, N.L., Aagaard, J. and Ørtenblad, L. (2017) Community Families: Bridging the gap between mental health services and civil society – A qualitative study from users’ perspective. International Journal of Social Psychiatry. 63(2) 132-138.

DOI: 10.1177/0020764016687789

Abstract

Background: Social interventions to support people with severe mental illness are important to improving the quality of life. The perspectives of users are essential in this process. This article explores users’ experiences, investments and concerns of a befriending programme.

Material: Focus group and individual qualitative interviews with service users.

Discussion: Overall, the experiences with the programme were positive, and the social interaction was highly valued. However, the fact that the relationships were arranged and facilitated by mental health workers remained an unresolved concern even after several years.

Conclusion: People with severe mental illness benefit from relationships despite the need of professional assistant.

v) Collins, P. and Crowe, S. (2017) Recovery and practice-based evidence: reconnecting the diverging discourses in mental health. Mental Health and Social Inclusion. 21(1) 34-42

DOI: 10.1108/MHSI-09-2016-0028

Abstract

Purpose: The purpose of this paper is to explore the discourses which exist around the alleviation of mental distress, from the different perspective of mental health professionals and service users. It then looks at the use of “practice-based evidence” as a means of bringing together these two diverging discourses.

Design/methodology/approach: Literature on the discourses which exist around the cause and treatment of mental distress, from the perspective of professionals and service users, is first explored. Differences between these two discourses are identified, as are theoretical and practical limitations of current professional diagnostic and treatment paradigms. Finally the use of practice-based evidence as a means of bridging the gap between these two discourses is outlined.

Findings: This paper highlights marked differences between the discourse which exists for professionals, and that for service users, around alleviating mental distress. The use of practice-based evidence is explored, not only as a means of bringing these two varying discourses together, but also as a tool which could help to improve treatment outcome in a way which is more inclusive of service users and fits with both empiricism and a broader recovery ethos.

Originality/value: This paper applies a “practice-based evidence” approach to bringing together the

divergent perspectives regarding mental health of service providers and users. In doing so it provides a practical and pragmatic approach to true collaborative working.

vi) Vandewalle, J., Debyser, B., Beeckman, D., Vandecasteele, T., Deproost, E., Hecke, A. and Verhaeghe, S. (2017) Constructing a positive identity: A qualitative study of the driving forces of peer workers in mental health-care systems. International Journal of Mental Health Nursing. [Early view. Online]

DOI:10.1111/inm.12332

Abstract

There is growing recognition in mental health for the perspective of individuals with lived experience of mental health problems and mental health service use. As peer workers, these individuals can use their specific experience to benefit and support peers and professional caregivers, and to participate at all levels of mental health-care systems. The aim of the present study was to develop a conceptual framework representing the driving forces of peer workers to fullfil their position in mental health-care systems. A qualitative interview approach was employed using principles of grounded theory. Over a period of 5 months in 2014–2015, semistructured interviews were conducted with 14 peer workers in residential and community mental health-care systems. The emerged conceptual framework reveals that peer workers strive towards constructing a positive identity. This process is powered by driving forces reflecting a desire for normalization and an urge for self-preservation. Peer workers realize a meaningful employment by applying their lived experience perspective as an asset, liberating themselves out of restrictive role patterns, and by breaking down stigma and taboo. As a precondition to engage in these normalization processes, peer workers perceive they need to secure their self-preservation by balancing the emergence of adverse emotional fluctuations. The conceptual framework can inform the development of work contexts in which peer workers have an authentic and meaningful contribution, while being offered sufficient support and learning opportunities to manage their well-being.

vii) Strand, M., Gammon, D. and Ruland, C.M. (2017) Transitions from biomedical to recovery-oriented practices in mental health: a scoping review to explore the role of Internet-based interventions. BMC Health Services Research. 17:257. 1-14.

DOI: 10.1186/s12913-017-2176-5

Abstract

Background: The Internet is transforming mental health care services by increasing access to, and potentially improving the quality of, care. Internet-based interventions in mental health can potentially play a role in transitions from biomedical to recovery-oriented research and practices, but an overview of what this may entail, current work, and issues that need addressing, is lacking. The objective of this study is to describe Internet-based recovery oriented interventions (referred to as e-recovery) and current research, and to identify gaps and issues relevant to advancing recovery research and practices through opportunities provided by the Internet.

Methods: Five iterative stages of a scoping review framework were followed in searching and analyzing the literature. A recovery framework with four domains and 16 themes was used to deductively code intervention characteristics according to their support for recovery-oriented practices. Only Internet-based interventions used in conjunction with ongoing care were included.

Results: Twenty studies describing six e-recovery interventions were identified and originated in Australia, Finland, the Netherlands, Norway and USA. The domain supporting personal recovery was most clearly reflected in interventions, whereas the last three domains, i.e., promoting citizenship, organizational commitment and working relationship were less evident. Support for the formulation and follow-up of personal goals and preferences, and in accessing peer-support, were the characteristics shared by most interventions. Three of the six studies that employed a comparison group used randomization, and none presented definitive findings. None used recovery oriented frameworks or specific recovery outcome measures. Four of the interventions were specific to a diagnosis.

Conclusion: Research about how technologies might aid in illuminating and shaping recovery processes is in its formative stages. We recommend that future e-recovery research and innovation attend to four dimensions: evidence-supported interventions, new knowledge about personal recovery, values-based approaches and Internet as a facilitator for organizational transformation. The incremental changes facilitated by e-recovery may help propel a shift in mental health care toward recovery-oriented practices.

Discussion

Drawing upon Lynn Tang’s (2016) paper (see RRN ebulletin Sept 2016) last month we posed the question: What are the elements that would help us to create a constructive conceptual way of making sense of the likely connections between understanding cultural fluidity, transformative community development approach and the intersecting structural inequality members of such minority groups.

We shall retain this question for this month, and invite any commentaries that the question evokes. Comments can be sent to either Shula or Tony, or emailed to: researchintorecovery@nottingham.ac.uk

Other News

The RRN Collective are currently working on putting an invitation out for any budding artists out there to design a logo for the network.  Watch this space for details!

Well done!

Congratulations to Dutch user/survivor researchers who recently completed their PhD theses on experiential knowledge (ervaringsdeskundigheid):

Wilma Boevink was awarded a doctorate degree from the Maastricht University on April 13th, 2017. Jim van Os gave a powerful congratulatory speech about Wilma’s contributions and declared his hopes for her to bring about further change by strengthening user research in the Netherlands. Link, free, to Wilma’s thesis-booklet in English: TREE Towards Recovery Empowerment and Experiential Knowledge https://assets.trimbos.nl/docs/e5b58bcc-d191-4b8a-9113-7b9cdbb92624.pdf

A year earlier, in May 2016, Alie Weerman was awarded a doctorate degree at the Free University Amsterdam for her proefschrift (thesis) ‘Care Workers and Social Workers with Experiential Knowledge: Stigma, Addiction and Existential Transformation’ (Ervaringsdeskundige zorg- en dienstverleners. Stigma, verslaving & existentiële transformatie). Link, free, to Alie’s published PhD thesis in Dutch:

https://disabilitystudies.nl/sites/disabilitystudies.nl/files/beeld/onderwijs/01_proefschrift_de_ervaringsdeskundige_hulpverlener_moet_meer_ruimte_krijgen.pdf

Digital technology and mental health

“Questions about using digital technology for mental health problems?

A new national survey has opened to give people the opportunity to direct future research into digital technologies for mental health. We are interested in hearing from people with mental health problems, people who support/care for others with mental health problems and health and social care professionals.

Effective research can help improve care and treatment. If you would like to add your questions, go to: www.mindtech.org.uk/digitalMHQ to complete the survey.”

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

page updated 11 May 2017

Recovery Research Network eBULLETIN

July 2017

RRN Meetings 

The next meeting of the Recovery Research Network will be held on the 21^st November 2017. The venue will be AG Palmer House, Morrell Crescent, Littlemore, Oxford Health NHS Foundation Trust.  OX4 4SU. Refreshments will be available from 9.30am, and the meeting will run from 10am to 4pm. The provisional topic will be around: Poverty and Social Inequality.  Further details will be made available in due course.

Registration for the event can be made by following the link below:

https://rrn-nov17.eventbrite.co.uk

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

shula.ramon@anglia.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

An opportunity to join the Recovery Research Network (RRN) Collective

We have three vacancies on the RRN Collective. The role and current Collective members are on the RRN website (researchintorecovery.com/rrn) under the RRN Collective tab. RRN Collective members co-ordinate the monthly e-bulletins, and organise and regularly attend the six-monthly meetings. If this (un-funded) role might be of interest then feel free to contact Mike Slade (m.slade@nottingham.ac.uk) to discuss.

Please can we encourage members to forward their peer-reviewed articles and book publications to us in a timely manner in order that we can best disseminate their literary efforts to the broader membership.

Conferences and Events

i) Making Real Change Happen. The 20^th International Congress of the ISPS will take place in the city of Liverpool, UK August 30^th – September 3^rd, 2017

Plenary Speakers will include: Alison Brabban, Jacqui Dillon, Grainne Fadden, Jim van Os Other speakers will include: Richard Bentall, Jim Geekie, Peter Kinderman, Eleanor Longden, Brian Martindale, John Read, Rai Waddingham

See more at:  http://tinyurl.com/isps-change

Contact: isps@isps.org or visit:  www.isps2017uk.org

Twitter: #isps2017uk

ii) Registration is open for Refocus on Recovery 2017, being held in Nottingham from 18th to 20th September 2017. The event will comprise expert workshops, an international conference and a Mad Celebration event. Conference themes will be Recovery for different groups, Re-situating mental health, Prevention of mental ill-health, Allocating resources.

See more at:  https://www.researchintorecovery.com/ror2017

iii) Delivering Excellence in Recovery Oriented Services in Mental Health

Monday 2 October 2017

De Vere West One Conference Centre, London

The Mental Health Taskforce Five Year Forward View for Mental Health focuses on recovery throughout. This one day conference focuses on delivering excellence in Recovery Oriented Services in Mental Health. Through national updates and practical case studies you will hear from expert speakers providing you with the opportunity to learn from established practice to understand and reflect on current challenges and ways of over-coming these challenges. The day will also identify key strategies for improving recovery orientated practice for mental health and look at ways you can implement these changes in your organisation, examine your role in improving recovery orientated services and self-assess and reflect on your own practice.

For further information and to book your place visit http://www.healthcareconferencesuk.co.uk/recovery-oriented-services-mental-health  or email nicki@hc-uk.org.uk

Follow the conference on Twitter #MHRecovery

iv) The 12th ENMESH Conference will be held in Groningen, Netherlands from 5^th to the 7^th October 2017. Conference themes are Assessment:  Understanding the context; Epidemiology:  Methodological approaches supporting personalised care; Approaches:  Novel approaches using the patient’s own context; and Policy:  Societal challenges for community mental health. Further information at:  http://enmesh2017groningen.com/home/

Papers and Publications

Call for Papers: Peer Specialist Services

Submission Deadline: October 1, 2017

The editorial staff for Psychological Services, the official journal of APA Division 18 (Psychologists in Public Service), is inviting manuscripts for a special section on the impact peer specialists are having on the delivery of mental health and health services and outcomes in organized care settings.  Drs. Matthew Chinman and Anne Klee have agreed to serve as our guest editors.

More information: http://www.apa.org/pubs/journals/ser/call-for-papers-peer-specialist-services.aspx

i)  Tang, L. (2017) Recovery, Mental Health and Inequality: Chinese Ethnic Minorities as Mental Health Service Users. Routledge

https://www.routledge.com/Recovery-Mental-Health-and-Inequality-Chinese-Ethnic-Minorities-as-Mental/Tang/p/book/9781138849976

About the book:

This book uses the rich narratives of the recovery journeys of Chinese mental health service users in the UK – a perceived ‘hard-to-reach group’ and largely invisible in mental health literature – to illustrate the myriad ways that social inequalities such as class, ethnicity and gender contribute to service users’ distress and mental ill-health, as well as shape their subsequent recovery journeys.

Recovery, Mental Health and Inequality contributes to the debate about the implementation of ‘recovery approach’ in mental health services and demonstrates the importance of tackling structural inequalities in facilitating meaningful recovery. This timely book would benefit practitioners and students in various fields, such as nurses, social workers and mental health postgraduate trainees.

ii)  Walsh, F. and Tickle, A. (2017). Listen to me, I’m talking: involvement and recovery. Mental Health Review Journal. 22(2). 111 – 123.

https://doi.org/10.1108/MHRJ-09-2016-0018

Abstract

Purpose: The purpose of this paper is to explore how those engaged in service user involvement (SUI) initiatives perceive involvement and recovery; whether involvement is related to their recovery process and, if so, how.

Design/methodology/approach:  An exploratory qualitative method, social constructionist grounded theory, was adopted throughout the research process. Nine semi-structured interviews were undertaken with participants who self-defined as having current or previous mental health problems and who were engaged in SUI initiatives.

Findings:  Most participants identified explicit links between their own experiences of SUI and recovery. These links represented a connection between the characteristics they perceived to be inherent to involvement and their personal definitions of recovery. In contrast, experiences of consultation and involvement as patient service users was limited and identified as an area for improvement. The core of the tentative grounded theory constructed suggests that individuals found in involvement elements which were concordant with and supported their own definitions of recovery and which were not apparent in their experiences as patients.

Research limitations/implications:  The small sample and narrow constituency of participants limit the nature of the claims made by the study.

Practical implications:  This study highlights the value of involvement in promoting recovery and indicates the merit of promoting meaningful involvement across the spectrum of the service user experience.

Originality/value:  This study offers a unique contribution to the current literature, highlighting the links made between involvement and personal recovery.

iii)  Zisman-Ilani, Y., Barnett, E., Harik, J., Pavlo, A. and O’Connell, M. (2017) Expanding the concept of shared decision making for mental health: systematic search and scoping review of interventions. Mental Health Review Journal. [online]

https://doi.org/10.1108/MHRJ-01-2017-0002

Abstract

Purpose:  Much of the existing literature on Shared Decision Making (SDM) in mental health has focused on the use of Decision Aids (DAs). However, DAs tend to focus on information exchange and neglect other essential elements to SDM in mental health. Therefore, the present work aimed to expand the review of SDM interventions in mental health by identifying important components, in addition to information exchange, that may contribute to the SDM process in mental health.

Design:: Systematic and scoping literature search.

Findings:  A final sample of 31 records was systematically selected. Most interventions were developed and/or piloted in the US for adults in community psychiatric settings. Although information exchange was a central component of the identified studies, important additional elements were: eliciting patient preferences and values, providing patient communication skills training, eliciting shared care planning, facilitating patient motivation, and eliciting patient participation in goal setting.

Originality: Our review indicates that additional elements, other than information exchange such as sufficient rapport and trusting relationships, are important and needed as part of SDM in mental health. Future SDM interventions in mental health could consider including techniques that aim to increase patient involvement in activities such as goal settings, values, and preference clarification, or facilitating patient motivation, before and after presenting treatment options.

iv)  Perestelo-Perez, L., Rivero-Santana, A., Alvarez-Perez, Y., Zisman-Ilani, Y., Kaminskiy, E. and Serrano-Aguilar, P. (2017) Measurement issues of shared decision making in mental health: Challenges and Opportunities. Mental Health Review Journal. [online]

https://doi.org/10.1108/MHRJ-01-2017-0004

Abstract

Purpose:  Shared decision making (SDM) is a model of health care in which patients are involved in the decision making process about their treatment, considering their preferences and concerns in a deliberative process with the health care provider. Many existing instruments assess the antecedents, process, or the outcomes of SDM. The aim of this article is to identify the SDM-related measures applied in a mental health context.

Design:  We performed a systematic review in several electronic databases from 1990 to October 2016. Studies that assessed quantitatively one or more constructs related to SDM (antecedents, process, outcomes) in the field of mental health were included.

Findings:  We included 87 studies that applied 48 measures on distinct SDM constructs. A large majority of them have been developed in the field of physical diseases and adapted or directly applied in the mental health context. The most evaluated construct is the SDM process in consultation, mainly by patients’ self-report but also by external observer measures, followed by the patients’ preferences for involvement in decision making. The most applied instrument was the Autonomy Preference Index (API), followed by the Observing Patient Involvement in Decision Making (OPTION) and the Control Preferences Scale (CPS). The psychometric validation in mental health samples of the instruments identified is scarce.

Research limitations/implications:  The bibliographic search is comprehensive, but could not be completely exhaustive. Effort should be invested in the development of new SDM for mental health tools that will reflect the complexity and specific features of mental health care.

Originality/value:  We highlight several limitations and challenges for the measurement of SDM in mental health care.

v)  Bhanbhro, S., Gee, M., Cook, S., Marston, L., Lean, M. and Killaspy, H. (2016) Recovery-based staff training intervention within mental health rehabilitation units: a two-stage analysis using realistic evaluation principles and framework approach. BMC Psychiatry. 16:292. 1-14.

DOI 10.1186/s12888-016-0999-y

Abstract

Background: Long-term change in recovery-based practice in mental health rehabilitation is a research priority.

Methods: We used a qualitative case study analysis using a blend of traditional ‘framework’ analysis and ‘realist’ approaches to carry out an evaluation of a recovery-focused staff training intervention within three purposively selected mental health rehabilitation units. We maximised the validity of the data by triangulating multiple data sources.

Results: We found that organisational culture and embedding of a change management programme in routine practice were reported as key influences in sustaining change in practice. The qualitative study generated 10 recommendations on how to achieve long-term change in practice including addressing pre-existing organisational issues and synergising concurrent change programmes.

Conclusions: We propose that a recovery-focused staff training intervention requires clear leadership and integration with any existing change management programmes to facilitate sustained improvements in routine practice

vi) Hickey, J. E., Pryjmachuk, S. and Waterman, H. (2017) Essays and Debates in Mental Health: Exploring personal recovery in mental illness through an Arabic sociocultural lens. Journal of Psychiatric and Mental Health Nursing. 24(2) 163–170

Introduction

Arabic culture in the Gulf region (i.e. Qatar, Kuwait, Saudi Arabia, Bahrain, Oman) is characterized by traditional values and beliefs. Islam guides nearly every aspect of life for the majority Muslim population. At the same time, development and globalization in the Gulf region is occurring at such a rapid pace that traditional values are under threat (Teller 2014). This situation sometimes creates tension between various stakeholders regarding what is understood to be good practice (Al-Subaiey 2010).

One example where the potential for tension exists can be found in the concept of personal recovery in mental illness. During the last three decades, personal recovery has become generally understood as an ongoing process that emphasizes hope, identity, meaning and personal responsibility (Ralph et al. 2002, Spaniol et al. 2002, Andresen et al. 2003). However, this understanding has been developed primarily in Western countries, and it is likely that it has inherent Western values that may not be appropriate in non-Western settings. This is important because non-Western countries have begun to incorporate recovery concepts into mental health service planning and development (See, for example Supreme Council of Health, 2013). However, very little research exists to inform our understanding of what recovery looks like in an Arabic context.

This article debates and critiques the concept of personal recovery, using an Arabic contextual lens and argues that recovery concepts should not be transplanted into non-Western contexts without careful contextual adaptation and evaluation.

Other News

United Nations Report Calls for Revolution in Mental Health Care. In a new report, the United Nations Special Rapporteur on the right to health, Dr. Dainius Pūras, calls for a move away from the biomedical model and “excessive use of psychotropic medicines”

http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=21689&LangID=E

Read the full report here:

http://ap.ohchr.org/documents/dpage_e.aspx?si=A/HRC/35/21

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

shula.ramon@anglia.ac.uk

Tony:               a.sparkes@bradford.ac.uk

page updated 9 August 2017