Recovery Research Network (RRN)
2018 RRN Emails
January 2018
Recovery Research Network eBULLETIN
January 2018
RRN Meetings
The 19th meeting of the Recovery Research Network will be held on 17th May 2018 in Room H2.5, 2nd Floor Hunter Wing, St George’s, University of London, Cranmer Terrace, London SW17 0RE. Directions are available at:
https://www.sgul.ac.uk/about-us/how-to-get-here
All Recovery Research Network events are free. Places are limited and you must register to attend. Registration is available from:
https://www.eventbrite.co.uk/e/recovery-research-network-spring-2018-tickets-41707438070
The provisional theme is ‘User-led initiatives, collective action and co-production’. Further details will be distributed when available. In the meantime however, speaker suggestions are welcome from the readership. Please contact Dr. Emma Kaminskiy (emma.kaminskiy@anglia.ac.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
Tony: a.sparkes@bradford.ac.uk
RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at: https://www.researchintorecovery.com/rrn
Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk
A call to PhD Students and their supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.
Conferences and Events
i) Refocus on recovery
Would you like to organise a national recovery conference? An exciting opportunity to build on success has just become available, with the decision to support national Refocus on Recovery conferences. Many Recovery Research Network members will have come to, or know of, the international Refocus on Recovery research conferences which have been run since 2010. The aim has been to develop a community of interest around mental health recovery, and hence to influence national and international mental health policy and practice. The conferences have all so far taken place in England (most recently in Nottingham in September 2017), which limits attendance from people further away (though people from around 25 countries do attend). So to meet demand, there is now the chance to organise national Refocus on Recovery conferences around the world. You can find out more at:
https://www.researchintorecovery.com/RoRNational
ii) First announcement: Western Lapland Health Care District will be hosting the 23rd International Network Meeting for the Treatment of Psychosis 2018
Welcome to Tornio – Western Lapland
August 29th – September 2nd, 2018
The Meeting will be arranged for teams, groups and individuals who in their work meet people and networks during severe life crises. In these meetings one of the aims is to find forms of treatment and care of psychotic crises that reduce the use of hospitalization and medication.
More information about program and registration will come with 2nd Announcement early in 2018.
Tornio is located in Western Lapland on the border of Finland and Sweden. The nearest airports are Kemi-Tornio (20 km), Rovaniemi (130 km), Oulu (140 km) and Luleå in Sweden (140 km).
iii) The International Society for Psychological and Social Approaches to Psychosis (ISPSUK) are hosting: Placing Psychosocial Approaches to Psychosis at the heart of the NHS
When: February 19, 2018 @ 6:00 pm – 8:00 pm
Where: St Cuthberts Church
Lytham Rd
Fulwood, Preston PR2 3AR
UK
Book your ticket for an evening of discussion and reflection around psychosocial approaches to psychosis, in Preston, Lancashire, on Monday 19th February.
The panel will each give a ten minute talk about the challenges and successes in regard to placing psychosocial approaches to psychosis at the heart of the NHS. Then we will open the discussion up to the audience for debate and discussion.
The panel members are as follows:
Mick McKeown is Professor of democratic mental health at the University of Central Lancashire and is interested in clinical and political alliances for change in mental health services and wider society.
Helen Spandler is a Reader in mental health in the School of Social Work, Care and Community at UCLan and Managing Editor of Asylum: the magazine for democratic psychiatry.
Rufus May has worked as a clinical psychologist for 20 years. He manages the psychology team at the Royal Bolton hospital’s acute mental health in-patient service. He has an interest in holistic approaches to mental health. His interest is originally rooted in his own treatment for psychosis in his late teens. He volunteers with the Bradford Hearing voices group and provides some independent training with his partner Elisabeth Svanholmer (see www.openmindedonline.com)
Book your ticket using the following link, free for ISPS UK members
Papers and Publications
In early 2019 Theo Stickley will be Guest Editor for a special issue of Perspectives in Public Health focussing on mental health:
This special issue will be drawing together research and features that identify and evaluate current practice that may prevent mental ill-health by promoting mental health recovery and wellbeing in communities or in primary care services. We will welcome papers that may address any of the following:
- Recovery or strengths-based approaches
- Salutogenic/community-orientated
- Evaluating social prescribing activities
- Focussing upon wellness/wellbeing outcomes
- Creative or innovative public mental health activities
- Tackling inequalities
- Combatting stigma and discrimination
The Journal has an impact factor of 0.919 (1.435 over 5 years).
Articles can be empirical (quals or quants), reviews, – all short or long, and also opinion pieces and practice articles.
As an example of content please see the current special edition on Arts, Health & Wellbeing:
http://journals.sagepub.com/toc/rshi/current
Please email Theo for any further information:
Theo.stickley@nottingham.ac.uk
i) Fullagar, S. and O’Brien, W. (2018) Rethinking women’s experiences of depression and recovery as emplacement: spatiality, care and gender relations in rural Australia. Journal of Rural Studies. 58. 12-19.
Abstract
In Australia and other OECD countries women who are recovering from depression in rural areas find that access to professional care is fraught with difficulties. Despite the emphasis on the social determinants shaping mental ill health and recovery, Australian rural support has been largely defined by biomedical and psy-expertise focused on correcting biochemistry and cognition through different models of formal medical care. Addressing the limitations of individualised biomedical models, this article offers a relational understanding of how recovery from depression is produced through rural and gendered emplacement (Pink, 2011). Theorising recovery through the notion of emplacement shifts attention from an individualised notion of embodied distress (symptoms, emotions, cognition) towards a social understanding of the dynamics of human and non-human relations that are afforded by different care practices (from medical treatment to social support). To date there has been little critical analysis of how women’s distress and recovery experiences are gendered in relation to both formal and informal care in rural places. Extending the insights of geographers, social anthropologists and feminist scholars we analyse the recovery stories of women living in rural and regional Australia. We focus specifically on how rural women experienced uncertainty and stigma that emerged through formal care spaces and impeded their recovery -the gendered dynamics of em(dis)placement were identified. In contrast, we identify how particular informal care spaces enabled women’s recovery through multiple relations with human and non-human others. Our research aims to contribute a critical understanding of how everyday professional care and self-care practices are intertwined with the complex gendered negotiations of emplacement and displacement that shape rural mental (ill) health.
ii) Rowe, S. L., Patel, K., French, R. S., Henderson, C., Ougrin, D., Slade, M. and Moran, P. (2018) Web-based decision aid to assist help-seeking choices for young people who self-harm: outcomes from a randomized controlled feasibility trial. JMIR Mental Health, 5(1)
http://mental.jmir.org/2018/1/e10
DOI: 10.2196/mental.8098
Abstract
Background: Adolescents who self-harm are often unsure how or where to get help. We developed a Web-based personalized decision aid (DA) designed to support young people in decision making about seeking help for their self-harm.
Objective: The aim of this study was to evaluate the feasibility and acceptability of the DA intervention and the randomized controlled trial (RCT) in a school setting.
Methods: We conducted a two-group, single blind, randomized controlled feasibility trial in a school setting. Participants aged 12 to 18 years who reported self-harm in the past 12 months were randomized to either a Web-based DA or to general information about mood and feelings. Feasibility of recruitment, randomization, and follow-up rates were assessed, as was acceptability of the intervention and study procedures. Descriptive data were collected on outcome measures examining decision making and help-seeking behaviour. Qualitative interviews were conducted with young people, parents or carers, and staff and subjected to thematic analysis to explore their views of the DA and study processes.
Results: Parental consent was a significant barrier to young people participating in the trial, with only 17.87% (208/1164) of parents or guardians who were contacted for consent responding to study invitations. Where parental consent was obtained, we were able to recruit 81.7% (170/208) of young people into the study. Of those young people screened, 13.5% (23/170) had self-harmed in the past year. Ten participants were randomized to receiving the DA, and 13 were randomized to the control group. Four-week follow-up assessments were completed with all participants. The DA had good acceptability, but qualitative interviews suggested that a DA that addressed broader mental health problems such as depression, anxiety, and self-harm may be more beneficial.
Conclusions: A broad-based mental health DA addressing a wide range of psychosocial problems may be useful for young people. The requirement for parental consent is a key barrier to intervention research on self-harm in the school setting. Adaptations to the research design and the intervention are needed before generalizable research about Das can be successfully conducted in a school setting.
iii) Sharma, P. (2014) Making song, making sanity: recovery from bipolar disorder. Canadian Journal of Music Therapy. 20(1), 65-84.
Abstract
I offer an autoethnographic inquiry into the process of finding one’s way out of the maze of mental illness; it is an examination of how in the course of creating music to express my suffering from bipolar disorder, I found a poetic and musical expression for my soul. Making music gradually moved my focus away from illness toward imagination and creativity and brought about a major shift in my positioning in terms of my identity, helping me to construct the selfhood of an artist rather than that of an ill person. This transformation is explored in the context of India’s music and spiritual tradition and the Western framework of resource-oriented music therapy, an approach that prioritizes participant empowerment and uses music for self-care.
iv) Stickley, T., Wright, N. and Slade, M. (In Press) The art of recovery: outcomes from participatory arts activities for people using mental health services. Journal of Mental Health
Abstract
Background: There is a growing evidence base for the use of participatory arts for the purposes of health promotion. In recent years, recovery approaches in mental healthcare have become commonplace in English speaking countries amongst others. There are few studies that bring together these two fields of practice.
Aims: The two aims of this study were (a) to investigate the validity of the CHIME framework (Leamy et al, 2011) for characterising the experience of Participatory Arts and (b) to use the CHIME framework to investigate the relationship between participatory arts and mental health recovery.
Method: The study employed a two-phase methodology: a rapid review of relevant literature followed by secondary analysis of qualitative data collected from 38 people who use mental health service who took part in participatory arts activities designed to improve mental health.
Results: Each of the recovery processes identified by CHIME are present in the qualitative research literature as well as in the data of the secondary analysis.
Conclusions: Participatory arts activities produce outcomes which support recovery, specifically including enhancing connectedness and improving hope. They can be recommended to people living with mental health problems.
v) De Ruysschera, C., Vanheuleb, S. and Vandeveldea, S. (2017) ‘A place to be (me)’: a qualitative study on an alternative approach to treatment for persons with dual diagnosis. Drugs: Education, Prevention and Policy. Published online: 21 Sep 2017
https://doi.org/10.1080/09687637.2017.1375461
Abstract
Objectives: This study aims at gaining insight into an alternative approach to treatment for persons with dual diagnosis by unravelling the daily practice of Villa Voortman, a community-based meeting place in Ghent (Belgium) offering support to this group.
Methods: Twelve in-depth interviews were conducted with several actors: visitors, staff members, volunteers, and persons involved from outside the meeting place.
Results: First, Villa Voortman was experienced as ‘a place to be’, providing visitors a possibility to feel safe and accepted, and belong to a peer group. Voluntary participation to activities is crucial to install such feeling. In time, the meeting place also becomes ‘the place to be’, as visitors start to feel at home. Secondly, it functions as ‘a place to be me’, helping participants to (re-)build their identity and become visible citizens.
Conclusions: The findings are highly consistent with recovery literature and Lacanian ideas on the treatment of psychosis. Some ‘contours’ that shape the daily practice of Villa Voortman could be identified: particularizing to personal needs, having a focus on personal, social, and structural aspects of recovery and the coexistence of different discourses.
Doctoral (PhD) research
Clara De Ruysscher, a PhD researcher at the department of Special Needs Education at Ghent University is currently working on the perspectives of persons with complex mental health needs (especially persons with dual diagnosis) on their pathway to recovery. She is working with Pete Tomlinson, a peer worker, on a study which aims to challenge some assumptions regarding the recovery concept and its operationalization in today’s mental health care system. They are doing this by engaging in a collaborative ‘bricolage’ journey, starting from Pete’s personal experiences.
Subject to the programme on the day, Clara and Pete will hopefully be able to present their work at the next RRN meeting, and will hopefully be able to keep us informed of any pertinent material that emerges from their research.
Other News
Mind-tech: Digital Technology for Mental Health: Asking the right questions
Dear Friends and colleagues
We need your help to set the priorities for future research into Digital Technology for Mental Health. Please take part in this survey to select the 10 questions you think are the most important. It will take about 10-15 minutes and there are prizes to be won for taking part!
Go to survey:
https://nv8w2j7z.optimalworkshop.com/optimalsort/digitalmhq
The project Digital Technology for Mental Health: Asking the right questions, led by NIHR MindTech Healthcare Technology Cooperative, has already carried out a wide reaching consultation to gather in questions about using digital technologies for mental health from people with personal experience of mental health problems and health and social care practitioners. They now need your help to start prioritising which questions are the most important.
To find out more about the project go to www.mindtech.org.uk/digitalMHQ
You can also view a short film about the project at www.youtube.com/watch?v=-jjodDAWZ5Q&t=7s
The project hashtag on social media is #digitalMHQ – be sure to let all in your networks know about the chance to pick their top 10.
Many thanks, Mat
Mat Rawsthorne CGMA
CLAHRC-EM Service User Consultant, REBOOT study
A decade of RRN
The first meeting of the RRN was held on the 23rd April 2009. November 2018 will be the 20th meeting of the RRN, and mark ten years of collegial networking around the topic of research into recovery. Suggestions for marking our 10-year anniversary would be most welcome!
Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk
February 2018
March 2018
Recovery Research Network eBULLETIN
March 2018
RRN Meetings
The 19th meeting of the Recovery Research Network will be held on 17th May 2018 in Room H2.5, 2nd Floor Hunter Wing, St George’s, University of London, Cranmer Terrace, London SW17 0RE. Directions are available at:
https://www.sgul.ac.uk/about-us/how-to-get-here
The theme for the meeting is: ‘User-led initiatives, collective action and co-production’.
All Recovery Research Network events are free. Places are limited and you must register to attend. This event is now fully subscribed, although please feel free to join the waitlist in case places do become available:
https://www.eventbrite.co.uk/e/recovery-research-network-spring-2018-tickets-41707438070
Agenda
Time |
Event |
Title |
9:30 |
Refreshments |
|
10:00 |
Introductions |
|
10:30 |
Toni King* and Jo Dawson** * Trust Lead, Recovery & Peer Workers, NHS Solent ** Chair of Solent NHS Mental Health Patient forum |
Reflections on the process and outcomes of coproduced staff training. |
11:10 |
Josephine NwaAmaka Bardi. Economic and Social Research Council (ESRC) PhD Student School of Health Sciences, University of Nottingham |
Floorboards, Whitewalls and Butterflies: Ethnography in a pop-up community mental health café. |
11:50 |
Break |
|
12:20 |
Rhiannon Foster, Sarah Gibson, Steve Gillard, Lucy Goldsmith, Jacqui Marks, Rosie Morshead, Kati Turner, Rebecca Turner Population Health Research Institute, St George’s, University of London |
(Randomised controlled) trials and tribulations: a critical look at the potentials and challenges of coproducing an RCT |
13:00 |
Lunch |
|
14:00 |
Alison Faulkner Survivor researcher and trainer |
Survivor research and Mad Studies: the role and value of experiential knowledge in recovery research |
14:40 |
Clara De Ruysscher and Peter Tomlinson Department of Special Needs Education, Ghent University |
Bricolage: an exploration of a recovery process |
15:20 |
Panel Discussion |
|
15:40 |
End of formal meeting Recovery Research Network business (all welcome) |
|
16:00 |
Close |
|
If you would like to present at a future meeting of the RRN please email either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk
RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at: https://www.researchintorecovery.com/rrn
Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk
A call to PhD Students and their supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.
Conferences and Events
i) Refocus on recovery
Would you like to organise a national recovery conference? An exciting opportunity to build on success has just become available, with the decision to support national Refocus on Recovery conferences. Many Recovery Research Network members will have come to, or know of, the international Refocus on Recovery research conferences which have been run since 2010. The aim has been to develop a community of interest around mental health recovery, and hence to influence national and international mental health policy and practice. The conferences have all so far taken place in England (most recently in Nottingham in September 2017), which limits attendance from people further away (though people from around 25 countries do attend). So to meet demand, there is now the chance to organise national Refocus on Recovery conferences around the world. You can find out more at:
https://www.researchintorecovery.com/RoRNational
ii) First announcement: Western Lapland Health Care District will be hosting the 23rd International Network Meeting for the Treatment of Psychosis 2018
Welcome to Tornio – Western Lapland
August 29th – September 2nd, 2018
The Meeting will be arranged for teams, groups and individuals who in their work meet people and networks during severe life crises. In these meetings one of the aims is to find forms of treatment and care of psychotic crises that reduce the use of hospitalization and medication.
More information about program and registration will come with 2nd Announcement early in 2018.
Tornio is located in Western Lapland on the border of Finland and Sweden. The nearest airports are Kemi-Tornio (20 km), Rovaniemi (130 km), Oulu (140 km) and Luleå in Sweden (140 km).
iii) Mental Health Qualitative Research Network (MHQRN)
The next meeting of the Mental Health Qualitative Research Network (MHQRN) meeting will be on 26 April 2018 (14:00 – 17:00) at:
Royal College of Psychiatrists
21 Prescot Street
London
E1 8BB
For more information about this network please contact Rose Thompson:
Presentations (abstracts below) will consider ‘Qualitative insights into the move from experiments to wider implementation of complex interventions.’
Quality of Intervention Delivery in a Cluster Randomised Controlled Trial: A qualitative observational study with lessons for ‘real world’ implementation
Dr. Alan Quirk, Senior Programme Manager (Audits & Research), Royal College of Psychiatrists
The study reported here used participant observation methods to explore the quality of implementation of a complex intervention (Safewards) on mental health wards, during a cluster randomised controlled trial (RCT). Specific aims were firstly to describe the different ways in which the intervention was implemented, and secondly to explore the contextual factors moderating the quality of intervention delivery. We observed modifications to the way the intervention was delivered that could enhance or dilute its effects. For example, we observed and documented ‘enhancement’, where super-keen practitioners “go the extra mile” to optimise the intervention, and ‘fidelity-inconsistent modification’, where practitioners adapt the intervention in a way that is not in keeping with its ‘spirit’, such that its impact will probably be reduced or nullified. While such qualitative findings are potentially very valuable to RCT researchers, because they can shed light on why the intervention was found to work or not, they can also provide important information about barriers and facilitators to successful implementation. This presentation will show that with appropriate training, research assistants can collect high-quality observational data about the quality of intervention delivery during a trial, which can be used to inform ‘real world’ implementation of the intervention.
Collaboration and shared decision-making – A participatory project to develop and implement SDM in psychiatric services
Katarina Grim, PhD student in Health and Welfare/Social Work, Dalarna University, Sweden.
The presentation will delineate a project intending to increase knowledge of how SDM can be successfully implemented in psychiatric services in Sweden. In the first phase a digital decision support tool was developed employing participatory design methods where service users were involved as interview respondents, usability testers and design partners. In a next step, this decision support tool was included in a multifaceted intervention, which involved staff training and the use of local facilitators at six outpatient units (2 municipal social services, 4 outpatient psychiatric services).
A process evaluation design was selected in order to investigate actual obstacles and possibilities for a structured intervention to facilitate participation in decision-making. The design utilized in the study (Moore et al. 2015) included collecting data focused on three identified evaluation components: Context, Implementation and Mechanism of impact.
Dr. Helen Brooks, Lecturer at University of Liverpool
This presentation will firstly introduce the findings of a review informed by normalisation process theory of international publications on the implementation of mental health shared decision making (SDM). Normalisation process theory is a tool which supports the implementation of complex interventions such as SDM by focusing on the work required by stakeholders to ensure an intervention is routinized into everyday practice. Key findings included a lack of a universally accepted concept of SDM and the importance of contextual integration and challenging prevailing norms. The presentation will then use an example of a randomised controlled trial of a user and carer informed training package to enhance SDM in care planning in secondary mental health care settings and a parallel process evaluation to further consider the influences on SDM implementation at service user, carer, mental health professional and organisational levels.
Papers and Publications
In early 2019 Theo Stickley will be Guest Editor for a special issue of Perspectives in Public Health focussing on mental health:
This special issue will be drawing together research and features that identify and evaluate current practice that may prevent mental ill-health by promoting mental health recovery and wellbeing in communities or in primary care services. We will welcome papers that may address any of the following:
- Recovery or strengths-based approaches
- Salutogenic/community-orientated
- Evaluating social prescribing activities
- Focussing upon wellness/wellbeing outcomes
- Creative or innovative public mental health activities
- Tackling inequalities
- Combatting stigma and discrimination
The Journal has an impact factor of 0.919 (1.435 over 5 years).
Articles can be empirical (quals or quants), reviews, – all short or long, and also opinion pieces and practice articles.
As an example of content please see the current special edition on Arts, Health & Wellbeing:
http://journals.sagepub.com/toc/rshi/current
Please email Theo for any further information:
Theo.stickley@nottingham.ac.uk
i) Johnstone, L. (2018) Psychological formulation as an alternative to psychiatric diagnosis. Journal of Humanistic Psychology. 58(1) 30-46.
Abstract
The article gives an overview of psychological formulation, a rapidly expanding practice in the United Kingdom that is supported by the British Psychological Society. It is argued that formulation can provide a credible alternative to psychiatric diagnosis in the context of public admissions about lack of reliability and validity of current diagnostic systems. However, vigilance and best-practice principles are essential to ensure that this approach is not assimilated back into the status quo.
ii) Kidd, J. and Ziebland, S. (2016) Narratives of experience of mental health and illness on healthtalk.org. BJPsych Bulletin 40(5) 273-276.
Abstract
Online health information is increasingly popular and may bring both benefits and potential harm to users with mental health problems. The encouragement of harmful behaviour among this population is a particular concern. The website healthtalk.org provides the benefits of shared experience by publishing excerpts from rigorous research interviews with patients, contextualised with medical information. This article sets out evidence for the positive and negative effects of online mental health information and describes the methodology behind healthtalk.org, with an overview of the mental health information it provides and how it can benefit patients and health professionals.
iii) Tucker, I. and Goodings, L. (2018) Medicated bodies: mental distress, social media and affect. New Media and Society. 20(2) 549-563.
Abstract
Social media are increasingly being recruited into care practices in mental health. This article analyses how a major new mental health social media site (www.elefriends.org.uk ) is used when trying to manage the impact of psychiatric medication on the body. Drawing on Henri Bergson’s concept of affection, analysis shows that Elefriends is used at particular moments of reconfiguration (e.g. change in dosage and/or medication), periods of self-experimentation (when people tailor their regimen by altering prescriptions or ceasing medication) and when dealing with a present bodily concern (showing how members have a direct, immediate relationship with the site). In addition, the analysis illustrates how users have to structure their communication to try to avoid ‘triggering’ distress in others. The article concludes by pointing to the need to focus on the multiple emerging relationships between bodies and social media in mental health, due to the ways the latter are becoming increasingly prominent technologies through which to experience the body when distressed.
iv) Haney, J.L. and Cullen, J.A. (2017) Learning about the lived experiences of women with autism from an online community. Journal of Social Work in Disability and Rehabilitation 16(1) 54-73.
Abstract
The experience of being an adult female with an autism spectrum disorder (ASD) has been understudied in social work literature. The purpose of this study was to develop an understanding of females with ASD, from their perspective, by examining content from an online autism community Web site. Using a phenomenological approach, data analysis on content obtained from the forum revealed several themes about the women’s experiences concerning the diagnostic process, managing and understanding symptoms, and the impact of ASD on their personal and work relationships. Implications for social work practice, including creating more effective services for females with ASD, are discussed.
v) Simpson, A., Oster, C. and Muir-Cochrane, E. (2017) Liminality in the occupational identity of mental health peer support worker: a qualitative study. International Journal of Mental Health Nursing. Online: https://doi.org/10.1111/inm.12351
Abstract
Peer support is increasingly provided as a component of mental health care, where people in recovery from mental health problems use their lived experiences to provide support to those experiencing similar difficulties. In the present study, we explored the evolution of peer support workers’ (PSW) occupational identities. A qualitative study was undertaken alongside a pilot randomized, controlled trial of peer support for service users discharged from a mental hospital in London, UK. Two focus groups were conducted with eight PSW. Semi-structured interviews were conducted with 13 service users receiving peer support and on two occasions with a peer support coordinator. The data were analysed using theoretical thematic analysis, focussing on occupational identity formation. We discuss how the occupational identity of PSW evolved through the interplay between their lived experience, their training, and their engagement in the practice environment in such a way as to construct a liminal identity, with positive and negative outcomes. While the difficulties associated with the liminality of PSW could be eased through the formalization and professionalization of the PSW role, there are concerns that this could lead to an undermining of the value of PSW in providing a service by peers for peers that is separate from formal mental health care and relationships. Skilled support is essential in helping PSW negotiate the potential stressors and difficulties of a liminal PSW identity.
vi) Newman-Taylor, K., Garner, C., Vernon-Wilson, E., Paas, K., Herbert, L., & Au-Yeung, S. (2017). Psychometric evaluation of the hope, agency and opportunity (HAO): a brief measure of mental health recovery. Journal of Mental Health, 26(6), 562-568.
DOI: 10.1080/09638237.2017.1385746
Abstract
Background: The development of safe and effective mental health services is a priority. This requires valid measures of personal recovery, yet these tools are not embedded in routine clinical practice. Brief “patient reported measures” are most likely to be acceptable to service-users and clinicians. The 4-item “Hope, Agency and Opportunity” (HAO) was co-produced to assess recovery outcomes and experience of mental health services.
Aim: To evaluate the psychometric properties of the HAO.
Method: A clinical sample from secondary healthcare services and a non-clinical sample were assessed at baseline and two weeks, on measures of personal recovery.
Results: Factor analysis indicated goodness of fit for the HAO with both clinical and non-clinical samples. The measure demonstrated acceptable internal consistency, moderate to strong construct validity and substantial test-retest reliability over two weeks.
Conclusions: The HAO demonstrates satisfactory psychometric properties. Co-production of the measure confers clinical credibility. The brevity of the tool means it can be incorporated into routine clinical practice to drive improvements in service quality.
Doctoral (PhD) research
Clara De Ruysscher, a PhD researcher at the department of Special Needs Education at Ghent University is currently working on the perspectives of persons with complex mental health needs (especially persons with dual diagnosis) on their pathway to recovery. She is working with Pete Tomlinson, a peer worker, on a study which aims to challenge some assumptions regarding the recovery concept and its operationalization in today’s mental health care system. They are doing this by engaging in a collaborative ‘bricolage’ journey, starting from Pete’s personal experiences.
Clara and Pete are now confirmed speakers at the next RRN meeting. As indicated in the January edition of the ebulletin, they will hopefully be able to keep us informed of any pertinent material that emerges from their research.
Other News
Dr Newman-Taylor, Associate Professor at the Psychology Academic Unit, University of Southampton (and co-author of the above paper evaluating the Hope, Agency and Opportunity measure) informs that:
The University of Southampton is now hosting the ‘Hope, Agency and Opportunity’ brief, co-produced measure of recovery, along with video resources and translated versions of the tool. Resources are freely available to clinicians and researchers for any use that prioritises the principles and practice of recovery in our mental health services: https://www.southampton.ac.uk/psychology/research/impact/hope-agency-and-opportunity-measure-of-recovery.page#overview
A decade of RRN
The first meeting of the RRN was held on the 23rd April 2009. November 2018 will be the 20th meeting of the RRN, and mark ten years of collegial networking around the topic of research into recovery. Suggestions for marking our 10-year anniversary would be most welcome!
Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk
April 2018
Recovery Research Network eBULLETIN
April 2018
RRN Meetings
The 19th meeting of the Recovery Research Network will be held on 17th May 2018 in Room H2.5, 2nd Floor Hunter Wing, St George’s, University of London, Cranmer Terrace, London SW17 0RE. Directions are available at:
https://www.sgul.ac.uk/about-us/how-to-get-here
The theme for the meeting is: ‘User-led initiatives, collective action and co-production’.
All Recovery Research Network events are free. Places are limited and you must register to attend. This event is now fully subscribed, although please feel free to join the waitlist in case places do become available:
https://www.eventbrite.co.uk/e/recovery-research-network-spring-2018-tickets-41707438070
Agenda
Time |
Event |
Title |
9:30 |
Refreshments |
|
10:00 |
Introductions |
|
10:30 |
Toni King* and Jo Dawson** * Trust Lead, Recovery & Peer Workers, NHS Solent ** Chair of Solent NHS Mental Health Patient forum |
Reflections on the process and outcomes of coproduced staff training. |
11:10 |
Josephine NwaAmaka Bardi. Economic and Social Research Council (ESRC) PhD Student School of Health Sciences, University of Nottingham |
Floorboards, Whitewalls and Butterflies: Ethnography in a pop-up community mental health café. |
11:50 |
Break |
|
12:20 |
Rhiannon Foster, Sarah Gibson, Steve Gillard, Lucy Goldsmith, Jacqui Marks, Rosie Morshead, Kati Turner, Rebecca Turner
Population Health Research Institute, St George’s, University of London |
(Randomised controlled) trials and tribulations: a critical look at the potentials and challenges of coproducing an RCT |
13:00 |
Lunch |
|
14:00 |
Alison Faulkner Survivor researcher and trainer |
Survivor research and Mad Studies: the role and value of experiential knowledge in recovery research |
14:40 |
Clara De Ruysscher and Peter Tomlinson Department of Special Needs Education, Ghent University |
Bricolage: an exploration of a recovery process |
15:20 |
Panel Discussion |
|
15:40 |
End of formal meeting Recovery Research Network business (all welcome) |
|
16:00 |
Close |
|
If you would like to present at a future meeting of the RRN please email either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk
RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at: https://www.researchintorecovery.com/rrn
Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk
A call to PhD Students and their supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.
Conferences and Events
i) Refocus on recovery
Would you like to organise a national recovery conference? An exciting opportunity to build on success has just become available, with the decision to support national Refocus on Recovery conferences. Many Recovery Research Network members will have come to, or know of, the international Refocus on Recovery research conferences which have been run since 2010. The aim has been to develop a community of interest around mental health recovery, and hence to influence national and international mental health policy and practice. The conferences have all so far taken place in England (most recently in Nottingham in September 2017), which limits attendance from people further away (though people from around 25 countries do attend). So to meet demand, there is now the chance to organise national Refocus on Recovery conferences around the world. You can find out more at:
https://www.researchintorecovery.com/RoRNational
ii) First announcement: Western Lapland Health Care District will be hosting the 23rd International Network Meeting for the Treatment of Psychosis 2018
Welcome to Tornio – Western Lapland
August 29th – September 2nd, 2018
The Meeting will be arranged for teams, groups and individuals who in their work meet people and networks during severe life crises. In these meetings one of the aims is to find forms of treatment and care of psychotic crises that reduce the use of hospitalization and medication.
More information about program and registration will come with 2nd Announcement early in 2018.
Tornio is located in Western Lapland on the border of Finland and Sweden. The nearest airports are Kemi-Tornio (20 km), Rovaniemi (130 km), Oulu (140 km) and Luleå in Sweden (140 km).
iii) The final digital showcase for the 5 year AHRC-funded programme Creative Practice as Mutual Recovery in association with Mental Health Foundation is available here: http://cpmr.mentalhealth.org.uk/
iv) Fourth International Psychiatric Congress on Mental Health and Recovery: Thursday and Friday, June 28th and 29th 2018, Insel Hospital, Children’s Hospital, Berne, Switzerland
The thematic focus of the previous congresses was on recovery as a benefit for society, social inclusion and recovery as a joined journey for those affected, relatives and professionals. For the next congress, we will look into the meaning of recovery during various stages in one’s life. At the beginning, Recovery originated as a grass-roots movement empowering mainly persons who had experienced psychotic episodes. The insights thus gained have been transferred and supplemented to other human experiences and encompass the entire life. There are new questions to be answered: how relevant is autonomy and self-determination for children and adolescents? What does hope and confidence mean when the memories and parts of the identity gently fade towards the last period of life? Is transformation important for elderly people?
Keynote speakers: Patricia Deegan, Patrick Corrigan, Jed Boardman, Janine Berg-Peer, Henriette Peer, Andrew Foster, Katja Beek, Walter Hofmann, Colin King,
For more information see: http://www.recovery-psychiatrie.eu/?lang=en
Papers and Publications
In early 2019 Theo Stickley will be Guest Editor for a special issue of Perspectives in Public Health focussing on mental health:
This special issue will be drawing together research and features that identify and evaluate current practice that may prevent mental ill-health by promoting mental health recovery and wellbeing in communities or in primary care services. We will welcome papers that may address any of the following:
- Recovery or strengths-based approaches
- Salutogenic/community-orientated
- Evaluating social prescribing activities
- Focussing upon wellness/wellbeing outcomes
- Creative or innovative public mental health activities
- Tackling inequalities
- Combatting stigma and discrimination
The Journal has an impact factor of 0.919 (1.435 over 5 years).
Articles can be empirical (quals or quants), reviews, – all short or long, and also opinion pieces and practice articles.
As an example of content please see the current special edition on Arts, Health & Wellbeing:
http://journals.sagepub.com/toc/rshi/current
Please email Theo for any further information:
Theo.stickley@nottingham.ac.uk
i) Gronholm, P. C., Thornicroft, G., Laurens, K. R. and Evans-Lacko, S. (2017) Mental health-related stigma and pathways to care for people at risk of psychotic disorders or experiencing
first-episode psychosis: a systematic review. Psychological Medicine. 47(11) 1867-1879.
Abstract
Background: Stigma associated with mental illness can delay or prevent help-seeking and service contact. Stigma-related influences on pathways to care in the early stages of psychotic disorders have not been systematically examined.
Method: This review systematically assessed findings from qualitative, quantitative and mixed-methods research studies on the relationship between stigma and pathways to care (i.e. processes associated with help-seeking and health service contact) among people experiencing first-episode psychosis or at clinically defined increased risk of developing psychotic disorder. Forty studies were identified through searches of electronic databases (CINAHL, EMBASE, Medline, PsycINFO, Sociological Abstracts) from 1996 to 2016, supplemented by reference searches and expert consultations. Data synthesis involved thematic analysis of qualitative findings, narrative synthesis of quantitative findings, and a meta-synthesis combining these results.
Results: The meta-synthesis identified six themes in relation to stigma on pathways to care among the target population: ‘sense of difference’, ‘characterizing difference negatively’, ‘negative reactions (anticipated and experienced)’, ‘strategies’, ‘lack of knowledge and understanding’, and ‘service-related factors’. This synthesis constitutes a comprehensive overview of the current evidence regarding stigma and pathways to care at early stages of psychotic disorders and illustrates the complex manner in which stigma-related processes can influence help-seeking and service contact among first-episode psychosis and at-risk groups.
Conclusions: Our findings can serve as a foundation for future research in the area, and inform early intervention efforts and approaches to mitigate stigma-related concerns that currently influence recognition of early difficulties and contribute to delayed help-seeking and access to care.
ii) Wilson, C., Rouse, L., Rae, S. and Kar Ray, M. (2018) Mental health inpatients’ and staff members’ suggestions for reducing physical restraint: A qualitative study. Journal of Psychiatric and Mental Health Nursing.
DOI: 10.1111/jpm.12453
Abstract
Introduction: Physical restraint has negative consequences for all involved, and international calls for its reduction have emerged. Some restraint reduction interventions have been developed, but limited qualitative research explores suggestions on how to reduce physical restraint (and feasibility issues with implementation) from those directly involved.
Aims: To explore mental health patients’ and staff members’ suggestions for reducing physical restraint.
Methods: Interviews were conducted with 13 inpatients and 22 staff members with experience of restraint on adult mental health inpatient wards in one UK National Health Service Trust.
Results: Findings centred on four overarching themes: improving communication and relationships between staff/patients; making staff-related changes; improving ward environments/spaces; and having more activities. However, concerns were raised around practicalities/feasibility of their implementation.
Discussion: Continued research is needed into best ways to reduce physical restraint, with an emphasis on feasibility/practicality and how to make time in busy ward environments.
Implications for Practice: Improving communication and relationships between staff/patients, making staffing-related changes, improving ward environments and providing patient activities are central to restraint reduction in mental healthcare. However, fundamental issues related to understaffing, high staff turnover and lack of time/resources need addressing in order for these suggestions to be successfully implemented.
iii) Wilson, C., Rouse, L., Rae, S. and Kar Ray, M. (2017) Is restraint a ‘necessary evil’ in mental health care? Mental health inpatients’ and staff members’ experience of physical restraint. International Journal of Mental Health Nursing. 26(5) 500-512.
Abstract
Restraint in mental health care has negative consequences, and guidelines/policies calling for its reduction have emerged internationally. However, there is tension between reducing restraint and maintaining safety. In order to reduce restraint, it is important to gain an understanding of the experience for all involved. The aim of the present study was to improve understanding of the experience of restraint for patients and staff with direct experience and witnesses. Interviews were conducted with 13 patients and 22 staff members from one UK National Health Service trust. The overarching theme, ‘is restraint a necessary evil?’, contained subthemes fitting into two ideas represented in the quote: ‘it never is very nice but… it’s a necessary evil’. It ‘never is very nice’ was demonstrated by the predominantly negative emotional and relational outcomes reported (distress, fear, dehumanizing, negative impact on staff/patient relationships, decreased job satisfaction). However, a common theme from both staff and patients was that, while restraint is ‘never very nice’, it is a ‘necessary evil’ when used as a last resort due to safety concerns. Mental health-care providers are under political pressure from national governments to reduce restraint, which is important in terms of reducing its negative outcomes for patients and staff; however, more research is needed into alternatives to restraint, while addressing the safety concerns of all parties. We need to ensure that by reducing or eliminating restraint, mental health wards neither become, nor feel, unsafe to patients or staff.
iv) Lim, E., Wynaden, D. and Heslop, K (2017) Recovery-focussed care: How it can be utilized to reduce aggression in the acute mental health setting. International Journal of Mental Health Nursing. 26(5) 445-460
Abstract
Consumer aggression is common in the acute mental health inpatient setting. Mental health nurses can utilize a range of interventions to prevent aggression or reduce its impact on the person and others who have witnessed the event. Incorporating recovery-focussed care into clinical practice is one intervention, as it fosters collaborative partnerships with consumers. It promotes their engagement in decisions about their care and encourages self-management of their presenting behaviours. It also allows the consumer to engage in their personal recovery as their mental health improve. Yet there is a paucity of literature on how nurses can utilize recovery-focussed care with consumers who are hospitalized and in the acute phase of their illness. In the present study, we report the findings of a scoping review of the literature to identify how recovery-focussed care can be utilized by nurses to reduce the risk of consumer aggression. Thirty-five papers met the inclusion criteria for review. Four components were identified as central to the use of recovery-focussed care with consumers at risk of becoming aggressive: (i) seeing the person and not just their presenting behaviour; (ii) interact, don’t react; (iii) coproduction to achieve identified goals; and (iv) equipping the consumer as an active manager of their recovery. The components equip nurses with strategies to decrease the risk of aggression, while encouraging consumers to self-manage their challenging behaviours and embark on their personal recovery journey. Further research is required to evaluate the translation of these components clinically in the acute care setting.
Doctoral (PhD) research
Clara De Ruysscher, a PhD researcher at the department of Special Needs Education at Ghent University is currently working on the perspectives of persons with complex mental health needs (especially persons with dual diagnosis) on their pathway to recovery. She is working with Pete Tomlinson, a peer worker, on a study which aims to challenge some assumptions regarding the recovery concept and its operationalization in today’s mental health care system. They are doing this by engaging in a collaborative ‘bricolage’ journey, starting from Pete’s personal experiences.
Clara and Pete are now confirmed speakers at the next RRN meeting. They will hopefully be able to keep us informed of any pertinent material that emerges from their research.
A decade of RRN
The first meeting of the RRN was held on the 23rd April 2009. November 2018 will be the 20th meeting of the RRN, and mark ten years of collegial networking around the topic of research into recovery. Suggestions for marking our 10-year anniversary would be most welcome!
Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk
May 2018
Recovery Research Network eBULLETIN
May 2018
RRN Meetings
The 19th meeting of the Recovery Research Network took place on the 17th May at St George’s, University of London. Thank you to St George’s for hosting the event and thank you to Steve Gillard for organising it. This was a well-attended occasion, with a range of thought-provoking presentations on the theme of ‘User-Led Initiatives, Collective Action and Co-Production’. Thank you to Emma Kaminskiy for co-ordinating the programme.
In keeping with the collegiality of the RRN, the speakers have kindly given permission for their material to be uploaded to the RRN website. These presentations, along with presentations and minutes from previous meetings, are available by following the link on the left-hand side of the RRN home page:
https://www.researchintorecovery.com/rrn
Chris Griffiths and Northamptonshire Healthcare NHS Foundation Trust have kindly offered to host the 20th meeting of the RRN. The event will be held on Wednesday the 7th November 2018 at:
Willow Room
Northamptonshire Healthcare NHS Foundation Trust
Berrywood Hospital
Northampton
NN5 6GQ
Link: https://www.nhft.nhs.uk/berrywood
The provisional theme will be ‘Social Connectedness’ and speaker suggestions are welcome from the readership.
All Recovery Research Network events are free and administrated through Eventbrite. The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly. Although there is a waiting list, we do kindly ask that you notify the RRN if, for whatever reason, you are unable to attend on the day. This allows us to offer your place to someone else.
If you would like to present at a future meeting of the RRN please email either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk
RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at: https://www.researchintorecovery.com/rrn
Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk
A call to PhD Students and their supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.
Recovery Research: We would like to learn from your experience of conducting recovery research
Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.
Conferences and Events
i) First announcement: Western Lapland Health Care District will be hosting the 23rd International Network Meeting for the Treatment of Psychosis 2018
Welcome to Tornio – Western Lapland
August 29th – September 2nd, 2018
The Meeting will be arranged for teams, groups and individuals who in their work meet people and networks during severe life crises. In these meetings one of the aims is to find forms of treatment and care of psychotic crises that reduce the use of hospitalization and medication.
More information about program and registration will come with 2nd Announcement early in 2018. Tornio is located in Western Lapland on the border of Finland and Sweden. The nearest airports are Kemi-Tornio (20 km), Rovaniemi (130 km), Oulu (140 km) and Luleå in Sweden (140 km).
ii) The final digital showcase for the 5 year AHRC-funded programme Creative Practice as Mutual Recovery in association with Mental Health Foundation is available here: http://cpmr.mentalhealth.org.uk/
iii) Fourth International Psychiatric Congress on Mental Health and Recovery: Thursday and Friday, June 28th and 29th 2018, Insel Hospital, Children’s Hospital, Berne, Switzerland
The thematic focus of the previous congresses was on recovery as a benefit for society, social inclusion and recovery as a joined journey for those affected, relatives and professionals. For the next congress, we will look into the meaning of recovery during various stages in one’s life. At the beginning, Recovery originated as a grass-roots movement empowering mainly persons who had experienced psychotic episodes. The insights thus gained have been transferred and supplemented to other human experiences and encompass the entire life. There are new questions to be answered: how relevant is autonomy and self-determination for children and adolescents? What does hope and confidence mean when the memories and parts of the identity gently fade towards the last period of life? Is transformation important for elderly people?
Keynote speakers: Patricia Deegan, Patrick Corrigan, Jed Boardman, Janine Berg-Peer, Henriette Peer, Andrew Foster, Katja Beek, Walter Hofmann, Colin King,
For more information see: http://www.recovery-psychiatrie.eu/?lang=en
iv) ENMESH 2019
Topic: Managing complexity in mental health systems.
6-8 June 2019, Lisbon, Portugal.
Key dates: abstract submission: 17th September to 15th December 2018, notification: February 2019.
v) Refocus 2019
Registration and abstract submission are now open for Refocus on Recovery 2019, which will take place in Nottingham from 3 to 5 September 2019. This long-standing conference showcases the latest recovery studies and is an ideal opportunity to present about your work and to create new collaborations with leading researchers. The 2019 conference has four themes: mental health and human rights, supporting recovery through services, supporting recovery through communities, and recovery and power. Keynote speakers at the conference and the pre-conference expert workshops will cover topics including Soteria Houses, Housing First, citizenship, survivor research, co-production, QualityRights, strategic litigation, peer support in low resource settings, and digital interventions. The event is also great fun to attend! More information at:
https://www.researchintorecovery.com/ronr2019
Papers and Publications
i) Ramon, S. (2018) The place of social recovery in mental health and related services. International Journal of Environmental Research and Public Mental Health. 1-14 [online]
http://dx.doi.org/10.3390/ijerph15061052
Abstract
This article looks at the place of social recovery in mental health and social care services, alongside personal recovery. Despite its conceptual and practice centrality to the new meaning of recovery, social recovery has remained a relatively neglected dimension. This article attempts to provide an updated critical commentary based on findings from fifty-nine studies, including a variety of research methodologies and methods. Definitions of social recovery within the new meaning of recovery are looked at. This is followed by outlining the development and significance of this dimension as reflected in the key areas of shared decision making, co-production and active citizenship, re-entering employment after experiencing mental ill health, being in employment, poverty and coping with poverty, the economic and the scientific cases for social recovery. The article highlights the connections between service users’ experiencing mental health and social care systems, and the implications of ideologies and policies reflecting positions on social recovery. The complexity of social recovery is indicated in each of these areas; the related conceptual and methodological frameworks developed to research this dimension, and key achievements and barriers concerning everyday practice application of social recovery. The summary indicates potential future development perspectives of this dimension.
ii) Birken, M., Henderson, C. and Slade, M. (2018) The development of an occupational therapy intervention for adults with a diagnosed psychotic disorder following discharge from hospital. BMC 1-12. [online]
https://doi.org/10.1186/s40814-018-0267-7
Abstract
Background: A deterioration in mental health and admission to an acute mental health unit can result in skill loss and decreased participation in daily life. Furthermore, discharge from hospital is associated with high risks of social isolation and suicide. This intervention development study aims to describe the rationale, methods and processes of developing an intervention for adults with a diagnosed psychotic disorder following discharge from hospital. The intervention aims to increase participation in self-care and leisure, wellbeing and quality of life and reduce crisis service use.
Methods: The UK Medical Research Council framework for the development of complex interventions was used to guide the process of developing the intervention to ensure the developed intervention is empirically justifiable and evidence based. The development involved a systematic and literature reviews and focus groups with people with psychosis and clinical staff to understand the problems the intervention should address and approaches to resolving these.
Results: A manualised 4-month intervention named Graduating Living skills Outside the Ward (GLOW) was developed for use by occupational therapists for people with a diagnosed psychotic disorder following discharge from hospital. The one-to-one stepped intensity intervention is of 4 months in duration and takes place in the person’s home and in community locations. The intervention aims to increase occupational performance of domestic and personal self-care, leisure and some productive roles.
Conclusions: The intervention developed in this study has potential to improve the efficiency of community mental health services following discharge from hospital as it is evidence-based, time-limited and manualised and aims to reduce hospital admissions and crisis service use. The intervention will be tested to assess its clinical and cost effectiveness in a randomised controlled trial.
iii) The following article is taken from World Psychiatry 17(2) 2018. The forum asks: Is the risk-benefit ratio of long-term antipsychotic treatment favourable for most people with schizophrenia, and what can we do to improve it? Although we do not reproduce the commentaries that follow, we do provide the abstract to the discussion paper from Correll et al (2018).
Correll, C. U., Rubio, J. M. and Kane, J. M. (2018) What is the risk-benefit ratio of long-term antipsychotic treatment in people with schizophrenia. World Psychiatry. 17(2) 149-160
Abstract
The long-term benefit-to-risk ratio of sustained antipsychotic treatment for schizophrenia has recently been questioned. In this paper, we critically examine the literature on the long-term efficacy and effectiveness of this treatment. We also review the evidence on the undesired effects, the impact on physical morbidity and mortality, as well as the neurobiological correlates of chronic exposure to antipsychotics. Finally, we summarize factors that affect the risk-benefit ratio. There is consistent evidence supporting the efficacy of antipsychotics in the short term and mid term following stabilization of acute psychotic symptoms. There is insufficient evidence supporting the notion that this effect changes in the long term. Most, but not all, of the long-term cohort studies find a decrease in efficacy during chronic treatment with antipsychotics. However, these results are inconclusive, given the extensive risk of bias, including increasing non-adherence. On the other hand, long-term studies based on national registries, which have lower risk of bias, find an advantage in terms of effectiveness during sustained antipsychotic treatment. Sustained antipsychotic treatment has been also consistently associated with lower mortality in people with schizophrenia compared to no antipsychotic treatment. Nevertheless, chronic antipsychotic use is associated with metabolic disturbance and tardive dyskinesia. The latter is the clearest undesired clinical consequence of brain functioning as a potential result of chronic antipsychotic exposure, likely from dopaminergic hypersensitivity, without otherwise clear evidence of other irreversible neurobiological changes. Adjunctive psychosocial interventions seem critical for achieving recovery. However, overall, the current literature does not support the safe reduction of antipsychotic dosages by 50% or more in stabilized individuals receiving adjunctive psychosocial interventions. In conclusion, the critical appraisal of the literature indicates that, although chronic antipsychotic use can be associated with undesirable neurologic and metabolic side effects, the evidence supporting its long-term efficacy and effectiveness, including impact on life expectancy, outweighs the evidence against this practice, overall indicating a favorable benefit-to-risk ratio. However, the finding that a minority of individuals diagnosed initially with schizophrenia appear to be relapse free for long periods, despite absence of sustained antipsychotic treatment, calls for further research on patient-level predictors of positive outcomes in people with an initial psychotic presentation.
iv) Byrne, L., Roennfeldt, H., O’Shea, P. and Macdonald, F. (2018) Taking a gamble for high rewards? Management perspectives on the value of mental health peer workers. International Journal of Environmental Research and Public Mental Health. 1-12 [online]
http://dx.doi.org/10.3390/ijerph15040746
Abstract
Mental health peer work is attracting growing interest and provides a potentially impactful method of service user involvement in mental health design and delivery, contributing to mental health reform. The need to effectively support this emerging workforce is consequently increasing. This study aimed to better understand the views of management in relation to peer work and specifically explores the value of peer work from the perspective of management. This qualitative research employed grounded theory methods. There were 29 participants in total, employed in both peer designated and non-peer designated management roles, in not for profit and public health organisations in Queensland, Australia. The value of peer work as described by participants is found to be partially dependent on practical supports and strategies from the organisation. There were high benefits for all facets of the organisation when effective recruitment and ongoing support for peer workers was prioritised and a higher perception of limitations when they were not. Due to some parallels, it may be useful to explore the potential for peer work to be conceptually and/or practically considered as a form of diversity and inclusion employment
v) Bouras, N., Ikkos, G. and Craig, T. (2018) From community to meta-community mental health care. International Journal of Environmental Research and Public Mental Health. 1-10 [online]
https://doi.org/10.3390/ijerph15040806
Abstract
Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income countries, it remains an aspiration. Although community mental health care has been positive for many service users, it has also had severe shortcomings. Expectations that it would lead to fuller social integration have not been fulfilled and many service users remain secluded in sheltered or custodial environments with limited social contacts and no prospect of work. Others receive little or no service at all. In today’s complex landscape of increasingly specialised services for people with mental health problems, the number of possible interfaces between services is increasing. Together with existing uneven financing systems and a context of constant change, these interfaces are challenging us to develop effective care pathways adjusted to the needs of service users and their carers. This discussion paper reviews the developments in community mental health care over the recent years and puts forward the concept of “Meta-Community Mental Health Care”. “Meta-Community Mental Health Care” embraces pluralism in understanding and treating psychiatric disorders, acknowledges the complexities of community provision, and reflects the realities and needs of the current era of care
vi) Tyrer, P. (2018) The importance of nidotherapy and environmental change in the management of people with complex mental disorders. International Journal of Environmental Research and Public Mental Health. 1-9. [online]
https://doi.org/10.3390/ijerph15050972
Abstract
Much has been done in the last 50 years to achieve a better understanding of the psychosocial causes and other factors influencing the manifestation of mental illness, but there has been a conspicuous omission. Although gross environmental deficiencies were exposed in old mental institutions, 70 years ago the more subtle maladaptive settings that reinforce chronicity in mental illness have often been forgotten. In this review, the potential of systematic environmental manipulation as a treatment (nidotherapy) and other similar forms of management, used many times in the past but now mainly in forensic settings, is examined. There is now accumulating evidence, reinforced by controlled trials, that planned environmental change, preferably carried out with the full cooperation of the patient, can be a major contributor to therapeutic benefit. It is also very cost-effective. All forms of the environment, physical, social and personal, can be addressed in making assessments, and once a planned way forward has been chosen, progress can be monitored by personnel with limited mental health experience. These interventions have applications in general mental health and occupational health services and deserve much wider use.
A decade of RRN
The first meeting of the RRN was held on the 23rd April 2009. November 2018 will be the 20th meeting of the RRN, and mark ten years of collegial networking around the topic of research into recovery. Suggestions for marking our 10-year anniversary would be most welcome! Celebrations would take place at the 21st meeting in the Spring of 2019.
Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk
June 2018
Recovery Research Network eBULLETIN
June 2018
RRN Meetings
Chris Griffiths and Northamptonshire Healthcare NHS Foundation Trust have kindly offered to host the 20th meeting of the RRN. The event will be held on Wednesday the 7th November 2018 at:
Willow Room
Berrywood Hospital
Northamptonshire Healthcare NHS Foundation Trust
Northampton
NN5 6GQ
Directions to room: as you enter main building entrance ascend stairs on the left
Link: https://www.nhft.nhs.uk/berrywood
The theme will be ‘Social Connectedness’ and speaker suggestions are welcome from the readership. Refreshments will be available from 9.30am, and the meeting will run from 10.00am until 4.00pm
All Recovery Research Network events are free and administrated through Eventbrite. The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly. Although there is a waiting list, we do kindly ask that you notify the RRN if, for whatever reason, you are unable to attend on the day. This allows us to offer your place to someone else. The Eventbrite link for the November meeting of the RRN will be circulated 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
Tony: a.sparkes@bradford.ac.uk
RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at: https://www.researchintorecovery.com/rrn
Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk
A call to PhD Students and their supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.
Recovery Research: We would like to learn from your experience of conducting recovery research
Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.
Conferences and Events
i) First announcement: Western Lapland Health Care District will be hosting the 23rd International Network Meeting for the Treatment of Psychosis 2018
Welcome to Tornio – Western Lapland
August 29th – September 2nd, 2018
The Meeting will be arranged for teams, groups and individuals who in their work meet people and networks during severe life crises. In these meetings one of the aims is to find forms of treatment and care of psychotic crises that reduce the use of hospitalization and medication.
More information about program and registration will come with 2nd Announcement early in 2018. Tornio is located in Western Lapland on the border of Finland and Sweden. The nearest airports are Kemi-Tornio (20 km), Rovaniemi (130 km), Oulu (140 km) and Luleå in Sweden (140 km).
ii) The final digital showcase for the 5 year AHRC-funded programme Creative Practice as Mutual Recovery in association with Mental Health Foundation is available here: http://cpmr.mentalhealth.org.uk/
iii) ENMESH 2019
Topic: Managing complexity in mental health systems.
6-8 June 2019, Lisbon, Portugal.
Key dates: abstract submission: 17th September to 15th December 2018, notification: February 2019.
iv) Refocus 2019
Registration and abstract submission are now open for Refocus on Recovery 2019, which will take place in Nottingham from 3 to 5 September 2019. This long-standing conference showcases the latest recovery studies and is an ideal opportunity to present about your work and to create new collaborations with leading researchers. The 2019 conference has four themes: mental health and human rights, supporting recovery through services, supporting recovery through communities, and recovery and power. Keynote speakers at the conference and the pre-conference expert workshops will cover topics including Soteria Houses, Housing First, citizenship, survivor research, co-production, QualityRights, strategic litigation, peer support in low resource settings, and digital interventions. The event is also great fun to attend! More information at:
https://www.researchintorecovery.com/ronr2019
v) Refocus on Recovery
The Refocus on Recovery international conference has proved popular, with 400-500 people from 20-25 countries regularly attending. The four previous conferences are described here and the September 2019 conference here (and please see above). Now that the conference is an established brand building a global community of influence, a new opportunity is now available to run a national Refocus on Recovery conference in order to develop regional and national momentum around recovery. More information is at https://www.researchintorecovery.com/RoRNational.
vi) 9th International Conference on Social Work in Mental Health
The 9th International Conference on Social Work in Health and Mental Health will be held at the University of York, UK, from 22nd to 26th July 2019:
- Abstracts will open from Friday 13 July and will close on Friday 28 September 2018.
- Delegate Registration will open from Monday 1st October 2018.
- Early Bird rate is available from Monday 1st October until Thursday 31 January 2019, prices start at £425 per person (excluding accommodation and conference dinner ticket).
- Full price fees will be from Friday 1st February until Friday 31 May 2019.
- Late fee will apply from Saturday 1st June until Friday 5 July 2019.
The event will be offering a number of prizes (bursary places) for the best abstracts in the following categories: student, submission from a developing country, service user researcher, early career researcher, practitioner. If you wish to be considered for a prize, you should indicate this when you submit your abstract via the online system which opens on 13th July. Prize winners will be awarded a fully funded place (excluding travel) at the 9th International Conference on Social Work in Health and Mental Health.
The conference is titled Shaping the Future: Promoting Human Rights and Social Perspectives in Health and Mental Health. It will bring together social work practitioners from all over the world, and provide a forum for the sharing of knowledge and interaction between educators, practitioners and researchers in health and community care sectors. Find out more about the event by visiting:
Papers and Publications
i) McDonald, S. and Bertram, M. (2018) Job creation through income generation: an evaluation of Re-Cover, a decorating project developed with forensic mental health service users. The Journal of Mental Health Training, Education and Practice. 13(3) 148-156
https://doi.org/10.1108/JMHTEP-11-2017-0062
Abstract
Aim: To explore and describe the effectiveness, achievements and challenges of a job creation project that was developed with people in contact with forensic mental health services.
Method: This evaluation (case study) used mixed methods: a range of quantitative and qualitative data were gathered, analysed and interpreted.
Results: There were economic and health benefits. The income generation was sufficient to fund a large chunk of the projects operating costs. Service users reported improvements in mental health, wellbeing, confidence, skill development and earning capacity.
Implications for Practice: A range of commercial activity can form the basis for job creation and work training projects in mental health services. Substantial operating costs can be generated, to re-invest in job creation/enterprises.
Conclusion: Social value can be enhanced within NHS public sector procurement procedures. Agreement and co-operation between NHS departments is necessary: Clinical, finance, commercial, estates and facilities, H.R. and procurement.
ii) Jensen, A. (2018) Mental health recovery and arts engagement. The Journal of Mental Health Training, Education and Practice. 13(3) 157-166
Abstract
Purpose: Arts and cultural activities have been illustrated to be beneficial for mental health service users. The purpose of this paper is to explore the benefits of museum visits and engage in arts activities for mental health service users.
Design/methodology/approach: Semi-structured interviews were conducted with 17 mental health service users in Denmark. A thematic approach was used to analyse the data and theoretical lens of sociological theories of institutional logics was employed to explore the findings.
Findings: These benefits are perceived to include empowerment and meaning in life, which are two of the core principles of recovery; arts engagement can, therefore, be a useful tool in recovery. The findings also show that the experience of visiting a museum was not always positive and depended upon the interaction with the museum educators.
Originality/value: The service users identified arts engagement as creating meaning in life and empowerment, which are two elements in the conceptual framework, CHIME (an acronym for: Connectedness, Hope and optimism, Identity, Meaning in life and Empowerment), that describes the human process of recovery. The findings also highlighted that if museums want to engage positively with people with mental health problems and contribute to their recovery then the training of staff and the improvement of institutional approaches to support working with vulnerable people are essential.
iii) Picton, C., Patterson, C., Moxham, L., Taylor, E.T., Perlman, D., Brighton, R. and Heffernan, T. (2018) Empowerment: the experience of Recovery Camp for people living with a mental illness. Collegian. 25(1) 113-118
Abstract
Background: Mental health recovery is still largely clinically defined and as such can lack person centeredness. To address this, recovery oriented experiences are required which recognise the holistic and diverse needs of individuals.
Aim: The aim of the study was to examine the experiences of people living with a mental illness who participated in a recovery oriented program called Recovery Camp. The study aimed to examine how the program may have related and contributed to their mental health recovery.
Methods: A descriptive phenomenological approach guided the study. Consenting participants (n = 5) were interviewed and asked about their subjective experience of Recovery Camp. The interviews were digitally audio recorded and transcribed verbatim. Data were analysed using van Kaam’s Psychophenomenological method.
Findings: This paper presents the perspective of consumers regarding the ways in which Recovery Camp facilitated mental health recovery. Data analysis revealed five themes (Self-determination, Participation, Extending Self, Relationships and Positive change) and a core essence of meaning (Empowerment).
Conclusions: Personal mental health recovery for people living with mental illness can be enhanced through recovery oriented mental health care approaches. Findings contribute to existing literature regarding therapeutic recreation and its link to mental health recovery.
iv) Petros, R., Solomon, P., Linz, S.J., DeCesaris, M. and Hanrahan, N.P. (2016) Capabilities Approach: Contextualizing Participants’ Perspectives on Systems Barriers to Recovery, International Journal of Mental Health 45(4) 262-278
Abstract
Mental health resources are designed to facilitate recovery for adults with psychiatric disabilities. Two participants of an autovideography intervention described systems barriers to recovery. Researchers employed narrative analysis, guided by the capabilities approach, to evaluate how participants storied their experiences. Participants made meaning from encounters with barriers in ways that oppose the spirit and advancement of recovery while engendering adaptive preferences. Findings indicate that inadequate resources attenuate wellbeing by increasing barriers that actively oppose recovery, and positive reframing of unaccommodating environments reinforces adaptive preferences and incapacity. Adequate resources are essential for successful recovery transformation within the mental health system.
v) Petros, R., Solomon, P., Linz, S., DeCesaris, M. and Hanrahan, N.P. (2016) Autovideography: the lived experience of recovery for adults with serious mental illness. Psychiatric Quarterly. 87(3) 417-426.
Abstract
Mental health services have been transforming toward a recovery orientation for more than a decade, yet a robust understanding of recovery eludes many providers, and consensus on a conceptual definition has yet to be reached. This article examines mental health consumers’ lived experience of recovery and evaluates the usefulness and comprehensiveness of CHIME, a major framework conceptually defining recovery for adults with serious mental illness. Researchers partnered with a mental health association in a major US city to engage in research with graduates of a recovery and education class for adults diagnosed with serious mental illness. Twelve participants were loaned video cameras and invited to ‘‘Tell us about your recovery’’ through autovideography. Of the 12 participants, six produced videos directly responding to the overall research question and were subsequently included in the present analysis. Data were analyzed thematically, and CHIME adequately represented the major domains presented in consumer videos with two notable modifications: subdomains of ‘‘reciprocity’’ within relationships and ‘‘contributing to others’’ were added to comprehensively represent consumer perspectives about recovery. Adding two subdomains to CHIME more effectively represents consumer narratives about recovery, contributes to the social construction of the personhood of people with serious mental illness, and offers a more robust description of the process of recovery
vi) Jennings, H., Slade, M., Bates, P., Munday, E. and Toney, R. (2018) Best practice framework for Patient and Public Involvement (PPI) in collaborative data analysis of qualitative mental health research: methodology development and refinement. BMC Psychiatry. 18:213.
https://doi.org/10.1186/s12888-018-1794-8
Abstract
Background: Patient and Public Involvement (PPI) in mental health research is increasing, especially in early (prefunding) stages. PPI is less consistent in later stages, including in analysing qualitative data. The aims of this study were to develop a methodology for involving PPI co-researchers in collaboratively analysing qualitative mental health research data with academic researchers, to pilot and refine this methodology, and to create a best practice framework for collaborative data analysis (CDA) of qualitative mental health research.
Methods: In the context of the RECOLLECT Study of Recovery Colleges, a critical literature review of collaborative data analysis studies was conducted, to identify approaches and recommendations for successful CDA. A CDA methodology was developed and then piloted in RECOLLECT, followed by refinement and development of a best practice framework.
Results: From 10 included publications, four CDA approaches were identified: (1) consultation, (2) development, (3) application and (4) development and application of coding framework. Four characteristics of successful CDA were found: CDA process is co-produced; CDA process is realistic regarding time and resources; demands of the CDA process are manageable for PPI co-researchers; and group expectations and dynamics are effectively managed. A four-meeting CDA process was piloted to co-produce a coding framework based on qualitative data collected in RECOLLECT and to create a mental health service user-defined change model relevant to Recovery Colleges. Formal and informal feedback demonstrated active involvement. The CDA process involved an extra 80 person-days of time (40 from PPI co-researchers, 40 from academic researchers). The process was refined into a best practice framework comprising Preparation, CDA and Application phases.
Conclusions: This study has developed a typology of approaches to collaborative analysis of qualitative data in mental health research, identified from available evidence the characteristics of successful involvement, and developed, piloted and refined the first best practice framework for collaborative analysis of qualitative data. This framework has the potential to support meaningful PPI in data analysis in the context of qualitative mental health research studies, a previously neglected yet central part of the research cycle.
A decade of RRN
The first meeting of the RRN was held on the 23rd April 2009. November 2018 will be the 20th meeting of the RRN, and mark ten years of collegial networking around the topic of research into recovery. Suggestions for marking our 10-year anniversary would be most welcome! Celebrations would take place at the 21st meeting in the Spring of 2019.
Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk
July 2018
Recovery Research Network eBULLETIN
July 2018
RRN Meetings
Chris Griffiths and Northamptonshire Healthcare NHS Foundation Trust have kindly offered to host the 20th meeting of the RRN. The event will be held on Wednesday the 7th November 2018 at:
Willow Room
Berrywood Hospital
Northamptonshire Healthcare NHS Foundation Trust
Northampton
NN5 6GQ
Directions to room: as you enter main building entrance ascend stairs on the left
Link: https://www.nhft.nhs.uk/berrywood
The theme will be ‘Social Connectedness’ and speaker suggestions are welcome from the readership. Refreshments will be available from 9.30am, and the meeting will run from 10.00am until 4.00pm
All Recovery Research Network events are free and administrated through Eventbrite. The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly. Although there is a waiting list, we do kindly ask that you notify the RRN if, for whatever reason, you are unable to attend on the day. This allows us to offer your place to someone else. The Eventbrite link for the November meeting of the RRN will be circulated 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
Tony: a.sparkes@bradford.ac.uk
RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at: https://www.researchintorecovery.com/rrn
Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk
A call to PhD Students and their supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.
Recovery Research: We would like to learn from your experience of conducting recovery research
Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.
Conferences and Events
i) ISPS UK
Compassion and Compulsion: Exploring the tensions faced by service users and clinicians when people experience psychosis
Tuesday 31st July 2018 Preston. 6pm – 8pm
ii) First announcement: Western Lapland Health Care District will be hosting the 23rd International Network Meeting for the Treatment of Psychosis 2018
Welcome to Tornio – Western Lapland
August 29th – September 2nd, 2018
The Meeting will be arranged for teams, groups and individuals who in their work meet people and networks during severe life crises. In these meetings one of the aims is to find forms of treatment and care of psychotic crises that reduce the use of hospitalization and medication.
More information about program and registration will come with 2nd Announcement early in 2018. Tornio is located in Western Lapland on the border of Finland and Sweden. The nearest airports are Kemi-Tornio (20 km), Rovaniemi (130 km), Oulu (140 km) and Luleå in Sweden (140 km).
iii) The final digital showcase for the 5-year AHRC-funded programme Creative Practice as Mutual Recovery in association with Mental Health Foundation is available here: http://cpmr.mentalhealth.org.uk/
iv) ENMESH 2019
Topic: Managing complexity in mental health systems.
6-8 June 2019, Lisbon, Portugal.
Key dates: abstract submission: 17thSeptember to 15thDecember 2018, notification: February 2019.
v) Refocus 2019
Registration and abstract submission are now open for Refocus on Recovery 2019, which will take place in Nottingham from 3 to 5 September 2019. This long-standing conference showcases the latest recovery studies and is an ideal opportunity to present about your work and to create new collaborations with leading researchers. The 2019 conference has four themes: mental health and human rights, supporting recovery through services, supporting recovery through communities, and recovery and power. Keynote speakers at the conference and the pre-conference expert workshops will cover topics including Soteria Houses, Housing First, citizenship, survivor research, co-production, QualityRights, strategic litigation, peer support in low resource settings, and digital interventions. The event is also great fun to attend! More information at:
https://www.researchintorecovery.com/ronr2019
vi) 9thInternational Conference on Social Work in Mental Health
The 9th International Conference on Social Work in Health and Mental Health will be held at the University of York, UK, from 22nd to 26th July 2019:
- Abstracts will open from Friday 13 July and will close on Friday 28 September 2018.
- Delegate Registration will open from Monday 1st October 2018.
- Early Bird rate is available from Monday 1st October until Thursday 31 January 2019, prices start at £425 per person (excluding accommodation and conference dinner ticket).
- Full price fees will be from Friday 1st February until Friday 31 May 2019.
- Late fee will apply from Saturday 1st June until Friday 5 July 2019.
The event will be offering a number of prizes (bursary places) for the best abstracts in the following categories: student, submission from a developing country, service user researcher, early career researcher, practitioner. If you wish to be considered for a prize, you should indicate this when you submit your abstract via the online system which opens on 13th July. Prize winners will be awarded a fully funded place (excluding travel) at the 9th International Conference on Social Work in Health and Mental Health.
The conference is titled Shaping the Future: Promoting Human Rights and Social Perspectives in Health and Mental Health. It will bring together social work practitioners from all over the world, and provide a forum for the sharing of knowledge and interaction between educators, practitioners and researchers in health and community care sectors. Find out more about the event by visiting:
Papers and Publications
i) Tang, L. (2018) Recovery, Hope and Agency: The Meaning of Hope amongst Chinese Users of Mental Health Services in the UK. British Journal of Social Work.Online:
https://doi.org/10.1093/bjsw/bcy033
Abstract
Hope is considered crucial to mental health recovery. However, the manner in which social inequalities shape individuals’ meaning of hope has received little attention. Based on a close analysis of the recovery journeys of six Chinese service users in the UK, this paper explores the diverse meanings of hope among service users from non-dominant cultures. Illustrative stories are selected from in-depth life history interviews conducted with twenty-two participants. Based on the capabilities approach and intersectionality analysis, the findings reveal a paradox of hope and show how hope can be embraced, cautiously pursued or held at bay by individuals. Whilst hope is one expression of human agency, service users with reservations about hope maintain agency in other ways, despite their diminished life chances. This paper argues for an increased focus on individuals’ agency development to support recovery and advocates for the challenging of inequalities to achieve this.
In this edition of the RRN eBulletin, we draw the reader’s attention to a recent edition of Psychosis (Vol.10, Issue 2. pp 81-162) where there are a number of articles related to recovery. Here, we report just three:
ii) Georgaca, E. and Zissi, A. (2018) Living with psychosis: strategies and social conditions for recovery. Psychosis. 10(2). 81-89.
https://doi.org/10.1080/17522439.2018.1447595
Abstract
The paper examines the often neglected, social factors implicated in recovery from severe mental distress, by presenting findings from a biographical study of individuals experiencing psychosis. Biographical interviews with 26 individuals with psychotic experiences and diagnosis of psychotic disorders were conducted and subjected to narrative biographical analysis. This paper focuses on a group of narrators who are engaged in a struggle to live a satisfactory life despite ongoing mental distress, and thus can be seen as being in recovery. In terms of therapeutic itineraries, the distinctive characteristics of this group are the early recognition and community management of psychotic experiences. Participants in this group also consistently employ various strategies for managing their psychotic experiences as well as for looking after their mental health. The two most central social parameters for recovery identified in this study are firstly, increased social participation through interpersonal and social networks, and secondly, access to empowering discourses and practices regarding mental distress, which are in turn related to developments in the mental health service system over the last two decades. We conclude that crucial parameters in building a life with psychosis involve the broader sociocultural context, the mental health service system, and familial and social networks.
iii) Bonnett, V., Berry, C., Meddings, S. and Holtum, S. (2018) An exploration of young people’s narratives of hope following experience of psychosis. Psychosis. 10(2) 99-109.
https://doi.org/10.1080/17522439.2018.1460393
Abstract
Aims: To expand understandings of how young people with psychosis experience hope. This included to which factors young people attributed changes in their hopefulness and the role played by professionals and others with lived experience.
Method: Ten young people recovering from an experience of psychosis were interviewed using narrative methodology.
Results: The experience of hope as an overarching strand throughout the narratives had three common elements: sense of belonging, which included social inclusion, the importance of information and the significance of planning and occupation. Professionals played an important role in facilitating small steps forwards.
Conclusions: The findings suggest the importance to young people of a sense of belonging and achieving small goals to facilitate hopeful thinking and, for clinicians, the value of supporting new peer relationships and meaningful occupation.
iv) Pyle, M., Pilling, S., Machin, K., Allende-Cullen, G. and Morrison, A. P. (2018) Peer support for internalised stigma experienced by people with psychosis: rationale and recommendations. Psychosis.10(2) 146-152.
https://doi.org/10.1080/17522439.2018.1437212
Abstract
People with experience of psychosis face stigma and discrimination, which can be a significant barrier to recovery. Internalisation of public stereotypes and prejudice into an individual’s self-identity is an understandable consequence of such discrimination. However, internalised stigma represents a significant barrier to recovery, resulting in a number of harmful consequences such as depression, demoralisation and loss of self-esteem. Interventions to support people with experience of psychosis who internalise stigma have demonstrated some promising results, but a recent meta-analysis did not find an overall significant effect. The current evidence base includes very few trials of peer support for internalised stigma; however, data from several trials and a recent meta-analysis show that peer support produces benefits on a number of dimensions related to internalised stigma, including empowerment, recovery and hope. In this paper, we argue that peer support is a suitable intervention for addressing internalised stigma and warrants further research. We provide a theoretical and evidence-based rationale for this argument and outlines some of the key challenges and possible solutions for future trials of peer support as an intervention for internalised stigma.
Research Request
Ed Mundy, a Trainee Clinical Psychologist from Canterbury Christ Church University, is inviting participation in the following research project. We use Ed’s words here:
Research title:Exploring the concept of ‘family recovery’ in family members and individuals with lived experience of psychosis.
Researcher: Edward Mundy, Trainee Clinical Psychologist, Canterbury Christ Church University (CCCU), supervised by academics at King’s College London and CCCU.
What is the project about?
There is a small but growing literature looking at extending recovery principles to families and family members, leading some to speak of the idea of ‘family recovery’. But what does this actually mean? What do those with lived experience of psychosis, as well as family members, think of the idea of family recovery? How does having a family member with psychosis shape family life? And can this be understood from a recovery perspective?
If you’re interest in talking about your experience of having a family member with psychosis and how this has affected you and your family, then you may be interested in taking part in this research project. I’m a trainee clinical psychologist looking to recruit anyone with a family member (sibling, daughter, son, partner, parent, extended family member) who has experienced psychosis to take part in an hour-long face-to-face interview or telephone interview, for my doctoral research.
If you’re interested in hearing more about the research, or have any questions, please contact Ed Mundy, either by email at e.g.mundy502@canterbury.ac.ukor telephone 07379905189 (available Monday-Friday 9-5, but you can leave a message outside of these times).
This study has been approved by the London-Surrey NHS Research Ethics Committee (18/LO/0202). Your participation is completely voluntary, and the information you provide would be in confidence (subject to any concerns around a person’s safety). Should you decide to take part, you can answer as little or as many of the questions asked. Should you have any questions around this, or wish to know more, please contact me and I’d be happy to talk further.
Vacancy
The International Society for Psychological and Social Approaches to Psychosis -UK (ISPS-UK) are recruiting for a series editor for their ISPS book series. Please see the attached document to this ebulletin for further details. Please also see:
A decade of RRN
The first meeting of the RRN was held on the 23rdApril 2009. November 2018 will be the 20thmeeting of the RRN, and mark ten years of collegial networking around the topic of research into recovery. Suggestions for marking our 10-year anniversary would be most welcome! Celebrations would take place at the 21st meeting in the Spring of 2019.
Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk
August 2018
Recovery Research Network eBULLETIN
August 2018
RRN Meetings
Chris Griffiths and Northamptonshire Healthcare NHS Foundation Trust have kindly offered to host the 20th meeting of the RRN. The event will be held on Wednesday the 7th November 2018 at:
Willow Room
Berrywood Hospital
Northamptonshire Healthcare NHS Foundation Trust
Northampton
NN5 6GQ
Directions to room: as you enter main building entrance ascend stairs on the left
Link: https://www.nhft.nhs.uk/berrywood
The theme will be ‘Social Connectedness’ and speaker suggestions are welcome from the readership. Refreshments will be available from 9.30am, and the meeting will run from 10.00am until 4.00pm
To register for the event, please use the following link:
https://www.eventbrite.co.uk/e/social-connectedness-tickets-48025805477?aff=ebdssbdestsearch
All Recovery Research Network events are free and administrated through Eventbrite. The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly. Although there is a waiting list, we do kindly ask that you notify the RRN if, for whatever reason, you are unable to attend on the day. This allows us to offer your place to someone else. The Eventbrite link for the November meeting of the RRN will be circulated 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
Tony: a.sparkes@bradford.ac.uk
RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at: https://www.researchintorecovery.com/rrn
Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk
A call to PhD Students and their supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.
Recovery Research: We would like to learn from your experience of conducting recovery research
Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.
Conferences and Events
i) The final digital showcase for the 5-year AHRC-funded programme Creative Practice as Mutual Recovery in association with Mental Health Foundation is available here: http://cpmr.mentalhealth.org.uk/
ii) ENMESH 2019
Topic: Managing complexity in mental health systems.
6-8 June 2019, Lisbon, Portugal.
Key dates: abstract submission: 17th September to 15th December 2018, notification: February 2019.
iii) Refocus 2019
Registration and abstract submission are now open for Refocus on Recovery 2019, which will take place in Nottingham from 3 to 5 September 2019. This long-standing conference showcases the latest recovery studies and is an ideal opportunity to present about your work and to create new collaborations with leading researchers. The 2019 conference has four themes: mental health and human rights, supporting recovery through services, supporting recovery through communities, and recovery and power. Keynote speakers at the conference and the pre-conference expert workshops will cover topics including Soteria Houses, Housing First, citizenship, survivor research, co-production, QualityRights, strategic litigation, peer support in low resource settings, and digital interventions. The event is also great fun to attend! More information at:
https://www.researchintorecovery.com/ronr2019
iv) 9th International Conference on Social Work in Mental Health
The 9th International Conference on Social Work in Health and Mental Health will be held at the University of York, UK, from 22nd to 26th July 2019:
- Abstracts will open from Friday 13 July and will close on Friday 28 September 2018.
- Delegate Registration will open from Monday 1st October 2018.
- Early Bird rate is available from Monday 1st October until Thursday 31 January 2019, prices start at £425 per person (excluding accommodation and conference dinner ticket).
- Full price fees will be from Friday 1st February until Friday 31 May 2019.
- Late fee will apply from Saturday 1st June until Friday 5 July 2019.
The event will be offering a number of prizes (bursary places) for the best abstracts in the following categories: student, submission from a developing country, service user researcher, early career researcher, practitioner. If you wish to be considered for a prize, you should indicate this when you submit your abstract via the online system which opens on 13th July. Prize winners will be awarded a fully funded place (excluding travel) at the 9th International Conference on Social Work in Health and Mental Health.
The conference is titled Shaping the Future: Promoting Human Rights and Social Perspectives in Health and Mental Health. It will bring together social work practitioners from all over the world, and provide a forum for the sharing of knowledge and interaction between educators, practitioners and researchers in health and community care sectors. Find out more about the event by visiting:
Papers and Publications
i) Austin, R. (2018) Exploring issues of self-stigma in “Emily’s Voices”: a memoir of psychosis and recovery. Psychosis. 10(2) 153-157
Abstract
“Emily’s Voices” is Roz Austin’s memoir of recovery from psychosis. She published it under a pseudonym (Emily Knoll) and changed identifying features for various reasons of confidentiality. As you will discover when you read extracts from the book, one of the main problems for people who struggle with mental health problems is that they experience stigma, and they can stigmatise themselves. This memoir tells Emily’s story of her struggle with hearing voices and her journey through the mental health system. Emily’s voices are distressing, but her therapist and close friends help her to challenge the voices, and to confront some of the self-stigma which she feels about being a voice-hearer. Emily must find a way of accepting that she hears voices, or she can’t be in the world – but it’s a confrontation that takes all of her new-found strength and resolve. “Emily’s Voices” is available to buy from Amazon. Roz recently completed her PhD with Durham University’s “Hearing the Voice” research project. Her survivor-researcher-led project explored emotional aspects of the experience of hearing voices in the English adult population.
ii) Söderström, O., Söderström, D., Codeluppi, Z., Empson, L.A. and Conus, P. (2017) Emplacing recovery: how persons diagnosed with psychosis handle stress in cities. Psychosis. 9(4) 322-329.
Abstract
The background of this study is recent work on the correlation between urban living and psychosis. It is part of a larger interdisciplinary research project using an experience-based approach to the city-psychosis nexus. The aim of this paper is to investigate how, soon after a first episode of psychosis, patients manage urban factors of stress. Methodologically, it is based on video-elicitation interviews of urban walks and ethnographic observations in a community care centre in the city of Lausanne, Switzerland. It shows that patients use three tactics: creating sensory bubbles; programming mobility; and creating places of comfort. On the basis of these findings, the paper discusses how the approach and results of our study can inform strategies of recovery that are both user-driven and take into consideration the importance of places and situations in the city in the phase following a first episode.
iii) Rennke, S., Yuan, P., Monash, B., Blankenburg, R., Chua, I., Harman, S., Sakai, D. S., Khan, A., Hilton, J. F., Shieh, L. and Satterfield, J. (2017) The SDM 3 circle model: a literature synthesis and adaptation for shared decision-making in the hospital. Journal of Hospital Medicine. 12(12) 1001-1008.
Abstract
Patient engagement through shared decision-making (SDM) is increasingly seen as a key component for patient safety, patient satisfaction, and quality of care. Current SDM models do not adequately account for medical and environmental contexts, which may influence medical decisions in the hospital. We identified leading SDM models and reviews to inductively construct a novel SDM model appropriate for the inpatient setting. A team of medicine and pediatric hospitalists reviewed the literature to integrate core SDM concepts and processes and iteratively constructed a synthesized draft model. We then solicited broad SDM expert feedback on the draft model for validation and further refinement. The SDM 3 Circle Model identifies 3 core categories of variables that dynamically interact within an “environmental frame.” The resulting Venn diagram includes overlapping circles for (1) patient/family, (2) provider/team, and (3) medical context. The environmental frame includes all external, contextual factors that may influence any of the 3 circles. Existing multistep SDM process models were then rearticulated and contextualized to illustrate how a shared decision might be made. The SDM 3 Circle Model accounts for important environmental and contextual characteristics that vary across settings. The visual emphasis generated by each “circle” and by the environmental frame direct attention to often overlooked interactive forces and has the potential to more precisely define, promote, and improve SDM. This model provides a framework to develop interventions to improve quality and patient safety through SDM and patient engagement for hospitalists.
iv) Bergström, T., Alakare, B., Aaltonen, J., Mäki, P., Köngäs-Saviaro, P., Taskila, J. T. and Seikkula, J. (2017) The long-term use of psychiatric services within the Open Dialogue treatment system after first episode psychosis. Psychosis. 9(4) 310-321
Abstract
Open Dialogue is a family-oriented early intervention model for mental health problems developed in the health district of Western Lapland, Finland. In the present study, the aim was to describe how psychiatric services were used in Western Lapland after decades of first-episode psychosis services, and to analyze how baseline characteristics were related to re-admission rates and the total duration of psychiatric treatment in geographical area where Open Dialogue approaches were developed and efforts made to systematically apply them to all psychiatric treatments. The data were obtained from the medical histories of patients who had first-episode psychosis in 1992–2005 and who lived continuously within the catchment area during the observation years (1992–2015) (N = 65). From baseline up to 2015, average length of treatment was 6 ± 2 years, and significant decrease (p < .001) in total use of psychiatric services was observed. The admission rates and duration of treatment were highest with subjects who behaved aggressively (U = 270, p < .005), and/or who were hospitalized (U = 157, p < .001) and medicated (U = 114, p < .001) at onset. Overall, external aggression at onset emerges as a factor that may challenge the application of the OD treatment principles, being associated with a greater need for hospitalization and longer treatment duration
v) Hine, R., Mayberry, D. and Goodyear, M. (2018) Resourcefulness and resilience: the experience of personal recovery for mothers with a mental illness. British Journal of Social Work. 48(5). 1257-1276.
Abstract
Understanding of key characteristics and processes of personal recovery from mental illness is growing. However, a paucity of research exists with mothers with mental illness around experiences of personal recovery. An improved understanding of the interplay between illness, parenting and broader social factors may better inform how mental health services respond to the needs of these women. Using constructivist grounded theory (CGT), in-depth interviews were conducted with seventeen women who were mothers with a mental illness, residing in Australia. Through the CGT technique of constant comparative analysis, initial codes were synthesised and theoretical sampling employed to reach saturation of the categories associated with the construct of personal recovery. For mothers with a mental illness, personal recovery takes place within and is shaped by broader social contexts. Six key dimensions of personal recovery were ‘recognising recovery’, ‘mothering’, ‘experiencing oppression’, ‘managing distress’, ‘making a change’ and ‘feeling better’. This study found that mothers with mental illness interpret recovery as enduring through difficult times, rather than a process of personal transformation and adjustment which is articulated within personal recovery literature. Well-being outcomes for women with children may be more effectively promoted through strategies that address underlying factors such as supporting early mothering, preventing violence against women, addressing trauma, and redressing socio-economic disadvantage and gender disparity.
Participation opportunity – the NEON study
Mike Slade’s NEON study [ https://www.researchintorecovery.com/NEON ] is currently conducting interviews to collect and analyse mental health recovery stories from selected groups.
The NEON study would particularly like to interview people who have experienced what might be called “psychosis”, or have experiences that others see as unusual (e.g. hearing voices, seeing or believing things that others do not), but who have not had support from the NHS, other than their GP, for at least five years.
If you are interested in participating, or know of others who might like to participate, then please contact Rose McGranahan [ rose.mcgranahan@qmul.ac.uk ], who is leading work with this group
A decade of RRN
The first meeting of the RRN was held on the 23rd April 2009. November 2018 will be the 20th meeting of the RRN, and mark ten years of collegial networking around the topic of research into recovery. Suggestions for marking our 10-year anniversary would be most welcome! Celebrations would take place at the 21st meeting in the Spring of 2019.
Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk
September 2018
Recovery Research Network eBULLETIN
September 2018
RRN Meetings
Chris Griffiths and Northamptonshire Healthcare NHS Foundation Trust have kindly offered to host the 20th meeting of the RRN. The event will be held on Wednesday the 7th November 2018 at:
Willow Room
Berrywood Hospital
Northamptonshire Healthcare NHS Foundation Trust
Northampton
NN5 6GQ
Directions to room: as you enter main building entrance ascend stairs on the left
Link: https://www.nhft.nhs.uk/berrywood
The theme will be ‘Social Connectedness’, and the agenda for the day is confirmed as:
09.30 Refreshments
10.00 Welcome and Introduction to NHFT
Anne Rackham, NHFT Assistant Director of Mental Health, Learning Disability and Specialty Services
10.15 Introductions
RRN Collective
10.30 The Use of Self to Build Recovery Focused Therapeutic Relationships: Learning lessons from peer support- applying to all mental health professionals.
Amanda Green, Peer Support Worker
11.10 Peer Support and Homelessness: What Makes it Work?
Stephanie Barker, PhD candidate and Research Assistant, University of Southampton
11.50 Break
12.20 Working on research to address loneliness and build social connectedness: reflections from three studies.
Dr Vanessa Pinfold, Research Director at McPin Foundation
13.00 Lunch
14.00 Social connection and active citizenship: the Connected Communities approach to research and network engagement
Prof. David Morris, Director of the Centre for Citizenship and Community, University of Central Lancashire
14.40 The impact of social media on connectedness and how to promote social connectedness.
Elvira Perez Vallejos, Associate Professor NIHR Nottingham Biomedical Research Centre for Mental Health & Digital Tech
To register for the event, please use the following link:
https://www.eventbrite.co.uk/e/social-connectedness-tickets-48025805477?aff=ebdssbdestsearch
All Recovery Research Network events are free and administrated through Eventbrite. The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly. Although there is a waiting list, we do kindly ask that you notify the RRN if, for whatever reason, you are unable to attend on the day. This allows us to offer your place to someone else. The Eventbrite link for the November meeting of the RRN will be circulated 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
Tony: a.sparkes@bradford.ac.uk
RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at: https://www.researchintorecovery.com/rrn
Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk
A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.
Recovery Research: We would like to learn from your experience of conducting recovery research
Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.
Conferences and Events
i) Mental Health Qualitative Research Network (MHQRN) meeting:
Date: Friday 19th October, 2018
Time: 2:00pm – 5:00pm
Location: McPin Foundation, CAN Mezzanine, 32-36 Loman Street, London, SE1 0EH
Room: Conference Room ‘B’
Agenda:
2:00 – 2:15 Welcome & introductions
2:15 – 3:00 Dr Mattia Fumanti (University of St Andrews): “The Anthropology of Mental Illness”
3:00 – 3:30 Dr Carlie Goldsmith (Samaritans): “Understanding young people’s experiences of loneliness and suicide: an exploratory study”
3:30 – 3:45 Break
3:45 – 4:15 Natassia Brennan (London School of Hygiene and Tropical Medicine): “an ethnographic study of psychotherapy services in the voluntary sector”
4.15 – 4.50 Panel of discussants
4:50 – 5:00 AOB
ii) AIR (Approaches to Involvement and Recovery) Conference
Exploring involvement, research and working together (see flyer attached to this edition of the ebulletin)
Date: Tuesday 6th November 2018
Time: 10.00am – 3.15pm (coffee and registration from 9.30am)
Location: Lecture Theatre, Sussex Education Centre, Mill View Hospital, Hove BN3 7HZ
iii) The final digital showcase for the 5-year AHRC-funded programme Creative Practice as Mutual Recovery in association with Mental Health Foundation is available here: http://cpmr.mentalhealth.org.uk/
iv) ENMESH 2019
Topic: Managing complexity in mental health systems.
6-8 June 2019, Lisbon, Portugal.
Key dates: abstract submission: 17th September to 15th December 2018, notification: February 2019.
v) Refocus 2019
Registration and abstract submission are now open for Refocus on Recovery 2019, which will take place in Nottingham from 3 to 5 September 2019. This long-standing conference showcases the latest recovery studies and is an ideal opportunity to present about your work and to create new collaborations with leading researchers. The 2019 conference has four themes: mental health and human rights, supporting recovery through services, supporting recovery through communities, and recovery and power. Keynote speakers at the conference and the pre-conference expert workshops will cover topics including Soteria Houses, Housing First, citizenship, survivor research, co-production, QualityRights, strategic litigation, peer support in low resource settings, and digital interventions. The event is also great fun to attend! More information at:
https://www.researchintorecovery.com/ronr2019
vi) 9th International Conference on Social Work in Mental Health
The 9th International Conference on Social Work in Health and Mental Health will be held at the University of York, UK, from 22nd to 26th July 2019:
- Abstracts will open from Friday 13 July and will close on Friday 28 September 2018.
- Delegate Registration will open from Monday 1st October 2018.
- Early Bird rate is available from Monday 1st October until Thursday 31 January 2019, prices start at £425 per person (excluding accommodation and conference dinner ticket).
- Full price fees will be from Friday 1st February until Friday 31 May 2019.
- Late fee will apply from Saturday 1st June until Friday 5 July 2019.
The event will be offering a number of prizes (bursary places) for the best abstracts in the following categories: student, submission from a developing country, service user researcher, early career researcher, practitioner. If you wish to be considered for a prize, you should indicate this when you submit your abstract via the online system which opens on 13th July. Prize winners will be awarded a fully funded place (excluding travel) at the 9th International Conference on Social Work in Health and Mental Health.
The conference is titled Shaping the Future: Promoting Human Rights and Social Perspectives in Health and Mental Health. It will bring together social work practitioners from all over the world, and provide a forum for the sharing of knowledge and interaction between educators, practitioners and researchers in health and community care sectors. Find out more about the event by visiting:
Papers and Publications
i) Bull, P., Gadsby, J. and Williams, S. (eds.) (2018) Critical mental health nursing: observations from the inside. PCCS Books.
Description from the publisher’s website:
The argument that propels this emphatic book is that mental health nursing cannot continue to pin the blame for its own actions and failings on the psychiatric hierarchy. As the editors point out, mental health nursing is a degree-level qualification; it has achieved its ambition to be ‘a profession in its own right’. But it has failed to find its own voice and identity or to challenge the coercive, invalidating and traumatising culture and practices within the mainstream mental health services.
It has failed above all to subject itself to its own critical scrutiny.
This is what these chapters set out to do, starting powerfully with an apology from the editors to all the many millions of users of mental health services who have been subjected to the profession’s failure to care: ‘We cannot think of a new knowledge, approach, skill or kind of empowerment that nurses have themselves forged as a “profession in our own right”, of which our service users are identifiably beneficiaries,’ they write.
The editors and several of the 13 contributors to this book are members of the Critical Mental Health Nurses Network, formally launched in 2015. The aim of the network is to provide an identity and forum for shared experience for mental health nurses who are able to admit that the world is far more complex than many would prefer to believe, that people’s messy lives cannot be tidied away into discrete diagnostic categories, and who are, above all, ‘critical’.
https://www.pccs-books.co.uk/products/critical-mental-health-nursing-observations-from-the-inside
ii) Turgoose, D., Ashwick, R. and Murphy, D. (2017) Systematic review of lessons learned from delivering tele-therapy to veterans with post-traumatic stress disorder. Journal of Telemedicine and Telecare. 0(0) 1-11.
DOI: 10.1177/1357633X17730443
Abstract
Introduction: Despite increases in the number of ex-service personnel seeking treatment for post-traumatic stress disorder (PTSD), there remain a number of barriers to help-seeking which prevents many veterans from accessing psychological therapies. Tele-therapy provides one potential method of increasing the number of veterans accessing support. This review aimed to systematically review the literature in order to summarise what lessons have been learned so far from providing trauma-focused tele-therapies to veterans with PTSD.
Methods: A systematic literature review was conducted from which 41 papers were reviewed. Studies were included if they involved the use of trauma-focused therapies carried out using tele-therapy technologies. Only studies using tele-therapy interventions via video or telephone with populations of ex-military personnel with PTSD were included.
Results: In the majority of cases tele-therapy was found to be as effective in reducing PTSD symptoms as in-person interventions. Similarly, there were few differences in most process outcomes such as dropout rates, with tele-therapy helping to increase uptake in some cases. Veterans using tele-therapy reported high levels of acceptability and satisfaction. Some challenges were reported in terms of therapeutic alliance, with some studies suggesting that veterans felt less comfortable in using tele- therapy. Several studies suggested it was harder for clinicians to read non-verbal communication in tele-therapy, but this did not affect their ability to build rapport. Technological issues were encountered, but these were not found to impede therapy processes or outcomes.
Discussion: Tele-therapy provides a viable alternative to in-person therapies and has the potential to increase access to therapy for veterans. Tele-therapy should continue to be evaluated and scrutinised in order to establish the most effective methods of delivery.
Please also see:
Combat Stress (2018) Exploring the feasibility and acceptability of using tele-therapy for UK veterans with PTSD. Combat Stress.
iii) Revealing Reality (2018) Hospital emergency department scoping research: a report for Mind by Revealing Reality. Revealing Reality.
Executive Summary (Background)
In 2015 Mind introduced the ‘Blue Light Programme’ to improve the mental health of ‘blue light’ emergency services staff and volunteers across England.
Mind identified that hospital emergency department staff face conditions and pressures similar to other emergency services, including organisational upheaval, exposure to trauma, management pressure and challenging performance targets, as well as fear of disclosing their stress levels or mental health difficulties.
Mind commissioned Revealing Reality to explore the pressures faced by, and mental wellbeing of, staff in emergency departments. The research investigated the existing support on offer and identified the drivers and barriers to accessing mental health support. It sought to gain a broad understanding and assess whether a tailored intervention akin to the Blue Light Programme could be applied to the emergency department.
The research was qualitative in nature, exploring needs, motivations and influences on current behaviour. The approach included ethnographic observation in six emergency departments (EDs) and interviews with staff in a range of roles, including medical, nursing, clerical and facilities.
iv) García-Mieres, H. and Eiroa-Orosa, F. J. (2018) A meta-analysis of recovery educational and awareness interventions for mental health professionals. Schizophrenia Bulletin 44(Issue suppl_1) s427.
https://doi.org/10.1093/schbul/sby018.1043
Abstract
Background: The history of mental health care has been marked by various struggles for the dignity of service users. Some reform movements have started to use strategies aimed at professionals’ beliefs and attitudes change. This conference paper intends to systematically review and synthesize all information related to awareness-raising and training of professionals in aspects related to empowerment, recovery and in general in rights-based care to achieve full citizenship of mental health services users.
Methods: We searched academic databases as well as web search engines, aiming at finding grey literature on the subject. Quantitative studies were included if they included mental health professionals, defined as all staff involved in the management of mental health service users, as well as mental health students. All participants included should have assisted to a recovery or psychosocial rehabilitation educational or awareness-raising program. Effect size of change in knowledge, attitudes and intention to implement recovery-based practice were meta-analyzed using a fixed effects model.
Results: After a preliminary search, a total of 800 articles were added to a global database, of which 50 include explicit information on concrete trainings. Of these, 25 reported information about evaluation of the effectiveness of these training activities. Finally, 13 studies were included in the analysis, with a total sample size of 1123. Six studies adopted a repeated measures design and seven an independent group design (including RCTs and quasi-experimental studies). Recovery and rehabilitation based interventions had, on average, a small-to-medium-sized effect on knowledge of recovery principles (d+ = 0.33, 95% CI: 0.13 to 0.49); a small-to-medium-sized effect on attitudes to recovery principles (d+ = 0.36, 95% CI: 0.25 to 0.46), and a small-to-medium-sized effect on intention to implement recovery practice (d+ = 0.37, 95% CI: 0.02 to 0.71).
Discussion: The results show positive effects of educational and awareness activities for mental health professionals. Elements such as duration and intensity of activities must be considered when analysing the persistence and applicability of the effects. More quality studies are needed to establish the active ingredients of these activities.
v) Aboujaoude, E. (2018) Telemental health: why the revolution has not arrived. World Psychiatry. 17(3) 277.
Elias Aboujaoude provides commentary on the relationship between mental health/technology, and considers a number of ‘challenges’ to its widespread appeal.
Doctoral (PhD) Research
Congratulations to Samantha Robertson, who successfully defended her PhD thesis this summer with work entitled: What does the process of developing a personal narrative involve and how does it contribute to mental health recovery? The abstract is presented below. For more information about Samantha’s work please contact her at:
Sam.Robertson@sussexpartnership.nhs.uk
Abstract
This research is based on the premise that mental health recovery is a unique and individual journey (Anthony, 1993), and that developing a personal narrative can support mental health recovery. In current UK recovery-orientated provision, service users are asked to ‘tell their stories’ within clinical settings as a tool for diagnosis, formulation and treatment plans. There is little current evidence that narrative or narrative development is being used systematically within an NHS therapeutic setting. The aim of this study was to explore the process of developing a personal narrative and its possible contribution to mental health recovery.
This study used a three-phased approach, where the emergent themes informed subsequent phases. Recovery background, study rationale, literature review (overview of narrative and use of media) and methodology are described to provide context to all phases. Phase 1 involved developing and analysing my recovery autoethnography, ‘From the edge of the abyss to the foot of the rainbow’. Phase 2 used a Participatory Action Research (PAR) approach. 11 co-researchers who had previously developed their personal narratives were recruited to two focus groups to discuss their experiences of narrative development. Six co-researchers continued into Phase 3, which involved three cycles of PAR. The output of the co-production was an eight-session, peer-led Personal Narrative Workshop Programme (to support service users to develop their narrative). This was fully documented – Programme Framework, Scheme of Work and Session Plans.
The integrated emergent themes from the three phases provided the following key findings (all were incorporated into the workshop programme): a realisation of the difficulty of developing a narrative (reliving trauma); the value of developing narrative within a group setting (supports factors such as collaboration and validation); and the role of ‘the voice of others’ in our narratives (implications for relational ethics). Given ‘my insider perspective’, Phase 3 also highlighted methodological issues including: the complexities of using a PAR approach; the multiplicity of roles and tensions of those roles; and the tensions between the PAR process with the need to develop practical outcomes (for the PhD process). A key element of the Personal Narrative Workshop Programme was ensuring a balanced approach between educational content and the time and space to ‘do’ within a supportive environment.
Participation Opportunity – the NEON study
Mike Slade’s NEON study [ https://www.researchintorecovery.com/NEON ] is currently conducting interviews to collect and analyse mental health recovery stories from selected groups.
The NEON study would particularly like to interview people who have experienced what might be called “psychosis”, or have experiences that others see as unusual (e.g. hearing voices, seeing or believing things that others do not), but who have not had support from the NHS, other than their GP, for at least five years.
If you are interested in participating, or know of others who might like to participate, then please contact Rose McGranahan [ rose.mcgranahan@qmul.ac.uk ], who is leading work with this group
Other News
The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care. Prompted by NHS England, NICE are currently developing guidelines regarding: Rehabilitation in adults with complex psychosis and related severe mental health conditions. The expected publication date is: June 2020. For more information and stakeholder information please:
https://www.nice.org.uk/guidance/indevelopment/gid-ng10092
A decade of RRN
The first meeting of the RRN was held on the 23rd April 2009. November 2018 will be the 20th meeting of the RRN, and mark ten years of collegial networking around the topic of research into recovery. Suggestions for marking our 10-year anniversary would be most welcome! Celebrations would take place at the 21st meeting in the Spring of 2019.
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
October 2018
Recovery Research Network eBULLETIN
October 2018
RRN Meetings
Chris Griffiths and Northamptonshire Healthcare NHS Foundation Trust have kindly offered to host the 20th meeting of the RRN. The event will be held on Wednesday the 7th November 2018 at:
Willow Room
Berrywood Hospital
Northamptonshire Healthcare NHS Foundation Trust
Northampton
NN5 6GQ
Directions to room: as you enter main building entrance ascend stairs on the left
Link: https://www.nhft.nhs.uk/berrywood
The theme will be ‘Social Connectedness’, and the agenda for the day is confirmed as:
09.30 Refreshments
10.00 Welcome and Introduction to NHFT
Anne Rackham, NHFT Assistant Director of Mental Health, Learning Disability and Specialty Services
10.15 Introductions
RRN Collective
10.30 The Use of Self to Build Recovery Focused Therapeutic Relationships: Learning lessons from peer support- applying to all mental health professionals.
Amanda Green, Peer Support Worker
11.10 Peer Support and Homelessness: What Makes it Work?
Stephanie Barker, PhD candidate and Research Assistant, University of Southampton
11.50 Break
12.20 Working on research to address loneliness and build social connectedness: reflections from three studies.
Dr Vanessa Pinfold, Research Director at McPin Foundation
13.00 Lunch
14.00 Social connection and active citizenship: the Connected Communities approach to research and network engagement
Prof. David Morris, Director of the Centre for Citizenship and Community, University of Central Lancashire
14.40 The impact of social media on connectedness and how to promote social connectedness.
Elvira Perez Vallejos, Associate Professor NIHR Nottingham Biomedical Research Centre for Mental Health & Digital Tech
To register for the event, please use the following link:
https://www.eventbrite.co.uk/e/social-connectedness-tickets-48025805477?aff=ebdssbdestsearch
All Recovery Research Network events are free and administrated through Eventbrite. The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly. Although there is a waiting list, we do kindly ask that you notify the RRN if, for whatever reason, you are unable to attend on the day. This allows us to offer your place to someone else. The Eventbrite link for the November meeting of the RRN will be circulated 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
Tony: a.sparkes@bradford.ac.uk
RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at: https://www.researchintorecovery.com/rrn
Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk
A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.
Recovery Research: We would like to learn from your experience of conducting recovery research
Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.
Conferences and Events
i) AIR (Approaches to Involvement and Recovery) Conference
Exploring involvement, research and working together (see flyer attached to this edition of the ebulletin)
Date: Tuesday 6th November 2018
Time: 10.00am – 3.15pm (coffee and registration from 9.30am)
Location: Lecture Theatre, Sussex Education Centre, Mill View Hospital, Hove BN3 7HZ
ii) The final digital showcase for the 5-year AHRC-funded programme Creative Practice as Mutual Recovery in association with the Mental Health Foundation is available here: http://cpmr.mentalhealth.org.uk/
iii) ENMESH 2019
Topic: Managing complexity in mental health systems.
6-8 June 2019, Lisbon, Portugal.
Key dates: abstract submission: 17th September to 15th December 2018, notification: February 2019.
iv) Refocus 2019
Registration and abstract submission are now open for Refocus on Recovery 2019, which will take place in Nottingham from 3 to 5 September 2019. This long-standing conference showcases the latest recovery studies and is an ideal opportunity to present about your work and to create new collaborations with leading researchers. The 2019 conference has four themes: mental health and human rights, supporting recovery through services, supporting recovery through communities, and recovery and power. Keynote speakers at the conference and the pre-conference expert workshops will cover topics including Soteria Houses, Housing First, citizenship, survivor research, co-production, QualityRights, strategic litigation, peer support in low resource settings, and digital interventions. The event is also great fun to attend! More information at:
https://www.researchintorecovery.com/ronr2019
v) 9th International Conference on Social Work in Mental Health
The 9th International Conference on Social Work in Health and Mental Health will be held at the University of York, UK, from 22nd to 26th July 2019:
- Abstracts will open from Friday 13 July and will close on Friday 26th October 2018. (please note this extended date)
- Delegate Registration will open from Monday 1st October 2018.
- Early Bird rate is available from Monday 1st October until Thursday 31 January 2019, prices start at £425 per person (excluding accommodation and conference dinner ticket).
- Full price fees will be from Friday 1st February until Friday 31 May 2019.
- Late fee will apply from Saturday 1st June until Friday 5 July 2019.
The event will be offering a number of prizes (bursary places) for the best abstracts in the following categories: student, submission from a developing country, service user researcher, early career researcher, practitioner. If you wish to be considered for a prize, you should indicate this when you submit your abstract via the online system which opens on 13th July. Prize winners will be awarded a fully funded place (excluding travel) at the 9th International Conference on Social Work in Health and Mental Health.
The conference is titled Shaping the Future: Promoting Human Rights and Social Perspectives in Health and Mental Health. It will bring together social work practitioners from all over the world, and provide a forum for the sharing of knowledge and interaction between educators, practitioners and researchers in health and community care sectors. Find out more about the event by visiting:
Papers and Publications
i) Toney. R., Elton, D., Munday, E., Hamill, K., Crowther, A., Meddings, S., Taylor, A., Henderson, C., Jennings, H., Waring, J., Pollock, K., Bates, P. and Slade, M. Mechanisms of action and outcomes for students in Recovery Colleges, Psychiatric Services. In press.
Abstract
Objective: Recovery Colleges are widespread, with little empirical research on how they work and outcomes they produce. This study aimed to co-produce a change model characterising mechanisms of action and outcomes for mental health service users attending as students at a Recovery College.
Methods: A systematised review identified all Recovery College publications. Inductive collaborative data analysis by academic researchers and co-researchers with lived experience of ten key papers informed a theoretical framework for mechanisms and outcome for students, which was refined through deductive analysis of 34 further publications. A change model was co-produced and then refined through stakeholder interviews (n=33).
Results: Three mechanisms of action for Recovery College students were identified: empowering environment (safety, respect, supporting choices), enabling different relationships (power, peers, working together) and facilitating personal growth (e.g. co-produced learning, strengths, celebrating success). Outcomes were change in the student (e.g. self-understanding, self-confidence) and changes in the student’s life (e.g. occupational, social, service use). A co-produced change model mapping mechanisms of action to outcomes was created.
Conclusions: The key features identified as differentiating Recovery Colleges from traditional services are an empowering environment, enabling relationships and growth orientation. Recovery Colleges may benefit most attenders, but mental health service users to particularly encourage to enrol may include those who lack confidence, those who services struggle to engage with, those who will benefit from exposure to peer role models, and those lacking social capital. The change model provides the first testable characterisation of mechanisms and outcomes, allowing formal evaluation of Recovery Colleges.
ii) Crowther, A., Taylor, A., Toney, R., Meddings, S., Whale, T., Jennings, H., Pollock, K., Bates, P., Henderson, C., Waring, J. and Slade, M. The impact of Recovery Colleges on mental health staff, services and society, Epidemiology and Psychiatric Sciences. In press.
Abstract
Aims: Recovery Colleges are opening internationally. The evaluation focus has been on outcomes for Recovery College students who use mental health services. However, benefits may also arise for: staff who attend or co-deliver courses; the mental health and social care service hosting the Recovery College; and wider society. A theory-based change model characterising how Recovery Colleges impact at these higher levels is needed for formal evaluation of their impact, and to inform future Recovery College development. The aim of this study was to develop a stratified theory identifying candidate mechanisms of action and outcomes (impact) for Recovery Colleges at staff, services and societal levels.
Methods: Inductive thematic analysis of 44 publications identified in a systematised review was supplemented by collaborative analysis involving a lived experience advisory panel to develop a preliminary theoretical framework. This was refined through semi-structured interviews with 33 Recovery College stakeholders (service user students, peer/non-peer trainers, managers, community partners, clinicians) in three sites in England.
Results: Candidate mechanisms of action and outcomes were identified at staff, services and societal levels. At the staff level, experiencing new relationships may change attitudes and associated professional practice. Identified outcomes for staff included: experiencing and valuing co-production; changed perceptions of service users; and increased passion and job motivation. At the services level, Recovery Colleges often develop somewhat separately from their host system, reducing the reach of the college into the host organisation but allowing development of an alternative culture giving experiential learning opportunities to staff around co-production and the role of a peer workforce. At the societal level, partnering with community-based agencies gave other members of the public opportunities for learning alongside people with mental health problems and enabled community agencies to work with people they might not have otherwise. Recovery Colleges also gave opportunities to beneficially impact on community attitudes.
Conclusions: This study is the first to characterise the mechanisms of action and impact of Recovery Colleges on mental health staff, mental health and social care services, and wider society. The findings suggest that a certain distance is needed in the relationship between the Recovery College and its host organisation if a genuine cultural alternative is to be created. Different strategies are needed depending on what level of impact is intended, and this study can inform decision-making about mechanisms to prioritise. Future research into Recovery Colleges should include contextual evaluation of these higher-level impacts, and investigate effectiveness and harms.
iii) Bouvet, C., Petot, J-M., Diot, E., Ettaher, N. and O.C. Hasan (2018) From medical insight to narrative insight: insight as a support for the therapeutic relationship. Psychosis. [online]
https://doi.org/10.1080/17522439.2018.1522539
Abstract
The concept of insight in psychiatry (“medical insight”) rests on a medical definition. The results obtained under this conception are difficult to interpret. The objective of this study is to show that participants diagnosed with schizophrenic and schizoaffective disorders (S/SD) have an awareness of their difficulties that is both greater than and different from that which is assessed by a medical insight scale. We recruited 50 participants diagnosed with S/SD and 90 non-patients. All participants were administered a general psychopathology scale (the SCL-90-R). Participants with S/SD were also administered an expert rating scale for depression (CDSS) and an insight scale (Insight Q8). The participants with S/SD had little or no medical insight according to the Insight Q8. But depression as assessed by self-rating was strong correlated to an expert rating of depression, and participants with S/SD scored significantly higher on the general psychopathology scale than controls. Participants with S/SD are more aware of their difficulties than the insight scale indicates. The medical conception implicit in the scale does not leave room for the patients’ own explanatory models. The notion of subjective narrative insight may allow us to renew both the concept of insight and its role in psychiatry.
iv) Hayes, D., Edbrooke‑Childs, J., Town, R., Wolpert, M. and Midgley, N (2018) Barriers and facilitators to shared decision making in child and youth mental health: clinician perspectives using the Theoretical Domains Framework. European Child & Adolescent Psychiatry. [online]
https://doi.org/10.1007/s00787-018-1230-0
Abstract
Shared decision making (SDM) is increasingly being suggested as an integral part of mental health provision. Yet, there is little research on what clinicians believe the barriers and facilitators around practice to be. At the same time, there is also increasing recognition of a theory–practice gap within the field, with calls for more pragmatic uses of theory to inform and improve clinical practice. Using the Theoretical Domains Framework (TDF), a comprehensive, theoretical-led framework, underpinned by 33 behaviour change theories and 128 constructs, clinician perceived barriers and facilitators to SDM are investigated. The sample comprised of 15 clinicians across two sites in England, who took part in qualitative semi-structured interviews and focus groups. Transcripts were analysed using a deductive thematic analysis, and themes were coded under each theoretical domain. Overall, 21 barriers and facilitators for SDM in child and youth mental health were identified across ten domains of the TDF. Under capability, barriers and facilitators were found for knowledge, skills, memory/attention/decision making processes, and behavioural regulation. For opportunity, barriers and facilitators were found for social influences, as well as environmental context and resources. Finally, for motivation, domains covered included: beliefs about consequences, beliefs about capabilities, emotions, and professional role and identity. Findings suggest that a range of barriers and facilitators affect clinicians’ abilities to engage in SDM with young people and parents. Interventions which target different domains related to capability, opportunity and motivation should be developed to better facilitate young people and their families in care and treatment decisions.
v) Tangvald-Pedersen, O. and Bongaardt, R. (2017) Towards a tinkering
participatory research method in mental health. Scandinavian Journal of Disability Research. 19(1) 7-17 [Online]
DOI: 10.1080/15017419.2016.122230
Abstract
The current agreement that evidence-based practice is a merger of research evidence, clinical expertise and patient preferences has made service user involvement and participant research is not only acceptable, but also called for and desired. However, what user involvement and participant research entails, and how best to implement it, is contestable and ideologically rooted. In this paper, we describe three different ideologies, a liberal, an emancipatory and a caring ideology, and we present their concomitant methodological solutions and preferences. Finally, we outline a tinkering participatory research method by borrowing from the above-mentioned ideological views. We would claim that this method balances well between the demands of scientific rigour and the expectations of ideological and social relevance
Participation Opportunity – the NEON study
Mike Slade’s NEON study [ https://www.researchintorecovery.com/NEON ] is currently conducting interviews to collect and analyse mental health recovery stories from selected groups.
The NEON study would particularly like to interview people who have experienced what might be called “psychosis”, or have experiences that others see as unusual (e.g. hearing voices, seeing or believing things that others do not), but who have not had support from the NHS, other than their GP, for at least five years.
If you are interested in participating, or know of others who might like to participate, then please contact Rose McGranahan
[ rose.mcgranahan@qmul.ac.uk ], who is leading work with this group
A decade of RRN
The first meeting of the RRN was held on the 23rd April 2009. November 2018 will be the 20th meeting of the RRN, and mark ten years of collegial networking around the topic of research into recovery. Suggestions for marking our 10-year anniversary would be most welcome! Celebrations would take place at the 21st meeting in the Spring of 2019.
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
November 2018
Recovery Research Network eBULLETIN
November 2018
Season’s greetings to our readership, and all the very best for the New Year!
RRN Meetings
The 20th meeting of the Recovery Research Network took place on the 7th November at Berrywood Hospital. Thank you to Northamptonshire Healthcare NHS Foundation Trust for hosting this event, and thank you to members of the RRN Collective for organising and co-ordinating the meeting; in particular to Chris Griffiths, Emma Kaminskiy and Fortune Mhlanga.
The meeting was well-attended and stimulated much conversation around the theme of the event, which was ‘Social Connectedness’. Speakers have kindly given permission for their material to be uploaded to the RRN website. These presentations, along with presentations and minutes from previous meetings, are available by following the link on the left-hand side of the RRN home page:
https://www.researchintorecovery.com/rrn
The first meeting of the RRN was held on the 23rd April 2009. To celebrate the 10th anniversary of the RRN, and to mark a decade of collegial networking around the topic of research into recovery, the 21st meeting of the RRN will be on: Friday the 10th May 2019 at: McPin Foundation, CAN Mezzanine, 32-36 Loman Street, London SE1 0EH. The meeting will begin at 10am (registration and refreshments from 9.30am) and end at 4pm. The theme of the meeting will be ‘Recovery Research 10 years on’. We will also be going for a celebratory meal after the meeting.
More details on booking to attend the meeting and the celebratory meal will follow in due course.
All Recovery Research Network events are free and administrated through Eventbrite. The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly. Although there is a waiting list, we do kindly ask that you notify the RRN if, for whatever reason, you are unable to attend on the day. This allows us to offer your place to someone else. The Eventbrite link for the November meeting of the RRN will be circulated 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
Tony: a.sparkes@bradford.ac.uk
RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at: https://www.researchintorecovery.com/rrn
Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk
A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.
Recovery Research: We would like to learn from your experience of conducting recovery research
Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.
Conferences and Events
i) The final digital showcase for the 5-year AHRC-funded programme Creative Practice as Mutual Recovery in association with Mental Health Foundation is available here: http://cpmr.mentalhealth.org.uk/
ii) ENMESH 2019
Topic: Managing complexity in mental health systems.
6-8 June 2019, Lisbon, Portugal.
Key dates: abstract submission: 17th September to 15th December 2018, notification: February 2019.
iii) Refocus 2019
Registration and abstract submission are now open for Refocus on Recovery 2019, which will take place in Nottingham from 3 to 5 September 2019. This long-standing conference showcases the latest recovery studies and is an ideal opportunity to present about your work and to create new collaborations with leading researchers. The 2019 conference has four themes: mental health and human rights, supporting recovery through services, supporting recovery through communities, and recovery and power. Keynote speakers at the conference and the pre-conference expert workshops will cover topics including Soteria Houses, Housing First, citizenship, survivor research, co-production, QualityRights, strategic litigation, peer support in low resource settings, and digital interventions. The event is also great fun to attend! More information at:
https://www.researchintorecovery.com/ronr2019
iv) 9th International Conference on Social Work in Mental Health
The 9th International Conference on Social Work in Health and Mental Health will be held at the University of York, UK, from 22nd to 26th July 2019:
- Abstracts for this event are now closed, and notifications are to be made on the 7th December.
- Delegate Registration will open from Monday 1st October 2018.
- Early Bird rate is available from Monday 1st October until Thursday 31 January 2019, prices start at £425 per person (excluding accommodation and conference dinner ticket).
- Full price fees will be from Friday 1st February until Friday 31 May 2019.
- Late fee will apply from Saturday 1st June until Friday 5 July 2019.
The event will be offering a number of prizes (bursary places) for the best abstracts in the following categories: student, submission from a developing country, service user researcher, early career researcher, practitioner. If you wish to be considered for a prize, you should indicate this when you submit your abstract via the online system which opens on 13th July. Prize winners will be awarded a fully funded place (excluding travel) at the 9th International Conference on Social Work in Health and Mental Health.
The conference is titled Shaping the Future: Promoting Human Rights and Social Perspectives in Health and Mental Health. It will bring together social work practitioners from all over the world, and provide a forum for the sharing of knowledge and interaction between educators, practitioners and researchers in health and community care sectors. Find out more about the event by visiting:
v) The International Society for Psychological and Social Approaches to Psychosis (ISPS) announced their 21st International Congress:
Stranger in the City:
On the circular relationship between alienation and psychosis and the healing power of human reconnection
Date: August 28th – September 1st 2019
For more information, including details of call for papers, please see:
http://www.isps.org/index.php/conferences-and-events/upcoming-isps-conferences-and-events
Papers and Publications
i) Varregoso, I., Souto Braz, I., Fanning, F. and Clarke, M. (2018) Early intervention in psychosis. Should we broaden the scope for action throughout the age span? Psychosis. [online] https://doi.org/10.1080/17522439.2018.1538384
Abstract
Early intervention for psychosis (EIP) programmes have attracted significant interest over the last three decades. It is generally agreed these initiatives are important, with demonstrated improvements in recovery rates and cost effectiveness. EIP programmes were originally designed with a youth focus, however it is known that psychosis presents across the age span and impacts at all life stages. These facts, added to the statistics on world ageing, justify rethinking whether EIP programmes are required across a broader age range.
ii) Hare Duke, L., Dening, T., de Oliveira, D., Milner, K. and Slade, M. (2019) Conceptual framework for social connectedness in mental disorders: Systematic review and narrative synthesis. Journal of Affective Disorders. 245 [in progress] 188-199.
https://doi.org/10.1016/j.jad.2018.10.359
Abstract
Background: Adults with mental disorders are at a high risk of loneliness. Loneliness has been implicated in a wide variety of physical and mental health problems. Social connectedness interventions are one means to tackle loneliness but have shown mixed effectiveness. This study aims to: (1) identify existing measures of social connectedness and (2) develop a conceptual framework of social connectedness to inform future measurement and the development of new interventions.
Methods: A systematic review of studies from six bibliographic databases was conducted. Studies were included if a quantitative measure of social connectedness was used amongst samples of adults with a mental disorder. Two analyses were conducted: a best evidence synthesis of measurement properties for identified measures and a narrative synthesis of items from these measures.
Results: Twenty-eight papers were included, employing 21 different measures. Measurement properties were of poor or unknown quality. Data synthesis identified a five-dimension conceptual framework of social connectedness: Closeness, Identity and common bond, Valued relationships, Involvement and Cared for and accepted (giving the acronym CIVIC).
Limitations: The majority of studies were conducted in high-income countries. It was not possible to validate the conceptual framework using the identified psychometric data. Conclusions: The new five-dimension framework of social connectedness in mental disorders provides the theoretical foundation for developing new measures and interventions for social connectedness.
iii) Toney, R., Knight, J., Hamill, K., Taylor, A., Henderson, C., Crowther, A., Meddings, S., Barbic, S., Jennings, H., Pollock, K., Bates, P., Repper, J. and Slade, M. Development and evaluation of a Recovery College fidelity measure. Canadian Journal of Psychiatry. [In press]
Abstract
Objective: Recovery Colleges are widespread, with little empirical research on their key components. This study aimed to characterise key components of Recovery Colleges, and to develop and evaluate (i) a developmental checklist and (ii) a quantitative fidelity measure.
Methods: Key components were identified through a systematised literature review, international expert consultation (n=77) and semi-structured interviews with Recovery College managers across England (n=10). A checklist was developed, and refined through semi-structured interviews with Recovery College students, trainers and managers (n=44) in three sites. A fidelity measure was adapted from the checklist and evaluated with Recovery College managers (n=39, 52%), clinicians providing psychoeducational courses (n=11) and adult education lecturers (n=10).
Results: Twelve components were identified, comprising seven non-modifiable components (Valuing equality; Learning; Tailored to the student; Co-production of the Recovery College; Social connectedness; Community focus; and Commitment to recovery) and five modifiable components (Available to all; Location; Distinctiveness of course content; Strengths-based; and Progressive). The checklist has service user student, peer trainer and manager versions. The fidelity measure meets scaling assumptions and demonstrates adequate internal consistency (0.72), test-retest reliability (0.60), content validity and discriminant validity.
Conclusions: Co-production and an orientation to adult learning should be the highest priority in developing Recovery Colleges. The creation of the first theory-based empirically-evaluated developmental checklist and fidelity measure (both downloadable at researchintorecovery.com/recollect) for Recovery Colleges will help service users understand what Recovery Colleges offer, will inform decision-making by clinicians and commissioners about Recovery Colleges, and will enable formal evaluation of their impact on students.
Participation Opportunity – the NEON study
Mike Slade’s NEON study [ https://www.researchintorecovery.com/NEON ] is currently conducting interviews to collect and analyse mental health recovery stories from selected groups.
The NEON study would particularly like to interview people who have experienced what might be called “psychosis”, or have experiences that others see as unusual (e.g. hearing voices, seeing or believing things that others do not), but who have not had support from the NHS, other than their GP, for at least five years.
If you are interested in participating, or know of others who might like to participate, then please contact Rose McGranahan [ rose.mcgranahan@qmul.ac.uk ], who is leading work with this group
Invitation to Collaborate
Prof David Morris has proposed a discussion between the RRN collective and the centre he leads (Centre for Citizenship and Community) at UCLAN, concerning the possibility of some joint work, as we have common research interests.
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
Tony: a.sparkes@bradford.ac.uk
December 2018
Recovery Research Network eBULLETIN
December 2018
RRN Meetings
The first meeting of the RRN was held on the 23rd April 2009. To celebrate the 10th anniversary of the RRN, and to mark a decade of collegial networking around the topic of research into recovery, the 21st meeting of the RRN will be on: Friday the 10th May 2019 at: McPin Foundation, CAN Mezzanine, 32-36 Loman Street, London SE1 0EH. The meeting will begin at 10am (registration and refreshments from 9.30am) and end at 4pm. The theme of the meeting will be ‘Recovery Research 10 years on’. We will also be going for a celebratory meal after the meeting.
More details on booking to attend the meeting and the celebratory meal will follow in due course.
All Recovery Research Network events are free and administrated through Eventbrite. The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly. Although there is a waiting list, we do kindly ask that you notify the RRN if, for whatever reason, you are unable to attend on the day. This allows us to offer your place to someone else. The Eventbrite link for the November meeting of the RRN will be circulated 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
Tony: a.sparkes@bradford.ac.uk
RRN Membership Profile
Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at: https://www.researchintorecovery.com/rrn
Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email researchintorecovery@nottingham.ac.uk
A Call to PhD Students and their Supervisors
Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN. The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.
Recovery Research: We would like to learn from your experience of conducting recovery research
Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.
Conferences and Events
i) The final digital showcase for the 5-year AHRC-funded programme Creative Practice as Mutual Recovery in association with Mental Health Foundation is available here: http://cpmr.mentalhealth.org.uk/
ii) ENMESH 2019
Topic: Managing complexity in mental health systems.
6-8 June 2019, Lisbon, Portugal.
Key dates: abstract submission: 17th September to 15th December 2018, notification: February 2019.
iii) Refocus 2019
Registration and abstract submission are now open for Refocus on Recovery 2019, which will take place in Nottingham from 3 to 5 September 2019. This long-standing conference showcases the latest recovery studies and is an ideal opportunity to present about your work and to create new collaborations with leading researchers. The 2019 conference has four themes: mental health and human rights, supporting recovery through services, supporting recovery through communities, and recovery and power. Keynote speakers at the conference and the pre-conference expert workshops will cover topics including Soteria Houses, Housing First, citizenship, survivor research, co-production, QualityRights, strategic litigation, peer support in low resource settings, and digital interventions. The event is also great fun to attend! More information at:
https://www.researchintorecovery.com/ronr2019
iv) 9th International Conference on Social Work in Mental Health
The 9th International Conference on Social Work in Health and Mental Health will be held at the University of York, UK, from 22nd to 26th July 2019:
- Abstracts for this event are now closed, and notifications are to be made on the 7th December.
- Delegate Registration will open from Monday 1st October 2018.
- Early Bird rate is available from Monday 1st October until Thursday 31 January 2019, prices start at £425 per person (excluding accommodation and conference dinner ticket).
- Full price fees will be from Friday 1st February until Friday 31 May 2019.
- Late fee will apply from Saturday 1st June until Friday 5 July 2019.
The event will be offering a number of prizes (bursary places) for the best abstracts in the following categories: student, submission from a developing country, service user researcher, early career researcher, practitioner. If you wish to be considered for a prize, you should indicate this when you submit your abstract via the online system which opens on 13th July. Prize winners will be awarded a fully funded place (excluding travel) at the 9th International Conference on Social Work in Health and Mental Health.
The conference is titled Shaping the Future: Promoting Human Rights and Social Perspectives in Health and Mental Health. It will bring together social work practitioners from all over the world, and provide a forum for the sharing of knowledge and interaction between educators, practitioners and researchers in health and community care sectors. Find out more about the event by visiting:
v) The International Society for Psychological and Social Approaches to Psychosis (ISPS) announced their 21st International Congress:
Stranger in the City:
On the circular relationship between alienation and psychosis and the healing power of human reconnection
Date: August 28th – September 1st 2019
For more information, including details of call for papers, please see:
http://www.isps.org/index.php/conferences-and-events/upcoming-isps-conferences-and-events
Papers and Publications
i) Ross, C. A. and Ross, A. W. (2018): Misleading use of heritability estimates in schizophrenia genetics. Psychosis. [online]
https://doi.org/10.1080/17522439.2018.1545862
Ross and Ross offer a brief, but nonetheless cogent argument claiming that heritability estimates in the field of schizophrenia genetics are a statistical artefact, giving the impression that schizophrenia is largely genetic. They make the case for greater clarity and use of raw concordance data when disseminating the findings from such studies.
ii) Toney, R., Elton, D., Munday, E., Hamill, K., Crowther, A., Meddings, S., Taylor, A., Henderson, C., Jennings, H., Waring, J., Pollock, K., Bates, P. and Slade, M. (2018) Mechanisms of action and outcomes for students in recovery colleges. Psychiatric Services. 69(12). 1222-1229.
doi: 10.1176/appi.ps.201800283
Abstract
Objective: Recovery colleges are widespread, with little empirical research on how they work and the outcomes they produce. This study aimed to coproduce a change model, characterizing mechanisms of action (how they work) and outcomes (their impact) for mental health service users who attend recovery colleges.
Methods: A systematized review identified all publications about recovery colleges. Inductive collaborative data analysis of 10 key publications by academic researchers and coresearchers with lived experience informed a theoretical framework for mechanisms of action and student outcomes, which was refined through deductive analysis of 34 further publications. A change model was coproduced and refined through stakeholder interviews (N=33).
Results: Four mechanisms of action for recovery colleges were identified: empowering environment (safety, respect, and supporting choices), enabling different relationships (power, peers, and working together), facilitating personal growth (for example, coproduced learning, strengths, and celebrating success), and shifting the balance of power through coproduction and reducing power differentials. Outcomes were change in the student (for example, self-understanding and self-confidence) and changes in the student’s life (for example, occupational, social, and service use). A coproduced change model mapping mechanisms of action to outcomes was created.
Conclusions: Key features differentiate recovery colleges from traditional services, including an empowering environment, enabling relationships, and growth orientation. Service users who lack confidence, those with whom services struggle to engage, those who will benefit from exposure to peer role models, and those lacking social capital may benefit most. As the first testable characterization of mechanisms and outcomes, the change model allows formal evaluation of recovery colleges.
iii) Aguey-Zinsou, M., Sommer, J. and Yule, E. (2018) Staff attitudes towards consumer participation and peer worker roles in a community mental health service. Journal of Recovery in Mental Health. 2(1) 82-90.
Abstract
Objective: To investigate the attitudes of community mental health staff towards consumer participation and peer workers in mental health services.
Methods: In this cross-sectional survey design study, community mental health staff completed the Mental Health Participation Questionnaire (MHPQ) which measures the attitudes of mental health professionals towards consumer participation at individual and systemic levels.
Results: 82 staff completed the questionnaire. Overall, staff expressed positive attitudes towards consumer involvement in mental health service care planning and treatment, with neutral attitudes towards the more systemic aspects of consumer involvement in management and consumers as educators. The results also demonstrated that staff do value lived experience expertise and change that consumer involvement and peer workers can bring to services to enable them to support recovery. Positive relationship qualities between mental health staff and peer workers were found to be important.
Conclusion: This study adds to existing research that has found community mental health staff generally have a positive attitude towards consumer participation in mental health services.
The authors of the ebulletin would draw attention to the focus and scope of the peer-reviewed journal in which the above article appears. In particular, the readership may be interested in the recovery related themes that cut across: v.1#1 – v.2#3 (Spring 2017 – Spring 2019). For more information see:
https://jps.library.utoronto.ca/index.php/rmh/about
iv) Pope, M. A., Malla, A. K. and Iyer, S. N. (2018) Who should be responsible for supporting
individuals with mental health problems? A critical literature review. International Journal of Social Psychiatry. 64(3) 293 – 302.
Abstract
Background: Individuals with mental health problems have many support needs that are often inadequately met; however, perceptions of who should be responsible for meeting these needs have been largely unexplored. Varying perceptions may influence whether, how, and to what extent relevant stakeholders support individuals with mental
health problems.
Aims: To critically evaluate the literature to determine who different stakeholders believe should be responsible for supporting individuals with mental health problems, what factors shape these perceptions, and how they relate to one another.
Method: A critical literature review was undertaken. Following an extensive literature search, the conceptual contributions of relevant works were critically evaluated. A concept map was created to build a conceptual framework
of the topic.
Results: Views of individual versus societal responsibility for need provision and health; the morality of caring; and attributions of responsibility for mental illness offered valuable understandings of the review questions. Creating a concept map revealed that various interrelated factors may influence perceptions of responsibility.
Conclusions: Varying perceptions of who should be responsible for supporting individuals with mental health problems may contribute to unmet support needs among this group. Our critical review helps build a much-needed conceptual framework of factors influencing perceptions of responsibility. Such a framework is essential as these views iteratively shape and reflect the complex divisions of mental healthcare roles and responsibilities. Understanding these perceptions can help define relevant stakeholders’ roles more clearly, which can improve mental health services and strengthen stakeholder accountability.
v) Perry, A., Gardener, C., Dove, J., Eiger, Y. and Loewenthal, K. (2018) Improving mental health knowledge of the Charedi Orthodox Jewish Community in North London: A partnership project. International Journal of Social Psychiatry. 64(3) 235 – 247.
Abstract
Introduction: This article describes a successful community-based partnership project between statutory and third-sector services targeting the strictly Orthodox Jewish community (OJC).
Methods: The City and Hackney Black and Minority Ethnic (BME) Access Service (East London NHS Foundation Trust (ELFT)) collaborated with Bikur Cholim, a local third-sector organisation based in the heart of a north London Charedi OJC, to develop a brief culturally tailored psychoeducational group intervention focusing on mental health promotion and prevention. In total, 34 carers in the Charedi OJC were provided with general information on mental health, the availability of support services and self-care.
Results: Overall improvements in well-being, increased intentions to access services, particularly talking therapies, and qualitative feedback indicated that the group was very well received.
Conclusion: The project endorses the value of culturally relevant psychoeducation, enabling suggestions for culturally appropriate service development
vi) Tanaka, K., Davidson, L. and Craig, T. J. (2018) Sense of clubhouse community belonging
and empowerment. International Journal of Social Psychiatry. 64(3) 276 – 285.
Abstract
Background: While the neighbourhood community literature well documents a link between participation in supportive and effective community groups or activities and empowerment, there is as yet little empirical evidence of this relationship in the context of community mental health programs.
Aim: The primary purpose of the study was to examine the relationship between sense of community belonging and empowerment among members of mental health clubhouses.
Methods: A secondary analysis using a hierarchical regression model was conducted on cross-sectional structured interview data collected through a self-report questionnaire from 102 clubhouse members from six clubhouses in the United States and Finland.
Results: The results indicated that members’ sense of clubhouse community belonging positively contributes to their empowerment.
Conclusion: Fostering sense of community belonging appears to be a valid approach to catalyze empowerment. Study limitations and future research agendas were discussed.
Participation Opportunity – the NEON study
Mike Slade’s NEON study [ https://www.researchintorecovery.com/NEON ] is currently conducting interviews to collect and analyse mental health recovery stories from selected groups.
The NEON study would particularly like to interview people who have experienced what might be called “psychosis”, or have experiences that others see as unusual (e.g. hearing voices, seeing or believing things that others do not), but who have not had support from the NHS, other than their GP, for at least five years.
If you are interested in participating, or know of others who might like to participate, then please contact Rose McGranahan [ rose.mcgranahan@qmul.ac.uk ], who is leading work with this group
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
Tony: a.sparkes@bradford.ac.uk