Recovery Research Network (RRN)

Recovery Research Network eBULLETIN

February 2019

RRN Meetings

The first meeting of the RRN was held on the 23rd April 2009.  To celebrate the 10^th anniversary of the RRN, and to mark a decade of collegial networking around the topic of research into recovery, the 21^st meeting of the RRN will be on: Friday the 10^th May 2019 at:  McPin Foundation, CAN Mezzanine, 7 – 14 Great Dover Street, London SE1 4YR. The nearest tube station is: Borough.

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’, and a provisional agenda is included below.  Booking information and tickets are available from:

https://www.eventbrite.co.uk/e/recovery-research-network-10th-anniversary-meeting-tickets-56032574940

As a separate event, we will also be going for a celebratory meal after the meeting, details of which will follow in due course.

Agenda (provisional)

09.30               Refreshments

10.00               Introductions

10.30               Mike Slade 10 years of Recovery Research

11.05               Sara Meddings and Louise Patmore. Recovery College Research: how we implement the findings in practice

11.40               Break

12.00               Andrew Shepherd Social and group dynamics in relation to the process of personal recovery

12.40               Lunch

13.30               Shula Ramon and Sarah Rae Researching service user experiences of positive Shared Decision Making

14.10               Emilia Deakin Digital approaches to data collection in people recovering from psychosis

14.45               Tony Sparkes The impact of the RRN through 10 years.

15.20               Panel Discussion + Q&A for speakers

15.40               Open discussion and sharing experiences – recovery research 10 years on. ALL. Please do think about your own experiences of the RRN, and how your own interests in recovery research have developed and changed over the 10 years of the RRN.

16.15               A walk, a drink, followed by optional celebration meal* [*details to follow]

Please note: all RRN events are free and administrated through Eventbrite.  The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly.  If you are unable to attend an event that you have booked onto, could we kindly ask that you inform us so that we may offer your place to someone on our ‘wait list’.

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) Working to Recovery will be presenting a number of one-day events on the subject of Creating Safe Places for Recovery.  Karen Taylor & Alison McCabe (Reeves) will explore their experiences of running Crisis and recovery houses.

Registration 9am.   Start 9.30.  Finish 4.30pm

Leeds:  March26th2019

Bristol:  March27th2019

London:  March 28th2019:

Cardiff:   March 29th2019:

Costs:  Waged £80.  Unwaged: and students £35

For more information see: https://www.workingtorecovery.co.uk/products/events-and-training/creating-safe-places-for-recovery-a-one-day-semina.aspx

ii) ENMESH 2019

http://enmesh2019lisbon.com/

Topic: Managing complexity in mental health systems.

6-8 June 2019, Lisbon, Portugal.

Key dates: abstract submission: 17^th September to 15^th 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, Quality Rights, 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) 9^th 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 7^th 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:

https://icsw2019york.org/

v)  The International Society for Psychological and Social Approaches to Psychosis (ISPS) announced their 21^st International Congress: 

Stranger in the City:

On the circular relationship between alienation and psychosis and the healing power of human reconnection

Date: August 28^th – 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)  Meadows, G., Brophy, L., Shawyer, F., Enticott, J. C., Fossey, E., Thornton, C. D., Weller, P. J., Wilson-Evered, E., Edan, V. and Slade, M. (2019)  REFOCUS-PULSAR recovery-oriented practice training in specialist mental health care: a stepped-wedge cluster randomised controlled trial. Lancet Psychiatry.  6(2) 102-114

http://dx.doi.org/10.1016/S2215-0366(18)30429-2

Summary

Background: Recovery-oriented practice promotes the strengths and recovery potential of individuals. We aimed to establish whether individuals who access mental health services where staff have received the REFOCUS-PULSAR intervention, an adaptation of the UK’s REFOCUS recovery-oriented staff intervention for use in Australia, show increased recovery compared with people using non-intervention services.

Methods: We did a pragmatic, two-step, stepped-wedge, randomised controlled trial at 18 sites grouped into 14 clusters across public mental health services and mental health community support services in Victoria, Australia. Eligible staff were working part-time or full-time in a direct service role at one of the 18 sites and had consumers being recruited for this study. Eligible consumers were receiving care from a participating cluster, with contact in the 3 months before data collection; aged 18–75 years; and not imprisoned. Clusters were randomly assigned with a web-based randomisation tool to receive the REFOCUS-PULSAR intervention in either the first year (step one) or second year (step two). Consumers, but not staff, were masked to treatment assignment. The primary outcome was the Questionnaire about the Process of Recovery (QPR), for which cross-sectional data were collected across three time-points (baseline [T0], year 1 [T1], and year 2 [T2]). The primary analysis was done by intention to treat. This trial is registered with ANZCTR, number ACTRN12614000957695.

Findings: 190 staff (111 from public mental health services and 79 from mental health community support services) received the REFOCUS-PULSAR recovery-oriented training intervention. Between Sept 18, 2014, and May 19, 2017, 942 consumers were recruited across the three time-points (T0: n=301; T1: n=334; T2: n=307). The mean QPR score was 53·6 (SD 16·3) in the control group and 54·4 (16·2) in the intervention group (adjusted difference 3∙7, 95% CI 0·5–6·8; p=0·023). The Cohen’s d value for the intervention effect was small (d=0·23).

Interpretation: The REFOCUS-PULSAR intervention had a small but significant effect on the QPRs of individuals using community mental health services and might be effective in promotion of recovery-oriented practice across sectors.

ii)  Ferrari, G., Feder, G., Agnew-Davies, R., Bailey, J. E., Hollinghurst, S., Howard., Howarth, E., Sardinha, L. Sharp, D. and Peters, T. J. (2018) Psychological advocacy towards healing (PATH): A randomized controlled trial of a psychological intervention in a domestic violence service setting.  PLoS ONE. 13(11) e0205485.

https://doi.org/10.1371/journal.pone.0205485

Abstract

Background: Experience of domestic violence and abuse (DVA) is associated with mental illness. Advocacy has little effect on mental health outcomes of female DVA survivors and there is uncertainty about the effectiveness of psychological interventions for this population.

Objective: To test effectiveness of a psychological intervention delivered by advocates to DVA survivors.

Design, masking, setting, participants: Pragmatic parallel group individually randomized controlled trial of normal DVA advocacy vs. advocacy + psychological intervention. Statistician and researchers blinded to group assignment. Setting: specialist DVA agencies; two UK cities. Participants: Women aged 16

years and older accessing DVA services.

Intervention: Eight specialist psychological advocacy (SPA) sessions with two follow up sessions.

Measurements: Primary outcomes at 12 months: depression symptoms (PHQ-9) and psychological distress (CORE-OM). Primary analysis: intention to treat linear (logistic) regression model for continuous (binary) outcomes.

Results: 263 women recruited (78 in shelter/refuge, 185 in community), 2 withdrew (1 community, control group; 1 intervention, refuge group), 1 was excluded from the study for protocol violation (community, control group), 130 in intervention and 130 in control groups. Recruitment ended June 2013. 12-month follow up: 64%. At 12-month follow up greater improvement in mental health of women in the intervention group. Difference in average CORE-OM score between intervention and control groups: -3.3 points (95% CI -5.5 to -1.2). Difference in average PHQ-9 score between intervention and control group: -2.2 (95% CI -4.1 to -0.3). At 12 months, 35% of the intervention group and 55% of the control group were above the CORE-OM -2clinical threshold (OR 0.32, 95% CI 0.16 to 0.64); 29% of the intervention group and 46% of the control group were above the PHQ-9 clinical threshold (OR 0.41, 95% CI 0.21 to 0.81),

Limitations: 64% retention at 12 months

Conclusions: An eight-session psychological intervention delivered by DVA advocates produced clinically relevant improvement in mental health outcomes compared with normal advocacy care.

The following paper was originally included in the December 2018 edition of the RRN ebulletin, and is repeated here by way of reminder that the topic is listed in the provisional agenda for the forthcoming RRN meeting in May.

iii)  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.20180028e 

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 co-produced 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.

Grey literature

Out of Cambridgeshire and Peterborough NHS Foundation Trust, the Recovery College East magazine ‘Speak Your Mind’ is currently in its 5th issue.  To download this edition, and back issues, along with their ‘Recovery Stories’ book and other informative material, please see:

http://www.cpft.nhs.uk/about-us/recovery-college-east.htm

Other News

i)  In the last edition of the ebulletin Dr Ada Hui (Assistant Professor in Mental Health) at the University of Nottingham contacted the network to bring attention to a new research study.  On the 19^th February, Dr Hui provided the following update:

Thank you for your support with the SHARE study so far.

I am delighted to let you know that we had our first Lived Experience Advisory Panel meeting yesterday where a lot of thoughts and ideas were generated. We have now also received ethical approval to begin our focus groups and so are looking for individuals to be involved.

Please could I ask you to circulate information about the study across your networks, particularly to enable those who may not ordinarily have opportunities such as this to be heard?

I have attached posters and information about the study and would be very happy to be contacted. Further information about the study as follows:

SHARE (Social, Health and Recovery Experiences) is a new research study that explores social influences (e.g. culture, identity and belonging) on mental health and recovery amongst Black, Asian and minority ethnic individuals. This is with a view to learning about different perspectives, challenges and processes associated with mental distress, to improve mental health service provision and bring about organisational change. The study is based in Nottingham, although anyone from the East Midlands may want to join.

We are currently looking for volunteers to join our focus groups (small group discussions) to capture the lived experiences of individuals who are:

• Aged 18 years or over
• Have experienced mental distress (e.g. have used mental health services previously) and
• Identify with being of a BAME backgrounds

There are also opportunities for individuals to join the SHARE Lived Experience Advisory Panel to provide expertise on shaping this study. Our first meeting took place in February and we have further meetings planned during April and June 2019.

The webpage for the study can be found here: https://www.researchintorecovery.com/SHARE 

and I have attached a poster and participant information for convenience.

It would be great to have a range of people and voices represented. If you are interested in being involved, know someone who would be interested or would like to find out more, please contact Ada Hui: ada.hui@nottingham.ac.uk for further details.

ii)  Dr Michelle Funk (Coordinator, Mental Health Policy and Service Development (MHP)

Department of Mental Health and Substance Abuse) at the World Health Organization Genève, writes:

Dear colleagues,

The WHO QualityRights initiative is working to improve access to quality mental health services globally and to promote the human rights of people with mental health conditions and psychosocial, intellectual, and cognitive disabilities.  As part of this initiative we are developing a good practice guidance document which will present information on community-based mental health services that promote human rights and the recovery approach. 

We are contacting you to help us identify people-centered services that you are aware of, that operate without coercion, and that respond to people’s needs by promoting autonomy, inclusion in the community, and the involvement of people with lived experience at all levels of decision-making. This should include services that support people experiencing acute crises but that do not resort to force, coercion, involuntary admission and treatment or the use of seclusion and restraints.

By completing the questionnaire in the link at the bottom of this email, you will have the opportunity to submit up to five mental health services that you believe should be considered as a good practice.  By participating, you can contribute to shaping the future of mental health services.

Anybody who is involved in providing a service, has experience of using a service, or knows of a service is welcome to complete the questionnaire.

Please note that we are not looking for e-interventions, phone-based interventions, training programs, or services focused on advocacy and/or system reform.

We will close the first phase of the online consultation for Western Pacific Region countries on 22^nd March 2019. These countries include Australia, Brunei Darussalam, Cambodia, China, Cook Islands, Fiji, Japan, Kiribati, Lao People`s Democratic Republic, Malaysia, Marshall Islands, Micronesia (Federated States of) Mongolia, Nauru, New Zealand, Niue, Palau, Papua New Guinea, Philippines, Republic of Korea, Samoa, Singapore, Solomon Islands, Tonga, Tuvalu, Vanuatu, Viet Nam.

For all other Countries, the first phase of the online Consultation will close on 30^th June 2019

You can access the consultation survey here

Thank you in advance for your contribution.

iii)  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

Recovery Research Network eBULLETIN

May 2019

RRN Meetings

Celebrating a decade of collegial networking, the RRN held their 21st meeting on Friday, the 10th May 2019 at the McPin Foundation, Great Dover Street, London.  This was a great success and many thanks to the McPin Foundation for hosting the event. Particular thanks go to Vanessa and Odette, and to Shula and Emma for their organisational skills. Special thanks to Vanessa for pathfinding a celebratory get-together afterwards.  Vanessa and Odette even prepared two cakes in celebration of the event! Thank you to all for making this day such a memorable one!

The meeting heard presentations on a range of topics including recovery colleges, social and group dynamics, shared decision making and digital approaches to data collection in people recovering from psychosis.  These topics were supplemented with presentations that considered recovery research and the impact of the network over the last 10-years. 

In collegial tradition of the network,  the speakers on the day kindly gave permission for their work to be archived to the RRN website.  Their 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

Tony Sparkes and The University of Bradford have kindly offered to host the 22nd meeting of the RRN. The event will be held on Wednesday the 27th November 2019.  More details will follow in due course.  The meeting will focus upon the twin themes of: recovery in context of marginalised communities and critical psychiatry.  Speaker suggestions are welcome from the readership.

All RRN events are free and administrated through Eventbrite.  The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly. 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. Details of 22nd meeting will be made available nearer the time.  Thank you.

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

Logo Design

After a decade of the RRN, the time has come to devise our own logo. An invitation is therefore made to our more creative readers to design a suitable RRN logo.  The only criterion is that the logo must contain the words Recovery Research Network (and be ‘acceptable’ as a logo of course!)  In the spirit of any work done for the network, there is no incentive for this submission, save of course the prestige and knowledge that your successful efforts will be posted to many people and countries the world over.

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)  ENMESH 2019

http://enmesh2019lisbon.com/

Topic: Managing complexity in mental health systems.

6-8 June 2019, Lisbon, Portugal.

Key dates: abstract submission: 17^th September to 15^th December 2018, notification: February 2019.

ii)  Mental Health Qualitative Research Network

The next meeting of the Mental Health Qualitative Research Network is due to take place on Thursday, 27th June, in the Royal College of Psychiatrists, London (21 Prescot St., London E1). The themes of this meeting will be:

1. Self-care of qualitative researchers
2. Impact of qualitative research in mental health

Please send abstracts of relevant presentation you wish to make on either of these themes to:

Shula Ramon (s.ramon@herts.ac.uk) and/or Dan Robotham (danrobotham@mcpin.org)

iii)  Refocus on Recovery 2019

Want to learn about the most recent recovery research and innovation?  Refocus on Recovery 2019 will take place in Nottingham from 3 to 5 September 2019, and will include 138 presentations from 23 countries. 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, and we hope you can come! More information about registering to attend is here.

Even if you can’t come, you can be involved! As part of the conference, a debate will be held at the conference on the motion ‘This house believes that there is no place for compulsion in a rights-oriented mental health system’ from 1200 to 1300 (BST) on Thursday 5 September 2019. More information about the debate is here.

The debate will be live-streamed, and participants around the world can watch for free and get involved using the sli.do App. At this stage we are looking for organisations outside the UK who would like to be involved in promoting and bannering the debate. If you might be interested please contact Lou.Rudkin@nottshc.nhs.uk

iv)  9^th International Conference on Social Work in Health and 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 were to be made on the 7^th 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:

https://icsw2019york.org/

v)  The International Society for Psychological and Social Approaches to Psychosis (ISPS) announced their 21^st International Congress:

Stranger in the City:

On the circular relationship between alienation and psychosis and the healing power of human reconnection

Date: August 28^th – September 1st 2019  Rotterdam

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

See also the detail of preconference workshops:

https://www.ispsconference.nl/preconference-workshops/

PhD Students

Justine Schneider writes:

At the University of Nottingham we have funding for a PhD that applies the principles of recovery to dementia, specifically using Wellness Recovery Action Planning (WRAP). This is a Marie Curie studentship, which means that people are only eligible if they have not worked in the UK for more than 12 months in the past 36 months.  Details are on the attached form.  Could you please circulate it to your network? This will be of particular interest to non-UK members.  I would be happy to respond to enquiries about the WRAP study.

Justine can be contacted on: justine.schneider@nottingham.ac.uk

The closing date for this is fast approaching (31st May) and we have included information from Jobs.ac.uk:

https://www.jobs.ac.uk/job/BRY748/marie-sklodowska-curie-itn-early-stage-researcher-posts-in-dementia-care-and-technology-fixed-term

Papers and Publications

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

i)  Whitley, R., Shepherd, G., and Slade, M. (2019) Recovery Colleges as a mental health innovation.  World Psychiatry 18(2), 141-142.

Writing the first overview of Recovery Colleges, and published in the world’s most cited psychiatric journal,  Whitley et al argue the case for Recovery Colleges and their capacity to redress inequality. They conclude that impact outcomes are a much-needed contribution the evidence base.

ii)  Watson, E. and Meddings, S. (eds) (2019). Peer support in mental health. Macmillan. (see attached flyer)

Description (from publisher’s website)

In recent years, the concepts of peer support, self-help and self-management have moved from the periphery of mental health care toward the centre, and have fast become mainstream approaches to supporting well-being. Peer Support in Mental Health provides an overview of the core concepts and an appreciation of the complexities, controversies and applications of each concept. This innovative textbook will support not only mental health professionals and trainees, but also peers, people who use services and their carers. 

iii)  Ng, F., Townsend, M., Miller, C., Jewell, M., and Grenyer, B. (2019) The lived experience of recovery in borderline personality disorder: A qualitative study.  Borderline Personality Disorder and Emotion Dysregulation  6(10) [online]

https://bpded.biomedcentral.com/articles/10.1186/s40479-019-0107-2

Abstract

Background: The concept of recovery in borderline personality disorder (BPD) is not well defined. Whilst clinical approaches emphasise symptom reduction and functioning, consumers advocate for a holistic approach. The consumer perspective on recovery and comparisons of individuals at varying stages have been minimally explored.

Method: Fourteen narratives of a community sample of adult women with a self-reported diagnosis of BPD, were analysed using qualitative interpretative phenomenological analysis to understand recovery experiences. Individuals were at opposite ends of the recovery continuum (seven recovered and seven not recovered).

Results: Recovery in BPD occurred across three stages and involved four processes. Stages included; 1) being stuck, 2) diagnosis, and 3) improving experience. Processes included; 1) hope, 2) active engagement in the recovery journey, 3) engagement with treatment services, and 4) engaging in meaningful activities and relationships. Differences between individuals in the recovered and not recovered group were prevalent in the improving experience stage.

Conclusion: Recovery in BPD is a non-linear, ongoing process, facilitated by the interaction between stages and processes. Whilst clinical aspects are targets of specialist interventions, greater emphasis on fostering individual motivation, hope, engagement in relationships, activities, and treatment, may be required within clinical practice for a holistic recovery approach

iv)  Bergström, T., Seikkula, J., Holma, J., Mäki, P., Köngäs-Saviaro, P. and Alakare, B. (2019)  How do people talk decades later about their crisis that we call psychosis? A qualitative study of the personal meaning-making process.  Psychosis.  11(2) 105-115.

https://doi.org/10.1080/17522439.2019.1603320

Abstract

Psychosis refers to a severe mental state that often significantly affects the individual’s life course. However, it remains unclear how people with the lived experiences themselves view these phenomena, as part of their life story. In order to evaluate this personal meaning-making process, we conducted in-depth life-story interviews with 20 people who had been diagnosed with non-affective psychosis 10 to 23 years previously in one catchment area. 35% of them were still receiving mental health treatment, and 55% of them were diagnosed with schizophrenia. Only a minority named their experiences as psychosis. On the basis of narrative analysis, two types of stories appeared to encompass how mental health crises and/or related experiences were presented as part of the life story: (i) crisis as a disruptor of the normative course of life (N= 9), and (ii) crisis as an expected reaction to life adversities (N= 7). In the majority of the stories, the mental health crisis was associated with cumulative life adversities in a central life area. Correspondingly, most of the factors that brought relief were narrated as inseparable from social and other real-life environments. We discuss the need for more person-centred and collaborative models of research and treatment.

v)  Das-Munshi, J., Schofield, P., Bhavsar, V., Chang, C., Dewey, M., Morgan, C., Stewart, R., Thornicroft, G. and Prince, M. (2019) Ethnic density and other neighbourhood associations for mortality in severe mental illness: a retrospective cohort study with multi-level analysis from an urbanised and ethnically diverse location in the UK.  Lancet Psychiatry. 6.  506-517.

Summary

Background:  Neighbourhood social context might play a role in modifying mortality outcomes in severe mental illness, but has received little attention to date. Therefore, we aimed to assess in an ethnically diverse and urban location the association of neighbourhood-level characteristics and individual-level factors for all-cause, natural-cause, and unnatural-cause mortality in those with severe mental illness.

Methods:  We did a retrospective cohort study using a case-registry from a large secondary mental health-care Trust in an ethnically diverse and urban location in south London, UK. Linked data for deaths and areas of residence were identified from the case-registry. We included all individuals aged 15 years or more at the time of diagnosis for a severe mental illness from Jan 1, 2007, to Dec 31, 2014. We used individual-level information in our analyses, such as gender, marital status, and the presence of current or previous substance use disorders. We assessed neighbourhood or area-level indicators at the Lower Super Output Area level. Association of neighbourhood-level characteristics, which included the interaction between ethnicity and own ethnic density, deprivation, urbanicity, and social fragmentation, alongside individual-level factors for all-cause, natural-cause, and unnatural-cause mortality in those with severe mental illness was assessed.

Findings:  A total of 18 201 individuals were included in this cohort for analyses, with a median follow-up of 6∙36 years. There were 1767 (9∙7%) deaths from all causes, 1417 (7∙8%) from natural causes, and 192 (1∙1%) from unnatural causes. In the least ethnically dense areas, the adjusted rate ratio (aRR) for all-cause mortality in ethnic minority groups with severe mental illness compared with white British people with severe mental illness were similar (aRR 0∙96, 95% CI 0∙71–1∙29); however in the highest ethnic density areas, ethnic minority groups with severe mental illness had a lower risk of death (aRR 0∙52, 95% CI 0∙38–0∙71; p<0∙0001), with similar trends for natural cause mortality (p=0∙071 for statistical interaction). In the cohort with severe mental illness, residency in deprived, urban, and socially fragmented neighbourhoods was not associated with higher mortality rates. Compared with the general population, age-standardised and gender-standardised mortality ratios were elevated in the cohort with severe mental illness across all neighbourhood-level characteristics assessed.

Interpretation:  For ethnic minority groups with severe mental illness, residency in areas of higher own-group ethnic density is associated with lower mortality compared to white British groups with severe mental illness.

Other News

i)  Item carried over from the March edition of the RRN Ebulletin.

In the last edition of the ebulletin Dr Ada Hui (Assistant Professor in Mental Health) at the University of Nottingham contacted the network to bring attention to a new research study.  On the 19^th February, Dr Hui provided the following update:

Thank you for your support with the SHARE study so far.

I am delighted to let you know that we had our first Lived Experience Advisory Panel meeting yesterday where a lot of thoughts and ideas were generated. We have now also

SHARE (Social, Health and Recovery Experiences) is a new research study that explores social influences (e.g. culture, identity and belonging) on mental health and recovery amongst Black, Asian and minority ethnic individuals. This is with a view to learning about different perspectives, challenges and processes associated with mental distress, to improve mental health service provision and bring about organisational change. The study is based in Nottingham, although anyone from the East Midlands may want to join.

We are currently looking for volunteers to join our focus groups (small group discussions) to capture the lived experiences of individuals who are:

• Aged 18 years or over
• Have experienced mental distress (e.g. have used mental health services previously) and
• Identify with being of a BAME backgrounds

There are also opportunities for individuals to join the SHARE Lived Experience Advisory Panel to provide expertise on shaping this study. Our first meeting took place in February and we have further meetings planned during April and June 2019.

The webpage for the study can be found here: https://www.researchintorecovery.com/SHARE

and I have attached a poster and participant information for convenience.

It would be great to have a range of people and voices represented. If you are interested in being involved, know someone who would be interested or would like to find out more, please contact Ada Hui: ada.hui@nottingham.ac.uk for further details.

ii)  Item carried over from the March edition of the RRN Ebulletin.

Dr Michelle Funk (Coordinator, Mental Health Policy and Service Development (MHP)

Department of Mental Health and Substance Abuse) at the World Health Organization Genève, writes:

Dear colleagues,

The WHO QualityRights initiative is working to improve access to quality mental health services globally and to promote the human rights of people with mental health conditions and psychosocial, intellectual, and cognitive disabilities.  As part of this initiative we are developing a good practice guidance document which will present information on community-based mental health services that promote human rights and the recovery approach.

We are contacting you to help us identify people-centered services that you are aware of, that operate without coercion, and that respond to people’s needs by promoting autonomy, inclusion in the community, and the involvement of people with lived experience at all levels of decision-making. This should include services that support people experiencing acute crises but that do not resort to force, coercion, involuntary admission and treatment or the use of seclusion and restraints.

By completing the questionnaire in the link at the bottom of this email, you will have the opportunity to submit up to five mental health services that you believe should be considered as a good practice.  By participating, you can contribute to shaping the future of mental health services.

Anybody who is involved in providing a service, has experience of using a service, or knows of a service is welcome to complete the questionnaire.

Please note that we are not looking for e-interventions, phone-based interventions, training programs, or services focused on advocacy and/or system reform.

We will close the first phase of the online consultation for Western Pacific Region countries on 22^nd March 2019. These countries include Australia, Brunei Darussalam, Cambodia, China, Cook Islands, Fiji, Japan, Kiribati, Lao People`s Democratic Republic, Malaysia, Marshall Islands, Micronesia (Federated States of) Mongolia, Nauru, New Zealand, Niue, Palau, Papua New Guinea, Philippines, Republic of Korea, Samoa, Singapore, Solomon Islands, Tonga, Tuvalu, Vanuatu, Viet Nam.

For all other Countries, the first phase of the online Consultation will close on 30^th June 2019

You can access the consultation survey here

Thank you in advance for your contribution.

iii)  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

Recovery Research Network eBULLETIN

June 2019

RRN Meetings

The next meeting of the Recovery Research Network (RRN) will be hosted by The University of Bradford. This will be the 22nd meeting of the network and will be held on Wednesday the 27th November 2019.  More details will follow in due course.  The meeting will focus upon the twin themes of: recovery in context of marginalised communities and critical psychiatry.

All RRN events are free and administrated through Eventbrite.  The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly. 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. Details of 22nd meeting will be made available nearer the time.  Thank you.

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

Logo Design

In the last edition of the ebulletin, we said that after a decade of the RRN, the time had come to devise our own logo. Well, some interest has been shown, and there are some impressive designs coming forward.  Thanks to those who have submitted their designs. 

We will extend the request through this edition of the ebulletin, and look towards closing the invitation at the end of July.  By way of reminder, and for any budding artists out there, the only criterion is that the logo must contain the words Recovery Research Network (and be ‘acceptable’ as a logo of course!)  In the spirit of any work done for the network, there is no incentive for this submission, save of course the prestige and knowledge that your successful efforts will be posted to many people and countries the world over.

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)  9^th International Conference on Social Work in Health and 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 were to be made on the 7^th 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:

https://icsw2019york.org/

ii)  The International Society for Psychological and Social Approaches to Psychosis (ISPS) announced their 21^st International Congress: 

Stranger in the City:

On the circular relationship between alienation and psychosis and the healing power of human reconnection

Date: August 28^th – September 1st 2019  Rotterdam

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

See also the detail of preconference workshops:

https://www.ispsconference.nl/preconference-workshops/

iii)  Refocus on Recovery 2019

Want to learn about the most recent recovery research and innovation?  Refocus on Recovery 2019 will take place in Nottingham from 3 to 5 September 2019, and will include 138 presentations from 23 countries. 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, and we hope you can come! More information about registering to attend is here.

Even if you can’t come, you can be involved! As part of the conference, a debate will be held at the conference on the motion ‘This house believes that there is no place for compulsion in a rights-oriented mental health system’ from 1200 to 1300 (BST) on Thursday 5 September 2019. More information about the debate is here.

The debate will be live-streamed, and participants around the world can watch for free and get involved using the sli.do App. At this stage we are looking for organisations outside the UK who would like to be involved in promoting and bannering the debate. If you might be interested please contact Lou.Rudkin@nottshc.nhs.uk

Papers and Publications

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

i)  McManus, S., Gunnell, D., Cooper, C., Bebbington, P.E., Howard, L.M., Brugha, T., Jenkins, R., Hassiotis, A., Weich, S. and Appleby, L. (2019) Prevalence of non-suicidal self-harm and service contact in England, 2000–14: repeated cross-sectional surveys of the general population. Lancet Psychiatry 6: 573-581.

http://dx.doi.org/10.1016/S2215-0366(19)30188-9

Summary

Background:  The number of people presenting to hospital emergency departments after self-harming has increased in England. However, most people who self-harm do not present to hospitals, so whether this rise reflects an increase in the prevalence of self-harm in the community is unknown. Also unknown is whether the prevalence of nonsuicidal self-harm (NSSH) or suicidal self-harm, or both, has increased. We aimed to establish temporal trends in the prevalence of NSSH in England.

Methods:  We analysed data from participants in the 2000 (n=7243), 2007 (n=6444), and 2014 (n=6477) Adult Psychiatric Morbidity Surveys of the general population, selecting those aged 16–74 years and living in England. We used weighted data and controlled for complex survey design. We generated temporal trends in lifetime prevalence and methods of, and motivations for, NSSH, and consequent service contact. We used multiple variable logistic regression analyses to investigate factors associated with service contact.

Findings:  The prevalence of self-reported lifetime NSSH increased from 2·4% (95% CI 2·0–2·8) in 2000, to 6·4% (5·8–7·2) in 2014. Increases in prevalence were noted in both sexes and across age groups—most notably in women and girls aged 16–24 years, in whom prevalence increased from 6·5% (4·2–10·0) in 2000, to 19·7% (15·7–24·5) in 2014. The proportion of the population reporting NSSH to relieve unpleasant feelings of anger, tension, anxiety, or depression increased from 1·4% (95% CI 1·0–2·0) to 4·0% (3·2–5·0) in men and boys, and from 2·1% (1·6–2·7) to 6·8% (6·0–7·8) in women and girls, between 2000 and 2014. In 2014, 59·4% (95% CI 54·7–63·9) of participants who had engaged in NSSH reported no consequent medical or psychological service contact, compared with 51·2% (42·2–60·0) in 2000 and 51·8% (47·3–56·4) in 2007. Male participants and those aged 16–34 years were less likely to have contact with health services than were female participants and older people.

Interpretation:  The prevalence of NSSH has increased in England, but resultant service contact remains low. In 2014, about one in five female 16–24-year-olds reported NSSH. There are potential lifelong implications of NSSH, such as an increased frequency of suicide, especially if the behaviours are adopted as a long-term coping strategy. Self-harm needs to be discussed with young people without normalising it. Young people should be offered help by primary care, educational, and other services to find safer ways to deal with emotional stress.

ii)  Walter, F., Carr, M.J., Mok, P.L.H., Antonsen, S., Pedersen, C.B., Appleby, L., Fazel, S., Shaw, J. and R.T. Webb (2019) Multiple adverse outcomes following first discharge from inpatient psychiatric care: a national cohort study.  . Lancet Psychiatry 6: 582-589.

http://dx.doi.org/10.1016/S2215-0366(19)30180-4

Summary

Background:  Discharged psychiatric inpatients are at elevated risk of serious adverse outcomes, but no previous study has comprehensively examined an array of multiple risks in a single cohort.

Methods:  We used data from the Danish Civil Registration System to delineate a cohort of all individuals born in Denmark in 1967–2000, who were alive and residing in Denmark on their 15th birthday, and who had been discharged from their first inpatient psychiatric episode at age 15 years or older. Each individual in the discharged cohort was matched on age and sex with 25 comparators without a history of psychiatric admission. Data linked to each individual were also obtained from the Psychiatric Central Research Register, Register of Causes of Death, National Patient Register, and the National Crime Register. We used survival analysis techniques to estimate absolute and relative risks of all-cause mortality, suicide, accidental death, homicide victimisation, homicide perpetration, non-fatal self-harm, violent criminality, and hospitalisation following violence, until Dec 31, 2015.

Findings:  We included 62 922 individuals in the discharged cohort, and 1 573 050 matched comparators. Risks for each of all eight outcomes examined were markedly elevated in the discharged cohort relative to the comparators. Within 10 years of first discharge, the cumulative incidence of death, self-harm, committing a violent crime, or hospitalisation due to interpersonal violence was 32·0% (95% CI 31·6–32·5) in the discharged cohort (37·1% [36·5–37·8] in men and 27·2% [26·7–27·8] in women). Absolute risk of at least one adverse outcome occurring within this timeframe were highest in people diagnosed with a psychoactive substance use disorder at first discharge (cumulative incidence 49·4% [48·4–50·4]), and lowest in those diagnosed with a mood disorder (24·4% [23·6–25·2]). For suicide and nonfatal self-harm, risks were especially high during the first 3 months post-discharge, whereas risks for accidental death, violent criminality, and hospitalisation due to violence were more constant throughout the 10-year follow-up.

Interpretation:  People discharged from inpatient psychiatric care are at higher risk than the rest of the population for a range of serious fatal and non-fatal adverse outcomes. Improved inter-agency liaison, intensive follow-up immediately after discharge, and longer-term social support are indicated.

iii)  Benkwitz, A. and Healy, L.C. (2019) ‘Think Football’: Exploring a football for mental health initiative delivered in the community through the lens of personal and social recovery.  Mental Health and Physical Activity. 17 1-9 (Online)

https://doi.org/10.1016/j.mhpa.2019.100292

Abstract

The practice and discourse of mental health recovery is evolving, with increasing appreciation given to personal recovery and now social recovery. It therefore follows that we need initiatives that enhance levels of social capital, positive social identities and social inclusion within the community, not just within mental health services. These initiatives must bring people together in ways that allow them to feel that they have ownership of any new social infrastructures and use evidence-based frameworks to evaluate them. One context that has been given some consideration is the use of community sport. This paper therefore contributes to the steadily growing literature in this area by exploring the specifics of a community mental health football project, through the utilisation of the personal and social recovery frameworks that have been established within the ‘mainstream’ mental health evidence base. This relativist study utilised seventeen semi-structured interviews (with participants and staff) and, as a deliberate departure from existing research, chose to adopt a deductive, theoretical approach to the analysis that located the data within the personal recovery and social recovery literature. Both participants and staff were considerably positive about the sessions, and data suggested an adherence to the empirically based CHIME personal recovery framework. In terms of alignment with the social recovery concepts, the data was particularly robust in supporting active citizenship processes, which can increase levels of social capital and enhance social identities. Future work is required to further explore the contextual impact of poverty and employment, and the role that sport can potentially play.

iv)  Slade, M., Rennick-Egglestone, S., Blackie, L., Llewellyn-Beardsley, J., Franklin, D., Hui, A., Thornicroft, G., McGranahan, R., Pollock, K., Priebe, S., Ramsay, A., Roe, D. and Deakin, E. (2019)  Post-traumatic growth in mental health recovery: qualitative study of narratives.  BMJ Open 2019;9:e029342.

doi:10.1136/bmjopen-2019-029342

Abstract

Objectives:  Post-traumatic growth, defined as positive psychological change experienced as a result of the struggle with challenging life circumstances, is under-researched in people with mental health problems. The aim of this study was to develop a conceptual framework for post-traumatic growth in the context of recovery for people with psychosis and other severe mental health problems.

Design:  Qualitative thematic analysis of cross-sectional semi-structured interviews about personal experiences of mental health recovery.

Setting:  England.

Participants:  Participants were adults aged over 18 and: (1) living with psychosis and not using mental health services (n=21); (2) using mental health services and from black and minority ethnic communities (n=21); (3) underserved, operationalised as lesbian, gay, bisexual and transgender community or complex needs or rural community (n=19); or (4) employed in peer roles using their lived experience with others (n=16). The 77 participants comprised 42 (55%) female and 44 (57%) white British.

Results:  Components of post-traumatic growth were present in 64 (83%) of recovery narratives. Six superordinate categories were identified, consistent with a view that post-traumatic growth involves learning about oneself (self-discovery) leading to a new sense of who one is (sense of self) and appreciation of life (life perspective). Observable positively valued changes comprise a greater focus on self-management (well-being) and more importance being attached to relationships (relationships) and spiritual or religious engagement (spirituality). Categories are non-ordered and individuals may start from any point in this process.

Conclusions: Post-traumatic growth is often part of mental health recovery. Changes are compatible with research about growth following trauma, but with more emphasis on self-discovery, integration of illness-related experiences and active self-management of well-being. Trauma-related growth may be a preferable term for participants who identify as having experienced trauma. Trauma-informed mental healthcare could use the six identified categories as a basis for new approaches to supporting recovery.

v)  Moore, D.A., Nunns, M., Shaw, L., Rogers, M., Walker, E., Ford, T., et al. (2019) Interventions to improve the mental health of children and young people with long-term physical conditions: linked evidence syntheses. Health Technol Assess 2019;23(22).

DOI 10.3310/hta23220

Abstract

Background:  Although mental health difficulties can severely complicate the lives of children and young people (CYP) with long-term physical conditions (LTCs), there is a lack of evidence about the effectiveness of interventions to treat them.

Objectives:  To evaluate the clinical effectiveness and cost-effectiveness of interventions aiming to improve the mental health of CYP with LTCs (review 1) and explore the factors that may enhance or limit their delivery (review 2).

Data sources:  For review 1, 13 electronic databases were searched, including MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Science Citation Index. For review 2, MEDLINE, PsycINFO and CINAHL were searched. Supplementary searches, author contact and grey literature searches were also conducted.

Review methods:  The first systematic review sought randomised controlled trials (RCTs) and economic evaluations of interventions to improve elevated symptoms of mental ill health in CYP with LTCs. Effect sizes for each outcome were calculated post intervention (Cohen’s d). When appropriate, random-effects meta-analyses produced pooled effect sizes (d). Review 2 located primary qualitative studies exploring experiences of CYP with LTCs, their families and/or practitioners, regarding interventions aiming to improve the mental health and well-being of CYP with LTCs. Synthesis followed the principles of metaethnography.  An overarching synthesis integrated the findings from review 1 and review 2 using a deductive approach. End-user involvement, including topic experts and CYP with LTCs and their parents, was a feature throughout the project. 

Results: Review 1 synthesised 25 RCTs evaluating 11 types of intervention, sampling 12 different LTCs. Tentative evidence from seven studies suggests that cognitive–behavioural therapy interventions could improve the mental health of CYP with certain LTCs. Intervention–LTC dyads were diverse, with few opportunities to meta-analyse. No economic evaluations were located. Review 2 synthesised 57 studies evaluating 21 types of intervention. Most studies were of individuals with cancer, a human immunodeficiency virus (HIV) infection or mixed LTCs. Interventions often aimed to improve broader mental health and well-being, rather than symptoms of mental health disorder. The metaethnography identified five main constructs, described in an explanatory line of argument model of the experience of interventions. Nine overarching synthesis categories emerged from the integrated evidence, raising implications for future research.

Limitations:  Review 1 conclusions were limited by the lack of evidence about intervention effectiveness. No relevant economic evaluations were located. There were no UK studies included in review 1, limiting the applicability of findings. The mental health status of participants in review 2 was usually unknown, limiting comparability with review 1. The different evidence identified by the two systematic reviews challenged the overarching synthesis.

Conclusions:  There is a relatively small amount of comparable evidence for the effectiveness of interventions for the mental health of CYP with LTCs. Qualitative evidence provided insight into the experiences that intervention deliverers and recipients valued. Future research should evaluate potentially effective intervention components in high-quality RCTs integrating process evaluations. End-user involvement enriched the project.

vi)  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. (2019) Development and evaluation of a recovery college fidelity measure. The Canadian Journal of Psychiatry 64(6) 405-414

doi.org/10.1177%2F0706743718815893

Abstract

Objective:  Recovery Colleges are widespread, with little empirical research on their key components. This study aimed to characterize key components of Recovery Colleges and to develop and evaluate a developmental checklist and a quantitative fidelity measure.

Methods:  Key components were identified through a systematized 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 3 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 7 non-modifiable components (Valuing Equality, Learning, Tailored to the Student, Coproduction of the Recovery College, Social Connectedness, Community Focus, and Commitment to Recovery) and 5 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:  Coproduction 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.

vii)  Bogen-Johnston, L., deVisser, R., Strauss, C. and Hayward, M. (2019) “It’s just a bit like a rollercoaster”: a longitudinal qualitative study exploring a model of the phases of voice hearing.  Psychosis.  2-12 (Online)

https://doi.org/10.1080/17522439.2019.1632375

Abstract

Background:  Existing models of the phases of hearing distressing voices have relied upon data from cross-sectional designs and the retrospective accounts of hearers. There is a need for a longitudinal study to examine the phases of voice hearing over time.

Methods:  A longitudinal, mixed-methods design was used. Stage 1 – semi-structured interviews were conducted at nine monthly intervals at four time-points with voice hearers (n = 12) from Early Intervention in Psychosis Services. Data were Thematically Analysed. Stage 2 – findings were mapped onto an integrated model of voice hearing.

Results:  Stage 1 analysis generated higher-order themes: “Common Pathway”, “Voices Stop”, “Voices Continue but Beliefs Change”, and “Voices Continue but Beliefs do not Change”. Stage 2 analysis generated a potential framework for a revised model of voice hearing over time with three novel sub-group pathways.

Conclusions:  Findings suggested three novel sub-group pathways. Beliefs about voices influenced the course of voice hearing. Changes in beliefs were associated with acceptance, meaning-making and recovery: whereas beliefs that did not change were associated with ongoing voice-related distress. Findings highlight the importance of therapeutic conversations in supporting hearers to explore their experiences with voices.

viii)  Thornicroft, G., Bakolis, I., Evans-Lacko, S., Gronholm, P.C., Henderson, C., Kohrt, B.A., Koschorke, M., Milenova, M., Semrau, M., Votruba, N. and Sartorius, N. (2019) Key lessons learned from the INDIGO global network on mental health related stigma and discrimination.  World Psychiatry 18(2) 229-230.

In the above short commentary, the authors summarise a decade of learning from the INDIGO Research Network, which was set-up to provide international research insights into stigma and discrimination. The authors provide a brief outline of their methodological and conceptual orientations to stigma and discrimination research. Grounded in their empirical work they conclude that whilst both concepts are culturally contingent, they are nevertheless universal and reversible. The INDIGO Network continues to develop, with considerations of how this learning can be applied to other contexts.

Other News

i)  From the Shekulo Tov Group, Shachar Liran-Hanan writes;

Dear friends and partners,

We are happy to share with you a video report about Shekulo Tov which was published by DW and done by the wonderful Michael Wetzel.

https://www.dw.com/en/israel-helping-people-with-mental-health-issues/av-49104465

The article was initiated by the Swab Foundation, where Irad Eichler, Shekulo Tov’s founder and chairman is a member of its social entrepreneurs community.

What did you think about the article?

We would love to hear your thoughts, ideas or feedback.

Best regards,

Shachar Liran-Hanan

Director of International Development 

+972 52 3485561

Shacharlh@s-tov.org.il

www.s-tov.org.il

ii)  Mental Health Today

The 27^th June is PTSD awareness day, and Mental Health Today write about the launch of a new information hub that focuses upon PTSD. For more information see:

https://www.mentalhealthtoday.co.uk/disorders/post-traumatic-disorders?utm_source=https%3a%2f%2fnews.pavpub.com%2fpavilionpublishingandmedialz%2f&utm_medium=GatorMail&utm_campaign=MHT+Ebul+270619&utm_term=PTSD+is+not+the+only+reaction+to+trauma&utm_content=62974&gator_td=WI2p%2fwvVkhVEhLHlaJDPuzF4cObntPYjwq53MuAIkQy%2b%2bfkO0SdUyb6P175krqJvSSTBX9GYNP0WTXwurO13bbjoLIDVS8de2usHAEOwdqi2ORvWzXY%2f0Xdn4TUx2X%2fDUfnhkQeiqTYjuD5gQtrjNw%3d%3d

https://www.mentalhealthtoday.co.uk/disorders/post-traumatic-disorders?utm_source=https%3a%2f%2fnews.pavpub.com%2fpavilionpublishingandmedialz%2f&utm_medium=GatorMail&utm_campaign=MHT+Ebul+270619&utm_term=PTSD+is+not+the+only+reaction+to+trauma&utm_content=62974&gator_td=WI2p%2fwvVkhVEhLHlaJDPuzF4cObntPYjwq53MuAIkQy%2b%2bfkO0SdUyb6P175krqJvSSTBX9GYNP0WTXwurO13bbjoLIDVS8de2usHAEOwdqi2ORvWzXY%2f0Xdn4TUx2X%2fDUfnhkQeiqTYjuD5gQtrjNw%3d%3d

iii)  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

Recovery Research Network eBULLETIN

August 2019

RRN Meetings

The 22^nd meeting of the Recovery Research Network (RRN) will be hosted by The University of Bradford. The meeting will focus upon the twin themes of: recovery in context of marginalised communities and critical psychiatry. A provisional agenda is included below.

Date:               Wednesday 27^th November 2019

Time:               09:30 – 16:00

Venue:            The Norcroft Centre

                        University of Bradford

                        Richmond Road

BRADFORD

BD7 1DP

Travel

Venue Information: The event will take place at the main campus of the University of Bradford, in The Norcroft Centre. For directions to the University’s City Campus, please click the following link: http://www.bradford.ac.uk/contact-and-find-us/maps/

Agenda (provisional)

09.30               Refreshments

10.00               Welcome and Introduction to Bradford University

10.15               Introductions

10.30               Hári Sewell – HS Consultancy:  Responsiveness and Resilient  Communities: Supporting Recovery as an act of Resistance

11.15               Jill Hemmington (Senior lecturer) – University of Central Lancashire:  TBC

12:00               Break

12.15               Tony Sparkes & Kate Karban – University of Bradford: Recovery and  Social Perspectives in Approved Mental Health Professional (AMHP) Practice

13.00               Lunch

14.00               Helen Spandler – (Professor of Mental Health Studies) – University of  Central Lancashire:  Reflections on critical approaches to recovery

14.45               Carine van der Boor (Demonstrator and PhD student) – University of  Liverpool:  Mental Health and Well-Being in Refugee and Asylum  Seeking Populations in the UK: A Capabilities Approach

15.30               Meeting close

15.40               RRN Panel Discussion (all invited)

To register for the event, please use the following link:

22^nd meeting of the Recovery Research Network

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

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

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

RRN Membership Profile

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

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

Logo Design

After much deliberation, and by majority decision, the RRN collective have chosen the attached design as the preferred logo for the network.  Preference went to the top left image.  A big thank-you to all those who took part, your efforts were very much appreciated.

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) Power of Music in Health and Social Care, University of Nottingham 4^th November 2019

Taken from the University of Nottingham website:

Following the success of the first Power of Music in Health and Social Care Conference in October 2018, Research and Innovation are delighted to announce a second conference in November 2019.  (…) The conference is for anyone who wants to learn more about the role music plays in care, including care providers, family and volunteer caregivers, care receivers, care workers, musicians, faith-based and community agencies, students, researchers, policymakers and the community.

For more information and registration details, see:

https://www.nottingham.ac.uk/home/featureevents/2019/power-of-music-in-health-and-social-care.aspx

ii)  JCI Nottingham mental health conference ‘Let’s get talking’, 26^th October 2019

With free admission for the public, and sponsored by The Institute of Mental Health, JCI Nottingham are hosting a one day Mental Health Conference, ’Let’s get talking’, at The Institute of Mental Health, University of Nottingham

For further information and booking details see:

https://www.jcinottingham.org.uk/2019/09/02/mental-health-conference-lets-get-talking/

Papers and Publications

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

i)  Pinfold, V., Dare, C., Hamilton, S., Kaur, H., Lambley, R., Nicholls, V., Petersen, I., Szymczynska, P., Walker, C. and Stevenson, F. (2019) Anti-psychotic medication decision making during pregnancy: a co-produced research study.  Mental Health Review Journal. 24(2) 69-84

https://doi.org/10.1108/MHRJ-04-2017-0018

Please note: a poster summarising this above article is attached to this edition of the ebulletin

Abstract

Purpose – The purpose of this paper is to understand how women with a diagnosis of schizophrenia or bipolar disorder approach medication decision making in pregnancy.

Design/methodology/approach – The study was co-produced by university academics and charity-based researchers. Semi-structured interviews were conducted by three peer researchers who have used anti-psychotic medication and were of child bearing age. Participants were women with children under five, who had taken anti-psychotic medication in the 12 months before pregnancy. In total, 12 women were recruited through social media and snowball techniques. Data were analysed following a three-stage process.

Findings – The accounts highlighted decisional uncertainty, with medication decisions situated among multiple sources of influence from self and others. Women retained strong feelings of personal ownership for their decisions, whilst also seeking out clinical opinion and accepting they had constrained choices. Two styles of decision making emerged: shared and independent. Shared decision making involved open discussion, active permission seeking, negotiation and coercion. Independent women-led decision making was not always congruent with medical opinion, increasing pressure on women and impacting pregnancy experiences. A common sense self-regulation model explaining management of health threats resonated with women’s accounts.

Practical implications – Women should be helped to manage decisional conflict and the emotional impact of decision making including long term feelings of guilt. Women experienced interactions with clinicians as lacking opportunities for enhanced support except in specialist perinatal services. This is an area that should be considered in staff training, supervision, appraisal and organization review.

Originality/value – This paper uses data collected in a co-produced research study including peer researchers

ii)  Daley, S., Slade, M., Dewey, M. and Banerjee, S. (2019) A feasibility study of the effects of implementing a staff-level recovery-oriented training intervention in older people’s mental health services.  Aging and Mental Health.  [online]

https://doi.org/10.1080/13607863.2019.1642297

Abstract

Objectives: The concept of recovery has exerted considerable traction in mental health services for adults of working age, but less so in older people’s mental health services. The aim of this study was to evaluate the feasibility of a staff-level recovery intervention in older people’s mental health services.

Method: The study used a mixed-method pre-post design. The study took place in NHS older people’s mental health services, UK. Staff participants were multi-disciplinary mental health team members from the same service. The intervention was a manualised staff-level recovery intervention called the Older Adults Recovery Intervention (OARI). Measurement included the Recovery Knowledge Inventory and the Recovery Attitudes Questionnaire (RAQ-7) as well as fidelity data and in-depth qualitative interviews.

Results: OARI was delivered to 204 staff in 15 clinical teams. There was a statistically significant change towards improvement in four of the six recovery attitude and knowledge sub-scales. There were positive findings in change in practice at individual level, but not at team level. A number of context barriers were identified leading to the intervention not being delivered as intended.

Conclusions: Further development of OARI will involve a clearer distinction about the practice implications for service users with dementia versus functional illnesses, a stronger focus on implementation support, more use of evidence in training materials and a tailoring of context to meet professional group training needs. Overall, this study contributes novel data to the evidence base for recovery within older people’s mental health services.

iii)  Ballesteros-Urpi, A., Slade, M., Manley, D. and Pardo-Hernandez, H. (2019) Conceptual framework for personal recovery in mental health among children and adolescents: a systematic review and narrative synthesis protocol. BMJ Open [online]

https://doi.org/10.1136/bmjopen-2019-029300

Abstract

Introduction: Personal recovery has been defined as ‘a profound personal and unique process for the individual to change their attitudes, values, feelings, goals, abilities and roles in order to achieve a satisfactory, hopeful and productive way of life, with the possible limitations of the illness’. However, research on personal recovery has focused almost exclusively on adults. This project aims to systematically review the available literature on definitions of personal recovery among children and adolescents with mental health conditions and to undertake a narrative synthesis to develop a conceptual framework of recovery.

Methods and analysis: Systematic review and narrative synthesis consisting (1) searching scientific literature databases, (2) hand-searching, (3) citation tracking, (4) grey literature searching, (5) web-based searching and expert consultation. We will include qualitative and quantitative studies or systematic reviews providing a definition, theoretical or conceptual framework, domains or dimensions of personal recovery among eligible participants. The study will follow standard systematic review methodology for study selection and data extraction. We will assess quality of the evidence using tools appropriate for each study design. We will develop a new conceptual framework using a modified narrative synthesis approach, as follows: (1) describing eligible studies and conducting a preliminary synthesis, (2) determining relationships within and between studies and (3) determining the robustness of the synthesis.

Ethics and dissemination: We obtained a waiver of approval from our local Research Ethics Committee. Results will be disseminated via publications in international peer-reviewed journals and conference proceedings. This study will result in a theoretical framework that is based on an exhaustive review of the literature and the input of experts in the field of recovery. We expect that this framework will foster a better understanding of the stages and processes of recovery in children and adolescents with mental health conditions.

iv)  Isaacs, A., Beauchamp, A., Sutton, K. and Kocaali, N. (2019). Care coordination can reduce unmet needs of persons with severe and persistent mental illness. Front. Psychiatry 10:00563.

https://doi.org/10.3389/fpsyt.2019.00563

Abstract

Introduction: Persons with severe and persistent mental illness (SPMI) have multiple and complex needs, many of which are not health related. Mental health services are unable to address these needs without collaboration with other agencies. In the absence of this collaboration, persons with SPMI often fall through the system cracks and are unlikely to experience recovery. Furthermore, previous studies have shown that unmet accommodation needs are associated with unmet needs in other areas. This study aimed to ascertain whether a care coordination model adopted in Australia’s Partners in Recovery [PIR] initiative was able to reduce unmet needs in such persons and also if meeting accommodation needs were associated with meeting other needs.

Methods: This was a longitudinal study where met and unmet needs of clients measured using the Camberwell Assessment of Needs Short Appraisal Schedule (CANSAS) were compared at enrolment and exit from the PIR initiative. Logistic regression was used to examine the association between change in accommodation needs and change in other CANSAS variables.

Results: In total, 337 clients (66% of 508 clients) had both baseline and follow-up data and were seen within the time frame of 14 to 101 weeks. At baseline, the most frequently reported unmet needs were psychological distress, daytime activity, and company (89%, 72%, and 67%, respectively). At follow-up, these had decreased to 27%, 22%, and 22%, respectively. The proportions of clients with an unmet need at baseline who subsequently progressed to having that need met at follow-up ranged between 62% and over 90%. Change in accommodation needs from unmet to met was associated with changes in monetary needs and needs related to childcare, food, safety to self, education, and access to other services, with the greatest change seen for monetary needs (adjusted OR 2.87, 95% CI 1.76, 4.69).

Conclusions: Reducing needs of persons with SPMI is the starting point of recovery and is a good indicator of psychiatric care. Care coordination is a useful way to address multiple and complex needs of persons with SPMI. While addressing needs, priority must be given to meeting accommodation needs.

Other News

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

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

September 2019

RRN Meetings

The 22^nd meeting of the Recovery Research Network (RRN) will be hosted by The University of Bradford. The meeting will focus upon the twin themes of: recovery in context of marginalised communities and critical psychiatry. A provisional agenda is included below.

Date:               Wednesday 27^th November 2019

Time:               09:30 – 16:00

Venue:            The Norcroft Centre

                        University of Bradford

                        Richmond Road

BRADFORD

BD7 1DP

Travel

Venue Information: The event will take place at the main campus of the University of Bradford, in The Norcroft Centre. For directions to the University’s City Campus, please click the following link: http://www.bradford.ac.uk/contact-and-find-us/maps/

Agenda (provisional)

09.30               Refreshments

10.00               Welcome and Introduction to Bradford University

10.15               Introductions

10.30               Hári Sewell – HS Consultancy:  Responsiveness and Resilient  Communities: Supporting Recovery as an act of Resistance

11.15               Jill Hemmington (Senior lecturer) – University of Central Lancashire:  Approved Mental Health Professionals’ Decision-Making:  Communication and Power.

12:00               Break

12.15               Tony Sparkes & Kate Karban – University of Bradford: Recovery and  Social Perspectives in Approved Mental Health Professional (AMHP)  Practice

13.00               Lunch

14.00               Helen Spandler – (Professor of Mental Health Studies) – University of  Central Lancashire:  Reflections on critical approaches to recovery

14.45               Carine van der Boor (Demonstrator and PhD student) – University of  Liverpool:  Mental Health and Well-Being in Refugee and Asylum  Seeking Populations in the UK: A Capabilities Approach

15.30               Meeting close

15.40               RRN Panel Discussion (all invited)

To register for the event, please use the following link:

22^nd meeting of the Recovery Research Network

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

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

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

RRN Membership Profile

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

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

A Call to PhD Students and their Supervisors

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

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

Conferences and Events

i) Power of Music in Health and Social Care, University of Nottingham 4^th November 2019

Taken from the University of Nottingham website:

Following the success of the first Power of Music in Health and Social Care Conference in October 2018, Research and Innovation are delighted to announce a second conference in November 2019.  (…) The conference is for anyone who wants to learn more about the role music plays in care, including care providers, family and volunteer caregivers, care receivers, care workers, musicians, faith-based and community agencies, students, researchers, policymakers and the community.

For more information and registration details, see:

https://www.nottingham.ac.uk/home/featureevents/2019/power-of-music-in-health-and-social-care.aspx

ii)  JCI Nottingham mental health conference ‘Let’s get talking’, 26^th October 2019

With free admission for the public, and sponsored by The Institute of Mental Health, JCI Nottingham are hosting a one day Mental Health Conference, ’Let’s get talking’, at The Institute of Mental Health, University of Nottingham

For further information and booking details see:

https://www.jcinottingham.org.uk/2019/09/02/mental-health-conference-lets-get-talking/

Papers and Publications

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

i)  Aga, N., Vander Laenen, F., Vandevelde, S. and Vanderplasschen, W. (2019) A qualitative inquiry on recovery needs and resources of individuals with intellectual disabilities labelled not criminally responsible.  Journal of Applied Research in Intellectual Disabilities.  Online:

https://doi.org/10.1111/jar.12670

Abstract

Background: Recovery is a widely accepted paradigm in mental health care, whilst the correctional and forensic–psychiatric field is still searching for foundations for its implementation. Knowledge regarding recovery of persons with intellectual disabilities in secure contexts is limited. This study assesses recovery needs and resources among persons with intellectual disabilities labelled not criminally responsible and investigates the impact of the judicial label on recovery processes.

Methods: A sample of 26 individuals was composed purposively, and in‐depth interviews were conducted. Recurrent themes were identified using thematic analysis.

Results: Traditional recovery themes emerged from the narratives, next to aspects of recovery in a forensic or correctional context. However, the operationalization and proportional impact are specific for this sample.

Conclusions: The social dimension overarches all other recovery dimensions. The integration of an explicit social rhetoric is imperative, including contextual, relational, interactional and societal dimensions. This offers pathways to reverse the traditional, paternalistic model of exclusion and classification.

ii)  Crowther, A., Taylor, A., Toney, R., Meddings, S., Whale, T., Jennings, H., Pollock, K., Bates, P., Henderson, C., Waring, J. and Slade, M. (2019) The impact of Recovery Colleges on mental health staff, services and society.  Epidemiology and Psychiatric Sciences.  28(5) 481-488

https://doi.org/10.1017/S204579601800063X

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)  Woods, A., Hart, A. and Spandler, H. (2019) The recovery narrative: politics and possibilities of a genre.  Culture, Medicine and Psychiatry. Online:

https://doi.org/10.1007/s11013-019-09623-y

Abstract

Recovery is now widely acknowledged as the dominant approach to the management of mental distress and illness in government, third-sector and some peer-support contexts across the United Kingdom and elsewhere in the Anglophone Global North. Although narrative has long been recognised in practice and in policy as a key “technology of recovery,” there has been little critical investigation of how recovery narratives are constituted and mobilised, and with what consequences. This paper offers an interdisciplinary, critical medical humanities analysis of the politics and possibilities of Recovery Narrative, drawing literary theoretical concepts of genre and philosophical approaches to the narrative self into conversation with the critiques of recovery advanced by survivor-researchers, sociologists and mad studies scholars. Our focus is not on the specific stories of individuals, but on the form, function and effects of Recovery Narrative as a highly circumscribed kind of storytelling. We identify the assumptions, lacunae and areas of tension which compel a more critical approach to the way this genre is operationalised in and beyond mental health services, and conclude by reflecting on the possibilities offered by other communicative formats, spaces and practices.

iv)  Cooke, A., Smythea, W. and Anscombe, P. (2019) Conflict, compromise and collusion: dilemmas for psychosocially-oriented practitioners in the mental health system. Psychosis. 11(3) 199-211.

Abstract

The nature and causes of mental health problems are contested. The dominant approach in services views them as “illnesses like any other”. The structure, legislative base and practices of mainstream mental health services are largely predicated on this idea, known variously as the medical, illness, disease or diagnostic model. By contrast, psychosocial theories highlight the role of the events and circumstances of peoples’ lives. The tension between these two approaches can lead to challenges and dilemmas for psychosocially oriented practitioners. Clinical psychologists participated in interviews and a focus group about these challenges and how they managed them. A grounded theory was constructed which suggested that their responses took three forms: openly “dissenting” (conflict), strategically “stepping into” the medical model (compromise), or inadvertently “slipping” into it (colluding). Strategies for managing the challenges included focusing on clients; foregrounding clients’ contexts and understandings; holding the tension between “expert” and “not-knowing” approaches; using ordinary language; forging robust working relationships; being mindful of difference and of constraints on colleagues; recognising one’s power and ability to influence; self-care and work/life balance; taking encouragement from small changes; consolidating a personal philosophy; mutual support and solidarity; drawing on scholarship and finally engaging in activism outside work.

v)  Fowler, D., Hodgekins, J., Berry, C., Clarke, T., Palmier-Claus, J., Sacadura, C., Graham, A., Lowen, C., Steele, A., Pugh, K., Fraser, S., Fitzsimmons, M. and French, P. (2019) Social recovery: a treatment manual.  Psychosis.  11(3) 261-272.

Abstract

Social Recovery Therapy is an individual psychosocial therapy developed for people with psychosis. The therapy aims to improve social recovery through increasing the amount of time individuals spend in meaningful structured activity. Social Recovery Therapy draws on our model of social disability arising as functional patterns of withdrawal in response to early socio-emotional difficulties and compounded by low hopefulness, self-agency and motivation. The core components of Social Recovery Therapy include using an assertive outreach approach to promote a positive therapeutic relationship, with the focus of the intervention on using active behavioural work conducted outside the clinical room and promoting hope, values, meaning, and positive schema. The therapy draws on traditional Cognitive Behavioural Therapy techniques but differs with respect to the increased use of behavioural and multi-systemic work, the focus on the development of hopefulness and positive self, and the inclusion of elements of case management and supported employment. Our treatment trials provide evidence for the therapy leading to clinically meaningful increases in structured activity for individuals experiencing first episode and longer-term psychosis. In this paper, we present the core intervention components with examples in order to facilitate evaluation and implementation of the approach.

In the following article, Ben Gray writes about the experience of a recent hospital admission. He draws attention to the importance and value of personal relationships in the recovery process.

vi)  Gray, B. (2019) Peer support in mental health hospital – a shared experience and journey.  Psychosis.  11(3)  282-283.

Abstract

This paper describes peer support in mental health hospital from a service user’s first person account

vii)  McGranahan, R., Rennick-Egglestone, S., Ramsay, A., Llewellyn-Beardsley, J., Bradstreet, S., Callard, F., Priebe, S. and Slade, M. (2019) Curation of mental health recovery narrative collections: systematic review and qualitative synthesis.  JMIR Mental Health 6(10) e14233

http://mental.jmir.org/2019/10/e14233/

Abstract

Background: Mental health recovery narratives are first-person lived experience accounts of recovery from mental health problems, which refer to events or actions over a period. They are readily available either individually or in collections of recovery narratives published in books, health service booklets, or on the Web. Collections of recovery narratives have been used in a range of mental health interventions, and organizations or individuals who curate collections can therefore influence how mental health problems are seen and understood. No systematic review has been conducted of research into curatorial decision making.

Objective: This study aimed to produce a conceptual framework identifying and categorizing decisions made in the curation of mental health recovery narrative collections.

Methods: A conceptual framework was produced through a systematic review and qualitative evidence synthesis. Research articles were identified through searching bibliographic databases (n=13), indexes of specific journals (n=3), and gray literature repositories (n=4). Informal documents presenting knowledge about curation were identified from editorial chapters of electronically available books (n=50), public documents provided by Web-based collections (n=50), and prefaces of health service booklets identified through expert consultation (n=3). Narrative summaries of included research articles were produced. A qualitative evidence synthesis was conducted on all included documents through an inductive thematic analysis. Subgroup analyses were conducted to identify differences in curatorial concerns between Web-based and printed collections.

Results: A total of 5410 documents were screened, and 23 documents were included. These comprised 1 research publication and 22 informal documents. Moreover, 9 higher level themes were identified, which considered: the intended purpose and audience of the collection; how to support safety of narrators, recipients, and third parties; the processes of collecting, selecting, organizing, and presenting recovery narratives; ethical and legal issues around collections; and the societal positioning of the collection. Web-based collections placed more emphasis on providing benefits for narrators and providing safety for recipients. Printed collections placed more emphasis on the ordering of narrative within printed material and the political context.

Conclusions: Only 1 research article was identified despite extensive searches, and hence this review has revealed a lack of peer-reviewed empirical research regarding the curation of recovery narrative collections. The conceptual framework can be used as a preliminary version of reporting guidelines for use when reporting on health care interventions that make use of narrative collections. It provides a theory base to inform the development of new narrative collections for use in complex mental health interventions. Collections can serve as a mechanism for supporting collective rather than individual discourses around mental health.

Other News

i) The Institute of Mental Health is an established partnership between Nottingham Healthcare NGHS Foundation Trust and the University of Nottingham.  To access their bi-monthly newsletter detailing a range of updates and achievements, including emerging new research areas, please see: 

https://www.institutemh.org.uk/news/newsletters/160-newsletters?highlight=WyJuZXdzbGV0dGVyIl0=

ii) The international Society for Psychological and Social Approached to Psychosis (ISPS) produce an informative e-newsletter containing a wealth of news, including details of forthcoming events.  For more information please see:

http://www.isps.org/index.php/publications/newsletter

iii)  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

Recovery Research Network eBULLETIN

October 2019

RRN Meetings

The 22^nd meeting of the Recovery Research Network (RRN) will be hosted by The University of Bradford. The meeting will focus upon the twin themes of: recovery in context of marginalised communities and critical psychiatry. The agenda for the day is included below:

Date:               Wednesday 27^th November 2019

Time:               09:30 – 16:00

Venue:            The Norcroft Centre

                        University of Bradford

                        Richmond Road

BRADFORD

BD7 1DP

Travel

Venue Information: The event will take place at the main campus of the University of Bradford, in The Norcroft Centre. For directions to the University’s City Campus, please click the following link: http://www.bradford.ac.uk/contact-and-find-us/maps/

Agenda (provisional)

09.30               Refreshments

10.00               Welcome and Introduction to Bradford University

10.15               Introductions

10.30               Hári Sewell – HS Consultancy:  Responsiveness and Resilient  Communities: Supporting Recovery as an act of Resistance

11.15               Jill Hemmington (Senior lecturer) – University of Central Lancashire:  Approved Mental Health Professionals’ Decision-Making:  Communication and Power.

12:00               Break

12.15               Tony Sparkes & Kate Karban – University of Bradford: Recovery and  Social Perspectives in Approved Mental Health Professional (AMHP)  Practice

13.00               Lunch

14.00               Helen Spandler – (Professor of Mental Health Studies) – University of  Central Lancashire:  Reflections on critical approaches to recovery

14.45               Carine van der Boor (Demonstrator and PhD student) – University of  Liverpool:  Mental Health and Well-Being in Refugee and Asylum  Seeking Populations in the UK: A Capabilities Approach

15.30               Meeting close

15.40               RRN Panel Discussion (all invited)

To register for the event, please use the following link:

22^nd meeting of the Recovery Research Network

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

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

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

RRN Membership Profile

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

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

A Call to PhD Students and their Supervisors

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

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

Conferences and Events

i)  Dr Pete Ord and Kate Lucre will be delivering a one-day event entitled:  Compassion Focused Therapy for people with attachment trauma and personality disorder, working at the edge of Therapeutic Opportunity. 

Taken from their description of the event, they write: This one-day event will feature one of the UK’s leading clinicians in CFT for attachment trauma and personality disorder, Kate Lucre. Attendees will be shown the science, clinical applications and latest research findings of Compassion Focused Therapeutic work with people with a personality disorder diagnosis

For further details please see:

CFT for Attachment Trauma and Personality Disorder – 1 day conference

https://www.eventbrite.co.uk/e/compassion-focused-therapy-for-people-with-attachment-trauma-and-personality-disorder-working-at-tickets-58836497548

Papers and Publications

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

i)  Rennick-Egglestone, S., Morgan, K., Llewellyn-Beardsley, J., Ramsay, A., McGranahan, R., Gillard, S., Hui, A., Ng, F., Schneider, J., Booth, S., Pinfold, V., Davidson, L., Franklin, D., Bradstreet, S., Arbour, S. and Slade, M. (2019)  Mental health recovery narratives and their impact on recipients: systematic review and narrative synthesis.  The Canadian Journal of Psychiatry.  64(10) 669-679.

Abstract

Objective: Mental health recovery narratives are often shared in peer support work and anti-stigma campaigns. Internet technology provides access to an almost unlimited number of narratives, and yet little is known about how they affect recipients.  The aim of this study was to develop a conceptual framework characterizing the impact of recovery narratives on recipients.

Method: A systematic review of evidence about the impact of mental health recovery narratives was conducted. Searches used electronic databases (n ¼ 9), reference tracking, hand-searching of selected journals (n ¼ 2), grey literature searching, and expert consultation (n ¼ 7). A conceptual framework was generated through a thematic analysis of included articles, augmented by consultation with a Lived Experience Advisory Panel.

Results: In total, 8137 articles were screened. Five articles were included. Forms of impact were connectedness, understanding of recovery, reduction in stigma, validation of personal experience, affective responses, and behavioural responses. Impact was moderated by characteristics of the recipient, context, and narrative. Increases in eating disorder behaviours were identified as a harmful response specific to recipients with eating disorders.

Conclusions: Mental health recovery narratives can promote recovery. Recovery narratives might be useful for clients with limited access to peers and in online interventions targeted at reducing social isolation in rural or remote locations, but support is needed for the processing of the strong emotions that can arise. Caution is needed for use with specific clinical populations.

ii)  Gray, B. (2019) What it’s like to hear voices and how ‘democratic psychiatry’  can help.  Mental Health Today. Available at: https://www.mentalhealthtoday.co.uk/blog/disorders/what-it-s-like-to-hear-voices-and-how-democratic-psychiatry-can-help

In a recent blog, Dr Ben Gray discusses his personal experience of hospitalisation and peer support.  He writes:

Many of the people, and there have been hundreds, with mental illness who I have talked with both as a patient and as a researcher and academic, tell me that they have had to suppress and hide their voices in order to be considered well, stable, and healthy. Not only is this a suppression of symptoms, but it is also a suppression of people’s personhood. Traditional psychiatry, in this gloomy and pessimistic view, could be argued to be little more than an instrument of social control and of oppression and a system of scientific belief that perhaps unintentionally crushes people’s subjectivity, choices, human rights, and free will.

Dr Gray also goes on to write about the personal, situated meaning that underpins hearing voices and the dearth of empirical work that seeks to better understand this, especially from a social perspective.  Democratic psychiatry is held up as a rallying call for a more inclusive and humane approach to working with people during times of distress.

iii)  Kaminskiy, E. and Finaly, M. (2018) It does take two to tango: an applied conversation analysis of interactions between a psychiatrist and service-users discussing medication. Health Communication.  34(13) 1628-1636

Abstract

Decisions concerning psychiatric medication are complex and often involve a protracted process of trial and error. We examine three recorded meetings for power-sharing and power-taking discourse strategies employed by both the psychiatrist and mental health service-user, when discussing psychiatric medication. We identify examples of good practice, as well as missed opportunities to engage service users in co-constructed dialogue, and highlight that participation and active involvement in decisions is not best seen as a fixed pattern, but is a complex interplay that changes both between and within interactions.

iv)  Public Health England (2019) Children and young people’s mental health: prevention evidence.  PHE.  Available from: https://www.gov.uk/government/publications/children-and-young-peoples-mental-health-prevention-evidence

Published at the end of October 2019, as part of Government guidance on children and young people’s mental health, a number of reports summarise the evidence for the effectiveness of universal approaches to improving children and young people’s mental health and wellbeing.

(For example)

Public Health England (2019) Universal approaches to improving children and young people’s mental health and wellbeing: narrative report of the synthesis of systematic reviews and grey literature review. PHE.

In the above narrative synthesis, interventions were classified in terms of: (a)  outcome and (b) domain.  Four outcome categories include: preventing behavioural difficulties, promoting resilience and capabilities, preventing emotional difficulties and promoting subjective wellbeing.  Three domain categories include: individual, family, school and community.  The narrative synthesis situates each of the three domain categories under the each of the outcome categories.

Other News

i)  In the following interview (with English sub-titles) Marius Romme and Sandra Escher discuss their involvement with voice hearing:

https://www.youtube.com/watch?v=Ie3ktbUCltU

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

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

November 2019

RRN Meetings

The 22^nd meeting of the Recovery Research Network (RRN) met at the University of Bradford last week. Thank you to the University for hosting the event, and thank you to members of the RRN Collective for organising and co-ordinating it.  Presentations were thought provoking, and embraced both conceptual and empirical work on the twin themes of marginalised communities and critical psychiatry.  The final presentation was delivered by members of Bradford Hearing Voices Network, which brought the event to a fitting conclusion.

As with previous meetings, speakers have kindly given permission for their material to be uploaded to the RRN website.  These will be uploaded soon, and may be accessed by following the ink on the left-hand side of the RRN home page:

https://www.researchintorecovery.com/rrn

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

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

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

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

RRN Membership Profile

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

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

A Call to PhD Students and their Supervisors

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

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

Conferences and Events

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

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

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

Venue: The Ridgeway Centre, Featherstone Road

Location: Wolverton

For more information please click here

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

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

Papers and Publications

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

i)  Williams, E., Dingle, G.A., Calligeros, R., Sharman, L. and Jetten, J. (2019) Enhancing mental health recovery by joining arts-based groups: a role for the social cure approach. Arts and Health.  (Online) https://doi.org/10.1080/17533015.2019.1624584

Abstract

Background. Even though emerging evidence suggests that participation in arts-based group programs are helpful in supporting mental health, the field lacks an established theoretical framework. This study explored the extent to which participants’ experiences of singing or creative writing groups aligned with theorising proposed by the social cure approach.

Methods. Semi-structured interviews were conducted with 25 choir members, and 23 creative writing group members with chronic mental health conditions at two time points. Transcripts of the interviews were examined by four coders using thematic analysis.

Results. Consistent with social cure theorising, participation in the choir and creative writing group facilitated meeting participants’ needs for belonging, support, self-efficacy, purpose, and positive emotions.

Conclusions. This study demonstrated the psychosocial mechanisms by which participation in arts-based groups can enhance mental health. We conclude that engagement with the social cure framework may be useful to structure practice in this field.

ii)  Kelly, M. and Coughlan, B. (2019) A theory of youth mental health recovery from a parental perspective.  Child and Adolescent Mental Health.  24(2)  161-169.

Abstract

Background: Mental health disorders have a negative impact on the individual, society and global economy. The prevalence of mental disorders is increasing in young people, if unaddressed, they may develop into severe and chronic illnesses. Despite this, research into youth mental health recovery is limited. The current study aims to develop a theoretical framework of recovery in youth mental health and identify what facilitates this process.

Methods: Fourteen parents of children engaged with the Child and Adolescent Mental Health Service were interviewed in relation to their understanding of youth mental health recovery. The transcripts of these interviews were analysed using the constructivist grounded theory approach.

Results: A theoretical model of youth mental health was developed. The model provides an understanding of (a) the characteristics of youth mental health recovery, (b) the facilitators of recovery and (c) the barriers to recovery. The theory suggests that due to developmental factors youth mental health recovery occurs within the ecological context of complex social systems.

Conclusions: The theory reflects elements of existing developmental and recovery research and provides a novel understanding of youth mental health recovery. This model may inform social, government and service attitudes and policy, and highlights areas for future research

iii) Hui, A., Stickley, T., Stubley, M. and Baker, F. (2019)  Project eARTh: participatory arts and mental health recovery, a qualitative study.  Perspectives in Public Health.  139(6)  296 – 302.

Abstract

Aims: To identify the potential mental health benefits of a rural-based participatory arts programme in the United Kingdom.

Methods: Fourteen narrative interviews were conducted among participants of the Project eARTh programme. The data were subjected to a thematic analysis process.

Results: Three overarching themes were identified: identity and self-expression; connectedness through occupation; wellbeing and personal growth. The importance of meaningful relationships was highlighted as preventing social isolation, particularly in rural locations. Engagement in artistic group activities enable participants to connect with their communities.

Conclusions: Artistic activities help people to develop friendships and to engage with local communities in rural locations. Connectedness to people and places were valued by participants as part of their personal growth. The groups empower people to experience increased confidence and identities beyond illness narratives. Artistic group activities can benefit the mental health of participants in rural locations.

iv)  Normsa Sandra Wayland has kindly shared details of a study that she conducted as part of her MSC in Psychology.  Sandra writes:

Title:

“It is l like a two-way street as opposed to a one way”: A Phenomenological Exploration of the lived experience of individuals who participate in a recovery college as a therapeutic intervention for mental health recovery.

This qualitative, interview-based study examined Recovery College (RC) participants’ lived experiences in the form of mental ill-health intervention for mental health recovery. The University of East London provided ethical approval for the research. The study took place at REACH Recovery College (RRC) (South Essex – Rochford), which offers a curriculum of recovery-oriented educational courses. The college was opened five years ago, it utilises a holistic approach providing sustainable resources for individuals and the community, delivering multi-outcomes and benefits such as health and education, employment, and community cohesion. REACH Recovery College cater for adults aged 16 and above who live in the area and have mild/moderate or severe mental health challenges including their careers, relatives, friends, or the staff of partner organisations. The purpose of the research was to raise awareness, understanding, and knowledge of the alternative community approach in facilitating the recovery of individuals with mental ill-health. An Interpretative Phenomenological Analysis (IPA) was adopted as a methodological approach, and four superordinate themes emerged: 1. Normalising and De-stigmatising environment, 2. Value of co-production and the challenges in power dynamics, 3. Social benefits: a sense of connectedness with those sharing similar experiences, 4. Sense of new identity. Three males and three females between the ages of 35 to 65 attending the RRC were interviewed to gather their experiences of participating at the College and its influence on their mental ill-health. Furthermore, the research wall was utilised to enrich the data collected through interview, where participants anonymously displayed their responses.

A RC is an organisation that takes an educational approach to create an environment whereby individuals with mental health/illness challenges feel safe, accepted, and welcomed (Lucchi, Chiaf, Placentino, & Scarsato, 2018; Meddings, et al., 2015; Perkins & Slade, 2012; Meddings, Guglietti, Lambe, & Byrne, 2014). It is an important feature of the RC approach that the individuals seeking support are not labelled by the college and so the distinction between mental health and illness is not drawn by the college but may be an identity that participants bring with them. This is one of several unresolved ambiguities in identity and relations to be found in the RC approach and interpretation of co-production

Co-productive approaches to mental health service design and delivery are critical of differences in power and authority of professionals and clients and seek to create parity between service users and providers. Part of this strategy focusses on the distribution of power in the processes of participants being identified. Consequently, co-productive approaches often introduce new forms of language that entail ambiguities in identity and instabilities in relations of authority and power. Where the recovery college approach acknowledges these ambiguities, they are often constructed as “blurred boundaries” that are potentially productive and a source of change, growth, and development for all participants, including those employed by the college.

Conclusion

The data collected is broadly supportive of the RRC’s representation of itself and consistent with ideas about RCs in general, as found in the research literature reviewed. Although there have been minimal randomised control trials in this field, the current study and other studies drawing on an array of methodological approaches propose that recovery-based interventions can have a variability of positive benefits for people with mental ill-health, as an adjunct to existing mainstream models. However, it is important to acknowledge that there are unresolved ambiguities and tensions in the identities of participants in the RRC and these are occasionally associated with complexities of power, authority, and status. Where these are productive, they are part of a process of development and change. Part of this process seems to be rooted in experiences of frustration that are not obviously empowering in and of themselves. However, when this sense of frustration is located in a more extensive developmental process, it becomes clearer that it can be a necessary transitional experience.

The RRC is the site of competing and occasionally conflicting knowledge claims about what is productive of recovery. However, the resolution of these conflicts is not as immediately pressing as the research question had supposed. Before engaging with participants and the RRC staff, it had been imagined that participants with limited insight into their own interests would come into conflict with professionals who intervene in those interests. However, the RRC is rarely the site of such widely divergent interpretations of what is good for a person. Rather, participants who reject the interpretation of their situation offered by staff and other participants are free to withdraw or engage in other RRC activities. Staff do not intervene but are more inclined to give space and time to the participant so that they can discover what might work for them. This is analogous to the wait, watch and wonder strategy advocated by Muir, Lojkasek, & Cohen, (1999) which invests in spontaneous creative activity as a source of material for therapeutic engagement.

Other News

i)  Dr Michelle Funk (Coordinator, Mental Health Policy and Service Development) at the World Health Organisation, writes

We are pleased to inform you that today we have launched key WHO materials, tools and a country implementation portal as part of the WHO QualityRights programme.

These aim to transform mental health and social care systems and services towards a person-centered, recovery-oriented and human rights-based approach in line with the Convention on the Rights of Persons with Disabilities – this is the vision called for by Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization – in the Foreword to the QualityRights materials.

Please see the following links:

QualityRights materials and tools – https://www.who.int/publications-detail/who-qualityrights-guidance-and-training-tools

QualityRights self-help recovery tool for mental health and well-being – https://www.who.int/publications-detail/who-qualityrights-self-help-tool

QualityRights country implementation portal – https://qualityrights.org/

WHO’s Feature story on WHO QualityRights – https://www.who.int/news-room/feature-stories/detail/mental-health-services-in-lebanon-an-approach-focused-on-recovery

Video: QualityRights in Lebanon – a personal perspective – https://qualityrights.org/wp-content/uploads/WHO-Mental-Health.mp4

We would be grateful if you can join our efforts to disseminate all the QualityRights materials, tools, portal  and social media posts (which will be visible at the following links https://twitter.com/WHO; https://www.instagram.com/who/?hl=en) as widely as possible through your networks including government stakeholders and non-state actors with whom you have contact in your country.

We are also happy to announce that we have moved on to a new phase of  large-scale, country-wide implementation of WHO QualityRights. This has been made possible through the leadership of Ministries of Health in collaboration with people with lived experience, professional groups, practitioners, NGOs, Organizations of Persons with Disabilities, and the support of WHO regional and country offices.

During 2019, high-level launches will have taken place in Ghana, Philippines, Kenya, Turkey, Estonia and Czechia.  QualityRights activities are also continuing in Lebanon, Armenia, Bosnia and Herzegovina, Romania, Slovakia, Croatia and Lithuania, with more launches scheduled for next year. More information about implementation can be found on the QualityRights country implementation portal https://qualityrights.org/.

ii)  Ashleigh Charles, a research worker from the School of Health Science, University of Nottingham contacted the RRN with the following request:

I work in the Recovery Research team in Nottingham led by Prof Mike Slade (University of Nottingham), and as a research worker on the international UPSIDES Study of peer support work led by Prof Bernd Puschner (University of Ulm). I am e-mailing to ask if it is possible to advertise our Delphi Consultation on the next e-bulletin please. Below is some information about the study:

The aim of the study is to inform the content of initial training programmes for peer support workers. The objectives are: (1) to identify the training which needs to be covered in initial mental health peer support work training; (2) to identify the degree of consensus that exists in relation to the training components (2a) overall, (2b) between peer support workers and their managers, and 2(c) between high and low income country experts; and (3) to identify training components which can be delivered online. The Delphi consultation will consist of 3-4 rounds of questions conducted online, and we hope to gather input from peer support workers, peer support work researchers, and supervisors/managers of peer support work from around the world. If you are interested in participating or would like further information about the study then please click here for more information.

Ashleigh also adds…

Peer support workers (PSWs) are individuals with lived experience of mental health problems/and or mental health services who are employed in a peer support capacity. The engagement of PSWs or peer providers has increased worldwide. This has resulted in benefits to peer recipients, peer providers, and to mental health service systems. Recently, guidelines, supervision, training and credentialing have been introduced to the mental health peer support workforce leading to the emergence of formal or intentional mental health peer support alongside the naturally occurring or informal peer support. However, there is no consensus about PSW core training topics specifically designed for the mental health peer support worker role.

Ashleigh can be contacted on:

Ashleigh.Charles@nottingham.ac.uk

iii)  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

Recovery Research Network eBULLETIN

December 2019

RRN Meetings

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

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

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

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

RRN Membership Profile

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

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

A Call to PhD Students and their Supervisors

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

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

Conferences and Events

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

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

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

Venue: The Ridgeway Centre, Featherstone Road

Location: Wolverton

For more information please click here

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

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

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

ISPS UK Conference

United Kingdom Friday, 24 January 2020 London

“Children, Young People and Psychosis: beyond Early Intervention”

Tickets are available here and more information is also on the ISPS UK website

ISPS Norway Conference

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

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

Further information (in Norwegian)

ISPS Suomi Conference

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

“Psychosis 2020”

Keynote speakers include Jan Olav Johannessen and Amy Hardy

Further information (in Finnish)

ISPS Perugia 2021

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

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

www.isps2021.it

Papers and Publications

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

i)  Bartram, M. (2019). Toward a shared vision for mental health and addiction recovery and well-being: an integrated two-continuum model. Journal of Recovery in Mental Health.  2(2-3) 55-72.

Retrieved from: 

https://jps.library.utoronto.ca/index.php/rmh/article/view/32749

Introduction

Recovery is a key concept driving system transformation in both the addiction and mental health sectors, with shared roots in advocacy and a shared focus on hope in the face of stigma, self-determination, and meaningful lives.¹ Nevertheless, while cure is generally not thought to be necessary for mental health recovery, addiction recovery is generally thought to start with abstinence. To the extent that cure, as the cessation of mental illness, is analogous with abstinence, as the cessation of addiction, this difference creates a disconnect between how recovery is conceptualized in the two sectors. While this difference has grown narrower with the growing integration of harm reduction into the addictions field and with the growing integration of the mental health and addictions sectors more broadly, the disconnect remains strong enough to undermine coherence at the policy level. Mental health policies use recovery in one way and addiction policies use it in another, or the term is used interchangeably without acknowledging important conceptual differences.

The lack of coherence at the policy level is particularly problematic given the central place of recovery in articulating and driving the vision for transformation in both the mental health and addictions sectors. At the service delivery level, conceptual confusion regarding recovery exacerbates the fragmentation between mental health and addictions services that is already concerning, particularly in light of shared risk and protective factors for mental health and substance use problems and high rates of concurrent disorders.² Among Canadians with mental health or substance use disorders an estimated 15–20% have both concurrently.³

This paper examines the potential for harm reduction, as an alternative to an abstinence-only model of addiction recovery, to bridge the conceptual differences with mental health recovery. Further, this paper considers whether integrating substance use and harm reduction into a two-continuum model of recovery and well-being that was developed in the mental health sector⁴ can bridge the conceptual differences between addiction recovery and mental health recovery, and in so doing clear a path toward a shared vision for recovery and well-being.

ii)  Ng, F., Charles, A., Pollock, K., Rennick-Egglestone, S., Cuijpers, P., Gillard, S., van der Krieke, L., Bongaardt, R., Pomberth, S., Repper, J., Roe, J., Llewellyn-Beardsley, J., Yeo, C., Hui, A., Hare-Duke, L., Manley, D. and Slade, M. (2019)  The mechanisms and processes of

connection: developing a causal chain model capturing impacts of receiving recorded mental health recovery narratives.  BMC Psychiatry.  19:413.  1-15. Online:

https://link.springer.com/article/10.1186/s12888-019-2405-z

Abstract

Background: Mental health recovery narratives are a core component of recovery-oriented interventions such as peer support and anti-stigma campaigns. A substantial number of recorded recovery narratives are now publicly available online in different modalities and in published books. Whilst the benefits of telling one’s story have been investigated, much less is known about how recorded narratives of differing modalities impact on recipients. A previous qualitative study identified connection to the narrator and/or to events in the narrative to be a core mechanism of change. The factors that influence how individuals connect with a recorded narrative are unknown. The aim of the current study was to characterise the immediate effects of receiving recovery narratives presented in

a range of modalities (text, video and audio), by establishing the mechanisms of connection and the processes by which connection leads to outcomes.

Method: A study involving 40 mental health service users in England was conducted. Participants were presented with up to 10 randomly-selected recovery narratives and were interviewed on the immediate impact of each narrative. Thematic analysis was used to identify the mechanisms of connection and how connection leads to outcome.

Results: Receiving a recovery narrative led participants to reflect upon their own experiences or those of others, which then led to connection through three mechanisms: comparing oneself with the narrative and narrator; learning about other’s experiences; and experiencing empathy. These mechanisms led to outcomes through three processes: the identification of change (through attending to narrative structure); the interpretation of change (through attending to narrative content); and the internalisation of interpretations.

Conclusions: This is the first study to identify mechanisms and processes of connection with recorded recovery narratives. The empirically-based causal chain model developed in this study describes the immediate effects on recipients. This model can inform selection of narratives for use in interventions, and be used to support peer support workers in recounting their own recovery narratives in ways which are maximally beneficial to others.

iii)  Rennick-Egglestone, S., Ramsay, A., McGranahan, R., Llewellyn-Beardsley, J., Hui, A., Pollock, K., Repper, J., Yeo, C., Ng, F., Roe, J., Gillard, S., Thornicroft, G., Booth, S., Slade, M. (2019) The impact of mental health recovery narratives on recipients experiencing mental health problems: Qualitative analysis and change model.  PLoS ONE. 14(12): e0226201

https://doi.org/10.1371/journal.pone.0226201

Abstract

Background: Mental health recovery narratives are stories of recovery from mental health problems. Narratives may impact in helpful and harmful ways on those who receive them. The objective of this paper is to develop a change model identifying the range of possible impacts and how they occur.

Method: Semi-structured interviews were conducted with adults with experience of mental health problems and recovery (n = 77). Participants were asked to share a mental health recovery narrative and to describe the impact of other people’s recovery narratives on their own recovery. A change model was generated through iterative thematic analysis of transcripts.

Results: Change is initiated when a recipient develops a connection to a narrator or to the events descripted in their narrative. Change is mediated by the recipient recognising experiences shared with the narrator, noticing the achievements or difficulties of the narrator, learning how recovery happens, or experiencing emotional release. Helpful outcomes of receiving recovery narratives are connectedness, validation, hope, empowerment, appreciation, reference shift and stigma reduction. Harmful outcomes are a sense of inadequacy, disconnection, pessimism and burden. Impact is positively moderated by the perceived authenticity of the narrative, and can be reduced if the recipient is experiencing a crisis.

Conclusions: Interventions that incorporate the use of recovery narratives, such as peer support, anti-stigma campaigns and bibliotherapy, can use the change model to maximise benefit and minimise harms from narratives. Interventions should incorporate a diverse range of narratives available through different mediums to enable a range of recipients to connect with and benefit from this material. Service providers using recovery narratives should preserve authenticity so as to maximise impact, for example by avoiding excessive editing.

iv) Ostrow, L., Croft, B., Weaver, A. and Naeger, S. (2019) An exploratory analysis of the role of social supports in psychiatric medication discontinuation: results related to family involvement. Psychosis.  11(3)  212-222

https://www.tandfonline.com/doi/abs/10.1080/17522439.2019.1615110

Abstract

Objective: Individuals in psychiatric treatment frequently choose to stop taking psychiatric medications, but little is known about the role of social supports in this process.

Methods: This service user-led study of 194 adults who sought to completely discontinue prescribed psychiatric medications explores the role of various groups that may be a source of social support. Respondents who attempted to discontinue medication completed a web survey. We conducted bivariate and multivariate analyses to explore the relationship of social support to discontinuation.

Results: Of all social support groups, only family was significantly associated with medication discontinuation. Respondents who rated family as helpful in the discontinuation process were less likely to completely discontinue than those who rated family as unhelpful or who reported no family involvement. Additionally, we observed a statistically significant but nonlinear relationship where respondents who rated their families as either “very supportive” or “very unsupportive” of the decision to discontinue were less likely to meet their original discontinuation goal than those with more neutral ratings.

Discussion: The results of this study suggest families have an important and complex role in medication decision-making. Efforts to improve the quality of social networks should include family, as should future research.

v)  Beresford, P. (2019) ‘Mad’, Mad studies and advancing inclusive resistance.  Disability and Society.  Online:

https://www.tandfonline.com/doi/full/10.1080/09687599.2019.1692168

Abstract

‘Mad’ is a contentious term with which many service users/survivors feel uncomfortable. Yet it is the framework for a major new user-led challenge to bio-medical thinking about distress – Mad Studies – which is coming in for criticism for this and other identified shortcomings. Why has it adopted this controversial, conflict-ridden title? This article will explore current criticisms and raise the question of what Mad Studies’ strategy should be to address them for the future?

vi)  Puschner, B., Repper, J., Mahlke, C., Nixdorf, R., Basangwa, D., Nakku, J., Ryan, G., Baillie, D., Shamba, D., Ramesh, M., Moran, G., Lachmann, M., Kalha, J., Pathare, S., Müller-Stierlin, A. and Slade, M., (2019) Using Peer Support in Developing Empowering Mental Health Services (UPSIDES): Background, Rationale and Methodology. Annals of Global Health.  85(1) 53, 1-10. Online:

https://doi.org/10.5334/aogh.2435

Abstract

Background: Peers are people with lived experience of mental illness. Peer support is an established intervention in which peers offer support to others with mental illness. A large proportion of people living with severe mental illness receive no care. The care gap is largest in low- and middle-income countries, with detrimental effects on individuals and societies. The global shortage of human resources for mental health is an important driver of the care gap. Peers are an under-used resource in global mental health.

Objectives: To describe rationale and methodology of an international multicentre study which will scale-up peer support for people with severe mental illness in high-, middle-, and low-income countries through mixed-methods implementation research.

Methods: UPSIDES is an international community of research and practice for peer support, including peer support workers, mental health researchers, and other relevant stakeholders in eight study sites across six countries in Europe, Africa, and Asia. During the first two years of UPSIDES, a series of qualitative studies and systematic reviews will explore stakeholders’ perceptions and the current state of peer support at each site. Findings will be incorporated into a conceptual framework to guide the development of a culturally appropriate peer support intervention to be piloted across all study sites. All intervention and study materials will be translated according to internationally recognised guidelines.

Expected Impact: UPSIDES: will leverage the unique expertise of people with lived experience of mental illness to strengthen mental health systems in high-, middle- and low-income countries. UPSIDES will actively involve and empower service users and embed patient-centeredness, recovery orientation, human rights approaches, and community participation into services. The focus on capacity-building of peers may prove particularly valuable in low-resource settings in which shortages of human capital are most severe.

Other News

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

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk