Recovery Research Network (RRN)

Recovery Research Network eBULLETIN

May 2020

RRN Meetings

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

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

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

Coronavirus and Mental Health

The impact of coronavirus, and government measures to restrict its transmission, means that we have to pay particular attention to our mental health and wellbeing.  There is a considerable amount of advice and information available online.  In this edition, we have included some examples at the end of the ebulletin.

RRN Membership Profile

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

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

A Call to PhD Students and their Supervisors

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

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

Conferences and Events 

In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world.  As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

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

Papers and Publications 

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

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

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

Abstract

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

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

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

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

https://doi.org/10.1017/S2045796019000234

Abstract

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

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

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

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

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

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

Abstract

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

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

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

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

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

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

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

Abstract

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

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

Abstract

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

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

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

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

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

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

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

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

https://doi.org/10.1080/17522439.2020.1742198

Abstract

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

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

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

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

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

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

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

Other News / Resources

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

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

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

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

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

iii)  Recovery stories

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

RRN members can help us in two ways:

1.     Recruitment and participation

The NEON Trial is currently recruiting people who:

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

2.     Promotion of the Trial

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

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

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

iii)  Coronavirus and Mental Health (information)

The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19.  It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation

Gov.uk

Social Care Institute for Excellence

Centre for Mental Health

Mental health Foundation

Mind

Rethink

Carers UK

National Service User Network

British Psychological Society

British Association of Social Workers

Royal College of Psychiatrists

Royal college of Nursing

Royal College of Occupational Therapists

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

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

June 2020

RRN Meetings

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

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

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

Coronavirus and Mental Health

The impact of coronavirus, and government measures to restrict its transmission, means that we have to pay particular attention to our mental health and wellbeing.  There is a considerable amount of advice and information available online.  In this edition, we have included some examples at the end of the ebulletin.

RRN Membership Profile

Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:  https://www.researchintorecovery.com/rrn  If you would like to leave the RRN and have your details removed from our database, please email:  researchintorecovery@nottingham.ac.uk

A Call to PhD Students and their Supervisors

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

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

Conferences and Events 

In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world.  As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

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

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

Papers and Publications 

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

i)  Mazor, Y., Gelkopf, M., and Roe, D. (2020). Posttraumatic growth in psychosis: Challenges to the assumptive world. Psychological Trauma: Theory, Research, Practice, and Policy, 12(1) 3–10.

https://doi.org/10.1037/tra0000443

Abstract

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

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

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

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

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

Disorders.  Online, 18th May 2020

https://doi.org/10.1080/10640266.2020.1740912

Abstract

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

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

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

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

Abstract

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

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

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

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

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

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

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

Abstract

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

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

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

https://doi.org/10.1080/23303131.2020.1767744

Abstract

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

Other News / Resources

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

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

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

ii)  Recovery stories

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

RRN members can help us in two ways:

1.     Recruitment and participation

The NEON Trial is currently recruiting people who:

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

2.     Promotion of the Trial

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

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

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

iii)  Coronavirus and Mental Health (information)

The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19.  It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation

Gov.uk

Social Care Institute for Excellence

Centre for Mental Health

Mental health Foundation

Mind

Rethink

Carers UK

National Service User Network

British Psychological Society

British Association of Social Workers

Royal College of Psychiatrists

Royal college of Nursing

Royal College of Occupational Therapists

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

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN 

August 2020 

RRN Meetings 

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

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

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

 Coronavirus and Mental Health 

The impact of coronavirus, and government measures to restrict its transmission, means that we have to pay particular attention to our mental health and wellbeing.  There is a considerable amount of advice and information available online.  In this edition, we have included some examples at the end of the ebulletin.

 RRN Membership Profile 

Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:  https://www.researchintorecovery.com/rrn  If you would like to leave the RRN and have your details removed from our database, please email:  researchintorecovery@nottingham.ac.uk

 A Call to PhD Students and their Supervisors 

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

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

 Conferences and Events  

In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world.  As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

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

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

 Papers and Publications  

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

i)  Llewellyn-Beardsley, J., Skye, B., Rennick-Egglestone, S., Ng, F., Roe, J., Hui, A., Franklin, D., Deakin, E., Hare-Duke, L. and Slade, M. (2020) INCRESE: Development of an inventory to characterize recorded mental health recovery narratives.  Journal of Recovery in Mental Health 3(2) 25-44. 

Abstract 

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

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

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

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

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

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

Abstract 

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

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

Abstract 

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

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

Abstract 

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

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

Abstract 

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

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

Other News / Resources 

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

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

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

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

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

iii)  Recovery stories

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

RRN members can help us in two ways:

1.     Recruitment and participation

The NEON Trial is currently recruiting people who:

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

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

2.     Promotion of the Trial

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

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

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

iv)  Coronavirus and Mental Health (information)

The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19.  It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation

Gov.uk

Social Care Institute for Excellence

Centre for Mental Health

Mental health Foundation

Mind

Rethink

Carers UK

National Service User Network

British Psychological Society

British Association of Social Workers

Royal College of Psychiatrists

Royal college of Nursing

Royal College of Occupational Therapists

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

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

September 2020

RRN Meetings

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

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

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

Coronavirus and Mental Health

The impact of coronavirus, and government measures to restrict its transmission, means that we have to pay particular attention to our mental health and wellbeing.  There is a considerable amount of advice and information available online.  In this edition, we have included some examples at the end of the ebulletin.

RRN Membership Profile

Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:  https://www.researchintorecovery.com/rrn  If you would like to leave the RRN and have your details removed from our database, please email:  researchintorecovery@nottingham.ac.uk

A Call to PhD Students and their Supervisors

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

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

Conferences, Events and Calls for Papers

In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world.  As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.

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

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

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

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

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

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

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

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

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

Papers and Publications

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

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

https://doi.org/10.1080/17522439.2020.1803954

Abstract

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

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

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

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

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

https://doi.org/10.1080/17522439.2020.1784257

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

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

https://doi.org/10.1080/17522439.2020.1801817

Abstract

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

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

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

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

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

https://doi.org/10.1080/17522439.2020.1798492

Abstract

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

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

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

https://doi.org/10.1080/17522439.2020.1817138

Abstract

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

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

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

Abstract

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

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

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

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

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

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

Other News / Resources

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

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

ii)  Recovery stories

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

RRN members can help us in two ways:

1. Recruitment and participation

The NEON Trial is currently recruiting people who:

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

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

1. Promotion of the Trial

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

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

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

iii)  Coronavirus and Mental Health (information)

The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19.  It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation

Gov.uk

Social Care Institute for Excellence

Centre for Mental Health

Mental health Foundation

Mind

Rethink

Carers UK

National Service User Network

British Psychological Society

British Association of Social Workers

Royal College of Psychiatrists

Royal college of Nursing

Royal College of Occupational Therapists

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

Shula:              s.ramon@herts.ac.uk

Tony:               a.sparkes@bradford.ac.uk

Recovery Research Network eBULLETIN

October 2020

 A new format for the RRN e-bulletin
From October 2020 our monthly e-bulletin will be sent out via Mailchimp. As you may have seen already, the RRN website has been refreshed, and a simplified joining form is available here. An option of viewing the e-bulletin via a browser is also possible.

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

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

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk

Coronavirus and Mental Health
The impact of coronavirus, and government measures to restrict its transmission, means that we have to pay particular attention to our mental health and wellbeing. There is a considerable amount of advice and information available online. In this edition, we have included some examples at the end of the e-bulletin.

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

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

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

Conferences, Events and Calls for Papers
In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world.  As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.  

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

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

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

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

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

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

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

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

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

Papers and Publications

In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin 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.

10. i)  Daley, S., Slade, M., Dewey, M. and Banerjee, S. (2020)  A feasibility study of the effects of implementing a staff-level recovery-oriented training intervention in older people’s mental health services. Aging & Mental Health. 24(11) 1926-1934
    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.

589731. ii)  Roe. J., Brown, S., Yeo, C., Rennick-Egglestone, S., Repper, J., Ng, F., Llewelyn-Beardsley, J., Hui, A., Cuijpers, P., Thornicroft, G., Manley, D., Pollock, K. and Slade, M. (2020) Opportunities, Enablers, and Barriers to the Use of Recorded Recovery Narratives in Clinical Settings. Psychiatry 11:589731.
        https://doi.org/10.3389/fpsyt.2020.589731

Abstract
Background: Recorded Recovery Narratives (RRNs) describing first-person lived experience accounts of recovery from mental health problems are becoming more available. Little is known about how RRNs can be used in clinical practice and clinical education.
Aims: The aim of this paper is to enable implementation planning for RRN interventions by identifying determinants of uptake. The objective was to identify opportunities, barriers, and enablers to the uptake of RRN interventions in clinical practice and education.
Method: Three phases of focus groups were conducted with multi-professional mental health clinicians. Phase 1 (4 groups, n = 25) investigated current and possible uses of RRNs, Phase 2 (2 groups, n = 15) investigated a specific intervention delivering recovery narratives. Phase 3 (2 groups, n = 12) investigated clinical education uses. Thematic analysis was conducted.
Results: RRNs can reinforce the effectiveness of existing clinical practices, by reducing communication barriers and normalizing mental health problems. They can also extend clinical practice (increase hope and connection, help when stuck). Clinical considerations are the relationship with care pathways, choice of staff and stage of recovery. In educational use there were opportunities to access lived experience perspectives, train non-clinical staff and facilitate attitudinal change. Barriers and enablers related to design (ability to use online resources, accessibility of language, ability to individualize choice of narrative), risk (triggering content, staff skills to respond to negative effects), trust in online resource (evidence base, maintenance), and technology (cost of use, technology requirements).
Conclusions: RRNs can both improve and extend existing clinical practice and be an important educational resource. RRNs can improve engagement and hope, and address internalized stigma. Beneficially incorporating RRNs into clinical practice and education may require new staff skills and improved technological resources in healthcare settings. Future work could focus on the use of peer support workers views on RRN use and how to avoid unnecessary and unhelpful distress.

iii)  Stuart, R., Akther, S.F., Machin, K., Persaud, K., Simpson, A., Johnson, S., and Oram, S. (2020) Carers’ experiences of involuntary admission under mental health legislation: systematic review and qualitative meta-synthesis.  BJPsych Open.  6, e19, 1–9.
https://doi.org/10.1192/bjo.2019.101

Abstract
Background:  Carers are key providers of care and support to mental health patients and mental health policies consistently mandate carer involvement. Understanding carers’ experiences of and views about assessment for involuntary admission and subsequent detention is crucial to efforts to improve policy and practice.
Aims:  We aimed to synthesise qualitative evidence of carers’ experiences of the assessment and detention of their family and friends under mental health legislation.
Method:  We searched five bibliographic databases, reference lists and citations. Studies were included if they collected data using qualitative methods and the patients were aged 18 or older; reported on carer experiences of assessment or detention under mental health legislation anywhere in the world; and were published in peer-reviewed journals. We used meta-synthesis.
Results:  The review included 23 papers. Themes were consistent across time and setting and related to the emotional impact of detention; the availability of support for carers; the extent to which carers felt involved in decision-making; relationships with patients and staff during detention; and the quality of care provided to patients. Carers often described conflicting feelings of relief coupled with distress and anxiety about how the patient might cope and respond. Carers also spoke about the need for timely and accessible information, supportive and trusting relationships with mental health professionals, and of involvement as partners in care.
Conclusions:  Research is needed to explore whether and how health service and other interventions can improve the involvement and support of carers prior to, during and after the detention of family members and friends.

iv)  Kumari, V. (2020)  Emotional abuse and neglect: time to focus on prevention and mental health consequences.  The British Journal of Psychiatry. 217, 597–599
https://doi.org/10.1192/bjp.2020.154

Summary
Emotional abuse and emotional neglect are among the most prevalent of childhood maltreatment types and associated with a range of poor mental health outcomes.  We need to move beyond correlational research and shift our focus to sophisticated multimodal studies to fully understand the psychobiological mechanisms underlying these associations and to intervention.

v)  Hornstein, G.A., Robinson Putnam, E. and Branitsky, A. (2020) How do hearing voices peer-support groups work? A three-phase model of transformation, Psychosis. 12(3)  201-211.
https://doi.org/10.1080/17522439.2020.1749876

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

Other News / Resources

i)  Writing out of the Salomons Institute for Applied Psychology at Canterbury Christ Church University, Dr Sue Holttum contacted the Network to advise about the publication of new guidelines from the British Association of Art Therapists’ (BAAT) on art therapy for people with a psychosis-related diagnosis.

Dr Holttum Writes:
I am a member of Research-into-Recovery, and psychologist with experience of mental health difficulties and working with clinical psychology trainees and art therapists, and regularly doing research involving service user consultation and input.

I wanted to let you know about the British Association of Art Therapists’ (BAAT) publication of new guidelines on art therapy for people with a psychosis-related diagnosis. It would be great if you could feature the BAAT Guidelines in the next Research-into-Recovery email circular. They are evidence-based and we had significant input from art therapy service users in its development. Part 1 also features artworks submitted by service users.  The document has a Creative Commons licence, which means it can be circulated widely without special permission. You could embed the link to the document in your newsletter/ regular email circular to your members. 

Direct link to the guidelines:  
https://www.baat.org/Assets/Docs/General/BAAT%20Guidelines%20AT%20Psychosis%20PART%201-2-3.pdf

We have also prepared a brief online questionnaire for (a) mental health professionals and (b) service users and members of the public to offer feedback on The Guidelines, which can be completed anonymously, and links to these could be circulated at the same time:   

Short questionnaire for mental health professionals: Go to survey
Short questionnaire for service users and members of the public: Go to survey(members of the public)  

The survey has undergone ethical scrutiny at my university and received full approval 

There is a limited supply of print copies, and if any member would like one of these with a paper version of the questionnaire and pre-paid return envelope for someone who would have difficulty reading and responding online, they could be invited to contact me.

Dr Holttum can be contacted on:  holttum@canterbury.ac.uk

ii)  Led by Rai Waddingham, The National Survivor User Network (NSUN) is currently co-ordinating a mapping exercise on the subject of Lived Experience Leadership.  To find out more about this initiative, please see:
https://www.nsun.org.uk/lived-experience-leadership

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

RRN members can help us in two ways:

1.  Recruitment and participation
The NEON Trial is currently recruiting people who:-

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

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

2.  Promotion of the Trial.  Would you help us to promote the NEON Trial through your networks? You can use any of the publicity materials available at www.researchintorecovery.com/neontrials/promotion or just tweet:
Can real-life mental health recovery stories help you with your own mental health? Access hundreds of recovery stories in the NEON Trial. Help researchers @InstituteMH understand the benefits of accessing other people’s recovery narratives. See recoverystories.uk

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

iv)  Coronavirus and Mental Health (information)
The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19.  It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation
Gov.uk
Social Care Institute for Excellence
Centre for Mental Health
Mental health Foundation
Mind
Rethink
Carers UK
National Service User Network
British Psychological Society
British Association of Social Workers
Royal College of Psychiatrists
Royal college of Nursing
Royal College of Occupational Therapists

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

A new format for the RRN e-bulletin
From October 2020 our monthly e-bulletin will be sent out via Mailchimp. As you may have seen already, the RRN website has been refreshed, and a simplified joining form is available here. An option of viewing the e-bulletin via a browser is also possible.

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

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

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula: s.ramon@herts.ac.uk
Tony: a.sparkes@bradford.ac.uk

Coronavirus and Mental Health
The impact of coronavirus, and government measures to restrict its transmission, means that we have to pay particular attention to our mental health and wellbeing. There is a considerable amount of advice and information available online. In this edition, we have included some examples at the end of the e-bulletin.

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

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

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

Conferences, Events and Calls for Papers
In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world.  As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.  

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

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

iii)  A call for papers has been expressed by:  Advances in Mental Health: Promotion, prevention and early intervention.

Title for the Special issue: Peer support in mental health services
Internationally the past decade has seen a burgeoning of lived experience, peer support services often driven by changes in mental health workforce policy. This special issue will focus on research on peer support for consumers and/or carers, in mental health, Alcohol and other Drugs and gambling services.  This issue is particularly interested in gaining an international perspective on peer support. Quantitative, qualitative, mixed methods and systematic review studies will be considered. We welcome publications that report consumer-  or carer-led research and are authored or co-authored by peer support workers.  It is expected that the special issue will be published in Nov 2021.

Process for submission:
1.  Abstracts of 200-250 words due 31 January 2021. Please email these directly to Dr Kitty Vivekananda at Kitty.Vivekananda@monash.edu.au
We will inform you by 12 February, 2021  if your abstract has been accepted to submit a full copy of the article.

2.  Full manuscripts of no more than 5000 words  due 11 April 2021.  We will encourage authors to make accepted manuscripts available via a pre-print server so that research is as accessible as possible to the peer support community.

Please contact the Editors of the special issue Kitty Vivekananda if you have any queries about a potential submission.

Submission guidelines: 
Please refer to the Taylor and Francis website for submission guidelines for the journal:
http://www.tandfonline.com/action/authorSubmission?journalCode=ramh20&page=instructions#.VPOfx2ccR9N

Guest Editors
Professor  Steve Gillard (Professor of Mental Health Research, City University, London, UK ),
Dr Kitty Vivekananda (Psychology and Counselling Programs, Monash University, Melbourne Australia), Dr Phillip Tchernegovski (Monash University, Melbourne), and Ms Chiara McDowell  (Monash University Melbourne), Ms Cate Bourke (Eastern Health, Melbourne).

Papers and Publications

In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin 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)  Centre for Mental Health (2020) Commission for Equality in Mental Health. Briefing 3: Inequalities of experience and outcomes. Centre for Mental Health.

Summary
The summary to the above briefing begins with the salient claim that People with the poorest mental health too often find the help they are offered the least effective, the least relevant and, for some, the most coercive.  The narrative draws attention to NHS England’s current workstream regarding Advancing Mental Health Equalities, in tandem with their implementation of the Patient and Carer Race Equality Framework, which was a key recommendation from the recent Independent Review of the Mental Health Act.  The Centre for Mental argue that in order to reduce inequalities in outcome and experiences, the UK health care system needs to be supported by:

• An enhanced community sector role in mental health support
• Coproduction at every level and in every service
• Culturally competent and trauma-informed approaches
• A commitment to meet all needs
• A whole system approach
• Accountability and transparency

ii)  de Wet, A., and Pretorius, C. (2020) Perceptions and understanding of mental health
recovery for service users, carers, and service providers: a South African perspective.
Psychiatric Rehabilitation Journal. Online:
http://dx.doi.org/10.1037/prj0000460

Abstract
Objective: Understandings of recovery in low- and middle-income countries, such as South Africa, are still emerging. This study explored recovery understandings by service users, carers, and service providers in South Africa.
Method: Thirty-seven in-depth, semi-structured interviews and three focus groups with service users, carers, and service providers from three public tertiary psychiatric hospitals in the Western Cape province of South Africa were conducted in 2018 and 2019. Data were transcribed and analysed, using atlas.ti and reflexive thematic analysis, to generate themes. Results: Seven themes, with further subthemes, were generated: (a) relationship with others, (b) moving positively forward, (c) relationship with self, (d) relating to the world, (e) (re-)gaining of strengths, (f) awareness of difficulties, and (g) clinical understanding to support personal recovery. From the themes, a definition of recovery for the South African context was developed.
Conclusion and Implications for Practice: The identified themes were not mutually exclusive— overlap is inevitable when describing personal recovery. These results and definition are informing the second phase of the overall study—developing a measure of personal mental health recovery for the South African context. The results can contribute to the wider clinical, academic and governmental comprehension of recovery, assist in the obtaining or retaining of funding for local recovery initiatives, and hopefully be useful for service users to understand their own process of recovery better and to be able to move along in that process. We recommend replicating the study and investigating recovery-conducive environments in South Africa with service users.

iii)  Sharif, N., Karasavva, V. and Farrell, S. (2020) One size doesn’t fit all: gender differences in trauma, PTSD, substance use and the SMI-PTSD conceptual model in persons with severe mental illness in assertive community treatment.  Psychosis. Online:
https://doi.org/10.1080/17522439.2020.1839123

Abstract
The literature on severe mental illness (SMI), trauma, PTSD, and substance use is expansive, yet no research exists examining the specific population served by Assertive Community Treatment (ACT) concerning these relationships and particularly the SMI-PTSD model proposed in the literature. In this paper, we employed retrospective chart reviews to extract information on trauma histories, PTSD, substance use, and psychosocial factors in a sample of 282 clients from four ACT teams (178 males; 104 females) to assess the gender differences in types of trauma, instances of PTSD, substances of choice, problematic substance use, and the SMI-PTSD model. Results indicated that rates of sexual trauma, emotional abuse, serious suicide attempts, rates of trauma in adulthood and PTSD were higher among women, whereas rates of alcohol, marijuana, and stimulant use as well as lifetime problematic substance use were higher among men. In terms of the SMI-PTSD model, results suggest that the model fits the experiences and possible trajectory of men with SMI better. Future work should investigate gender differences and gendered trajectories around the complex relationships between SMI, trauma, PTSD, substance use and examine how the SMIPTSD model applies to persons of diverse backgrounds.

iv)  Jaiswal, A., Carmichael, K., Gupta, S., Siemens, T., Crowley, P., Carlsson, A., Unsworth, G., Landry, T, and Brown, N. (2020) Essential elements that contribute to the recovery of persons with severe mental illness: a systematic scoping study. Frontiers of Psychiatry 11(586230).  Online:
https://doi.org/10.3389/fpsyt.2020.586230

Abstract
Introduction: There is an increasing emphasis on recovery-oriented care in the design and delivery of mental health services. Research has demonstrated that recovery-oriented services are understood differently depending on the stakeholders involved. Variations in interpretations of recovery lead to challenges in creating systematically organized environments that deliver a consistent recovery-oriented approach to care. The existing evidence on recovery-oriented practice is scattered and difficult to apply. Through this systematic scoping study, we aim to identify and map the essential elements that contribute to recovery outcomes for persons living with severe mental illness.
Methods: We used the Arksey & O’Malley framework as our guiding approach. Seven key databases (MEDLINE, PubMed, CINAHL/EBSCO, EMBASE, ProQuest, PsycINFO, and Google Scholar) were searched using index terms and keywords relating to recovery and severe mental illness. To be included, studies had to be peer-reviewed, published after 1988, had persons with severe mental illness as the focal population, and have used recovery in the context of mental health. The search was conducted in August 2018 and last updated in February 2020.
Results: Out of 4,496 sources identified, sixty (n = 60) sources were included that met all of the selection criteria. Three major elements of recovery that emerged from the synthesis (n = 60) include relationships, sense of meaning, and participation. Some sources (n = 20) highlighted specific elements such as hope, resilience, self-efficacy, spirituality, social support, empowerment, race/ethnicity etc. and their association with the processes underpinning recovery.
Discussion: The findings of this study enable mental health professionals to incorporate the identified key elements into strategic interventions to facilitate recovery for clients with severe mental illness, and thereby facilitate recovery-oriented practice. The review also documents important gaps in knowledge related to the elements of recovery and identifies a critical need for future studies to address this issue.

v)  White, S., Foster, R., Marks, J., Morshead, R., Goldsmith, L., Barlow, S., Sin, J. and Gillard, S. (2020) The effectiveness of one-to-one peer support in mental health services: a
systematic review and meta-analysis.  BMC Psychiatry.  20(534)  Online:
https://doi.org/10.1186/s12888-020-02923-3

Abstract
Background: Peer support is being introduced into mental health services internationally, often in response to workforce policy. Earlier systematic reviews incorporate different modalities of peer support (i.e. group and one-to-one), offer inconsistent evidence of effectiveness, and also indicate substantial heterogeneity and issues of quality in the evidence base at that time. An updated review, focussed on one-to-one peer support, is timely given current policy interest. This study aims to systematically review evidence for the effectiveness of one-to-one peer support interventions for adults using mental health services, and to explore heterogeneity in peer support interventions.
Method: We searched MEDLINE, PsycINFO, Embase, CINAHL and Cochrane databases from inception until 13 June 2019. Included studies were assessed for risk of bias, and meta-analyses conducted where multiple trials provided usable data.
Results: Twenty-three studies reporting nineteen trials were eligible, providing data from 3329 participants. While seven trials were of low to moderate risk of bias, incomplete reporting of data in many studies suggested bias in the evidence base. Peer support interventions included peer workers in paraclinical roles (e.g. case manager), providing structured behavioural interventions, or more flexible support for recovery. Meta-analyses were conducted for eleven outcomes, with evidence that one-to-one peer support may have a modest positive impact on self-reported recovery and empowerment. There was no impact on clinical symptoms or service use. Analyses of heterogeneity suggest that peer support might improve social network support.
Conclusions: One-to-one peer support in mental health services might impact positively on psychosocial outcomes, but is unlikely to improve clinical outcomes. In order to better inform the introduction of peer support into mental health services, improvement of the evidence base requires complete reporting of outcome data, selection of outcomes that relate to intervention mechanisms, exploration of heterogeneity in the implementation of peer support and focused reviews of specific types of one-to-one peer support.

vi)  Williams, O., Sarre, S., Papoulias, S. C., Knowles, S., Robert, G., Beresford, P., Rose, D., Carr, S., Kaur, M. and Palmer, V. J. (2020) Health Research Policy and Systems. 18(43) Online:
https://doi.org/10.1186/s12961-020-00558-0

Abstract
This article is a response to Oliver et al.’s Commentary ‘The dark side of coproduction: do the costs outweigh the benefits for health research?’ recently published in Health Research Policy and Systems (2019, 17:33). The original commentary raises some important questions about how and when to co-produce health research, including highlighting various professional costs to those involved. However, we identify four related limitations in their inquiry, as follows: (1) the adoption of a problematically expansive definition of co-production that fails to acknowledge key features that distinguish co-production from broader collaboration; (2) a strong focus on technocratic rationales for co-producing research and a relative neglect of democratic rationales; (3) the transposition of legitimate concerns relating to collaboration between researchers and practitioners onto work with patients, service users and marginalised citizens; and (4) the presentation of bad practice as an inherent flaw, or indeed ‘dark side’, of co-production without attending to the corrupting influence of contextual factors within academic research that facilitate and even promote such malpractice. The Commentary’s limitations can be seen to reflect the contemporary use of the term ‘co-production’ more broadly. We describe this phenomenon as ‘cobiquity’ – an apparent appetite for participatory research practice and increased emphasis on partnership working, in combination with the related emergence of a plethora of ‘co’ words, promoting a conflation of meanings and practices from different collaborative traditions. This phenomenon commonly leads to a misappropriation of the term ‘co-production’. Our main motivation is to address this imprecision and the detrimental impact it has on efforts to enable co-production with marginalised and disadvantaged groups. We conclude that Oliver et al. stray too close to ‘the problem’ of ‘co-production’ seeing only the dark side rather than what is casting the shadows. We warn against such a restricted view and argue for greater scrutiny of the structural factors that largely explain academia’s failure to accommodate and promote the egalitarian and utilitarian potential of co-produced research.

vii)  Wright, N., Hadziosmanovic, E., Dang, M., Bales, K., Brookes, C., Jordan, M., Slade, M. [and the ] Lived Experience Research Advisory Board (2020) BMJ Open. 10:e038583. Online:
https://bmjopen.bmj.com/content/10/11/e038583

Abstract
Introduction: Slavery and human trafficking are crimes involving the violation of human rights and refer to exploitative situations where an individual cannot refuse or leave due to threats, coercion or abuse of power. Activities involving slavery include forced labour exploitation, forced sexual exploitation, forced marriage and servitude. Epidemiological studies show high levels of mental health need and poor provision of appropriate support for survivors. What mental health recovery means to victims/survivors and how it could be promoted is under-researched.
Methods and analysis: A grounded theory study based on individual interviews will be undertaken. Survivors across the UK will be identified and recruited from non-governmental organisations and via social media. As per grounded theory methodology, data collection and analysis will be undertaken concurrently and recruitment will continue until theoretical saturation is reached. It is anticipated that approximately 30 participants will be recruited. Interviews will be audio recorded, transcribed verbatim and uploaded to NVivo V.11. The constant comparative method will be used to analyse the data, in order to produce a theoretical framework for mental health recovery that is grounded in the experiences of survivors.
Ethics and dissemination: Ethical approval has been obtained from the Faculty of Medicine and Health Sciences Ethics Committee at the University of Nottingham. The findings of the study will be disseminated to academic, professional and survivor-based audiences to inform future policy developments and the provision of mental health recovery support to this population.

viii)  Thornicroft, G. and Sunkel, C. (2020) Announcing the Lancet Commission on stigma and discrimination in mental health. The Lancet. Online:
https://doi.org/10.1016/S0140-6736(20)32203-0

Summary
As part of their announcement concerning the Lancet Commission on Stigma and discrimination in mental health, Thornicroft and Sunkel draw attention to the international context and argue that the evidence base surrounding the effectiveness of interventions in this domain necessitate a reappraisal of the field.  Such re-evaluation is required in order to develop ‘a set of radical and practical recommendations ‘ to guide local, national and international action.  Reporting in 2022, the authors aim to generate a greater understanding of stigma and discrimination, with a particular emphasis upon the global context.  The aims of their work will include definitions and models, evidence surrounding the ways in which stigma and discrimination may be experienced, and its broader impacts.  The effectiveness of interventions, and the broader socio-political analysis of what is needed to eradicate stigma and discrimination in mental health are also indicated, alongside a range of ‘actionable recommendations’.

ix)  Hosted on the Peer Nation website, the Training Manual for Mental Health Peer Support Workers (September 2020) represents a significant collaboration between a range of people and agencies.  Using words from the acknowledgements on page 3, The training package has been developed and modified over the course of three Brain Gain Projects (2012-2018) and the manual has been developed with feedback from trainers and students.

Other News / Resources

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

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

RRN members can help us in two ways:

1.  Recruitment and participation
The NEON Trial is currently recruiting people who:-

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

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

2.  Promotion of the Trial.  Would you help us to promote the NEON Trial through your networks? You can use any of the publicity materials available at www.researchintorecovery.com/neontrials/promotion or just tweet:
Can real-life mental health recovery stories help you with your own mental health? Access hundreds of recovery stories in the NEON Trial. Help researchers @InstituteMH understand the benefits of accessing other people’s recovery narratives. See recoverystories.uk

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

iii)  Coronavirus and Mental Health (information)
The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19.  It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation
Gov.uk
Social Care Institute for Excellence
Centre for Mental Health
Mental health Foundation
Mind
Rethink
Carers UK
National Service User Network
British Psychological Society
British Association of Social Workers
Royal College of Psychiatrists
Royal college of Nursing
Royal College of Occupational Therapists

iv)  Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. 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 2020

A new format for the RRN e-bulletin
From October 2020 our monthly e-bulletin will be sent out via Mailchimp. As you may have seen already, the RRN website has been refreshed, and a simplified joining form is available here.  An option of viewing the e-bulletin via a browser is also possible.

RRN Meetings
Due to the ongoing developments with regards to Covid-19, RRN in-person meetings are suspended at the present time.

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

Thank-you. Please stay safe, and our best wishes to you all.

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are:
Shula:     s.ramon@herts.ac.uk
Tony:      a.sparkes@bradford.ac.uk

Coronavirus and Mental Health
The impact of coronavirus, and government measures to restrict its transmission, means that we have to pay particular attention to our mental health and wellbeing.  There is a considerable amount of advice and information available online.  In this edition, we have included some examples at the end of the e-bulletin.  

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/events/rrn/join/

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

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

Conferences, Events and Calls for Papers
In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world.  As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality.

Whilst it is likely that face-face conferencing/events will not be taking place in their ‘traditional’ format, it may be that alternative or innovative platforms are being utilised to deliver such events going forward.  

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

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

iii)  A call for papers has been expressed by:  Advances in Mental Health: Promotion, prevention and early intervention.

Title for the Special issue: Peer support in mental health services
Internationally the past decade has seen a burgeoning of lived experience, peer support services often driven by changes in mental health workforce policy. This special issue will focus on research on peer support for consumers and/or carers, in mental health, Alcohol and other Drugs and gambling services.  This issue is particularly interested in gaining an international perspective on peer support. Quantitative, qualitative, mixed methods and systematic review studies will be considered. We welcome publications that report consumer-  or carer-led research and are authored or co-authored by peer support workers.  It is expected that the special issue will be published in Nov 2021.

Process for submission:
1.  Abstracts of 200-250 words due 31 January 2021. Please email these directly to Dr Kitty Vivekananda at Kitty.Vivekananda@monash.edu.au
We will inform you by 12 February, 2021  if your abstract has been accepted to submit a full copy of the article.

2.  Full manuscripts of no more than 5000 words  due 11 April 2021.  We will encourage authors to make accepted manuscripts available via a pre-print server so that research is as accessible as possible to the peer support community.

Please contact the Editors of the special issue Kitty Vivekananda if you have any queries about a potential submission.

Submission guidelines: 
Please refer to the Taylor and Francis website for submission guidelines for the journal:
http://www.tandfonline.com/action/authorSubmission?journalCode=ramh20&page=instructions#.VPOfx2ccR9N

Guest Editors
Professor  Steve Gillard (Professor of Mental Health Research, City University, London, UK ),
Dr Kitty Vivekananda (Psychology and Counselling Programs, Monash University, Melbourne Australia), Dr Phillip Tchernegovski (Monash University, Melbourne), and Ms Chiara McDowell  (Monash University Melbourne), Ms Cate Bourke (Eastern Health, Melbourne).

Papers and Publications

In addition to peer-reviewed literature and work of a purely academic nature, the e-bulletin 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)  Carr, S. (2020)   ‘AI gone mental’: engagement and ethics in data driven technology for mental health.  Journal of Mental Health.  29(2) 125-130.

Summary
Sarah Carr’s recent editorial sets out an engaging and informative commentary regarding the increasing role of artificial intelligence within mental health care and associated research.  Carr discusses issues of ‘power, scrutiny and trust’ and the necessity of adhering to standards and ethical frameworks that promote safe, transparent and accountable practices.  The issue of building trust is further expounded in the consideration of ‘patient and public involvement (PPI) in mental health AI research. However it is suggested that the role of PPI within AI research is both unclear and underdeveloped.  Finally, it is argued that the service user, patient or carer to be situated as the ‘domain expert’ with regard to AI research.  In conclusion, Carr draws upon a rights-based agenda to support and develop the involvement of patients, service users and carers in the ethical use of AI and AI research within mental health care.

ii)  Carrotte, E. R., Hartup, M. E., Lee-Bates, B. and Blanchard, M. (2020) “I think that  everybody should be involved”: What informs experiences of shared decision-making in supporting people living with schizophrenia spectrum disorders?  Patient Education and Counselling.  Online:
https://doi.org/10.1016/j.pec.2020.11.012

Abstract
Objective: To identify facilitators and barriers associated with shared decision-making (SDM) in Australians affected by schizophrenia spectrum disorders.
Methods: We surveyed 78 participants with lived experience and held 12 in-depth interviews, including seven carers.
Results: A multiple linear regression model identified two independent variables significantly associated with degree of SDM: Personal Wellbeing Index scores (ß = .32, t = 3.3, p = .001) and treatment satisfaction rating (ß =.46, t = 4.7, p < .001), indicating that higher personal wellbeing and higher treatment satisfaction were significantly related to higher degree of SDM. Two key themes were identified through interview data: a complex pathway to SDM and impacts on wellbeing. Sub-themes included: self and carer characteristics, holistic care, education and knowledge, and power balance. Generally, participants reported a desire for SDM, noting that healthcare professionals inconsistently involve them in treatment decisions.
Conclusion: SDM is associated with treatment satisfaction and personal wellbeing among people living with schizophrenia spectrum disorders, but can be difficult to implement due to a range of challenges.  Practice implications: There is a need to improve SDM in this population by decreasing stigma and discrimination, balancing power in consultations, increasing access to holistic treatment, and improving education and knowledge.

iii)  Moore, T. and Zeeman, L. (2020) More ‘milk’ than ‘psychology or tablets’: Mental health professionals’ perspectives on the value of peer support workers.  Health Expectations.  00:1-9.  Online:
https://doi.org/10.1111/hex.13151

Abstract
Background: Though growing numbers of peer support workers are employed in the UK National Health Service (NHS), conflicts persist between core values of peer support and values which exert power within these services.
Objectives: To explore what NHS mental health professionals’ value about the peer support worker role.
Design: Five professionals from different professions and mental health settings were interviewed twice. The first interviews explored their experiences of working with peers. Transcripts were analysed using discourse analysis and psychosocial theory.  Second interviews allowed participants to respond to the analysis and influence subsequent analysis.
Results: Mental health professionals valued peers for the deeply empathic, relational approach they brought, based in their subjective experience. Peer work was also valued for the affect-focused quality of this work, and the challenge peers pose to existing values in mental health services. The values of peer support troubled dominant ways of working based in forms of knowledge that favour objectivity and hence encountered challenges.
Conclusions: Peers fulfil the role of amplifying the status of diverse forms of knowledge, values and related ways of working that have become marginalized in NHS mental health services. It is important that peers are not seen as an isolated solution to the marginalization of these forms of knowledge and values, but that their way of working becomes reflected in other roles whilst evoking change throughout these services. Patient or Public Contribution: Patient and Public Involvement groups were consulted both in the design and analysis stages of the study.

iv)  Prytherch, H.,  Cooke, A. and Marsh, I.  (2020): Coercion or collaboration: service-user experiences of risk management in hospital and a trauma-informed crisis house.  Psychosis. Online:
https://doi.org/10.1080/17522439.2020.1830155

Abstract
Background and aims: Improving care for people in crisis remains high on the UK government agenda. Trauma-informed approaches (TIAs) have been advocated to address concerns raised about psychiatric hospital services by service-users, particularly around the use of coercion in risk management. This study explores service-users’ experiences of risk management in both hospital services and a trauma-informed crisis house.
Methods: Eight women were interviewed using a semi-structured interview schedule. Interviews were transcribed and analysed using thematic analysis within a critical realist framework.
Results and discussion: Four themes were developed. In the first two (‘The Medical-Custodial Approach: They Only Think About Physical Safety‘ and ‘Coercion is Counterproductive‘) participants described hospital as being dominated by a medical-custodial approach, which they said was ineffective in managing long term safety and could exacerbate distress. In the next two themes (’Talking Heals’ and ’Relationships as Risk Management’) the crisis house was described as using a relational approach to risk management that enabled women to maintain some freedom, privacy and control and was felt to be more effective long term. This research was carried out with a small sample and both recruitment and context likely privileged positive accounts of TIAs. Clinical implications and areas for further research are discussed.

v)  Riches, S., Brownell, T., Schrank, B., Lawrence, V., Rashid, T. and Slade, M. (2020) Understanding ‘forgiveness’ in the context of psychosis: A qualitative study of service
user experience.  Clinical Psychology Forum.  336.  41-48.

Summary
Twenty-three people with psychosis were interviewed about their subjective experience of ‘forgiveness’. Resulting themes of enabling conditions, thinking styles, psychological and interpersonal benefits, and need for caution may inform clinical practice on trauma, adverse life events, and relationships in psychosis.

vi)  Manthorpe, J. and Rapaport, J. (2020)   Researching Family Group Conferences in adult services: methods review.  London. NIHR School for Social Care Research.

Abstract
This methods review considers the background and child-care origins of Family Group Conferences (FGCs) as a context to growing research interests about FGCs’ potential as successful interventions in adult social care and social work practice. The theoretical frameworks underpinning the initiative’s development and their relevance to social work principles and practice are identified. Methods used to describe and evaluate FGC initiatives for adults in the United Kingdom (UK) are outlined. International research into FGCs’ use and effectiveness in adult services is examined and implications for future development and research are discussed.

This review aims to be relevant to practitioners, managers, policymakers, educationalists, researchers and to families themselves all of whom may want to know if FGCs will lead to cost-effective, acceptable and positive outcomes for adults with needs for care and support.

As a methods review commissioned by the National Institute for Health Research (NIHR) School for Social Care Research, this review outlines the methods used to obtain the evidence about FGCs, commenting on the advantages of different methods and their disadvantages. Guides to the running of FGCs are available and, as noted in the review, they are increasingly being included in the family of approaches referred to as strengths-based social work or practice. 

Other News / Resources

1. i)  Following the successful online two half days conference on ‘Shared Decision Making 2020 and Beyond’, we attach a link to the website which has the recordings of all presentations, and slides of our distinguished speakers. You can take a look at the resources here:
   https://www.health.herts.ac.uk/elearning/SDM2020/web/

   The comments and questions are also included on the website.

   If you wish to contribute to the website, please contact Prof. Shula Ramon (ramon@herts.ac.uk)

   ii)  Led by Rai Waddingham, The National Survivor User Network (NSUN) is currently co-ordinating a mapping exercise on the subject of Lived Experience Leadership.  To find out more about this initiative, please see:
   https://www.nsun.org.uk/lived-experience-leadership

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

   RRN members can help us in two ways:

   1.  Recruitment and participation
   The NEON Trial is currently recruiting people who:-

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

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

2.  Promotion of the Trial.  Would you help us to promote the NEON Trial through your networks? You can use any of the publicity materials available at www.researchintorecovery.com/neontrials/promotion or just tweet:
Can real-life mental health recovery stories help you with your own mental health? Access hundreds of recovery stories in the NEON Trial. Help researchers @InstituteMH understand the benefits of accessing other people’s recovery narratives. See recoverystories.uk

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

iv)  Coronavirus and Mental Health (information)
The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19.  It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions.

World Health organisation
Gov.uk
Social Care Institute for Excellence
Centre for Mental Health
Mental health Foundation
Mind
Rethink
Carers UK
National Service User Network
British Psychological Society
British Association of Social Workers
Royal College of Psychiatrists
Royal college of Nursing
Royal College of Occupational Therapists

v)  Shula Ramon and Tony Sparkes co-produce the RRN monthly e-bulletin. 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