Recovery Research Network eBULLETIN

January 2021

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 Healh

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 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 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)  Griffiths, C., Walker, K., Reid, I.,  da Silva, K.M. and O’Neill-Kerr, A. (2021) A qualitative study of patients’ experience of ketamine treatment for depression: The ‘Ketamine and me’ project. Journal of Affective Disorders Reports.  Vol.4 April 2021. Online:
https://doi.org/10.1016/j.jadr.2021.100079

Abstract
Background: There has been a lack of in-depth interviews investigating patient experience of ketamine treatment for depression. We examined participants’ pathways to receiving ketamine infusion to treat their depression, and their responses to, lived experiences of, and attitudes towards ketamine treatment.
Methods: Qualitative methods were used to conduct in-depth interviews with 13 patients (6 male; 7 female) diagnosed with treatment resistant depression (TRD) with experience of receiving ketamine treatment for depression. Interpretative phenomenological analysis (IPA) was employed.
Results: For the majority of participants ketamine infusion causes a reported initial ‘high’, enhanced perception, and dissociative experience; followed by a lifting of mood and a reduction in or removal of suicidal ideation and depression symptoms lasting around 3–6 days. This leads to a reported increase in motivation, socialisation, and activity. All participants valued the therapeutic alliance with clinicians which enhanced the treatment experience and all advocated treatment access for those with depression who have not responded to other treatments.
Limitations: Small numbers, purposive sample, participant self-selection, and single site recruitment limit generalisability.
Conclusions: Ketamine for depression can have many beneficial effects, and it is potentially life-transforming for some. Ketamine may be a source of hope for patients for whom other treatments have not been effective. For some, ketamine is not tolerated or does not have anti-depressive effects. Further qualitative in-depth exploration of patient experience and consideration of how ketamine depression treatment access can be appropriately made available are warranted.

ii)  Karbouniaris, S., Abma, T., Wilken, J-P. and Weerman, Alie. (2020) Use of experiential knowledge by mental health professionals and its contribution to recovery: literature review. Journal of Recovery in Mental Health.  4(1) Online:
https://jps.library.utoronto.ca/index.php/rmh/article/view/35243

Abstract
Objective: This article explores the use of experiential knowledge by traditional mental health professionals and the possible contribution to the recovery of service users.
Design and Methods: The review identified scientific publications from a range of sources and disciplines. Initial searches were undertaken in databases PsycINFO, PubMed, and Cochrane using specific near operator search strategies and inclusion and exclusion criteria.
Results: Fifteen articles were selected. These were published in a broad range of
mental health and psychology journals reporting research in western countries. In the selected articles, a varying conceptualization of experiential knowledge was found, differing from therapeutic self-disclosure embedded in psychotherapeutic contexts to a relational and destigmatizing use in recovery-oriented practices. Nurses and social workers especially are speaking out about their own experiences with mental health distress. Experiential knowledge stemming from lived experience affects the professional’s identity and the system. Only a few studies explored the outcomes for service users’ recovery.
Conclusion: A small body of literature reports about the use of experiential knowledge by mental health professionals. The mental health system is still in transformation to meaningfully incorporate the lived experience perspective from traditional professionals. There is little data available on the value for the recovery of service users. This data indicates positive outcomes, such as new understandings of recovery, feeling recognized and heard, and increased hope, trust, and motivation. More research about the meaning of experiential knowledge for the recovery of service users is desirable.

iii)  Mosher, J.K. (2020) “I remember…so, let’s not forget”: remembering our past lest we repeat it.  Psychosis.  12(4), 368-376

Abstract
What happens when we, as a profession, forget our past, whether it is what history and research have taught or the values that motivated us to become healers? Here, I explore this question. First, I remember several experiences I have had that illustrate what can go wrong when we “forget.” Then, I review some of our history and research, critically examining it, to remind us of those lessons. Finally, I share examples from my own practice to show how remembering the past can guide us in the present.

iv)  Henson, C., Truchot, D. and Canevel, A. (2020) What promotes post traumatic growth? A systematic review.  European Journal of Trauma and Dissociation.  Online:
https://doi.org/10.1016/j.ejtd.2020.100195

Abstract
People who experience major life crises often report post-traumatic stress. However, the literature suggests that traumatic experiences can also be “catalysts” for positive change (i.e., posttraumatic growth; PTG). PTG (Calhoun & Tedeschi, 2006) can include improved relationships, new possibilities for one’s life, a greater appreciation for life, a greater sense of personal strength, and spiritual development.

While the general population isn’t confronted with traumatic events regularly, individuals such as firefighters, policemen, and EMTs are. But what factors foster the emergence of PTG? To answer this question, a systematic search of four major database (Psychology and Behavioural Sciences Collection, PsycARTICLES, PsycINFO, and ScienceDirect) was conducted.

Some of the factors that promoted PTG included sharing negative emotions, cognitive processing or rumination, positive coping strategies (e.g. positive reappraisal), personality traits (e.g. agreeableness), experiencing multiple sources of trauma, event centrality, resilience, and growth actions. Other factors may be mediators of PTG rather than direct influencers (e.g., seeking social support coping, social support, optimism, etc.). Finally, studies show a positive correlation between PTG and support for aggressive behaviour suggesting that growth may be more nuanced than originally thought. By exploring systematically the factors that foster PTG in trauma-exposed professionals, we hope this systematic review would both provide avenues for future research and help design news methods of prevention and intervention for first responders

v)  Howlett, N., Bottoms, L., Chater, A., Clark, A.B., David, L., Irvine, K., Jones, A., Jones, J., Mengoni1, S.E., Murdoch, J., Pond, M., Sharma, S., Sims, E.J., Turner, D.A., Wellsted, D., Wilson, J., Wyatt, S. and Trivedi, D. (2021) A randomised controlled trial of energetic activity for depression in young people (READY): a multi-site feasibility trial protocol. Pilot and Feasibility Studies.  7(6).  Online:
https://doi.org/10.1186/s40814-020-00734-7

Abstract
Background: Prevalence of depression is increasing in young people, and there is a need to develop and evaluate behavioural interventions which may provide benefits equal to or greater than talking therapies or pharmacological alternatives. Exercise could be beneficial for young people living with depression, but robust, large-scale trials of effectiveness and the impact of exercise intensity are lacking. This study aims to test whether a randomised controlled trial (RCT) of an intervention targeting young people living with depression is feasible by determining whether it is possible to recruit and retain young people, develop and deliver the intervention as planned, and evaluate training and delivery.
Methods: The design is a three-arm cluster randomised controlled feasibility trial with embedded process evaluation. Participants will be help-seeking young people, aged 13–17 years experiencing mild to moderate low mood or depression, referred from three counties in England. The intervention will be delivered by registered exercise professionals, supported by mental health support workers, twice a week for 12 weeks. The three arms will be high-intensity exercise, low-intensity exercise, and a social activity control. All arms will receive a ‘healthy living’ behaviour change session prior to each exercise session and the two exercise groups are energy matched. The outcomes are referral, recruitment, and retention rates; attendance at exercise sessions; adherence to and ability to reach intensity during exercise sessions; proportions of missing data; adverse events, all measured at baseline, 3, and 6 months; resource use; and reach and representativeness.
Discussion: UK National Health Service (NHS) policy is to provide young people with advice about using exercise to help depression but there is no evidence-based exercise intervention to either complement or as an alternative to medication or talking therapies. UK National Institute for Health and Care Excellence (NICE) guidelines suggest that exercise can be an effective treatment, but the evidence base is relatively weak. This feasibility trial will provide evidence about whether it is feasible to recruit and retain young people to a full RCT to assess the effectiveness and cost-effectiveness of an exercise intervention for depression

vi)  Pierce, M., Hope, H., Ford, T., Hatch, S., Hotopf, M., John, A., Kontopantelis, E., Webb, R., Wessely, S., McManus. S. and Abel, K.M. (2020) Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population.  Lancet Psychiatry 7. 883–92.  Online:
https://doi.org/10.1016/S2215-0366(20)30308-4

Abstract
Background: The potential impact of the COVID-19 pandemic on population mental health is of increasing global concern. We examine changes in adult mental health in the UK population before and during the lockdown.
Methods: In this secondary analysis of a national, longitudinal cohort study, households that took part in Waves 8 or 9 of the UK Household Longitudinal Study (UKHLS) panel, including all members aged 16 or older in April, 2020, were invited to complete the COVID-19 web survey on April 23–30, 2020. Participants who were unable to make an informed decision as a result of incapacity, or who had unknown postal addresses or addresses abroad were excluded. Mental health was assessed using the 12-item General Health Questionnaire (GHQ-12). Repeated cross-sectional analyses were done to examine temporal trends. Fixed-effects regression models were fitted to identify within-person change compared with preceding trends.
Findings: Waves 6–9 of the UKHLS had 53 351 participants. Eligible participants for the COVID-19 web survey were from households that took part in Waves 8 or 9, and 17 452 (41·2%) of 42 330 eligible people participated in the web survey. Population prevalence of clinically significant levels of mental distress rose from 18·9% (95% CI 17·8–20·0) in 2018–19 to 27·3% (26·3–28·2) in April, 2020, one month into UK lockdown. Mean GHQ-12 score also increased over this time, from 11·5 (95% CI 11·3–11·6) in 2018–19, to 12·6 (12·5–12·8) in April, 2020. This was 0·48 (95% CI 0·07–0·90) points higher than expected when accounting for previous upward trends between 2014 and 2018. Comparing GHQ-12 scores within individuals, adjusting for time trends and significant predictors of change, increases were greatest in 18–24-year-olds (2·69 points, 95% CI 1·89–3·48), 25–34-year-olds (1·57, 0·96–2·18), women (0·92, 0·50–1·35), and people living with young children (1·45, 0·79–2·12). People employed before the pandemic also averaged a notable increase in GHQ-12 score (0·63, 95% CI 0·20–1·06).
Interpretation:  By late April, 2020, mental health in the UK had deteriorated compared with pre-COVID-19 trends. Policies emphasising the needs of women, young people, and those with preschool aged children are likely to play an important part in preventing future mental illness.

vii)  Agenda (2020) Often Overlooked: Young women, poverty and self-harm.  A briefing by Agenda, the alliance for women and girls at risk, and the National Centre for Social Research.  NatCen: London

Summary of report
Agenda draw upon new analysis of data carried out in three surveys (2000, 2007 and 2014) of 16-74 year olds living in England. Their briefing suggests that:

• Since the year 2000, rates of self-harm in England have increased across the population; and in young women they have tripled.
• Self-harm is more common among people who face poverty and disadvantage. This seems to be particularly the case for women.
• Young women living in the lowest income households are five times more likely to self-harm than those in the highest income homes.
• Most people who self-harm receive no medical or psychological help as a result, and this is particularly true for young people.

From their summary page, Agenda argue that: A cross-government response to prevention and support, that takes account of gender, poverty and disadvantage, is needed.

viii)  Niederkrotenthaler, T., Gunnell, D., Arensman, E., Pirkis, J., Appleby, L., Hawton, K., John, A., Kapur, N., Khan, M., O’Connor, R.C., Platt, S. and the International COVID-19 Suicide Prevention Research Collaboration. (2021) Suicide Research, Prevention, and COVID-19: Towards a Global Response and the Establishment of an International Research Collaboration.  Crisis. 41(5), 321–330

Summary
Niederkrotenthaler et al. offer a cogent and timely case for the establishment of an international research collaboration with regard to suicide research and prevention at a time of Covid-19.  Their editorial pulls to the importance and relevance of an evidence-based response that focuses upon assessing the impact of Covid-19 upon both mental health, and upon suicide and suicidal behaviour. The authors attend to a number of research considerations that have emerged due to the pandemic, before clearly setting out a case for international collaboration. It is concluded that such a collaboration represents an important step forward in better understanding the impact of suicide and suicidal behaviour at this time, and an appeal is made for colleagues to register suicide prevention research studies to facilitate this initiative:
https://www.iasp.info/covid-19/covid-19-suicide-research-studies

Other News

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)  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!

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

February 2021

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 Healh

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 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 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)  Hertfordshire County Council, Public Health & the University of Hertfordshire Masterclass: Public mental health and the COVID-19 response
Wednesday, 24th March 2021, 10am – 12pm. This is an online event which will be held via zoom.

The aim of this masterclass is to provide an overview of the work undertaken to support resident’s mental health and wellbeing during the COVID-19 pandemic. It will draw on case examples and research from across the system demonstrating the need for a joined-up approach to address the complex issues impacting on people’s mental health and improve outcomes for the population of Hertfordshire.

To register, or to find out further information please visit the Eventbrite page (password:publichealth123) Please direct any queries regarding this event to publichealth@hertfordshire.gov.uk

This event is free for all relevant professionals working in Hertfordshire, whether statutory, private or voluntary sector.

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

iv)  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).

v)  Lancet Psychiatry Commission on the Psychoses in a Global Context: Request for participatory & or user-led research, commentaries & reports.

The Lancet Commission on the Psychoses in a Global Context consists of a group of researchers, policy makers, clinicians , family members and service users convened to produce a comprehensive knowledge synthesis and vision for future research and development focused on psychosis. As part of the overall Commission, the lived experience/psychosocial disabilities involvement workgroup will be conducting a systematic review of studies and reports focused on psychosis that have utilized participatory methods (spanning user/survivor-led research, co-production, participatory action research and so on). While we will conduct traditional searches of the academic literatures, due to the variety of terms used internationally and variations in reporting of methods or lived experience/stakeholder involvement, we are seeking self-submissions of relevant work in the following categories:

• Peer reviewed research studies of any kind (autoethnographic qualitative, quantitative, etc.) led or co-led by researchers who identify as service users/persons with psychosocial disability/lived experience;
• Peer-reviewed research studies of any kind (qualitative, quantitative, mixed methods) that have included an explicit service user/psychosocial disability and/or family participation component;
• Doctoral dissertations or theses that would otherwise meet the above criteria and have not (yet) been published;
• Commentaries specifically focused on psychosis (language, subjective experience, service reform, innovation, human rights, etc.) and that are led or co-produced by authors with personal experience of psychosis, whether they appear in academic or non-academic venues;
• Self nominated studies or evaluations using participatory methodologies that have not been published in a peer-reviewed academic journal (ie ‘grey literature’ texts) but that include some description of methodology (who the sample is, what methods were used, how data was analyzed).
• Note that submissions can be in any language – we are actively working on developing translated versions of the flyer and survey: please contact us to request a copy in another language.

Have something to submit? Click or copy the URL below or the  QR code to the right :
https://usf.az1.qualtrics.com/jfe/form/SV_5ptxGnxIayEZhsy

Questions? : contact us at lancetcommissionpsychosis@gmail.com

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)  Sofouli, E. (2020) Cross-cultural conceptualization and implementation of recovery in mental health: a literature review.  Mental Health and Social Inclusion. 25(1) 32-40. https://doi.org/10.1108/MHSI-08-2020-0057

Abstract
Purpose:  The purpose of this paper is to review the literature in terms of the conceptualization of the recovery concept among cultural and ethnic minorities drawing on the connectedness, hope and optimism about the future; Identity, meaning in life, empowerment (CHIME) framework; highlight the cultural adaptations of supported housing – a prominent recovery-oriented intervention, as it was implemented in a multicultural western country; and delineate the future implications for research, policy and practice in regard to mental health recovery interventions for cultural and ethnic minorities.
Design/methodology/approach:  An online search was performed to identify recent empirical studies published in English in peer-reviewed journals.
Findings:  Included studies confirmed what the authors of CHIME had initially reported: spirituality and support networks could act as enablers or inhibitors in the recovery process of mental health services users with diverse cultural backgrounds. The stigma surrounding mental illness is a key challenge that skews the recovery experience. Other cultural-specific factors include linguistic peculiarities of the maternal language and gender. The cultural adaptation of a recovery-oriented intervention was feasible and effective but also challenging.
Originality/value:  By studying the cultural variations of mental health recovery, the intention is to inform mental health practitioners and other key stakeholders of the distinct cultural components that influence the recovery process, thereby promoting the development of culturally sensitive, accessible and effective recovery-oriented interventions. It is worth noting that providing culturally appropriate mental health services could be viewed as a human right issue for minority groups

ii)  Cochrane, C., Moran, N. and Newton, E. (2021) Exploring the impacts of a carers’ psycho-education group: personal insights from the family of people with early psychosis.  Psychosis.  Online:
https://doi.org/10.1080/17522439.2020.1861073

Abstract
Introduction:  Carers (family and friends) are simultaneously impacted by a loved one’s experience of psychosis and influential in supporting recovery from psychosis. This study examines carers’ experiences and perceived impacts of a psycho-education group within one Early Intervention in Psychosis (EIP) service in England.
Methods:  Semi-structured, face-to-face interviews were conducted with seven carers who had attended a psycho-education group. Interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis (IPA) for which a small sample is recommended.
Results:  Participants highlighted the importance of carers’ early access to information and of working around barriers to attendance at psychoeducation groups. They perceived that their attendance at the group had enhanced their confidence and independence in supporting loved ones with their symptoms, encouraged greater involvement in care planning, and overall improved carer wellbeing. Further, sharing experiences had increased their understanding of psychosis and helped with tackling stigma and feelings of shame.
Implications and areas for further research are discussed.

iii)  Leendertse, J.C.P., Wierdsma, A.I., van den Berg, D., Ruissen, A.M., Slade, M., Castelein, S. and Mulder, C.L. (2021) Personal recovery in people with a psychotic disorder: A systematic review and meta-analysis of associated factors. Frontiers in Psychiatry.  12:622628.  Online:
https://www.frontiersin.org/articles/10.3389/fpsyt.2021.622628/full

Abstract
Background: Personal recovery (PR) is a subjective, multidimensional concept, and quantitative research using PR as an outcome is rapidly increasing. This systematic review is intended to support the design of interventions that contribute to PR in psychotic disorders, by providing an overview of associated factors and their weighted importance to PR: clinical factors, social factors, and socio-demographic characteristics are included, and factors related to the concept of PR (organized into CHIME dimensions).
Methods: A systematic literature search was conducted from inception to March 2020. Quantitative studies that had used a validated questionnaire assessing the concept of PR were included. Mean effect sizes for the relationship between PR-scale total scores and related factors were calculated using meta-analyses. Sources of heterogeneity were examined using meta-regression tests.
Results: Forty-six studies, that used (a total of) eight PR measures, showed that in clinical factors, affective symptoms had a medium negative association with PR-scale total scores (r = −0.44, 95%CI −0.50 to −0.37), while positive, negative and general symptoms had small negative correlations. No association was found with neuro-cognition. Social factors (support, work and housing, and functioning) showed small positive correlations. Gender and age differences had barely been researched. Large associations were found for PR-scale total scores with the CHIME dimensions hope (r = 0.56, 95%CI 0.48–0.63), meaning in life (r = 0.48, 95%CI 0.38–0.58) and empowerment (r = 0.53, 95%CI 0.42–0.63); while medium associations were found with connectedness (r = 0.34, 95%CI 0.43–0.65) and identity (r = 0.43, 95%CI 0.35–0.50). Levels of heterogeneity were high, sources included: the variety of PR measures, variations in sample characteristics, publication bias, variations in outcome measures, and cultural differences.
Discussion: Most interventions in mental healthcare aim to reduce symptoms and improve functioning. With regard to stimulating PR, these interventions may benefit from also focusing on enhancing hope, empowerment, and meaning in life. The strength of these findings is limited by the challenges of comparing separate CHIME dimensions with questionnaires assessing the concept of PR, and by the high levels of heterogeneity observed. Future research should focus on the interaction between elements of PR and clinical and social factors over time.

iv)  van Bussel, E.M.M., Nguyen, N.H.M., Wierdsma, A.I., van Aken, B.C., Willems, I.E.M.G. and Mulder, C.L. (2021) Adult attachment and personal, social, and symptomatic recovery from psychosis: systematic review and meta-analysis. Frontiers of Psychiatry. 12:641642. Online:
https://www.frontiersin.org/articles/10.3389/fpsyt.2021.641642/full

Abstract
Despite growing evidence for the role of attachment in psychosis, no quantitative review has yet been published on the relationship in this population between insecure attachment and recovery in a broad sense. We therefore used meta-analytic techniques to systematically appraise studies on the relationship between attachment and symptomatic, social and personal recovery in clients with a psychotic disorder. Using the keywords attachment, psychosis, recovery and related terms, we searched six databases: Embase, Medline Epub (OVID), Psycinfo (OVID), Cochrane Central (trials), Web of Science, and Google Scholar. This yielded 28 studies assessing the associations between adult attachment and recovery outcome in populations with a psychotic disorder. The findings indicated that insecure anxious and avoidant attachment are both associated with less symptomatic recovery (positive and general symptoms), and worse social and personal recovery outcomes in individuals diagnosed with a psychotic disorder. The associations were stronger for social and personal recovery than for symptomatic recovery. Attachment style is a clinically relevant construct in relation to the development and course of psychosis and recovery from it. Greater attention to the relationship between attachment and the broad scope of recovery (symptomatic, social, and personal) will improve our understanding of the illness and efficacy of treatment for this population.

v)  Pipkin, A., Armitage, S., Knight, M. and Hogg, L. (2021) “A blank canvas of me”: an interpretive phenomenological analysis study of the experience of client self-disclosure in cognitive behavioural therapy for psychosis.  Psychosis.  Online:
https://doi.org/10.1080/17522439.2021.1881597

Abstract
Background:  Client disclosure of emotionally salient information to a therapist may be an important factor in the effectiveness of Cognitive Behavioural Therapy for Psychosis (CBTp). The present study explores how people engaging with CBTp make sense of sharing emotionally salient information with a therapist and considers how mental health stigma may influence how participants decide whether to share information.
Methods:  Eight participants were recruited for semi-structured interviews lasting 30–75 minutes. Interpretive Phenomenological Analysis was used.
Results:  Two main themes were identified. I am responsible for controlling the negative impact of disclosure refers to participants’ awareness that sharing distressing experiences may have negative consequences. Participants worried about being judged, such as being seen as abnormal or having the potential to harm others. They also worried about feeling shamed or dis- tressed. Non-disclosure may be a way of avoiding these fears. The second theme, Therapy makes me feel normal, describes how participants viewed themselves more positively from their therapist validating and understanding their experiences.
Conclusions:  Internalized stigma-based beliefs may influence self-disclosure, and the therapeutic relationship may provide alternative, positive beliefs about the self as normal. Further research can explore beliefs about self- disclosure and consider micro-affirmations as a therapeutic process.

vi)  Bhavsar, V., Kirkpatrick, K., Calcia, M. and Howard, L.M. (2021) Lockdown, domestic abuse perpetration, and mental health care: gaps in training, research, and policy.  The Lancet. 8(3) 172-174

Summary
Situated at a time of Covid-19, Bhavsar et al provide commentary about the disproportionate impact of domestic abuse on children and women and its causal role in avoidable morbidity and patient safety.  Although the authors rightly caution about inappropriate causal attributions between mental illness and domestic abuse, they point out that mental health services may encounter populations that have a higher prevalence of people affected by domestic abuse than does the general population.  Drawing upon empirical work, Bhavsar et al make a strong case for ‘addressing the gaps in mental health services’ training and practice in responding to domestic abuse perpetration’. Moreover their call is comprehensive, cutting across many issues (such as idenitication and disclosure, and risk assessment for example) while stressing the need for maintaining engagement and safety.  The author’s comments also come at a time of Covid-19 which may have contributed to an increase in domestic abuse on the one hand, and decreased its visibility on the other.

vii)  Schout, G. (2020) Into the swampy lowlands. Evaluating family group conferences, European Journal of Social Work. Online:
https://doi.org/10.1080/13691457.2020.1760796

Abstract
A recent debate in the UK on the merits of randomised controlled trials in evaluating Family Group Conferencing is a reason to bring this debate to a wider audience than the UK. Other countries are also struggling with accountability and the desire to know what works in the light of public spending. This paper explores, debunks and rethinks ways of evaluating FGCs and how it is connected to our desire to predict and control future circumstances. For the latter insights of the Dutch philosopher Kunneman are used to understand what is going on. The rise of personalised medicine, however, holds practical reasons to rethink the value of population-based randomised controlled trials in social work in general. Where the field of medicine is moving from ‘one cure for all’ and population-based RCTs to individually tailored therapy and N-of-1 studies in order to meet the complexity of particular cases, some fields in the social sciences seem to have difficulties in moving from reductionism towards a more integrated view of life.

Other News

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:
The Recovery Research Team at University of Nottingham is running the NEON trials, which are looking at whether access to online stories of recovery from mental health problems can help people affected by mental health problems. People can join the trials at https://www.recoverystories.uk.

We currently have over 1,600 participants from across England taking part, so many thanks to the Recovery Research Network for all the support. Trials will be closing to recruitment very soon, so if you know of anyone who might want to take part, please let them know. The three trials are:

• People with experience of psychosis in the NEON Trial
• People living with any other type of mental health problem in the NEON-O Trial
• Carers of people living with ANY mental health problem in the NEON-C Trial

We have recently featured on the BBC Radio 4 programme ‘All in the mind’ and on the BBC South East regional news. If you are interested in hearing more about the study you can take a look at www.bbc.co.uk/programmes/m000pfh3 and https://bit.ly/2MlQxoC

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

March 2021

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 Healh

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 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 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 

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).

iv)  Lancet Psychiatry Commission on the Psychoses in a Global Context: Request for participatory & or user-led research, commentaries & reports.

The Lancet Commission on the Psychoses in a Global Context consists of a group of researchers, policy makers, clinicians , family members and service users convened to produce a comprehensive knowledge synthesis and vision for future research and development focused on psychosis. As part of the overall Commission, the lived experience/psychosocial disabilities involvement workgroup will be conducting a systematic review of studies and reports focused on psychosis that have utilized participatory methods (spanning user/survivor-led research, co-production, participatory action research and so on). While we will conduct traditional searches of the academic literatures, due to the variety of terms used internationally and variations in reporting of methods or lived experience/stakeholder involvement, we are seeking self-submissions of relevant work in the following categories:

• Peer reviewed research studies of any kind (autoethnographic qualitative, quantitative, etc.) led or co-led by researchers who identify as service users/persons with psychosocial disability/lived experience;
• Peer-reviewed research studies of any kind (qualitative, quantitative, mixed methods) that have included an explicit service user/psychosocial disability and/or family participation component;
• Doctoral dissertations or theses that would otherwise meet the above criteria and have not (yet) been published;
• Commentaries specifically focused on psychosis (language, subjective experience, service reform, innovation, human rights, etc.) and that are led or co-produced by authors with personal experience of psychosis, whether they appear in academic or non-academic venues;
• Self nominated studies or evaluations using participatory methodologies that have not been published in a peer-reviewed academic journal (ie ‘grey literature’ texts) but that include some description of methodology (who the sample is, what methods were used, how data was analyzed).
• Note that submissions can be in any language – we are actively working on developing translated versions of the flyer and survey: please contact us to request a copy in another language.

Have something to submit? Click or copy the URL below or the  QR code to the right :
https://usf.az1.qualtrics.com/jfe/form/SV_5ptxGnxIayEZhsy

Questions? : contact us at lancetcommissionpsychosis@gmail.com

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)  Friesen, P., Goldstein, J. and Dixon, L.  (2021): A “blip in the road”: experiences of identity after a first episode of psychosis.  Psychosis.  Online:
https://doi.org/10.1080/17522439.2021.1876159

Abstract
Introduction: Psychosis can affect identity in fundamental ways. Increasingly, those experiencing psychosis for the first time are enrolled in early intervention services. We sought to explore how individuals enrolled in such services felt their identity was impacted by their experience of psychosis.
Methods: In-depth interviews exploring themes related to identity and psychosis were conducted with 10 participants from two early intervention services in New York City.
Findings: The experience of psychosis alienated many participants from themselves, although participants differed in whether these experiences were meaningful to their self-understanding. Participants also varied in how they sought to explain their experiences of psychosis; some participants questioned their diagnoses and the explanations offered to them, whereas others tried to negotiate between a clinical description of psychosis and their own understanding of their experiences. Many participants also experienced positive changes following their experience of psychosis, including greater maturity, empathy, and compassion.
Discussion: Some participants appeared to take on recovery styles of both integrating and sealing-over in response to their experience of psychosis, while most participants’ reports were suggestive of posttraumatic growth. Several struggled to make sense of the explanatory frameworks offered to them, drawing from various explanatory frameworks in a form of bricolage.

ii)  Longden, E., Corstens, D., Pyle, M., Emsley, R., Peters, S., Chauhan, N., Dehmahdi, N. and  Morrison, A.P.  (2021): Engaging dialogically with auditory hallucinations: design, rationale and baseline sample characteristics of the Talking With Voices pilot trial.  Psychosis.  Online:
https://doi.org/10.1080/17522439.2021.1884740

Abstract
The Talking With Voices (TWV) pilot trial assesses feasibility and acceptability of a novel dialogical intervention to ameliorate distress associated with auditory hallucinations. The single-site, single-blind (rater) feasibility randomised controlled trial recruited adult participants with a diagnosis of schizophrenia-spectrum disorder who were allocated to either treatment as usual (TAU), or TAU plus up to 26 sessions of TWV therapy over six months. Participants were assessed at baseline and at six-month follow-up. The primary outcomes are quantitative and qualitative assessments of feasibility and acceptability amongst patients and healthcare staff. Secondary outcomes are clinical measures, including targeted instruments for voice hearing, dissociation, and emotional distress. Recruitment figures and baseline characteristics of the sample are reported (N = 50). The TWV pilot trial aims to extend the evidence-base for interventions which use techniques such as dialogue, formulation, and trauma-informed working to improve relationships between hearer and voice, with results intended to inform a definitive, randomised trial to assess clinical and cost-effectiveness of the intervention. Current findings demonstrate that recruitment and treatment allocation targets were met. If shown to be acceptable, the intervention may provide new therapeutic options for voice hearers with a diagnosis of psychosis.

iii)  Orsi, J.A., Malinowski, F.R.L. Kagan, S., Weingarten, R., Villares, C.C., Bressan, R.A., de Oliveira, W.F.,  Andrade, M.C.R. and Gadelha, A.  (2021)  Evaluation of ongoing participation of people with schizophrenia in a mutual support group as a complementary intervention to outpatient psychiatric treatment.  Psychiatric Quarterly. Online:
https://doi.org/10.1007/s11126-021-09893-z

Abstract
This study aims to evaluate a group of people with schizophrenia undergoing outpatient treatment and who participate in a mutual support intervention, compared to another group of people with the same diagnosis, but attending only the usual outpatient treatment. This is a prospective study, with two measurements between six months. The mutual support group was initially composed of 16 people and the treatment as usual group was composed of 15 people. Clinical (medication adherence and functioning) and Recovery (hope, well-being, recovery and internalized stigma) outcomes were assessed. Nonparametric tests were used to verify differences in measurements between groups and between two moments. A higher level of internalized stigma and a decrease in the adherence to drug treatment in the treatment as usual group were verified. When comparing the pre-post difference between groups, there was a greater increase in adherence to drug treatment in the mutual support group. Our data point to more favourable results in the mutual support group, showing that ongoing participation in these groups is an important tool for the recovery process and for the treatment itself.

iv)  Phillips, C., Tai, S. and Berry, K.  (2021): Experiences of acute mental health inpatient care in the UK: from admission to readmission. Psychosis.  Online:
https://doi.org/10.1080/17522439.2021.1881596

Abstract
Eight service users with experiences of psychosis were interviewed about the support provided by mental services before, during and after acute mental health inpatients admissions in the UK. All participants had at least one other admission to an acute mental health ward in the preceding six months. Interviews were analysed using Interpretative Phenomenological Analysis. Three themes were identified: 1) Quality of therapeutic relationships, 2) Adjusting to sudden shifts in care, 3) Struggling without the ward environment. Although participants acknowledged positive care experiences within their narratives, significant challenges were evident in the abilities of services to effectively meet service users’ needs across the care pathway. Findings highlight the importance of consistent support centred on service users’ needs at all stages of care. Service users need support to build autonomy and coping skills to sustain meaningful recovery within the community and reduce the likelihood of readmission.

v)  Enticott, J.C., Shawyer, F., Brophy, L.M., Russell, G., Mazza, D., Wilson-Evered, E., Weller, P.J., Slade, M., Edan, V. and Meadows, G.N.  (2021) REFOCUS-PULSAR Recovery-oriented practice training in adult primary mental health care: exploratory findings including from a pretest–posttest evaluation. Front. Psychiatry.  12:625408.
https://doi.org/10.3389/fpsyt.2021.625408

Abstract
Objectives: Australian general practitioners (GPs) are pivotal in mental health care. The REFOCUS-PULSAR (Principles Unite Local Services Assisting Recovery) primary care study aimed to improve personal recovery outcomes in adults with mental health problems consulting GPs.
Design: Modified from an intended stepped-wedge cluster study, an exploratory (pre- and post-intervention) design employed cross-sectional surveys of patients consulting GPs.
Setting: Eighteen primary care sites (clusters) in Victoria, Australia in 2013–2017.
Participants: From 30 GPs recruited, 23 participated (76%), with 235 patient surveys returned from adults aged <75 years receiving mental health care.
Intervention: A co-delivered face-to-face training intervention for GPs in recovery-oriented practice (ROP), with personal recovery a key focus, used multimedia, mnemonics, and targeted interview schedules to encourage ROP—with availability of support sessions for 1 year.
Outcome Measures: Primary: the Questionnaire about the Process of Recovery full-scale score (outcome). Secondary: INSPIRE (experience),Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and Kessler Psychological Distress Scale (K10) (outcomes). Other: General-practice-Users Perceived-need Inventory (experience).
Results: Small positive significant effects indicated primary-outcome post-intervention improvements [t-test (233) = −2.23, p = 0.01], also improvement in two secondary outcomes (WEMWBS t(233) = −2.12, p = 0.02 and K10 t(233) = 2.44, p = 0.01). More patients post-intervention reported “no need” for further help from their GP; but in those reporting needs, there was greater unmet need for counselling.
Conclusions: ROP implementation, internationally influential in specialist mental health care, here is explored in primary care where it has had less attention. These exploratory findings suggest better patient outcomes followed introducing GPs to ROP in routine practice conditions. Higher unmet need for counselling post-intervention reported by patients might be a sign of limited supply despite ROP facilitating better identification of needs. Challenges in project implementation means that these findings carry risks of bias and flag the importance establishing research infrastructure in primary care.

vi)  Hornstein, G.A., Branitsky, A. and Robinson Putnam, E.  (2021): The diverse functions of hearing voices peer-support groups: findings and case examples from a US national study. Psychosis.  Online:
https://doi.org/10.1080/17522439.2021.1897653

Abstract
Hearing voices peer-support groups (HVGs) enable people coping with voices, visions, or other unshared perceptual experiences to explore the particularities and potential meanings of their experiences while receiving support from others facing similar challenges. HVGs have now spread to 30 countries on five continents, and many members report profound life changes as a result of participating. Yet systematic research exploring how and why these groups work is still in its early stages. To understand the diverse functions that HVGs can serve, we analyzed the experiences of 111 group members across the US, who provided detailed accounts of their voice-hearing histories and group participation. Using phenomenological and thematic analyses, our collaborative team of voice hearers and researchers identified key elements that make HVGs distinctive, including their prioritizing of self-determination; de-emphasizing behavioural targets or pressure to change; respecting and welcoming multiple frameworks of understanding; cultivating curiosity about perplexing experience in any form; and fostering egalitarian collaboration and genuine relationships among members seen as “experts by experience.” We illustrate the dynamic relations among these elements through case examples, and then outline comparisons between HVGs and other types of groups, as well as directions for future research.

vii)  Wynter, E., Meade, T. and Perich, T. (2021) Parental and partner role functioning and personal recovery in bipolar disorder.  Journal of Clinical Psychology.  Online:
https://doi.org/10.1002/jclp.23127

Abstract
Objectives: Bipolar disorder research has primarily focused on clinical outcomes but there is increasing understanding of the importance of personal recovery. This study aimed to explore the relationship between functioning in key social roles including parenting and intimate relationships with personal recovery.
Method: Participants with bipolar disorder (N = 393) were recruited to participate in an online survey. Participants provided clinical information and completed measures of personal recovery, parental and intimate relationship functioning.
Results: Parental functioning and intimate relationship functioning were found to be significantly associated with recovery scores with higher scores being associated with greater recovery. Parental functioning was also found to have a predictive effect, with higher parental functioning predicting greater recovery scores.
Conclusions: This study suggests that greater parental functioning may have an important role in the experience of personal recovery for people living with bipolar disorder. Future studies should further assess how supporting parenting may contribute recovery outcomes.

viii)  Aga, N., Rowaert, S., Vander Laenen, F., Vandevelde, S., Vander Beken, T., Audenaert, K. and Vanderplasschen, W. (2021)  Connectedness in recovery narratives of persons labelled Not Criminally Responsible: a qualitative study.  International Journal of Forensic Mental Health. Online:
https://doi.org/10.1080/14999013.2021.1880503

Abstract
Objective: Connectedness is placed at the heart of the recovery process in mental health care. However, in regard to persons labelled not criminally responsible (NCR), considerations of recovery and connectedness remain in the background. The aim of this study is to under- stand and explore how individuals labelled not criminally responsible experience connectedness.
Research method: Sixty-seven in-depth interviews were examined and thematically analyzed.
Results: Interviews revealed emotional, functional and personal connectedness as categories of connectedness, each with different qualitative determinants.
Conclusion: This study shows that connectedness should be considered as an essential ingredient of the recovery process by practitioners as well as policy makers. We recommend a shift from an individualistic, punitive approach toward a recovery-supportive rhetoric and more ‘shared decision making’ between service users and providers at all levels

Other News

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:
The Recovery Research Team at University of Nottingham is running the NEON trials, which are looking at whether access to online stories of recovery from mental health problems can help people affected by mental health problems. People can join the trials at https://www.recoverystories.uk.

We currently have over 1,600 participants from across England taking part, so many thanks to the Recovery Research Network for all the support. Trials will be closing to recruitment very soon, so if you know of anyone who might want to take part, please let them know. The three trials are:

• People with experience of psychosis in the NEON Trial
• People living with any other type of mental health problem in the NEON-O Trial
• Carers of people living with ANY mental health problem in the NEON-C Trial

We have recently featured on the BBC Radio 4 programme ‘All in the mind’ and on the BBC South East regional news. If you are interested in hearing more about the study you can take a look at www.bbc.co.uk/programmes/m000pfh3 and https://bit.ly/2MlQxoC

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

April 2021

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 Healh

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 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 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).

iv)  Lancet Psychiatry Commission on the Psychoses in a Global Context: Request for participatory & or user-led research, commentaries & reports.

The Lancet Commission on the Psychoses in a Global Context consists of a group of researchers, policy makers, clinicians , family members and service users convened to produce a comprehensive knowledge synthesis and vision for future research and development focused on psychosis. As part of the overall Commission, the lived experience/psychosocial disabilities involvement workgroup will be conducting a systematic review of studies and reports focused on psychosis that have utilized participatory methods (spanning user/survivor-led research, co-production, participatory action research and so on). While we will conduct traditional searches of the academic literatures, due to the variety of terms used internationally and variations in reporting of methods or lived experience/stakeholder involvement, we are seeking self-submissions of relevant work in the following categories:

• Peer reviewed research studies of any kind (autoethnographic qualitative, quantitative, etc.) led or co-led by researchers who identify as service users/persons with psychosocial disability/lived experience;
• Peer-reviewed research studies of any kind (qualitative, quantitative, mixed methods) that have included an explicit service user/psychosocial disability and/or family participation component;
• Doctoral dissertations or theses that would otherwise meet the above criteria and have not (yet) been published;
• Commentaries specifically focused on psychosis (language, subjective experience, service reform, innovation, human rights, etc.) and that are led or co-produced by authors with personal experience of psychosis, whether they appear in academic or non-academic venues;
• Self nominated studies or evaluations using participatory methodologies that have not been published in a peer-reviewed academic journal (ie ‘grey literature’ texts) but that include some description of methodology (who the sample is, what methods were used, how data was analyzed).
• Note that submissions can be in any language – we are actively working on developing translated versions of the flyer and survey: please contact us to request a copy in another language.

Have something to submit? Click or copy the URL below
https://usf.az1.qualtrics.com/jfe/form/SV_5ptxGnxIayEZhsy

Questions? : contact us at lancetcommissionpsychosis@gmail.com

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)  Boden‐Stuart, Z. V., Larkin, M., and Harrop, C. (2021). Young adults’ dynamic relationships with their families in early psychosis: Identifying relational strengths and supporting relational agency. Psychology and Psychotherapy: Theory, Research and Practice.  Online:
https://doi.org/10.1111/papt.12337

Abstract
Objectives: Most existing research on the family context of psychosis focuses on the ‘burden’ of caring for people experiencing psychosis. This research is the first to ask young people experiencing early psychosis to ‘map’ and describe their experiences and understandings of their family relationships, and how they have related to their psychosis and recovery.
Design: The research took an inductive, multimodal hermeneutic–phenomenological approach (Boden, Larkin & Iyer, 2019, Qual. Res. Psychology, 16, 218-236; Boden & Larkin, 2020, A handbook of visual methods in psychology, 358-375).
Method: Ten young adults (18–23), under the care of early intervention in psychosis services in the UK, participated in an innovative relational mapping interview (Boden, Larkin & Iyer, 2018), which invited participants to draw a subjective ‘map’ of their important relationships. This visual methodology enables subtle, complex, ambivalent, and ambiguous aspects of the participants’ experiences to be explored.
Results: Findings explore the participants’ accounts of how they love, protect, and care for their families; how they wrestle with family ties as they mature; and their feelings about talking about their mental health with loved ones, which was typically very difficult.
Conclusions:  This paper advances understanding of recovery in psychosis through consideration of the importance of reciprocity, and the identification and nurturance of relational strengths. The capacity of a young person to withdraw or hold back when trying to protect others is understood as an example of relational agency. The possibility for extending strengths-based approaches and family work within the context of early intervention in psychosis services is discussed.

ii)  Mbanu, J. (2021) Understanding how patients with psychosis would prefer to be contacted about research.  Psychosis,13(1) 71-77.  Online:
https://doi.org/10.1080/17522439.2020.1798490

Abstract
Background: There has been no published research exploring the attitudes of people with psychosis to different communication methods for being contacted about research.
Methods: Fifty patients diagnosed with schizophrenia, psychosis and related disorders completed an open ended questionnaire about: The method(s) by which patients with psychosis would prefer to be contacted about research opportunities; attitudes towards texting as a proposed method for informing patients about research studies; attitudes towards being contacted from a private number; and preferred contact method(s) for research appointment reminders.
Results: Emergent themes from the questionnaire are presented.
Conclusions: The implications for improving research engagement within the psychosis population are discussed and scope for further research highlighted.

iii)  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. (2021) A five-year prospective evaluation of a new community psychosis service in North London: introducing the Recovery and Enablement Track (RET) Psychosis, 13(1) 1-12
https://doi.org/10.1080/17522439.2020.1803954

Abstract
Background: 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

iv)  Todd, T. (2021) “Epistemic injustice” in the administration of mental health legislation. Psychosis, 13(1) 85-88
https://doi.org/10.1080/17522439.2020.1853204

Abstract
The concept of “Epistemic Injustice” was used as a tool to interpret practices applied during the administration of Mental Health legislation by the Mental Health Tribunal Scotland. This highlighted instances of being wronged on several occasions in my capacity as a knower. Example contributory factors included the Tribunal structure and suboptimal application of heuristics by panel members. Factors associated with an appeal process involving a “Designated Medical Practitioner” may offer some potential for improvement of routine application of administrative aspects of Mental Health legislation. Testimonial and hermeneutical issues should be considered.

v)  Nakanishi, S., Kurokawa, G., Niimura, J., Nishida, A., Shepherd, G. and Yamasaki, S. (2021)
System-level barriers to personal recovery in mental health: qualitative analysis of co-productive narrative dialogues between users and professionals.  BJPsych Open. 7, e25, 1–8. https://doi.org/10.1192/bjo.2020.156

Abstract
Background:  No co-productive narrative synthesis of system-level facilitators and barriers to personal recovery in mental illness has been undertaken in Japan previously.
Aims:  To clarify system-level facilitators and barriers to personal recovery of people with mental illness.
Method:  Qualitative study guided by thematic analysis. Data were collected through one focus group, which involved seven service users and three professionals. This group had 11 meetings, each lasting 2h at a local research institute, between July 2016 to January 2018.
Results:  The analysis yielded three themes: barriers inhibiting positive interaction within personal relationship networks, roots of barriers from mental health systems and the social cultural context, and possible solutions to address the roots. Barriers were acknowledged as those related to sense of safety, locus of control within oneself and reunion with self. The roots of barriers were recognised within mental health services, including system without trauma sensitivity, lack of advocacy support and limited access to psychosocial approaches. Roots from social cultural context were also found. There were no narratives relating to
facilitators. A possible solution was to address the roots from systems. Social cultural change was called for that makes personalised goals most valued, with an inclusive design that overcomes stigma, to achieve an open and accepting community.
Conclusions: The analysis yielded system-level barriers specific to each recovery process. Roots of barriers that need transformation to facilitate personal recovery were identified within mental health services. Social interventions should be further explored to translate the suggested social cultural changes into action.

vi)  Hui, A., Rennick-Egglestone, S., Franklin, D., Walcott, R., Llewellyn-Beardsley, J., Ng, F., et al. (2021) Institutional injustice: Implications for system transformation emerging from the mental health recovery narratives of people experiencing marginalisation. PLoS ONE 16(4): e0250367.
https://doi.org/10.1371/journal.pone.0250367

Abstract
Background:  Institutional injustice refers to structures that create disparities in resources, opportunities and representation. Marginalised people experience institutional injustice, inequalities and discrimination through intersecting personal characteristics and social circumstances. This study aimed to investigate sources of institutional injustice and their effects on marginalised people with experience of mental health problems.
Methods: Semi-structured interviews were conducted with 77 individuals from marginalised groups with experience of mental health problems, including psychosis, Black, Asian and minority ethnic (BAME) populations, complex needs and lived experience as a work requirement.  These were analysed inductively enabling sensitising concepts to emerge.
Findings:  Three processes of institutional injustice were identified: not being believed because of social status and personal backgrounds; not being heard where narratives did not align with dominant discourses, and not being acknowledged where aspects of identity were disregarded. Harmful outcomes included disengagement from formal institutions through fear and mistrust, tensions and reduced affiliation with informal institutions when trying to consolidate new ways of being, and damaging impacts on mental health and wellbeing through multiple oppression.
Conclusions:  Institutional injustice perpetuates health inequalities and marginalised status. Master status, arising from dominant discourses and heuristic bias, overshadow the narratives and experiences of marginalised people. Cultural competency has the potential to improve heuristic availability through social understandings of narrative and experience, whilst coproduction and narrative development through approaches such as communities of practice might offer meaningful avenues for authentic expression.

vii)  Slade, M. (2021) Management of a High-Performing Mental Health Recovery Research Group.  Int. J. Environ. Res. Public Health 18, 4007.
https://doi.org/10.3390/ijerph18084007

Abstract: A personal perspective is given on the processes involved in managing and sustaining a high-performing mental health recovery research group. The broader context of scholarship in the United Kingdom is outlined, in which academic productivity is commodified specifically in relation to peer-reviewed journal papers. Four leadership choices in developing a high-performing research group are discussed: optimal group size; sharing the workload; maintaining a programmatic focus; and performance expectations. Approaches to maximising innovation are identified, including emotional and intellectual engagement of team members, working with diverse stakeholders and convening communities of practice. We use a highly managed approach to publications from inception to acceptance, which is described in detail. The use of these approaches is illustrated in relation to the Recovery Research Team which was formed in 2009. Specific recovery-related issues covered include demonstrating the ability to develop a significant recovery research portfolio (our four current large [>UK£2 m] studies relate to recovery narratives, global mental health peer support work, digital interventions and Recovery Colleges); the positive implications of actively recruiting researchers with mental health lived experience; how performance issues are managed; our approach to involving lived experience co-authors in papers; and our decision to conduct mixed-methods rather than solely qualitative studies.

Other News

i)  Recovery stories:
The Recovery Research Team at University of Nottingham is running the NEON trials, which are looking at whether access to online stories of recovery from mental health problems can help people affected by mental health problems.

We are delighted to announce that we have now completed recruitment to all three of our trials, with 1830 people from across England taking part. We wanted to take this opportunity to thank everyone who has helped us out over the past year, we couldn’t have done it without all of the support we have received, much of which we will never know about.

We will now shift our focus to the continued running of the trials, which will enable us to understand how recovery stories can help people.
If you’re interested in keeping up with NEON’s progress, we’ll be posting regular updates to our News page. In late 2022 or early 2023, results from our trials will be made available on the NEON websitein the form of a research publication and a programme summary.

Thank you again for your support

ii)  Writing out of Canterbury Christ Church University, trainee Clinical Psychologist Becky Donne advertises the following research study:
A research team from Canterbury Christ Church University is looking for participants for a study exploring voice-hearers’ experiences of reading narratives about hearing voices contained in the following books:

• Accepting Voices by Marius Romme
• Living with Voices: 50 stories of recovery by Marius Romme and Sandra Escher
• Young People Hearing Voices by Marius Romme and Sandra Escher
• Learning from the Voices in my Head by Eleanor Longden
• Hearing Voices, Living Fully by Claire Bien
• Recovery: An Alien Concept? by Ron Coleman
• Working with Voices II: Victim to Victor by Ron Coleman and Mike Smith

We would like to talk to adults (18+) who identify as hearing voices (currently or in the past) and have read at least half of one of the above books. If you are interested in taking part in this study or would like some more information, please visit https://tinyurl.com/3bzbrswp or email Becky Donne (lead researcher) at b.donne204@canterbury.ac.uk  Participation is completely voluntary and all personal information will be kept confidential.

iii)  Prof. Steve Gillard draws attention to the recruitment of up to two PhD studentships at City, University of London, and writes:
One project is on peer support in A&E, and the other about assessment for trauma and complex-PTSD in Black British people using mental health services. The latter is ring-fenced for Black British students. For more information please see:
https://www2.i-grasp.com/fe/tpl_cityuniversity01.asp?s=4A515F4E5A565B1A&jobid=117115,3577123421&key=225047236&c=86480234528254&pagestamp=sewwxzbfwsnxhxrlds

The deadline is the 7th June, and it is advised that anyone interested would be encouraged to contact Prof. Gillard (or one of the other supervisors) in the first instance to discuss the application process.  Prof. Gillard can be contacted at:
sgillard@sgul.ac.uk

iv)  Focussed upon mental health recovery, wellbeing and social inclusion, the University of Nottingham are advertising for a Research Associate/Fellow (fixed-term).  For more information please see:
https://www.nottingham.ac.uk/jobs/currentvacancies/ref/MED133221

v)  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

vi)  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

May 2021

International call to support the Trieste Mental Health Service Model
Due to the importance of the request, we are prefacing our May 2021 edition of the RRN ebulletin with an urgent appeal made by Dr Roberto Mezzina, Chair – International Mental Health Collaborating Network.

Dr Mezzina has written out for support following challenge to the Trieste Mental Health Service Model.  The Trieste model has been internationally renowned for its innovative way of working, which currently includes having peer support workers and employment co-operatives, with evidence demonstrating that community services can do well without the need for more than an 8 bedded ward in the general hospital for a population of 300,000 people.  The current challenge threatens a return to the old system, and re-opening the psychiatric hospitals.

Dr Mezzina’s letter (in full, below) is asking for support, with the request that the letter be signed and returned to him.  A link to the letter is hosted on the Change.org website, available here: http://chng.it/SMGHrcLj

The International Mental Health Collaborating Network (IMHCN) has put the English version of Dr Mezzina’s letter on its website too:
https://imhcn.org/news/call-to-add-your-support-for-triestes-current-challenges/

Mental Health disappearing permanently from the radar
Due to the Covid 19 pandemic, the already dramatic Italian situation consisting in a lack of resources in mental health services, has worsened further throughout all the country. Inaccessible mental health centers, contraction and even suspension of home visits, reduction of voluntary work and social cooperatives.

Nevertheless, it was thanks to the easy and quick access to Mental Health Centers, without waiting lists, that not only the services of Trieste, but those of the whole Region of Friuli Venezia Giulia, had consolidated a national and international recognition and reputation.

The WHO has indicated again, in these days, the Trieste model (which now has become regional) as a global example of an integrated network of community services. This recognition will appear in an important WHO document to be published soon. Responses to people “in real time”, with an approach that is not only psychiatric in the strict sense but broadened to respond to the needs of life in its all aspects, respecting and promoting human rights, have been the pillars of Trieste model.

In many other Italian regions, on the other hand, residential structures are spreading, often looking as traditional closed institutions, often privatized and absorbing most of the resources; people are tied up in squalid hospital wards; no home visits are provided; psychotropic drugs are used almost as the exclusive intervention (and often badly); people’s daily needs are burdened on families. This is the situation shown a few years ago by the Parliamentary Commission, which instead rewarded our services. However, despite the multiple awards, the current regional government from the very beginning did not hide the desire to put their hand on the Mental Health Services, and the achievement of the improvement objectives established by the Regional Plan for Mental Health in 2018 became immediately difficult. Listening to the requests of citizens and associations has been also substantially interrupted. There was a reduction in the workforce of all professional figures. The desire to reduce and merge the Community Mental Health Centers became clear, taking a direction which is the opposite to what should be the ultimate goal of a Community Mental Health Service, and so doing blocking the process undertaken during many years, including the functioning of mental health services for 24 hours, with the possibility of welcoming people in crisis in a non-alienating environment. All this has been questioned by re-proposing old hospital wards. This will be achieved with the administrative measures which will break the continuity of the management line.

After the numerous retirements, the management of the facilities, even of the Departments, has been entrusted to staff “acting”, or for short periods, with top functions often entrusted “to override” several services. At the same time, the competitions for the directions of the Mental Health Centers were suspended, and they will be reduced. In these days the competitions for leading positions in Trieste and Pordenone have restarted and quite bizarre rankings have come out: all those who were trained by Basaglia’s school have been penalized or excluded, despite years of commitment and excellent curricula, to the benefit of candidates, often unknown, who come from outside the region. We never thought that even in this region the spoils system would reach executive positions, in which skills and public health orientation should be fundamental elements.

We are entrusting our services to psychiatrists completely alien to consolidated – avant-garde experiences, and who, instead, come from backward situations, from psychiatric wards that are often closed and that still use physical restraint. In other words our services will be managed by people offering old-fashioned outpatient or hospitalization models instead of treatment and reintegration programs that respond to the needs of people with mental disorders. These self-defeating choices are harmful not only to the current system, but to citizens in general, and lead the way of the dismantling of the best services created by the psychiatric reform, resulting in the impoverishment and inefficiency of the public service which risks to become progressively privatized throughout Italy.

Citizens must be involved and restart from a strong alliance of users, families, professionals, services, putting together the experiences of yesterday and today before the breakdowns are irreparable and the huge heritage accumulated in 50 years of experience is dispersed. Freedom is therapeutic, it has been said and argued: it is a right, the greatest, for human beings the one which Franco Basaglia has given back to all Italians, closing the asylums and changing the law. For this reason, let’s not leave the services alone, and let’s prevent the mental health services of the region, from disappearing permanently from the radar, with serious damage for everyone.

Mauro Asquini, Renzo Bonn, Angelo Cassin, Peppe Dell’Acqua, Roberto Mezzina, Franco Perazza, Franco Rotelli (Ex Directores de los Departamentos de Salud Mental de Trieste, Gorizia, Udine, Alto Friuli e Pordenone) 

Grazia Cogliati, psichiatra 
Giovanna Del Giudice, presidente COPPERSAM “Conferenza Basaglia” 
John Jenkins, International Mental Health Collaborating Network
Mario Novello, psichiatra 
Sashi Sashidharan, psichiatra 
Benedetto Saraceno, past director department of Mental Health and Substance Abuse WHO 
Paul Baker, Secretary,  International Mental Health Collaborating Network

Please, add your name and affiliation.

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 Healh

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 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 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)  Lancet Psychiatry Commission on the Psychoses in a Global Context: Request for participatory & or user-led research, commentaries & reports.

The Lancet Commission on the Psychoses in a Global Context consists of a group of researchers, policy makers, clinicians , family members and service users convened to produce a comprehensive knowledge synthesis and vision for future research and development focused on psychosis. As part of the overall Commission, the lived experience/psychosocial disabilities involvement workgroup will be conducting a systematic review of studies and reports focused on psychosis that have utilized participatory methods (spanning user/survivor-led research, co-production, participatory action research and so on). While we will conduct traditional searches of the academic literatures, due to the variety of terms used internationally and variations in reporting of methods or lived experience/stakeholder involvement, we are seeking self-submissions of relevant work in the following categories:

• Peer reviewed research studies of any kind (autoethnographic qualitative, quantitative, etc.) led or co-led by researchers who identify as service users/persons with psychosocial disability/lived experience;
• Peer-reviewed research studies of any kind (qualitative, quantitative, mixed methods) that have included an explicit service user/psychosocial disability and/or family participation component;
• Doctoral dissertations or theses that would otherwise meet the above criteria and have not (yet) been published;
• Commentaries specifically focused on psychosis (language, subjective experience, service reform, innovation, human rights, etc.) and that are led or co-produced by authors with personal experience of psychosis, whether they appear in academic or non-academic venues;
• Self nominated studies or evaluations using participatory methodologies that have not been published in a peer-reviewed academic journal (ie ‘grey literature’ texts) but that include some description of methodology (who the sample is, what methods were used, how data was analyzed).
• Note that submissions can be in any language – we are actively working on developing translated versions of the flyer and survey: please contact us to request a copy in another language.

Have something to submit? Click or copy the URL below: 
https://usf.az1.qualtrics.com/jfe/form/SV_5ptxGnxIayEZhsy

Questions? : contact us at lancetcommissionpsychosis@gmail.com

iv)   From the Department of Mental Health and Substance Use at the World Health Organisation (WHO), Dr Michelle Funk announces the following event:

Online Launch Event
Thursday 10 June 2021 (15.00 to 16.45 CET)

“Is rights-based transformation truly possible in mental health? … Yes, and it’s already started!“

Many mental health services in high-, middle- and low-income countries around the world are failing people. Not only is access to services limited, but many people in distress and experiencing mental health crises are not receiving the support they need to feel better and move forward. Many people with mental health conditions and psychosocial disabilities are disempowered by mental health services and denied the right to decide over their own health and life choices. Some are further institutionalized and subject to coercive measures such as involuntary admission, forced treatment, seclusion, and restraints. These practices negatively impact people’s physical and mental health.

There is a different path that countries and services can take – no matter what part of the world.  This is the path towards rights-based services that respect people’s right to make decisions about their treatment and lives, that are free from coercive practices, that consider people in the context of their whole lives, that support people to be included in their community. These services also learn from and utilize the vast expertise of people with lived experience in order to provide responsive care and support.

Join us on 10 June at 15.00 CET for the launch of WHO’s new guidance on community mental health services: Promoting person-centred and rights-based approaches.  You will learn about innovative mental health services that are revolutionizing mental health practices and hear personal testimonies from people who use mental health services and service providers, as well as from national and international policy-makers who are calling for a sea-change in mental health. The event will include interpretation in Arabic, French and Spanish, and captioning will also be available.

• The draft launch programme is attached (see below)

• Please register now for the 10 June launch event here:  https://who.zoom.us/webinar/register/WN_2MQvtqJ_SlOOP25HCV-SEA

(After registering, you will receive a confirmation email containing information about joining the webinar)
 

Taken from the World Health Organisation website, and dated 24^th May 2021, the following overview is provided below:

Overview
The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches is a set of publications that provides information and support to all stakeholders who wish to develop or transform their mental health system and services to align with international human rights standards including the UN Convention on the Rights of Persons with Disabilities.

The main reference source for all stakeholders is the Guidance on community mental health services: Promoting person-centred and rights-based approaches document which provides a detailed description of person-centred and human rights-based approaches in mental health, and summary examples of good practice services around the world and recommendations for integrating such services into national health and social care systems and services. This comprehensive document is accompanied by a set of seven technical packages focused on specific categories of mental health services and guidance for setting up new services.

This guidance aims to empower governments, policy makers, health and social care professionals, nongovernmental organizations, organizations of persons with disabilities and other stakeholders, to introduce and scale up good practice mental health services that protect and promote human rights, ultimately improving the lives of people with mental health conditions and psychosocial disabilities everywhere

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)  Slade. M. et al. (2021) Recorded mental health recovery narratives as a resource for people affected by mental health problems: development of the narrative experiences online (NEON) intervention.  JMIR Formative Research.  5(5) e24417

Abstract
Background: The internet enables sharing of narratives about health concerns on a substantial scale, and some digital health narratives have been integrated into digital health interventions. Narratives describing recovery from health problems are a focus of research, including those presented in recorded (eg, invariant) form. No clinical trial has been conducted on a web-based intervention providing access to a collection of Recorded Recovery Narratives (RRNs). 
Objective: This study presents knowledge produced through the development of the Narrative Experiences Online (NEON) Intervention, a web-based intervention incorporating the algorithmic recommendation of RRNs.
Methods: Knowledge was gathered through knowledge integration (KI) activities. KI1 synthesized previous studies to produce the NEON Impact Model describing how accessing RRNs produces health-related outcomes. KI2 developed curation principles for the NEON Collection of RRNs through consultation with the NEON Lived Experience Advisory Panel and the curation of a preliminary collection. KI3 identified harm minimization strategies for the NEON Intervention through consultation with the NEON International Advisory Board and Lived Experience Advisory Panel. The NEON Intervention was finalized through 2 research studies (RS). In RS1, mental health service users (N=40) rated the immediate impact of randomly presented narratives to validate narrative feedback questions used to inform the recommendation algorithm. In RS2, mental health service users
(n=25) were interviewed about their immediate response to a prototype of the NEON Intervention and trial procedures and then were interviewed again after 1 month of use. The usability and acceptability of the prototype and trial procedures were evaluated and refinements were made.
Results: KI1 produced the NEON Impact Model, which identifies moderators (recipient and context), mechanisms of connection (reflection, comparison, learning, and empathy), processes (identification of change from narrative structure or content and internalization of observed change), and outcomes (helpful and unhelpful). KI2 identified 22 curation principles, including a mission to build a large, heterogeneous collection to maximize opportunities for connection. KI3 identified seven harm minimization strategies, including content warnings, proactive and reactive blocking of narratives, and providing resources for the self-management of emotional distress. RS1 found variation in the impact of narratives on different participants, indicating that participant-level feedback on individual narratives is needed to inform a recommender system. The order of presentation did not predict narrative feedback. RS2 identified amendments to web-based trial procedures and the NEON Intervention. Participants accessed some narratives multiple times, use reduced over the 4-week period, and narrative feedback was provided for 31.8% (105/330) of narrative accesses.
Conclusions: RRNs can be integrated into web-based interventions. Evaluating the NEON Intervention in a clinical trial is feasible. The mixed methods design for developing the NEON Intervention can guide its extension to other clinical populations, the design of other web-based mental health interventions, and the development of narrative-based interventions in mental health.

ii)  Charles et al. (2021) Initial training for mental health peer support workers: systematized review and international Delphi consultation. JMIR Mental Health 8(5) e25528

Abstract
Background: Initial training is essential for the mental health peer support worker (PSW) role. Training needs to incorporate recent advances in digital peer support and the increase of peer support work roles internationally. There is a lack of evidence on training topics that are important for initial peer support work training and on which training topics can be provided on the internet.
Objective: The objective of this study is to establish consensus levels about the content of initial training for mental health PSWs and the extent to which each identified topic can be delivered over the internet.
Methods: A systematized review was conducted to identify a preliminary list of training topics from existing training manuals. Three rounds of Delphi consultation were then conducted to establish the importance and web-based deliverability of each topic. In round 1, participants were asked to rate the training topics for importance, and the topic list was refined. In rounds 2 and 3, participants were asked to rate each topic for importance and the extent to which they could be delivered over the internet.
Results: The systematized review identified 32 training manuals from 14 countries: Argentina, Australia, Brazil, Canada, Chile, Germany, Ireland, the Netherlands, Norway, Scotland, Sweden, Uganda, the United Kingdom, and the United States. These were synthesized to develop a preliminary list of 18 topics. The Delphi consultation involved 110 participants (49 PSWs, 36 managers, and 25 researchers) from 21 countries (14 high-income, 5 middle-income, and 2 low-income countries). After the Delphi consultation (round 1: n=110; round 2: n=89; and round 3: n=82), 20 training topics (18 universal and 2 context-specific) were identified. There was a strong consensus about the importance of five topics: lived experience as an asset, ethics, PSW well-being, and PSW role focus on recovery and communication, with a moderate consensus for all other topics apart from the knowledge of mental health. There was no clear pattern of differences among PSW, manager, and researcher ratings of importance or between responses from participants in countries with different resource levels. All training topics were identified with a strong consensus as being deliverable through blended web-based and face-to-face training (rating 1) or fully deliverable on the internet with moderation (rating 2), with none identified as only deliverable through face-to-face teaching (rating 0) or deliverable fully on the web as a stand-alone course without moderation (rating 3). 
Conclusions: The 20 training topics identified can be recommended for inclusion in the curriculum of initial training programs for PSWs. Further research on web-based delivery of initial training is needed to understand the role of web-based moderation and whether web-based training better prepares recipients to deliver web-based peer support.

iii)  Griffiths, C. et al. (2021) A qualitative study of early intervention psychosis (EIP) service patient’s experience of sleep, exercise, sleep hygiene advice and fitbit.  Wearable activity and sleep tracker.  Open Journal of Psychiatry. 11. 91-106.  Online:
https://doi.org/10.4236/ojpsych.2021.112009

Abstract
Background: In psychosis physical activity, sleep, mental health, physical health, wellbeing, quality of life, cognition and functioning are interconnected. People who experience psychosis are more likely than the general population to have low levels of physical activity, high levels of sedentary behaviour and sleep problems. This project was innovative in seeking to address these issues through provision of a wearable activity and sleep tracker (a Fitbit)
and sleep hygiene advice.
Participants: Participants using an early intervention psychosis (EIP) service took part in an eight-week intervention, which incorporated the provision of a Fitbit, sleep hygiene advice as well as three engagement, feedback and discussion points with a clinician.
Methods: A qualitative approach was used to conduct in-depth semi-structured interviews with 12 of the 25 intervention participants (5 male; 7 female). Thematic and content analyses were employed to analyse the data.
Results: Participants provided valuable insights into their experience of sleep, exercise, Fitbit use and sleep hygiene advice use. It was found that participants placed a high value on effective night time sleep, recognized improvements in physical activity and noted a positive effect on mood and wellbeing as a result of Fitbit use. The negative impact of having ineffective night time sleep and insufficient physical activity was described. Participants demonstrated a good level of understanding of the connection between sleep, exercise, wellbeing, and health.
Conclusion: Participants reported the Fitbit and sleep hygiene advice received through an EIP service to be beneficial for improved levels of physical activity and exercise, and more effective sleep. This is a simple and low cost intervention which could be made widely available through EIP and other mental health services.

iv)  Skar-Fröding, R. et al. (2021) Relationship between satisfaction with mental health services, personal recovery and quality of life among service users with psychosis: a cross-sectional study.  BMC Health Services Research. 21:439.  Online:
https://doi.org/10.1186/s12913-021-06409-0

Abstract
Background: Mental health policy internationally emphasizes patient centredness and personal recovery. This study investigated the relationship between satisfaction with mental health services among service users with psychosis in Norway, and personal recovery, perceived support for personal recovery, and quality of life.
Methods: Cross-sectional data were collected from 292 service users diagnosed with psychosis from 39 clinical sites across Norway. Satisfaction with services was assessed using the Client Satisfaction Questionnaire-8. A linear mixed model was estimated to explore the relationship between satisfaction with services and preselected covariates, and to control for confounding factors.
Results: A large majority of participants (89%) reported moderate-to-high levels of satisfaction. Satisfaction with services was positively associated with perceived support for personal recovery, but not with personal recovery or quality of life. In addition, service users under a Community Treatment Order (CTO) were significantly less satisfied than those who were not.
Conclusions: Satisfaction levels among service users were higher compared with similar, international studies. Those who feel supported in their personal recovery were more satisfied with the care they receive, which support the need for implementation of recovery-oriented practices for service users with psychosis. However, satisfaction with services was not related to service user-rated quality of life or level of personal recovery; thus, more follow-up studies are needed. The lower satisfaction of service users placed under CTOs shows the importance of targeted interventions to improve satisfaction with services among this group.

v)  Cooper, R. E. et al. (2021) Opinion piece: The case for establishing a minimal medication alternative for psychosis and schizophrenia.  Psychosis.  Online:
https://doi.org/10.1080/17522439.2021.1930119

Abstract
The development of severe mental health conditions is strongly linked to our environments, particularly experiences of trauma and adversity. However treatments for severe mental health conditions are often primarily biomedical, centred around medication. For people diagnosed with schizophrenia or psychosis, this is antipsychotic medication. Although antipsychotics have been found to reduce symptoms and risk of relapse, some patients derive little benefit from these drugs, and they can lead to severe adverse effects. Subsequently, a high proportion of people do not want to take antipsychotics and request an alternative. Yet in the UK and in many countries there are currently no guidelines for stopping antipsychotics or formal treatment alternatives, despite such alternatives being available in some countries. For example, in Norway and Vermont (USA), in response to pressure from service user organisations, governments have mandated the establishment of “minimal medication” services. We examine whether everyone with a psychotic condition needs long-term antipsychotic treatment and evidence for alternative models of care. We recommend that healthcare providers should be encouraged to develop a psychosocial treatment package for people with psychosis or schizophrenia that provides a realistic possibility of minimising antipsychotic exposure.

vi)   Dawson, S., Muir-Cochrane, E., Simpson, A. and Lawn, S. (2021). Risk versus recovery: Care planning with individuals on community treatment orders. International Journal of Mental Health Nursing. Online (early view)
https://doi.org/10.1111/inm.12877

Abstract
Community treatment orders (CTOs) require individuals with a mental illness to accept treatment from mental health services. CTO legislation in South Australia states that treatment and care should be recovery-focused, although justification for use is predominantly risk-based, and care often coercive. Although CTOs are contested, individuals, families, and clinicians frequently engage in care planning within this context. This paper examines how the concepts of risk and risk management impact care planning from the perspectives of individuals on CTOs, their families, and clinicians. Ethnographic methods of observation and interview provided a detailed account of the perspectives of each group over an 18-month period from two community mental health teams in South Australia. Findings show that care planning occurred within a culture of practice dominated by risk. Risk, however, was understood differently by each participant group, with the dominant narrative informed by biogenetic understandings of mental illness. This dominance impacted on the positioning of participant groups in care planning, focus of care contacts, and care options available. To improve care experiences and outcomes for individuals on CTOs, narrow conceptualizations of risk and recovery need to broaden to include an understanding of personal and social adversities individuals face. A broader understanding should reposition participants in the care planning context and rebalance care discussions, from a focus on clinical recovery to recovering citizenship.

vii)  Holtum, S., Wright, T. and Wood, C. (2021) Art therapy with people diagnosed with psychosis: therapists’ experiences of their work and the journey to their current
practice.  International Journal of Art Therapy.  Online:
https://doi.org/10.1080/17454832.2021.1893370

Abstract
Background: There was insufficient understanding of how art therapists experience their work with people with psychosis-related diagnoses, and of their practice development.
Aims: To understand art therapists’ perceived practise and its development regarding psychosis. 
Methods: Within a grounded theory framework, interviews and a focus group carried out in the years 2015–2017 elicited the experiences of 18 UK-based art therapists, working in a range of National Health Service (NHS) contexts, concerning art therapy in relation to psychosis and how they developed their current practice. Audio-recordings were transcribed verbatim and analysed to build theory.

Results: The grounded theory proposes how practice and its development intertwine. Training confers resilience but therapists learn greatly from their clients, enhancing their ability for alliance building. Therapists’ early struggles also spur further training. Skills for trauma are helpful. Clients may become stuck or disengage, and/or develop through ongoing engagement with art and the art therapist, who supports their journey. The service and wider societal contexts impact the art therapist’s work through their effect on clients and/or the art therapist’s ability to attune to clients.
Conclusions: The findings concur with previous research regarding common therapeutic factors, especially the alliance, and on other therapists’ practice development. Implications for practice and research: Understanding therapy processes should incorporate service and societal influences on therapist and client. Training needs to include understanding adversity and trauma, and working with trauma.

Other News

i)  Recovery stories:
The Recovery Research Team at University of Nottingham is running the NEON trials, which are looking at whether access to online stories of recovery from mental health problems can help people affected by mental health problems.

We are delighted to announce that we have now completed recruitment to all three of our trials, with 1830 people from across England taking part. We wanted to take this opportunity to thank everyone who has helped us out over the past year, we couldn’t have done it without all of the support we have received, much of which we will never know about.

We will now shift our focus to the continued running of the trials, which will enable us to understand how recovery stories can help people.
If you’re interested in keeping up with NEON’s progress, we’ll be posting regular updates to our News page. In late 2022 or early 2023, results from our trials will be made available on the NEON websitein the form of a research publication and a programme summary.

Thank you again for your support

ii)  Writing out of Canterbury Christ Church University, trainee Clinical Psychologist Becky Donne advertises the following research study:
 A research team from Canterbury Christ Church University is looking for participants for a study exploring voice-hearers’ experiences of reading narratives about hearing voices contained in the following books:

• Accepting Voices by Marius Romme
• Living with Voices: 50 stories of recovery by Marius Romme and Sandra Escher
• Young People Hearing Voices by Marius Romme and Sandra Escher
• Learning from the Voices in my Head by Eleanor Longden
• Hearing Voices, Living Fully by Claire Bien
• Recovery: An Alien Concept? by Ron Coleman
• Working with Voices II: Victim to Victor by Ron Coleman and Mike Smith

We would like to talk to adults (18+) who identify as hearing voices (currently or in the past) and have read at least half of one of the above books. If you are interested in taking part in this study or would like some more information, please visit https://tinyurl.com/3bzbrswp or email Becky Donne (lead researcher) at b.donne204@canterbury.ac.uk  Participation is completely voluntary and all personal information will be kept confidential.

iii)  Prof. Steve Gillard draws attention to the recruitment of up to two PhD studentships at City, University of London, and writes:
 One project is on peer support in A&E, and the other about assessment for trauma and complex-PTSD in Black British people using mental health services. The latter is ring-fenced for Black British students. For more information please see:
https://www2.i-grasp.com/fe/tpl_cityuniversity01.asp?s=4A515F4E5A565B1A&jobid=117115,3577123421&key=225047236&c=86480234528254&pagestamp=sewwxzbfwsnxhxrlds

The deadline is the 7th June, and it is advised that anyone interested would be encouraged to contact Prof. Gillard (or one of the other supervisors) in the first instance to discuss the application process.  Prof. Gillard can be contacted at:
sgillard@sgul.ac.uk

iv)  Writing out of the Department of Biostatistics and Health Informatics at King’s College London, Dr Sarah Markham draws attention to current research at a time of Covid-19:

The COVID-19 pandemic has led to over 3 million deaths worldwide. It has disrupted the lives of people across the world due to its rapid spread, mortality, disruption of social fabric, burden on health care systems, and devastating economic impact. There is widespread concern about the effects on mental health, particularly among vulnerable populations.

However, the rapid pace, volume, and limited quality of mental health evidence being generated and disseminated both through the media and academic channels during COVID-19 poses a barrier to effective synthesis and decision-making. We are conducting a series of living systematic reviews on mental health in COVID-19, including a review of randomised controlled trials of interventions to address mental health challenges in COVID-19 and longitudinal studies that compare mental health in COVID-19 to mental health prior to the pandemic or across points during the pandemic.

Here is a link to our COVID-19 Mental Health Living Systematic Review:
https://www.depressd.ca/covid-19-mental-health

v)  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

vi)  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

RRN e-bulletin June 2021

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)  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

ii)  Lancet Psychiatry Commission on the Psychoses in a Global Context: Request for participatory & or user-led research, commentaries & reports.

The Lancet Commission on the Psychoses in a Global Context consists of a group of researchers, policy makers, clinicians , family members and service users convened to produce a comprehensive knowledge synthesis and vision for future research and development focused on psychosis. As part of the overall Commission, the lived experience/psychosocial disabilities involvement workgroup will be conducting a systematic review of studies and reports focused on psychosis that have utilized participatory methods (spanning user/survivor-led research, co-production, participatory action research and so on). While we will conduct traditional searches of the academic literatures, due to the variety of terms used internationally and variations in reporting of methods or lived experience/stakeholder involvement, we are seeking self-submissions of relevant work in the following categories:

Peer reviewed research studies of any kind (autoethnographic qualitative, quantitative, etc.) led or co-led by researchers who identify as service users/persons with psychosocial disability/lived experience;
Peer-reviewed research studies of any kind (qualitative, quantitative, mixed methods) that have included an explicit service user/psychosocial disability and/or family participation component;
Doctoral dissertations or theses that would otherwise meet the above criteria and have not (yet) been published;
Commentaries specifically focused on psychosis (language, subjective experience, service reform, innovation, human rights, etc.) and that are led or co-produced by authors with personal experience of psychosis, whether they appear in academic or non-academic venues;
Self nominated studies or evaluations using participatory methodologies that have not been published in a peer-reviewed academic journal (ie ‘grey literature’ texts) but that include some description of methodology (who the sample is, what methods were used, how data was analyzed).
Note that submissions can be in any language – we are actively working on developing translated versions of the flyer and survey: please contact us to request a copy in another language.

Have something to submit? Click or copy the URL below or the  QR code to the right : 
https://usf.az1.qualtrics.com/jfe/form/SV_5ptxGnxIayEZhsy

Questions? : contact us at lancetcommissionpsychosis@gmail.com

 

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)  Penas, P., Uriarte, J-J., Gorbe, S., Slade, M., a-Concepci, M., Moreno-Calvete, M. C. and
Iraurgi, I. (2021) Discrepancy between experience and importance of recovery components in the symptomatic and recovery perceptions of people with severe mental disorders.  BMC Psychiatry. 21:277.  Online:
https://doi.org/10.1186/s12888-021-03287-y

Abstract
Background:  Personal recovery has become an increasingly important approach in the care of people with severe mental disorders and consequently in the orientation of mental health services. The objective of this study was to assess the personal recovery process in people using mental health services, and to clarify the role of variables such as symptomatology, self-stigma, sociodemographic and treatment.
Methods:  Standardised measures of personal recovery process, clinical recovery, and internalized stigma were completed by a sample of 312 participants in a Severe Mental Disorder program.
Results:  Users valued most the recovery elements of: improving general health and wellness; having professionals who care; hope; and sense of meaning in life. Significant discrepancies between perceived experience and relative importance assigned to each of the components of the REE were observed. Regression modelling (χ2 = 6.72, p = .394; GFI = .99, SRMR = .03) identified how positive discrepancies were associated with a higher presence of recovery markers (β = .12, p = .05), which in turn were negatively related to the derived symptomatology index (β = −.33, p < .001). Furthermore, the relationship between clinical and personal recovery was mediated by internalized stigma.
Conclusions: An improvement in psychiatric services should be focused on recovery aspects that have the greatest discrepancy between importance and experience, in particular social roles, basic needs and hope. Personal and clinical recovery are correlated, but the relationship between them is mediated by internalized stigma, indicating the need for clinical interventions to target self-stigma.

ii)  Castelein, S., Timmerman, M. E., PHAMOUS investigators, van der Gaag, M. and Visser, E.  (2021) Clinical, societal and personal recovery in schizophrenia spectrum disorders across time: states and annual transitions.  The British Journal of Psychiatry.  Online:
https://doi.org/10.1192/bjp.2021.48

Abstract
Background:  Recovery in schizophrenia is a complex process, involving clinical, societal and personal recovery. Until now, studies analysed these domains separately, without examining their mutual relations and changes over time.
Aims:  This study aimed to examine different states of recovery and transition rates between states.
Method:  The Pharmacotherapy Monitoring and Outcome Survey (2006–2017) yearly assesses patients with schizophrenia in the Northern Netherlands. Data from 2327 patients with one up to 11 yearly measurements on clinical, societal and personal recovery were jointly analysed with a mixture latent Markov model (MLMM).
Results:  The selected MLMM had four states that differed in degree and pattern of recovery outcomes. Patients in state 1 were least recovered on any domain (16% of measurements), and partly recovered in states 2 (25%; featured by negative symptoms) and 3 (21%; featured by positive symptoms). Patients in state 4 (38%) were most recovered, except for work, study and housekeeping.  At the subsequent measurement, the probability of remaining in the same state was 77–89%, transitioning to a better state was 4–12% and transitioning to a worse state was 4–6%; no transitions occurred between states 1 and 4. Female gender, shorter illness duration and less schizophrenia were more prevalent in better states.
Conclusions:  Quite a high recovery rate was present among a substantial part of the measurements (38%, state 4), with a high probability (89%) of remaining in this state. Transition rates in the other states might increase to a more favourable state by focusing on adequate treatment of negative and positive symptoms and societal problems.

iii)  Prytherch, H., Cooke, A. and Marsh, I. (2021) Coercion or collaboration:
service-user experiences of risk management in hospital and a trauma-informed crisis house.  Psychosis.13(2) 93-104
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.

iv)  Zidaru, T., Morrow, E. M. and Stockley, R. (2021) Ensuring patient and public involvement in the transition to AI-assisted mental health care: A systematic scoping review and agenda for design justice.  

Abstract
Background:  Machine-learning algorithms and big data analytics, popularly known as ‘artificial intelligence’ (AI), are being developed and taken up globally. Patient and public involvement (PPI) in the transition to AI-assisted health care is essential for design justice based on diverse patient needs.
Objective:  To inform the future development of PPI in AI-assisted health care by exploring public engagement in the conceptualization, design, development, testing, implementation, use and evaluation of AI technologies for mental health.
Methods:  Systematic scoping review drawing on design justice principles, and (i) structured searches of Web of Science (all databases) and Ovid (MEDLINE, PsycINFO, Global Health and Embase); (ii) handsearching (reference and citation tracking); (iii) grey literature; and (iv) inductive thematic analysis, tested at a workshop with health researchers.
Results:  The review identified 144 articles that met inclusion criteria. Three main themes reflect the challenges and opportunities associated with PPI in AI-assisted mental health care: (a) applications of AI technologies in mental health care; (b) ethics of public engagement in AI-assisted care; and (c) public engagement in the planning, development, implementation, evaluation and diffusion of AI technologies. 
Conclusion:  The new data-rich health landscape creates multiple ethical issues and opportunities for the development of PPI in relation to AI technologies. Further research is needed to understand effective modes of public engagement in the context of AI technologies, to examine pressing ethical and safety issues and to develop new methods of PPI at every stage, from concept design to the final review of technology in practice. Principles of design justice can guide this agenda.

v)  Skar-Fröding, R., Clausen, H. K., Benth, J. S., Ruud, T., Slade, M. and Heiervang, K. S. (2021)  The importance of personal recovery and perceived recovery support among service users with psychosis.  Psychiatric Services. 72(6) 661-668.  Online:
https://doi.org/10.1176/appi.ps.202000223

Abstract
Objective: More knowledge is needed about whether personal recovery, as defined by the CHIME framework (connectedness, hope, identity, meaning and purpose, and empowerment), is considered important by service users with psychosis. This study examined the importance of personal recovery for a large, heterogeneous group of service users with psychosis and their perceived support from clinicians for personal recovery.
Methods: This cross-sectional study used baseline data from 321 service users with psychosis from 39 clinical units across Norway. The INSPIRE Measure of Staff Support for Personal Recovery (based on CHIME) was used to examine personal recovery and perceived support provided for recovery. Twenty support-for-recovery items were each rated on importance (yes or no) and on the extent of support received (5-point scale). Bivariate and multiple linear regression models assessed variables associated with rated importance and support.
Results: Most service users rated personal recovery items as important, regardless of their symptomatology and functioning. Previous experience with Illness Management and Recovery, knowledge about coping with stress and illness, and having a plan for early detection and prevention of relapse were significantly associated with higher perceived support. Higher self-reported depressive symptoms, lower score on the Global Assessment of Functioning symptom subscale, and male sex were significantly associated with less perceived support.
Conclusions: Most service users with psychosis found personal recovery important, regardless of symptomatology and functioning, which has implications for clinical practice and provides empirical evidence that recovery-oriented treatments are relevant for most service users with psychosis in various mental health services.

vi)  Emrich, L., Wood, L. and Taggart, D. (2021) The subjective experience of recovery from psychosis in an acute mental health inpatient setting. Psychosis, 13(2) 154-166.  Online: 
https://doi.org/10.1080/17522439.2020.1841271

Abstract
Background:  Experiences of recovery from psychosis have been well explored but not with service users in the acute stages of psychosis. This study aimed to explore the subjective experiences of recovery from psychosis from the perspective of service users receiving acute mental health inpatient care.
Methods: Ten participants undertook a semi-structured interview examining their experiences of recovery from psychosis during acute mental health inpatient care. Data were analysed using Interpretative Phenomenological Analysis (IPA).
Results: Five superordinate themes emerged: “My future is just being ripped out in front of me”: Living with psychosis is a struggle; “Would you want to be in here?”: Traumatic experience of being in hospital; “I know roughly why I got ill anyway and what caused this”: A journey towards reaching an understanding; Recovery/Rehabilitation/Recuperation: A process of evolution; and “You need all the help you can get”: Facilitators of Recovery.
Conclusions: This study highlighted that mental health inpatient settings are not settings where everyone can be in recovery or approaching recovery. For some participants, recovery appeared to be an empty signifier, and is a word used by services but does not necessarily correspond with their experiences of mental health inpatient settings.

vii) de Wet, A. and Pretorius, C. (2020) From darkness to light: Barriers and facilitators to mental health recovery in the South African context.  International Journal of Social Psychiatry.  Online:
https://doi.org/10.1177/0020764020981126

Abstract
Background:  South Africa is a low and middle income country facing many challenges in public mental health care and implementation of recovery.
Aims:  To contribute to what barriers and facilitators to recovery might be for service users in South Africa, from the perspective of service users, carers and service providers from three psychiatric hospitals in the Western Cape province.
Method: Interviews and focus groups were conducted with service users, carers and service providers. Interviews and focus groups were transcribed and analysed using atlas.ti software and reflexive thematic analysis, from the bottom up.
Results: The barriers, environment, family, public mental health services, stigma and service users’ attitude or behaviour generated, were found to be the most salient. The facilitators to recovery generated were support, family or friends, service providers, structure and empowerment. The need for support was identified as an underlying component to all these themes.
Conclusion: Barriers and facilitators to recovery seemed to have both intrapersonal and external sources that intersect at times. Recovery needs to be supported at an individual level, especially through an under-utilised resource such as peer support work, but in conjunction with the development of recovery-enabling environments in services and communities in South Africa. 

viii)  Herrera, S. N., Sarac, C., Bilgrami, Z. R., Dobbs, M. F. Jespersen, R., Haas, S. S., Garg, S., Shaik, R. B., Landa, Y. and Corcoran, C. M. (2021) A case report and first-person account of an individual at risk for psychosis who improved during the COVID-19 pandemic.  Psychosis.  Online:
https://doi.org/10.1080/17522439.2021.1915369

Abstract
Background: The COVID-19 pandemic is expected to increase stress and mental health symptoms. We present the case of a young man at risk for psychosis who has paradoxically shown symptomatic and functional improvement as a result of circumstances produced by COVID-19. These changes were unexpected given the client’s persistent mental health struggles in the year leading up to the COVID-19 outbreak in the United States and the expectation of an exacerbation of psychotic-like symptoms.
Methods:  This report is based on clinical assessments and the client’s first person account during the height of the pandemic when stay at home orders were in place.
Results:  During the pandemic, the client demonstrated increased agency by taking on more responsibility at home and obtaining part-time employment. He showed improvement in his mood and relationships with others, had less symptom-related distress, and significantly reduced his cannabis use. The client interpreted these improvements in terms of changing his mindset toward more adaptive
thoughts and engaging in healthy coping skills such as praying, reading, and healthy eating.
Conclusions:  This case highlights the importance of fostering agency in clients during a time of crisis and ensuring that clinicians be aware of potential biases about mental health symptom exacerbation.

ix)  Kaminskiy, E.,  Zisman-Ilani, Y. and Ramon, S. (2021)  Barriers and enablers to shared decision making in psychiatric medication management: A qualitative investigation of clinician and service users’ views/. Frontiers in Psychiatry.  Online:
https://doi.org/10.3389/fpsyt.2021.678005

Abstract
Shared decision making (SDM) is a recommended health communication approach in mental health settings. Yet, implementation of SDM in psychiatric consultations discussing medication management is challenging. Insufficient attention has been given to examine the views of both clinicians and service users together about the experiences of SDM in psychiatric medication management. The purpose of this paper is to examine the views of service users, community psychiatric nurses, and psychiatrists about enablers and barriers of SDM. A thematic analysis of 30 semi structured interviews with service users, psychiatrists, and community psychiatric nurses, in a community mental health team in the UK, was conducted. A service user advisory group was involved in all phases of the research cycle, including data collection, analysis, and dissemination. The results offer a detailed contextualized account of how medication decisions are made. For psychiatrists and service user participants SDM is seen as a way of enhancing service users’ engagement in and control over treatment decisions. While psychiatrists value the transactional benefits of SDM, service user participants and psychiatric nurses conceptualize SDM as a long-term endeavour embedded within therapeutic partnerships. For service users these partnerships mitigate acknowledged problems of feeling unable to be fully involved during times of crisis. This study identified a range of barriers and facilitators to SDM concerning psychiatric medications from the lived experience of service users and the professional experience of clinicians. Furthermore, it indicates new potential intervention points to support SDM in psychiatric medication decisions.

x)  We also include in this section a recent webinar available on the Social Care Institute for Excellence (SCIE) website on the topic of strengths-based practice. The webinar was recorded on the 15th June 2021.  Speakers include: Ewan King, Deputy Chief Executive, SCIE (Chair); Jo, who draws on care services; Phil Holmes, Director of Adults, Health and Wellbeing, Doncaster Council and Jerry Tew, University of Birmingham.

A link to the webinar is available here:
https://www.scie.org.uk/strengths-based-approaches/webinar20210615

 

Other News / Resources

i)  Shared decision making (SDM module), Delivered as part of the MSc in Advanced Social Work Practice: January-March 2022.

Writing out of Hertfordshire University, Prof. Shulamit Ramon writes:

Shared decision making (SDM) has been an emerging research and practice area in health and social care since the end of the 1990s. It focuses on a process that enables sharing information and preferences while aiming at reaching a joint decision. It is based on the assumption that service users are experts in their own experience, while the service providers’ expertise lies in scientific knowledge. Evaluative research findings demonstrate its usefulness in sharing information, enhancing motivation, mutual therapeutic trust and respect, new skills of both client and provider, and reducing intervention time.

Shared decision making follows the Strengths approach developed initially in social work, the Recovery Approach in health, as well as the need for meaningful Co-production between service users and providers.

This 15 credits module offers a conceptual framework for SDM with individuals and families; research evidence in physical and mental health, and in social care work with individuals and families across adult and child care; in community work, and the use of relevant shared decision aids.

This multidisciplinary, interactive, module will enable students to learn research-supported principles and practices for working with SDM in applied settings. It will be provided online, to enable busy practitioners the flexibility which online learning gives, applying interactive learning methods. Individual tutorials will be available also online. People with relevant lived experience and academic background would be welcomed too.

Methods of teaching and learning   will include presentations by the module leader, providers and experts in experience specialising in SDM, videos, practical exercises in small groups and group discussions. The module assignment is a reflective practice focused written account of applying SDM in working with a client.

The module leader, Prof. Ramon, is a registered social worker and chartered clinical psychologist by her training, experienced in researching and training on SDM. 

For further information, please contact Prof. Shulamit Ramon s.ramon@herts.ac.uk
An Information Meeting on this module and the MSc in Advanced Social Work Practice will take place on Wednesday, June 23rd 2021 at 17.00 online: 
Join Zoom Meeting: https://herts-ac-uk.zoom.us/j/95448032985
Meeting ID: 954 4803 2985

ii) Prof. Shula Ramon also draws attention to the online MSc Mental Health Recovery and Social Inclusion Programme at the University of Hertfordshire.  Please see below for further information:

 

 

iii)  Dr Daniel Hayes (Research Fellow, King’s College London Institute of Psychiatry) and Study Co-ordinator for the RECOLLECT Study, writes to inform readers about the following: 

Launch of Recovery College surveys
As part of the RECOLLECT Study ( researchintorecovery.com/recollect )  we will be conducting surveys of all Recovery Colleges (a) in England and (b) internationally. The aim of both surveys is to explore the characteristics of Recovery Colleges, identify where Recovery Colleges are and how they are similar or different from each other. We will present findings descriptively, such as the numbers courses offered and also use statistical tests to explore geographical comparisons, such as how they are funded.

(a)   For the survey of Recovery Colleges in England, we are currently collecting contact details for all colleges. If you manage a Recovery College in England and have not already heard from us please contact us through recollect@kcl.ac.uk for more information.

(b)   For the international survey in all other countries, we currently are aware of/have contacts to Recovery Colleges in 8 countries: Australia, Canada, Ireland, Italy, Japan, Uganda, UK and USA. If you know of Recovery Colleges in any country not on this list, or would like to add your Recovery College to take part in the survey, please could you send us your name and contact details: Daniel.Hayes@kcl.ac.uk

iv)  Becky Donne
A research team from Canterbury Christ Church University is looking for participants for a study exploring voice-hearers’ experiences of reading narratives about hearing voices contained in the following books:

Accepting Voices by Marius Romme
Living with Voices: 50 stories of recovery by Marius Romme and Sandra Escher
Young People Hearing Voices by Marius Romme and Sandra Escher
Learning from the Voices in my Head by Eleanor Longden
Hearing Voices, Living Fully by Claire Bien
Recovery: An Alien Concept? by Ron Coleman
Working with Voices II: Victim to Victor by Ron Coleman and Mike Smith

We would like to talk to adults (18+) who identify as hearing voices (currently or in the past) and have read at least half of one of the above books. If you are interested in taking part in this study or would like some more information, please visit:
https://tinyurl.com/3bzbrswp

Or, email Becky Donne (lead researcher) at b.donne204@canterbury.ac.uk. Participation is completely voluntary and all personal information will be kept confidential.

v)  Writing out of the Department of Biostatistics and Health Informatics at King’s College London, Dr Sarah Markham draws attention to current research at a time of Covid-19:

The COVID-19 pandemic has led to over 3 million deaths worldwide. It has disrupted the lives of people across the world due to its rapid spread, mortality, disruption of social fabric, burden on health care systems, and devastating economic impact. There is widespread concern about the effects on mental health, particularly among vulnerable populations.

However, the rapid pace, volume, and limited quality of mental health evidence being generated and disseminated both through the media and academic channels during COVID-19 poses a barrier to effective synthesis and decision-making. We are conducting a series of living systematic reviews on mental health in COVID-19, including a review of randomised controlled trials of interventions to address mental health challenges in COVID-19 and longitudinal studies that compare mental health in COVID-19 to mental health prior to the pandemic or across points during the pandemic.

Here is a link to our COVID-19 Mental Health Living Systematic Review:
https://www.depressd.ca/covid-19-mental-health

vi) Bengt Karlsson (University of South Eastern Norway)
In this engaging TEDx talk, Bengt’s narrative engages ‘the act of recovering from mental health issues and living with them’.  Listed on the 22 April 2021, a useful (text) introduction is also supplied.
https://www.youtube.com/watch?v=qOLZt2QBzEM 
Please note: this Ted talk does come with subtitles and you can switch these on/off as appropriate.

vii)  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

viii)  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

July 2021

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 continues to have unprecedented effects both nationally and internationally.  From July 2021, Covid-19 restrictions are gradually being relaxed within the UK.  Nevertheless, there remain subtle differences in the rules affecting England, Northern Ireland, Scotland and Wales and we would encourage our readers to keep safe as the restrictions are eased.   Please can we urge our readership to continue to submit material to the 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.  We continue to include 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)  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 ii)  Lancet Psychiatry Commission on the Psychoses in a Global Context: Request for participatory & or user-led research, commentaries & reports.   The Lancet Commission on the Psychoses in a Global Context consists of a group of researchers, policy makers, clinicians , family members and service users convened to produce a comprehensive knowledge synthesis and vision for future research and development focused on psychosis. As part of the overall Commission, the lived experience/psychosocial disabilities involvement workgroup will be conducting a systematic review of studies and reports focused on psychosis that have utilized participatory methods (spanning user/survivor-led research, co-production, participatory action research and so on). While we will conduct traditional searches of the academic literatures, due to the variety of terms used internationally and variations in reporting of methods or lived experience/stakeholder involvement, we are seeking self-submissions of relevant work in the following categories: Peer reviewed research studies of any kind (autoethnographic qualitative, quantitative, etc.) led or co-led by researchers who identify as service users/persons with psychosocial disability/lived experience; Peer-reviewed research studies of any kind (qualitative, quantitative, mixed methods) that have included an explicit service user/psychosocial disability and/or family participation component; Doctoral dissertations or theses that would otherwise meet the above criteria and have not (yet) been published; Commentaries specifically focused on psychosis (language, subjective experience, service reform, innovation, human rights, etc.) and that are led or co-produced by authors with personal experience of psychosis, whether they appear in academic or non-academic venues; Self nominated studies or evaluations using participatory methodologies that have not been published in a peer-reviewed academic journal (ie ‘grey literature’ texts) but that include some description of methodology (who the sample is, what methods were used, how data was analyzed). Note that submissions can be in any language – we are actively working on developing translated versions of the flyer and survey: please contact us to request a copy in another language. Have something to submit? Click or copy the URL below or the  QR code to the right :  https://usf.az1.qualtrics.com/jfe/form/SV_5ptxGnxIayEZhsy Questions? : contact us at lancetcommissionpsychosis@gmail.com 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)  Dillon, J., Corstens, D. and Runciman, O. (2021)  Sandra Escher – an Obituary.  Psychosis. https://doi.org/10.1080/17522439.2021.1949385   Summary The opening sentence to the above obituary simply reads: We have lost Sandra Escher. She died in Amsterdam on the 31st of May 2021.  We will not repeat Dillon et al’s thoughtful words here, preferring instead to let them speak for themselves.     ii)  Ramon, S. (2021) Family Group Conferences as a Shared Decision-Making strategy in adults mental Health work.  Frontiers in Psychiatry.   12:663288. https://doi.org/10.3389/fpsyt.2021.663288   Abstract Background:  Family Group conferences (FGC) provide a system by which a client and their family reach jointly key intervention decisions, from a number of options proposed by professionals. The system originated in child protection social work. Conceptually FGC is based on the assumption that the family is potentially a supportive social system for an individual with a variety of difficulties, including mental ill health.  Reaching a family network agreement can lead to long term positive outcomes in self-confidence and social relationships. This strategy of shared decision making (SDM) can re-unite the family around the client’s needs and wishes. It fits well the strengths based and the recovery-oriented approaches to mental ill health. Methodologically: this article provides a narrative review of existing empirical research about FGC in the context of adult mental health. In addition, two community case studies consisting of videos of a mother experiencing mental ill health and a daughter are analysed in terms of their subjective experience of the FGCs they were involved in, and looks at both the process and the outcomes of FGCs.  The key findings:  demonstrate a high level of satisfaction from participating in the FGC meeting, while the evidence pertaining to the outcomes is inconclusive. Only very few systematic review studies, or comparative studies of different approaches to family decision making, exist, and there are no studies which offer cost effectiveness analysis. Discussion: The observed gap between the satisfaction from the process of FGC by the participants vs. the inconclusive outcomes relates to the implementation phase, in which the decisions made by the family are tested. Evaluating FGC processes and outcomes is complex. A systematic and comprehensive research of the implementation process is missing at this stage. In conclusion:  FGC is a promising strategy of SDM in adult mental health. The research evidence indicates the need for further exploration of its implementation process, evaluative methodology and methods.     iii)  Piat, M., Wainwright, M., Sofouli, E., Vachon, B., Deslauriers, T., Préfontaine, C. and Frati, F. (2021) Factors influencing the implementation of mental health recovery into services: a systematic mixed studies review.  Systematic Reviews. 10:134.   https://doi.org/10.1186/s13643-021-01646-0   Abstract Background:  Countries around the world have committed in policy to transforming their mental health services towards a recovery orientation. How has mental health recovery been implemented into services for adults, and what factors influence the implementation of recovery-oriented services? Methods: This systematic mixed studies review followed a convergent qualitative synthesis design and used the best-fit framework synthesis method. Librarians ran searches in Ovid- MEDLINE, Ovid-EMBASE, Ovid-PsycInfo, EBSCOCINAHL Plus with Full Text, ProQuest Dissertations and Theses, Cochrane Library, and Scopus. Two reviewers independently screened studies for inclusion or exclusion using DistillerSR. Qualitative, quantitative, and mixed methods peer-reviewed studies published since 1998 were included if they reported a new effort to transform adult mental health services towards a recovery orientation, and reported findings related to implementation experience, process, or factors. Data was extracted in NVivo12 to the 38 constructs of the Consolidated Framework for Implementation Research (CFIR). The synthesis included a within-case and a cross-case thematic analysis of data coded to each CFIR construct. Cases were types of recovery-oriented innovations. Results: Seventy studies met our inclusion criteria. These were grouped into seven types of recovery-oriented innovations (cases) for within-case and cross-case synthesis. Themes illustrating common implementation factors across innovations are presented by CFIR domain: Intervention Characteristics (flexibility, relationship building, lived experience); Inner Setting (traditional biomedical vs. recovery-oriented approach, the importance of organizational and policy commitment to recovery-transformation, staff turnover, lack of resources to support personal recovery goals, information gaps about new roles and procedures, interpersonal relationships), Characteristics of Individuals (variability in knowledge about recovery, characteristics of recovery-oriented service providers); Process (the importance of planning, early and continuous engagement with stakeholders). Very little data from included studies was extracted to the outer setting domain, and therefore, we present only some initial observations and note that further research on outer setting implementation factors is needed. Conclusion:  The CFIR required some adaptation for use as an implementation framework in this review. The common implementation factors presented are an important starting point for stakeholders to consider when implementing recovery-oriented services.     iv)  McGranahan, R., Jakaite, Z., Edwards, A., Rennick-Egglestone, S., Slade, M. and Priebe, S. (2021) Living with psychosis without mental health services: a narrative interview study.  BMJ Open.  2021;11:e045661. https://doi.org/10.1136/bmjopen-2020-045661   Abstract Objectives:  Little research has looked at how people who do not use mental health services experience psychosis. Thus, the present study aimed to explore the experiences and views of people with psychosis who have neither sought nor received support from mental health services for at least 5 years. Design:  A narrative interview study. Thematic analysis was used to analyse the data. Setting:  England. Participants:  Twenty-eight participants with self-defined psychotic experiences were asked to provide a free narrative about their experiences. Results:  Five themes were identified: (1) Perceiving psychosis as positive; (2) Making sense of psychotic experiences as a more active psychological process to find explanations and meaning; (3) Finding sources of strength, mainly in relationships and the environment, but outside of services; (4) Negative past experiences of mental health services, leading to disengagement and (5) Positive past experiences with individual clinicians, as an appreciation of individuals despite negative views of services as a whole. Conclusions:  Perceiving psychosis as something positive, a process of making sense of psychotic experiences and the ability to find external sources of strength all underpin—in addition to negative experiences with services—a choice to live with psychosis outside of services. Future research may explore to what extent these perceptions, psychological processes and abilities can be facilitated and strengthened, in order to support those people with psychosis who do not seek treatment and possibly also some of those who are in treatment.     v)  Rennick-Egglestone, S. (2021) Principles for the production and dissemination of recruitment material for three clinical trials of an online intervention.  Trails.  22:441 https://doi.org/10.1186/s13063-021-05412-4   Abstract Some health research studies recruit participants through electronic mechanisms such as the placement of messages on social media platforms. This raises questions for ethics committee oversight, since effective social media campaigns might involve the production and dissemination of hundreds of contemporaneous messages. For the Narrative Experiences Online (NEON) study, we have developed nine principles to control the production and dissemination of promotional material. These have been approved by an ethics committee and enable the audit of our recruitment work. We propose that the drafting for approval of recruitment principles by health research studies may, in many cases, strike an appropriate balance between enabling ethical oversight of online recruitment work and the potential burden of message review.     vi)  Moernaut, N., Krivzov, J., Lizon, M., Feyaerts, J. and Vanheule, S. (2021) Negative symptoms in psychosis: failure and construction of narratives.  Psychosis.   https://doi.org/10.1080/17522439.2021.1948092   Abstract Background:  Despite considerable scientific interest in the negative symptoms of psychosis, the subjective dimension of these experiences has barely been studied. Methods: This paper aims at addressing this shortcoming by means of an Interpretative Phenomenological Analysis of semi-structured interviews with 12 participants with a psychotic disorder.  Results:  The analysis yielded three major themes: 1) negative symptoms can be conceptualized as a failure of narratives to account for perplexing experiences participants are confronted with in psychosis; 2) negative symptoms challenge participants to make sense of them with metanarratives; 3) participants highlight a withdrawn attitude towards life after psychosis. Conclusions:  The standard characterization of negative symptoms as a loss of normal functioning should be revised, as this does not match participants’ subjective experiences. Negative symptoms rather represent hard to verbalize experiences. This difficulty of linguistic expression is not a shortcoming of the person experiencing them, but characteristic of the experiences themselves.     vii) Armstrong, L. V., Hogg, L. and Jacobsen, P. (2021) Do voice-hearing assessment measures capture the positive experiences of individuals, and to what extent? A systematic review of published assessment measures.  Psychosis. https://doi.org/10.1080/17522439.2021.1924242   Abstract Background:  Many individuals have positive experiences of voice- hearing (VH). However, current assessment tools do not capture positive aspects of VH as comprehensively as they do negative aspects. This may limit assessment and formulation of VH when people seek support from mental health services. Our review question was therefore:- ‘Do voice- hearing assessment measures capture the positive experiences of individuals, and to what extent?’ Method:  We conducted a systematic review of assessment measures which included at least one item on VH. We developed a novel framework to define “positive VH experiences”, which was co-produced by clinical experts in psychosis and people with VH experiences. This framework was then used to identify and map items relating to positive aspects of VH. Results:  Thirty-three measures were identified, of which twenty incorporated positive VH experiences. Measures published within the last decade (2009-2019) captured a greater number and diversity of positive VH experiences, compared to measures published prior to 2009. Items relating to the function/intention of voices and the emotional impact, were most commonly identified. Conclusions:  Results suggest that research perceptions around VH are broadening and the nuances of experiences are increasingly considered alongside everyday and positive psychological functioning. Implications for both services and voice-hearers are discussed in the paper.     viii)  Putman, N. and Martindale, B. (eds.) (2021) Open dialogue for psychosis: organising mental health services to prioritise dialogue, relationship and meaning.  Abingdon, Routledge.   Published by Routledge on the 30th July, Open Dialogue for psychosis, this is the first international book on the Open Dialogue approach, with 47 chapters written by people engaged in/developing the approach in 11 different countries.  Taken from the blurb on the back cover:   This highly readable book provides a comprehensive examination of the use of Open Dialogue in working with people having psychotic experiences. It presents the basic principles and practice of Open Dialogue, explains the training needed to practice and explores how it is being developed internationally.   Open Dialogue for Psychosis includes first-hand accounts of the process by people receiving services due to having psychotic experiences, their family members and professionals who work with them.  It explains how aspects of Open Dialogue have been introduced in services around the world, its overlap with and differentiation from other psychological approaches and its potential integration with biological and pharmacological considerations.  The book concludes with a substantive section on the research available and its limitations.   Open Dialogue for Psychosis will be a key text for clinicians and administrators interested in this unique approach, particularly those who recognise that services need to change for the better and who are seeking guidance on how this can be achieved. It will also be suitable for people who have experienced psychosis and members of their families and networks.  Other News / Resources i)  Assistant Professor in Mental Health The above post is currently being advertised by the University of Nottingham, School of Health Sciences.  The closing date is: Tuesday 31st August 2021.  For more information about this opportunity, please click here. ii)  Shared decision making (SDM module), Delivered as part of the MSc in Advanced Social Work Practice: January-March 2022.   Writing out of Hertfordshire University, Prof. Shulamit Ramon writes: Shared decision making (SDM) has been an emerging research and practice area in health and social care since the end of the 1990s. It focuses on a process that enables sharing information and preferences while aiming at reaching a joint decision. It is based on the assumption that service users are experts in their own experience, while the service providers’ expertise lies in scientific knowledge. Evaluative research findings demonstrate its usefulness in sharing information, enhancing motivation, mutual therapeutic trust and respect, new skills of both client and provider, and reducing intervention time.   Shared decision making follows the Strengths approach developed initially in social work, the Recovery Approach in health, as well as the need for meaningful Co-production between service users and providers.   This 15 credits module offers a conceptual framework for SDM with individuals and families; research evidence in physical and mental health, and in social care work with individuals and families across adult and child care; in community work, and the use of relevant shared decision aids.   This multidisciplinary, interactive, module will enable students to learn research-supported principles and practices for working with SDM in applied settings. It will be provided online, to enable busy practitioners the flexibility which online learning gives, applying interactive learning methods. Individual tutorials will be available also online. People with relevant lived experience and academic background would be welcomed too.   Methods of teaching and learning   will include presentations by the module leader, providers and experts in experience specialising in SDM, videos, practical exercises in small groups and group discussions. The module assignment is a reflective practice focused written account of applying SDM in working with a client.   The module leader, Prof. Ramon, is a registered social worker and chartered clinical psychologist by her training, experienced in researching and training on SDM.    For further information, please contact Prof. Shulamit Ramon s.ramon@herts.ac.uk iii) Prof. Shula Ramon also draws attention to the online MSc Mental Health Recovery and Social Inclusion Programme at the University of Hertfordshire.  Please see below for further information: iv)  Dr Daniel Hayes (Research Fellow, King’s College London Institute of Psychiatry) and Study Co-ordinator for the RECOLLECT Study, writes to inform readers about the following:    Launch of Recovery College surveys As part of the RECOLLECT Study ( researchintorecovery.com/recollect )  we will be conducting surveys of all Recovery Colleges (a) in England and (b) internationally. The aim of both surveys is to explore the characteristics of Recovery Colleges, identify where Recovery Colleges are and how they are similar or different from each other. We will present findings descriptively, such as the numbers courses offered and also use statistical tests to explore geographical comparisons, such as how they are funded. (a)   For the survey of Recovery Colleges in England, we are currently collecting contact details for all colleges. If you manage a Recovery College in England and have not already heard from us please contact us through recollect@kcl.ac.uk for more information. (b)   For the international survey in all other countries, we currently are aware of/have contacts to Recovery Colleges in 8 countries: Australia, Canada, Ireland, Italy, Japan, Uganda, UK and USA. If you know of Recovery Colleges in any country not on this list, or would like to add your Recovery College to take part in the survey, please could you send us your name and contact details: Daniel.Hayes@kcl.ac.uk     v)  Becky Donne A research team from Canterbury Christ Church University is looking for participants for a study exploring voice-hearers’ experiences of reading narratives about hearing voices contained in the following books: Accepting Voices by Marius Romme Living with Voices: 50 stories of recovery by Marius Romme and Sandra Escher Young People Hearing Voices by Marius Romme and Sandra Escher Learning from the Voices in my Head by Eleanor Longden Hearing Voices, Living Fully by Claire Bien Recovery: An Alien Concept? by Ron Coleman Working with Voices II: Victim to Victor by Ron Coleman and Mike Smith   We would like to talk to adults (18+) who identify as hearing voices (currently or in the past) and have read at least half of one of the above books. If you are interested in taking part in this study or would like some more information, please visit: https://tinyurl.com/3bzbrswp   Or, email Becky Donne (lead researcher) at b.donne204@canterbury.ac.uk. Participation is completely voluntary and all personal information will be kept confidential.     vi)  Writing out of the Department of Biostatistics and Health Informatics at King’s College London, Dr Sarah Markham draws attention to current research at a time of Covid-19:   The COVID-19 pandemic has led to over 3 million deaths worldwide. It has disrupted the lives of people across the world due to its rapid spread, mortality, disruption of social fabric, burden on health care systems, and devastating economic impact. There is widespread concern about the effects on mental health, particularly among vulnerable populations.   However, the rapid pace, volume, and limited quality of mental health evidence being generated and disseminated both through the media and academic channels during COVID-19 poses a barrier to effective synthesis and decision-making. We are conducting a series of living systematic reviews on mental health in COVID-19, including a review of randomised controlled trials of interventions to address mental health challenges in COVID-19 and longitudinal studies that compare mental health in COVID-19 to mental health prior to the pandemic or across points during the pandemic.   Here is a link to our COVID-19 Mental Health Living Systematic Review: https://www.depressd.ca/covid-19-mental-health   vii)  On the subject of carers and personal recovery, Claire Hilton (PhD candidate from the Spectrum Centre for Mental Health Research at Lancaster University) writes her work into the development of the Carer Recovery Questionnaire (CRQ):   Carers of those with psychosis and schizophrenia are often put under a lot of strain taking on a caring role after the crisis of a psychosis.  Understanding their wellbeing can help health professionals better support them.  Many carers go through a process of ‘personal recovery’ in parallel to service users where they find a way to adapt and cope with their caring responsibilities in a positive way.  There is currently no questionnaire to assess carer recovery, however.  A new one has been devised based on qualitative interviews with carers discussing the topic.  We are now at the stage of wanting feedback from carers on the draft questionnaire.  We are looking to recruit carers to do a 30-minute interview where we will discuss the draft questionnaire.  Carers will be offered a £10 Amazon voucher to thank them for their time.  This study is part of an ESRC funded PhD at Lancaster University.   If you are interested, please contact Claire Hilton at c.a.hilton@lancaster.ac.uk viii)  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   ix)  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

August 2021

RRN Meetings Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time.  However, the current suspension arrangements are under constant review by the RRN Collective and it is possible that a webinar-style meeting may provide an interim measure to coalesce our membership prior to the resumption of face-face networking when it becomes safe to do so.  More information about this possibility will be circulated in due course. Set against a background of close monitoring, Covid-19 restrictions are gradually being relaxed within the UK.  Nevertheless, there remain subtle differences in the rules affecting England, Northern Ireland, Scotland and Wales and we would encourage our readers to keep safe as the restrictions are eased.   Please can we urge our readership to continue to submit material to the 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.  We continue to include 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. i)  From the University of Bremen, PhD candidate and long-standing member of the RRN Ingo Tschinke writes:   Dear colleges, I have started my PhD work about personal recovery support at the University of Bremen in Germany. For this work I would like to do some networking with other PhD students and professionals who are working on the same topic. You can send me information about literature, materials, books etc. Therefore, I want to inform you about my theme I would like to discuss:    Background: The concept of the personal recovery became more and more common in German mental health services. For example in guidelines for medical and psychological treatment (DGPPN 2019). But the transfer into daily praxis is much more difficult as the description in theory. There are different reasons for this cause. One reason is the separated health system in Germany another reason is still the dominance “bio-psychosocial medicine“ concept and the social mental health “Over-Care“ system which supports learned helplessness instead of consequent autonomy, self-determination and self-care which is necessary for a recovery orientated support (Schaedle-Deininger 2019). This doctoral work should bring light into this tension field and should defining a re-constructing theory for mental health nursing to support personal recovery in people with severe mental health problems.   Method: In the first step a search in literature on MEDLINE, EMBASE, Psycinfo, EBSCO, CINAHL Plus with full text, ProQuest Dissertations and Theses, Cochrane Library, and Scopus will be accomplished. Through this the evidence-based state of the art should be determined and discussed. Further on ethical and philosophical theories should be consulted to understand the deeper meaning of the concept of personal recovery. Through this the reasoning relationships should be defined, so later a recovery-oriented theory of the necessities to support personal recovery could be established. Based on the determined knowledge from the literature research two interview guides should be compiled. One guide for interviews with nursing experts about recovery-orientation and one interview guide for focus groups with peers with longstanding expertise about personal Recovery.  The expert interviews will be accomplished by the researcher and the focus groups through a peer with 22 years of psychosis experience and a Bachelor of Social Science. The data from expert interviews will be processed with a thematical analysis (Braun und Clarke 2013). The data from the focus groups will undergo a depth-hermeneutic analysis and interpretation, because of the involved existential experience  (Heinze 2016; Nerheim 2001).   Results: Through the analysis of literature research and the inner philosophical and ethical meaning of personal recovery combined with results from the qualitive analysis a theory of a supporting attitude for psychiatric nurses to support personal recovery should be developed.    Discussion and perspectives: This doctoral work should be conducive for a behavioural theory for mental health nurses to support personal recovery in nursing praxis as well it should help for future trainings in mental health nursing. It will focus on the re-construction of recovery oriented theory for mental health nursing, following a qualitative methodology in which expert psychiatric nurses will be interviewed about the type of practice nurses would need to adopt in order to support personal recovery in stationary and ambulant settings. In addition, Ingo will conducting focus groups with peers experiencing personal recovery. These groups will enable a discussion about useful and not so useful factors to the development of personal recovery, and the implications of their views for psychiatric nursing. A philosophical dimension of the values and behaviours involved in the support of personal recovery will be added.  This data will be incorporated into the re-construction a conceptual base for psychiatric nurses concerning their work on personal recovery with people experiencing severe mental health illness.  the involved existential experience  (Heinze 2016; Nerheim 2001).   In addition to the above, Ingo also wishes to inform the readers about two publications he has written: 1.  Tschinke, I. (2021) Werteorientiertes recovery.  In Sabine Weißflog and Julia Lademann (editors).  Verstehen in der Psychiatrischen Pflegewissenschaft.  Stuttgart, Kohlhammer.  Chapter 4.  Ingo’s chapter refers to ‘value-oriented recovery’.  A link to the publisher’s website is available here.   In chapter 4, Ingo looks at the CHIME concept from a philosophical existentialist perspective, to include Kirkegaard, Nietzsche, Heidegger, Sartre, Levinas and Merleau-Pointy. Future research in mental Health nursing should take a philosophical look on the value-orientated intervention of mental health nurses under the background of the expectations of the users. The philosophical view concerns the level of being following Martin Heidegger and the meaning of life as understood by Victor Frankl. Ingo sees the value-orientation of the concept of personal recovery as a bridge with which to understand the transformation of people with mental health problems to their way of change to personal recovery. The variables of the CHIME concept are looked at from the perspectives of phenomenology and existentialism. The value-orientation of recovery is compared with the philosophy of Frankl’s “Logo-therapy”. Future research in mental Health nursing should take a philosophical look on the value-orientated intervention of mental health nurses under the background of the expectations of the users.    2.  Tschinke, I., Finklenburg, U., Gaehler, B. Konhaeuser, T. (eds.) (2021) Lehrbuch ambulante psychiatrische pflege.  Hogrefe, Switzerland.   The title of the book would translate to: ‘Textbook of outpatient psychiatric care’.  A link to the publisher’s homepage is included here.     The guide takes into account the fact that a number of German states do not have the option of mental health nursing in people’s homes, while some do have it.  The guide encompasses all aspects of mental nursing in this setting and it is based mainly on the REFOCUS program with the REACH Model as a core system to supported recovery.   The authors of this book describe:  Mental health home care in Germany and Switzerland Professional attitudes for a recovery-oriented mental health nursing Organisational elements of mental health home care, such as the planning of contacts, the documentation, marketing, leadership, change-and quality-management and the planning of the own self.  Process-oriented models such as the REACH model working together with the nursing process The legal aspect underlying mental health nursing service, prevention of violence and coercion, Liability law and privacy regulations.  The difference of coaching in mental health nursing and in psychological therapy Working with peers and with carers, in support of participation, housing, employment, and relationships in the community.  Mental health care settings for children, adults, and elderly people as well as multicultural and forensic work.  Explaining different phenomena like Adherence, Aggression, Anxiety, Boredom, Coercion, Confusion, Eating, Humour, Hope, Identity, Integration, Powerlessness, Manipulation, Migration, Mourning and Grief, Privacy, Shame, Sleep, Self-concept, Self-infliction, Sexuality, Trauma, Trust, and wellbeing.  The importance of networking, the personal training and the engagement for innovation and change in mental health nursing.  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)  Guadalupe Morales Cano, Director of the International Bipolar Foundation invites colleagues to the following webinar:   Dear colleagues, As part of the EU Horizon2020  Research project, Recover-E http://www.recover-e.eu  I´m coordinating the webinar: Peer workers perspective: Human rights in mental health and the importance of the role of peer workers in mental health care. Oct. 14th 10:00-12:30.  This webinar is focused on promoting, protecting and upholding the human rights of persons with mental health problems. A flyer for the webinar reads: The webinar is organized by RECOVER-E, a Horizon 2020 project on the implementation and evaluation of multidisciplinary community mental health teams (CMHTs) consisting of a psychiatrist, psychologist, nurse, social worker and peer worker in five sites in five countries Croatia, Montenegro, Romania, North Macedonia and Bulgaria. This webinar focuses on the pioneering role of peer workers in these project sites. Anyone, from users, to mental health care professionals, policy makers, advocacy organizations, researchers and more can join this webinar. The overall goal of the RECOVER-E project is to contribute to the implementation of and research on an evidence-based community-based service delivery model for recovery-oriented care in the five sites.    Part 1. Human Rights & persons with mental health problems The webinar kicks off with a welcome by project leader Dr. Laura Shields-Zeeman and a brief talk by notable members: Dr. Jan Wise, member of Committee on Ethical Issues from the European Psychiatric Association (EPA), Nora Sveaass and Polli Hagenaars, members of the European Federation of Psychologists’ Association (EFPA) and Board of Human Rights & Psychology, (partners of RECOVER-E) about their views on human rights and persons with mental health problems.   In the first presentation Dr. Aleksandar Tomcuk (site leader in Montenegro) will discuss human rights and persons with mental health problems based in the EU Convention on Human Rights.   In the second presentation, Ms. Guadalupe Morales (trainer and dissemination leader in the project) will present the element of including peer workers in mental health care services, the UN Convention, employment, and meaningful involvement of persons with mental health problems. This first part of the webinar will be concluded with a Q&A with the speakers and a moderator. The audience is invited and encouraged to ask their questions.   Part 2. Community mental health teams in RECOVER-E, the role of the peer worker The introduction of a Community Mental Health Team including a peer worker, in which the project is pioneering, has been a new experience for all those involved in the implementation in the sites. In the second part of the webinar peer workers and other community mental health team members (site leaders and/or psychologists) from different implementation sites will share their experiences through a presentation. After hearing about achievements, challenges and sustainability from the community mental health team members, the second part will end with another Q&A session where again the audience is encouraged and invited to ask questions.  Dr. Laura Shields-Zeeman (project leader) will conclude and close the webinar. Contact details: Nina Bos Nbos@trimbos.nl Junior Project Manager RECOVER-E Trimbos Institute ii)  Lancet Psychiatry Commission on the Psychoses in a Global Context: Request for participatory & or user-led research, commentaries & reports.   The Lancet Commission on the Psychoses in a Global Context consists of a group of researchers, policy makers, clinicians , family members and service users convened to produce a comprehensive knowledge synthesis and vision for future research and development focused on psychosis. As part of the overall Commission, the lived experience/psychosocial disabilities involvement workgroup will be conducting a systematic review of studies and reports focused on psychosis that have utilized participatory methods (spanning user/survivor-led research, co-production, participatory action research and so on). While we will conduct traditional searches of the academic literatures, due to the variety of terms used internationally and variations in reporting of methods or lived experience/stakeholder involvement, we are seeking self-submissions of relevant work in the following categories: Peer reviewed research studies of any kind (autoethnographic qualitative, quantitative, etc.) led or co-led by researchers who identify as service users/persons with psychosocial disability/lived experience; Peer-reviewed research studies of any kind (qualitative, quantitative, mixed methods) that have included an explicit service user/psychosocial disability and/or family participation component; Doctoral dissertations or theses that would otherwise meet the above criteria and have not (yet) been published; Commentaries specifically focused on psychosis (language, subjective experience, service reform, innovation, human rights, etc.) and that are led or co-produced by authors with personal experience of psychosis, whether they appear in academic or non-academic venues; Self nominated studies or evaluations using participatory methodologies that have not been published in a peer-reviewed academic journal (ie ‘grey literature’ texts) but that include some description of methodology (who the sample is, what methods were used, how data was analyzed). Note that submissions can be in any language – we are actively working on developing translated versions of the flyer and survey: please contact us to request a copy in another language. Have something to submit? Click or copy the URL below or the  QR code to the right :  https://usf.az1.qualtrics.com/jfe/form/SV_5ptxGnxIayEZhsy Questions? : contact us at lancetcommissionpsychosis@ iii)  Open Dialogue Conference.  Online: 28th and 29th September 2021 Jointly organised by ISPS and Open Dialogue UK and featuring keynote presentations and workshops led by authors of chapters in the book, ‘Open Dialogue for Psychosis: Organising Mental Health Services to Prioritise Dialogue, Relationship and Meaning’ For further information please see 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. i)  Fox, J. (2021) Models underpinning mental health: A proposal for A user-based framework.  American Journal of Biomedical Science and Research.  13(3) AJBSR.MS.ID.001863.  https://doi.org/10.34297/AJBSR.2021.13.001863   Abstract Purpose: This article seeks to explore the models of mental health used in the delivery of care and the impact theoretical frameworks have on the implementation of practice. It discusses the development of a user-led model of care which is based on forms of practice which enhance the place of experiential knowledge in developing care and treatment, and service users’ responsibility for involvement in their own care. Approach: A conceptual discussion of the literature is presented which leads to the suggested development of a new model of care to underpin the implementation of mental health practice. Findings: The biomedical model of mental health predominates explanations of the aetiology of disease, the development of treatments and the delivery of care. Other models such as the bio-psycho-social model and the spiritual model have also been developed. Moreover, in their practice, professionals often adhere to the traditional model that underpins their professional training. Originality: A user-led model of care to frame the delivery and implementation of mental health support is posited and it is suggested that professionals need to receive training which reinforces developmental rather than routinised learning. Such training would enable them to respond to ways of innovative working which reinforce the autonomy and power of service users in their experience of mental health care and support. This suggests the potential of both a new way for professionals to work alongside service users, recognising the primacy of their expertise, and puts forward a novel emphasis on the kind of training practitioners receive. ii)  Hare-Duke, L., Dening, T., Oliveira, D., Dewa, R. and Slade, M. (2021) Social connectedness in adults with mental disorders: ecological validation of a conceptual framework for novel complex interventions.  Journal of Mental Health. 30(3) 333-340, https://doi.org/10.1080/09638237.2021.1875409   Abstract Background: Social connectedness interventions may improve the clinical outcomes and personal recovery of adults with mental disorders but many interventions lack a clear theory-base and show limited effectiveness. Aim: To evaluate the validity of a newly developed conceptual framework (the CIVIC framework: Closeness, Identity, Valued relationships, Involvement and Cared for and accepted) to function as the theory-base for novel social connectedness-based mental health interventions. Method: Semi-structured interviews with adults with diagnostically heterogeneous mental disorders (n¼13) and mental health professionals (n¼9). Participants reported their social connectedness experiences, their views on the CIVIC framework and potential targets for new interventions. Sequential inductive and deductive thematic analyses were used. Data quality was assessed through respondent validation. Results: Both inductive and deductive analyses provided validation of the CIVIC framework. Additional themes of Stigma and Connectedness beyond social relationships were identified in the inductive analysis.  Candidate interventions to target each CIVIC domain were identified. Conclusions: The CIVIC framework demonstrates ecological validity and can therefore serve as the theory-base for the development of novel social connectedness-based interventions. This study indicates that interventions would be most effective when they incorporate evidence-based approaches which target each of the categories described by the CIVIC framework. iii)  Caballero, R., Chaves, C. and Valiente, C. (2021) Life satisfaction in people affected by a severe psychiatric condition: a comprehensive model, Psychosis. https://doi.org/10.1080/17522439.2021.1961011   Abstract Research on severe psychiatric conditions has primarily focused on deficits and symptoms, while there is limited understanding about the underlying factors that contribute to the life satisfaction (LS) of patients who suffer from such conditions. The presence of positive affect has an important role in the LS in the general population. Its presence activates personal resources that facilitate the achievement of their life purposes. However, these associations have not yet been evaluated in people affected by a severe psychiatric condition. The main aim of this study was to explore, using structural equation modelling, the role of different hedonic and eudaimonic well-being dimensions as predictors of LS in schizophrenia spectrum disorders. A total of 149 adult participants with schizophrenia spectrum disorders were assessed about their LS, hedonic well-being (i.e., positive affect, openness to the future) and eudaimonic well-being (i.e., social support, self-compassion, and strengths). Results indicate that self-compassion, caring and self-control strengths and social support mediate the relationship between hedonic well-being and LS. These findings help understand the mechanisms involved in LS in this population and shed light on the design of future interventions aimed at promoting a more satisfying life for them. iv)  Damsgaard, J. B. and Angel, S. (2021). Living a meaningful life while struggling with mental health: Challenging aspects regarding personal recovery encountered in the mental health system.  International Journal of Environmental Research and Public Health.  18:2708 https://doi.org/10.3390/ijerph18052708   Abstract Based upon academic and clinical experience from Denmark, this article aims to highlight international research-based knowledge concerning challenging aspects about the understanding and implementation of recovery-oriented practice. Three key points are located: (a) An integrative biopsychosocial approach considering both the clinical and personal recovery perspectives is relevant for research and practice. (b) Barriers in implementing a recovery-oriented approach include both individual and systemic challenges. This is well documented in the research-based literature, highlighting the need for changes. (c) A shift from professional control to a service-user orientation is seen as crucial. Examples of a positive shift are seen in helping the health professionals in their development and practicing of skills and competences through education and personal formation. Within these perspectives, a paradigm shift from a one-dimensional biomedical approach to a biopsychosocial approach is suggested. Instead of focusing on rapid stabilisation and symptom relief as a clinical outcome, a humanistic approach building on social- and person-oriented values is fundamental for social and personal recovery leading to a meaningful life. v)  Turner, K., Stapelberg, N. J. C., Sveticic, J. and Dekker, S. W. A. (2020) Inconvenient truths in suicide prevention: Why a Restorative Just Culture should be implemented alongside a Zero Suicide Framework.  Australian and New Zealand Journal of Psychiatry.  54(6) 571–581.   Abstract Objective: The prevailing paradigm in suicide prevention continues to contribute to the nihilism regarding the ability to prevent suicides in healthcare settings and a sense of blame following adverse incidents. In this paper, these issues are discussed through the lens of clinicians’ experiences as second victims following a loss of a consumer to suicide, and the lens of health care organisations. Method: We discuss challenges related to the fallacy of risk prediction (erroneous belief that risk screening can be used to predict risk or allocate resources), and incident reviews that maintain a retrospective linear focus on errors and are highly influenced by hindsight and outcome biases. Results: An argument that a Restorative Just Culture should be implemented alongside a Zero Suicide Framework is developed. Conclusions: The current use of algorithms to determine culpability following adverse incidents, and a linear approach to learning ignores the complexity of the healthcare settings and can have devastating effects on staff and the broader healthcare community. These issues represent ‘inconvenient truths’ that must be identified, reconciled and integrated into our future pathways towards reducing suicides in health care. The introduction of Zero Suicide Framework can support the much-needed transition from relying on a retrospective focus on errors (Safety I) to a more prospective focus which acknowledges the complexities of healthcare (Safety II), when based on the Restorative Just Culture principles. Restorative Just Culture replaces backward-looking accountability with a focus on the hurts, needs and obligations of all who are affected by the event. In this paper, we argue that the implementation of Zero Suicide Framework may be compromised if not supported by a substantial workplace cultural change. The process of responding to critical incidents implemented at the Gold Coast Mental Health and Specialist Services is provided as an example of a successful implementation of Restorative Just Culture–based principles that has achieved a culture change required to support learning, improving and healing for our consumers, their families, our staff and broader communities. vi) Joshi, P. (2021) What does reform of the Mental Health Act mean for people of colour? https://gal-dem.com/reform-of-the-mental-health-act-mean-for-people-of-colour/   In a short article updated by gal-dem in May this year, Priyankaa Joshi raises interesting and salient points about the recent review of the 1983 Mental Health Act and questions its ability to significantly improve mental health outcomes for Black and ethnic minority communities.  Despite the government’s claim to be tackling ‘racial disparities in mental health services’, the enduring and disproportionate impact of the Mental Health Act in the lives of Black and ethnic minority people continues to be an important issue in need of redress. Priyankaa Joshi questions whether recent reforms can go far enough to make such attempts a reality.     vii)  Cooper, R. E., Mason, J. P., Calton, T., Richardson, J. and Moncrieff, J. (2021) Opinion piece: The case for establishing a minimal medication alternative for psychosis and schizophrenia.  Psychosis.  13:3. 276-285. https://doi.org/10.1080/17522439.2021.1930119   Abstract The development of severe mental health conditions is strongly linked to our environments, particularly experiences of trauma and adversity.  However treatments for severe mental health conditions are often primarily biomedical, centred around medication. For people diagnosed with schizophrenia or psychosis, this is antipsychotic medication. Although antipsychotics have been found to reduce symptoms and risk of relapse, some patients derive little benefit from these drugs, and they can lead to severe adverse effects. Subsequently, a high proportion of people do not want to take antipsychotics and request an alternative. Yet in the UK and in many countries there are currently no guidelines for stopping antipsychotics or formal treatment alternatives, despite such alternatives being available in some countries. For example, in Norway and Vermont (USA), in response to pressure from service user organisations, governments have mandated the establishment of “minimal medication” services. We examine whether everyone with a psychotic condition needs long-term anti- psychotic treatment and evidence for alternative models of care. We recommend that healthcare providers should be encouraged to develop a psychosocial treatment package for people with psychosis or schizophrenia that provides a realistic possibility of minimising antipsychotic exposure. viii)  O’Keeffe, D., Sheridan, A., Kelly, A., Doyle, R., Madigan, K., Lawlor, E. and Clarke, M. (2021) A qualitative study exploring personal recovery meaning and the potential influence of clinical recovery status on this meaning 20 years after a first‐episode psychosis.  Social Psychiatry and Psychiatric Epidemiology https://doi.org/10.1007/s00127-021-02121-w   Abstract Purpose:  Long-term data on recovery conceptualisation in psychotic illness are needed to support mental health services to organise themselves according to recovery-oriented frameworks. To our knowledge, no previous research has investigated how first-episode psychosis (FEP) service users (sampled across psychotic illness type) perceive recovery beyond 5 years after diagnosis. We aimed to explore personal recovery meaning with individuals 20 years after their FEP and examine the potential influence of clinical recovery status on how they defined recovery (i.e. personal recovery). Methods:  Twenty participants were purposefully sampled from an epidemiologically representative FEP incidence cohort. At 20-year follow-up, semi-structured interviews were conducted with 10 cohort members who met full ‘functional recovery criteria’ (Clinically Recovered Group) and 10 who did not (Not Clinically Recovered Group). A thematic analysis was performed to develop shared themes and group-specific sub-themes to capture agreement and divergence between groups. Results:  Five shared themes were produced: pursuing balance in conflict, generating meaning in life, experiencing a dynamic personal relationship with time, redressing inequality while managing added challenges/vulnerability, and directing life from resilience to flourishing. The five group-specific sub-themes developed illuminate differences in the meaning ascribed to personal recovery by each group. Conclusion:  Findings emphasise the role of time in how personal recovery is conceptualised by service users and identify ways clinical recovery may influence personal recovery meaning in FEP at mid-later life. Mental health services failing to consider temporal changes in meaning-making and discounting clinical recovery risk ignoring key factors affecting personal recovery. Other News / Resources i)  Writing out of Anglia Ruskin University, Dr Joanna Fox explains: Dear colleagues My name is Dr Joanna Fox, and I am based at Anglia Ruskin University, UK.  This research is taking place in collaboration with the University of the West of England, UK. We are inviting UK academics who identify themselves as having experienced mental health difficulties in the workplace, either linked to a diagnosed condition or to general mental health and emotional difficulties, to take part in an online survey. This will help us to understand the factors enabling or inhibiting HE academics from disclosing their experiences of mental or emotional difficulties in the workplace; and how we can better support people who choose to disclose, or not to disclose, these experiences.  All participants will be kept anonymous. No names or institutional affiliations will be recorded at all in data sets. You will find further information, including an information sheet on the research through the web link below.  The survey will take approximately 25 minutes to complete depending on factors such as your Internet connection speed and the answers you give.  The survey is open until 12th November https://angliaruskin.onlinesurveys.ac.uk/disclosure-of-mental-distress-in-the-hei-workplace If you have any questions, please contact: Dr. Joanna Fox Email:  Joanna.Fox@aru.ac.uk   Tel:  +44 (0) 1223 698939 Postal address: Dr. Joanna Fox, Anglia Ruskin University, East Road, Cambridge, CB1 1PT   Thank you very much in advance for your consideration.   Dr. Joanna Fox ii)  Shared decision making (SDM module), Delivered as part of the MSc in Advanced Social Work Practice: January-March 2022.   Writing out of Hertfordshire University, Prof. Shulamit Ramon writes: Shared decision making (SDM) has been an emerging research and practice area in health and social care since the end of the 1990s. It focuses on a process that enables sharing information and preferences while aiming at reaching a joint decision. It is based on the assumption that service users are experts in their own experience, while the service providers’ expertise lies in scientific knowledge. Evaluative research findings demonstrate its usefulness in sharing information, enhancing motivation, mutual therapeutic trust and respect, new skills of both client and provider, and reducing intervention time.   Shared decision making follows the Strengths approach developed initially in social work, the Recovery Approach in health, as well as the need for meaningful Co-production between service users and providers.   This 15 credits module offers a conceptual framework for SDM with individuals and families; research evidence in physical and mental health, and in social care work with individuals and families across adult and child care; in community work, and the use of relevant shared decision aids.   This multidisciplinary, interactive, module will enable students to learn research-supported principles and practices for working with SDM in applied settings. It will be provided online, to enable busy practitioners the flexibility which online learning gives, applying interactive learning methods. Individual tutorials will be available also online. People with relevant lived experience and academic background would be welcomed too.   Methods of teaching and learning   will include presentations by the module leader, providers and experts in experience specialising in SDM, videos, practical exercises in small groups and group discussions. The module assignment is a reflective practice focused written account of applying SDM in working with a client.   The module leader, Prof. Ramon, is a registered social worker and chartered clinical psychologist by her training, experienced in researching and training on SDM.    For further information, please contact Prof. Shulamit Ramon s.ramon@herts.ac.uk iii) Prof. Shula Ramon also draws attention to the online MSc Mental Health Recovery and Social Inclusion Programme at the University of Hertfordshire.  Please see below for further information: iv)  Dr Daniel Hayes (Research Fellow, King’s College London Institute of Psychiatry) and Study Co-ordinator for the RECOLLECT Study, writes to inform readers about the following:    Launch of Recovery College surveys As part of the RECOLLECT Study ( researchintorecovery.com/recollect )  we will be conducting surveys of all Recovery Colleges (a) in England and (b) internationally. The aim of both surveys is to explore the characteristics of Recovery Colleges, identify where Recovery Colleges are and how they are similar or different from each other. We will present findings descriptively, such as the numbers courses offered and also use statistical tests to explore geographical comparisons, such as how they are funded. (a)   For the survey of Recovery Colleges in England, we are currently collecting contact details for all colleges. If you manage a Recovery College in England and have not already heard from us please contact us through recollect@kcl.ac.uk for more information. (b)   For the international survey in all other countries, we currently are aware of/have contacts to Recovery Colleges in 8 countries: Australia, Canada, Ireland, Italy, Japan, Uganda, UK and USA. If you know of Recovery Colleges in any country not on this list, or would like to add your Recovery College to take part in the survey, please could you send us your name and contact details: Daniel.Hayes@kcl.ac.uk v)  Becky Donne A research team from Canterbury Christ Church University is looking for participants for a study exploring voice-hearers’ experiences of reading narratives about hearing voices contained in the following books: Accepting Voices by Marius Romme Living with Voices: 50 stories of recovery by Marius Romme and Sandra Escher Young People Hearing Voices by Marius Romme and Sandra Escher Learning from the Voices in my Head by Eleanor Longden Hearing Voices, Living Fully by Claire Bien Recovery: An Alien Concept? by Ron Coleman Working with Voices II: Victim to Victor by Ron Coleman and Mike Smith We would like to talk to adults (18+) who identify as hearing voices (currently or in the past) and have read at least half of one of the above books. If you are interested in taking part in this study or would like some more information, please visit: https://tinyurl.com/3bzbrswp   Or, email Becky Donne (lead researcher) at b.donne204@canterbury.ac.uk. Participation is completely voluntary and all personal information will be kept confidential.   vi)  Writing out of the Department of Biostatistics and Health Informatics at King’s College London, Dr Sarah Markham draws attention to current research at a time of Covid-19:   The COVID-19 pandemic has led to over 3 million deaths worldwide. It has disrupted the lives of people across the world due to its rapid spread, mortality, disruption of social fabric, burden on health care systems, and devastating economic impact. There is widespread concern about the effects on mental health, particularly among vulnerable populations.   However, the rapid pace, volume, and limited quality of mental health evidence being generated and disseminated both through the media and academic channels during COVID-19 poses a barrier to effective synthesis and decision-making. We are conducting a series of living systematic reviews on mental health in COVID-19, including a review of randomised controlled trials of interventions to address mental health challenges in COVID-19 and longitudinal studies that compare mental health in COVID-19 to mental health prior to the pandemic or across points during the pandemic.   Here is a link to our COVID-19 Mental Health Living Systematic Review: https://www.depressd.ca/covid-19-mental-health   vii)  On the subject of carers and personal recovery, Claire Hilton (PhD candidate from the Spectrum Centre for Mental Health Research at Lancaster University) writes her work into the development of the Carer Recovery Questionnaire (CRQ):   Carers of those with psychosis and schizophrenia are often put under a lot of strain taking on a caring role after the crisis of a psychosis.  Understanding their wellbeing can help health professionals better support them.  Many carers go through a process of ‘personal recovery’ in parallel to service users where they find a way to adapt and cope with their caring responsibilities in a positive way.  There is currently no questionnaire to assess carer recovery, however.  A new one has been devised based on qualitative interviews with carers discussing the topic.  We are now at the stage of wanting feedback from carers on the draft questionnaire.  We are looking to recruit carers to do a 30-minute interview where we will discuss the draft questionnaire.  Carers will be offered a £10 Amazon voucher to thank them for their time.  This study is part of an ESRC funded PhD at Lancaster University.   If you are interested, please contact Claire Hilton at c.a.hilton@lancaster.ac.uk viii)  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   ix)  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

September 2021

RRN Meetings Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time.  However, the current suspension arrangements are under constant review by the RRN Collective and it is possible that a webinar-style meeting may provide an interim measure to coalesce our membership prior to the resumption of face-face networking when it becomes safe to do so.  More information about this possibility will be circulated in due course. Set against a background of close monitoring, Covid-19 restrictions are gradually being relaxed within the UK.  Nevertheless, there remain subtle differences in the rules affecting England, Northern Ireland, Scotland and Wales and we would encourage our readers to keep safe as the restrictions are eased.   Please can we urge our readership to continue to submit material to the 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.  We continue to include 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)  Guadalupe Morales Cano, Director of the International Bipolar Foundation invites colleagues to the following webinar:   Dear colleagues, As part of the EU Horizon2020  Research project, Recover-E http://www.recover-e.eu  I´m coordinating the webinar: Peer workers perspective: Human rights in mental health and the importance of the role of peer workers in mental health care. Oct. 14th 10:00-12:30.  This webinar is focused on promoting, protecting and upholding the human rights of persons with mental health problems.   A flyer for the webinar reads:   The webinar is organized by RECOVER-E, a Horizon 2020 project on the implementation and evaluation of multidisciplinary community mental health teams (CMHTs) consisting of a psychiatrist, psychologist, nurse, social worker and peer worker in five sites in five countries Croatia, Montenegro, Romania, North Macedonia and Bulgaria. This webinar focuses on the pioneering role of peer workers in these project sites. Anyone, from users, to mental health care professionals, policy makers, advocacy organizations, researchers and more can join this webinar. The overall goal of the RECOVER-E project is to contribute to the implementation of and research on an evidence-based community-based service delivery model for recovery-oriented care in the five sites.   Part 1. Human Rights & persons with mental health problems The webinar kicks off with a welcome by project leader Dr. Laura Shields-Zeeman and a brief talk by notable members: Dr. Jan Wise, member of Committee on Ethical Issues from the European Psychiatric Association (EPA), Nora Sveaass and Polli Hagenaars, members of the European Federation of Psychologists’ Association (EFPA) and Board of Human Rights & Psychology, (partners of RECOVER-E) about their views on human rights and persons with mental health problems.   In the first presentation Dr. Aleksandar Tomcuk (site leader in Montenegro) will discuss human rights and persons with mental health problems based in the EU Convention on Human Rights.   In the second presentation, Ms. Guadalupe Morales (trainer and dissemination leader in the project) will present the element of including peer workers in mental health care services, the UN Convention, employment, and meaningful involvement of persons with mental health problems.   This first part of the webinar will be concluded with a Q&A with the speakers and a moderator. The audience is invited and encouraged to ask their questions.   Part 2. Community mental health teams in RECOVER-E, the role of the peer worker The introduction of a Community Mental Health Team including a peer worker, in which the project is pioneering, has been a new experience for all those involved in the implementation in the sites. In the second part of the webinar peer workers and other community mental health team members (site leaders and/or psychologists) from different implementation sites will share their experiences through a presentation. After hearing about achievements, challenges and sustainability from the community mental health team members, the second part will end with another Q&A session where again the audience is encouraged and invited to ask questions.   Dr. Laura Shields-Zeeman (project leader) will conclude and close the webinar.   Contact details: Nina Bos Nbos@trimbos.nl Junior Project Manager RECOVER-E Trimbos Institute     ii)  International Shared Decision Making Conference 2022. The 11th International Shared Decision Making Conference takes place June 20-22 2022 with a pre-conference June 19. The venue for the conference is Comwell Kolding (Denmark) – just next to the site of Lillebaelt University Hospital – Kolding site.   Conference registration for the above event opens on Monday 1st November 2021. For further details, please see here.     iii)  Hertfordshire Partnership University Foundation Trust (HPFT) announces its 15th Annual Recovery Conference: Remembering, Recovering and Reflecting Together.  The online event is scheduled for Thursday 4th November 2021.  International contributors include: Dr Roberto Mezzina (Chair of the International Mental Health Collaborating Network who for several decades lead Mental Health Services in Trieste, Italy), and Dr Yael Mazor (Senior Lecturer in Social Work @ Sapir College).   For more information and registration/booking please see 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. i)  Damsgaard, J. B. and Jensen, A. (2021) Music activities and mental health recovery:  Service users’ perspectives presented in the CHIME Framework.  International Journal of Environmental Research and Public Health.  18:6638 https://doi.org/10.3390/ijerph18126638   Abstract Internationally, mental health service developments are increasingly informed by the principles of recovery, and the availability of arts and creative activities are becoming more common as part of provision. Mental health service users’ experiences, reflecting on the complex nature of using music participation in recovery are, however, limited. This essay considers literature that explores how music can support mental health service users in a recovery process. We have selected studies that include a broad spectrum of music activities, as well as literature considering various concepts about recovery. The conceptual recovery framework CHIME, that includes five important components in the recovery process, is used as the backdrop for exploring music activities as a contribution to recovery-oriented practice and services in mental health care. Eleven key components are identified in which music can support the recovery process: Feelings of equality; Social and emotional wellbeing; Tolerance; Hope and social agency; Triggering encounters; Redefining and reframing; A social practice; Moments of flow and peak experiences; Moments of meaning; Continuity; and Potentials instead of limitations. This essay concludes that the experiential knowledge of music activities from service users’ perspectives is essential knowledge when developing and using music activities in mental health recovery services. While this essay acknowledges that music activities can also produce unintended negative outcomes, the focus is on the positive contributions of music to mental health recovery processes. ii)  Dehmahdi, N., Law, H., Pyle, M., Byrne, R., Jones, W., Peel, H. and Morrison, A. P. (2021) Estimating the minimum important difference for the questionnaire about the Process of Recovery (QPR): an anchor-based approach.  Psychosis.  13(3). 220-230. https://doi.org/10.1080/17522439.2021.1883726   Abstract Background: Despite wide usage of the Questionnaire about the Process of Recovery 10 (QPR), the minimum important difference (MID) for the measure has not been identified. Establishing the MID for the QPR is required in order to facilitate the interpretation of outcomes in clinical practice and the use of this scale in research, to measure meaningful change in people with psycho- sis. Methods: Using an anchor-based method, data from four existing trials of interventions for people with psychosis (N = 681) were used to identify the MID for the QPR. Changes in QPR total scores between baseline and end of treatment were assessed for correspondence with several anchor measures which had established MIDs or face-value clinical meaning. A range of MID values were calculated. Results: Based on anchor measures that were orientated towards service- user priorities, a within-person MID of 5 points and a between-group MID of 4 points are suggested. Results also indicated that the reliability and validity of the 15-item version of the QPR was high, which provides support for its use in clinical practice and research. Conclusions: Implications for future research and clinical practice are discussed. iii)  Faulkner, A., Carr, S., Gould, D., Khisa, C., Hafford-Letchfiled, T., Cohen, R., Megele, C. and Holley, J. (2021) ‘Dignity and respect’: An example of service user leadership and co‐production in mental health research.  Health Expectations.  2021:24(Suppl. 1) 10-19.   Abstract This paper explores the methodological aspects of a user‐led study investigating mental health service user experiences of targeted violence and abuse (often called ‘hate crime’). ‘Keeping Control’ was a 16‐month qualitative study, undertaken in the context of adult safeguarding reforms in England. By collecting data on service user concepts and experiences, the research sought to address a gap in research and practice knowledge relating to targeted violence, abuse and hostility against people with mental health problems. In this paper, we discuss the significance of the design and methodology used for this study, with a particular focus on the interviews with service users. The research was both user‐led and carried out in collaboration with practitioners and academics, a form of research co‐production. Our aim is to inform researchers, practitioners and policymakers about the value of user leadership in co‐productive research with practitioners, particularly for a highly sensitive and potentially distressing topic. iv)  Zisman-Ilani, Y., Chmielowska, M., Dixon, L. B. and Ramon, S. (2021). NICE shared decision making guidelines and mental health: challenges for research, practice and implementation.  BJPsych Open.  7, e154 1-4 https://doi.org/10.1192/bjo.2021.987 Abstract The National Institute for Health and Care Excellence (NICE) initiated an ambitious effort to develop the first shared decision making guidelines. The purpose of this commentary is to identify three main concerns pertaining to the new published guidelines for shared decision making research, practice, implementation and cultural differences in mental health. Editors note: The above article highlights the significance of ignoring any non-systematic studies research, ethnic minorities, and mental health in the guidelines. Key words: patients; shared decision making; mental health; NICE; policy. v)  Dawson, S., Muir-Cochrane, E., Simpson, A., and Lawn, S. (2021). Community treatment orders and care planning: How is engagement and decision-making enacted? Health Expectations. https://doi.org/10.1111/hex.13329 Abstract Background:  In many jurisdictions worldwide, individuals with a mental illness may be forced to receive care and treatment in the community. In Australia, legislation states that such care should be driven by a care plan that is recovery-focussed. Key components in the care planning process include engagement and decision-making about a person’s support needs and care options, with trust being an essential component of care planning relationships. Objective:  This study examines how these components were enacted during service care contacts for individuals on community treatment orders. Methods:  The study was located at two community mental health teams in South Australia. Ethnographic observations of care planning discussions between consumers, their carers and clinicians, and interviews with individuals from these groups, were conducted over 18 months. Carspecken’s critical ethnography provided a rigorous means for examining the data to identify underlying cultural themes that were informing day-to-day care interactions. Results:  Care planning was not occurring as it was intended, with service culture and structures impeding the development of trusting relationships. Clinicians striving to work collaboratively with consumers had to navigate a service bias and culture that emphasized a hierarchy of ‘knowing’, with consumers assumed to have less knowledge than clinicians. Conclusions:  Services and clinicians can challenge prejudicial ethical injustice and counter this through testimonial justice and implementation of tools and approaches that support genuine shared decision-making. Patient or Public Contribution: This study included individuals with lived experience of mental illness, their carers and clinicians as participants and researchers. vi) Kline, E,R., Thibeau, H., Sanders, A. S., English, K., Davis, B.J., Fenley, A.R., and Keshavan, M.S. (2021) Motivational Interviewing for Loved Ones in Early Psychosis: Development and Pilot Feasibility Trial of a Brief Psychoeducational Intervention for Caregivers. Frontiers in Psychiatry.  12:659568. https://doi.org/10.3389/fpsyt.2021.659568   Abstract Treatment delay and non-adherence in first episode psychosis is a pressing public health problem. Ambivalence regarding psychiatric intervention and labelling among young people with psychosis is a contributing factor. For these individuals, caregivers often facilitate the pathway to care and support ongoing engagement and adherence. Caregivers describe distress and burden associated with this role. This manuscript describes the development and pilot feasibility testing of a motivational interviewing-derived communication training for caregivers of individuals with untreated or under-treated early course psychosis. Individuals with lived experience were consulted in the intervention development process. The training consisted of four 60-min sessions teaching the philosophy and basic skills of motivational interviewing as well as two brief practice calls. Feasibility was assessed with regard to study enrolment, retention, and completion. Satisfaction was assessed through the Client Satisfaction Questionnaire and qualitative feedback. Thirty-one caregivers consented to this pilot feasibility trial and participated via telehealth over the course of 5 months. Intervention completion and reported satisfaction were high, with 94% of consented participants completing at least three training sessions and 84% reporting that they would “definitely” recommend the training to a friend in similar circumstances. There were no between-clinician differences in MILO session attendance (F[2] = 0.53, p = 0.596) or satisfaction total scores (F[2] = 1.03, p = 0.371). Brief motivational interviewing skills training appears to be a feasible and valued intervention for caregivers of individuals with poorly managed early course psychosis. vii) Williams, A., Farhall, J., Fossey, E. and Thomas, N. (2019) Internet-based interventions to support recovery and self-management: A scoping review of their use by mental health service users and providers together. BMC Psychiatry.  19:191.  https://doi.org/10.1186/s12888-019-2153-0 Abstract Background: Internet-based interventions can make self-management and recovery-oriented information and tools more accessible for people experiencing severe mental illness, including psychosis. The aim of this scoping review was to identify and describe emerging joint uses of these Internet-based interventions by service users experiencing psychosis and mental health workers. It also investigated how using these Internet-based interventions influenced interactions between service users and workers and whether recovery-oriented working practices were elicited. Methods: A scoping review method was used. Iterative review stages included identifying the review question, a comprehensive search including searching six electronic databases to locate relevant studies, selecting studies, charting the data, and collating and reporting the results. Rigour of the scoping review was enhanced by using an appraisal tool to evaluate the quality of included studies, and by using a published template for systematic description of interventions. Results: Fifteen papers about eleven Internet-based interventions that focused on self-management and/or recovery were identified. Interventions were web-based, mobile-device based, or both. The eleven interventions were used by service users either with their usual mental health workers, or with mental health workers employed in a research project. Emerging evidence suggested that jointly using an Internet-based intervention could support a positive sense of working together. However, mismatched expectations and poor integration of Internet-based interventions into service systems could also negatively influence interactions, leading to mistrust. The interventions demonstrated potential to elicit recognised recovery-oriented practices, specifically understanding service users’ values and supporting their goal striving. Conclusions: The use of Internet-based interventions focused on self-management and recovery in mental health services by service users and workers jointly demonstrates potential to support working together and recovery-oriented practice. Given that the quality of relationships is critical in recovery-oriented practice, greater focus on human support in Internet-based interventions is needed in future research and practice.

Other News /Resources i)  King’s College London are currently advertising for a research assistant to support the RECOLLECT study.  The closing date is listed as the 13th October 2021.  Further details can be found here. ii)  The University of Nottingham are seeking a Research Associate/Fellow to join the Recovery Research Team (RRT) in the School of Health Sciences.  The team is led by Mike Slade, Professor of Mental Health Recovery and Social Inclusion.  The closing date for applications is Friday the 15th October.  For further information please see here.     iii)  Writing out of Anglia Ruskin University, Dr Joanna Fox explains: Dear colleagues, My name is Dr Joanna Fox, and I am based at Anglia Ruskin University, UK.  This research is taking place in collaboration with the University of the West of England, UK.   We are inviting UK academics who identify themselves as having experienced mental health difficulties in the workplace, either linked to a diagnosed condition or to general mental health and emotional difficulties, to take part in an online survey. This will help us to understand the factors enabling or inhibiting HE academics from disclosing their experiences of mental or emotional difficulties in the workplace; and how we can better support people who choose to disclose, or not to disclose, these experiences.  All participants will be kept anonymous. No names or institutional affiliations will be recorded at all in data sets.   You will find further information, including an information sheet on the research through the web link below.  The survey will take approximately 25 minutes to complete depending on factors such as your Internet connection speed and the answers you give.  The survey is open until 12th November   https://angliaruskin.onlinesurveys.ac.uk/disclosure-of-mental-distress-in-the-hei-workplace   If you have any questions, please contact: Dr. Joanna Fox Email:  Joanna.Fox@aru.ac.uk   Tel:  +44 (0) 1223 698939 Postal address: Dr. Joanna Fox, Anglia Ruskin University, East Road, Cambridge, CB1 1PT   Thank you very much in advance for your consideration. Dr. Joanna Fox iv)  Shared decision making (SDM module), Delivered as part of the MSc in Advanced Social Work Practice: January-March 2022. Writing out of Hertfordshire University, Prof. Shulamit Ramon writes: Shared decision making (SDM) has been an emerging research and practice area in health and social care since the end of the 1990s. It focuses on a process that enables sharing information and preferences while aiming at reaching a joint decision. It is based on the assumption that service users are experts in their own experience, while the service providers’ expertise lies in scientific knowledge. Evaluative research findings demonstrate its usefulness in sharing information, enhancing motivation, mutual therapeutic trust and respect, new skills of both client and provider, and reducing intervention time. Shared decision making follows the Strengths approach developed initially in social work, the Recovery Approach in health, as well as the need for meaningful Co-production between service users and providers. This 15 credits module offers a conceptual framework for SDM with individuals and families; research evidence in physical and mental health, and in social care work with individuals and families across adult and child care; in community work, and the use of relevant shared decision aids. This multidisciplinary, interactive, module will enable students to learn research-supported principles and practices for working with SDM in applied settings. It will be provided online, to enable busy practitioners the flexibility which online learning gives, applying interactive learning methods. Individual tutorials will be available also online. People with relevant lived experience and academic background would be welcomed too.   Methods of teaching and learning   will include presentations by the module leader, providers and experts in experience specialising in SDM, videos, practical exercises in small groups and group discussions. The module assignment is a reflective practice focused written account of applying SDM in working with a client.   The module leader, Prof. Ramon, is a registered social worker and chartered clinical psychologist by her training, experienced in researching and training on SDM.    For further information, please contact Prof. Shulamit Ramon s.ramon@herts.ac.uk v)  On the subject of carers and personal recovery, Claire Hilton (PhD candidate from the Spectrum Centre for Mental Health Research at Lancaster University) writes her work into the development of the Carer Recovery Questionnaire (CRQ): Carers of those with psychosis and schizophrenia are often put under a lot of strain taking on a caring role after the crisis of a psychosis.  Understanding their wellbeing can help health professionals better support them.  Many carers go through a process of ‘personal recovery’ in parallel to service users where they find a way to adapt and cope with their caring responsibilities in a positive way.  There is currently no questionnaire to assess carer recovery, however.  A new one has been devised based on qualitative interviews with carers discussing the topic.  We are now at the stage of wanting feedback from carers on the draft questionnaire.  We are looking to recruit carers to do a 30-minute interview where we will discuss the draft questionnaire.  Carers will be offered a £10 Amazon voucher to thank them for their time.  This study is part of an ESRC funded PhD at Lancaster University. If you are interested, please contact Claire Hilton at c.a.hilton@lancaster.ac.uk vi)  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     vii)  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

October 2021

RRN Meetings Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time.  However, the current suspension arrangements are under constant review by the RRN Collective and it is possible that a webinar-style meeting may provide an interim measure to coalesce our membership prior to the resumption of face-face networking when it becomes safe to do so.  More information about this possibility will be circulated in due course. Set against a background of close monitoring, Covid-19 restrictions are gradually being relaxed within the UK.  Nevertheless, there remain subtle differences in the rules affecting England, Northern Ireland, Scotland and Wales and we would encourage our readers to keep safe as the restrictions are eased.   Please can we urge our readership to continue to submit material to the 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.  We continue to include 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)  International Shared Decision Making Conference 2022. The 11th International Shared Decision Making Conference takes place June 20-22 2022 with a pre-conference June 19. The venue for the conference is Comwell Kolding (Denmark) – just next to the site of Lillebaelt University Hospital – Kolding site. Conference registration for the above event opens on Monday 1st November 2021. For further details, please see 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. i)  Karbouniaris, S., Weerman, A., Dunnewind, B., Wilken, J.P. and Abma, T.A. (2021) Professionals harnessing experiential knowledge in Dutch mental health settings.  Mental Health and Social Inclusion. Online: https://doi.org/10.1108/MHSI-08-2021-0054   Abstract Purpose: – This study aims to explore the perspectives of mental health professionals who are in a process of integrating their own experiential knowledge in their professional role. This study considers implications for identity, dilemmas and challenges within the broader organization, when bringing experiential knowledge to practice. Design/methodology/approach: – As part of a participatory action research approach, qualitative methods have been used, such as in-depth interviews, discussions and observations during training and project team. Findings: – The actual use of experiential knowledge by mental health care professionals in their work affected four levels: their personal–professional development; the relation with service users; the relation with colleagues; and their position in the organization. Research limitations/implications: – Because of its limited context, this study may lack generalisability and further research with regard to psychologists and psychiatrists, as well as perceptions from users, is desirable. Social implications: – According to this study, social change starts from a bottom-up movement and synchronously should be facilitated by top-down policy. A dialogue with academic mental health professionals seems crucial to integrate this source of knowledge. Active collaboration with peer workers and supervisors is desired as well. Originality/value: – Professionals with lived experiences play an important role in working recovery oriented, demonstrating bravery and resilience. Having dealt with mental health distress, they risked stigma and rejections when introducing this as a type of knowledge in current mental health service culture. Next to trainings to facilitate the personal–professional process, investments in the entire organization are needed to transform governance, policy and ethics.     ii)  Karbouniaris, S. (2021). Fragmented selves: a first person account on trauma and dissociation. Journal Archives of Psychiatry and Psychotherapy, 3. 7–10 https://doi.org/10.1108/MHSI-08-2021-0054   Abstract This first person account on recovery from trauma and dissociation has been written by a social scientist who went through a long journey in mental health care before receiving adequate treatment. A steady therapeutic relationship paired with different resources of the Comprehensive Resource Model eventually provided enough stability to overcome dissociation and process trauma. Although traditional psychotherapy is based on a psychoanalytical framework, it was helpful to look for framings that affirm a social and hermeneutic dialogue. This paper provides reflections that have proven to be helpful for the author and that might be helpful for others with similar problems.     iii)  Dreyer, R. P., Pavlo, A. J., Horne, A., Dunn, R., Danvers, K., Brush, J., Slade, M. and Davidson, L. (2021) Conceptual framework for personal recovery in patients with acute myocardial infarction.  Journal of the American Heart Association.  10(19) https://doi.org/10.1161/JAHA.121.022354   Abstract Background: Although there has been movement in cardiology to advance patient-centered approaches to postacute myocardial infarction (AMI) care, work remains to be done in aligning patient preferences with clinical care. Our objective was to characterize patients’ experience of AMI and treatment to develop a new conceptual framework of patient-centered recovery in cardiology. Methods and Results: We conducted in-depth interviews with people who previously experienced an AMI (2016–2019). The interview focused on participants’ experiences of their recovery, which were audio-recorded, transcribed verbatim, and analyzed using a phenomenological framework. The overarching theme described by the 42 participants was feeling like a “different person” after the AMI. This shift manifested itself in both losses and gains, each of which posed new challenges to everyday life. The experience appeared to be an active process requiring people to take responsibility for their health. In terms of loss, participants describe how the AMI threatened their sense of safety and security and led to social isolation, fragility, uncertainty about the future, and difficulty expressing emotions accompanied this new fear. A conceptual framework describing the relationship between AMI, identity change, and functioning was developed. Conclusions: Participants experienced the AMI as an unexpected disruption in their lives that had far-reaching effects on their daily functioning, and were resolved in numerous ways. The conceptual framework may assist in providing a theoretical basis for future interventions in cardiology that not only engage and retain patients in care but also improve long-term adherence to secondary prevention and other aspects of self-care.     iv)  Griffiths, C. and Hina, F. (2021) Integrated review of lifestyle interventions targeting diet and exercise in early or first-episode psychosis. Open Journal of Psychiatry.  11, 265-278 https://doi.org/10.4236/ojpsych.2021.11402   Abstract Aims: Life expectancy is reduced by 10 – 20 years in psychotic disorders compared with the general population, largely due to high incidence of physical health disorders: heart attack, stroke, obesity, cardiovascular disease (CVD), and type 2 diabetes. Early or first-episode psychosis patients can be especially vulnerable to physical health, psychological and social consequences of antipsychotic medication weight gain. The aim of this paper is to review diet and exercise lifestyle interventions employed to address these issues. Method: A review of research evidence on lifestyle interventions (diet and exercise) for individuals with early or first-episode psychosis (2000 to 2020) was undertaken. An internet-based literature search employed Medline, PsycINFO, Embase, PubMed and Web of Science. Results: Nine studies meeting the criteria were identified: comprising of three exercise intervention studies, one diet intervention study, and five combined diet and exercise intervention studies. Only one study used a RCT design with prior power analysis to determine participant numbers, two had a RCT design, two had a comparison group and four had no control group. Overall, these studies show that exercise and diet focused interventions may provide beneficial physical and mental health outcomes, but participant engagement and behaviour change may be difficult to achieve in early or first-episode psychosis due to individual factors associated with the experience of psychosis and medication prescribed, and health service related factors. Conclusion: There is a need for evidence-based lifestyle programmes in early or first-episode psychosis that includes individually targeted evidence based exercise and diet interventions. Further appropriately powered RCTs are required to strengthen the evidence base.     v) Hawsawi, T., Stein-Parbury, J., Orr, F., Roche, M. and Gill, K. (2021) Exploring recovery-focused educational programmes for advancing mental health nursing: An integrative systematic literature review.  International Journal of Mental Health Nursing. 30 (Suppl1) 1310-1341 https://doi.org/10.1111/inm.12908   Abstract Recovery-focused educational programmes have been implemented in mental health services in an attempt to transform care from a purely biomedical orientation to a more recovery oriented approach. Mental health nurses have identified the need for enhancing their abilities and confidence in translating recovery knowledge into mental health nursing practice. However, recovery-focused educational programmes have not fully address nurses’ learning needs. Therefore, this review synthesized the evidence of the effectiveness of recovery-focused educational programmes for mental health nurses. A systematic search of electronic databases and hand searched references was conducted. It identified 35 programmes and 55 educational materials within 39 studies. Synthesizing the literature revealed three themes and nine subthemes. The first theme, a framework for understanding and supporting consumers’ recovery, had four subthemes: consumers’ involvement, multidisciplinary approach, profession-specific training, and performance indicators. The second theme, contents of educational materials, included the subthemes: knowledge development and recovery-focused care planning. The final theme, nurses’ learning experiences, included the subthemes: understanding recovery, the positive effects of recovery focused educational programmes, and implementation of recovery-oriented practices. Based on these findings, a mental health nursing recovery-focused educational programme framework is proposed. Further research should investigate the effectiveness of the framework, especially in relation to recovery-focused care planning and consumer and carer involvement in the development, delivery, participation, and evaluation of these educational programmes.   vi)  Topor, A., Fredwall, T. E., Hodoel, E. K. S. H. and Larson, I. B. (2021) Before recovery: a blind-spot in recovery research?  Journal of Recovery in Mental Health. 4(2) 29-47   Abstract Objective: Recently, the position of persons with mental health and drug problems has evolved from victim of an illness to holder of an experience-based knowledge (EBK). Studies about recovery are often based on recovery  narratives.  However, focusing on components of the recovery process—parts  of  this  EBK  concerned  with  the  causes, onset, and journey before the proper recovery process—risks forming a blind spot. In this study, we aim to analyse service users’ EBK about recovery, the backgrounds and causes of the problems, and how they related these conditions to their recovery journey. Research Design and Methods: We interviewed  29  persons  in  recovery.  Data were analysed by using thematic analysis.  Results: We found that a childhood characterized by violence and abuse reoccurred in the stories. The child’s situation was not addressed by schools, social agencies, or neighbours,  creating  an  experience  of  social  isolation  and  invisibility.  Mental health distress and drug abuse were described as ways of managing these situations, until these became problems in themselves. The recovery journey started in a situation of despair and with a decision to stop using the developed threat response. For many, this meant going back to a  situation  of  loneliness  and  invisibility  before finding  places  and people and allowing  experiences  of  being  part  of  a positive  context  where  they  could  also contribute.  Conclusions: There is a risk of a blind spot in recovery research. EBK should be used to develop recovery-oriented services and also preventive interventions directed toward the social and psychological conditions in which children are raised.     vii) Santomauro, D. F. et al. (2021) Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic.  The Lancet.  Online: https://doi.org/10.1016/S0140-6736(21)02143-7   Summary Background:  Before 2020, mental disorders were leading causes of the global health-related burden, with depressive and anxiety disorders being leading contributors to this burden. The emergence of the COVID-19 pandemic has created an environment where many determinants of poor mental health are exacerbated. The need for up-to-date information on the mental health impacts of COVID-19 in a way that informs health system responses is imperative.  In this study, we aimed to quantify the impact of the COVID-19 pandemic on the prevalence and burden of major depressive disorder and anxiety disorders globally in 2020. Methods:  We conducted a systematic review of data reporting the prevalence of major depressive disorder and anxiety disorders during the COVID-19 pandemic and published between Jan 1, 2020, and Jan 29, 2021. We searched PubMed, Google Scholar, preprint servers, grey literature sources, and consulted experts. Eligible studies reported prevalence of depressive or anxiety disorders that were representative of the general population during the COVID-19 pandemic and had a pre-pandemic baseline. We used the assembled data in a meta-regression to estimate change in the prevalence of major depressive disorder and anxiety disorders between pre-pandemic and mid-pandemic (using periods as defined by each study) via COVID-19 impact indicators (human mobility, daily SARS-CoV-2 infection rate, and daily excess mortality rate). We then used this model to estimate the change from pre-pandemic prevalence (estimated using Disease Modelling Meta-Regression version 2.1 [known as DisMod-MR 2.1]) by age, sex, and location. We used final prevalence estimates and disability weights to estimate years lived with disability and disability-adjusted life-years (DALYs) for major depressive disorder and anxiety disorders. Findings:  We identified 5683 unique data sources, of which 48 met inclusion criteria (46 studies met criteria for major depressive disorder and 27 for anxiety disorders). Two COVID-19 impact indicators, specifically daily SARS-CoV-2 infection rates and reductions in human mobility, were associated with increased prevalence of major depressive disorder (regression coefficient [B] 0·9 [95% uncertainty interval 0·1 to 1·8; p=0·029] for human mobility, 18·1 [7·9 to 28·3; p=0·0005] for daily SARS-CoV-2 infection) and anxiety disorders (0·9 [0·1 to 1·7; p=0·022] and 13·8 [10·7 to 17·0; p<0·0001]. Females were affected more by the pandemic than males (B 0·1 [0·1 to 0·2; p=0·0001] for major depressive disorder, 0·1 [0·1 to 0·2; p=0·0001] for anxiety disorders) and younger age groups were more affected than older age groups (–0·007 [–0·009 to –0·006; p=0·0001] for major depressive disorder, –0·003 [–0·005 to –0·002; p=0·0001] for anxiety disorders). We estimated that the locations hit hardest by the pandemic in 2020, as measured with decreased human mobility and daily SARS-CoV-2 infection rate, had the greatest increases in prevalence of major depressive disorder and anxiety disorders. We estimated an additional 53·2 million (44·8 to 62·9) cases of major depressive disorder globally (an increase of 27·6% [25·1 to 30·3]) due to the COVID-19 pandemic, such that the total prevalence was 3152·9 cases (2722·5 to 3654·5) per 100 000 population. We also estimated an additional 76·2 million (64·3 to 90·6) cases of anxiety disorders globally (an increase of 25·6% [23·2 to 28·0]), such that the total prevalence was 4802·4 cases (4108·2 to 5588·6) per 100 000 population. Altogether, major depressive disorder caused 49·4 million (33·6 to 68·7) DALYs and anxiety disorders caused 44·5 million (30·2 to 62·5) DALYs globally in 2020. Interpretation:  This pandemic has created an increased urgency to strengthen mental health systems in most countries. Mitigation strategies could incorporate ways to promote mental wellbeing and target determinants of poor mental health and interventions to treat those with a mental disorder. Taking no action to address the burden of major depressive disorder and anxiety disorders should not be an option     viii) Jagfeld, G., Lobban, F., Marshall, P. and Jones, S. H. (2021) Personal recovery in bipolar disorder: Systematic review and “best fit” framework synthesis of qualitative evidence – a POETIC adaptation of CHIME.  Journal of Affective Disorders 292  375-385 https://doi.org/10.1016/j.jad.2021.05.051   Abstract Background:  Personal recovery, living a satisfying, hopeful life alongside symptoms, has become an increasingly valued aim across mental health care agendas internationally. However, there is little understanding of how people experience personal recovery alongside the mood challenges characteristic of a bipolar disorder diagnosis. Personal recovery frameworks have been developed for populations with mixed psychiatric diagnoses, predominantly psychotic disorders. Methods:  This systematic review of qualitative data used the widely adopted personal recovery processes Connectedness, Hope and optimism, Identity, Meaning and purpose, Empowerment (CHIME) in a “best fit” framework synthesis to understand personal recovery experiences in bipolar disorder. Included studies were coded with deductive framework analysis based on the CHIME processes and inductive thematic analysis for aspects beyond the a priori framework. Results:  A comprehensive search of six literature databases led to inclusion of twelve articles published 2010-2020. Deductive coding supported the fit with the CHIME framework but revealed difficulties, losses, and tensions within and across recovery processes. The proposed framework for personal recovery in bipolar disorder, Purpose and meaning, Optimism and hope, Empowerment, Tensions, Identity, Connectedness (POETIC), organises all CHIME processes around these tensions. Limitations:  Diversity among study participants was limited with majority middle-aged, female, Western participants. Conclusions:  The compact POETIC personal recovery framework tailored for bipolar disorder is directly applicable to clinical practice with personal recovery objectives. It highlights the need for professionals to introduce personal recovery in a realistic and balanced way to address recent criticism by service user organisations of personal recovery as overly optimistic.     ix)  The following two articles, both authored by Simon Usbourne, who is a freelance feature writer and reporter, do not follow the usual mould of publications we put into the RRN monthly e-bulletin. They are not summarising research on mental health recovery or views about such research.    Instead, they summarise two life histories where the protagonists changed direction due to personal trauma, with one of them focusing on changing approaches to psychosocial aspects of mental health  and the other to becoming an activist in preventing suicide.   As such they are examples of posttraumatic growth, an issue awaiting its place in understanding and contributing to recovery, which all too often it not recognised in existing research on this issue.   We would welcome readers’ reactions to these confessional reflections by sharing their own reflections on the conclusions drawn by the two commentators.   ‘I don’t intend to let my son down twice’: the bereaved father trying to end suicide https://www.theguardian.com/society/2021/aug/11/i-dont-intend-to-let-my-son-down-twice-the-bereaved-father-trying-to-end-suicide   and   Richard Bentall: the man who lost his brother – then revolutionised psychology  https://www.theguardian.com/society/2021/sep/29/richard-bentall-the-doctor-who-lost-his-brother-then-revolutionised-psychology?utm_term=50c8ae0a850cf7bece901703b370b773&utm_campaign=SocietyWeekly&utm_source=esp&utm_medium=Email&CMP=societyweekly_email     x) In a similar fashion to the above (ix), readers are encouraged share their thoughts and opinions on a second pairing.  In this instance, the focus is upon Kaiisha Kukendra’s piece, entitled ‘Section Zero (indefinite exclusion)’.  Hosted by the National Service User Network, Kukendra’s writing is prompted by a reading of a recent peer reviewed article by Dr Chloe Beale who critically examines the structural arrangements of mental health services and the extent to which they exclude. Kukendra draws upon lived experience to reflect upon Beale’s article and in doing so finds an unexpected meeting point.   Kukendra’s writing is linked below, and reference to Beale’s paper is included below also.   Kaiisha Kukendra (2021) Section Zero (indefinite exclusion) https://www.nsun.org.uk/section-zero-indefinite-exclusion/   and  Beale, C. (2021) Magical thinking and moral injury: exclusion culture in psychiatry.  BJPsych Bulletin. Online https://doi.org/doi:10.1192/bjb.2021.86     Summary This is an article about exclusion. We might not like to admit it – even fail to realise it – but National Health Service (NHS) mental health service structures have become increasingly focused on how to deny people care instead of help them to access it. Clinicians learn the art of self-delusion, convincing ourselves we are not letting patients down but, instead, doing the clinically appropriate thing. Well-meant initiatives become misappropriated to justify neglect. Are we trying to protect ourselves against the knowledge that we’re failing our patients, or is collusion simply the easiest option? Problematic language endemic in psychiatry reveals a deeper issue: a culture of fear and falsehood, leading to iatrogenic harm. An excessively risk averse and under-resourced system may drain its clinicians of compassion, losing sight of the human being behind each ‘protected’ bed and rejected referral Other News /Resources i)  Writing out of Anglia Ruskin University, Dr Joanna Fox explains: Dear colleagues, My name is Dr Joanna Fox, and I am based at Anglia Ruskin University, UK.  This research is taking place in collaboration with the University of the West of England, UK.   We are inviting UK academics who identify themselves as having experienced mental health difficulties in the workplace, either linked to a diagnosed condition or to general mental health and emotional difficulties, to take part in an online survey. This will help us to understand the factors enabling or inhibiting HE academics from disclosing their experiences of mental or emotional difficulties in the workplace; and how we can better support people who choose to disclose, or not to disclose, these experiences.  All participants will be kept anonymous. No names or institutional affiliations will be recorded at all in data sets.   You will find further information, including an information sheet on the research through the web link below.  The survey will take approximately 25 minutes to complete depending on factors such as your Internet connection speed and the answers you give.  The survey is open until 12th November   https://angliaruskin.onlinesurveys.ac.uk/disclosure-of-mental-distress-in-the-hei-workplace   If you have any questions, please contact: Dr. Joanna Fox Email:  Joanna.Fox@aru.ac.uk   Tel:  +44 (0) 1223 698939 Postal address: Dr. Joanna Fox, Anglia Ruskin University, East Road, Cambridge, CB1 1PT   Thank you very much in advance for your consideration. Dr. Joanna Fox ii)  Shared decision making (SDM module), Delivered as part of the MSc in Advanced Social Work Practice: January-March 2022. Writing out of Hertfordshire University, Prof. Shulamit Ramon writes: Shared decision making (SDM) has been an emerging research and practice area in health and social care since the end of the 1990s. It focuses on a process that enables sharing information and preferences while aiming at reaching a joint decision. It is based on the assumption that service users are experts in their own experience, while the service providers’ expertise lies in scientific knowledge. Evaluative research findings demonstrate its usefulness in sharing information, enhancing motivation, mutual therapeutic trust and respect, new skills of both client and provider, and reducing intervention time. Shared decision making follows the Strengths approach developed initially in social work, the Recovery Approach in health, as well as the need for meaningful Co-production between service users and providers. This 15 credits module offers a conceptual framework for SDM with individuals and families; research evidence in physical and mental health, and in social care work with individuals and families across adult and child care; in community work, and the use of relevant shared decision aids. This multidisciplinary, interactive, module will enable students to learn research-supported principles and practices for working with SDM in applied settings. It will be provided online, to enable busy practitioners the flexibility which online learning gives, applying interactive learning methods. Individual tutorials will be available also online. People with relevant lived experience and academic background would be welcomed too.   Methods of teaching and learning   will include presentations by the module leader, providers and experts in experience specialising in SDM, videos, practical exercises in small groups and group discussions. The module assignment is a reflective practice focused written account of applying SDM in working with a client.   The module leader, Prof. Ramon, is a registered social worker and chartered clinical psychologist by her training, experienced in researching and training on SDM.    For further information, please contact Prof. Shulamit Ramon s.ramon@herts.ac.uk iii)  On the subject of carers and personal recovery, Claire Hilton (PhD candidate from the Spectrum Centre for Mental Health Research at Lancaster University) writes her work into the development of the Carer Recovery Questionnaire (CRQ): Carers of those with psychosis and schizophrenia are often put under a lot of strain taking on a caring role after the crisis of a psychosis.  Understanding their wellbeing can help health professionals better support them.  Many carers go through a process of ‘personal recovery’ in parallel to service users where they find a way to adapt and cope with their caring responsibilities in a positive way.  There is currently no questionnaire to assess carer recovery, however.  A new one has been devised based on qualitative interviews with carers discussing the topic.  We are now at the stage of wanting feedback from carers on the draft questionnaire.  We are looking to recruit carers to do a 30-minute interview where we will discuss the draft questionnaire.  Carers will be offered a £10 Amazon voucher to thank them for their time.  This study is part of an ESRC funded PhD at Lancaster University. If you are interested, please contact Claire Hilton at c.a.hilton@lancaster.ac.uk 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 2021

RRN Meetings
Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time. However, the current suspension arrangements are under constant review by the RRN Collective and it is possible that a webinar-style meeting may provide an interim measure to coalesce our membership prior to the resumption of face-face networking when it becomes safe to do so. More information about this possibility will be circulated in due course.

The national and international response to Covid-19 are under constant review, and particularly so following the identification of a variant of concern named Omicron by the World Health Organisation in late November. We would encourage our readers to keep safe and follow relevant guidance as appropriate.

Please can we urge our readership to continue to submit material to the 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. We continue to include 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) International Shared Decision Making Conference 2022.
The 11th International Shared Decision Making Conference takes place June 20-22 2022 with a pre-conference June 19. The venue for the conference is Comwell Kolding (Denmark) – just next to the site of Lillebaelt University Hospital – Kolding site.

Conference registration for the above event opens on Monday 1st November 2021. For further details, please see here
The full URL is provided here: https://www.isdm2022.com

ii). A Follow-up day for the International Peer Respite/Soteria Summit is scheduled for Sunday, December 5, 2021. 12-2 pm EST, 5-7 pm GMT, 7-9 pm IST
A Zoom link and agenda can be found here

The full URL is provided here: https://www.soterianetwork.org.uk/2021/12/01/peer-respite-and-soteria-summit-follow-up-day/

 

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 recoveryIn the last edition of the ebulletin we included an incorrect link to the following paper by Simona Karbouniaris. We include the correct link here:

i) Karbouniaris, S. (2021). Fragmented selves: a first person account on trauma and dissociation. Journal Archives of Psychiatry and Psychotherapy, 3. 7–10

7Karbouniaris__Archives_PP_3_2021.pdf (archivespp.pl)

Abstract
This first person account on recovery from trauma and dissociation has been written by a social scientist who went through a long journey in mental health care before receiving adequate treatment. A steady therapeutic relationship paired with different resources of the Comprehensive Resource Model eventually provided enough stability to overcome dissociation and process trauma. Although traditional psychotherapy is based on a psychoanalytical framework, it was helpful to look for framings that affirm a social and hermeneutic dialogue. This paper provides reflections that have proven to be helpful for the author and that might be helpful for others with similar problems.

ii) Řezníková, V., Černá, M. and Dubnová, M. (2021): Experience with introducing peer trainers into mental health education. Social Work Education. Online:
https://doi.org/10.1080/02615479.2021.1998425

 

Abstract
People who have experienced mental health problems often encounter stigmatisation, mainly by professional mental health care providers. Therefore, involvement of experts by experience in courses taught at a higher education institution that provides training for future healthcare professionals aims at destigmatising mental illnesses. Peer trainers have a lived mental health problems experience who take on the role of trainers to present the latest mental health care trends and theories and introduce recovery elements into the educational process.
The data on which the article is based were gathered over a period of three years from focus groups involving 2nd year students of the bachelor’s degree programme of ‘Clinical Social Worker’. The results obtained clearly show the destigmatising effect of this type of teaching: what has proven to be crucial in this regard was, on the one hand, the experience of former patients, and on the other hand, a counterweight to the often-one-sided information prevalent in professional literature on mental health available in the Czech Republic. The teaching reinforced the students’ ability to work in a multidisciplinary team together with a peer support worker and also undermined any prejudice they may have had towards people with mental health problems.

iii) Lau, B., Shiryaeva, O., Ruud, T. and Victor, M (2019) What are they returning to? Psychosocial work environment as a predictor of returning to work among employees in treatment for common mental disorders: A prospective observational pre–post study. PLoS ONE 14(4): e0215354.
https://doi.org/10.1371/journal.pone.0215354

 

Abstract
Introduction: Long-term sick leave and disabilities due to common mental disorders are challenging for society, employers, and individuals. Hence, we wanted to investigate whether psychosocial work environments experienced by employees undergoing treatment for such disorders was associated with return to work.
Methods: At the start of treatment, 164 patients responded to questionnaires concerning their psychosocial work environment (the Job Demand–Control–Support model and the Effort–Reward Imbalance model), symptoms (The Clinical Outcomes in Routine Evaluation Outcome Measure) and ability to work (Work Ability Index). In addition, the respondents reported whether they were working or on sick leave at the start and end of their courses of treatment. Their therapists provided information about diagnoses.
Results: Return to work was associated with control of decisions, support from colleagues, esteem, and job promotion opportunities as measured at the start of treatment. In multivariate analyses, control over decisions and job promotion opportunities continued to predict return to work when adjusted for symptoms, current work ability, and expected future work ability.
Discussion: The working conditions that predicted return to work are considered to facilitate work performance and to be sources of motivation, job satisfaction, and job commitment. Consequently it is important to examine whether this patient group has a favourable working environment and consider changes in the workplace if the environment is not favourable.

iv) Jordan, G., Iyer, S. N., Malla, A. and Davidson, L. (2020) Posttraumatic growth and recovery following a first episode of psychosis: a narrative review of two concepts, Psychosis. 12(3), 285-294

Abstract
A first episode of psychosis is often a traumatic experience that leads to significant life disruptions. However, many young people recover following a first episode of psychosis. Two types of recovery from psychosis have been described in the literature: clinical recovery (i.e. the resolution of symptoms and resumption of social, occupational or educational goals) and personal recovery (i.e. finding a way to live a meaningful life despite the limitations of having a mental illness). Further, some young people may experience posttraumatic growth (i.e. positive psychological changes following the struggle with psychosis). It is unclear how posttraumatic growth and recovery are similar or distinct. This conceptual ambiguity may limit both theoretical and empirical work in the field. The purpose of this narrative review is to help resolve this ambiguity by describing similarities and differences in the historical roots, phenomenology, and predictors of recovery (both clinical and personal) and posttraumatic growth within the context of a first episode of psychosis. Our review concludes that personal recovery may be best understood as a broader construct under which clinical recovery is subsumed, and that posttraumatic growth may be a phenomenon that is related to, yet distinct from, personal recovery. Future empirical studies are needed to disentangle these phenomena.

v) Hopkins, L., Foster, A., Belmore, S., Anderson, S., and Wiseman, D. (2021) Recovery colleges in mental health-care services: an Australian feasibility and acceptability study. Mental Health and Social Inclusion. Online ahead-of-print
https://doi.org/10.1108/MHSI-06-2021-0035

 

Abstract
Purpose: This study aims to evaluate the feasibility and acceptability of establishing a recovery college in an Australian acute and community adult mental health service. Very little has been published on efforts to incorporate recovery colleges in inpatient settings other than forensic. This study offers an evaluation of feasibility and acceptability of this service model within a health-care setting.
Design/methodology/approach: Participant feedback and qualitative implementation data, from an acute mental health-care inpatient ward and adult community care were used. Participants were mental health service consumers and staff. The intervention involved a co-produced, co-designed, co-delivered and co-received educational opportunity for mental health consumers, carers, staff and the community.
Findings: Feedback from course participants indicates that learning objectives were met by the majority of participants, while stakeholders identified that establishing a recovery college within both the inpatient and community health-care service was feasible at a service level and broadly acceptable to consumers.
Originality/value: Establishing an adult recovery college in inpatient and community care is likely

vi) Hardy, K. V., Dickens, C. E. Roach, E. L. Harrison, V., Desai, A., Flynn, F., Noordsy, D. L., Dauberman, J. and Adelsheim, S. (2020) Lived experience perspectives on reducing the duration of untreated psychosis: the impact of stigma on accessing treatment. Psychosis, 12(3), 269-280.

Abstract
Introduction: Prolonged duration of untreated psychosis (DUP) has long-term deleterious effects on outcomes. Research has focused on identifying factors contributing to prolonged DUP and initiatives to reduce the time it takes individuals to access treatment. Stigma may contribute to extended DUP, but there has been little exploration of the experience of stigma and its impact on accessing care.
Objectives: The aim of this study was to explore the impact of stigma on
decisions to seek care from the perspective of individuals with lived experience of psychosis and their caregivers.
Methods: A survey, developed by a group consisting of individuals with lived experience of psychosis, and distributed online, was designed to elicit quantitative and qualitative data relating to the experience of accessing care at the onset of psychosis. Qualitative data were analysed using Thematic Analysis.
Results: 193 respondents completed the survey. Qualitative analysis yielded themes including “perception of stigma” and “outcomes associated with stigma”.
Conclusions: There is a need to address stigma at the outset of treatment, and wider dissemination of information about psychosis is necessary. Future research should address cultural differences in individuals’ experiences of psychosis, as well as the role siblings play in the care of affected individuals.

vii) Yanos, P. T., DeLuca, J. S., Roe, D. and Lysaker, P. H. (2020) The impact of illness identity on recovery from severe mental illness: A review of the evidence. Psychiatry Research. 288
https://doi.org/10.1016/j.psychres.2020.112950

 

Abstract
The “Illness Identity” model proposed that self-stigma impacts hope and self-esteem and subsequently leads to a cascade of negative effects on outcomes related to recovery among people diagnosed with severe mental illnesses. The purpose of the present review is to take stock of research support for the model. The citation index SCOPUS was reviewed for all papers published in peer-reviewed journals in English between 2010 and 2019 citing one of the initial 3 articles discussing the model: 111 studies met inclusion criteria and were reviewed. The most frequently tested, and supported, aspects of the model were relationships between self-stigma and self-esteem, hope, psychiatric symptoms and social relationships. Least frequently studied areas were relationships with suicide, avoidant coping, treatment adherence and vocational functioning, although they were supported in the majority of studies. The “insight paradox” was also tested in a relatively small number of studies, with mixed results. Findings were robust to geographic location of study, method, and subpopulation studied. Findings indicate that a large body of research has tested, and largely supported, the various components of the Illness Identity model, although some components need further investigation and there is a need for more comprehensive tests of the model.

viii) Law, H., Gee, B., Dehmahdi, N., Carney, R., Jackson, C., Wheeler, R., Carroll, B., Tully, S. and Clarke, T (2020) What does recovery mean to young people with mental health difficulties? – “It’s not this magical unspoken thing, it’s just recovery”. Journal of Mental Health, 29(4) 464-472.

Abstract
Background: There is extensive literature documenting the nature of recovery in mental health in adult populations, but there is very little exploring its nature and meaning for young people.
Aims: To gain a detailed understanding from the perspective of young people about the concept of recovery in young people’s mental health.
Method: Semi structured interviews were conducted with 23 young people. Interviews were transcribed verbatim and analysed using thematic analysis.
Results: Themes emerging from the interviews included young people’s dynamic conceptualisations of recovery, awareness of others views of recovery, polarised goals of recovery, and facilitators and barriers of recovery.
Conclusions: To be relevant for young people, the mental health recovery model must incorporate individual needs, developmental considerations and fluctuations in goals. It must also be embedded within the young person’s ecological system such as family, friends and school, and be focussed around an explicit and collaborative recovery discussion with the young person

 

Other News / Resources
i) NEON Study
The Recovery Research Team at University of Nottingham is running the NEON trials, which are looking at whether access to online stories of recovery from mental health problems can help people affected by mental health problems. Participants in the NEON trials receive access to the NEON Collection of more than 600 international mental health recovery stories.

We are delighted to announce that we have now completed recruitment to all three of our trials, with 1830 people from across England taking part. We wanted to take this opportunity to thank everyone who has helped us out over the past year, we couldn’t have done it without all of the support we have received, much of which we will never know about.

We will now shift our focus to the continued running of the trials, which will enable us to understand how recovery stories can help people.

The NEON Collection is still accepting donations of personal recovery stories, and these will be integrated into our trials. If you are interested in donating a story, or know someone else that might be interested, please look at our Donate a Story page.

If you’re interested in keeping up with NEON’s progress, we’ll be posting regular updates to our News page. In late 2022 or early 2023, results from our trials will be made available on the NEON website in the form of a research publication and a programme summary.

Thank you again for your support.

ii) 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

 

iii) 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 2021

RRN Meetings
Due to the ongoing developments with regards to Covid-19 both nationally and internationally, RRN in-person meetings continue to be suspended at the present time. However, the current suspension arrangements are under constant review by the RRN Collective and it is possible that a webinar-style meeting may provide an interim measure to coalesce our membership prior to the resumption of face-face networking when it becomes safe to do so. More information about this possibility will be circulated in due course.

The national and international responses to Covid-19 are under constant review, and particularly so following the identification of a variant of concern named Omicron by the World Health Organisation in late November. We would encourage our readers to keep safe and follow relevant guidance as appropriate.

Please can we urge our readership to continue to submit material to the 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. We continue to include 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) International Shared Decision Making Conference 2022.
The 11th International Shared Decision Making Conference takes place June 20-22 2022 with a pre-conference June 19. The venue for the conference is Comwell Kolding (Denmark) – just next to the site of Lillebaelt University Hospital – Kolding site.

Conference registration for the above event opened on Monday 1st November 2021. For further details, please see here
https://www.isdm2022.com

ii) 14th International Conference of the European Network for Mental Health Services Evaluation (ENMESH)

Focus on: Collectivism and Individualism in Mental Health. June 27-29, 2022, Tel Aviv, Israel.

https://ENMESH2022.com
https://ENMESH2022.com/program-at-a-glance
https://targetconferences.com

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.

On the 6th December, the World Association for Psychosocial Rehabilitation (WAPR) issued volume 47 of their Bulletin. The issue reflected the WAPR World Congress theme of: “Mental health, rights, equity, recovery and social inclusion in testing times”. The issue contains several articles that are of relevance for the RRN ebulletin:
• “Whose Plan is it Anyway?”… Reimagining person-led planning. Helen Glover
• Recovery-Oriented Practices – Key Learnings in a Changing World. Larry Davidson
• The United Arab Emirates (UAE) National Promotion of Mental Health. Ala Alnaqbi and Medhat Elsabbahy
• Trieste 50 years after: a more humane, person-centred whole system of care is now at risk. Roberto Mezzina
• Like a bolt from the blue. Katerina Nomidou
• Empowering youth refugees and asylum-seekers through arts in refugee sites in mainland Greece: the example of YouCreate. Eleni Strati & Eleftheria Aravidou

The whole issue can be downloaded and there are options to download individual articles too. Please see:
http://www.wapr.org/released-wapr-bulletin-no-47/

i) Lee, S. A. (2020) Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death Studies, 44(7) 393-401
https://doi.org/10.1080/07481187.2020.1748481

Abstract
Mental health concerns of people impacted by the coronavirus pandemic have not been adequately addressed. The objective of this study was to develop and evaluate the properties of the Coronavirus Anxiety Scale (CAS), which is a brief mental health screener to identify probable cases of dysfunctional anxiety associated with the COVID-19 crisis. This 5-item scale, which was based on 775 adults with anxiety over the coronavirus, demonstrated solid reliability and validity. Elevated CAS scores were found to be associated with coronavirus diagnosis, impairment, alcohol/drug coping, negative religious coping, extreme hopelessness, suicidal ideation, as well as attitudes toward President Trump and Chinese products. The CAS discriminates well between persons with and without dysfunctional anxiety using an optimized cut score of   9 (90% sensitivity and 85% specificity). These results support the CAS as an efficient and valid tool for clinical research and practice.

ii) McCartan, C., Adell, T., Cameron, J., Davidson, G., Knifton, l., McDaid, S. and Mulholland, C. (2021)
A scoping review of international policy responses to mental health recovery during the COVID-19 pandemic. Health Research Policy and Systems. 19(58). Online:
https://doi.org/10.1186/s12961-020-00652-3

Abstract
The COVID-19 pandemic has affected people’s physical and mental health. Quarantine and other lockdown measures have altered people’s daily lives; levels of anxiety, depression, substance use, self-harm and suicide ideation have increased. This commentary assesses how international governments, agencies and organisations are responding to the challenge of the mental health impact of COVID-19 with the aim of informing the ongoing policy and service responses needed in the immediate and longer term. It identifies some of the key themes emerging from the literature, recognises at-risk populations and highlights opportunities for innovation within mental health services, focusing on the published academic literature, international health ministry websites and other relevant international organisations beyond the United Kingdom and Ireland. COVID-19 has challenged, and may have permanently changed, mental health services. It has highlighted and exacerbated pre-existing pressures and inequities. Many decision-makers consider this an opportunity to transform mental health care, and tackling the social determinants of mental health and engaging in prevention will be a necessary part of such transformation. Better data collection, modelling and sharing will enhance policy and service development. The crisis provides opportunities to build on positive innovations: the adaptability and flexibility of community-based care; drawing on lived experience in the design, development and monitoring of services; interagency collaboration; accelerating digital healthcare; and connecting physical and mental health.

iii) Germani, A., Buratta, L., Delvecchio, E., Gizzi, G. and Mazzeschi, C. (2020) Anxiety severity, perceived risk of COVID-19 and individual functioning in emerging adults facing the pandemic. Front. Psychol. 11:567505.
https://doi.org/10.3389/fpsyg.2020.567505

Abstract
The COVID-19 pandemic is showing a strong impact on people in terms of uncertainty and instability it has caused in different areas of daily life. Uncertainty and instability are also emotions that characterize emerging adulthood (EA). They generate worries about the present and the future and are a source of anxiety that impacts negatively on personal and interpersonal functioning. Anxiety seems a central effect of the pandemic and recent studies have suggested that it is linked to COVID-19 risk perception. In the present study, a sample of 1045 Italian emerging adults was collected: (1) to assess anxiety severity and perceived risk related to COVID-19 and their association and (2) to compare general health and protective factors such as attitudes about security, relationships, self-esteem, and self-efficacy across anxiety severity and perceived risk categories. The findings of this study highlighted that anxiety severity categories were distributed homogeneously across the sample and that half of the participants referred to moderate-severe anxiety. A series of analysis of variances and post hoc comparisons showed that general health and all protective factors decreased according to anxiety severity. They were higher in participants with high perceived risk, with the exception of self-efficacy. Given the challenging features of the pandemic and EA, it is crucial to monitor anxiety severity in order to prevent last longing effects on mental and physical health, as well as keeping emerging adults informed about the risks related to the pandemic. Intervention and supportive programs based on improving self-esteem and self-efficacy, as well as confidence in relationships, should be offered to emerging adults over the long term, beyond the current outbreak.

iv) Barry, J. and Higgins, A. (2021) PhotoVoice: An ideal methodology for use within recovery-oriented mental health research. Issues in Mental Health Nursing. 42(7) 676-681.
https://doi.org/10.1080/01612840.2020.1833120

Abstract
At the heart of recovery-orientated mental health care and the Patient and Public Involvement (PPI) movement, is the inclusion of experts by experience as collaborators on mental health research projects. However, embedding Public and Patient Involvement (PPI) can be challenging in academic institutions that have long-standing researcher-as-expert structures in place. PhotoVoice is a collaborative, participant-centric community-based methodology that has potential to overcome some of the challenges encountered within Public and Patient Involvement (PPI). This discursive paper describes what PhotoVoice is, why it was developed, it’s application in research and its alignment to recovery principles. Thereby arguing that PhotoVoice is an ideal methodology for use within recovery-orientated research.

v) Dell, N. A., Long, C. and Mancini, M. A. (2021) Models of mental health recovery: An overview of
systematic reviews and qualitative meta-syntheses. Psychiatric Rehabilitation Journal. 44(3) 238-253.
https://doi.org/10.1037/prj0000444

Abstract
Objective: This study systematically reviews the systematic review (SR) evidence on mental health recovery from the perspective of adults with mental illness.
Methods: Web of Science, ProQuest Dissertations & Theses, CINAHL, PubMed, PsycINFO, Scopus, and the libraries of the Cochrane Collaboration, Campbell Collaboration, and Joanna Briggs Institute were searched to identify eligible SRs including qualitative primary research. Two reviewers independently conducted data extraction and quality assessment. Overlap of primary studies was calculated. A framework for recovery was generated using reflexive thematic analysis.
Results: An ecological model of recovery that included elements of psychological well-being was generated from 25 studies bridging personal/clinical, individual/social, and process/outcome conceptualizations of recovery. The first theme was a definition of recovery as a transformation from a negative identity state marked by despair, brokenness, and helplessness to a positive state of psychological wellbeing. This transformation was contingent upon four additional themes that included: (a) social and environmental conditions supporting access to basic resources and safety; (b) development of a sense of autonomy and personal responsibility; (c) roles and relationships that facilitated the personal experience of belonging and meaning; and (d) enlightenment defined as acceptance of the illness as a part of oneself and insight into how to promote well-being. Conclusions and Implications for Practice: Professionals working in recovery-oriented systems must consider how the subjective self-representations of persons with mental illness and objective social relationships interact to impact recovery. We close by discussing interventions that may promote the personal and social conditions of recovery.

vi) Pai, N. and Vella, S-L. (2021) Covid-19 and loneliness: A rapid systematic review. Australian and New Zealand Journal of Psychiatry. 55(12). 1144–1156

Abstract
Background: Loneliness is known to be associated with both poorer physical and mental health, being associated with increased mortality. Responses throughout the world to the current COVID-19 pandemic all incorporate varying degrees of social distancing and isolation. There is an imperative to provide a timely review and synthesis of the impact of COVID-19 on loneliness in the general population.
Methods: PubMed was searched using the key terms ‘COVID-19’, ‘coronavirus’, ‘SARS-COV2’ and ‘loneliness’. Fifty- four articles were identified and screened against the inclusion criteria. The inclusion criteria stipulated that the study needed to incorporate a measure of loneliness with participants being drawn from the general adult population. Twenty- four studies met the inclusion criteria.
Results: The key data extracted from the 24 reviewed studies are presented and summarised with a focus on key demographics of participants, the research designs utilised, the measures of loneliness employed and the other variables assessed in the studies. Overall, the findings indicate that loneliness has been a significant issue during the current COVID-19 pandemic and loneliness is positively associated with mental health symptoms. However, there were inconsistencies in the results evident across studies.
Conclusion: To our knowledge, this is the first systematic review of research investigating loneliness during the current COVID-19 pandemic in the general adult population. Despite the inconsistencies evident in some of the results across the studies, it is clearly apparent that loneliness is having an impact on the mental health and wellbeing of the general adult population. Furthermore, it is apparent that the current COVID-19 pandemic has had an impact on loneliness in the general adult population and that loneliness is significantly positively associated with mental illness symptomatology. Thus, there is an imperative to address loneliness through public policy and interventions. The limitations of this review are noted and directions given for future research

Other News / Resources
i) NEON Study
The Recovery Research Team at University of Nottingham is running the NEON trials, which are looking at whether access to online stories of recovery from mental health problems can help people affected by mental health problems. Participants in the NEON trials receive access to the NEON Collection of more than 600 international mental health recovery stories.

We are delighted to announce that we have now completed recruitment to all three of our trials, with 1830 people from across England taking part. We wanted to take this opportunity to thank everyone who has helped us out over the past year, we couldn’t have done it without all of the support we have received, much of which we will never know about.

We will now shift our focus to the continued running of the trials, which will enable us to understand how recovery stories can help people.

The NEON Collection is still accepting donations of personal recovery stories, and these will be integrated into our trials. If you are interested in donating a story, or know someone else that might be interested, please look at our Donate a Story page.

If you’re interested in keeping up with NEON’s progress, we’ll be posting regular updates to our News page. In late 2022 or early 2023, results from our trials will be made available on the NEON website in the form of a research publication and a programme summary.

Thank you again for your support.

ii) Writing out of King’s College London, Dr Sarah Markham raises the profile of the COVID-19 | DEPRESSD Project. Dr Markham explains:

This is a Living Systematic Review led by Prof Brett Thombs (McGill University Canada) evaluating (1) changes in mental health symptoms among the same participants from pre-COVID or across delineated events during COVID-19 (e.g., outbreak announcement versus peak, peak restrictions on movement versus post-restrictions); (2) factors associated with levels or changes in symptoms during COVID-19, and (3) the effect of interventions on mental health symptoms during COVID-19.

Dr Markham also provides a link to a useful editorial in which she and her colleagues offer further detail regarding their work:

Thombs, B. D., Bondari, O., Rice, D. B., Boruff, J. T., Azar, M., He, C., Markham, S., Sun, Y., Wu, Y. Krisnan, A., Tombs-Vite, I. and Benedetti, A. (2020) Curating evidence on mental health during Covid-19: A living systematic review. Journal of Psychosomatic Research. 133:110113
https://doi.org/10.1016/j.jpsychores.2020.110113

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