Mental Health and Social Inclusion

Holttum, Sue

2014 Mental Health and Social Inclusion

doi: 10.1108/MHSI-08-2014-0027

Purpose– The randomised controlled trial, though highly valued, has been criticised as not helping to understand how results occur: Real-life complexity is not captured, i.e. what actually happens at trial sites (rather than what was intended). The purpose of this paper is to summarise and comment on two 2014 research papers addressing this challenge of randomised trials – concerning new therapeutic approaches for people diagnosed with psychotic disorders. Design/methodology/approach– One paper is about what staff thought when adopting a new recovery-focused approach in two mental health services as part of a randomised trial. The other is the plan for a small pilot trial of a new treatment for psychosis called positive psychotherapy. It describes how the researchers planned to study the detail of what happens in their small trial, to help them improve the design of a future, larger trial. Findings– The first paper recommends avoiding services undergoing too many changes and ensuring managers will visibly support the project. When training staff in a new approach, trainers should recognise staff's existing knowledge and skills and use practical methods like role-play. In the second paper, the plan for the small positive psychotherapy trial seems detailed enough to explain what really happens, except in one area: looking at how clinicians actually select service users for the trial. Originality/value– These papers concern pioneering therapeutic approaches in psychosis. With randomised trials highly influential, both these papers recognise their potential problems, and seem to represent good attempts to understand what really happens.

Watson, Emma

2014 Mental Health and Social Inclusion

doi: 10.1108/MHSI-08-2014-0030

Purpose– The purpose of this paper is to provide an insight into a day in the life of a peer support worker. Design/methodology/approach– Narrative account and analysis of the boundary challenges and “boundary issues” raised by work with a client. Findings– Reflective account, no findings presented. Originality/value– An original viewpoint on the challenges and “boundary issues” raised in the work of a peer support worker.

Jenkins, Caitlin; Carson, Jerome

2014 Mental Health and Social Inclusion

doi: 10.1108/MHSI-08-2014-0031

Purpose– The purpose of this paper is to offer a profile of Caitlin Jenkins. Design/methodology/approach– Caitlin gives a short biographical account and is then interviewed by Jerome. Areas covered in the interview include her interest in psychiatric diagnosis, the helpfulness of counselling and personal narrative. Findings– Caitlin believes that her recovery was only really possible when she was allowed to tell her own story, to be allowed the time and space to talk about events in her life. She mentions how psychodynamic therapy and CBT prevented her from truly exploring her personal story. Research limitations/implications– While this is of course one person's account, it will find resonance with many others. Practical implications– Reinforces the central role of narrative and its role in personal recovery. Social implications– It stresses the importance of a truly therapeutic relationship. As Caitlin states, this enabled her to begin, “joining the dots of my experience to construct a meaningful personal narrative”. Originality/value– Counselling is often undervalued in contrast to more established therapies. This account demonstrates that what really matters to individuals recovering from mental health problems, is being listened to and being helped to make sense of their experiences.

Walker, Liz

2014 Mental Health and Social Inclusion

doi: 10.1108/MHSI-09-2014-0033

Purpose– The purpose of this paper is to illustrate, from the lived experience of the author, that recovery does not only apply to people who use services, it is just as relevant to the staff who work in those services. Design/methodology/approach– Narrative account. Findings– Reflective account, no findings presented. Originality/value– In offer the author's account of moving from a dissatisfied, passive approach at work towards a rewarding, hopeful position, this paper demonstrates the relevance of hope, control and opportunity in recovering job satisfaction.

Barrett, Daniel; Benson, Janette; Foster, Rhiannon; Leader, Alan

2014 Mental Health and Social Inclusion

doi: 10.1108/MHSI-08-2014-0026

Purpose– The purpose of this paper is to describe the conceptual basis and development of Prosper: an emerging and evolving self-directed network and movement for people with lived experience of mental health problems in South West London. Design/methodology/approach– The conceptual principles from which Prosper emerged – co-production, recovery and social movement approaches – are outlined. The ways in which these ideas were translated into action, the guiding principles and operation of Prosper are then described. Findings– An evolving self-directed network and movement has been developed that comprises around 150 “members” and a wider network of 20 service user groups across South West London. As well as open forums, collective actions fall under the themes of “create” (peer support, outreach, campaigns, training) and “collaborate” (partnership working with user-led organisations and a Recovery College, peer support networks, supporting the development of personal health budgets and local commissioning, and consultancy). This network has initially been funded by South West London and St George's Mental Health Trust with a view to it becoming an independent entity. Originality/value– The innovative and evolving social network and movement for people with lived experience of mental health problems that is continuously influenced and changed by the skills, ideas and energy of its growing and developing membership could act as a useful model for others to follow.

Miller, Lynne; Clinton-Davis, Suzanne; Meegan, Tina

2014 Mental Health and Social Inclusion

doi: 10.1108/MHSI-08-2014-0029

Purpose– The purpose of this paper is to provide the personal accounts of the journey back to work from the perspective of both the person entering employment and the Employment Specialist who assisted them. Design/methodology/approach– Two people with mental health problems who received help into employment from an employment service in a London Mental Health Trust were asked to give write their accounts of their journey. The Employment Specialists who assisted them in this journey were also asked to write their accounts. Findings– Reflective accounts – no findings presented. Originality/value– Much has been written about the effectiveness of Individual Placement and Support evidence-based supported employment, but little has been published about the lived experience of this approach from the perspective of both the person endeavouring to return to work and the employment specialists who support them. This paper presents two such accounts.

Chandley, Mark; Cromar-Hayes, Maxine; Mercer, Dave; Clancy, Bridget; Wilkie, Iain; Thorpe, Gary

2014 Mental Health and Social Inclusion

doi: 10.1108/MHSI-08-2014-0024

Purpose– The purpose of this paper is to derive from an on-going, innovative, project to explore the concept, and application, of “recovery” in the care and clinical management of patients detained in one UK high-security hospital. Design/methodology/approach– Utilising a qualitative, action research, methodology the aim was to involve forensic mental health nurses in a collaborative, client-centred approach to identification and resolution of dilemmas in the process of planning care for offender-patients. Findings– In this context the authors identify constraints and contradictions involved in employing recovery principles in institutions critics refer to as part of the disciplinary apparatus of psychiatric and social control; where the taken for granted lives, and relations, of an incarcerated population are measured by the calendar, not the clock. Research limitations/implications– Protective practices remain highly relevant in high-secure practice. Safety, an important value for all can by and large be achieved through recovery approaches. The humanistic elements of recovery can offer up safe and useful methods of deploying the mental health nurse on the ward. Many nurses have the prerequisite approach but there remains a wide scope to enhance those skills. Many see the approach as axiomatic though nurse education often prepares nurses with a biomedical view of the ward. Practical implications– Currently, philosophical tenets of recovery are enshrined in contemporary health policy and professional directives but, as yet, have not been translated into high-secure settings. Drawing on preliminary findings, attention is given to the value of socially situated approaches in challenging historic dominance of a medical model. Social implications– It is concluded that recovery could be a forerunner of reforms necessary for the continued relevance of high-secure care into the twenty-first century. Originality/value– This research is located in high-secure setting. The social situation is marked by the extent of the isolation involved. A value is in this situation. First it is akin to the isolation of the tribe utilised by many anthropologists for their ability to adopt the “social laboratory” status to test out theories of behaviour in industrial society. The authors urge others to utilise this research in this way. Second, the situation represents the locus of so many of societies dilemmas, paradoxes and fears that moral issues morph from what is the mundane in wider society. In this way humanistic approaches are tested via action research with nurses in some rigouous ways.

Booth, David; Francis, Simon; Mcivor, Neil; Hinson, Patrick; Barton, Benjamin

2014 Mental Health and Social Inclusion

doi: 10.1108/MHSI-08-2014-0025

Purpose– The purpose of this paper is to explore the economic benefits of Individual Placement with Support programmes commissioned by NHS North in the North West and Yorkshire and Humber regions. Design/methodology/approach– A literature review was conducted and data collected from supported employment programmes in four localities. An econometric analysis was performed to evaluate likely savings for local commissioners and return on investment for the Treasury. Findings– Integration of employment support within mental health services is central to success. Econometric analysis showed that local commissioners could save £1,400 per additional job outcome by commissioning evidence-based interventions and there is a positive return on investment to the Treasury for every £1 spent there is a return to the Treasury of £1.04. Originality/value– This paper demonstrates the economic and social value of evidence-based supported employment for people with severe mental illness. The economic data generated could be helpful in encouraging investment in effective employment support in other areas. The work, views and perspectives contained in this paper are those of the authors. It does not necessarily reflect the views of the organisations for whom the authors work.