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Research watch: the power of genetic and biological explanations to reduce social inclusion
- Author:
- HOLTTUM Sue
- Journal article citation:
- Mental Health and Social Inclusion, 16(3), 2012, pp.116-120.
- Publisher:
- Emerald
This review summarises two recent research papers relating to the use of biological explanations. The first paper highlights how unhelpful it can be to over-use genetic explanations for various human experiences, and the second paper discusses the unhelpfulness of exclusively biological explanations for mental health conditions. The first paper explores the many ways in which genetic explanations are over-used to understand race, ethnicity, the sexes, sexual orientation, crime, mental health and obesity. This over-use of genetic explanations leads to various negative consequences, among them social exclusion, but may be counteracted by better explanations of both the relatively weak nature of genetic influences and how people's genes and environment interact. The second paper examines evidence about whether it is really helpful to think of mental health conditions as illnesses “like any other”. The author points to the need for promoting a more holistic understanding of human experience, and against focusing too narrowly on only one kind of cause, namely biological, and mostly on one aspect of biology – genes.
Hearing voices and befriending schemes
- Author:
- HOLTTUM Sue
- Journal article citation:
- Mental Health and Social Inclusion, 15(4), 2011, pp.160-164.
- Publisher:
- Emerald
This paper provides a summary of 2 recent research papers relating to mental health and social inclusion. The first (Beavan, J. Mental Health, 2011, 20, 281-92) considers the prevalence of voice hearing. Voice hearing is defined as when someone hears a voice that sounds real (rather than a thought) but that others cannot hear. Studies spanning more than 100 years are reviewed and suggest that hearing voices is more common than usually thought. The article argues the case for viewing hearing voices more positively than at present. The second article (Mitchell & Pistrang, Psychology and Psychotherapy, 2011, 84, 151-69) looks at befriending schemes for people with mental health problems. Interviews involving 8 people with mental health conditions and their befrienders suggest that demonstrating empathy and being non-judgmental helped people with mental health conditions to talk things through, with both parties learning from one another. Going out together helped befriendees gain greater confidence to participate in further activities and feel less isolated.
How included are mental health service users in decisions about their medication?
- Author:
- HOLTTUM Sue
- Journal article citation:
- Mental Health and Social Inclusion, 20(3), 2016, pp.141-148.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to consider four recent articles relating to how included service users are in decision making about their medication in mental health services. Design/methodology/approach: One article describes conversations between a psychiatrist and service users about medication. The second paper describes a study in which young people were supported with the aim of developing their confidence to challenge medication decisions. The third paper reports on interviews with both professionals and service users about medication decisions. The fourth paper presents a theory of how the wider context can affect medication decision making in mental health. Findings: The first paper shows how a psychiatrist can persuade service users to accept medication decisions. The second paper shows how some young people can challenge medication decisions if they have the right support. The third paper illustrates how both professionals and service users may doubt service users’ ability to decide about medication, and pessimistically suggests that shared decision making may be unrealistic. In contrast to this, the fourth paper offers hope of changing how mental health services are organised in order to enable service users to be more empowered about medication decisions. Originality/value: A model of shared decision making is being imported into mental health from physical health. These four papers illustrate problems with a simple transfer from physical to mental health. The present paper points to differences in apparent awareness of different clinical researchers of the need to tackle service users’ disempowerment in mental health care, showing how some researchers are tackling this. (Publisher abstract)
Research watch: art therapy: a dose of treatment, an aid to social inclusion or an unnecessary indulgence?
- Author:
- HOLTTUM Sue
- Journal article citation:
- Mental Health and Social Inclusion, 17(2), 2013, pp.64-69.
- Publisher:
- Emerald
Purpose – This Research Watch aims to summarise two recent and very different research publications on art therapy and comments on their ability to shed light on the usefulness of art therapy to address mental distress and enhance social inclusion. Design/methodology/approach – The author discusses a recent edition of a UK art therapy journal in which research papers focus on art therapy with people who have been given a diagnosis of personality disorder. The main methodologies are qualitative describing participants’ and/or therapists’ experiences and the role of art therapy in addressing serious mental distress. The second publication is a recent report of a large randomised controlled trial of art therapy for people given a diagnosis of schizophrenia. The author assesses the value of both publications in informing us about the usefulness of art therapy in addressing mental distress and enhancing social inclusion. Findings – In the author's view, neither publication establishes definitively how or whether art therapy might address serious mental distress, whether labelled personality disorder or schizophrenia. However, the qualitative articles provide insight into possible helpful (and less helpful) aspects of therapy. The randomised trial should have been able to establish general principles about the effectiveness of art therapy for a specific group of people in specified contexts, but instead exemplifies many problems inherent in the pervasive research culture of putting numbers onto complex human interactions and calculating their value for money, sometimes at the expense of really understanding what is going on. Originality/value – The author draws upon these two very different examples of research to reflect a current dilemma in UK art therapy research, and tentatively looks at possible ways forward. (Publisher abstract)
Poor quality employment is worse for mental health than no job at all and contributes to mental distress in new mothers
- Author:
- HOLTTUM Sue
- Journal article citation:
- Mental Health and Social Inclusion, 16(2), 2012, pp.66-71.
- Publisher:
- Emerald
Two recent research papers on employment and mental health, one relating to all sectors of the working age population and the other to women who had recently had a child, are reviewed and summarised in this article. Both studies involved large samples of people in Australia. In the first study, information from a longitudinal survey was used to follow people over time and assess whether the quality of employment was related to mental health. It found that mental health was significantly better for people who were in jobs compared to those who were not, but that a poor quality job was no better than unemployment in terms of mental health and that, when the effect of other predictors of mental ill health was taken into account, a poor quality job was worse than no job at all. The second study focused on employed women who had given birth in the previous 12 months and had returned to work. It assessed the effect of working conditions on mental health, and found that quality of employment predicted whether they experienced mental distress, with psychological distress significantly associated with poor employment conditions. The author reports that the papers add to understanding of the relationship between mental health and employment, and comments that social inclusion through employment may depend not only on being in work but on the quality of that work.
Now I have a voice: service user and carer involvement in clinical psychology training
- Authors:
- HOLTTUM Sue, et al
- Journal article citation:
- Mental Health and Social Inclusion, 15(4), 2011, pp.190-197.
- Publisher:
- Emerald
UK universities have only recently begun to address the need for a partnership with service users in higher education. This paper describes the challenges and rewards of service user and carer involvement in clinical psychology training as experienced in Canterbury Christ Church University. The aim of involvement is to ensure that trainee clinical psychologists understand the experiences and perspectives of mental health service users and their carers. Members of the service user and carer advisory group Salomons Advisory Group of Experts by Experience (SAGE) regularly take part in a variety of clinical psychology training sessions. Three members of SAGE describe their contributions to the work. The challenges of inclusion and specific approaches that are used to work with these challenges are explored. They require that everyone involved should fully acknowledge the social and historical barriers in order to work together to overcome them.
Research watch: Coronavirus (COVID-19), mental health and social inclusion in the UK and Ireland
- Author:
- HOLTTUM Sue
- Journal article citation:
- Mental Health and Social Inclusion, 24(3), 2020, pp.117-123.
- Publisher:
- Emerald
Purpose: This paper aims to examine recent papers on the effects of the COVID-19 pandemic on mental health, including implications for some of the groups of people already less included in society. Design/methodology/approach: A search was carried out for recent papers on mental health and the COVID-19 pandemic. Findings: Two papers describe surveys of adults in the UK and Irish Republic in the first days of lockdown. Low income and loss of income were associated with anxiety and depression. These surveys could not examine distress in Black and minority ethnicities, who have higher death rates from COVID-19. Two surveys of children and young people report distress and what can help. One paper summarises a host of ways in which the pandemic may affect mental well-being in different groups, and what might help. Another calls for research to understand how to protect mental well-being in various groups. Originality/value: These five papers give a sense of the early days of the pandemic, especially in the UK. They also highlight the needs of some specific groups of people, or the need to find out more about how these groups experience the pandemic. They suggest some ways of trying to ensure that everyone has the best chance to thrive in the aftermath of the pandemic. (Edited publisher abstract)
Research watch: mental health services supporting social inclusion
- Author:
- HOLTTUM Sue
- Journal article citation:
- Mental Health and Social Inclusion, 23(4), 2019, pp.149-155.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to examine three recent papers on mental health services and social inclusion. Design/methodology/approach: A search was carried out for recent papers on mental health and social inclusion. The author selected three papers that each spoke to a similar theme, from slightly different angles, and that seemed to advance understanding of how social inclusion might be supported to a greater degree in mental health services. Findings: One paper vividly describes some of the blocks to social inclusion, and what that can feel like from a service user perspective, and also points to ways for peer workers to support service users’ social inclusion. A second paper illustrates how mental health professionals and peer workers can choose to stand up for people’s human rights despite lack of organisational support for such actions. The third paper describes pioneering co-designed work to build dedicated support for social inclusion alongside mental health services. Originality/value: All three papers highlight the ongoing need for better support for social inclusion in mental health services across different countries. They also show how such support can be implemented and even made more mainstream. This raises hope for wider progress in mental health services becoming real enablers of social inclusion. (Publisher abstract)
Research watch: is social inclusion for service users increased when mental health professionals "come out" as service users?
- Author:
- HOLTTUM Sue
- Journal article citation:
- Mental Health and Social Inclusion, 22(2), 2017, pp.73-79.
- Publisher:
- Emerald
This paper discusses two recent studies of mental health professionals who have experience of mental distress, one in the USA and one in Australia. The purpose of this paper is to highlight different experiences, first of largely concealing their experience, and second of disclosing and using it. Design/methodology/approach: The Australian study examined the barriers experienced by mental health professionals, including trainees, in relation to seeking help. The USA study reported on a sample of mental health professionals who were doing well, including leaders of services, despite current or past mental distress. Findings: Both studies included more psychologists than other mental health professionals. Australian mental health professionals reported similar fears and barriers to those found in other studies, in addition to concern about their colleagues’ duty to report impairment to the regulating body. Professionals in the USA-based study were described as potentially helpful in reducing stigma about mental distress because their achievements demonstrated that recovery is possible. However, many of them were also cautious about who they disclosed to, and wanted further reduction in stigma and discrimination. Originality/value: The Australian study highlighted specifically that the requirement to report impairment to the regulator deterred people from disclosing distress at work, making it less likely that they would get help. The USA-based study was ground-breaking in documenting achievements of a substantial sample of mental health professionals with experience of mental distress. Potentially more professionals being “out and proud” might help increase recovery and social inclusion for service users more generally.
School inclusion for children with mental health difficulties
- Author:
- HOLTTUM Sue
- Journal article citation:
- Mental Health and Social Inclusion, 19(4), 2015, pp.161-168.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to highlight research on the exclusion from school of children with disabilities, and especially those identified as experiencing emotional disturbance. Two studies of schools that are inclusive are then described in order to examine how they achieve good results. Design/methodology/approach: Three papers are summarised. The first examines things that predict children with disabilities being excluded from school, including characteristics of children and of schools. The second is a qualitative study of four English schools involved in a national programme aimed at improving children’s mental health. The third is a case study of one American school identified for its high inclusivity and excellent educational results. Findings: In the first study, children with emotional disturbance, and African-American children were most likely to be excluded from school. The study of four English schools suggested that implementation of the national programme was variable but leadership and planning seemed vital, as well as whole-school commitment. The high-performing inclusive American school had whole-school commitment, high quality planning alongside flexibility, on-going further training for teachers, and close pupil tracking. Originality/value: The study of school exclusion was the first to examine children and schools together, as well as different disabilities and ethnicity. The study of English schools highlights the experiences of those directly involved in implementing a national programme to promote children’s mental health. The study of a high-performing inclusive school in America discovered much in common with inclusive high-performing schools in England, suggesting that some practices can be identified across the two cultures that aid successful inclusion of children with disabilities including mental health difficulties. (Original abstract)