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Validation of Warwick-Edinburgh Mental Well-being Scale (WEMWBS) in a population of people using Secondary Care Mental Health Services
- Authors:
- BASS Malcolm, et al
- Journal article citation:
- Journal of Mental Health, 25(4), 2016, pp.323-329.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Aims: To investigate the validity of using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) for measuring the mental well-being of users in a secondary care mental health service user population. Method: Data was collected from two NHS Trusts and one charity. Analyses are based on 1180 completed WEMWBS. Results: WEMWBS scores for this population are significantly lower than those in a general population (Mean 34.9, SD 13.8). Overall the data analyses supported the use of WEMWBS in this population sample. The Rasch analysis found that the majority of the items can be seen as measuring one dimension. The confirmatory factor analysis supports a one factor solution and thus, measures a single underlying concept. Conclusions: The findings from this study show WEMWBS to be a valid and reliable measure for this population sample. (Edited publisher abstract)
“From the same mad planet”: a grounded theory of service users’ accounts of the relationship within professional peer support
- Authors:
- BAILIE H. Alistair, TICKLE Anna, RENNOLDSON Michael
- Journal article citation:
- Mental Health Review Journal, 21(4), 2016, pp.282-294.
- Publisher:
- Emerald
Purpose: Peer support (PS) workers are being employed despite uncertain evidence for clinical and cost-effectiveness. Psychological theories have been proposed to explain the mechanisms of PS but these lack empirical validation and specificity to professional PS. The purpose of this paper is to develop a substantive interpretive grounded theory of service-users’ experience of professional PS work. Design/methodology/approach: Constructivist grounded theory was used throughout. Semi-structured interviews were conducted with ten service-users who had engaged with a professional PS worker. Findings: Three overarching themes were constructed. “The process of disclosure” describes how disclosure of mental health difficulties, experiences as a service-user and wider disclosure about life experiences, interests and values facilitate the development of a shared identity with the PS worker. “The product of disclosure” highlights the sense of being understood as a result of the disclosure and marks a deepening of the relationship. “Dual roles” describes the tenuous position of holding both a professional relationship and friendship. Research limitations/implications: Future research should seek to refine the theory developed and compare the effects of therapist self-disclosure with that found within PS. There were limitations within the study, including limited diversity within the sample as well as difficulties with recruitment. Originality/value: This study connects service-users’ accounts of receiving PS with existing psychological theory to move towards an understanding of the relationship between receivers and providers of professional PS. (Publisher abstract)
Development of a mental health smartphone app: perspectives of mental health service users
- Authors:
- GOODWIN John, et al
- Journal article citation:
- Journal of Mental Health, 25(5), 2016, pp.434-440.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: Current mental health policy emphasises the importance of service user involvement in the delivery of care. Information Technology can have an effect on quality and efficiency of care. Aims: The aim of this study is to gain the viewpoint of service users from a local mental health service in developing a mental health app. Method: A qualitative descriptive approach was used. Eight volunteers aged 18–49 years were interviewed with the aid of a semi-structured questionnaire. Results: Interviewees defined a good app by its ease of use. Common themes included availability of contact information, identifying triggers, the ability to rate mood/anxiety levels on a scale, guided relaxation techniques, and the option to personalise the app. The researchers will aim to produce an app that is easily accessible, highly personalisable and will include functions highlighted as important (i.e. contact information, etc.). Conclusions: This research will assist in the development of an easy-to-use app that could increase access to services, and allow service users to take an active role in their care. In previous studies, apps were developed without the involvement of service users. This study recognises the important role of service users in this area. (Publisher abstract)
Position paper: are mainstream mental health services ready to progress transformative co-production?
- Author:
- CARR Sarah
- Publisher:
- National Development Team for Inclusion
- Publication year:
- 2016
- Pagination:
- 32
- Place of publication:
- Bath
Building on an earlier literature review by the New Economics Foundation and Mind, this position paper discusses the challenges for progressing co-production work in mental health services. It looks at the implementation of service user and survivor reform and revolution concepts in mainstream mental health services, to assess how ready mainstream mental health is for ‘transformative co-production’. Ideas discussed include: empowerment; personal recovery; service user and survivor participation; direct payments. It then identifies a number of unique challenges facing co-production in mainstream mental health services. These include resistance to change; restrictive administrative procedure and professional practice; avoidance of challenge; confrontation or emotional expression; and the demand to conform by institutional rules and cultural norms. It aims to examine co-production from a perspective of mental health service users, survivors and their organisations and it is written by someone with lived experience of mental health service use. The paper will be of interest for people involved in mental health policy and development, as well as service users and practitioners who want to engage with and understand transformative co-production in mental health. It is one of a series of publications produced as part of the NDTi’s ‘Peoples Voice’ programme with funding from the Esmée Fairbairn Foundation and has been co-produced with people who use services. (Edited publisher abstract)
“Knowing that I’m not alone”: client perspectives on counselling for self-injury
- Authors:
- LONG Maggie, MANKTELOW Roger, TRACEY Anne
- Journal article citation:
- Journal of Mental Health, 25(1), 2016, pp.41-46.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: Self-injury is an increasingly common phenomenon among clinical and non-clinical populations. Health care providers generally recommend behavioural interventions that address coping skills for people who self-injure despite a lack of a consistent evidence base about their effectiveness. There is limited understanding about experiences of counselling for self-injury from the perspectives of clients. Aim: To understand clients’ experiences of counselling for self-injury. Method: Ten interviews were conducted, audio-recorded and transcribed. Data were analysed using Grounded Theory (GT). Results: One central category, “Developing a healing reconnection with self and others” and four categories: (i) Building trust; (ii) seeing beyond the cutting; (iii) human contact and (iv) integrating experiences. Conclusions: Overcoming self-injury is possible within the context of a trusting and accepting therapeutic relationship. Participants perceived counselling to be helpful when counsellors were willing to work with underlying issues rather than focus primarily on the cessation of self-injury. Counsellors and mental health practitioners must look beyond the behaviour to meet with the person and facilitate the development of a therapeutic relationship, which promotes a healing reconnection with self and others. (Publisher abstract)
Building on the recovery approach: the development of a conceptual model of service design for carers in mental health
- Author:
- FOX Joanna
- Journal article citation:
- Research Policy and Planning, 32(3), 2016/17, pp.183-196.
- Publisher:
- Social Services Research Group
Carers’ views about their role in recovery are under-researched, and studies investigating their needs are underdeveloped. In this study, participatory action research was used; the researcher was supported by a steering group of eight stakeholders to co-produce a training programme on recovery and data collection methods to explore the meaning of recovery for carers. The programme was delivered by the researcher, an expert-by-experience with a diagnosis of schizophrenia, and a carer of her son with a similar diagnosis, to a group of eleven participants. Mainly qualitative data was collected together with supplementary quantitative socio-demographic data from the participants. Selected findings based on the carers’ discussions are presented which focus on how the relationship between carers and professionals can most effectively facilitate service user recovery. Issues of information exchange between carers and professionals and the impact of patient confidentiality are highlighted, the nature of recovery practice is considered, and the participants’ need to be regarded as ‘experts’ is addressed. A conceptual model of service design based on a recovery-oriented ‘triangle of care’ is presented. The potential implementation of this model in the current UK mental health service context is considered with the need for co-production between all stakeholders to ensure its development. (Edited publisher abstract)
Following the Francis report: investigating patient experience of mental health in-patient care
- Authors:
- WILLIAMS E., et al
- Journal article citation:
- British Journal of Psychiatry, 209(1), 2016, pp.35-39.
- Publisher:
- Cambridge University Press
Background: The Francis report highlights perceptions of care that are affected by different factors including ward structures. Aims: To assess patient and staff perceptions of psychiatric in-patient wards over time. Method: Patient and staff perceptions of in-patient psychiatric wards were assessed over 18 months. The authors also investigated whether the type of ward or service structure affected these perceptions. They included triage and routine care. The goal was to include at least 50% of eligible patients and staff. Results: The most dramatic change was a significant deterioration in all experiences over the course of the study. Systems of care or specific wards did not affect patient experience but staff were more dissatisfied in the triage system. Conclusions: This is the first report of deterioration in perceptions of the therapeutic in-patient environment that has been captured in a rigorous way. It may reflect contemporaneous experiences across the National Health Service of budget reductions and increased throughput. The ward systems the authors investigated did not improve patient experience and triage may have been detrimental to staff. (Edited publisher abstract)
Shared treatment decision-making and empowerment-related outcomes in psychosis: systematic review and meta-analysis
- Authors:
- STOVELL Diana, et al
- Journal article citation:
- British Journal of Psychiatry, 209(1), 2016, pp.23-28.
- Publisher:
- Cambridge University Press
Background: In the UK almost 60% of people with a diagnosis of schizophrenia who use mental health services say they are not involved in decisions about their treatment. Guidelines and policy documents recommend that shared decision-making should be implemented, yet whether it leads to greater treatment-related empowerment for this group has not been systematically assessed. Aims: To examine the effects of shared decision-making on indices of treatment-related empowerment of people with psychosis. Method: A systematic review and meta-analysis of randomised controlled trials (RCTs) of shared decision-making concerning current or future treatment for psychosis (PROSPERO registration CRD42013006161) was conducted. Primary outcomes were indices of treatment-related empowerment and objective coercion (compulsory treatment). Secondary outcomes were treatment decision-making ability and the quality of the therapeutic relationship. Results The authors identified 11 RCTs. Small beneficial effects of increased shared decision-making were found on indices of treatment-related empowerment (6 RCTs; g = 0.30, 95% CI 0.09–0.51), although the effect was smaller if trials with >25% missing data were excluded. There was a trend towards shared decision-making for future care leading to reduced use of compulsory treatment over 15–18 months (3 RCTs; RR = 0.59, 95% CI 0.35–1.02), with a number needed to treat of approximately 10 (95% CI 5–∞). No clear effect on treatment decision-making ability (3 RCTs) or the quality of the therapeutic relationship (8 RCTs) was found, but data were heterogeneous. Conclusions: For people with psychosis the implementation of shared treatment decision-making appears to have small beneficial effects on indices of treatment-related empowerment, but more direct evidence is required. (Edited publisher abstract)
Recovery versus risk? from managing risk to the co-production of safety and opportunity
- Authors:
- PERKINS Rachel, REPPER Julie
- Journal article citation:
- Mental Health and Social Inclusion, 20(2), 2016, pp.101-109.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to propose a recovery-focused approach to risk and safety and what this might look like in practice. Design/methodology/approach: Review of recovery approaches and the ways in which traditional approaches to risk might hinder people in their recovery journey. Consideration of the principles of a recovery-focused approach to safety. Findings: A recovery-focused approach to risk based on co-produced safety plans that enable people to do the things they value as safely as possible and shared responsibility for safety. Four key principles of a recovery-focused approach to promoting safety, autonomy and opportunity are proposed. Originality/value: A recovery-focused approach to risk and safety is central to the development of recovery-focused practice within services. This paper outlines such an approach. (Publisher abstract)
Non-helpful relationships with professionals – a literature review of the perspective of persons with severe mental illness*
- Authors:
- LJUNGBERG Amanda, DENHOV Anne, TOPOR Alain
- Journal article citation:
- Journal of Mental Health, 25(3), 2016, pp.267-277.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: The relationship with professionals has proved to be important with regard to outcome for persons with severe mental illness (SMI). The understanding of non-helpful relationships is important complementary knowledge to that regarding helpful relationships. Aim: To review the available qualitative research providing knowledge of non-helpful relationships from the perspective of persons with SMI. Method: A review of qualitative studies, based on an earlier systematic search, analysed through thematic analysis. Results: The main themes were “non-helpful professionals”, “organisation versus relation” and “the consequences of non-helpful relationships with professionals”. Examples of professionals described as non-helpful were pessimistic and uncaring professionals who were paternalistic and disrespectful. Discontinuity, insufficient time and coercion were some of the contextual factors described as non-helpful. These sorts of relationships were non-helpful because they hindered helpful relationships from developing and contributed to further suffering, instilling hopelessness and hindering personal growth. Conclusions: Non-helpful relationships with professionals can be understood as impersonal relationships that contain no space for negotiation of the relationship nor of the support and treatment provided through it. It is important that organizations provide professionals with favorable conditions to negotiate the organisational framework and to treat persons with SMI as whole human beings. (Edited publisher abstract)