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This paper aims to highlight the critical importance of the perspectives of mental health service-users during the COVID-19 pandemic.

This viewpoint is based on a review of recent research and literature and draws on consultations with experts by experience, including the lead author.

The authors argue that expertise-by-experience is critical to policy, service development and research; but there is a risk it will be neglected at a time of rapid and reactive clinical development.

Understanding and responding to the nuances of individual need can only be achieved through coproducing service strategy design, delivery and research with mental health service users. The consultation outlined in this viewpoint gives some indication of the type of valuable insights that can be gained through seeking and listening to the perspectives of experts by experience.

The discussions revealed that experience of managing severe and complex mental health conditions can actually be advantageous when facing a crisis such as COVID-19.

Recovery Colleges were developed to support the recovery of people with mental health difficulties through courses co-produced by professionals and people with lived experience. This study aims to examine the use of Recovery Colleges to support people with dementia.

A survey was circulated to UK Recovery College and memory service staff, exploring provision, delivery and attendance of dementia courses. Open responses provided insight into participant views about recovery in post-diagnostic support and the practicalities of running dementia courses.

A total of 51 Recovery College staff and 210 memory service staff completed the survey. Twelve Recovery College dementia courses were identified across the UK. Three categories emerged from the qualitative data: post-diagnostic support, recovery in the context of dementia, challenges and areas of innovation.

This study highlights the benefits and practicalities of running Recovery College courses with people with dementia. Peer-to-peer learning was seen as valuable in post-diagnostic support but opinions were divided about the term recovery in dementia.

Comparatively, men have poorer physical and mental health outcomes than women, with a significantly higher suicide rate. Contributory factors are thought to be social and biological, leading to reduced access to health-care services. The study aims to develop and implement community-based support to increase awareness of and access to men’s mental health support networks and groups.

The project involved three key work-packages discussed in this paper: raising awareness of men’s mental health needs in health care, educational and community settings; collaboration between National Health Services (NHS) and non-NHS health-care support organisations to build multi-sector partnership working; and developing a supported sports-based community intervention aimed at men living with mental health conditions. The acceptability and feasibility of these work-packages were pragmatically evaluated through mixed-methods surveys and qualitative content analysis.

Overall, both community events and sports groups successfully engaged men living with mental health problems. Organisations interested in men’s mental health are continuing to engage in a partnership initiative. Community events were well-attended and received positive feedback, particularly regarding the educative and real-life experiences approach promoted in the events. The sports intervention is feasible and well-accepted by participants, who described feeling supported with their physical and mental health needs, with increased mental well-being reported.

The main limitations of this project are that the authors only evaluated a football group rather than all work areas. The project collected outcomes relating to participants’ demographics and qualitative reflections of participating in the football group along with a retrospective survey of perceived benefits, but the project did not undertake a pre- and post-comparison of well-being outcomes owing to low completion of these measures. Future work could focus on collecting more pre- and post-measures related to well-being, recovery and inclusion and compare these with men not involved in the football groups or public events.

This paper discusses the development and feasibility of setting up community-based men’s mental health support networks, involving public events, partnership working and targeted-sports interventions. All initiatives were well-received and successfully attended by men living with mental health conditions. Evaluation of the programme revealed the value placed on education about mental health and the role that community sports interventions may play in men’s mental health care.

This project has demonstrated three different ways of supporting men’s mental health needs in the community. Community public events were held to raise awareness of men’s mental health needs and issues were well-attended and highlighted the need for health promotion and education in this area across all the communities. The men’s football group demonstrated the feasibility of moving mental health support out into a non-clinical and more community arena in a way that men engaged effectively. Finally, the creation of MensNet has bought together disparate multi-sector organisations successfully to lead public health mechanisms to support men’s mental health needs.

This paper describes a new multi-disciplined approach to supporting health-seeking challenges among men, in particular, how partnership working across NHS and non-NHS sectors can successfully support an identified public health need pragmatically using existing services and organisations.

Approximately 3.5% of the workforce is diagnosed with attention deficit hyperactivity disorder (ADHD). With a greater risk of work-related stress and absences, work-based social interactions and environments are significant factors. The purpose of this study was to identify the professional challenges and benefits of living with ADHD in healthcare settings.

Interpretative phenomenological analysis was used to explore how employees with ADHD both experience and make sense of their employment and professional relationships. Participants self-identified from two NHS trusts and participated in semi-structured interviews.

A total of seven interviews contributed to the final analysis. A total of four themes emerged: social environment (relationships), physical environment, behaviour and work tasks. Complex interactions were observed between individuals’ internal constructs and overall employment experience.

The findings can be used to inform local NHS management frameworks for supporting workforce with ADHD.

This is a novel study that explores the psychodynamic and physical presentations of ADHD providing a unique perspective on the challenges and strengths of employees with ADHD.

The purpose of this systematic review is to assess if there is a relationship between literacy abilities and mental health outcomes as reported in global literature. Fourteen percent of the global population has little or no literacy. Literacy skills impact on daily functioning and have been shown to impact on social outcomes. Whilst there has been research examining the potential association between literacy and mental health outcomes in specific populations, there has been no systematic review of this literature to date.

A systematic review was carried out using Embase, PsycINFO and PubMed to identify relevant papers that measured both literacy and mental health. Data relating to the association between literacy and mental health were extracted. The papers included were assessed for quality using a bespoke quality rating tool. A narrative synthesis describes the findings.

Nineteen studies from across nine countries were included in the analysis. Seventeen studies showed a significant association between literacy and mental health, those with lower literacy had greater mental health difficulties. Some papers reported factors that interacted with this association, such as age, gender, poverty and years of education.

To the best of the authors’ knowledge, this is the first systematic review to look at the global picture of literacy and mental health. It suggests there is a relationship between literacy abilities and mental health outcomes, highlighting the importance of healthcare professionals and services including identification of literacy needs within routine mental health practice.

This paper aims to evaluate service user (SU) and clinician acceptability of video care, including future preferences to inform mental health practice during COVID-19, and beyond.

Structured questionnaires were co-developed with SUs and clinicians. The SU online experience questionnaire was built into video consultations (VCs) via the Attend Anywhere platform, completed between July 2020 and March 2021. A Trust-wide clinician experience survey was conducted between July and October 2020. Chi-squared test was performed for any differences in clinician VC rating by mental health difficulties, with the content analysis used for free-text data.

Of 1,275 SUs completing the questionnaire following VC, most felt supported (93.4%), and their needs were met (90%). For future appointments, 51.8% of SUs preferred video, followed by face-to-face (33%), with COVID-related and practical reasons given. Of 249 clinicians, 161 (64.7%) had used VCs. Most felt the therapeutic relationship (76.4%) and privacy (78.7%) were maintained. Clinicians felt confident about clinical assessment and management using video. However, they were less confident in assessing psychotic symptoms and initiating psychotropic medications. There were no significant differences in clinician VC rating by mental health difficulties. For future, more SUs preferred using video, with a quarter providing practical reasons.

The study provides a real-world example of video care implementation. In addition to highlighting clinician needs, support at the wider system/policy level, with a focus on addressing inequalities, can inform mental health care beyond COVID-19.

Low health literacy is a hidden epidemic. Identifying individuals with low health literacy is a formidable barrier to eliminating disparities and improving health care quality and health outcomes. However, screening individual patients for low health literacy can be prohibitively expensive, time consuming, and inefficient. Focusing on communities, rather than individuals, provides opportunities for action. Identifying geographic areas with large numbers of individuals with low health literacy can enable stakeholders to focus interventions in areas of greatest need. Creating such a measure also sheds light on health literacy as a community or neighborhood-level resource that contributes to health disparities and can inform health interventions.

We applied regression coefficients from a predictive model of health literacy to US Census data to estimate health literacy scores for census geographic areas in Missouri. We then created maps displaying the variability in health literacy levels. Finally, we compared areas identified by the predictive model to those identified on the basis of educational attainment alone.

Areas identified by the predictive model as having the lowest health literacy were substantially different from those identified using educational attainment alone, suggesting that a multivariate approach using a limited set of widely available predictors is considerably more accurate.

This study demonstrates a cost-effective and feasible method for estimating and mapping community-level health literacy. Predicting and mapping areas of low health literacy is relatively straightforward and inexpensive and makes complex data readily accessible to many stakeholders. Such maps can also identify and prioritize geographic areas for intervention by health care and public health providers. Moreover, this focus on community-level health literacy may help foster stakeholder collaboration, leading to efficient resource use that is targeted effectively and resulting in a positive return on investment for stakeholders.

The decade of the 1980s was unique for the sheer quantity of education reform reports and legislation. Virtually every state enacted education reform legislation, including reforms of teacher education, licensing, and comprehension. According to Darling‐Hammond and Berry, over 1,000 pieces of legislation related to teachers have been drafted since 1980, and “a substantial fraction have been implemented.” As I discussed in my 1989 RSR article, “Five Years after A Nation at Risk: An Annotated Bibliography,” two waves of 1980s reform reports were identified in the enormous body of primary and secondary literature dealing with education reform. The reform publications of the early 1980s stressed improvements in curricular standards, student performance outcomes, and changes to the education programs, such as salary increases, teacher testing, and stricter certification requirements. The second‐wave reform publications emphasized more complex issues centered around the concepts of restructuring the schools and teacher education programs, as well as empowering teachers to become more involved in curriculum and governance issues.

This chapter provides both an introduction to the volume and a brief review of literature on education and other social factors and health beliefs in health care services.

Literature review.

The chapter argues for the importance of greater examination of education, other social factors, and health beliefs in the use of health care services.

Reviews the issues of education, social factors, and beliefs and previews this volume.