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The purpose of this paper is to focus on the findings of a review of the Learning Advice Service which provided mainstream learning opportunities and individual support to people using mental health services. The service was decommissioned after 15 years due to service reconfiguration and cost-cutting.

Semi-structured interviews were carried out with members of the Learning Advisor’s caseload by a researcher with no affiliation to the NHS or the Institute of Mental Health and no connection to the clients. The researcher also transcribed and analysed the interviews. This ensured that there could be no personal or positive bias. The clients faced significant mental health challenges and used the Learning Advice Service to facilitate and support their entry into mainstream learning.

The service enabled individuals facing significant mental health challenges to gain access to adult, community, distance and further and higher education facilitated by individual advice, guidance and support. They were able to broaden their sense of identity beyond that of someone using mental health services and to widen their social and educational base.

Lack of funding within mental health services to continue this type of work limits research which would further explore the value of mainstream education in the recovery of people with a mental health diagnosis. While this cohort was small because of funding and staffing constraints, it would be possible to generalise to a larger scale, using flexible person-centred ways of working if the will, staffing and funding were made available. Further research is certainly indicated as current practice has moved away from mainstream inclusion to discrete provision with associated limitations.

The practical implications include the development of autonomy and the development of a sense of identity that is separate from a mental health diagnosis and where appropriate to gain qualifications and further the student’s knowledge.

Social implications include broadening one’s experience, developing communication skills in a broad context, transferable skills, independence and strengthening one’s sense of identity separate from a mental health diagnosis.

Individuals from a variety of educational and other backgrounds who expressed an interest in pursuing education in mainstream facilities were encouraged and supported in doing so in flexible and individual ways. It appears to be more usual that people using mental health services are encouraged to learn in groups comprising other people using such services, frequently on mental health service premises with associated limitations.

This study aims to explore the coping styles that can be inferred from the discourse of dyads with dementia, and how these appear to impact on care management.

This was a case study approach. Participants were recruited from two teams managing crisis in dementia in the UK. The authors conducted multiple qualitative interviews with people with dementia and their family carers over the course of one month. The analysis was first performed through thematic analysis. Data were further analysed through narrative inquiry to create a story line, or play in our case, for our findings.

Five dyads were interviewed and a total of 16 interviews were conducted. Three dyads were husband–wife and two were daughter–mother relationships. The mean age was 67.4 years for carers and 79.8 years for people with dementia. In these cases, the carer assumed responsibility for managing the episode and was more likely to seek formal help if a pre-existing plan was in place. Otherwise, when a crisis arose, dyads preferred to avoid involving professionals.

Psychosocial interventions should aim to identify and replace unhelpful strategies used by dyads to manage crisis episodes.

To the best of the authors’ knowledge, this is the first study using qualitative interviews of dyads to inquire into their experience of mental health crisis.

This paper explores the experiences of people with borderline and low intelligence when compared to the general population. The aim was to explore whether people with low intelligence, who are rarely considered apart from the general population, might have particular needs in relation to health or social care. The method was secondary analysis of the ONS survey of psychiatric morbidity, 2000. Variables associated with low intelligence were identified and entered into a logistic regression. We found that a person with low intelligence was significantly more likely to be a smoker, have problems with paperwork and be renting their home, and a significant subgroup was more likely to be friendless. The pursuit of social justice and social inclusion may require greater attention to be paid to the health and well‐being of people with below‐average intelligence.

Social capital is a complex and multidimensional construct, which has been used widely in the social sciences, and which focuses attention on non‐monetary resources and relationships. The aim of this analysis study was to test the feasibility of deriving social capital variables from an epidemiological dataset, to explore associations between social capital and psychosis and to investigate the utility of the concept for understanding and treating mental illness. We set out to derive social capital variables from an existing epidemiological study, and tested their associations with first episode psychosis. Associations were found between psychosis and one form of social capital, active engagement in social activities. We conclude that social capital is a promising construct that can be utilised in analysing social dimensions of mental illness. Secondary analysis is possible, but longitudinal surveys with comprehensive measures of social capital and mental health are needed.

The purpose of this paper is to draw out the lessons learned from the implementation of the Individual Placement and Support (IPS) approach to supported employment in two contrasting adult mental health teams; one “standard” CMHT, and one early intervention in psychosis (EIP) team.

These inferences are based on the evidence from a four-year study of IPS in one mental health care provider in the UK, which began by setting up a new service, and went on to run a RCT looking at the impact of psychological input as an adjunct to IPS alone.

In attempting to introduce IPS to mental health teams in Nottingham the authors came across numerous barriers, including service reorganisation, funding cuts and the wider context of recession. Differences were observed between mental health teams in the willingness to embrace IPS. The authors argue that this variability is due to differences in caseload size, recovery priorities and client profiles. The authors have learnt that perseverance, strenuous efforts to engage clinical staff and the use of IPS fidelity reviews can make a positive difference to the implementation process.

The experience suggests that setting up an IPS service is possible even in the most challenging of times, and that EIP services may be a particularly fertile ground for this approach. The authors also discuss potential barriers to implementing new services in mental health teams.

This paper will be of value to service development and the science of implementation in mental health.

Formal ties between the theatre and research dissemination have only recently developed and its general efficacy is largely unknown. Here the purpose of this paper is to redress this neglect by examining the effectiveness of a research-based theatrical event in promoting dementia knowledge transfer with a group of front line care workers. The event ran over eight days and consisted of an original theatrical production followed by a chaired audience discussion and workshops.

Questionnaires which had been developed specifically for this evaluation were completed by 863 front line workers on the day of the event, eliciting their profiles and immediate reactions. Three months after the event, 30 completed a follow-up questionnaire and eight were interviewed.

Attendance was well received with high degrees of both cognitive and emotional engagement being expressed in the initial questionnaire. The follow-up evaluation suggested that these positive reactions were sustained over time. However, many taking part in this follow-up thought that their practice had not changed as a result of event attendance. This apparent discrepancy between knowledge transfer and utilisation appeared to be partly the result of the influence of contextual factors in impeding this utilisation within work settings.

Evidence is provided on the positive impact of theatre on dementia carers’ working lives. This is sufficient to warrant further applications of this method, provided there is careful attention to embedding the messages in the workplace context and evaluating their efficacy.

A feasibility study of cognitive-behavioural therapy (CBT) as an adjunct to individual placement and support (IPS) with adults with severe mental illness showed that fewer people who received CBT dropped out and more obtained jobs. The purpose of this paper is to investigate how the adjunct CBT programme worked. CBT used a problem-solving approach to address common psychological barriers to employment.

Baseline and six-month follow-up scores were compared on measures of problem solving, executive functioning, fear of negative evaluation, self-esteem, and stigma.

At baseline, the majority of the 23 participants scored within the normal range on measures. Around half of the participants showed improvement in social problem solving, executive functioning, and fear of negative evaluation. General improvements in self-esteem were seen. Change in the expected areas according to module choice was evident, however this was inconsistent.

Many participants were within normal ranges on the measures at baseline. Offering participants a choice of topics led to some people having few sessions, possibly too few to produce benefits. Although the modules on offer targeted commonly experienced problems, they may not have been the most important to these participants.

CBT does appear to enhance IPS but the mechanisms by which this occurs is unclear. To improve adjunct CBT, there is a need to clarify the most beneficial targets and identify the mechanisms by which CBT may augment IPS.

This study begins to identify the processes by which CBT can enhance IPS for adults with severe mental illness.

The purpose of this paper is to review the role of social networks in the translation of research into practice, propose a broader model of communities of practice (CoPs) involving practitioners, researchers and service users, and describe a case report which adopts this broader model.

Using the evidence on both knowledge transfer and the use of CoPs to share practice, this work presents an approach to supporting and developing CoPs around the specific context of an applied research programme in health and social care.

The development of CoPs across the professional and organisational boundaries of researchers, practitioners, and service users has the potential to enhance the translation of evidence into practice. It requires bringing together the right people and providing a supportive infrastructure to facilitate exchanges. Methods of engaging and involving the different stakeholder groups vary according to the specific context and pre‐existing networks, but developing closer working relationships and sharing common values is an important step in this process. Within the applied health research partnership of the Collaboration for Leadership in Applied Health Research and Care for Nottinghamshire, Derbyshire and Lincolnshire (CLAHRC‐NDL), the role of Diffusion Fellows, Engagement Fellows and CLAHRC Associates provides a way of engaging with its diverse stakeholders.

This paper builds on existing evidence about CoPs and the role of social networks in knowledge transfer.

Evidence accumulated over many years illustrates the benefits of work for mental health, including that of mental health service users. Despite strong evidence of the effectiveness of the individual placement and support (IPS) approach in enabling this group to find and keep paid employment, employment rates among mental health service users remain low, and IPS is not widely implemented in the UK. This paper reviews recent evidence for IPS, describes the key features of the approach and compares these with service users' accounts of the kind of support that they find helpful. The current situation regarding implementation of IPS is then considered, together with the barriers hindering implementation. It is clear that the barriers are multifaceted, and action will be required at a number of levels if mental health service users are to be enabled to achieve their employment goals.

People with intellectual disabilities commonly come into contact with the criminal justice system as victims, witnesses or suspects. Their intellectual disabilities may make them disadvantaged in relation to all components of the criminal justice system, including police interviews, fitness to plead and stand trial, capacity to give evidence in court, and issues to do with criminal responsibility and sentencing. The focus in this paper is on police interviews and the capacity of adults with intellectual disabilities to give evidence in Court. Research into the types of vulnerability seen by people interviewed by police have focused on interviewees' understanding of the Oath and their legal rights, suggestibility, acquiescence, compliance and perceptions of the consequences of making self‐incriminating admissions. The essential components of any interview and testifying in court require that the person can communicate effectively and give reliable answers and accounts of events. Research into police interviews has highlighted the importance of taking into account the interviewee's vulnerabilities and providing appropriate support, and suggests a more humane approach to interviews and when vulnerable people testify in Court.