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The purpose of this paper is to evaluate the usefulness of the first Trialogue Meetings throughout Ireland for individuals from mental health communities by using a…
The purpose of this paper is to evaluate the usefulness of the first Trialogue Meetings throughout Ireland for individuals from mental health communities by using a participatory action research (PAR) framework.
Seven communities participated in monthly Trialogue Meetings as a community-based PAR project. A mixed-methods PAR evaluation was performed on data from 48 participants (service users, service providers, family members/friends and interested community members) who participated in the final Trialogue Meetings.
Participants identified that Trialogue increased knowledge/awareness of mental health, irrespective of gender, mental health role, age or employment status. Trialogue Meetings provided a supportive environment for many, where men may be comfortable talking and where service providers may benefit from exposure to broader perspectives on mental health. Participants also perceived that Trialogue Meetings deconstructed pre-existing mental health power structures, allowed them to understand mental health from different perspectives and express themselves better.
The study identifies barriers to Trialogue efficacy such as low service provider engagement and political dynamics extraneous to the meetings themselves.
Where desirable conditions are present, Trialogue Meetings appear to be sustainable community development initiatives where pre-existing mental health power dynamics may be levelled and knowledge/communication surrounding mental health may be enhanced.
This is the first large-scale evaluation of the innovative Trialogue method among mental health stakeholders using a PAR approach.
The purpose of this paper is to stimulate discussion within mental health and psychiatric nursing as to how the open dialogue approach can contribute to their work. The…
The purpose of this paper is to stimulate discussion within mental health and psychiatric nursing as to how the open dialogue approach can contribute to their work. The paper is mainly theoretical, though relates to practical examples of open dialogue in mental health care research and practice to illustrate the actual potential in practice.
First the authors raise issue with the narrow lens of psychiatric diagnosis and question its usefulness against a contemporary backdrop of personalised care and recovery orientated practice. Open dialogue as a way of being and as a process are explored as they relate to people interaction and contribute to therapeutic interaction, organisational and community development. The authors reflect on how open dialogue can be and is practiced in different ways and at different levels.
The authors consider open dialogue as a suitable approach for working with people who have mental health and/or psychiatric problems. The approach is also recommended for working in larger circumstances as families and social network, on organisational and community levels in different ways. Open dialogue should be considered not as a method or technique but as a process of interaction which can be applied to different conditions and circumstances.
Within mental health discourse open dialogue is increasingly evident and filtering into the broader discussion on increasing effectiveness of mental health interventions. Perfectly suited to mental health and psychiatric nursing as a way of being with service user, this reflection on open dialogue offers further thoughts on how as a process it has already filtered into nursing practice and how as nurses we can easily accommodate it within the therapeutic approach.
This paper provides an historical perspective on dual diagnosis and current developments in the delivery of mental health and addiction services to people with dual…
This paper provides an historical perspective on dual diagnosis and current developments in the delivery of mental health and addiction services to people with dual diagnosis in Ireland. In light of government policy, it describes attempts made to improve the standards of care provided, recognising deficits in services, and not just those services provided to clients with a dual diagnosis. It identifies a number of issues that need to be addressed, including training, research, service developments, co‐operation between different service providers, information availability and measurement of client outcomes. It concludes that, although there is increasing awareness of the issue of dual diagnosis, this has not resulted in significant relevant policy implementation and improvements in services provided to clients with a dual diagnosis. Yet there is sufficient evidence available for a meaningful response to dual diagnosis, given the state of play in policy and service delivery in those settings with which people with dual diagnosis engage.
Developing a dual diagnosis service in Cork, Ireland by way of participatory action research (PAR) background: internationally there is a growing consensus regarding the…
Developing a dual diagnosis service in Cork, Ireland by way of participatory action research (PAR) background: internationally there is a growing consensus regarding the ideal of integrated treatment. In Ireland, recommendations identified the need for multi-disciplinary team integration and client participation being central to service development. Such recommendations collectively fit most appropriately with PAR, the methodological and theoretical framework best suited to achieve the objectives of the inquiry. PAR's inclusive philosophy creates processes of negotiation, self-reflexivity and exploration of power issues with the lived experience of communities. Key elements of this approach facilitate the development of emancipatory and participatory democracy whilst highlighting identified social issues through research, learning and action. The paper aims to discuss these issues.
Cyclical processes of planning, action, observation and reflection in cycle one have facilitated the introduction of PAR's methodological framework into the existing public health (Health Service Executive) system of primary care addiction and mental health services. Developing stakeholder relationships in decision making processes has been pivotal in cycle 1 as the process of collective engagement evolves. Stakeholders begin to experience their collective participation in the methods adopted and a collective sense of ownership and commitment to the iterative process begins to take shape. Stakeholders in cycle 1 have participated in multiple data generation methods including: informal interviews, planned discussion and focus groups, multidisciplinary team meetings, testimonials, observations and reflections.
Cycle 1 of this PAR inquiry has engaged stakeholders (service users and their families, practitioners including; academic/practitioners, a consultant psychiatrist, psychologist, mental health nurses, an occupational therapist, psychotherapists, an acupuncturist, an addiction counsellor, an art therapist) in an integrated process of inquiry. PAR methods adopted in this cycle have facilitated particular dual diagnosis service developments and emerging initiatives (previously unidentified). Actions collaboratively planned for and illustrated in this paper include: the implementation of a psychotherapy group and implementing direct access to an acupuncture clinic.
Stakeholders collaboratively experience PAR's methodological and theoretical approach which has facilitated service developments in cycle 1 of the inquiry. This sets the stage for the completion of actions already in motion and for further initiatives to continue to evolve as cycle 2 processes emerge.