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1 – 10 of 26Mick McKeown, Charlotte Byrne, Holly Cade, Jo Harris and Karen Wright
Secure mental health services in one UK region have acted within a network to develop a range of involvement practices. A new quality benchmarking tool has been created to…
Abstract
Purpose
Secure mental health services in one UK region have acted within a network to develop a range of involvement practices. A new quality benchmarking tool has been created to appraise the implementation of these involvement practices. The purpose of this paper is to report upon a qualitative evaluation of this development.
Design/methodology/approach
Staff and service users involved in the co-production of the benchmarking tool were engaged in a series of focus groups and participatory inquiry approaches enacted in the course of scheduled network meetings. Data thus collected was subject to thematic analysis.
Findings
Four distinct themes were identified which were titled: Taking time, taking care; The value not the label; An instrument of the network; and All people working together. These are discussed in relation to recent theorising of co-production.
Research limitations/implications
Effectively, this study represents a case study of developments within one region. As such, the findings may have limited transferability to other contexts.
Practical implications
Staff and service users can work together effectively to the benefit of each other and overall forensic services. The benchmarking tool provides a readymade mechanism to appraise quality improvements.
Social implications
Despite a prevailing culture of competition in wider health-care policy, cooperation leads to enhanced quality.
Originality/value
The benchmarking tool is a unique development of a longstanding involvement network, demonstrating the positive implications for enacting co-production within secure services.
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Helen Spandler and Mick McKeown
The purpose of this paper is to explore the case for a truth and reconciliation (T&R) process in the context of mental health services.
Abstract
Purpose
The purpose of this paper is to explore the case for a truth and reconciliation (T&R) process in the context of mental health services.
Design/methodology/approach
The approach is a conceptual review of T&R approaches; a consideration of why they are important; and how they might be applied in the context of mental health services and psychiatry. First, the paper sets out a case for T&R in psychiatry, giving some recent examples of how this might work in practice. Then it outlines potential objections which complicate any simplistic adoption of T&R in this context.
Findings
In the absence of an officially sanctioned T&R process a grassroots reparative initiative in mental health services may be an innovative bottom-up approach to transitional justice. This would bring together service users, survivors and refusers of services, with staff who work/ed in them, to begin the work of healing the hurtful effects of experiences in the system.
Originality/value
This is the first paper in a peer-reviewed journal to explore the case for T&R in mental health services. The authors describe an innovative T&R process as an important transitional step towards accomplishing reparation and justice by acknowledging the breadth and depth of service user and survivor grievances. This may be a precondition for effective alliances between workers and service users/survivors. As a result, new forms of dialogic communication and horizontal democracy might emerge that could sustain future alliances and prefigure the social relations necessary for more humane mental health services.
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Helen Spandler and Mick McKeown
This paper is an author’s reply to the article by Cresswell (2017) critiquing the original piece by Spandler and McKeown (2017) on truth and reconciliation (T&R) in psychiatry…
Abstract
Purpose
This paper is an author’s reply to the article by Cresswell (2017) critiquing the original piece by Spandler and McKeown (2017) on truth and reconciliation (T&R) in psychiatry. The paper aims to discuss this issue.
Design/methodology/approach
It continues the dialogue about the nature of reconciliation in mental health services and reflects on distinctions between the nature of historical abuses within the asylum system and the need to understand and prevent further harm within contemporary services.
Findings
Whilst the authors acknowledge the tension between reconciliation and democratic debate they suggest that the process does not have to mean agreement or acquiescence. They reaffirm their optimistic belief that better mental health services are possible and appreciate that true reconciliation is a process that will require both debate and the building of constructive alliances.
Originality/value
A grassroots T&R process might be a form of transitional justice which does not negate the need for wider social and policy changes, but may actually help achieve it.
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Gary Lamph, Alison Elliott, Sue Wheatcroft, Gillian Rayner, Kathryn Gardner, Michael Haslam, Emma Jones, Mick McKeown, Jane Gibbon, Nicola Graham-Kevan and Karen Wright
The aim of this paper is to provide an overview of a novel offender personality disorder (OPD) higher education programme and the research evaluation results collected over a…
Abstract
Purpose
The aim of this paper is to provide an overview of a novel offender personality disorder (OPD) higher education programme and the research evaluation results collected over a three-year period. Data from Phase 1 was collected from a face-to-face mode of delivery, and Phase 2 data collected from the same programme was from an online mode of delivery because of the COVID-19 pandemic.
Design/methodology/approach
In Phase 1, three modules were developed and delivered in a fully face-to-face format before the pandemic in 2019–2020 (n = 52 student participants). In 2020–2021 (n = 66 student participants), training was adapted into a fully online mode of delivery in Phase 2. This mixed-methods study evaluated participant confidence and compassion. Pre-, post- and six-month follow-up questionnaires were completed. Qualitative interviews were conducted across both phases to gain in-depth feedback on this programme (Phase 1: N = 7 students, Phase 2: N = 2 students, N = 5 leaders). Data from Phase 1 (face-to-face) and Phase 2 (online) are synthesised for comparison.
Findings
In Phase 1 (N = 52), confidence in working with people with personality disorder or associated difficulties improved significantly, while compassion did not change. In Phase 2 (N = 66), these results were replicated, with statistically significant improvements in confidence reported. Compassion, however, was reduced in Phase 2 at the six-month follow-up. Results have been integrated and have assisted in shaping the future of modules to meet the learning needs of students.
Research limitations/implications
Further research into the impact of different modes of delivery is important for the future of education in a post-pandemic digitalised society. Comparisons of blended learning approaches were not covered but would be beneficial to explore and evaluate in the future.
Practical implications
This comparison provided informed learning for consideration in the development of non-related educational programmes and, hence, was of use to other educational providers.
Originality/value
This paper provides a comparison of a student-evaluated training programme, thus providing insights into the impact of delivering a relational-focused training programme in both face-to-face and online distance learning delivery modes. From this pedagogic research evaluation, the authors were able to derive unique insights into the outcomes of this programme.
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Gary Lamph, Alison Elliott, Kathryn Gardner, Karen Wright, Emma Jones, Michael Haslam, Nicola Graham-Kevan, Raeesa Jassat, Fiona Jones and Mick McKeown
Workforce development is crucial to the offender personality disorder (OPD) service to provide contemporary, evidenced care and treatment. This study aims to provide an overview…
Abstract
Purpose
Workforce development is crucial to the offender personality disorder (OPD) service to provide contemporary, evidenced care and treatment. This study aims to provide an overview and the research evaluation results of a regional higher education programme delivered to a range of criminal justice workers used on the OPD pathway.
Design/methodology/approach
Three modules were developed and delivered; these are (1) enhancing understanding (20 students), (2) formulation and therapeutic intervention (20 students) and (3) relationships, teams and environments (17 students). A mixed-methods study evaluated participant confidence and compassion. Pre, post and six-month follow-up questionnaires were completed. Additionally, a series of focus groups were conducted to gain in-depth qualitative feedback with a cross-section of students across the modules (N = 7). Quantitative data was collected and analysed separately due to the three modules all having different content. Qualitative data was analysed, and a synthesis of qualitative findings was reported from data taken across the three modules.
Findings
A total of 52 students participated, drawn from three modules: Module 1 (N = 19); Module 2 (N = 18); Module 3 (N = 15). Confidence in working with people with a personality disorder or associated difficulties improved significantly following completion of any of the modules, whereas compassion did not. Results have been synthesised and have assisted in the future shaping of modules to meet the learning needs of students.
Research limitations/implications
Further evaluation of the effectiveness of educational programmes requires attention, as does the longer-term durability of effect. Further research is required to explore the post-training impact upon practice, and further exploration is required and larger sample sizes to draw definitive conclusions related to compassion.
Practical implications
This unique model of co-production that draws upon the expertise of people with lived experience, occupational frontline and academics is achievable and well received by students and can be reproduced elsewhere.
Social implications
The positive uptake and results of this study indicate a need for expansion of accessible OPD workforce training opportunities across the UK. Further research is required to explore student feedback and comparisons of effectiveness comparing different modes of training delivery, especially in light of the pandemic, which has forced organisations and higher education institutions to develop more digital and distance learning approaches to their portfolios.
Originality/value
This novel research provides an evaluation of the only higher education credit-bearing modules in the UK focussed solely upon the OPD workforce and aligned with the national drive for non-credit bearing awareness level training “knowledge and understanding framework” (KUF).
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Gary Lamph, Jake Dorothy, Tamar Jeynes, Alison Coak, Raeesa Jassat, Alison Elliott, Mick McKeown and Tim Thornton
The label “Personality Disorder” continues to divide opinion. Challenges to the terminology of personality disorder led by people with lived experience and supported by critical…
Abstract
Purpose
The label “Personality Disorder” continues to divide opinion. Challenges to the terminology of personality disorder led by people with lived experience and supported by critical practitioners and academics are tempered by acknowledgement of certain positive social consequences of obtaining a diagnosis. This study aims to engage service users and staff in a process of inquiry to better understand the complexities of views on the terminology of Personality Disorder.
Design/methodology/approach
This study set out to qualitatively explore the views of a range of people with lived, occupational and dual lived experience/occupational expertise, relating to the diagnostic label of Personality Disorder, via participatory and critical group debate. The World Café approach is an innovative methodology for participatory inquiry into subjective views suited to exploring the contested subject matter.
Findings
This study identified contrasting opinions towards the label of Personality Disorder and provides insight into the concerns described for both keeping and losing the label. Although many felt the words “personality” and “disorder” are not in themselves helpful, certain positive views were also revealed. Perspectives towards the label were influenced by the way in which diagnosis was explained and understood by patients and practitioners, alongside the extent to which service provision and evidence-based interventions were offered.
Research limitations/implications
The findings have the potential to contribute to the ongoing critical debate regarding the value of the Personality Disorder construct in the provision of care and support. Specific emphasis upon the relational framing of care provision offers a means to ameliorate some of the negative impacts of terminology. Perspectives are influenced in the way the label is understood, hence, attention is required to enhance these processes in clinical practice. There is much more study required to overcome stigmatisation, prejudice, and lack of knowledge and understanding. Further research identifying means for challenging stigma and the factors contributing to positive clinical interactions are required.
Originality/value
This study brings together a wide range of views and experiences of mental health professionals, individuals lived experiences and those who align to both lived and occupational expertise. A safe space was provided via the uniquely co-produced World Café research event to bring together discussion and debates from mixed perspectives makes this a novel study. The focus being on perspectives towards contested language, labelling and social impact adds to scholarship in this field.
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Leanne Harper and Mick McKeown
Whilst there is growing evidence to suggest that the recovery college (RC) environment supports students towards their mental health recovery (Meddings et al., 2015b), students’…
Abstract
Purpose
Whilst there is growing evidence to suggest that the recovery college (RC) environment supports students towards their mental health recovery (Meddings et al., 2015b), students’ initial motivations for engagement, alongside factors that may hinder or support attendance, have yet to be exclusively explored. The paper aims to discuss these issues.
Design/methodology/approach
All new RC students were invited to take part in a semi-structured interview three months following their enrolment. Four participants completed an interview which were later analysed using thematic analysis.
Findings
Four themes emerged within analysis: making the effort; being “too unwell”; friendly environment; and glad I came. These are discussed alongside the literature, and it is proposed that whilst there is a substantial struggle involved in engagement with a RC, likely related to mental health and social factors, the RC environment, peer support and support of the tutors helps students to overcome the impact of this.
Research limitations/implications
Due to the small sample size and exploratory stance of this study, additional research into the complexities around engagement with RCs is strongly recommended. Only students who had attended at least one RC course chose to participate in this study, therefore an under-researched population of non-attendees may provide a valuable contribution to further understanding.
Originality/value
This is one of the first studies to qualitatively explore factors which may support, or hinder, initial and ongoing engagement with a RC. It is proposed that a greater understanding of these important issues could be used to increase RC accessibility and inclusion.
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John Wainwright, Mick McKeown and Malcolm Kinney
The purpose of this paper is to explore experiences of survivors of the mental health system regularly attending a mental health resource centre predominantly but not exclusively…
Abstract
Purpose
The purpose of this paper is to explore experiences of survivors of the mental health system regularly attending a mental health resource centre predominantly but not exclusively focussed on needs of the BAME community.
Design/methodology/approach
In total, 25 participants took part in a qualitative research study regarding their experiences of mental health and racism, alternative mental health support and struggles in the local black community.
Findings
Issues of race, place and space were central to the experiences of BAME mental health survivors. Participants emphasised the importance of place-based support in their everyday life, with the service provided engendering a sense of belonging conducive to coping with various struggles. Race and racism were also central to these daily struggles and the place of Liverpool 8 was at the core of notions of identity and belonging. The space within the centre provided a sanctuary from the combined discriminations and exclusions attendant on being BAME survivors of the mental health system.
Practical implications
Attention to matters of place and space appears crucial to the articulation of appropriate support.
Social implications
Place is salient to understanding the intersecting identities/experience of racism and mental health discrimination, constituting the basis for a concept of placism; associated with exclusions from feeling safe and included in everyday public places (including within the black community) with the exception of the welcoming and unconditionally accepting space of the centre.
Originality/value
This paper is the first to inquire into place-based experiences of alternative black mental health support. Placism is a novel construct that merits further inquiry and theoretical development.
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The purpose of this paper is to critique Spandler and McKeown’s recent advocacy of a truth and reconciliation (T&R) process in psychiatry.
Abstract
Purpose
The purpose of this paper is to critique Spandler and McKeown’s recent advocacy of a truth and reconciliation (T&R) process in psychiatry.
Design/methodology/approach
A critique of a recent paper in Mental Health Review Journal.
Findings
That Spandler and McKeown’s advocacy of a T&R process in psychiatry can be criticised from a number of inter-related practical, political and ethical perspectives.
Originality/value
The present critique contributes to the ongoing debate about the desirability of a T&R process in psychiatry.
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Mick McKeown, Steve Robertson, Zemikael Habte‐Mariam and Mark Stowell‐Smith
This paper reports on key findings from the practice survey wing of a broader knowledge review into mental health advocacy with African and Caribbean men funded by the Social Care…
Abstract
This paper reports on key findings from the practice survey wing of a broader knowledge review into mental health advocacy with African and Caribbean men funded by the Social Care Institute for Excellence (SCIE). Selected themes from the analysis are discussed in the light of theory regarding ethnicity, masculinity and mental health. Conclusions are drawn that suggest that understandings of mental health and advocacy within black communities are congruent with ideologies of holism, recovery and transformational goals for services and society at large. This is in contrast to experiences in mainstream mental health services which privilege a relatively narrow medical model and treatments that are emasculating. The empowerment and emancipatory potential wrapped up in both individual and collective notions of advocacy can be seen as one part of a resistance to oppressive practices and a means of reclaiming personal efficacy and potency by virtue of challenging emasculation in services.
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