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1 – 10 of over 16000Myra Piat, Jessica Spagnolo, Suzanne Thibodeau-Gervais, Catherine Deschamps and Yves Gosselin
The purpose of this paper is twofold: first, assess the effects of the peers’ recovery narratives on service users’ perceived mental health recovery; and second, explore various…
Abstract
Purpose
The purpose of this paper is twofold: first, assess the effects of the peers’ recovery narratives on service users’ perceived mental health recovery; and second, explore various stakeholders’ perspectives on the program, specifically its facilitators and barriers.
Design/methodology/approach
The study used a convergent mixed-method design. First, a pre-test post-test design was used with service users to evaluate the peer recovery narrative program. They completed the Recovery Assessment Scale (RAS) and participated in qualitative interviews that explored perspectives on their mental health recovery before and after the program. Second, a cross-sectional design was used to explore stakeholder groups’ perspectives on the recovery narrative program immediately after listening to the narratives.
Findings
While findings show that there was no statistical difference between scores on the RAS before and after the peer narratives, thematic analysis revealed a change in service users’ understanding of recovery post-narratives. Other stakeholder groups confirmed this change. However, some healthcare professionals questioned the universal positive effects of the peer recovery narrative program on service users. Stakeholders agreed that beyond effects of the peer recovery narrative program on service users, there were also positive effects among the peers themselves.
Originality/value
To the authors’ knowledge, this is the first Canadian study, and one of the first studies to rely on mixed-methods and various stakeholder groups to evaluate the impact of peer recovery narratives on service users. The research, thus, fills a knowledge gap on peer recovery narratives.
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David Palmer, Lucy Williams, Sue White, Charity Chenga, Verusca Calabria, Dawn Branch, Sue Arundal, Linda Storer, Chris Ash, Claire Cuthill, Haile Bezuayehu and Eleni Hatzidimitriadou
In 2008, Mind in Bexley received a research development grant from the Big Lottery Fund and a training grant from Bexley Care Trust to empower service users to participate and…
Abstract
In 2008, Mind in Bexley received a research development grant from the Big Lottery Fund and a training grant from Bexley Care Trust to empower service users to participate and contribute to a pilot research project. The project aims were to work with, develop, train and support service users as researchers, in order to record the narratives of service users who have common experiences of mental health distress and treatment. The research development project set up an advisory group, created and developed a partnership with the University of Kent and provided workshops and training sessions to explore some of the principles of research and ethics. In addition, the group undertook a preliminary literature review, developed and refined a research questionnaire and piloted interviews with six service users. Many issues were raised and lessons learned during the planning and conduct of the project. This paper discusses the process and reflects on aspects of the project's design and delivery. In addition, this paper highlights some of the difficulties in undertaking service user research and suggests recommendations as to how to overcome some of these complex issues.
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The purpose of this study is to highlight the impacts that service user involvement can have on the education of UK undergraduate student mental health nurses both personally and…
Abstract
Purpose
The purpose of this study is to highlight the impacts that service user involvement can have on the education of UK undergraduate student mental health nurses both personally and professionally. It reports the findings from a short module evaluation of a collaboratively delivered theory unit using a qualitative approach.
Design/methodology/approach
The study reports the findings from a short module evaluation of a collaboratively delivered theory unit using a qualitative approach embracing two focus groups.
Findings
The findings from the two focus groups highlight that the service user input (expert by experience) offered a positive learning experience for the students, enabled them to appreciate the meaning of recovery and hope and facilitated the identification of the importance of their role in terms of connecting meaningfully with those they are supporting and reconsidering key priorities for practice. They also suggest that there is theory/practice gap reduction as students were able to connect the service user narratives to the evidence base for deeper understanding and application.
Research limitations/implications
Although only a brief evaluation of a short theory module within a wider programme involving a small number of participants, the findings echo the wider literature and offers further rationale to support direct service user involvement within mental health education across all healthcare professions. This finding is also relevant, as, increasingly, learning/teaching programmes now seek to implement blended learning with significant online teaching and less face-to-face facilitation of learning.
Practical implications
This study highlights not only the positive impact of service user input on health-care education but also the benevolent influence skilled narratives can have as a pedagogical approach to learning.
Originality/value
Although there is much in the literature as to the benefits for student learning in involving service users within higher education institute education, there is limited information as to “how” and “why” this is the case, this article seeks to bridge that gap.
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Samantha Cooke, Anna Daiches and Emma Hickey
As part of an attitudinal shift surrounding personality disorder stigma, a training package termed the Knowledge and Understanding Framework (KUF) is delivered in collaboration…
Abstract
Purpose
As part of an attitudinal shift surrounding personality disorder stigma, a training package termed the Knowledge and Understanding Framework (KUF) is delivered in collaboration between experts by experience (EBE) and professionals. The purpose of this paper is to explore the narratives of EBE delivering KUF; in particular the impact of this role and its varying contexts.
Design/methodology/approach
Eight women took part in the study and a narrative analysis explored their stories.
Findings
The analysis suggested five temporal chapters: first, life before becoming involved: “Like being in a milk bottle screaming”; second, a turning point: “It wasn’t actually me that was disordered it was the life that I’d had”; third, taking up the trainer role: “It all just […] took off”; fourth, the emergence of a professional identity: “I am no longer a service user”; and fifth, impact on self, impact on others.
Originality/value
The use of qualitative literature is sparse within co-production research. The study therefore adds value in exploring in-depth experiences of the phenomena.
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Benjamin Thomas Gray and Matthew Sisto
The purpose of this study is to describe peer support work in a men’s mental health unit from a lived experience and service user’s perspective. The intertwining of process (a…
Abstract
Purpose
The purpose of this study is to describe peer support work in a men’s mental health unit from a lived experience and service user’s perspective. The intertwining of process (a lived experience perspective) and subject (the therapeutic value of peer support) leads to greater knowledge and insight into peer support for people with mental health problems.
Design/methodology/approach
This service user narrative draws on the extracts from a reflective journal of interactions and conversations with people with mental health problems as well as feedback from service users and staff about the value of peer support. These methods allow a first-person, service user’s, reflective and narrative account of peer support work.
Findings
Peer support work, particularly hearing voices sessions, are found to be highly therapeutic and worthwhile. They promote insight and create feelings of safety and hope in what can sometimes be a frightening and hostile ward environment. Peer support provides emotional and practical support. Sharing stories and experiences of mental illness with people leads to trust, feelings of being valued, heard and accepted as well as better experiences of care and being seen as a person first. Due to their shared experiences, peer support workers are able to befriend people with mental health problems on the ward. Peer support work bridges the gap and vacuum of care between people with mental health problems and staff. It compensates for understaffing to provide more holistic and person-centred care and support.
Originality/value
Lived experience/ service user perspectives and narratives on peer support are rare, particularly in a hospital setting. This article provides a rich, perhaps overlooked and hidden narrative on the nature of peer support work. People with mental health problems, like Ben, are often excluded from society, health and social care, education, employment and research. This narrative opens up a pathway to understanding peer support from a service user perspective.
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Heather Castillo and Shulamit Ramon
While shared decision making (SDM) in general health has proven effectiveness, it has received far less attention within mental health practice with a disconnection between policy…
Abstract
Purpose
While shared decision making (SDM) in general health has proven effectiveness, it has received far less attention within mental health practice with a disconnection between policy and ideals. The purpose of this paper to review existing developments, contemporary challenges, and evidence regarding SDM in mental health with a particular focus on the perspectives of service users.
Design/methodology/approach
This is a review of international papers analysed using narrative synthesis of relevant data bases.
Findings
The review shows significant barriers to the utilisation of SDM including ethical and legal frameworks, accountability and risk. The medical model of psychiatry and diagnostic stigma also contributes to a lack of professional acknowledgement of service user expertise. Service users experience an imbalance of power and feel they lack choices, being “done to” rather than “worked with”.
Practical implications
The paper also presents perspectives about how barriers can be overcome, and service users enabled to take back power and acknowledge their own expertise.
Originality/value
This review is the first with a particular focus on the perspectives of service users and SDM.
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Lorna Montgomery, Deborah Hanlon and Christine Armstrong
The purpose of this paper is to describe a small scale pilot study undertaken in Northern Ireland to gather service user feedback from individuals who have been subject to adult…
Abstract
Purpose
The purpose of this paper is to describe a small scale pilot study undertaken in Northern Ireland to gather service user feedback from individuals who have been subject to adult safeguarding procedures.
Design/methodology/approach
The aims, methods and findings of the “Adult Safeguarding: 10,000 Voices” pilot project are presented.
Findings
The pilot project highlighted how an initiative which captures the experiences of patients, service users, carers and staff in the health and social care sector (10,000 Voices) could be successfully adapted for use in adult safeguarding, facilitating the collation of complex experiences and enabling insights to be gleaned and shared.
Research limitations/implications
The pilot study is limited by the small number of participants. The findings are preliminary.
Practical implications
For the first time in Northern Ireland the 10,000 Voices model was utilised in the context of a non-health related service, namely, adult safeguarding.
Social implications
This outline of the model and methodology for obtaining service user feedback can inform user involvement in other contexts.
Originality/value
This paper provides an accessible overview of an innovative approach to engaging service users in adult safeguarding, such approaches, to date have been limited.
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Nadia Robb and Trisha Greenhalgh
This article explores issues of trust in narratives of interpreted consultations in primary health care.
Abstract
Purpose
This article explores issues of trust in narratives of interpreted consultations in primary health care.
Design/methodology/approach
The paper is based on empirical data from a qualitative study of accounts of interpreted consultations in UK primary care, undertaken in three north London boroughs. In a total of 69 individual interviews and two focus groups, narratives of interpreted consultations were sought from 18 service users, 17 professional interpreters, nine family member interpreters, 13 general practitioners, 15 nurses, eight receptionists, and three practice managers. The study collected and analysed these using a grounded theory approach and taking the story as the main unit of analysis. It applies a theoretical model that draws on three key concepts: Greener's taxonomy of trust based on the different “faces” of power in medical consultations; Weber's notion of bureaucratic vs traditional social roles; and Habermas' distinction between communicative and strategic action.
Findings
Trust was a prominent theme in almost all the narratives. The triadic nature of interpreted consultations creates six linked trust relationships (patient‐interpreter, patient‐clinician, interpreter‐patient, interpreter‐clinician, clinician‐patient and clinician‐interpreter). Three different types of trust are evident in these different relationships – voluntary trust (based on either kinship‐like bonds and continuity of the interpersonal relationship over time, or on confidence in the institution and professional role that the individual represents), coercive trust (where one person effectively has no choice but to trust the other, as when a health problem requires expert knowledge that the patient does not have and cannot get) and hegemonic trust (where a person's propensity to trust, and awareness of alternatives, is shaped and constrained by the system so that people trust without knowing there is an alternative). These different types of trust had important implications for the nature of communication in the consultation and on patients' subsequent action.
Research limitations/implications
The methodological and analytic approach, potentially, has wider applications in the study of other trust relationships in health and social care.
Practical implications
Quality in the interpreted consultation cannot be judged purely in terms of accuracy of translation. The critical importance of voluntary trust for open and effective communication, and the dependence of the latter on a positive interpersonal relationship and continuity of care, should be acknowledged in the design and funding of interpreting services and in the training of both clinicians, interpreters and administrative staff.
Originality/value
This is the first study in which interpreted consultations have been analysed from a perspective of critical sociology with a particular focus on trust and power relations.
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Suzanne Heffernan, Sandra Neil and Stephen Weatherhead
The purpose of this paper is to explore the extent to which inpatient mental health services attend to the religious needs of service-users. Literature is presented to argue that…
Abstract
Purpose
The purpose of this paper is to explore the extent to which inpatient mental health services attend to the religious needs of service-users. Literature is presented to argue that whilst the importance of religion is highlighted in consumer accounts, research and policy; inpatient services continue to neglect religion and service-users consistently report insufficient attention to religious needs during hospitalisation.
Design/methodology/approach
This review adopts a narrative approach to the literature, drawing upon published journal articles, book chapters and policy documentation.
Findings
Literature into the topic area is reviewed and discussed within three themes. First, the extent to which religious needs are currently met is explored. Second, potential reasons for neglect of religion are considered. Finally, examples of religiously informed group programmes, individual psychotherapy and the use of traditional healers are detailed.
Practical implications
Findings of the review point towards the requirement for inpatient services to more adequately meet religious needs in terms of available facilities. The need for spiritual assessment and collaboration with hospital chaplains is also highlighted, along with the call for increased staff training.
Originality/value
It is expected that this review will be of interest to a range of stakeholders including professionals, policy makers and service users. It highlights the void in clinical attention to religious needs and offers practical suggestions for meeting this need.
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Andrew Stott and Helena Priest
Existing literature has examined what recovery means to people with co-occurring difficulties, but does little to examine experiences of recovery as a process. The purpose of this…
Abstract
Purpose
Existing literature has examined what recovery means to people with co-occurring difficulties, but does little to examine experiences of recovery as a process. The purpose of this paper is to use a narrative approach to explore the process of recovery as an individual journey in a social context. It focuses on people who use alcohol in order to explore the impact of alcohol’s specific cultural meanings on the recovery journey.
Design/methodology/approach
Ten interviews with people with coexisting mental health and alcohol misuse difficulties were conducted, audio-recorded, and transcribed. The transcriptions were analysed using narrative analysis.
Findings
Most participants’ narratives shared a three-part structure, from a traumatic past, through an episode of change, to an ongoing recovery phase. Change and recovery were attributed to several factors including flexible and practical support from services, therapeutic relationships with key professionals, and peer support. Some participants redefined themselves and their alcohol use in relation to ideas of what it is to be “normal”.
Research limitations/implications
The research excluded people who recover outside of services, replicating a shortcoming of much research in this area.
Practical implications
The value placed on professionals having specialised therapeutic skills in working with trauma highlights the need for training in this area. The role for practical and material support underlines the importance of multi-agency working.
Originality/value
The narrative methodology enables the study to draw links between personal stories of recovery and wider social influences, allowing comment on the implications for services. Further, the experiences of people with coexisting mental health and alcohol misuse difficulties have rarely been studied apart from the dual diagnosis population in general, so this paper is able to investigate the specific challenges for this population.
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