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Kageyama M, Yokoyama K, Ichihashi K, Noma S, Hashimoto R, Nishitani M, Okamoto R, Solomon P. A peer-led learning program about intimate and romantic relationships for persons with mental disorders (AIRIKI): co-creation pilot feasibility study. BMC Psychiatry 2023; 23:767. [PMID: 37858119 PMCID: PMC10588039 DOI: 10.1186/s12888-023-05254-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Intimate and romantic relationships are important in life for individuals, irrespective of mental health status. We developed a four-hour peer-led learning program for persons with mental disorders about intimate and romantic relationships through a co-creation process with service users and examined its preliminary effectiveness and feasibility of implementing the program. METHODS A one-group pretest-posttest trial was conducted using a mixed-method design for 45 individuals with mental disorders in Japan. Outcome data were collected at three time points: baseline, post-intervention, and one month after program completion. Mixed models for repeated measures (MMRM) were used to examine changes over time in the Rosenberg Self-Esteem Scale (RSES), Recovery Assessment Scale (RAS), Herth Hope Index (HHI), and the original items. Group interviews were conducted for process evaluation. RESULTS MMRM showed significant changes over time on RSES, RAS, HHI, and two original items "I am able to communicate well with others about myself" and "I am able to listen to others well." In multiple comparisons, RSES and HHI were significant one month after the program. Participants reported changes during the first month after attending the program in terms of their positive attitude toward romantic relationships (n = 14), taking romantic actions (n = 11), and feeling their overall communication improved (n = 11). Although two participants had an unscheduled psychiatric visit that could be attributed to attending the program, all recovered after one month. CONCLUSIONS The program exhibited preliminary effectiveness to a moderate extent in improving recovery, particularly regarding self-esteem and hope. The program is feasible but requires further modifications regarding inclusion criteria for participants and the training of peer facilitators. TRIAL REGISTRATION UMIN000041743;09/09/2020.
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Affiliation(s)
- Masako Kageyama
- Osaka University Institute of Advanced Co-Creation Studies, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Keiko Yokoyama
- Department of Nursing, Faculty of Nursing, Yokohama Soei University, 1Miho-cho, Yokohama, Kanagawa, 226-0015, Japan
| | - Kayo Ichihashi
- Department of Neuropsychiatry, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan
| | - Shintaro Noma
- Peer support online group 'Hamaccha', Yokohama, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo, 113-8655, Japan
| | - Misato Nishitani
- Department of Health Promotion Science, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Reiko Okamoto
- Department of Health Promotion Science, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Phyllis Solomon
- School of Social Policy & Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA, 19104-6214, USA
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Brasier C, Brophy L, Harvey C. Constructing recovery: A Lived Experience and post-structuralist exploration of how the meaning of personal recovery and rehabilitation has changed over time. Australas Psychiatry 2023; 31:607-609. [PMID: 37579295 DOI: 10.1177/10398562231194193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
OBJECTIVE This article explores how the concept of 'recovery' has been much debated and often sits at odds with our notion of rehabilitation. METHOD This article provides a Lived Experience and post-structural commentary on the ever-changing meaning of recovery and rehabilitation. RESULTS Building on the contemporary Consumer Movement's use of the term recovery, this article explores how constructions of recovery try to create a boundary which stops people being invalidated based on their experience, or perceived experience, of mental distress. The concept of recovery has insufficiently influenced rehabilitation practices. Recovery is also frequently reappropriated, often with no or minimal consumer input, and reconstructed in line with notions of progress and improvement. CONCLUSION People with Lived Experience have challenged the concept of rehabilitation; however, rehabilitation may still have relevance if it is redefined according to Lived Experience values and recovery-oriented practice.
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Affiliation(s)
- Catherine Brasier
- Social Work and Social Policy, La Trobe University, Melbourne, Australia; and
- Wellways Australia, Melbourne, Australia
| | - Lisa Brophy
- Social Work and Social Policy, La Trobe University, Melbourne, Australia
| | - Carol Harvey
- Department of Psychiatry, University of Melbourne, Melbourne, Australia; and
- Northwest Area Mental Health Services, Melbourne, Australia
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3
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Granholm Valmari E, Melander M, Hariz GM, Naesström M, Lindström M. Translation and linguistic validation of the Swedish recovering quality of life (ReQoL) - A brief research report. Front Psychiatry 2023; 14:1059406. [PMID: 36824668 PMCID: PMC9941141 DOI: 10.3389/fpsyt.2023.1059406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/18/2023] [Indexed: 02/10/2023] Open
Abstract
In research and among clinicians, the focus has shifted from mainly symptom reduction and increasing functionality to a more recovery-oriented focus. Although there are instruments measuring recovery, there has been a lack of instruments sensitive enough to measure the quality of life for people with severe mental health disorders. Therefore, this study aimed to obtain a Swedish version of the Recovering Quality of Life (ReQoL) questionnaire adhering to best practice guidelines using various steps of translation, linguistic validation, and cognitive debriefing. The cognitive debriefing was conducted with seven participants, and all felt the items in the questionnaire were relevant to their health, apprehensible, and easy to complete. However, some issues were raised regarding wording and the concepts behind certain items. All feedback was considered, and some items were revised in response to criticism after continuous discussions. A Swedish version of ReQoL now exists, and although there is a need for ReQoL in different clinical research settings in Sweden, further research is required to psychometrically test the construct validity as well as reliability of the Swedish version in Sweden.
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Affiliation(s)
- Elin Granholm Valmari
- Occupational Therapy Unit, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Marianne Melander
- Psychiatric Unit, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Gun-Marie Hariz
- Occupational Therapy Unit, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.,Department of Clinical Science, Neurosciences, Umeå University, Umeå, Sweden
| | - Matilda Naesström
- Psychiatric Unit, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Maria Lindström
- Occupational Therapy Unit, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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4
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Espeland K, Loa Knizek B, Hjelmeland H. Lifesaving turning points: First-person accounts of recovery after suicide attempt(s). DEATH STUDIES 2022; 47:550-558. [PMID: 35939504 DOI: 10.1080/07481187.2022.2108941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study explores the recovery processes of persons who had attempted suicide. Semi-structured interviews were conducted with eight persons who had attempted suicide and the data were analyzed by means of systematic text condensation. The participants described lifesaving turning points, which were connected to meaningful relationships, taking control over one's own life, and establishing a new everyday life. Suicide prevention efforts must be adapted to individual needs. First-person knowledge is important if we are to understand what is seen as helpful and should be emphasized when implementing suicide prevention work.
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Affiliation(s)
- Kristin Espeland
- Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Birthe Loa Knizek
- Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Heidi Hjelmeland
- Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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5
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Occupational Dysfunction as a Mediator between Recovery Process and Difficulties in Daily Life in Severe and Persistent Mental Illness: A Bayesian Structural Equation Modeling Approach. Occup Ther Int 2022; 2022:2661585. [PMID: 35832099 PMCID: PMC9262536 DOI: 10.1155/2022/2661585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 05/13/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022] Open
Abstract
Background. This study is aimed at verifying a hypothetical model of the structural relationship between the recovery process and difficulties in daily life mediated by occupational dysfunction in severe and persistent mental illness (SPMI). Methods. Community-dwelling participants with SPMI were enrolled in this multicenter cross-sectional study. The Recovery Assessment Scale (RAS), the World Health Organization Disability Assessment Schedule second edition (WHODAS 2.0), and the Classification and Assessment of Occupational Dysfunction (CAOD) were used for assessment. Confirmatory factor analysis, multiple regression analysis, and Bayesian structural equation modelling (BSEM) were determined to analyze the hypothesized model. If the mediation model was significant, the path coefficient from difficulty in daily life to recovery and the multiplication of the path coefficients mediated by occupational dysfunction were considered as each the direct effect and the indirect effect. The goodness of fit in the model was determined by the posterior predictive
value (PPP). Each path coefficient was validated with median and 95% confidence interval (CI). Results. The participants comprised 98 individuals with SPMI. The factor structures of RAS, WHODAS 2.0, and CAOD were confirmed by confirmatory factor analysis to be similar to those of their original studies. Multiple regression analysis showed that the independent variables of RAS were WHODAS 2.0 and CAOD, and that of CAOD was WHODAS 2.0. The goodness of fit of the model in the BSEM was satisfactory with a
. The standardized path coefficients were, respectively, significant at -0.372 from “difficulty in daily life” to “recovery” as the direct effect and at -0.322 (95% CI: -0.477, -0.171) mediated by “occupational dysfunction” as the indirect effect. Conclusions. An approach for reducing not only difficulty in daily life but also occupational dysfunction may be an additional strategy of person-centered, recovery-oriented practice in SPMI.
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6
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Khan N, Tracy DK. The challenges and necessity of situating 'illness narratives' in recovery and mental health treatment. BJPsych Bull 2022; 46:77-82. [PMID: 33597058 PMCID: PMC9074157 DOI: 10.1192/bjb.2021.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In mental health services, recovery constitutes a guiding principle that is endorsed in professional medical guidelines and has become central to mental health policies across the world. However, for many clinicians, it can be a challenge to effectively embed recovery concepts into professionally directed treatment of disease without distortion, and ostensibly away from what matters to those who use the services. We discuss the evolving and multifaceted concept of 'recovery', including illness narratives to frame our discussion. We demonstrate how integration between a person-directed management of illness and a professionally directed treatment of disease can converge, resulting in positive outcomes for people with mental illness.
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Affiliation(s)
| | - Derek K Tracy
- Oxleas NHS Foundation Trust, UK.,King's College London, UK
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7
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Brookfield S, Selvey L, Maher L, Fitzgerald L. ‘Making Ground’: An Ethnography of ‘Living With’ Harmful Methamphetamine Use and the Plurality of Recovery. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426211073911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The trajectories of people attempting to reduce harmful methamphetamine use are frequently understood within a binary framework of transitioning between states of health and disease. This framework can often be reinforced by service interactions informed by these dominant narratives of recovery and addiction. In this paper, we draw on a critical interactionist analysis of ethnographic fieldwork conducted with people who use methamphetamine, to examine how their experiences could undermine this binary, observing the ways participants experienced growth, change, and progress, without necessarily maintaining abstinence. These findings support a more diverse understanding of drug use trajectories, and we explore the concept of ‘living with drug use’, similar to how people live with other chronic conditions by finding ‘health in illness’. Participant experiences are also interpreted within the context of counter public health, arguing for the recognition and integration of values and goals which are divergent from the implicit aims of public health practice.
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Affiliation(s)
- Samuel Brookfield
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Linda Selvey
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Lisa Maher
- Kirby Institute for Infection and Immunity, University of New South Wales, Sydney, Australia
| | - Lisa Fitzgerald
- School of Public Health, The University of Queensland, Brisbane, Australia
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8
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Wedema D, Siero J, Korevaar EL, Wardenaar KJ, Alma MA, Schoevers RA. Storytelling and training to advance individual recovery skills (STAIRS). A feasibility study of a blended program to support personal recovery among patients with a major depressive disorder in remission. Front Psychiatry 2022; 13:984104. [PMID: 36213919 PMCID: PMC9539704 DOI: 10.3389/fpsyt.2022.984104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/02/2022] [Indexed: 12/03/2022] Open
Abstract
Because major depressive disorder (MDD) has a strong negative impact on patients' lives, well-designed treatment programs are needed that address the lasting effects of MDD. Previous work has shown that such programs should not only focus on symptomatic recovery, but also on the subsequent personal recovery process. Currently, few programs with this specific focus exist. Therefore, this study aimed to assess the feasibility of a newly developed blended program to support the personal recovery process of MDD patients: Storytelling and Training to Advance Individual Recovery Skills (STAIRS). STAIRS is a program using peer support and guidance by experts by experience and clinicians, which can be added to regular depression treatment when symptomatic recovery is almost reached. Topics addressed in this program are: (1) effects of depression and treatment; (2) structure; (3) (self) stigma; (4) self-image; (5) meaning of life; (6) connection to others; (7) physical health; (8) relaxation; and (9) preventing relapse. Experiences with the STAIRS program were collected from five participating patients with questionnaires and a focus-group interview, as well as from four trainers using semi-structured interviews. Participants valued the topics addressed in STAIRS, the used working methods, the presence of an expert by experience and the ability to share experiences with peers. The use of an online platform and the involvement of others is seen as potentially supportive but turned out to be more challenging. Perceived effects of STAIRS include positive changes in participants' daily lives and their contacts with others. Overall, the results indicate that when implemented accessibly, STAIRS is a promising and feasible program to foster personal recovery among patients recovering from MDD.
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Affiliation(s)
- David Wedema
- Research and Innovation Center for Rehabilitation, Hanze University of Applied Sciences, Groningen, Netherlands
| | - Joanieke Siero
- Research School of Behavioural and Cognitive Neurosciences (BCN), Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Eliza L Korevaar
- Research and Innovation Center for Rehabilitation, Hanze University of Applied Sciences, Groningen, Netherlands
| | - Klaas J Wardenaar
- Research School of Behavioural and Cognitive Neurosciences (BCN), Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Manna A Alma
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Robert A Schoevers
- Research School of Behavioural and Cognitive Neurosciences (BCN), Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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9
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Damsgaard JB, Jensen A. Music Activities and Mental Health Recovery: Service Users' Perspectives Presented in the CHIME Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126638. [PMID: 34205491 PMCID: PMC8296349 DOI: 10.3390/ijerph18126638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/04/2021] [Accepted: 06/15/2021] [Indexed: 01/14/2023]
Abstract
Internationally, mental health service developments are increasingly informed by the principles of recovery, and the availability of arts and creative activities are becoming more common as part of provision. Mental health service users' experiences, reflecting on the complex nature of using music participation in recovery are, however, limited. This essay considers literature that explores how music can support mental health service users in a recovery process. We have selected studies that include a broad spectrum of music activities, as well as literature considering various concepts about recovery. The conceptual recovery framework CHIME, that includes five important components in the recovery process, is used as the backdrop for exploring music activities as a contribution to recovery-oriented practice and services in mental health care. Eleven key components are identified in which music can support the recovery process: Feelings of equality; Social and emotional wellbeing; Tolerance; Hope and social agency; Triggering encounters; Redefining and reframing; A social practice; Moments of flow and peak experiences; Moments of meaning; Continuity; and Potentials instead of limitations. This essay concludes that the experiential knowledge of music activities from service users' perspectives is essential knowledge when developing and using music activities in mental health recovery services. While this essay acknowledges that music activities can also produce unintended negative outcomes, the focus is on the positive contributions of music to mental health recovery processes.
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Affiliation(s)
- Janne Brammer Damsgaard
- Research Unit of Nursing and Healthcare, Institute of Public Health, Aarhus University, 8000 Aarhus, Denmark
- Correspondence:
| | - Anita Jensen
- Center for Primary Health Care Research, Region Skåne, 205 02 Malmö, Sweden;
- Department of Communication and Psychology, Aalborg University, 2450 Copenhagen, Denmark
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10
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Penas P, Uriarte JJ, Gorbeña S, Slade M, Moreno-Calvete MC, Iraurgi I. Discrepancy between experience and importance of recovery components in the symptomatic and recovery perceptions of people with severe mental disorders. BMC Psychiatry 2021; 21:277. [PMID: 34059038 PMCID: PMC8168040 DOI: 10.1186/s12888-021-03287-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/13/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Personal recovery has become an increasingly important approach in the care of people with severe mental disorders and consequently in the orientation of mental health services. The objective of this study was to assess the personal recovery process in people using mental health services, and to clarify the role of variables such as symptomatology, self-stigma, sociodemographic and treatment. METHODS Standardised measures of personal recovery process, clinical recovery, and internalized stigma were completed by a sample of 312 participants in a Severe Mental Disorder program. RESULTS Users valued most the recovery elements of: improving general health and wellness; having professionals who care; hope; and sense of meaning in life. Significant discrepancies between perceived experience and relative importance assigned to each of the components of the REE were observed. Regression modeling (χ2 = 6.72, p = .394; GFI = .99, SRMR = .03) identified how positive discrepancies were associated with a higher presence of recovery markers (β = .12, p = .05), which in turn were negatively related to the derived symptomatology index (β = -.33, p < .001). Furthermore, the relationship between clinical and personal recovery was mediated by internalized stigma. CONCLUSIONS An improvement in psychiatric services should be focused on recovery aspects that have the greatest discrepancy between importance and experience, in particular social roles, basic needs and hope. Personal and clinical recovery are correlated, but the relationship between them is mediated by internalized stigma, indicating the need for clinical interventions to target self-stigma.
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Affiliation(s)
- Patricia Penas
- University of Deusto, Avda. de las Universidades 24, 48007, Bilbao, Spain.
| | - Jose-Juan Uriarte
- Biocruces Bizkaia Health Research Institute. Basque Health Service, Bizkaia Mental Health Network, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia Spain
| | - Susana Gorbeña
- grid.14724.340000 0001 0941 7046University of Deusto, Avda. de las Universidades 24, 48007 Bilbao, Spain
| | - Mike Slade
- grid.4563.40000 0004 1936 8868School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - María-Concepción Moreno-Calvete
- Biocruces Bizkaia Health Research Institute. Basque Health Service, Bizkaia Mental Health Network, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia Spain
| | - Ioseba Iraurgi
- grid.14724.340000 0001 0941 7046University of Deusto, Avda. de las Universidades 24, 48007 Bilbao, Spain
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11
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Bellaert L, Martinelli TF, Vanderplasschen W, Best D, van de Mheen D, Vander Laenen F. Chasing a pot of gold: an analysis of emerging recovery-oriented addiction policies in Flanders (Belgium) and The Netherlands. DRUGS: EDUCATION, PREVENTION AND POLICY 2021. [DOI: 10.1080/09687637.2021.1915250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Lore Bellaert
- Department of Special Needs Education, Ghent University, Ghent, Belgium
| | - Thomas F. Martinelli
- IVO Research Institute, The Hague, The Netherlands
- Tranzo Scientific Center for Care and Wellbeing, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | | | - David Best
- Department of Criminology, University of Derby, Derby, UK
| | - Dike van de Mheen
- Tranzo Scientific Center for Care and Wellbeing, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Freya Vander Laenen
- Department of Criminology, Penal Law, and Social Law, Ghent University, Ghent, Belgium
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12
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Evans AM, Quinn C, McKenna B, Willis K. Consumers living with psychosis: Perspectives on sexuality. Int J Ment Health Nurs 2021; 30:382-389. [PMID: 33047501 DOI: 10.1111/inm.12795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/04/2020] [Accepted: 09/14/2020] [Indexed: 12/14/2022]
Abstract
Mental health clinicians work within a recovery framework that is rights based and emphasizes positive and respectful approaches to working with mental health consumers. Mental health nurses' practice is also predicated on holism and inclusiveness, yet consumers' sexuality is sometimes neglected and rights in this area overlooked. Also overlooked is sexuality as an area for investigation, particularly from a consumer perspective, even though it constitutes part of consumers' broader remit of sexual health. This paper reports findings from a case study where consumers were asked about their ability to negotiate and sustain sexual expression while residing in a long-stay mental health rehabilitation facility. There were three main findings. First, the physical space of the facility, inclusive of consumers' bedrooms, was policed by mental health clinicians with ongoing intrusions into consumers' privacy, which inhibited their sexual expression. The creation of barriers to sexual expression is counter to polices that promote recovery. Second, consumers reported significant medication-related weight gain which negatively affected their self-image and sexual sense of self. Third, the consumers spoke about their sexuality in ordinary, everyday language devoid of any hallmark of psychosis. This highlights the importance of relating to consumers about their sexuality and sexual needs from a humane rather than technical framework. Further, it foregrounds the relational aspect of the mental health nurses' role rather than the technical aspect. Yet sexuality is a topic that is often neglected, indicating that an upskilling of the mental health nursing workforce is required, to strengthen communication and relationship skills.
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Affiliation(s)
- Alicia M Evans
- Australian Catholic University, Fitzroy, Victoria, Australia
| | | | - Brian McKenna
- Auckland University of Technology, Auckland, New Zealand.,Auckland Regional Forensic Psychiatry Services, Waitemata District Health Board, Auckland, New Zealand.,Centre for Forensic Behavioural Science, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Karen Willis
- La Trobe University/Royal Melbourne Hospital, Melbourne, Victoria, Australia
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13
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Mathias K, Pillai P, Gaitonde R, Shelly K, Jain S. Co-production of a pictorial recovery tool for people with psycho-social disability informed by a participatory action research approach-a qualitative study set in India. Health Promot Int 2020; 35:486-499. [PMID: 31098623 DOI: 10.1093/heapro/daz043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Mental health problems are recognized as a leading cause of disability and have seen increased allocations of resources and services globally. There is a growing call for solutions supporting global mental health and recovery to be locally relevant and built on the knowledge and skills of people with mental health problems, particularly in low-income countries. Set in Dehradun district, North India, this study aimed to describe first, the process of co-production of a visual tool to support recovery for people affected by psycho-social disability; second, the key outputs developed and third, critical reflection on the process and outputs. The developmental process consisted of participatory action research and qualitative methods conducted by a team of action researchers and an experts by experience (EBE) group of community members. The team generated eight domains for recovery under three meta-domains of normalcy, belonging and contributing and the ensuing recovery tool developed pictures of activities for each domain. Challenges to using a participatory and emancipatory process were addressed by working with a mentor experienced in participatory methods, and by allocating time to concurrent critical reflection on power relationships. Findings underline the important contribution of an EBE group demonstrating their sophisticated and locally valid constructions of recovery and the need for an honest and critically reflective process in all co-productive initiatives. This study generated local conversations around recovery that helped knowledge flow from bottom-to-top and proposes that the grass-root experiences of participants in a disadvantaged environment are needed for meaningful social and health policy responses.
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Affiliation(s)
- Kaaren Mathias
- Landour Community Hospital, Mussoorie, Uttarakhand 248179, India
| | | | - Rakhal Gaitonde
- Department of Public Health and Clinical Medicine, Umea University, Sweden
| | | | - Sumeet Jain
- School of Social and Political Science, University of Edinburgh, UK
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14
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Charles A, Thompson D, Nixdorf R, Ryan G, Shamba D, Kalha J, Moran G, Hiltensperger R, Mahlke C, Puschner B, Repper J, Slade M, Mpango R. Typology of modifications to peer support work for adults with mental health problems: systematic review. Br J Psychiatry 2020; 216:301-307. [PMID: 31992375 DOI: 10.1192/bjp.2019.264] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Peer support work roles are being implemented internationally, and increasingly in lower-resource settings. However, there is no framework to inform what types of modifications are needed to address local contextual and cultural aspects. AIMS To conduct a systematic review identifying a typology of modifications to peer support work for adults with mental health problems. METHOD We systematically reviewed the peer support literature following PRISMA guidelines for systematic reviews (registered on PROSPERO (International Prospective Register of Systematic Reviews) on 24 July 2018: CRD42018094832). All study designs were eligible and studies were selected according to the stated eligibility criteria and analysed with standardised critical appraisal tools. A narrative synthesis was conducted to identify types of, and rationales for modifications. RESULTS A total of 15 300 unique studies were identified, from which 39 studies were included with only one from a low-resource setting. Six types of modifications were identified: role expectations; initial training; type of contact; role extension; workplace support for peer support workers; and recruitment. Five rationales for modifications were identified: to provide best possible peer support; to best meet service user needs; to meet organisational needs, to maximise role clarity; and to address socioeconomic issues. CONCLUSIONS Peer support work is modified in both pre-planned and unplanned ways when implemented. Considering each identified modification as a candidate change will lead to a more systematic consideration of whether and how to modify peer support in different settings. Future evaluative research of modifiable versus non-modifiable components of peer support work is needed to understand the modifications needed for implementation among different mental health systems and cultural settings.
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Affiliation(s)
- Ashleigh Charles
- Research Assistant, School of Health Sciences, Institute of Mental Health, University of Nottingham, UK
| | - Dean Thompson
- Research Fellow, Institute of Applied Health Research, University of Birmingham, UK
| | - Rebecca Nixdorf
- Research Assistant, Department of Psychiatry, Universitätsklinikum Hamburg-Eppendorf, Germany
| | - Grace Ryan
- Research Fellow, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, UK
| | - Donat Shamba
- Researcher, Department of Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Tanzania
| | - Jasmine Kalha
- Centre for Mental Health Law and Policy, Indian Law Society, India
| | - Galia Moran
- Senior Lecturer, Faculty of Humanities and Social Science, Ben Gurion University of the Negev, Israel
| | | | - Candelaria Mahlke
- Researcher, Department of Psychiatry, Universitätsklinikum Hamburg-Eppendorf, Germany
| | - Bernd Puschner
- Professor, Department of Psychiatry II, Ulm University, Germany
| | | | - Mike Slade
- Professor of Mental Health Recovery and Social Inclusion, School of Health Sciences, Institute of Mental Health, University of Nottingham, UK
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15
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Matejkowski J, Severson ME. Predictors of shared decision making with people who have a serious mental illness and who are under justice supervision in the community. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2020; 70:101568. [PMID: 32482304 DOI: 10.1016/j.ijlp.2020.101568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 06/11/2023]
Abstract
Shared decision making (SDM) can be an effective method for promoting service involvement among persons with serious mental illness (SMI). This survey study sought to identify predictors of positive attitudes toward the use of SDM with people with SMI who are living under probation and parole supervision. Supervising officers' (n = 291) perceptions of the capabilities of supervisees with SMI to contribute to their supervision plans, and their familiarity with recovery-oriented mental health services, were positively associated with attitudes toward using SDM. Training officers in common human goals and mental health recovery may advance SDM with supervisees with SMI.
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Affiliation(s)
- Jason Matejkowski
- The University of Kansas School of Social Welfare, 1545 Lilac Lane; 201 Twente Hall, Lawrence, Kansas 66045, United States of America.
| | - Margaret E Severson
- The University of Kansas School of Social Welfare, 1545 Lilac Lane; 201 Twente Hall, Lawrence, Kansas 66045, United States of America.
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Abstract
OBJECTIVES Our aim was to develop a framework for clinical decision-making that can be used to take into account risk in an era of recovery and rights. CONCLUSION We developed a framework influenced by civil liability law to develop a guide for clinical decision-making which emphasises collaboration, clarification of the available information and communication of decisions as essential components of recovery-oriented risk management.
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Affiliation(s)
- Andrew Carroll
- Associate Professor (Adjunct), Centre for Forensic Behavioural Science, Swinburne University of Technology, Melbourne, VIC, and; Honorary Senior Fellow, University of Melbourne, Melbourne, VIC, and; Consultant Forensic Psychiatrist, Forensicare, Melbourne, VIC, Australia
| | - Bernadette McSherry
- Professor of Law and Foundation Director, Melbourne Social Equity Institute, University of Melbourne, Melbourne, VIC, Australia
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Abstract
SummaryWe consider key facets of the concept of mental health recovery and how they are reflected in other concepts that run through the emerging focus on public mental healthcare. We widen the scene to portray the niche into which recovery fits and show how it and recent research indicate why psychiatrists should use the social sciences more widely to complement neuroscience.
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Abstract
SummaryProfessional practice explicitly focused on supporting the recovery of those it serves is broadly backed by an emerging profile of necessary knowledge, key skills and innovative collaborations, although there is no universally accepted practice ‘model’. This article outlines these components and discusses the associated need for change in the culture of provider organisations along with implementation of wider social and economic policies to support peoples' recovery and social inclusion. This is a values-led approach supported by persuasive advocacy and international endorsement but still in need of further development, systematic evaluation and confirmatory evidence.
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McCaffrey T. Evaluating music therapy in adult mental health services: Tuning into service user perspectives. NORDIC JOURNAL OF MUSIC THERAPY 2017. [DOI: 10.1080/08098131.2017.1372510] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Tríona McCaffrey
- Irish world Academy of Music and Dance, University of Limerick, Limerick, Ireland
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20
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Söderström O, Söderström D, Codeluppi Z, Empson LA, Conus P. Emplacing recovery: how persons diagnosed with psychosis handle stress in cities. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2017. [DOI: 10.1080/17522439.2017.1344296] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Ola Söderström
- Institute of Geography, University of Neuchâtel, Neuchâtel, Switzerland
| | | | - Zoé Codeluppi
- Institute of Geography, University of Neuchâtel, Neuchâtel, Switzerland
| | - Lilith Abrahamyan Empson
- Treatment and Early Intervention in Psychosis Program(TIPP), Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Clinique de Cery, Prilly, Switzerland
| | - Philippe Conus
- Treatment and Early Intervention in Psychosis Program(TIPP), Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Clinique de Cery, Prilly, Switzerland
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21
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McSherry B. Regulating seclusion and restraint in health care settings: The promise of the Convention on the Rights of Persons with Disabilities. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2017; 53:39-44. [PMID: 28595808 DOI: 10.1016/j.ijlp.2017.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 04/29/2017] [Accepted: 05/11/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Bernadette McSherry
- Melbourne Social Equity Institute, University of Melbourne, 201 Grattan Street, Carlton, Vic 3056, Australia.
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22
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Cusack E, Killoury F, Nugent LE. The professional psychiatric/mental health nurse: skills, competencies and supports required to adopt recovery-orientated policy in practice. J Psychiatr Ment Health Nurs 2017; 24:93-104. [PMID: 27860051 DOI: 10.1111/jpm.12347] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2016] [Indexed: 12/01/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Nationally and internationally there has been a movement away from the traditional medical model towards a more holistic recovery-oriented approach to mental health care delivery. At every level of service provision the emphasis is firmly on recovery and on facilitating active partnership working and involvement of service users, their carers and family members. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to identify on a national level specific areas of care that are addressed most or least by psychiatric and mental health nurses in care planning for mental health service users in Ireland. In addition, this is the first study to identify nationally how the recovery approach is being implemented by psychiatric and mental health nurses in relation to current recovery-orientated policy. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental healthcare staff require more education on the recovery concept and this needs to be multidisciplinary team wide. Further research is required to establish how best to develop a shared approach to working with service users and their families within the mental healthcare environment. Further investigation is required to help determine how funding could be allocated appropriately for education and training and service development nationally. ABSTRACT Introduction The restructuring of national mental health policy to an integrated recovery ethos demands a clarification in the psychiatric/mental health nurse's role, skills and competencies. Aim/Question To explore the psychiatric/mental health nurse's role and identify skills, competencies and supports required to adopt recovery-orientated policy in practice. Method An exploratory mixed methods study in multiple health services in Ireland with N = 1249 psychiatric/mental health nurses. Data collection used a survey, focus groups and written submissions. Data analysis used descriptive statistics and thematic analysis. Results The medical profession use a symptom-focused approach to mental healthcare delivery. Nurses viewed this as a primary inhibitor to recovery-orientated practice. Professional development in prevention and earlier intervention within primary care environments requires development. Nurses require research support to measure the effectiveness of the mental health interventions they provide. Implications and conclusion The effective implementation of the recovery approach requires a multitude of strategies and narrative threads in an overall medical assessment. Nurses need support from medics in providing consistency of assessments/documentation of required psychosocial interventions. A greater range of specialist services provided by nurses including psychosocial interventions and health promotion is fundamental to quality care and improving service user outcomes in primary care.
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Affiliation(s)
- E Cusack
- HSE, Dublin North, Quality and Clinical Care Directorate, Swords, Dublin, Ireland
| | - F Killoury
- Department of Psychiatry, University Hospital Limerick, Limerick, Ireland
| | - L E Nugent
- RCSI School of Nursing & Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
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23
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Stuart SR, Tansey L, Quayle E. What we talk about when we talk about recovery: a systematic review and best-fit framework synthesis of qualitative literature. J Ment Health 2016; 26:291-304. [DOI: 10.1080/09638237.2016.1222056] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Simon Robertson Stuart
- Clydesdale Psychological Therapies Team, NHS Lanarkshire, Carluke, UK,
- Clinical Psychology, NHS Lothian, Edinburgh, UK, and
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, UK
| | - Louise Tansey
- Clinical Psychology, NHS Lothian, Edinburgh, UK, and
| | - Ethel Quayle
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, UK
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Abstract
This study focused on resilience in patients who recently received a diagnosis of schizophrenia spectrum disorder (SSD). Psychopathological symptoms, depressive symptoms, and hopelessness were considered as sources of stress in the context of psychosis. Forty-eight SSD patients (mean period between diagnosis and recruitment, 20.79 months) were enrolled. Psychopathological symptoms were assessed by the Positive and Negative Syndrome Scale, depression by the Calgary Depression Scale for Schizophrenia, hopelessness by the Beck Hopelessness Scale, and functioning by the Social and Occupational Functioning Scale. Resilience was evaluated by the Connor-Davidson Resilience Scale, which was additionally completed by 81 healthy controls. Patients demonstrated less resilience than did healthy participants. Female patients showed higher resilience levels and functioning than did males. High resilience levels were associated with less severe positive symptoms, general psychopathological symptoms, depression, and hopelessness. Apart from negative symptoms, results indicated that resilience may be a potential moderator of functioning. Thus, resilience-oriented interventions might constitute an additional therapeutic approach for SSD patients.
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25
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Winship G. A meta-recovery framework: positioning the 'New Recovery' movement and other recovery approaches. J Psychiatr Ment Health Nurs 2016; 23:66-73. [PMID: 26799056 PMCID: PMC4991289 DOI: 10.1111/jpm.12266] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- G Winship
- School of Education, University of Nottingham, Jubilee Campus, Nottingham, NG2 5BY, UK
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López Alvarez M, Laviana Cuetos M. La coordinación sociosanitaria en la atención a personas con trastornos mentales graves. ENFERMERIA CLINICA 2016; 26:61-7. [DOI: 10.1016/j.enfcli.2015.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 08/30/2015] [Indexed: 11/26/2022]
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