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When I’m not PhD-ing I’m often covered in paint. Recently, I gifted two paintings to the ‘crisis house’ that helped me and held me together earlier this year. Today, I received the most unexpected of thank you cards from the house. It was one of those game changing, reflective moments and I very nearly tweeted about it. Why? Because I work in self-harm and suicide prevention and I think that the ‘crisis house’ (which I maintain is an odd term to use to describe places of sanctuary and support) does a fantastic job.  Because hope is possible and hope is here. Because small things can make a huge difference and small acts of kindness can change your day and change your world. Because I tweet most everything and why should this be different?

But it is different.

It is a disclosure and talking about mental health as an Early Career Researcher (ECR) is not a neutral act. Depending on who you talk to it is either brave or foolish, but never neutral. Even as someone who is directly and indirectly relatively open about her history, I am aware that writing it down is a gamble. But I don’t want to work in a world where it is only acceptable to talk about lived experience in the past tense. Or where it is too much of a gamble to do unless you already have your tenure position and an established reputation. How can we meaningfully encourage others to talk about suicidality when we still live in a culture where we don’t talk about it ourselves? In many ways, I live in a very privileged world. I work in a lab that is passionate about involvement, engagement and the value of lived experience and sees no reason why this would not apply to the whole team. I have an incredibly supportive supervisor who I can be very honest with. My mental health has never been a secret and I am respected for who I am and what I bring - no more, no less. Above and beyond, I have colleagues who will visit me in hospital and deal with important emails when I’m out of Wi-Fi range. I have collaborators who send support (animal GIFs and postcards) and mentors who mean it when they tell me to prioritise my health and stay well. In short, my world is full of ‘good guys’.

But disclosure is still a risk.

I know it is a risk because I’ve felt it. I’ve dealt with the judgement from Healthcare professionals when I have told them about what I study and, with guidance, I’ve navigated satisfying the additional requirements needed to get back to the PhD that I love. I’ve handled being asked at an international conference if I ever felt ‘a fraud’ as a researcher, given my lived experience. Sure, at the time, I came out with something strikingly coherent about spheres of expertise, but it shook me. It really shook me and it made me question whether there was a space for me in academia. No one should be made to feel that. I shouldn’t still feel as though I have to work twice as hard as my peers as I have something to ‘make up for’. I shouldn’t feel the pressure of how to explain the periods of absence from my PhD at job interviews. If I had been physically unwell there wouldn’t be a problem in explaining; this would not be a conundrum. Within a field that should be informed and understanding, when it comes to mental health there remains a question mark around how open to be. A question mark and a lot of silence.

And that is part of the problem. For as long as we go on leaving the silence unchallenged, people will internalise it. I’m guilty of this myself. When planning my research fellowship last year, I selected dates based on temperature. Yes, New England is beautiful in ‘the fall’. I got to experience Halloween, Thanksgiving and the US Elections. I got to go to the Association for Behavioral and Cognitive Therapies (ABCT) Convention and the Harvard Vs. Yale football game. These were all awesome features of the Autumn, but they weren’t why I chose that semester to travel. I chose the Autumn semester for ease of covering up.

I think if you had asked me at the time why that mattered, I would have said because I want the choice to disclose or not. And 100% I think everyone has the right to make that choice. For me though, I think it is closer to the truth that I wanted to be seen as a researcher first and foremost - as if lived experience somehow challenged that. And this is the problem. This is the underlying hum that I think needs to change.

As researchers we frequently quote prevalence statistics, yet I wonder who we think they refer to, if not ourselves as well. There is no simple ‘us’ and ‘them’.  At best, expertise and experience is a Venn-diagram, arguably with a decent sized overlap. There are lots of us with lived experience – who have had thoughts of harming, who have harmed or made attempts, who care for someone affected and/or who have lost someone to suicide. We all wear many hats and we shouldn’t be afraid to acknowledge that. Research is richer for having input from multiple perspectives. Research communities are too. Just as we want to educate people that is it okay to talk and that experiencing suicidal thoughts is not that uncommon, we need to turn the spot light back on ourselves. I think we need to consider why we collectively aren’t able to support a culture in which academics, particularly ECRs, feel freely able to raise their hand and say ‘me too’. I was once asked why I spend my time painting when 'painting is never going to save the world'. At the time I shrugged and said ‘it might’, but in all honesty my painting won’t. Painting sure hasn't saved me, but it has helped me to rediscover a version of myself that I deem worth saving. For me, painting is authentic and authenticity is transformative. I think if we could all be a little more authentic – with ourselves, with our colleagues, with our social media presence. If we could all do that, maybe that would start to change our worlds. From here there is hope.

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Emma Nielsen (@EmmaLNielsen) is a PhD student in the Self-Harm Research Group (SHRG), School of Psychology (This email address is being protected from spambots. You need JavaScript enabled to view it.) and an Associate Fellow of the Institute of Mental Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If you need someone to talk to, Samaritans are available round-the-clock (and free to contact) on 116 123 (UK & ROI) or This email address is being protected from spambots. You need JavaScript enabled to view it..

 

We are holding a free event at Nottingham Contemporary on 23^rd July 6-8.30 pm where we will be discussing innovative work that the Self-Harm Research Group (University of Nottingham) have being doing with Harmless and young people on finding new ways to talk about self-harm and eating issues. You will hear from a range of people about the project and hear performances from spoken word artists.

See details below.

Spaces are limited so you need book here: https://tinyurl.com/cafeconnect-SHRG Refreshments will be provided.

Comments on the vacuum in Social Care Since the 1959 Mental Health Act: Then and Now

 
Having unexpectedly arrived well into my ‘eighties,’ it seems timely to reflect on my personal experience of the mental health arena, past and present.

In May 1959, when I opened the doors of Lancaster Lodge, Richmond, it was with the aim of providing a place which would nurture and respect people who had nowhere decent to go on leaving mental hospital. Yet, what seemed to me to be an obvious response to need, did not commend itself to those from whom support might have been expected and I found that not a soul was willing to back me.

For a start, I was a foreigner whose credentials were highly suspect! I was a Divinity student from Holland who had come equipped “merely” with three years’ relevant training (and – more important - three years practical work, mostly as leader/carer of a group of adolescents, and as the so-called practical work supervisor of the 1^st year Psychology students) at the Paedologisch Instituut of the Free University (Amsterdam). Following this I had completed a three year nursing training which was accepted in the U.K. and which qualified me as a State Registered Nurse. This was in addition to the experience gained through the stresses endured by my whole family during the War years! I learned to cope with the constant dangers of Nazi-occupied Holland, and to assist my mother in finding the means of survival not only for her nine children but also for a succession of illegal refugees from Germany and from the Dutch west coast.

Furthermore, in 1959 it was considered dangerous and irresponsible to create, in an ordinary house in an ordinary street, a Therapeutic Community for people who had been     “Inmates” in mental hospitals. For a number of years, TCs had in fact existed in an army unit for traumatised soldiers and as specialised units in a number of mental hospitals, but even there they were often looked on with suspicion or scorn by other staff, who considered it “asking for trouble” to employ democracy and peer support with patients who were considered incapable of understanding and supporting one another.

And, of course, my project was not plain sailing, and that first year in Richmond was full of challenges. My fellow house-mates – some of whom had been discharged by the Cassel Hospital as “unsuitable for treatment”- came with strong dependency needs and, in some instances, with well-developed powers of manipulation! Our initial group meetings were focussed on me, and I came under pressure to accept the role of mother, nurse, cleaner, bread-winner - even mistress. It took several months and some tremulous perseverance on my part, before we had formulated, and agreed, a workable way of living together and of respecting boundaries, with the aim of enabling the recovery and independence of each person. All of which was a challenge and a steep learning curve for myself, as well as for my house mates.

However, having sat in on the debates in Parliament on what was then the Mental Health Bill 1959, I saw the danger of mini-institutions being created. These would tend to be staffed by those who, for want of specialist training would perpetuate patterns of care based on the long-term institutionalised concept of “mental patients” and their needs. Eager to avoid that trap, I chose to start from an assumption of shared “normality”, and from this to explore what was needed on the basis of our common experience. Yet, despite my wish to be on an equal footing with my fellow residents, an important principle emerged quite soon: I could not just be a member of the Community on a par with the others. Although there was amongst the residents a true spirit of care for one another, I was there to provide what others had come to receive, and willy-nilly I had to modify my definitions of my role and input. There was no escape!

Nor was I left in peace by the outside world. I was threatened with deportation when the Home Office (at the request of an organisation with an ostensibly similar remit) questioned my right to set up my small community. The objection raised was that, as a foreign student, I had neither a work permit nor permission to operate a service. I was able, however, to counter this by demonstrating that I had sat my Intermediate Batchelor of Divinity (with excellent results!) and was registered with London University. I had no position or salary for any activities and was merely sharing my home with free citizens who, on leaving mental hospital, had chosen to share my house with me. I conducted my own defence – successfully – and have since found that most issues which tend to be referred to a lawyer can in fact be resolved in person if one takes time to study the details and record them appropriately.

Meanwhile, the experience of the residents’ Psychiatrists, on the basis of their (typically) fifteen-minute monthly sessions, was that their patients showed substantial improvement, and that this appeared to be associated with the process of receiving help from, and of contributing to, the wellbeing of their fellow residents.

From this small and largely informal beginning, a more structured organisation began to be formed. An increasing number of psychiatrists formally referred residents, and the capacity of Lancaster Lodge, plus the surrounding flats which I had rented, could not accommodate more people. Fortunately, Surrey Local Authority promised 50 % funding for an additional building which was eventually found in East Molesey. As the Organisation grew, we held senior staff meetings to articulate and to commit to paper the principles and practice of our group life.

The evident benefits of the carefully debated and designed T.C. with its clear principles, practices and boundaries, became widely recognised, and resulted in a demand for such a resource from many parts of the UK. Subsequently demand grew from other developed countries, and also from countries whose mental health services were either non-existent or at a very primitive stage. The WHO requested a handbook that could be universally accepted and before the seventies a comprehensive manual existed that did not provide precepts so much as concepts.

The extension of therapeutic provision overseas naturally involved a whole new stage of this work. In each country a reliable and capable Board of Trustees needed to be appointed, and positive relationships built up with Governments, universities, churches and secular bodies. Prospective Managing Directors needed to be identified, who would then train in the UK - a training designed to enable them to translate their newly acquired expertise to their own country and culture. It was doubtless due to the fact that the time was ripe for the TC model - which recognises the potential in people to respond to being valued and validated – that this model became quickly recognised for its universal effectiveness and relevance. Such was the level of support, both from Governments and the community, that there now exists a worldwide group of Affiliates and Associates who have ongoing professional links as well as affectionate personal bonds with many of us in “ the old country.”

In 1959 - our first year of operation - I started our training function by organising a monthly meeting between clergy and doctors to explore mental health issues, and especially to consider how to be pro-active and how to respond to crisis needs. Our sessions always included our staff and from their participation it became clear that, although the majority came with professional degrees, they needed specific and relevant training in how to provide leadership in the TC, how to understand its group dynamics, and how to create a truly healing community in which members could develop the courage to be open and the ability to become sensitive to the feelings and rights of others. My next step, therefore, was to expand our training activities and, in 1966, to create a College providing enhanced training facilities for our staff, who had already been training on a one day per week basis as part of their employment contract. The College was then able to extend this programme to provide courses for the staff of Local Authorities and Charities, and to launch group dynamics “experiences” – not only for our own staff but also for those in leadership roles in, for example, schools, social services, and the Church. The external training was funded by the bodies involved, but the training of our staff had to be funded by ourselves – an expensive item for our budget, but worth every penny as far as the benefit for residents was concerned. A knock-on effect, of great benefit for the staff, was that they acquired skills which were welcomed widely in Universities and Social Services posts.

THAT WAS THEN; BUT WHAT OF NOW?

Today the papers are full of neglect and abuse of the elderly – which sadly, it appears, continues and worsens despite this publicity. Children have a somewhat better deal and, when they are neglected or ill-treated, the sadness and shame of it never leaves the headlines. But what about mentally ill adults of working age?

They were promised, in the July 1959 Mental Health Act and subsequently, a better deal – better alternatives to the large institutions, relevant care, opportunities to regain a full life - but where are the alternatives and where are the resources? Many are deprived of timely help, and many are at risk, wretched and desperate – not only outside the hospital but also within it, since available funding has been put into other needy parts of the Health Service, leaving precious little for therapy and therapeutic activities.  And on leaving hospital (usually still struggling to cope) there are not the means to devote to relevant aftercare resources, and to address the problems that have in the past defeated them. A recurring consequence is the “revolving door” which too often follows discharge, i.e. a speedy re-admission to the hospital ward, which itself is critically short of beds and severely restricted in its resources. This is a pattern which is far more costly than a Therapeutic Care Home which can provide a “bridge” between hospital and community. The well-run therapeutic community has the best means to help those who feel defeated and alienated. It has the potential to restore self-respect and to nurture the ability to enter into a positive relationship with self and others.

However, the problem of lack of relevant care is not just the result of cut-backs: it derives also from short sightedness - a lack of recognition of the most essential elements of relevant intervention, and of planning and co-ordination – usually on the part of Government and of hard-pressed or uninformed Local Authorities. The tragic result is that modestly priced community rehabilitation resources remain underused and/or underfunded whilst those in desperate need are being deprived of relevant help and all too frequently return, again and again, to costly and over-subscribed hospitals, with a lessening of hope at every stage or, alternatively, giving up the struggle altogether.

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Elly Jansen founded the Richmond Fellowship in 1959 and directed it for 32 years. The fellowship is now one of the largest voluntary sector providers of mental health support services in England.

You can find more information about the fellowship here

Summary
In partnership with the Institute of Mental Health Peer Support Education Team, students and staff at the University of Nottingham’s School of Health Sciences are launching a brand new initiative to support the mental health and wellbeing of students studying within the school.

In recognition of the specific challenges faced by people studying to be healthcare professionals, the ‘Bridge Network’ is being created. The network aims to set up peer support groups led by student peer facilitators; meeting with each other and providing a safe space to gain support and talk about mental health.  Peer facilitators will receive accredited training and supervision for this role.

Students are at the heart of this project and the network will be developed and run by student peers from the School of Health Sciences who themselves have experienced mental health challenges.

 
Background and Plans for the Project
The number of students who experience mental distress is increasing and universities are having to develop new and innovative ways to support these students.  Healthcare courses involve working in health care settings which can place additional pressures on students in terms of hours, assessments, professional body requirements and the emotional strain that comes with healthcare work.  In light of this, the Bridge Network is a student-led initiative designed to meet the needs of this student group.

The network will not only allow students to share experiences, but will equally provide a space for students to support one another, to increase their self-confidence, to build connections and gain a sense of belonging; supporting students to maximise their achievements at University.

Sabrina Carter is a final year BSc Mental Health Nursing student who has increasingly worked alongside a number of peers who have experienced or continue to experience mental health difficulties. One thing that has become apparent to her over the years is the need for a comfortable and supportive space for health science students to come together to talk about mental distress in a way that empowers each and every individual.

Dr Anne Felton, an Associate Professor in Mental Health, has worked in mental health nursing for 15 years. She has seen the successful growth of peer support approaches in health care; involving people with their own experience of mental distress using these experiences to challenge stigma and positively impact on others.  She has worked in alongside Sabrina to create the plans for the Bridge Network.

The University of Nottingham Cascade Fund has pledged £6,000 towards the initiative if the Network can raise £1,000 through Jumpstart, the University’s crowdfunding platform.

The money raised will go towards providing;

• Five day accredited training programmes for student peer support facilitators
• Peer support student learning guides
• Peer support training resources
• Provision of supervision for network facilitators
• Conference fees for two students to attend a national conference to present the project

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If you would like to make a donation to support this fantastic project, please follow the link to our crowdfunding page: https://jumpstart.hubbub.net/p/thebridgenetwork/
For more information, please contact:

Anne Felton     This email address is being protected from spambots. You need JavaScript enabled to view it.
Sabrina Carter This email address is being protected from spambots. You need JavaScript enabled to view it.

What is peer research?

Peer research involves patients and carers helping academics to carry out research, through providing input into how research is designed, conducting interviews and focus groups, and helping to disseminate the findings. Patients and carers bring their lived experience to the project, and coupled with research skills, helps us to conduct research in a way that adds a rich level of insight and sensitivity. In our project, we are conducting focus groups with NHS staff, carers, and patients who have , and we’re asking people with dementia and carers of people with dementia to help us to facilitate these groups.

 

Why is it important?

In our project, we are looking into the way that care is provided to people with dementia who experience a mental health crisis.To explore this we are conducting interviews and focus groups with members of NHS staff, carers of people with dementia who have used crisis services, and people with dementia themselves. The stories that we ask our participants to tell can involve times of distress and sensitive topics, and involving peer researchers to help us to ask the questions helps our participants to feel comfortable, safe, and valued; enabling them to open up and engage in way that is less formal.

There are benefits for anyone who is a peer researcher too, as our peer researchers are able to learn new skills, and put existing skills to new uses. Being a peer researcher can be a rewarding experience by being able to help other people in a similar situation tell their story in a sensitive way.

We also hope that for participants who have dementia, seeing a peer researcher with dementia taking such an active role in a research project will prove inspiring, and will help to reduce stigma by showing that a diagnosis of dementia does not exclude people from such activities.

 

Progress so far

We held two training events for people with dementia and carers of people with dementia to learn about what peer research is, what our project is about, and exactly how to do the research activities that we will be doing. I led the training in collaboration with a lady called Sheena*, who has experience of being a peer researcher on projects investigating secure forensic settings. So far we have had 15 people attend the training, most from the local area but with a few travelling from further afield.

On the first training event we had a smaller group, and discovered that several of the group had been somewhat miss-sold the day through an error in communication, thinking that they were attending to learn more about dementia! However, after some explanation, we were back on track and the group were thoroughly interested in what we were doing, and were very keen to take part. There was a mixture of lived experiences amongst the group, which made for some interesting conversations. Towards the end of the training we had a practice run at doing a focus group, and one of our peer researchers helped me to co-facilitate it. Another member of the group commented that he felt a lot more comfortable having a peer researcher there to direct his answers to.

Our second training event was a much busier affair with a larger group, and again we had a variety of lived experiences amongst the group, as some members of the group had dementia, and some were carers. We had a lot of insightful questions: for example some peer researchers were concerned that hearing someone else’s story might set them back by highlighting what situations might happen to them in the course of their dementia journey, and we reassured our peer researchers that part of our job as academic researchers is to support them. We also highlighted the exercise books given as part of the training, which we hope our peer researchers will use to reflect upon their experiences of working with us to co-facilitate the focus groups by recording their thoughts and feelings before and after the discussions. Another peer researcher worried that she might lose her words during the discussion because of her dementia, and we reassured her that she would be helping us to co-facilitate a focus group with other people who also had dementia, who would understand if she lost her words, and would hopefully feel reassured at her presence if they were struggling with their own words.

I can definitely say that there was a real buzz and enthusiasm during the training events, and our peer researchers were very keen to get started. We explained exactly what will happen on the day of each focus group clearly and simply and checked with everyone that they understood the process, and once everyone had got the hang of it our peer researchers felt confident that they could do it.

 

Reflections

I was absolutely delighted with how enthusiastic our peer researchers were, firstly about learning a new skill, and then being keen to put it into practice. Our peer researchers understood the challenges associated with conducting research but were happy to give it a go, with one peer researcher saying ‘throw me in at the deep end!’

The insights that Sheena brought to the training from her own experience of being a peer researcher were hugely valuable and inspirational to our peer researchers. I couldn’t have communicated what it is like to be a peer researcher, or inspired such interesting discussions amongst our peer researchers without Sheena, and she really helped to put our new peer researchers at ease.

 

Going forwards

We have already completed several focus groups, which have each been co-facilitated by a member of our research team and a peer researcher, and I’m delighted to say that they have been a resounding success. Our peer researchers have asked some very insightful questions and really helped to sum up what was being said and reiterate key points, and I’m confident that this has thoroughly enriched our data.

We have more focus groups booked in and are matching our peer researchers to focus groups in terms of the types of participants to ensure that we draw on the relevant lived experiences of peer researchers.

We are asking our peer researchers to reflect on their experiences and share these reflections with us so that we can improve how we do things and continue to ensure that the experience of being a peer researcher is a positive one. We will also be putting together further blogs, tweets, and research papers detailing our work in this area to share what we are learning, and inspire others to involve people with dementia and people who care for someone with dementia in similar ways.

 
*Sheena gave her permission for Aqueduct to blog about our activities

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Dr Jen Yates is a Research Fellow in the Division of Psychiatry and Applied Psychology, University of Nottingham. Jen’s research interests focus on the health and well-being of older people who experience difficulties with their cognitive functioning, and how health services operate in the care of older people. Jen also enjoys gardening, baking cakes and going out for the afternoon on her bicycle.

Get in touch by email (This email address is being protected from spambots. You need JavaScript enabled to view it.) or Twitter (@jenniferayates).

To find out more about Project Aqueduct by getting in touch via email: This email address is being protected from spambots. You need JavaScript enabled to view it. or on Twitter: @AqueductIMH

 
 
 

We are delighted to announce the publication of a new book titled Mental Health Uncertainty and Inevitability: Rejuvenating the Relationship between Social Science and Psychiatry, edited by Dr Hugh Middleton and Dr Melanie Jordan. The book celebrates the interdisciplinary doctoral work and supervision of scholars from the School of Sociology and Social Policy, School of Health Sciences and Institute of Mental Health, University of Nottingham. The book offers original knowledge, debate and understanding from frontline fieldwork data and the relations between mental health difficulties, mental healthcare provision and social theory. Over nine chapters, key questions and discussions examine:

• A Symbolic Interactionist Approach to Mental Health Assertive Outreach – Dr James Roe
• The Role of Everyday Interaction Rituals Within Therapeutic Communities – Dr Jenelle Clarke
• The Dementia Experience: Sociological Observations on the Construction of Cognition in Care Homes – Dr Kezia Scales
• “The Will’s There and the Skill’s There”: Prison Mental Healthcare – Dr Melanie Jordan
• Institutional and Emotion Work in Forensic Psychiatry: Detachment and Desensitisation – Dr Ada Hui
• Community Mental Health Teams: Interacting Groups of Citizen-Agent? – Dr Hugh Middleton
• Handling Role Boundaries: A Basic Social Process Underpinning Decision-Making in Mental Health Teams – Dr Melanie Narayanasamy

Andrew Grundy, current PhD candidate in the School of Health Sciences, in the foreword to the book, wrote: “I commend this book to the field of mental health and illness and encourage scholars, clinicians, service users, and carers to read and consider its contents. It represents a timely, apt and worthy contribution to both psychiatry and social science. This book will obviously be of benefit to anyone interested in social theory as it presents novel applications of existing sociological theories; it will also help clinicians to step back and consider the social context in which they are working and the impacts that it can have on their practice. But it is my hope that this book will also be of benefit to mental health service users (and their carers) as they consider their social identity and what they want to get out of the services that they choose to use.” Praise for the book has come from renowned leaders and scholars within this field. Brigitte Nerlich, Professor of Science, Language and Society, University of Nottingham writes: “It is refreshing to see contributions by young and emerging social science writers grappling with cutting edge issues that transgress disciplines and academic cultures. Their findings should make academic and non-academic readers alike think afresh about mental health as an issue not only of medicine and medication but of culture and socialisation. Most importantly, the book makes us all think about whether it is possible or desirable to take refuge in biomedical certainty alone when dealing with mental health issues.” Anne Rogers, Professor of Health Systems Implementation, University of Southampton, Author of A Sociology of Mental Health and Illness states: “Scholarly work undertaken by up and coming social scientists working in the area of social science applied to mental health.  The novelty of these interesting contributions lies in the concern to link social science theory, concepts and methods to the various settings and places within which mental health is managed thought about and enacted.   This collection which provides excellent insights into contemporary mental health matters demonstrates the opportunities and possibilities  that  mental health service settings can provide for  conducting  exciting social science research.” Michael West, Senior Fellow, The King's Fund and Professor of Organizational Psychology, Lancaster University:  “This collection offers powerful insights into the ways in which social science research can help us understand how to develop mental health services to ensure high quality, continually improving and compassionate care. It reveals also the rich field of opportunities for research that the study of mental health services offers for researchers. The contributors are all practitioners with social science research training and their commitment, wisdom and compassion shine through the content.” ……………………………………………………………………………………………………………………

A panel discussion will be held to mark the launch of this book on 30th June 2017, 1-3pm, C11, Portland Building, University Park: https://mentalhealthuncertaintyandinevitability.eventbrite.co.uk Further information about the book can be found on the publisher’s website: https://www.palgrave.com/de/book/9783319439693 This post was prepared by Dr Ada Hui, Assistant Professor at the School of Health Sciences, University of Nottingham. Ada has particular interests working with disenfranchised communities.  Her research focuses on emotional labour, organisational culture and social suffering.

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.                                                                                       Twitter: @adahui1

   

As a former clinical psychologist who now writes fiction, I’m not particularly drawn to crime on the page. So it was almost as much a surprise to me as to anyone that my forthcoming second novel, Underneath, is about a man who keeps a woman captive in a cellar. But, as you might expect from my mental health background, what attracts me to this topic is not the offence itself, but the character underneath it; less the what (although the novel certainly addresses that), but the how and why.

My character Steve’s emotionally neglectful childhood has left him with abandonment issues, which he’s managed to side-step for most of his life by a peripatetic lifestyle with no expectation of forming long-term bonds. Eventually, it’s time to settle down and, as his new girlfriend moves in with him, life seems to have turned out fine. But even then there are warning signs in his defensive cognitive style. In conversation with her friend and colleague – and Steve’s nemesis – Jules, Liesel refers to Steve’s reaction to an art exhibition they’d seen together (p30):

Liesel stroked my hand. “Steve found the exhibition rather disturbing.”

“No I didn’t. I found it boring.”

“Same difference,” said Jules. “When you’re overwhelmed by emotion your mind switches itself off.”

Later, when Liesel’s priorities change, Steve rejects her attempts to talk through their differences, preferring, instead, to locate all vulnerability in her. This isn’t too difficult given her own issues with loss stemming from her mother’s suicide (p153):

Jules knows a good psychotherapist, she’d said, as if it were my mind that needed to be fixed.

Liesel’s perspective on mental health is grounded in her work as an art therapist in a forensic mental health unit. Unfortunately, although he respects her professional status, Steve disregards her expertise (p151 -2):

I felt sorry for her in a way. I imagined her spouting this nonsense in her interview and the panel covering their smirking mouths with their hands. I imagined her being ridiculed by the prosecution for trying to convince the jury that some thug hadn’t meant to throttle his wife, he was acting out some pre-conscious childhood trauma … She seemed to have rather too much in common with her patients. Fortunately, there was no hint as yet of criminality.

On visiting her workplace one lunchtime, Liesel tries to explain her therapeutic approach (and apologies to the art psychotherapists I’ve worked with for Steve’s misrepresentation of the profession). But he shows little empathy for the patients, instead envying the attention she gives them (p91-92):

“If you’ve missed out on the basics, like my patients have, you live with a yearning, an absence, whether you remember where it comes from or not.”

She was going all Freudian again. I gazed at the brown stain at the bottom of my coffee mug as I stifled a yawn.

Liesel squeezed my shoulder. “Sorry, I’m lecturing you like you’re one of my students.” She scraped back her chair. “I’m afraid you’ll have to go. It’s time for my group.”

I covered her hand with mine, imagining fucking her across the mottled table. “Let them wait.” It seemed morally offensive for a bunch of hooligans and perverts to have a woman like Liesel at their beck and call.

Advice to writers on creating an immoral character suggests being nonjudgemental and empathic, and framing the character’s behaviour as the outcome of various unfortunate events rather than a random act. It would spoil the story to give much detail about how personality combines with happenstance to make Steve a jailer, but there are parallels between my task as a writer and that of health and social care professionals working with mentally disordered offenders. Despite the disapproval and distaste one may feel for the crime that has been committed, professionals are conscious of the perpetrator’s circumstances and underlying vulnerability that have led them to cross the boundary. In a society that is often lacking in empathy for offenders, it can be hard to juggle the conflicting feelings of compassion for the person and condemnation of the crime.

I hope that mental health professionals, service users and their families with direct experiences of such services, if they should read Underneath, will consider that I’ve approached these issues respectfully. I also hope that readers without this background knowledge might be nudged a little closer towards a more compassionate perspective on the mentally disordered offender which, as a society, we urgently require.

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Anne Goodwin is a former employee of Nottinghamshire Healthcare NHS trust. Her second novel, Underneath, is published internationally on 25th May 2017 in e-book and paperback and launched at Nottingham Writers’ Studio on 10th June.

She has contributed two previous articles to the Institute of Mental Health blog:

Three novelistic approaches to mental health issues that won’t set your teeth on edge From clinical and academic writing to fiction

[caption id="attachment_1364" align="alignnone" width="2880"] House for a Gordian Knot, Ekkehard Altenburger

  Tomorrow (Tuesday, May 9th) the IMH will be hosting its Annual Research Day to highlight the work of the Institute’s doctoral candidates, Managed Innovation Networks (MINs), and all early-career researchers (including research assistants, research fellows, and research-active clinicians and service users).

There are some fantastic talks and poster presentations lined up including a Keynote discussion from Max Birchwood titled  “Translating the science of prevention to service reform in youth mental health: the emergence of 0-25 years services across the West Midlands of England”.

The event will start at 9am and finish just before 5pm and will take place in the Institute of Mental Health, Jubilee Campus. Attendance is open to everyone so please feel free to come by.

 

We are looking for a new committee for 2017-18! There are a range of roles on offer, from Co-ordinator to Events Team member. You don't have to have any prior experience to apply but if mental health is something you are passionate about, or just helping people in general, one of these roles may be for you!

Check out the variety of roles we have on offer by clicking here. If one of these roles takes your fancy, please click here to apply.
Applications for committee close: Sunday 7th May 2017
We are also looking for student volunteers to help run our Positive Minds Course for University of Nottingham.We provide a fantastic opportunity for students who are interested in receiving training and on-going support in delivering these projects. Successful applicants will join us for a two-day training workshop, on the 16th and 17th September, covering all the basics of running a safe and effective support group, from listening skills to publicity and lots more. By creating a positive atmosphere for talking about mental health, we aim to give students the confidence to look after their own wellbeing. This is an opportunity not only to make a real difference to student life but also to develop your own skills and experience!

For more information on how to apply, go to http://www.studentminds.org.uk/peer-support-application-and-training.htmlApplications for facilitators close: Sunday 30th April 2017
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We are delighted to announce the publication of a new book called Wellbeing, Recovery and Mental Health, edited by Mike Slade from IMH, Lindsay Oades from Australia and Aaron Jarden from New Zealand. The book brings together two bodies of knowledge – wellbeing and recovery. Wellbeing and ‘positive’ approaches are increasingly influencing many areas of society. Recovery in mental illness has a growing empirical evidence base. For the first time, overlaps and cross-fertilisation opportunities between the two bodies of knowledge are identified.

 Wellbeing, Recovery and Mental Health will be of interest to anyone connected with the mental health system, especially people using and working in services, and clinical and administrative leaders, and those interested in using research from the mental health system in the wider community.

 Mike Slade commented “It has been exciting to bring together expert contributions from around the world. I have learned a lot about enhancing wellbeing in schools (‘positive education’), workplaces, families (‘need-supportive parenting’) and cities (‘urban liveability’). Marshalling the very best evidence from recovery and wellbeing research raises important questions for us all. How much should policy-making be judged by its impact on population wellbeing? If employing peer workers in mental health systems is proving so beneficial, should we be employing people with a criminal history in police forces, or people with experience of homelessness as housing workers? Should wellbeing literacy be taught in schools, alongside traditional numeracy and literacy skills? What would be the impact on society if co-production became the norm?”

 Prof Martin Seligman is often described as the ‘father of positive psychology’, and he wrote the foreword to the book. He states that “psychotherapy and drugs as they now are used are half-baked. At their very, very best they remove the internal disabling conditions of life. Removing the disabling conditions, however, is not remotely the same as building the enabling conditions of life. If we want to flourish and to have wellbeing, we must indeed minimize our misery, but in addition we must have positive emotion, meaning, accomplishment, and positive relationships. The skills of flourishing – of having positive emotion, meaning, good work, and positive relationships – are something over and above the skills of minimizing suffering. These skills are documented to build wellbeing and they also may act to relieve psychopathology itself. This volume tells their story.”

 The book has been endorsed by international leaders. Prof Larry Davidson (Professor of Psychiatry, Yale University) wrote “This exciting collection of groundbreaking research from around the world shows how hope, recovery, and wellbeing are far better than suffering, misery, and illness as guiding concepts for policy and practice in mental health and beyond, to civil society”. Prof Ken Sheldon (Curators’ Professor of Psychological Sciences, University of Missouri) states “Slade, Oades, and Jarden have fostered a long-overdue conversation within this book – between clinicians focusing on recovery, and positive psychologists focusing on well-being.  Although the first group has traditionally focused on returning clients to baseline, the other group has tried to leave the baseline behind, for new heights of well-being. The upshot of the conversation is this:  That the processes bringing recovery and the processes bringing well-being are much the same, though they have been focused on in isolation. This book also stakes a claim for diversity, and the equal personhood of “victims” needing to “recover” from mental illness.  They are not different from us, it turns out:  they ARE us!”. A/Prof Acacia Parks (Hiram College) identifies that “research has been converging on the idea that positive psychological approaches have great utility for people at risk for and experiencing mental disorders. This book provides a much needed framework for synthesizing that literature and planning ahead for what is sure to be a vibrant and massively impactful field of study".

 More information about the wellbeing research programme led by Prof Slade is at http://www.researchintorecovery.com/WELLFOCUS, and the publisher’s website is http://www.cambridge.org/gb/academic/subjects/medicine/mental-health-psychiatry-and-clinical-psychology/wellbeing-recovery-and-mental-health?format=PB&isbn=9781107543058.

Hope. It’s a word often used in day to day conversation; I hope I win the lottery, I hope my partner has put the washing on when I get home. When we use the word hope in conversation, we are usually expecting something good or positive to happen but often it’s used without any action or thought to make the intended outcome a reality.

Well I’m going to talk about a different kind of hope. A hope that needs time, attention, nurturing and care. A hope that you can’t leave to fend for itself or ignore. I have blogged before, about the magic of peer support, of how transformative it has been for me and my personal journey. As I settle into this role, now well into my second year, other questions begin to surface, and I share them with you here.

I was a ‘frequent flyer’ to mental health wards before becoming a peer support worker. Now, somehow, magically I visit these places only as a staff member. Working side by side with the very people who have cared for me, seen me at my lowest, and seen me behave in a very distressed manner and now I’m part of the team. I really feel it. They check up on me, joke with me, and best of all, ask my opinion on how best to help someone. What more could anyone ask for? This integration into the team fosters my own hope and it grows daily.

I do spend some time helping people to understand what peer support is, but I’m happiest when I’m showing them what it is. How I can sit with someone in distress, and story share small bits to give them hope, that there is a way out of the darkness they find themselves in. How I can talk about my experiences of medication, when it worked well for me, when I resisted and how I got to a position to make my own choices. Or how I can suggest social activities that are going on outside of the ward, that can help give people other identities than that of’ mental health patient’.

Peer support on an acute psychiatric ward is all about growing hope. It’s fast paced; you never know how long you have to work with someone, how long they will be there, or even how ready they are for peer support. Even those who say they don’t want peer support, I can still help. Sitting with someone in silence is still a way to show them that you are there for them, and the hope sits there with me, waiting for them, being there for someone when they need it. Hope is also fostered in the language you use – positive affirmations, compliments and a genuine belief that someone is so much more than their diagnosis. Many people I see have lacked positive support in their lives, and who doesn’t want someone to believe in them? We all benefit from that and just because someone is detained under the mental health act doesn’t mean they can’t have hope; I am living proof!

An acute psychiatric ward may seem a place where there isn’t much hope that it’s all about control and dis-empowering people. I know different. Without being sectioned I wouldn’t have found peer support, I wouldn’t have been encouraged to apply to do the training, and ultimately change my life. All the staff want the same thing, for the person to recover and now with peer support on the team, I do all I can to prevent a ward becoming a revolving door, like it was for me for so many years.

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Clare is an accredited peer support worker based in Worcestershire, a passionate coach, mentor, cat owner and lover of kindness..NHS champion..survivor….expert by experience. You can follow her on Twitter @knightonstar for daily tweets about peer support.

You can also read more of her other fantastic posts here

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Note from editor:
 
 
 

In January 2017 the INDUCT (Interdisciplinary Network for Dementia Using Current Technology) team got together in Maastricht, a city in the south of the Netherlands, for the first INDUCT school. It was a great opportunity to finally meet, in person, all of our fellow PhDs on the programme. We were only able to meet each other virtually before, one of the wonders of technology, during an online course offered by INTERDEM (Early Detection and Timely Intervention in Dementia).

As the week progressed, our bond became stronger, not only because we could share and relate to each other’s challenges and struggles of starting a PhD, but also because we shared moments of joy and intellectual and personal growth. It was an intense week with multiple sessions providing us opportunities to learn new and exciting things. Have a look below for a brief overview of the week.

Monday: We kicked off the week with a session of elevator pitches in which every PhD student was required to explain his/her research in 90 seconds. It was an interesting moment for many, since it was just the beginning of the week and it was challenging to explain a huge amount of information in a short amount of time. The presence of 20 people you did not know very well contributed to the nerves. However, it was a safe environment which meant that people were given the space to think and take time. This feeling of safety set the tone for the rest of the week. The day continued with wonderful presentations on different methods to use technology in dementia research by Dr. Marco Blom and Rob Groot Zwaaftink from Alzheimer Nederland. Joris Wiersinga from Silverfit talk to us about the use of exergaming in dementia care to promote physical activity among people with dementia. We concluded the day with an interactive session by Phil Joddrell and Yvonne Kerkhof on making better use of touch-screen applications (apps) and how to make these more accessible for people with dementia.

Tuesday: The second day started with a session by Marc Wortmann from Alzheimer Disease International on global dementia policy which was followed by a talk by Professor Anne Margriet Pot on the World Health Organisation (WHO) dementia policy and an online, worldwide tool developed by the WHO for carers of people with dementia. We continued with a fun and enlightening role playing activities coordinated by our fellow ESRs, in which each of us took on the role of a different stakeholder when talking about ethics and the involvement of people with dementia. The last session about Patient and Public Involvement (PPI) with Dr. Nancy Preston informed us about PPI work in the UK and its importance for research.

Wednesday: On day three we enjoyed some workshops and were joined by members from the INTERDEM academy. The first workshop, led by Professor Rose-Marie Dröes from the VUmc in Amsterdam, covered the MRC (Medical Research Council) Framework and its application to piloting interventions. We had the opportunity to develop our own potential feasibility study in dementia care. In the afternoon we had a lecture and a workshop on the Theory of Change and the MRC framework led by Dr. Graham Moore, Professor Lieve Van der Block, Dr. Lara Pivodic and MSc. Joni Glissen.

Thursday: This day stood out as we had the participation of Alzheimer Europe, represented by Project Officer Ana Diaz, and the EWGPWD (European Working Group of People with Dementia), with Chris Roberts and Alv Orheim. After an inspiring talk Ms. Diaz and Mr. Roberts, we had the chance to ask Mr. Roberts and Mr. Orheim about how to involve people living with dementia in our PhDs. This session was great and provided us with a lot of useful and directed feedback.

Friday: The snow did not stop us from having a great last day. We started with a lecture given by Rosalie van Knippenberg and Dr. Lizzy Boots about the use of technology in their research. This was a relatable session because we could learn from their experience; the do’s and don’ts in dementia research while using technology. We also had the participation of second level partners (Betawerk and Eumedianet) who showed us their work and told us more about implementation of technology in health care settings (as well as dementia care).

On Friday it was also time to say goodbye. This was a great week for all of us, with a lot of learning and networking. The whole week was a fantastic experience and we just can’t wait for the next INDUCT school in September this year in Salamanca, Spain.

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Aline Cavalcanti Barroso and Harleen Rai are Marie Sklodowska-Curie Researcher Fellows for INDUCT and PhD candidates at the Institute of Mental Health, University of Nottingham. Contact: This email address is being protected from spambots. You need JavaScript enabled to view it. and This email address is being protected from spambots. You need JavaScript enabled to view it.    

I work for two days a week as an intentional peer support worker (PSW, 07:00 – 15:00, Worcestershire Health and Care NHS Trust) in a recovery unit offering:  facilitated training group work, along with spending time with people on a one to one basis (1:1s), practical and emotional support.  People with longer term stays can develop their interests in, and benefit from the hearing voices group, bite size psychology group, peer group using the PeerZone free materials (from Mary O’Hagan in New Zealand), and the early warning signs course (written by Prof Jo Smith and Dr Tom Barker).  There’s also the gardening project which I initiated - growing vegetables and flowers in dedicated beds.  Other types of groups are run by the second intentional PSW who works on the other three days.

The day starts with the nursing handover, moves on to preparation for the days’ groups and 1:1s and then really gets going with 1:1s recovery orientated conversations with people, practical and emotional support.  The groups of up to nine people run at 11:00 and 14:00 for up to 45 minutes and I write case notes and make diary entries after the groups and 1:1 conversations.  It’s a hectic two days a week and reflection, refinement and lesson planning are taken home but not dwelt overly on.  There is a group meeting/ supervision with the other seven peer support workers across the county for two hours once a month and line management supervision from the ward manager too.

I really enjoy relating little chunks of my relevant experiences of poor mental health and how I coped with being in hospital in an empathetic way to people when I hear their stories. I know that holding hope for them to recover will see them improve and be discharged to live a self-determined life away from the hospital ward with the tools they need to prevent re-admission or at least reduce its longevity.

Within Worcestershire PSWs have typically worked exclusively with people with mental distress, but I have also met families and friends during the evening so that they can understand the ethos of recovery from its beginnings. By doing so I am able to help and support them in applying recovery principles when visiting and living with their loved ones.

The peer support I offer is unique because it flows from my personal experience of 38 years in secondary mental health services (now discharged), all its ups and down across four acute inpatient wards including three of the old asylums around England with multiple admissions as a ‘revolving door patient’. These chunks of relevant personal experience come from more than half a lifetime of mental distress. I am seen as a role model, someone that’s been there and got the t-shirt. Not many other mental health practitioners have that sort of experience “from the other side” – to know what it feels like to recover a life, trying to cope alone with lots of systems.

Although I have worked in many fields (notably as an agricultural research scientist for 16 years) in a number of roles and organisations, none has matched what I feel I am giving back to others with mental health difficulties as a PSW. I feel it gives me a sense of achievement when these people have ‘light bulb’ moments around the recovery principles and what it means to them. It especially gives me great joy when they are discharged.

Along with my recent academic successes both within the Trust and the University of Worcester in the Institute of Health and Society as an associate lecturer and research stemming from the IMPACT group of service users and carers (SUAC), I feel I am making a contribution to the knowledge base around peer support and SUAC, student and staff perceptions of SUAC involvement in higher education through peer reviewed publications. I am also a student again, taking a part-time Diploma in Education and Training to benefit my practice around teaching recovery in group sessions and teaching research, recovery and mental health, advocacy and long term conditions within the University of Worcester.

Being an intentional peer support worker is really important to my own wellbeing.

Dr Joy M Rooney is a project leader and peer support worker with Worcestershire Health and Care NHS Trust and an associate lecturer and researcher at the University of Worcester. Contact: This email address is being protected from spambots. You need JavaScript enabled to view it. or This email address is being protected from spambots. You need JavaScript enabled to view it. ……………………………………………………………………………………………………………………

Recent Publications/ conferences:

Rooney, J. M., Osborne, N. and Unwin, P. F. (2015). “The impact of IMPACT – reflections on the first seven years of a service user and carer (SUAC) group at the University of Worcester, UK”. Conference paper: Where’s The Patient’s Voice in Health Professional Education - 10 years on, 13/11/2015, Vancouver, Canada.

Rooney, J. M., Miles, N., and Barker, T. (2016a). "Patients’ Views: Peer Support Worker on Inpatient Wards." Mental Health and Social Inclusion 20(3) 160-166. doi 10.1108/MHSI-02-2016-0007.

Rooney, J. M. and Unwin, P. (2016b). “Transformative or Tokenistic - Can involving service users and carers in the training of health and social care professionals promote social justice?” Social Justice Conference 26/06/2016 University of Worcester.

Rooney, J. M., Unwin, P. F. and Osborne, N. D. (2016c). "Gaining by Giving? Peer Research into Service User and Carer perceptions of Inclusivity in Higher Education." Social Work Education. 35(8) 945-959. http://dx.doi.org/10.1080/02615479.2016.1227314

Rooney, J. M. (2017). "HQUIP Case Study. Patients value peer support worker in their recovery. " http://www.hqip.org.uk/resources/case-study-patients-value-peer-support-worker-in-their-recovery/

Unwin, P., Rooney, J. M. and Cole, C. (2017, in press). "An evaluation of the impact of service user and carer involvement on students’ classroom learning in higher education." Journal of Further and Higher Education. http://dx.doi.org/10.1080/0309877X.2017.1281886.

Unwin, P., Rooney, J. M., Osborne, N., and Cole, C. (201x, accepted). “Are perceptions of disability changed by the involvement of service users and carers in the qualifying training of health and social work professionals?” Disability and Society.

   

We are pleased to announce the publication of a new book called Positive Psychotherapy for Psychosis, by Mike Slade, Tamsin Brownell, Tayyab Rashid and Beate Schrank. The book describes a new psychological intervention, which for the first time applies emerging research from the field of positive psychology specifically to psychosis. It is a guide and manual for clinicians, divided into two sections: theory and intervention manual. The intervention is based on methodologically rigorous research and case studies, and gives detailed aims and instructions for clinicians and therapists. The structured, step-by-step manual, for use with clients, includes downloadable handouts, session materials, activities, guides and therapist tips. The book also contains guidance on adapting the approach for use in individual treatments, and on providing part of the intervention, either as individual sessions or by integrating Positive Psychotherapy for Psychosis sessions into other treatments.

Positive Psychotherapy for Psychosis will be of interest to mental health clinicians working with people with psychosis, as well as clinical and counselling psychologists, psychiatrists, mental health nurses, psychotherapists, social workers, occupational therapists, support workers and peer support specialists. The aim is for the manual to be a practical, positive and innovative resource for mental health professionals, providing all the material needed to deliver this evidence-based approach that is designed to improve wellbeing and reduce symptoms experienced by people living with psychosis.

Mike Slade commented “there is a growing interest within society about positive psychology and wellbeing approaches such as mindfulness, character strengths, forgiveness and gratitude. In developing this intervention we started with the assumption that what people living with psychosis need in order to get on with their life is in many, but not all, ways similar to what everyone else needs to live well. So we looked at the small ways in which positive psychology approaches need to be modified for people who experience psychosis, and then evaluated and further refined these approaches using randomised controlled trial and qualitative methodologies. The hope is that this type of intervention – based on research and focused on supporting people with psychosis to ‘live well’ rather than having their problems fixed – is part of a broader movement towards citizenship for people living with psychosis.”

The book has been endorsed by international leaders. Prof Bob Drake from Dartmouth Medical School said “This book should become required reading for all of us who treat people with serious mental illness” and A/Prof Lindsay Oades from the Centre for Positive Psychology at University of Melbourne said “The Positive Psychotherapy for Psychosis intervention represents state-of-the-art psychological practice”.

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IMH blog readers can get an exclusive 20% off! Just follow the link to the publishers website and use the discount code  IRK71

More information about the development and evaluation of the intervention is at: http://www.researchintorecovery.com/WELLFOCUS
 
 

Refocus on Recovery 2017 is an exciting international scientific conference which is coming to the Institute of Mental Health. It is the largest regular scientific conference on recovery in the world, and will take place on 18-20 September 2017. This is the first time the conference has been held outside London, and we know Nottingham will do us proud!

The conference is all about recovery for people with mental health problems, and is presenting world-leading research about how people can live well with illness. It is being organised by the Institute of Mental Health, School of Health Sciences (University of Nottingham), Nottinghamshire Healthcare NHS Foundation Trust, ImROC, Making Waves and Mental Health Foundation.

Keynote speakers come from the UK (Steve Gillard, Isabella Goldie, Jayasree Kalathil, Anu Singh, Mike Slade) as well as from India (Manoj Kumar), Canada (Kwame McKenzie), Germany (Jasna Russo) and Norway (Mark Hopfenbeck). We will also hear from Jenny Edwards (Chief Executive, Mental Health Foundation) and Ruth Hawkins (Chief Executive, Nottinghamshire Healthcare NHS Foundation Trust).

It promises a great opportunity for learning and networking. For the three previous Recovery conferences, around 500 people came from 25 countries.

There is a lively social programme, as well as the Gala Dinner, we have exciting creative opportunities such as the boomwhacker percussion energiser event, a ‘Story Shop’ offering a range of stories from people with lived experience and more….

The conference has four themes:
Theme 1: Recovery for different groups: The meaning of, and support for, recovery in long-term conditions (physical and mental). Recovery in marginalised groups, e.g. culturally-sensitive services. Understanding and supporting recovery in mental health systems, e.g. Open Dialogue, REFOCUS, Individual Placement and Support. Organisational and individual influences on Peer Support Workers, including the meaning of ‘peer’.

Theme 2: Re-situating recovery: Engaging with culture and community to make recovery a reality. Mainstreaming recovery, and links with other community initiatives, e.g. dementia-friendly communities. The role of family and supporters – what is a family in recovery? Improving access, e.g. digital interventions. Recovery Colleges as a bridge between mental health system and community. Insights from Mad Studies about recovery.

Theme 3: Prevention of mental ill-health: Supporting the development of resilience in individuals and communities. Creating inclusive communities. Inter-sectoral understandings of stigma and discrimination. National and local anti-stigma campaigns. Supporting self-management, including peer-led approaches. The role of inter-dependence. The impact of language and embedded assumptions. Developing new narratives, e.g. Mad lit, Photovoice.

Theme 4: Allocating resources: How money is spent, and with what effect. Service models and structures which foster or hinder recovery. Co-production and co-development approaches. The role of volunteers. Providing services in resource-poor settings. The contribution of health and social policy to recovery. The impact of legislation and commissioning arrangements.

Get on board!

• Find out more about the expert workshops and the conference at com/ror2017
• Submit an abstract (don’t miss the deadline: 28 February 2017).
• Come along – register now, with a limited number of reduced rates for ‘early bird’ registrations.
• Spread the word! This is such a great opportunity we don’t want to keep it to ourselves. Please feel free to send a link to this blog or the website to colleagues who may be interested.
• Join the conversation on Twitter using the hashtag (#RonR2017).

We hope to see you there.

Mike Slade is Professor of Mental Health Recovery and Social Inclusion at the University of Nottingham, based in the School of Health Sciences in the Faculty of Medicine and Health Sciences, and working at the Institute of Mental Health.

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The Institute of Mental Health (IMH) will be hosting its Annual Research Day to highlight the work of the Institute’s doctoral candidates, Managed Innovation Networks (MINs), and early-career researchers (including research assistants, research fellows, and research-active clinicians and service users).

There will be prizes for best oral presentation and best poster. The event is being promoted to all IMH members and we anticipate a good selection of speakers presenting and a good range of people in the audience — both local and national health researchers and practitioners plus IMH members. The event will be chaired by Professor Peter Bartlett and Dr Jenelle Clarke. There will also be plenary sessions from inspiring and established experts.

This Annual Research Day focuses intentionally on those at the beginning of their research careers, and represents a welcoming and career-developing forum for researchers (it is wonderful for the CV and excellent presentation practice in a friendly setting).

We expect the format to resemble that of a conference with 20 minute oral presentations per paper with 10 minutes for questions from the floor.

Please submit a title and 250 word abstract to:Dr Jenelle Clarke (This email address is being protected from spambots. You need JavaScript enabled to view it.) By Monday 3rd April 2017

Can we create a dementia-friendly society? This was the question around which people with dementia, carers, professionals and academic researchers gathered during the 26^th Alzheimer Europe conference in Copenhagen.

A large representation from the Institute of Mental Health (IMH) attended the event to promote the innovative (and diverse) research that the Institute is nationally and internationally renowned for and contribute with their ideas and expertise to the scientific discourse around dementia. All the attendees had unique networking opportunities with colleagues from all over the world and many of us presented their work through posters and oral presentations. Professor Martin Orrell, director of the IMH and Head of the division of Psychiatry and Applied Psychology, was present to promote the work of the institute and to create new European partnerships in dementia research.

Professor Tom Dening, head of the IMH Centre for Dementia, gave an oral presentation during the INTERDEM session entitled, ‘Where’s the happiness in dementia?’, which led to a lively discussion about the emotional experiences of people with dementia. He gave an oral presentation on a parallel session about   (The Arts and Dementia), a programme of the Nottingham-Worcester doctoral training centre funded by the Alzheimer’s Society. Tom also exhibited a poster on the NIHR Optimal project on effective health care for older people resident in care homes. A Medical student, Imogen Ovenden, who Tom supervises for her BMedSci, displayed a poster entitled ‘Bowling for Dementia’

Professor Justine Schneider and Alessandro Bosco co-presented a Social return on investment analysis of the Imagine study on arts interventions for people with dementia. People with dementia and their carers reported positive outcomes in relation to the mental wellbeing of participating individuals following involvement in arts programmes. These findings call for consistent integration of diverse arts activities in the care setting.

An example of art performance which promotes the mental wellbeing and quality of life of people with dementia was illustrated by Dr Orii McDermott, who presented on the development and preliminary evaluation of the CHORD (CHOrus Research in Dementia) Manual. This project aims to identify music therapeutic techniques that are transferable to facilitators of music activities and to develop a standardised singing manual.

Quality of life was central to the work that Déborah De Oliveira presented, entitled ‘Identifying meaningful aspects of quality of life for older family carers of people with dementia in focus groups’. Deborah also had a poster on the ‘Development and psychometric evaluation of the dementia quality of life scale for older family carers – DQoL-OC’. Our colleague Lucy Perry-Young presented ‘Broadening our understanding of good home care for people with dementia’.

Some PhD students also attended the conference. Aline Cavalcanti Barroso and Harleen Rai had an opportunity to collect ideas around their PhD projects on assistive technology in dementia. Claudio Di Lorito discussed and promoted his PhD project on the mental health of forensic psychiatric patients with dementia.

Having just begun with my doctoral studies, this was a spectacular first taste of my journey in dementia research. Indeed, I considered this my baptism of fire, as I had the opportunity to co-present my work in front of a large and technical audience during a parallel session. This was a fulfilling experience and a professionally enriching one, as I was able to challenge my stage fright, build up confidence and master my presentation. The audience responded engagingly to my talk and I was thrilled to receive very positive feedback from members of the audience at the end.

Although there were several poster and oral presentations on quality of care, little was dedicated to the models of person-centred care in dementia. Does the support people with dementia receive respect their personhood? Are the current models inclusive of the experience of the carers? During my first year, I aim to gather the existing evidence in this crucial area through a scoping review around person-centred care models. Given the centrality of personhood and the role of carers in delivering the care, it is timely that this concept is acknowledged and addressed if we aim to build a dementia-friendly society. I hope I will have the opportunity to present the findings of my review during the conference next year and share good practice with colleagues from different countries at the INTERDEM academy meetings to come.

Hoping that an even larger representation of researchers and people from the public will attend next year’s conference, we invite you to join us as ambassadors for dementia at the Alzheimer Europe conference 2017 in Berlin, Germany.
Alessandro Bosco is a postgraduate researcher and an Economic and Social Research Council PhD candidate in Mental Health & Wellbeing at the Institute of mental Health, University of Nottingham. Contact: This email address is being protected from spambots. You need JavaScript enabled to view it.


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Dear reader,

As we come to the end of another fantastic year for the blog we would like to thank you for all your support. We've had some fantastic content this year and as always its been great to have so many people sharing their experiences, research, views and opinions. We hope you have a brilliant festive season and look forward to sharing some great new content with you in January.

 

  Remember: if you end up with a little time to spare over the holiday season and you would like to write something, please get in touch as we would love to hear from you.

Happy holidays!

IMH blog team

The ESRC Public Engagement Event successfully took place on Saturday 12^th November 2016 at St Peter’s Square in Nottingham. This event follows the successful RAMHHE conference which was held on 10^th October 2016 and the ongoing campaign which encourages students to leave one sentence about how we can support students in higher education with mental ill-health experiences.

As a mental health nurse and an economic and social research council (ESRC) PhD student in Mental Health, I am aware that mental health does not affect only higher education students, so it was important to facilitate a space of interaction for student volunteers and the public to dialogue on the issue of mental health.

The main aim of the Public Engagement Event was to engage in dialogue with the non-academic audience in Nottingham and explore their views on three questions:

What do you think mental health is?

Who or where would you go to for your mental health?

How can we better support mental health in Nottingham?

This was an event that nearly did not happen. You see, this was my first grant application and I did not know to ask for funding. Fortunately, I decided not to let the lack of funding stop me, so I self-funded the event and I am glad that I did.

Initially, the event was supposed to be held at the Queen’s Medical Centre (QMC) but my Head of School, Jo Lymn advised that it would be better held in town where we could interact with diverse groups of people rather than only people visiting the QMC. Luckily, my efforts to obtain permission paid off and we were allowed to host the event at St Peter’s Square.

Prior to the event, I met the Lord Mayor of Nottingham Councillor Saghir at the Royal College of Nursing Tea Party. We talked about the successful RAMHHE campaign and the Public Engagement event, and he promised to attend. A week later, the Civic Office wrote to confirm this.

On the morning of the event, I remember arriving at St Peter’s Square on that freezing cold and rainy day. I was anxious because I was not sure if the other volunteers and the Lord Mayor would attend because of the rain. That feeling soon changed as the volunteers arrived and we quickly set up a tiny sheltered space in front of a vacant store. We put up the ESRC banner, clipped the questionnaires to the clipboards, grabbed our umbrellas and smiled our way through the cold and rain. At 11.00am, the Lord Mayor arrived and he joined in the voluntary effort by speaking and taking photographs with people, answering their questions and interacting with us. The Lord Mayor’s selflessness inspired myself and the volunteers, for which I remain grateful.

We approached more than 500 passers-by and although some of them did not participate, they were polite as they walked by with either a wave of their hand to signal a no, a sorry I am not interested or I am in a hurry. However, we were able to obtain 150 completed questionnaires/surveys from 150 people who gave their verbal consent to taking photographs with us and answered the following three questions above.

It was a privilege to listen to people as they expressed their views about the questions and shared their family member’s experiences of mental ill-health. Several common themes emerged out of our 150 survey answers from the three questions above, of which the three most common themes included:

1:More funding to employ more mental health providers.

2: Early intervention to mental health.

3:More anti-stigma awareness campaigns.

As we packed up to leave, I could not help but wonder how useful this Public Engagement Event was, how my resilience to host the event despite the funding challenges paid off and how much I have learnt about public mental health from a few hours ’interaction and three questions.

The questions now is, how can we sustain such important mental health awareness events, so as to engage with the public and hear their views, perceptions and experiences?

Josephine NwaAmaka Bardi is a Registered Mental Health Nurse and an Economic and Social Research Council PhD student on the mental health and wellbeing pathway. She is also the founder of Raising Awareness of Mental Health in Higher Education. Contact: This email address is being protected from spambots. You need JavaScript enabled to view it.

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For more information and sources of support:

Mind
Student minds
Graduate school advice about mental health
RAMHHE
 

[caption id="attachment_1364" align="alignnone" width="2880"] House for a Gordian Knot, Ekkehard Altenburger

As the bunting is taken down, and the remaining sausage rolls are cleared away following our 10th Anniversary celebrations, it is an ideal time to take a moment to reflect on the achievements of the past 10 years, and look to the exciting future ahead of us.

We aim to be the leading centre in the UK for applied mental health research and education. Being a true partnership between the University of Nottingham and Nottinghamshire Healthcare NHS Trust enables us to research and innovate in the best way possible to support service users and carers, as well as promoting innovation, evaluation and clinical excellence across NHS services.

Narrowing down the highlights from the last 10 years is a challenge but worth a mention is the launch of our first Centre of Excellence in 2011 – the start of a journey that reaches a new milestone in November 2016 with the launch of the latest of our seven Centres of Excellence. Another highlight was the opening of our new IMH building on Innovation Park in 2012, part of the Jubilee Campus at the University of Nottingham.

Our Centres of Excellence provide focus and strategic leadership around each Centres key themes. The network of researchers and clinical staff provides a conduit for common interest, greater depth of information sharing, knowledge pools and support under the umbrella of a coordinated frameworks. Masterclasses, education, exchanges and training form part of the core objectives of Centres to further support the IMH vision of excellence in research and education.

Looking forward to the 20th Anniversary my belief is that we will have been on an extraordinary journey during which we have delivered really useful research projects and training that have had a direct benefit for those living with mental health issues; Improving the identification and speedy implementation of treatment and support methods that help service users, and promoting good mental health and sustainable recovery in people across the world.

The Institute in numbers: - 7 Centres of Excellence - 9 Managed Innovation Networks (MINs) - 33 full and associate professors - Over 100 PhD students - Over 350 external members - Over 400 peer reviewed journal papers per year - Nearly £11 million of new grants launching in 2016/17 - Over £28 million in active research grants

Our Seven Centres of Excellence:

• CANDAL: Advancing the translation of research into practice for ADHD and neurodevelopmental disorders across the lifespan
•  Health and Justice : Improving the understanding of and provision for mentally disordered offenders
•  Social Futures : Transforming how service users, carers and professionals work together in a new community of understanding
•  Translational Neuroimaging : Building on recent advances in neuroscience, diagnosis and treatment
•  Dementia : Tackling one of the biggest health challenges facing the population
•  Education : Providing accredited and non-accredited training in the form of one-off modules and courses, undergraduate and postgraduate programmes in healthcare practice
•  Mood Disorders : Launching soon

This blog post was written by Martin Orrell, who is the Director of the Institute of Mental Health at the University of Nottingham. ……………………………………………………………………………………………………………………