Emerald | Mental Health and Social Inclusion | Table of Contents

“Articles of faith”? Questioning the assumptions of disability welfare and benefits

literatinetwork@emeraldinsight.com (Sophie Corlett) — Fri, 22 Feb 2013 00:00:00 +0000

Abstract

Purpose – The Policy Watch series reflects on recent and forthcoming developments in mental health policy across the UK. This paper aims to review the impact of welfare reforms on people with mental health problems. As well as focusing at specific problems with the current system, the paper criticises the general “direction of travel” in welfare policy and calls for a rethink of fundamental assumptions that underpin this. Design/methodology/approach – The paper reviews and summarizes recent and longer term developments in national welfare and benefits policy in England and Wales and their implications for people with mental health problems. Findings – The paper describes how key components of the current disability benefits system are not working for people with mental health problems and also how the design of welfare reform over recent years has been ineffective for supporting the health and employment aspirations of people with mental health problems. Originality/value – The paper updates and discusses knowledge on recent and forthcoming welfare reform and cites recent evidence from Government.

The linkage of social exclusion and poor mental health in minority Asian groups in Britain and America

literatinetwork@emeraldinsight.com (Sue Holttum) — Fri, 22 Feb 2013 00:00:00 +0000

Abstract

Purpose – This Research Watch aims to summarise two recent research papers on social exclusion and mental health within minority Asian population groups in the UK and USA. Design/methodology/approach – A search was carried out for research papers with a mental health and social inclusion focus published within the past 12 months. Findings – The first paper summarises 12 recent research papers on the experience of British South Asians of accessing health care for long term physical conditions and depression. Gaining access to health care was a complex process of negotiation between those seeking it and health service representatives. This process was hampered by lack of fit between patients' and clinicians' cultural context and understandings. The second paper summarises 14 questionnaire-based research studies of the relationship between discrimination experiences and mental and physical health in Asian Americans, finding significant links between discrimination and mental and physical health. Originality/value – The first paper's authors used recently developed, rigorous methods of summarising findings from multiple interview and focus group studies, arriving at a new understanding of the processes experienced by British South Asians when accessing services for health conditions, including depression. The second paper extends existing knowledge about links between discrimination and poor physical and mental health in American minority groups to Asian Americans, a group relatively overlooked hitherto.

Andrew Voyce in conversation with Jerome Carson

literatinetwork@emeraldinsight.com (Andrew Voyce, Jerome Carson) — Fri, 22 Feb 2013 00:00:00 +0000

Abstract

Purpose – This paper aims to provide a profile of Andrew Voyce. Design/methodology/approach – Andrew gives a short biography and is then interviewed by Jerome. Areas covered in the interview include the central role of Mrs Thatcher in closing down the old asylums, homelessness, education, benefits and digital art. Findings – Andrew's recovery from long term mental health problems has seen him return to higher education. He failed to get his undergraduate degree, but decades later and with the encouragement of workers in the community, he completed both undergraduate and postgraduate studies. He talks of the negative impact of asylum care, especially the terrible side effect of akathisia, which resulted from the depot neuroleptic medication. Originality/value – This paper shows a remarkable journey of recovery, from a life of being a “revolving door” patient, to homelessness, to re-establishing an ordinary life in the community. The inmate's perspective is one that has largely been absent from narratives of asylum care.

Promoting social inclusion through community arts

literatinetwork@emeraldinsight.com (Peter Swan) — Fri, 22 Feb 2013 00:00:00 +0000

Abstract

Purpose – Using a case study of Artspace, a community arts and health charity, this article discusses how community-based organisations can successfully promote the social inclusion of people with mental illness and other disabilities. Design/methodology/approach – A research project involved a year-long ethnographic engagement with Artspace, where the researcher participated within the organisation and worked closely with both staff and participants. It drew upon informal discussions and 43 semi-structured interviews with participants and staff. Findings – Social inclusion was fostered through the positive and welcoming atmosphere within the building and also through the nature of the activities themselves. There was evidence that interactions between people with and without disabilities helped to challenge negative perceptions held by both groups. Artspace also offered a safe and non-judgemental environment for vulnerable participants whilst avoiding the downsides associated with services aimed solely at people with mental health difficulties or other disabilities. Research limitations/implications – The case study approach was based on a single organisation and thus transferability of findings may be problematic. Originality/value – This article has shown it is possible for a community-based organisation to meet the needs of a wide range of people whilst maintaining a safe environment for vulnerable participants. These findings may thus be of use to similar organisations seeking to diversify their user base.

Happiness in severe mental illness: exploring subjective wellbeing of individuals with psychosis and encouraging socially inclusive multidisciplinary practice

Fri, 22 Feb 2013 00:00:00 +0000

Abstract

Purpose – This paper seeks to extend the focus of positive psychology research to individuals with severe mental illness (SMI) to address an aspect of social exclusion experienced by this disadvantaged client group. Design/methodology/approach – The article summarises and builds on the outcomes of an earlier subjective wellbeing in psychosis study and arrives at original implications to challenge socially exclusive assumptions about limited emotional capabilities of those with SMI. The authors make suggestions for enhancing the wellbeing of people with SMI from the perspective of social inclusion. Data were gathered through validated self-report rating scales and analysed statistically. Findings – The levels of subjective wellbeing within the sample were shown to approximate those established in the general population. Depression was demonstrated to mediate the effects that the experience of psychosis had on participants' life satisfaction. Psychosis did not appear to prevent individuals from experiencing happiness, although when associated with depression, life satisfaction was lowered. Research limitations/implications – Because of the focus on subjective aspects of wellbeing, external indicators of objective quality of life were not explored. Individual appraisals of experiences of psychosis were not investigated. Originality/value – The study demonstrates that individuals with psychosis are capable of experiencing happiness. Thus, it challenges an aspect of a widespread socially exclusive assumption about limited internal capabilities of those with SMI. It also highlights that those with combined symptoms of psychosis and depression are in particular need of multidisciplinary support to enhance their wellbeing.

Include me in: user involvement in research and evaluation

Fri, 22 Feb 2013 00:00:00 +0000

Abstract

Purpose – This paper aims to discuss the experiences of a group of eight user and carer researchers from learning disability and mental health services who worked together in a research project. The research was to find out about the changes that took place as over 300 people moved from hostel accommodation into independent tenancies. These moves were part of a three year project involving a partnership between a local authority and a housing association. Design/methodology/approach – The evaluation was based on a model of user participation. Findings – User involvement in research can mean different things with different levels of involvement, from consultation through to user-controlled research. In this paper the authors discuss some of the challenges in doing this kind of evaluation study, as well as the opportunities that came from involving users and carers in the research. This includes how the researchers got involved and some of the activities they did. Research limitations/implications – The authors also describe some of the difficulties that were faced, including payments and criminal record checks. The ways in which people were trained and supported to take part and stay involved are outlined as well as how the group feel that they have learnt new skills and increased their confidence. Originality/value – This paper adds the voices of the co-researchers to the literature and provides “lessons learned” for other researchers in this area.

Supervised community treatment: does it facilitate social inclusion? A perspective from approved mental health professionals (AMHPs)

Fri, 22 Feb 2013 00:00:00 +0000

Abstract

Purpose – This paper aims to set out the views of approved mental health professionals (AMHPs) on the impact of supervised community treatment (SCT) on their work and their patients' lives in the community. Design/methodology/approach – The study covered a total of 56 community treatment order (CTO)-related activities undertaken in 2010 in a local social services authority (LSSA) in the north west of England, and looked at data from the records of 25 CTO patients. Nine AMHPs responded to a CTO outcomes questionnaire and five participated in a focus group. Findings – The characteristics of CTO patients in this LSSA study were consistent with national data. AMHPs were often undecided about the benefits of CTOs to their patients. A majority agreed that CTOs could benefit patients by earlier identification of relapse, improving access to housing and reducing the risk of avoidable harm to self or others. However, a majority also agreed that CTOs had not improved patients' access to employment, education, training or recreational activities; nor had they helped reduce the stigma and discrimination that patients faced. Research limitations/implications – This was a relatively small-scale study. However, its findings are consistent with previous work in this area, and provide pointers to how SCT can be more effectively implemented across England. Originality/value – There is very little published research into the impact of SCT in England. Although small in scale, this study provides valuable insights into the views of AMHPs, who play a core role in the CTO process.

Developing practical social inclusion outcome measures to evidence mental health recovery

literatinetwork@emeraldinsight.com (Tony Ryan, Michael Clark, Nick Dixon) — Fri, 22 Feb 2013 00:00:00 +0000

Abstract

Purpose – The aim of this paper is to describe the development of a suite of social inclusion outcome measures and how they are being applied in practice within Stockport. Design/methodology/approach – The paper gives a description of the development approach; the development of the measures and how the data collection systems have been established. Findings – A suite of practical measures of social inclusion has been developed that are being used to inform local service delivery, commissioning and service redesign with the purpose of evidencing the effectiveness of provision in delivering social inclusion for people who have used mental health services in Stockport. Research limitations/implications – The paper does not contain data. It is anticipated that the data will inform a business case for commissioning in new ways and which may be the subject of a further paper. Practical implications – The paper describes the practical approaches that have led to the development of the measures. Social implications – The measures will be able to demonstrate the social impact of services for people who use them. Originality/value – Mental health services are striving to develop meaningful measures that are embedded in day-to-day practice and are meaningful to people who use services. These measures and the way they are being used in services will provide evidence to service commissioners of effectiveness and have been signed off as such by commissioners. The outcomes framework will have implications locally for the implementation of payment by results in mental health.

Welcome to Mental Health and Social Inclusion

literatinetwork@emeraldinsight.com (Adam Pozner) — Fri, 22 Feb 2013 00:00:00 +0000