Monthly Archives: February 2014

Social work and recovery

Social workers support the recovery of people with mental health problems. Recovery is a process whereby individuals or families restore rights, roles, and responsibilities lost through illness, disability, or other social problems. It requires hope and empowerment, supported by a vision for a different way of being.

Recovery is a concept at the heart of social work practice, though the profession is frequently following others in articulating and evidencing good practice. Yet despite the theoretical basis of recovery finding synergy with social work, there is limited research informing social workers on how best to intervene effectively and to influence the social factors enabling or impeding recovery.

The term ‘recovery’ has now become part of routine mental health service delivery and policy frequently without acknowledging its social origins. Internationally, recovery is being framed as core to community mental health service delivery, but all too frequently with reference to symptom reduction and service rationing rather than regaining control over one’s life.

Social work theory and practice largely adopts a holistic, bio-psycho-social systems approach, which is central to models of social recovery. Practitioners are working daily to support the recovery of the individuals and families they are working with, frequently using highly effective approaches such as strengths or asset-based assessments, self-directed support or enhancing social inclusion. However, ‘recovery’ is rarely taught as a social theory informing social work practice on qualifying programmes, possibly because it is under-theorised and lacking a well-developed evidence base.

Special Issue of the British Journal of Social Work, 2015

ICMHSR Director Dr Martin Webber and ICMHSR international collaborator Associate Professor Lynette Joubert of the University of Melbourne, Australia, are editing a special issue of the British Journal of Social Work on the theme of ‘Social Work and Recovery’.

This special issue will publish internationally relevant contributions to social work research and thinking about recovery across multiple social work fields. Social work researchers and practitioners who are researching and working in the field of recovery are invited to contribute their work to make a distinct social work contribution to the growing evidence base about recovery.

They are seeking abstracts of up to 800 words by 9th May 2014 and full papers will be required by 5th September 2014.

For full details of the aims and key themes of the special issue can be found on the British Journal of Social Work website.

 

University Mental Health and Wellbeing Day: 19th February 2014

University Mental Health and Wellbeing Day is an annual event to promote the mental health of those who live and work in higher education settings. This year it will be held on Wednesday 19th February.

7169066_orig

The International Centre for Mental Health Social Research (ICMHSR) and the Department of Social Policy and Social Work are marking the event by sharing ideas about what we do to look after our minds.

ICMHSR have put up a Mindapples tree in the reception of the Department of Social Policy and Social Work in Alcuin College C block. Hanging on the tree are Mindapples: notes about simple day-to-day activities that we do which are good for our minds.

20140218_161025

“We invite all staff, students and visitors of the University to contribute to the Mindapples tree,” says Dr Martin Webber, Reader in Social Work and ICMHSR Director. “Pens and Mindapple cards are available in the reception area. Please take a few minutes of your time to fill out your Mindapples and hang them on the tree.”

The tree will be on display in Alcuin College C block for several weeks. Everyone is welcome to come along and see what others do to look after their minds.

 

Sharing lived experience in mental health services

Self-disclosure refers to sharing information about ourselves with other people. Most people share things all the time without thinking much about it, including what they had for tea last night, what they think about social issues, and more personal things, like their past experiences and their personal identities.

It is these last two types of disclosure – experiences and identity – that tend to cause most controversy, especially in professional settings. How much should a therapist share about themselves with a service user? What about doctors, nurses, and social workers? What should they share, or what is acceptable for them to share?

Opinion is divided between those who think professionals should be a neutral, blank canvas, and those who think judicious disclosure can be beneficial to the therapeutic relationship. The divide isn’t always that neat, of course. Practitioners might decide to disclose some things, in some settings or roles, but not in others. The decision on whether to share information might also be affected by how personal it is. For some professionals, though, disclosure about the self is an integral and necessary part of their job.

Peer Mentors share (or disclose) information about their “lived experience” automatically because of the job they do. This can help to build relationships with service users in ways that they might find helpful, beneficial, and an aid to recovery. If service users benefit from Peer Mentors sharing information about themselves, then sharing lived experience by other professionals might also be beneficial and welcomed by service users. On the other hand, disclosures made by doctors and nurses, for example, might be seen as unprofessional, or unwelcome. 

There is little training, guidance or research available on the subject of self-disclosure and sharing lived experience in mental health interventions to help people make decisions about what to share and when. To address this issue, the International Centre for Mental Health Social Research at the University of York, and Leeds and York Partnership NHS Foundation Trust, are working together to find out what service users and staff think about self-disclosure (or sharing lived experience) so we can produce guidance and training that will be delivered and evaluated.

The research will involve recruiting service user researchers to collaborate in all aspects of the research. Views will be sought about self-disclosure and sharing lived experience from both practitioners and service users through a survey, and focus groups will examine emerging themes. From there, a collaboration between practitioners, service users, and researchers will develop training and guidance that will be delivered and evaluated. Discussions are also taking place with a mental health service in Australia, with a view to undertaking the research out there too, to get wider perspectives and provide a comparison to the UK investigation.

The methods and tools for undertaking the research are in the process of development and, after ethical approval is gained, it is anticipated that the field work will begin in the summer of 2014. One service user has come forward with an interest in being involved as a researcher, and one mental health practitioner has offered their services too, which is great news (thank you for getting involved!).

Consultation about the research took place at the Lived Experience in the Workforce conference in Leeds in December 2013, and with Leeds Researchers (the Leeds and York Partnership NHS Foundation Trust service user research group) in January 2014. The comments and suggestions received have been integrated into the research design.

Questions, comments, and suggestions are welcome at any stage, so if there is something that you’d like to say, please get in touch with the Lead Researcher, Jonny Lovell, PhD Student in the International Centre for Mental Health Social Research, in the Department of Social Policy and Social Work at the University of York, by email: jl1155@york.ac.uk.

Find regular updates about the study, please follow Jonny’s blog.

Community Treatment Orders: Effectiveness, Understanding and Impact

Community Treatment Orders (CTOs) were one of the most controversial amendments made to the Mental Health Act 1983. In 2008 England and Wales joined Scotland and around 70 different jurisdictions around the world in obliging people to adhere to treatment in the community. The rationale is usually to prevent relapse or provide a less restrictive alternative to hospital for ‘revolving-door patients’ with severe and enduring mental illness. However, despite their widespread use, the evidence for their effectiveness is limited.

Last year the Oxford Community Treatment Order Evaluation Trial (OCTET), the first major evaluation of CTOs in England and Wales, reported its findings. This randomised controlled trial found that the same number of people on CTOs were readmitted to hospital as those on section 17 leave of absence. The extra restrictions placed on people on a CTO did not appear to reduce their readmission rate, as was originally envisaged when the orders were first introduced.

Running alongside the randomised controlled trial was an extensive qualitative study which explored patient, consultant and family carer experiences. Findings from this study may help to explain some of the results of the trial. We are pleased to welcome OCTET researchers at our next International Centre for Mental Health Social Research seminar on 12th February to discuss these emergent findings.

In three interlinked presentations, OCTET researchers will present findings and research in progress from the OCTET programme of work:

  • Jorun Rugkåsa will present an up-to-date review of the evidence for the effectiveness of CTOs (including OCTET) and OCTET’s main findings, and discuss the implications of these and the wider current evidence base for the future of CTOs.
  • Krysia Canvin will present findings from the qualitative arm. She will juxtapose consultants’ and patients’ interpretations of the CTO’s powers to consider the implications for patients’ experiences and the predictability of CTOs.
  • Francis Vergunst will present his ongoing DPhil research in which he is exploring the effect of CTOs on patients’ longer-term social outcomes by assessing patients’ social inclusion, social networks, and capabilities/quality of life.

The seminar will be held from 12 noon to 1.00pm at the University of York and is free and open to all. Further information can be found on our events page.