Category Archives: Mental health workers

The research behind the Connecting People Intervention

The first paper reporting findings from research which led to the creation of the Connecting People Intervention was published on 1st December 2014 online by the journal Health and Social Care in the Community.

‘Enhancing social networks: a qualitative study of health and social care practice in UK mental health services‘ explores how workers connect people with mental health problems to others in their various communities. It focuses on good practice which enables us to recommend to other agencies how best to train their workers to undertake this vital work.

Supporting people’s connectivity is important as it helps them to get on and get ahead with their lives. People who are better connected in society can find better jobs and more resources, which lead to wealth, power and status. Supporting people to enhance their networks helps them to stand a better chance when looking for work or other life opportunities which can enhance their well-being and recovery.

We worked with six agencies and teams who were a mixture of third sector and statutory agencies:

We spent a lot of time with workers in these teams, talking to them and the service users they were working with, shadowing them on visits and community activities, and sitting in on team meetings. We observed how they supported people to connect with others and how the agencies which employed them supported them with this task. In total we collected data from 73 workers and 51 people who used their services in this study.

We conducted our data analysis with some of the participants of the study to ensure our assumptions were correct. Focus groups helped us to refine our themes and develop the intervention model, which will be reported in a separate paper.

The prominent themes to emerge were the importance of worker skills; attitudes and roles; connecting people processes; the role of the agency; and barriers to network development. The sub-themes which were identified included worker attitudes; person-centred approach; equality of worker–individual relationship; goal setting; creating new networks and relationships; engagement through activities; practical support; existing relationships; the individual taking responsibility; identifying and overcoming barriers; and moving on.

These themes are consistent with recovery models used within mental health services and were subsequently modelled into the Connecting People Intervention.

This study was important as it helped us to define the components of the Connecting People Intervention which has subsequently been shown to be effective in enhancing individuals’ access to social capital.

We would like to thank all the participants of the study, the participating agencies and the NIHR School for Social Care Research for funding the research.

Webber, M., Reidy, H., Ansari, D., Stevens, M. & Morris, D. (2014) Enhancing social networks: a qualitative study of health and social care practice in UK mental health services, Health and Social Care in the Community DOI: 10.1111/hsc.12135

Please do not hesitate to contact me if you would like a PDF copy of the paper and do not have access to this via the publisher’s website.

Mental health social interventions in Sierra Leone

post by Meredith Newlin
Martin Webber and I have been in Sierra Leone to follow-up from my last visit in July 2013 when I conducted a feasibility study to explore the potential for developing social interventions with mental health workers. The initial visit, funded by the Centre for Chronic Diseases and Disorders (C2D2), was an opportunity to meet with a variety of stakeholders to better understand current practice and explore the extent to which principles social capital are relevant to the communities in Sierra Leone. The second visit, funded by Maudsley Charity, was focussed on co-producing a culturally appropriate social model and training programme for the nurses with local partners, as well as exploring the acceptability of this model of practice.

Findings from the feasibility study indicate enthusiasm for the potential of social interventions to promote meaningful involvement for adults with mental health problems, aiding in their recovery and enhancing social inclusion. Mental health services on the whole are extremely under-resourced and there is significant need for training in low-cost psychosocial approaches to mental health care at both the district and community levels. Findings from the feasibility study were developed into a short film, which can be viewed here.

Based on reflections from the feasibility study, we identified 21 trained psychiatric nurses as the most appropriate group to work with in future training, as they have strong mental health experience but are still limited in how they might be able to apply the biomedical model in which they were largely trained. Through conversations with our partners, King’s Sierra Leone Partnership (KSLP), EU-funded Enabling Access to Mental Health (EAMH), and the Sierra Leone Mental Health Coalition (MHC), we recognise gaps in their current practice around the social aspects of mental health, particularly the capacity for nurses to engage with service users social support networks such as family members and the wider community.

The 21 nurses received extensive training from the College of Medicine and Allied Health Sciences (COMAHS) and EAMH over the past two years. We acknowledge that new skills must fit into the training they have received, and this not meant to be replacement training but rather supplemental. It’s important that training modules and activities for interactive learning also serve as refresher to what they have already learnt. For example, nurses were trained in the MHGap Intervention Guide, the World Health Organization’s (WHO) flagship programme on mental health for scaling-up interventions by general health practitioners in low- and middle-income countries. The nurses have a strong foundation in diagnosing mental illness but what we suggest is an extension of their initial training in which we integrate practical application of social methods, enabling nurses to work in the most under resourced settings.

We heard from stakeholders the importance of teaching nurses about other community-based models of mental health services in African contexts. We will use the limited evidence available to ensure the training programme is in-line with strategies found to be effective in other West African countries. Also in regards to sharing good practice, we recognise the challenges faced by the nurses as they have been posted across the country in all 14 districts, thus peer support approaches are important to ensure the nurses learn from one another.

It is our hope that is in the future the model and training programme could be a useful tool and product for cross-disciplinary training. From the conversations we’ve had, the capacity for its use in other health sectors has been made clear; it might be useful in future training of social workers, PHU staff, CHO’s or primary care doctors. We plan to make the training bespoke for the variety of contexts the nurses are working in. For example, the nurses from the Sierra Leone Psychiatric Hospital in Freetown have different challenges and capacities to an outpatient hospital in Bo, and a community-based clinic in Kono District, but there are ways to take this approach to all these contexts.

Read Martin’s first impressions on mental health services in Sierra Leone here.