Who am I? The identity crisis of mental health professionals living with mental illness.

A Global Call for Action to Prioritize Healthcare Worker Suicide Prevention During the COVID-19 Pandemic and Beyond.

This paper explores the lived experience of mental illness within the field of psychology across higher education and the mental health workforce. There is a high prevalence of mental health issues among psychology students and practitioners, and it is critical not only to provide support for these populations, but also to acknowledge the value of leveraging their lived experience within their education and practice. There has been increased interest in and advocacy for the involvement of those with lived experience of mental illness within mental healthcare service provision to improve patient experiences and outcomes. However, there have been limited acknowledgement and research regarding the role of psychologists with personal lived experiences of mental illness, and how to leverage this experience. Further, there are challenges faced by both psychology students and practising psychologists with lived experience that act as barriers to leveraging their unique skills and experiences. Psychology students with lived experience face stigma, inadequate support, and incongruence between the course material and their personal experiences. Similarly, practising psychologists with lived experience encounter stigma and isolation, indicating the need for a culture change that promotes transparency and understanding. The paper calls for research in five key directions to provide evidence that can be used to support and leverage lived experience in psychology.

BackgroundThe role of community pharmacists is changing globally with pharmacists engaging in more clinically-oriented roles, including in mental health care. Pharmacists’ interventions have been shown to improve mental health related outcomes but various barriers can limit pharmacists in their care of patients. We aimed to explore the experiences of people with lived experience of mental illness and addictions in community pharmacies to generate findings to inform practice improvements.MethodsWe used interpretive description methodology with analytic procedures of thematic analysis to explore the experiences of people with lived experience of mental illness and addictions with community pharmacy services. Participants were recruited through multiple mechanisms (e.g., paper and online advertisements), offered honorarium for their time, and given the option of a focus group or interview for participation in our study. Data were gathered during July to September of 2012. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed by two researchers.ResultsWe collected approximately nine hours of audio data from 18 individuals in two focus groups (n = 12) and six individual interviews. Fourteen participants were female and the average age was 41 years (range 24 to 57 years). Expectations, decision-making, and supports were identified as central themes underlying the community pharmacy experiences of people with lived experience of mental illness and addictions. Eight subthemes were identified including: relationships with pharmacy staff; patient’s role in the pharmacist-patient relationship; crisis and triage; privacy and confidentiality; time; stigma and judgment; medication-related and other services; and transparency.ConclusionsPeople with lived experience of mental illness and addictions demonstrate a high regard and respect for pharmacist’s knowledge and abilities but hold conservative expectations of pharmacy health services shaped by experience, observations, and assumptions. To some extent, expectation management occurs with the recognition of the demands on pharmacists and constraints inherent to community pharmacy practice. Relationships with pharmacy staff are critical to people with lived experience and influence their decision-making. Research in the area of pharmacists’ roles in crises and triage, especially in the area of suicide assessment and mitigation, is needed urgently.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1817-4) contains supplementary material, which is available to authorized users.

Social contact strategy or social contact based anti-stigma intervention, where a person with lived experience (PWLE) of mental illness shares his/her lived experiences with the target group, has been found to be effective in reducing stigma and discrimination. A culturally appropriate social contact based anti-stigma intervention training module would be helpful in training PWLE. Since there is no culturally appropriate training module available in India, there is a need to develop a training module for PWLE of mental illness to deliver a social contact based anti-stigma intervention. Thus, the proposed mixed-methods study aims to develop and test the efficacy of a training module for PWLE of mental illness, using social contact strategy to reduce stigma and discrimination towards people with mental illness amongst undergraduate students. The proposed study will be carried out in three phases; Phase-I: formative work will be conducted using an explorative research design. After a formative and extensive literature review, the culturally appropriate training module will be developed and subsequently reviewed and validated by mental health experts and service users. Phase-II: PWLE of mental illness will be trained using the developed manual adopting a case series design. Phase-III: To test the efficacy of the training, a quasi-experimental research design will be used, in which the target group’s knowledge, attitudes and behaviour towards mental illness will be assessed pre- and post and at three-month follow-up. Socio-demographic data will be analysed using descriptive statistics. Qualitative data (Phase-I and Phase-III) will be analysed through thematic analysis. Based on normality distribution, a parametric test like RMANOVA or an equivalent non parametric test will be adopted during phase III for efficacy testing. In addition, the outcomes amongst the PWLE, i.e., self-stigma and self-esteem, will be assessed and use of the training module will be analysed using thematic analysis.

Opportunities in mental health services research.

Directly engaging with People with lived experiences of mental illness from the communities in India

Community-Based Recreation Therapy and Mental Health Recovery:A Mixed-Media Participatory Action Research Study Jessica J Ariss, MRSc, Alison Gerlach, PhD, J.B. Baker, Keith Barry, Lyn Cooper, Theressa L. de Vries, Kevin Halligan, and Monica Lacroix What Is the Purpose of this Study? • To understand how community-based recreation therapy can support mental health recovery, from the perspectives of people diagnosed with mental illness. • To guide the development, delivery, and evaluation of recovery-oriented mental health services. What Is the Problem? • The concept of personal recovery, as defined by mental health service users, emphasizes the importance of lived experience of mental illness. Few studies about recreation therapy in community mental health settings have involved partnerships with people who use mental health services. • Recreation therapists who strive to provide recovery-oriented services do not have enough evidence, informed by the lived experience of mental illness, to understand the role of therapeutic recreation in the recovery process. What Are the Findings? • Community-based recreation therapy can support the recovery process by providing a safe and fun environment that encourages self-determination in leisure while promoting hope and building confidence. • Service recipients' unique preferences and perspectives must be integral to service development, delivery, and evaluation to provide services that are truly recovery oriented. Who Should Care Most? • Mental health service providers (particularly in community-based settings). • Senior administrators in the mental health sector. • People who use mental health services. • Recreation therapists. • Mental health researchers. [End Page 125] Recommendations for Action • Involve mental health service users in service development, delivery, and evaluation. • Provide paid and volunteer peer support positions. • Listen to service users and provide personalized services according to each person's unique preferences. • Offer open access to a wide variety of recreation/leisure supplies at community-based mental health facilities and maximize opportunities to express personal choice. [End Page 126] Jessica J Ariss Waypoint Centre for Mental Health Care Alison Gerlach School of Child & Youth Care, Faculty of Human & Social Development, University of Victoria, Coast Salish Territories J.B. Baker HERO Centre Keith Barry HERO Centre Lyn Cooper HERO Centre Theressa L. de Vries HERO Centre Kevin Halligan HERO Centre Monica Lacroix HERO Centre Copyright © 2019 Johns Hopkins University Press

Canadian youth can experience a range of mental health problems and mental illness, many of which perpetuate into adulthood. In contrast with preventative and medical care for physical problems, youth who experience difficulties with mental health or illness meet restricted access to evaluation, diagnostic and treatment services. Obstacles vary from low funding levels for services to the fear of being stigmatised by society. Conventional therapies could be complemented by the use of arts-based therapies, which are reported to offer a tangible alternative and could relieve delays in treatment. However, research regarding the treatment options, monitoring and assessment of outcomes is based largely on narrative evidence or idiographic studies, thus constraining the dissemination of supporting evidence and limiting the range of treatments for use by practitioners. While arts-based therapies receive support from many areas, including people with lived experience of mental health problems and illness, it is argued that the development of a theoretical foundation and extensive empirical research are required to develop the potential that arts-based therapies have to offer.

Plain English summaryInvolving people in health research is increasingly recognised as being important to make sure that research is focused more on the needs of people who use health services. At present, ideas about what should be researched most often comes from researchers and/or health professionals like doctors and nurses rather than people with a lived experience of mental illness. In this study, we will talk with this group of people from across Wales to explore what they think research into their health services should focus on. The findings from this work will help to influence the work of the National Centre for Mental Health Research Partnership Group; as well as` researchers and health professionals and others who concentrate on mental health research. The Research group is a partnership between people with a lived experience of mental ill health and professionals with an interest in mental ill health. The group plan to take forward the ideas that came from this research and some of the ideas have already been used to increase funding in the area of mental health research.Background This paper is the result of continued collaboration between members of the Service User and Carer Research Partnership, based in Wales and supported by the National Centre for Mental Health, Health and Care Research Wales, and Hafal. The aim of this study was to explore the research priorities of people with experience of mental health services which include people with a lived experience of mental ill health, their carers, and professionals.Method A nominal group technique was used to gather data. A one-day workshop ‘Getting Involved in Research: Priority Setting’ was held to gather the ideas and suggestions for research priorities from people who have experience of mental health services.Results Twenty-five participants attended the workshop. 5 were mental health professionals, 20 had a lived experience of mental ill health, (of which 3 were also carers). 11 were male and 14 were female. 120 research ideas were generated across 6 ‘Ideas Generating Workstations’. Participants took part in a 3 stage vote to narrow down the ideas to 2 main research priorities.Conclusion The two main research priority areas that were identified:‘Developing the knowledge of mental health issues amongst school-aged children’ as a vehicle to overcome stigma and discrimination, and to support young people to manage their own mental health.‘Developing education as a tool for recovery’, for example by peer support. In addition, participants engaged in a notable discussion over the research priority: ‘How are carers supported during the recovery of the person for whom they care?’

To explore whether nursing student's experiences at Recovery Camp have impacted their current nursing practices. Recently, there has been a move towards more holistic models of nursing care, which seek to break down barriers of stigmatisation and embrace the tenets of self-determination, to acknowledge people with lived experiences of mental illness and their ability to manage their recovery. In that regard, future health professionals such as nursing students will need to be educated in a manner that recognises the importance of lived experience. In this paper, we propose that Recovery Camp, an alternative clinical placement setting model, enhances clinical practice in multiple domains and is beneficial for both nursing practitioners and people with lived experiences of mental illness, as well as offering an effective nontraditional alternative to conventional clinical placement opportunities. This study employed a phenomenological research design, involving individual semi-structured telephone interviews. The Standards for Reporting Qualitative Research (SRQR) checklist was adhered to. Three main themes were identified from the analysis: (a) engagement, (b) understanding mental health and (c) holistic care. "I definitely look at people with mental health conditions in a different light." At Recovery Camp, participants felt that they had greater opportunities for engagement with people with lived experiences, and through this engagement, their preconceptions of mental illness began to change. Recovery Camp may have facilitated the transfer of knowledge that is more person-centred among nursing students, consequently impacting their current nursing practices. Nurses should be equipped with mental health skills regardless of their career trajectory. While Recovery Camp represents a promising approach to facilitate knowledge transfer, further investigation will be required to determine which other factors are instrumental. This approach may have wider implications for nursing education.

Objective Australian mental health care remains hospital centric and fragmented; it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence. Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD. Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care; (2) an absence of services providing acute day care and non-acute day care; (3) low availability of specific employment services for people with a lived experience of mental ill-health; and (4) a lack of comprehensive data on the availability of supported housing. Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care. What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system. What does this paper add? This paper provides a critical analysis of the pattern of adult mental health care provided within the boundaries of the Western Sydney LHD using a standard, internationally validated tool to describe and classify the services. This provides a good picture of the availability of adult mental health care at the local level that was hitherto lacking. What are the implications for practitioners? The data presented herein provide a better understanding of the context in which mental health practitioners work. Managers and planners of services providing care for people with a lived experience of mental illness can use the information herein for better planning informed by local evidence.

WHAT IS KNOWN ON THE SUBJECT?: People with mental health problems are often left behind, forgotten and excludedLittle is known or written from a service user perspective about experiences of psychiatry, mental health nursing, Mental Health Tribunals and alternative approaches (such as counselling, peer support, psychological and recovery approaches, cognitive behavioural therapy-CBT and creative/art/music/drama/horticultural/dance therapies). WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper aims to remedy this gap in knowledgeIt focuses on positive and negative experiences of psychiatry, Mental Health Tribunals and alternative treatments from a service user's perspective. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The paper makes several recommendations. In brief, (1) psychiatrists need to listen more attentively rather than being focused on signs of psychosis; (2) de-escalation techniques (for example, talking calmly with the patient) should be used by nurses before physical restraint; (3) psychiatry should be less biomedical. Nurses and social care professionals deserve better training, time for and practice in alternative and more therapeutic forms of care; (4) carers need to be more involved; (5) there need to be better, more democratic, more open processes of law; (6) voluntary work and supported employment schemes should be run by health and social services for people who want to work and want to have a vocational life. This paper aims to describe the lived experience of mental illness, coercive treatment by psychiatry and mental health nursing, and the problematic case and bias of Mental Health Tribunals. It then looks at more positive experiences of alternative approaches and makes recommendations for improving mental health services and people's experiences of them.

A conceptual framework for the revision of the ICD‐10 classification of mental and behavioural disorders

The mental health community: An underserved and undertreated population: Encouraging research but challenges remain

PurposeThe purpose of this study was to evaluate the effects of an online mental health ally program on several measurements of readiness to help and stigma reduction. Allyship is one way to support people with mental health challenges beyond traditional care services.Design/methodology/approachThe efficacy of the program was evaluated in pre and postintervention surveys (n = 26) including measures of self-care, help-seeking intentions, peer-support self-efficacy, advocacy, knowledge of resources and stigma. A within-subject, repeated measures design was conducted analyzing changes at completion. Twenty-six participants who completed the program (either with or without lived experience of mental illness) were included in the study. A subgroup of participants (n = 11) who reported lived experiences of mental illness were assigned additional measures of internalized stigma, stigma stress, stigma resistance and self-esteem.FindingsAnalysis of mean differences indicated a statistically significant change in scores pre and postcompletion. The program increased peer-support, help-seeking intentions and self-esteem, while reducing internalized stigma and stigma stress. Findings provide preliminary support for program effectiveness in training individuals to support others and themselves through mental health challenges.Research limitations/implicationsTrained allies might improve the lives of individuals with mental health challenges by reducing discrimination and improving social support. We discuss the implication of allies to complement the mental health system.Originality/valueTo the best of the authors’ knowledge, this is the first exploratory study on the efficacy of an online ally training program for individuals with mental illness. The NoStigmas Ally Program is a novel and original development in ally training.