Service User Narratives Research Articles

More than you know: critically reflecting on learning experiences by attuning to the ‘community of learners’

This reflection, using auto‐ethnography as method, explores the value of attunement to feedback in the teaching of a professional postgraduate course for allied mental health professionals. This is, therefore, a story of two halves: a narrative of my learning based on my reflections of my own teaching, and a story of how I have integrated feedback from students and their clinical supervisors to refine my teaching and course development in the programme. The resulting model of teaching and learning I have developed involves a process of ‘creative attunement’. ‘Attunement’ is a psychodynamic concept involving ‘contact’ or a quality of relationship based on availability, presence, empathy, respect and selective disclosure. The learning activities of the programme aim to develop an awareness of the students' own ‘craft knowledge’ as graduate social workers and occupational therapists during their intern year in the health services. Through a process of growing the students' awareness of self in the clinician's role by attuning to students' feedback, learning from undergraduate education becomes more available to be applied in a new field of practice. Designing learning activities that incorporate stories of practice and align with clinical supervisors and service user narratives provides access to a variety of learning experiences. I explore the implications for developing critical‐reflective practice within a ‘community of learners' model.

Dual Diagnosis (Drug/Alcohol and Mental Health): Service User Experiences

The inadequacies that frequently manifest in service provision for people who live with dual diagnosis are widely acknowledged. However, the perspectives of these individuals have generally been overlooked within the existing literature. In this context, the following study aims to develop insight into the lived experience of dual diagnosis, particularly with respect to accessing and using services, by exploring the narratives of service users through qualitative research. A series of individual topic-focused interviews were undertaken with service users accessed through a statutory substance use agency. The recordings of these interviews were then transcribed and analysed through systematic coding before being presented and discussed thematically. The findings concur with the wider dual diagnosis literature to a large extent: identified inadequacies with regard to service provision were echoed within the study and the negative impact of issues of exclusion and stigma were noted. A further concern was the tendency for the prevalent parallel model of service provision to curtail any integrated consideration of dual diagnosis. Additionally, the study highlighted the importance accorded by service users to peer support and lived experience. A more inclusive, integrated approach was felt to be desirable and recommendations are offered in this context.

Fabrication or Induction of Illness in a Child: a Critical Review of Labels and Literature Using Electronic Libraries

This paper argues that the variance between professionals on the use of terminology to describe and define this form of child maltreatment may lead to a loss of focus on children's welfare. The author argues that the label Munchausen Syndrome by Proxy has outlived its use and recommends the adoption of a new label 'Fabrication or Induction of Illness in a Child'. The article presents a critical analysis of the titles of 41 0 unique library entries collated from electronic libraries to discern the prevalence of labels to denote the fabrication or induction of illness in children. The article also re views recent developments in the UK courts and some critical observations on the challenges to the field. The author notes with concern that there does not appear to be a preponderance of service user narratives or critical perspectives in the literature. The adoption of a more critical orientation and the acknowledgement of critical service user narratives may be a useful focus for future research. The paper reviews the merits of electronic libraries to efficiently discern an up to date reading list on a particular theme or issue. Electronic libraries can be of particular use to research minded practitioners and as a tool to support evidence­ based practice . The use of electronic libraries to facilitate the research process is affirmed, although some issues regarding accuracy and research skills are noted. Electronic libraries can be of particular use to research minded practitioners and as a tool to support practice.

‘No one knows like we do’ — the narratives of mental health service users trained as researchers

In 2008, Mind in Bexley received a research development grant from the Big Lottery Fund and a training grant from Bexley Care Trust to empower service users to participate and contribute to a pilot research project. The project aims were to work with, develop, train and support service users as researchers, in order to record the narratives of service users who have common experiences of mental health distress and treatment. The research development project set up an advisory group, created and developed a partnership with the University of Kent and provided workshops and training sessions to explore some of the principles of research and ethics. In addition, the group undertook a preliminary literature review, developed and refined a research questionnaire and piloted interviews with six service users. Many issues were raised and lessons learned during the planning and conduct of the project. This paper discusses the process and reflects on aspects of the project's design and delivery. In addition, this paper highlights some of the difficulties in undertaking service user research and suggests recommendations as to how to overcome some of these complex issues.

Psychiatry for the person

This review considers much recent work focused around the Psychiatry for the Person Programme of the World Psychiatric Association. Yet we have also considered the wider medical context, based on recent publications familiar to us in the fields of ethics, religion, spirituality and person-centred medicine as well as 'medicine of the person' as developed by Tournier. There is an urgent need for evaluative outcome studies of person-centred care, including the narratives of service users, rigorous scientific methods and new conceptual models; and for a reformulation of the bio-psychosocial model to incorporate new knowledge in the neurosciences, philosophy, anthropology, ethics and theology. We suggest that a biosocial/psychospiritual (BSPS) approach to relationship-based healthcare should be more actively considered.

The Power of Stories: Using Narrative for Interdisciplinary Learning in Health and Social Care

This paper discusses the aims, process and outcomes of an interdisciplinary workshop day held for undergraduate students from Social Work, Mental Health Nursing, Adult Nursing, Midwifery and Occupational Therapy courses. The day's activities focused on mental health and were based on the use of service user narrative within three different workshops. The feedback from the students showed that the day was relevant to the curriculum that they were engaged in; allowed them to interact with and explore the perspectives of different professional groups; assisted them in understanding the lived experience of mental health difficulties; offered them the opportunity to consider implications for practice; was enjoyable and added ‘value’.

Workplace interventions can reduce stigma

Stigma and discrimination towards people with mental health problems is a global issue, imposing a considerable public health burden in terms of social isolation, limited life chances, delayed help‐seeking behaviour and stress. While numerous initiatives have been undertaken to address these issues, an evidence base for what works is still emerging. This paper explores the impact of 15 population‐level awareness workshops delivered over a five‐month period to 137 participants. These were employees drawn from workplaces identified as being important in the day‐to‐day lives of people with mental health problems. Evaluation approaches maximised specificity, sensitivity and anonymity and they assessed participant knowledge, attitude and behaviour. The workshops significantly improved participant knowledge. Attitude change was more complex with an overall significant improvement in attitudes, particularly in relation to unpredictability and recovery, but not dangerousness, which had more positive baseline attitudes. Social distance, a proxy for behavioural intent, had significant improvements in relation to ‘moderate’ social contact only. Qualitative feedback indicated that complex, unanticipated and positive messages had been absorbed by participants and influenced beliefs and behavioural intent. Service user narratives focusing on recovery were identified as the most valuable component of the intervention.

Mental Health User Narratives: New Perspectives on Illness and Recovery - Mental Health User Narratives: New Perspectives on Illness and Recovery. Bruce M. Z. Cohen. Palgrave Macmillan, 2007, £50.00 hb, 256 pp. ISBN 9781403945365

Mental Health User Narratives: New Perspectives on Illness and Recovery - Mental Health User Narratives: New Perspectives on Illness and Recovery. Bruce M. Z. Cohen. Palgrave Macmillan, 2007, £50.00 hb, 256 pp. ISBN 9781403945365 - Volume 33 Issue 3