Research into Recovery and Wellbeing

A website about the work of the recovery research team at the Institute of Mental Health

The University of Nottingham

February 2020

Recovery Research Network eBULLETIN


February 2020


RRN Meetings

The 23rd meeting of the Recovery Research Network (RRN) will be hosted by Camden and Islington NHS Foundation Trust.  The theme of the meeting will be implementation challenges for a recovery-orientated NHS. A provisional agenda and registration details will follow shortly.


Date:               Thursday 28th May 2020

Time:               09:30 – 16:00

Venue:            St Pancras Hospital

4 St. Pancras Way





St Pancras Hospital Telephone:  020 3317 3500

Tube:  Mornington Crescent

Train:  St Pancras International/ Kings Cross


From St Pancras International (Kings Cross) station allow 15 min walking time.  From Mornington Crescent: turn right from the station to Crowndale Road. Continue down Crowndale Road. The entrance to the hospital is on St Pancras Road. The conference hall is next to main reception in West Wing building.


All RRN events are free and administrated through Eventbrite.  The fact that the RRN is able to attract speakers who are experts in their field means that places are filled quickly.  We do kindly ask that you notify the RRN if, for whatever reason, you are unable to attend on the day. This allows us to offer your place to someone else.


If you would like to present at a future meeting of the RRN please email either Shula Ramon or Tony Sparkes. Their contact details are:





RRN Membership Profile

Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:


Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email



A Call to PhD Students and their Supervisors

Please could we remind the readership that PhD students (and their supervisors) are particularly welcome to join the RRN.  The forum provides a unique opportunity to network and build research capacity. The network also provides a collegial environment to present doctoral work.


Recovery Research: We would like to learn from your experience of conducting recovery research.  Therefore, would readers kindly get in touch with the Network to let us know about the things that have helped and the things that have hindered during your experience of undertaking recovery research. Please send your comments to either Tony or Shula.



Conferences and Events

i)  The 3rd Meeting of the International Open Dialogue Research Collaboration (IODRC.  Developed as a multicentre, international extension of the ODEDESSI trial) will take place in Rome 4th – 5th May 2020.


For further details and registration, please click here.



ii) A One-day International Conference on Shared Decision Making in Mental Health is due to take place at Addenbrooke’s Hospital, Cambridge, on Tuesday, May 12th 2020.


For more information and registration, please click here



iii)  Organised by Ajuda, The Mental Health and Wellbeing Show is to be held on Thursday 21st May 2020 at Cardiff City Stadium, Leckwith Road, Cardiff (08:00am – 16:00pm).  For more information please see:



iv)  International Society for Psychological and Social Approaches to Psychosis (ISPS) international conference 2021:


ISPS Perugia 2021

Italy Wednesday, 01 September 2021 - Sunday, 05 September 2021 Perugia

The 22nd International Conference of the ISPS will take place in Perugia, Italy in 2021.



v)  International Resilience Revolution Conference Blackpool, 8-11 September 2020

A conference and a call-for-action, recognising the importance of resilience focused, co-produced research and action to achieve equality and social justice for all.

Organised by the Centre of Resilience for Social Justice at the University of Brighton with Boingboing and HeadStart Blackpool. Come and learn from local communities, practitioners and academics who are developing ideas we want to share and grow.


For more information click here



Papers and Publications

In addition to peer-reviewed literature and work of a purely academic nature, the ebulletin also welcomes the submission of material that would include grey literatures (such as briefing papers, reports and so on) that attest to the broader impact of personal recovery.



i)  De Wet, A., Parker, J. and Pretorius, C. (2019) The Spring Foundation: a recovery approach to institutional public mental health services in South Africa. Perspectives in Public Health. 139(3)  123-124.  Online:



Recent change in mental healthcare policy in South Africa has promoted a recovery approach to support people with mental health problems within communities and institutions. In this article, Anneliese De Wet and her co-authors share the progress and early successes of The Spring Foundation, one of the first interventions to be developed and based in Cape Town.



ii)  Bartram, M. (2020)  ‘It’s really about wellbeing’: a Canadian Investigation of harm reduction as a bridge between mental health and addiction recovery.  International Journal of Mental Health and Addiction.  Online:



Recovery is a key concept driving system transformation in both the addiction and mental health sectors, with shared roots in advocacy and a shared focus on hope in the face of stigma, self-determination and meaningful lives. Nevertheless, while mental health recovery is possible even with on-going symptoms, addiction recovery generally starts with or leads to abstinence. This disconnection undermines coherence at the policy level and exacerbates fragmentation between services and supports in the mental health and addiction sectors in Canada and internationally. At the same time, harm reduction, which does not require abstinence, has been gaining ground in the Canadian addiction sector. This qualitative policy study explores the potential for harm reduction to bridge the gap between mental health recovery and addiction recovery in the Canadian context, drawing on diverse experiences from the mental health and addiction sectors. The findings could be adapted internationally to address similar policy challenges.


iii)   Hui, A., Latif, A., Hinsliff-Smith, K. and Chen, T. (2020) Exploring the impacts of organisational structure, policy and practice on the health inequalities of marginalised communities: Illustrative cases from the UK healthcare system.  Health Policy.  124(3) 298-302.



This paper explores how organisational structure, policies and practices in healthcare can inadvertently disadvantage marginalised populations (e.g. individuals from ethnic minority backgrounds) and reinforce health inequalities. We draw upon three diverse UK healthcare settings (long term care institutions, high security hospitals and community pharmacies) to illustrate how systemic injustices negatively impact on access to care, treatment and health outcomes. The first case study considers the care of older people within nursing homes; specifically the disempowering effects of this service structure and impacts of choice reduction upon health and their access to health provision. The second case study explores the impact of security restrictions upon patients within high security hospitals, focusing particularly on the maintenance of relationships and support networks outside of the hospital. The third and final case study, draws upon a national community pharmacy medicine management service to illustrate ways in which policies and guidelines inadvertently obstruct patients' engagement with the service within a community setting. We draw upon these settings to highlight inequalities within different contexts and to illustrate the ways in which well-intended services can inadvertently disadvantage marginalised communities in multiple ways.



iv)  Petros, R. and Solomon, L. (2020) Social Workers’ propensity to endorse recovery-oriented service provision: a randomised factorial design.  British Journal of Social Work. 50(1) 42-61.



Providers inconsistently provide recovery-oriented services to adults with serious mental illness despite US federal mandate. An online randomised factorial survey was used to identify and evaluate predictors of social workers’ degree of endorsement of recovery-oriented service provision. Respondents (N ¼ 107) each rated scale items indicating support for recovery-oriented services for four client vignettes (n ¼ 398) and completed standardised measures of recovery knowledge and expectations. The final predictive model was significant (p < 0.0001), accounting for 61 per cent of the variance of the degree of endorsement of recovery-oriented services. Recovery knowledge explains the largest portion of the variance, followed by psychotic symptoms. The finding that client characteristics predict endorsement of recovery-oriented services suggests a fundamental misunderstanding of recovery. Recommendations include training and supervision to enhance application of recovery-oriented principles to service provision.



v)  Rosmarin, D.H., Pargament, K.I. and Koenig, H.K. (2020) Spirituality and mental health: challenges and opportunities (commentary).  Lancet Psychiatry.  S2215-0366(20)30048-1.  Online:


Couched in terms of challenges and opportunities, Rosmarin et al offer a brief commentary of the relevance of spirituality to contemporary mental health care.  Relevance is expressed in terms of personal meaning and ‘connection’, and in terms of service provision.  The authors argue that greater levels of research funding would greatly contribute to the knowledge base in this domain.



vi)  K, L.E. Peteet, J.R. and Cook, C.C.H. (2020) Spirituality and mental health.  Journal for the Study of Spirituality.  Online:



In many contexts, emotional ailments have been considered problems of religious or spiritual origin. Historically, religious groups were often the primary providers of mental health care. This changed over time with advances in medicine and Freud’s writings framing religion/spirituality (R/S) as a sign of neurosis. In the early- to mid-twentieth century, mental health and R/S were often viewed by Western clinicians and patients as separate and antithetical. Recent decades have been marked by another shift in thought, with increased interest in the overlap between mental health and R/S, and recognition that R/S may in fact serve protective and healing roles in the face of emotional suffering. There has been a concomitant increase in research investigating the connections between R/S and mental health, along with increased development and application of clinical interventions addressing the two in combination. In this narrative review, we summarize the history of how mental health and R/S have been viewed as relating to one another, recent research evidence on the effects of R/S on mental health, and clinical implications of these findings. We conclude with a discussion of ongoing challenges and opportunities in the study and application of how mental health and R/S affect one another.



vii)  Llewellyn‑Beardsley, J., Rennick‑Egglestone, S., Bradstreet, S., Davidson, L., Franklin, D., Hui, A., McGranahan, R., Morgan, K., Pollock, K., Ramsay, A., Smith, R., Thornicroft, G. and Slade, M. (2020) Not the story you want? Assessing the fit of a conceptual framework characterising mental health recovery narratives.  Social Psychiatry and Psychiatric Epidemiology.  55.  295-308.



Purpose: Narratives of recovery have been central to the development of the recovery approach in mental health. However, there has been a lack of clarity around definitions. A recent conceptual framework characterised recovery narratives based on a systematic review and narrative synthesis of existing literature, but was based on a limited sample. The aims of this study were to assess the relevance of the framework to the narratives of more diverse populations, and to develop a refined typology intended to inform narrative-based research, practice and intervention development.

Method: 77 narrative interviews were conducted with respondents from four under-researched mental health sub-populations across England. Deductive and inductive analysis was used to assess the relevance of the dimensions and types of the preliminary typology to the interview narratives.

Results: Five or more dimensions were identifiable within 97% of narratives. The preliminary typology was refined to include new definitions and types. The typology was found not to be relevant to two narratives, whose narrators expressed a preference for non-verbal communication. These are presented as case studies to define the limits of the typology.

Conclusion: The refined typology, based on the largest study to date of recovery narratives, provides a defensible theoretical base for clinical and research use with a range of clinical populations. Implications for practice include ensuring a heterogeneous selection of narratives as resources to support recovery, and developing new approaches to supporting non-verbal narrative construction.



viii)  Ibrahim, N., Thompson, d., Nixdorf, R., Kalha, J., Mpango, R., Moran, G., Mueller‑Stierlin, A., Ryan, G., Mahlke, C.,  Shamba, D., Puschner, B., Repper, J. and Slade, M. (2020) A systematic review of influences on implementation of peer support work for adults with mental health problems.  Social Psychiatry and Psychiatric Epidemiology.  55. 285-293



Purpose: The evidence base for peer support work in mental health is established, yet implementation remains a challenge.  The aim of this systematic review was to identify influences which facilitate or are barriers to implementation of mental health peer support work.

Methods: Data sources comprised online databases (n = 11), journal table of contents (n = 2), conference proceedings (n = 18), peer support websites (n = 2), expert consultation (n = 38) and forward and backward citation tracking. Publications were included if they reported on implementation facilitators or barriers for formal face-to-face peer support work with adults with a mental health problem, and were available in English, French, German, Hebrew, Luganda, Spanish or Swahili. Data were analysed using narrative synthesis. A six-site international survey [Germany (2 sites), India, Israel, Tanzania, Uganda] using a measure based on the strongest influences was conducted. The review protocol was pre-registered (Prospero: CRD42018094838).

Results: The search strategy identified 5813 publications, of which 53 were included. Fourteen implementation influences were identified, notably organisational culture (reported by 53% of papers), training (42%) and role definition (40%). Ratings on a measure using these influences demonstrated preliminary evidence for the convergent and discriminant validity of the identified influences.

Conclusion: The identified influences provide a guide to implementation of peer support. For services developing a peer support service, organisational culture including role support (training, role clarity, resourcing and access to a peer network) and staff attitudes need to be considered. The identified influences provide a theory base to prepare research sites for implementing peer support worker interventions.



ix)  Cooper, R.E., Grünwald, L.M. and Horowitz, M. (2020) The  case for including antipsychotics in the UK NICE guideline: “Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults”.  Psychosis.  12(1)  89-93.



The UK’s National Institute for Health and Care Excellence (NICE) is in the process of writing guidelines for “Medicines Associated with Dependence or Withdrawal Symptoms: Safe Prescribing and Withdrawal Management for Adults”. NICE has excluded antipsychotics, despite inclusion having been requested by all four groups participating in the guideline scoping workshop, as well as the Royal College of Psychiatrists, the All-Party Parliamentary Group for Prescribed Drug Dependence, the International Institute for Psychiatric Drug Withdrawal (IIPDW), Bangor University, Grünenthal Ltd, Pfizer and Mind (the UK’s largest mental health non-profit organisation). The IIPDW subsequently submitted the following request, drafted on their behalf by three researchers with expertise in this field, that NICE review its decision to exclude antipsychotics. The request draws on the recently updated German National Guideline for Schizophrenia. Two additional studies published since the submission, adding weight to the case, are also summarised.



x)  Dawson, S., Muller, J., Renigers, V., Varona, L. and Kernot, J. (2020). Consumer, health professional and employment specialist experiences of an individual placement and support programme.  Scandinavian Journal of Occupational Therapy  24.  1-13. Online:



Background: Individuals with severe mental illness (SMI) are under-represented in the workforce. The Individual Placement and Support (IPS) programme is an evidence-based intervention that co-locates an Employment Specialist in a community mental health team to support individuals with a SMI with their goal of finding work. Previous research predominantly explored IPS programme outcomes rather than stakeholder experiences.

Aim: To explore programme stakeholder perspectives and experiences during the early stages of IPS programme implementation.

Methods: Qualitative descriptive methodology explored consumers (n = 11), health professionals and employment specialist (n = 11) perceptions and experiences of the IPS programme. Semi-structured interviews were conducted and thematically analysed.

Results: Three main themes emerged: enacting core care philosophies, IPS programme process and catalyst for supportive environments and relationships. The combination of IPS programme relationships, enactment of core care philosophies, and programme process promoted development of supportive environments and relationships for consumers participating in the programme.

Conclusion: Findings suggest IPS processes promoted the enactment of person-centred and recovery-oriented care approaches and positively influenced care planning practices and service culture.

Significance: IPS directly tackles the compounding disadvantage resulting from unemployment for people with a SMI. At a service level, IPS can foster positive changes to care practices and service culture.



xi)  Kemp, H., Bellingham, B., Gill, K., McCloughen, A., Roper, C., Buus, N. and River, J. (2020) Peer support and open dialogue: possibilities for transformation and resistance in mental health services.  In Rhodes, P. (ed.) Beyond the psychology industry: how else might we heal?  Springer Nature Switzerland.  Chapter 6.



This chapter is about peer support and open dialogue (OD). Peer support workers (PSWs) purposefully bring to their work knowledge and wisdom gained through lived experience of emotional distress and/or extreme states of mind (distress/extreme states) to establish connections with service users and engage in mutually transformative dialogue. The transformative power of peer support is often curtailed in health service cultures that are resistant to change and continue to privilege biomedical responses to distress/extreme states. Open dialogue is a social network–based approach to mental healthcare that came out of ‘psy’ (psychiatry and psychology) disciplines, and radically challenged clinicians to put aside their disciplinary expertise, diagnoses and clinical judgements to see distress/extreme states in a relational context. Using a co-production framework, which aims to yield new forms of knowledge through a collaborative, exploratory and reflective process of interaction between people with lived experience and researchers, we explore the histories and possibilities of each practice and the potential for transformation and resistance in mental health services by the pairing of the two.



xii)  Crawford, P., Brown, B. and Charise, A. (eds.) (2020) The Routledge companion to health humanities.  Abingdon, Routledge.



The health humanities is a rapidly rising field, advancing an inclusive, democratizing, activist, applied, critical, and culturally diverse approach to delivering health and well-being through the arts and humanities. It has generated new kinds of interdisciplinary research, knowledge, and communities of practice globally. It has also acted to bring greater coherence and political force to contributions across a range of related disciplines and traditions.


In this volume, a formidable set of authors explore the history, current state, and future of the health humanities, in particular how its vision of the arts and humanities:

  • Promotes creative public health.
  • Opens new routes to health and well-being.
  • Informs and drives better health care.
  • Interrogates relationships between ill health and social equality.
  • Develops humanist theory in relation to health and social care practice.
  • Foregrounds cultural difference as a resource for positive change in society.
  • Tests the humanity of an increasingly globalized health-care system.
  • Looks to overcome structural and process obstacles to cross-disciplinary ventures.
  • Champions co-construction, co-design, and mutuality in solving health and well-being challenges.
  • Showcases less familiar, prominent, or celebrated creative practices.
  • Includes multiple perspectives on the value and health benefits of the arts and humanities not limited to or dominated by medicine.


Divided into two main sections, the Companion looks at "Reflections and Critical Perspectives," offering current thinking and definitions within health humanities, and "Applications," comprising a wide selection of applied arts and humanities practices from comedy, writing, and dancing to yoga, cooking, and horticultural display.



Other News

i)  Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following: