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

July 2020

 

Recovery Research Network eBULLETIN 

 

July 2020 

 

RRN Meetings 

The 23rd meeting of the Recovery Research Network (RRN) was due to be hosted by Camden and Islington NHS Foundation Trust.  Due to the current developments with regard to Covid-19, this event has been cancelled. 

 

The coronavirus pandemic is having unprecedented effects both nationally and internationally.  During this time of social distancing and self-isolation, remaining connected to our networks is important.  Please can we encourage our readership to continue to submit material to e-bulletin using the detail below.  As ever, comments are welcome from the readership about articles included in the ebulletins. 

 

Thank-you. Please stay safe, and our best wishes to you all. 

 

Please submit material to either Shula Ramon or Tony Sparkes. Their contact details are: 

Shula:              s.ramon@herts.ac.uk 

Tony:               a.sparkes@bradford.ac.uk 

 

 Coronavirus and Mental Health 

The impact of coronavirus, and government measures to restrict its transmission, means that we have to pay particular attention to our mental health and wellbeing.  There is a considerable amount of advice and information available online.  In this edition, we have included some examples at the end of the ebulletin.   

 

 RRN Membership Profile 

Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:  http://www.researchintorecovery.com/rrn  If you would like to leave the RRN and have your details removed from our database, please email:  researchintorecovery@nottingham.ac.uk 

 

 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  

In an attempt to restrict the spread of coronavirus, limitations upon the free movement of people are evident in many countries throughout the world.  As you will no doubt be aware, such measures have impacted upon national and international travel and hospitality. 

 

Whilst it is almost certain that traditional face-face conferencing/events will not be taking place in their ‘traditional’ format, certainly in the immediate future, please check with the organisers.  It may be that alternative or innovative platforms are being utilised to deliver such events going forward.   

 

Looking ahead, the University of South-Eastern Norway are hosting a rescheduled seminar with the title: The Politics of Recovery: controversy and co-option in the era of austerity.  Originally scheduled for later this month, the new date will be:  16th June 2021.  For more information please 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)  Cheli, S., Cavalletti, V. and Petrocchi, N. (2020): An online compassion-focused crisis intervention during COVID-19 lockdown: a cases series on patients at high risk for psychosis, Psychosis.  Online: 

https://doi.org/10.1080/17522439.2020.1786148 

 

Abstract 

Aim: To pilot-test the effectiveness of an online compassion-focused crisis intervention for persons who were diagnosed with brief psychotic disorder and were still at high risk for a psychotic episode at the Italian announcement of lockdown on March 9th, 2020. 

Methods: Six patients who, at the moment of the lockdown, were treated through different psychotherapy approaches and antipsychotic drugs for a first brief psychotic episode accessed a 4-week online compassion-focused intervention comprising a weekly individual video-call session, and an open messenger service with audio-recorded compassion-focused practices. Primary outcome (general symptomatology) was assessed one week before and at the end of the intervention. Secondary outcomes (depression, anxiety and stress symptoms) were assessed daily during the intervention, for a total of 28 days. 

Results: Five of six participants demonstrated a reliable change in both primary and secondary outcomes, and no one reported acute psychotic episodes during the lockdown. All participants reported a stable or increased working alliance. 

Conclusion: These data provide the preliminary feasibility and effectiveness of a brief online compassion-focused crisis intervention for patients diagnosed with a brief psychotic disorder, in situations where the telepsychology is offered, unplanned, as the only possible treatment option. 

 

 

ii)  Moreno, C., Wykes, T., Galderisi, S., Nordentoft, M., Crossley, N., Jones, N., Cannon, M., Correll, C.U., Byrne, L., Carr, S., Chen, E.Y.H., Gorwood, P., Johnson, S., Kärkkäinen, H., Krystal, J.H., Lee, J., Lieberman, J., López-Jaramillo, C., Männikkö, M., Phillips, M.R., Uchida, H., Vieta, E., Vita, A. and Arango, C. (2020) How mental health care should change as a consequence of the COVID-19 pandemic.  The Lancet.  July 16 2020. Online: 

https://doi.org/10.1016/S2215-0366(20)30307-2 

 

Abstract 

The unpredictability and uncertainty of the COVID-19 pandemic; the associated lockdowns, physical distancing, and other containment strategies; and the resulting economic breakdown could increase the risk of mental health problems and exacerbate health inequalities. Preliminary findings suggest adverse mental health effects in previously healthy people and especially in people with pre-existing mental health disorders. Despite the heterogeneity of worldwide health systems, efforts have been made to adapt the delivery of mental health care to the demands of COVID-19. Mental health concerns have been addressed via the public mental health response and by adapting mental health services, mostly focusing on infection control, modifying access to diagnosis and treatment, ensuring continuity of care for mental health service users, and paying attention to new cases of mental ill health and populations at high risk of mental health problems. Sustainable adaptations of delivery systems for mental health care should be developed by experts, clinicians, and service users, and should be specifically designed to mitigate disparities in health-care provision. Thorough and continuous assessment of health and service-use outcomes in mental health clinical practice will be crucial for defining which practices should be further developed and which discontinued. For this Position Paper, an international group of clinicians, mental health experts, and users of mental health services has come together to reflect on the challenges for mental health that COVID-19 poses. The interconnectedness of the world made society vulnerable to this infection, but it also provides the infrastructure to address previous system failings by disseminating good practices that can result in sustained, efficient, and equitable delivery of mental health-care delivery. Thus, the COVID-19 pandemic could be an opportunity to improve mental health services 

 

 

iii)  Rennick-Egglestone, S., Elliott, R., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, K., Llewellyn-Beardsley, J., Ng, F., Yeo, C., Roe, J., Hui, A.,  van der Krieke, L., Walcott, R. and Slade, M. (2020)  Impact of receiving recorded mental health recovery narratives on quality of life in people experiencing psychosis, people experiencing other mental health problems and for informal carers: Narrative Experiences Online (NEON) study protocol for three randomised controlled trials.  Trials 21, 661 (2020). Online: https://doi.org/10.1186/s13063-020-04428-6 

 

Abstract 

Background: Mental health recovery narratives have been defined as first-person lived experience accounts of recovery from mental health problems which refer to events or actions over a period of time and which include elements of adversity or struggle, and also self-defined strengths, successes or survival. They are readily available in invariant recorded form, including text, audio or video. Previous studies have provided evidence that receiving recorded recovery narratives can provide benefits to recipients. This protocol describes three pragmatic trials that will be conducted by the Narrative Experiences Online (NEON) study using the NEON Intervention, a web application that delivers recorded recovery narratives to its users. The aim of the NEON Trial is to understand whether receiving online recorded recovery narratives through the NEON Intervention benefits people with experience of psychosis. The aim of the NEON-O and NEON-C trials is to evaluate the feasibility of conducting a definitive trial on the use of the NEON Intervention with people experiencing non-psychosis mental health problems and those who care for others experiencing mental health problems respectively. 

Methods: The NEON Trial will recruit 683 participants with experience of psychosis. The NEON-O Trial will recruit at least 100 participants with experience of non-psychosis mental health problems. The NEON-C Trial will recruit at least 100 participants with experience of caring for others who have experienced mental health problems. In all three trials, participants will be randomly allocated into one of two arms. Intervention arm participants will receive treatment as usual plus immediate access to the NEON Intervention for 1 year. Control arm participants will receive treatment as usual plus access to the NEON Intervention after 1 year. All participants will complete demographics and outcome measures at baseline, 1 week, 12 weeks and 52 weeks. For the NEON Trial, the primary outcome measure is the Manchester Short Assessment of Quality of Life at 52 weeks, and secondary outcome measures are the CORE-10, Herth Hope Index, Mental Health Confidence Scale and Meaning in Life Questionnaire. A cost-effectiveness analysis will be conducted using data collected through the EQ-5D-5 L and the Client Service Receipt Inventory. 

Discussion: NEON Trial analyses will establish both effectiveness and cost-effectiveness of the NEON Intervention for people with experience of psychosis, and hence inform future clinical recommendations for this population. 

 

 

iv)  Barrenger, S.L., Maurer, K., Moore, K.L. and Hong, Inhwa.  (2020)  Mental health recovery: peer specialists with mental health and incarceration experiences.  American Journal of Orthopsychiatry 90(4) 479-488. 

 

Abstract 

Mental health recovery has not been examined widely in individuals with mental illnesses re-entering the community from correctional settings. An important component of mental health recovery is engaging in work and many with lived mental health experiences become peer support specialists, yet little is known how this process unfolds for individuals who also have incarceration histories. Using life history phenomenological interviewing, this study investigates recovery pathways for peer support specialists with incarceration histories. Findings show that experiences of hope, connectedness, identity, meaningfulness, and empowerment were evident in individuals’ recovery pathways of activating change, getting into recovery, integrating past and present, and living recovery every day. Notably, establishing a peer identity and drawing on past experiences were particularly salient. Training and working as a peer supported the recovery process through experiencing hope, facilitating connections, and witnessing disclosure. These findings can be applied to recovery-oriented services for those with experiences of mental illness and incarceration. 

 

 

v)  Chan, S. and Weich, S. (2020) Mental well-being and recovery in serious mental illness: associations between mental well-being and functional status in the Health Survey for England 2014.  BJPsych Open 6(4) 1-7.  Online: 

https://doi.org/10.1192/bjo.2020.46 

 

Abstract 

Background:  Mental illness and mental well-being are independent but correlated dimensions of mental health. Both are associated with social functioning (in opposite directions), but it is not known whether they modify the effects of one another. New treatment targets might emerge if improving mental well-being in people with serious mental illness improved functional outcomes independent of clinical status. 

Aims:  To describe associations between mental well-being and functioning in people classified according to mental illness status. 

Method:  Cross-sectional data from 5485 respondents to the Health Survey for England 2014 were analysed. Mental illness status (including whether diagnosed by a professional) was by self-report and grouped into four categories, including ‘diagnosis of serious mental illness’. Mental well-being was measured using the Warwick-Edinburgh Mental Well-Being Scale, and functioning by items from the EQ-5D. Mental distress was assessed using General Health Questionnaire (GHQ-12) items. Associations were examined using moderated regression models with group membership as an interaction term. 

Results:  Mental well-being score was associated with (higher) functioning score (P < 0.05). This association varied between mental illness groups, even after adjusting for age, gender, ethnicity, physical health and symptoms of mental distress (F(3) = 14.60, P < 0.001). The gradient of this association was greatest for those with diagnosed serious mental illness. 

Conclusions:  Mental well-being was associated with higher functional status in people with mental illness, independent of the symptoms of mental distress and other confounders. The association was strongest in the diagnosed serious mental illness group, suggesting that mental well-being may be important in recovery from mental illness. 

 

 

vi)  Perski, M., Wilton, R. and Evans, J. (2020)  An ambivalent atmosphere: employment training programs and mental health recovery.  Health and Place.  62.  1-7.   

Online:  https://doi.org/10.1016/j.healthplace.2019.102266 

 

Abstract 

This article critically examines the role of employment training programs in the personal recovery of adults living with mental illness in community settings. Using Cameron Duff’s (2014) notion of ‘assemblages of recovery,’ we explore how, and to what extent, employment training programs provide the supportive resources linked to personal recovery. Using an ethnographic case study, we describe the ambivalent atmospheres associated with one program. This ambivalence expresses the fundamental tension between the genuine aspirations of personal recovery and the realities of the capitalist labour process. 

 

 

vii)  Although the editors are clear to point out that their newsletters do not necessarily reflect endorsement of the World Association of Psychosocial Rehabilitation (WAPR), the recent series of newsletters provide insightful testimony about the ways in which Coronavirus is experienced ‘from the ground’  There are three newsletters to date, each containing a collection of storied accounts sent in by WAPR members, their colleagues and friends.  The first two newsletters are available here: 

Newsletter 1  March 16 – April 1 2020 

Newsletter 2  March 15 – April 26 2020 

 

We are anticipating that the third edition will be available on the World Association for Psychosocial Rehabilitation website (http://www.wapr.org) in due course. 

 

Other News / Resources 

 

i)  Dr Juliana Onwumere, senior lecturer and consultant clinical psychologist, writes out of Kings College London to encourage participation in a new survey exploring carers' experiences during covid-19.  More information and the survey itself can be found here: 

https://kcliop.eu.qualtrics.com/jfe/form/SV_2bFquevHV5up8PP 

 

Note:  When following the above link, please click the blue button at the bottom left to access the next page. 

 

 

ii)  Recovery stories 

Mike Slade’s Narrative Experiences Online (NEON) study has launched www.recoverystories.uk a new interactive website which provides online access to mental health recovery stories. We have collected hundreds of stories from around the world, in text, video and audio form, and preliminary evidence suggests that these stories can help people feel connected to others including the storyteller. We are now running three trials using this website, the largest of which is called the NEON Trial.  

 

RRN members can help us in two ways: 

 

1.     Recruitment and participation 

The NEON Trial is currently recruiting people who:   

  • Have experienced psychosis or psychosis-like experiences in the past 5 years 
  • Have experienced mental health distress in the past 6 months 
  • Live in England 
  • Aged over 18 years 
  • Have access to the internet 
  • Can provide informed consent 


If you or someone else you know meet the inclusion criteria, more information and eligibility checking can be accessed here www.recoverystories.ukWe would also like to recruit people who have cared for others experiencing mental health problems. 

 

2.     Promotion of the Trial 

Would you help us to promote the NEON Trial through your networks? You can use any

of the publicity materials available at www.researchintorecovery.com/neontrials/promotion or just tweet: 

Can real-life mental health recovery stories help you with your own mental health

Access hundreds of recovery stories in the NEON Trial. Help researchers @InstituteMH

understand the benefits of accessing other people’s recovery narratives. See

recoverystories.uk 

 

Follow us on Twitter (@neontrials), Instagram (@neontrials) and Facebook today!

 

 

iii)  Coronavirus and Mental Health (information) 

The following links are intended to illustrate the range of information and advice that is currently available with regard to Covid-19.  It is neither exhaustive, nor is it arranged in any particular order. Apologies for any obvious omissions. 

 

World Health organisation 

Gov.uk 

Social Care Institute for Excellence 

Centre for Mental Health 

Mental health Foundation 

Mind 

Rethink 

Carers UK 

National Service User Network 

British Psychological Society 

British Association of Social Workers 

Royal College of Psychiatrists 

Royal college of Nursing 

Royal College of Occupational Therapists 

 

iv)  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: 

Shula:              s.ramon@herts.ac.uk 

Tony:               a.sparkes@bradford.ac.uk