Mental health service user experiences of targeted violence and hostility and help-seeking in the UK: a scoping review

The aim of this research scoping review was to assemble an evidence base for the UK on mental health service user experiences and perspectives on mental health-related targeted violence and hostility ('disability hate crime'). It also aims to address some of the gaps in the knowledge on risk management, help-seeking and prevention from the perspectives of those who experienced targeted violence and hostility because of their mental health problems or psychiatric status. Seven key mental health and social care bibliographic databases were searched for relevant UK research studies from 1990 until 2016. Grey literature was identified through online searches. A scoping review charting approach and thematic analysis methodology were used to analyse the studies. In total 13 studies were finally included, over half of which used survey methods. All studies included people with experiences of mental health problems. The studies provide information on: the types of potential hate crime; indicate where incidents take place; give some insight into the victims' relationship with the perpetrators; the location of incidents as well as the psychological, social, financial and physical impacts on the victim; the types of help-seeking behaviours adopted by the victims; a range coping strategies that people with mental health problems adopted in response to experiences of targeted violence or abuse. This scoping review provides a UK-based overview of mental health service user concepts and experiences of mental health-related targeted violence and hostility ('disability hate crime'). It reveals some specific issues relating to mental health and disability hate crime. Further investigation into disability hate crime with a specific focus on mental health is required. This is a UK-based overview, which offers a useful comparator for researchers, practitioners and policy-makers internationally

Ecohydrological characterization of the Nyando wetland, Lake Victoria, Kenya: A State of System (SoS) analysis

Lake Victoria floodplain wetlands have a complex hydrological setting characterized by transition from a terrestrial to an aquatic environment. A state-of-system (SoS) analysis was carried out in a papyrus dominated wetland in the Nyando River Delta, on the eastern shores of Lake Victoria, Kenya, to characterize and provide data for detailed ecohydrological studies. The objectives of the study were to: (1) determine the spatio- temporal changes in the wetland evolution and (2) analyze the main hydrological factors that have influenced wetland evolution. Multi-temporal dry-season Landsat MSS, Landsat TM and Landsat ETM+ imagery covering Nyando Wetland and its surrounding area were processed and analyzed to generate time series polygon and polyline maps of the wetland and river. Results show that the wetland increased in size from 5,925 ha in 1950 to 9,925 ha in 1973, and declined to 4,527 ha in 2008. In the last 60 years, Nyando River has migrated in a general eastward direction. Time series hydrological data (1950-2009) were statistically tested for homogeneity  using the Spearman’s rank test for linear trends, Pettit test and Standard Normal Homogeneity test (SNHT) for change point analysis, and split-record tests performed for variance (F-test) and mean (t-test). In addition, data were analyzed using descriptive statistics and frequency analyses. Statistical test results show that the hydrological data series were homogeneous. Results of change point analyses indicate that total annual rainfall in Nyando declined in 1979, while the mean annual discharge for Nyando River and Lake Victoria levels had significant upward shifts in 1961. The decadal mean discharges varied significantly over time and increased by 80% from 11.45 m3/s observed in the 1950-1961 subset, reducing by 11.4 and 21.9% in the next two decadal sub-sets, before rising by 35.0% in 1990s and dropping by 24.0% in the last decade. The decadal mean annual lake levels increased from 1134.0 to 1135.43 m in the 1951-1961 and 1962-1972 and remained above the longterm mean of 1135.0 m for 43 years since 1962 before dropping drastically by 1.4 m to an average of 1134 m/year in 2005-2009. The highest recorded lake level at Kisumu Station was 1136.2 m in 1964 after increasing by 2.5 m from 1961. Discharge data exhibit trimodal seasonal patterns, while the lake levels had two peaks. The lake levels are more sensitive to direct lake rainfall. Changes in the Nyando wetland area are linked to the seasonal and episodic flood and drought events coupled with anthropogenic activities (regulation of lake levels, modification of river including cut-off meanders, river training and construction of dykes, drainage of wetland for cultivation, settlement and livestock grazing, abstraction of water for irrigation). A combination of these hydrological and human factors is the main cause of the Nyando Wetland evolution. If the land use trend continues unabated, then the increase in papyrus losses will pose a big challenge to the ecological functioning of the wetland and its support to sustaining community livelihoods.Key words: Nyando Wetland, River, ecohydrology, Lake Victoria

"Keeping Control": a user‐led exploratory study of mental health service user experiences of targeted violence and abuse in the context of adult safeguarding in England

The situation for people with mental health problems as a group of disabled people who experience targeted violence and abuse is a complex one. Disabled people, particularly those with mental health problems, are at higher risk of targeted violence and hostility with few effective evidence‐based prevention and protection strategies. Achieving effective safeguarding for adults with mental health problems is characterised by differential attitudes to and understandings of abuse by safeguarding practitioners, as well as systemic issues arising from multi‐agency working. “Keeping Control” was a 16‐month user‐led, co‐produced exploratory qualitative study into service user experiences of targeted violence and abuse that was examined in the context of Care Act 2014 adult safeguarding reforms in England. User‐controlled interviews of mental health service users (N = 23) explored their experiences and concepts of targeted violence and abuse, prevention and protection. Preliminary findings from these interviews were discussed in adult safeguarding and mental health stakeholder and practitioner focus groups (N = 46). The data were also discussed via two facilitated Twitter chats (responses N = 585 and N = 139). Mental health service users’ experiences and concepts of risk from others, vulnerability and neglect can be different to those of practitioners but should be central to adult safeguarding. Histories of trauma, multi‐factorial abuse; living with fear and stigma as well as mental distress; the effects of “psychiatric disqualification” and individual blaming should be addressed in adult safeguarding in mental health. Fragmented responses from services can mean a person becomes “lost in the process”. Staff can feel disempowered, afraid or lacking in confidence to “speak up” for individuals in complex service systems with poor communication and lines of accountability. Adult safeguarding practitioners and stakeholders need to be confident, accessible and respond quickly to service users reporting incidents of targeted violence and abuse particularly in closed environments such as wards or supported housing

‘Dignity and respect’: An example of service user leadership and co‐production in mental health research

This paper explores the methodological aspects of a user‐led study investigating mental health service user experiences of targeted violence and abuse (often called 'hate crime'). 'Keeping Control' was a 16‐month qualitative study, undertaken in the context of adult safeguarding reforms in England. By collecting data on service user concepts and experiences, the research sought to address a gap in research and practice knowledge relating to targeted violence, abuse and hostility against people with mental health problems. In this paper, we discuss the significance of the design and methodology used for this study, with a particular focus on the interviews with service users. The research was both user‐led and carried out in collaboration with practitioners and academics, a form of research co‐production. Our aim is to inform researchers, practitioners and policymakers about the value of user leadership in co‐productive research with practitioners, particularly for a highly sensitive and potentially distressing topic

A synthesis of past, current and future research for protection and management of papyrus (Cyperus papyrus L.) wetlands in Africa

Papyrus wetlands (dominated by the giant sedge Cyperus papyrus L.) occur throughout eastern, central and southern Africa and are important for biodiversity, for water quality and quantity regulation and for the livelihoods of millions of people. To draw attention to the importance of papyrus wetlands, a special session entitled ‘‘The ecology of livelihoods in papyrus wetlands’’ was organized at the 9th INTECOL Wetlands Conference in Orlando, Florida in June 2012. Papers from the session, combined with additional contributions, were collected in a special issue of Wetlands Ecology and Management. The current paper reviews ecological and hydrological characteristics of papyrus wetlands, summarizes their ecosystem services and sustainable use, provides an overview of papyrus research to date, and looks at policy development for papyrus wetlands. Based on this review, the paper provides a synthesis of research and policy priorities for papyrus wetlands and introduces the contributions in the special issue. Main conclusions are that (1) there is a need for better estimates of the area covered by papyrus wetlands. Limited evidence suggests that the loss of papyrus wetlands is rapid in some areas; (2) there is a need for a better understanding and modelling of the regulating services of papyrus wetlands to support trade-off analysis and improve economic valuation; (3) research on papyrus wetlands should include assessment of all ecosystem services (provisioning, regulating, habitat, cultural) so that trade-offs can be determined as the basis for sustainable management strategies (‘wise use’); (4) more research on the governance, institutional and socio-economic aspects of papyrus wetlands is needed to assist African governments in dealing with the challenges of conserving wetlands in the face of growing food security needs and climate change. The papers in the special issue address a number of these issues

‘Capacity for what? Capacity for whom?’ A decolonial deconstruction of research capacity development practices in the Global South and a proposal for a value-centred approach

Whilst North to South knowledge transfer patterns have been extensively problematised by Southern and decolonial perspectives, there is very little reflection on the practice of research capacity development (RCD), still strongly focused on technoscientific solutionism, yet largely uncritical of its underlying normative directions and power asymmetries. Without making transparent these normative and epistemological dimensions, RCD practices will continue to perpetuate approaches that are likely to be narrow, technocratic and unreflexive of colonial legacies, thus failing to achieve the aims of RCD, namely, the equitable and development-oriented production of knowledge in low- and middle-income societies. Informed by the authors’ direct experience of RCD approaches and combining insights from decolonial works and other perspectives from the margins with Science and Technology Studies, the paper undertakes a normative and epistemological deconstruction of RCD mainstream practice. Highlighting asymmetries of power and material resources in knowledge production, the paper’s decolonial lens seeks to aid the planning, implementation and evaluation of RCD interventions. Principles of cognitive justice and epistemic pluralism, accessibility enabled by systems thinking and sustainability grounded on localisation are suggested as the building blocks for more reflexive and equitable policies that promote research capacity for the purpose of creating social value and not solely for the sake of perpetuating technoscience

Practitioner perspectives on service users experiences of targeted violence and hostility in mental health and adult safeguarding

People with lived experience of mental distress experience high rates of targeted violence and hostility based on their mental health status. This user-led study explored practitioners’ perceptions and experiences of supporting service users in these challenging situations and considered the role of adult safeguarding. Six focus groups with practitioners (n = 46) enabled them to respond to data documenting service user’s experiences. This process facilitated knowledge exchange between the research team and practitioners on the ground. The findings illuminate a complex picture where lack of effective structures and processes mitigate against service users in these difficult situations. Practitioners need to invest in trusting relationships, to optimise resources and actively help service users with lived experience of mental distress to find their own solutions. These should involve collaborative empowerment whereby feelings of isolation and rejection can be replaced with hope, a sense of agency and belief in personal control. Points of interest People with lived experience of mental distress are at a high risk of exposure to hate crimes, hostility and discrimination. These risks and those experiencing them, often go unrecognised. There is a lack of knowledge and understanding about what people need, how they cope and what helps in these situations. Professionals and practitioners from different disciplines face very complex challenges in responding to and helping people, resulting in service users falling through the net when they need it most. Services in the community and hospital are not working together effectively to support people experiencing targeted violence and hostility. There is a lack of coherence in the way that the criminal justice system and adult safeguarding frameworks support effective working. There is an urgent need to listen to and engage with service users’ own voices in these environments and to work with them to find solutions that help them feel safe and in control. These should particularly utilise relationship-based practice and peer support