Using participatory action research methods to address epistemic injustice within mental health research and the mental health system

open access articleIn this paper, we describe a model of research practise that addresses epistemic injustice as a central objective, by valuing lived experience and addressing structural disadvantages. We set out here the processes we undertook, and the experiences of those involved in an attempt to transform research practise within a study known as Co-pact. We do not discuss the findings of the research. Rather, we wish to build expertise on how to address epistemic injustice and offer examples of participatory research processes, central values, and practical procedures that we implemented

Global Position Statement: Religion and Spirituality in Mental Health Care

Careif is an international mental health charity that works towards protecting and promoting mental health and resilience, to eliminate inequalities and strengthen social justice. Our principles include working creatively with humility and dignity, and with balanced partnerships in order to ensure all cultures and societies play their part in our mission of protecting and promoting mental health and wellbeing. We do this by respecting the traditions of all world societies, whilst believing traditions can evolve, for even greater benefit to individuals and society. Careif believes that knowledge should not only be available to those with wealth or those who live in urban and industrialised parts of the world. It considers knowledge sharing to be a basic human right, particularly where this knowledge can change lives and help realise true human potential. Furthermore, there is substantial knowledge to be found in low and middle income countries and within rural and poorer areas of the world and this knowledge is just as valuable to the wellbeing of people in areas which are wealthier. This Position Statement aims to highlight the current position and need for understanding the role of culture, spirituality and religion in the diagnosis and treatment of mental illness. Globalisation has created culturally rich and diverse societies. During the past several decades, there has been a steadily increasing recognition of the importance of cultural influences on life and health. Societies are becoming multi-ethnic and poly-cultural in nature worldwide, where different groups enrich each other's lives with their unique culture/s. Cultural transition and acculturation is often discussed as relevant to migrants and the need to integrate, when in fact it is of relevance to all cultures in an ever-interconnected world. It is indeed necessary to be equipped with knowledge about cultures and their influence on mental health and illness. Until the early 19th century, psychiatry and religion were closely connected. Religious institutions were responsible for the care of the mentally ill. A major change occurred when Charcot and his pupil Freud associated religion with hysteria and neurosis. This created a divide between religion and mental health care, which has continued until recently. Psychiatry has a long tradition of dismissing and attacking religious experience. Religion has often been seen by mental health professionals in Western societies as irrational, outdated, and dependency forming and has sometimes been viewed as resulting in emotional instability

Global Position Statement: Stigma, Mental Illness and Diversity

Careif is an international mental health charity that works towards protecting and promoting mental health, wellbeing, resilience and resourcefulness with a special focus towards eliminating inequalities and strengthening social justice. Our principles include working creatively with humility, dignity and balanced partnerships in order to ensure that all cultures and societies play their part in our mission of protecting and promoting mental health and wellbeing. We do this by respecting the traditions of all world societies, whilst believing that culture and traditions can evolve for even greater benefit to individuals and society. Globalisation has created culturally rich and diverse societies. During the past several decades, there has been a steadily increasing recognition of the importance of societal and cultural influences on life and health. Societies are becoming multi-ethnic and poly-cultural in nature worldwide, where different groups enrich each other's lives with their unique culture/s. Cultural transition and acculturation is often discussed as relevant to migrants and mentions the need to integrate, when in fact it is of relevance to all cultures in an ever interconnecting world. It is indeed necessary to be equipped with knowledge about cultures and their influence on mental health and illness. Culturally informed mental health care is rapidly moving from an attitudinal orientation to an evidence-based approach, therefore understanding culture and mental health care becomes greater than a health care issue

Experience based investigation and Co-design of approaches to Prevent and reduce Mental Health Act Use (CO-PACT): A Protocol

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Open access article.Abstract Introduction The Independent Review of the Mental Health Act (MHA) in England and Wales confirmed increasing levels of compulsory detentions, especially for racialised communities. This research aims to: a) understand the causes of and propose preventive opportunities to reduce the disproportionate use of the MHA; b) use an adapted form of experience-based co-design (EBCD) to facilitate system-wide changes; and c) foreground the voices of service users at risk of detention to radically reform policy and implement new legislation to ensure the principles of equity are retained. Methods and Analysis This is a qualitative study, using a comparative case study design. This study is composed of five work packages; photovoice workshops will be conducted in eight local systems with service users and health care professionals separately (WP1); a series of three EBCD workshops in each local system to develop approaches that reduce detentions and improve the experience of people from racialised communities. This will inform a comparative analysis and national fourth knowledge exchange workshop (WP2); an evaluation led by the PPI group to better understand what it is like for people to participate in photovoice, co-design and participatory research (WP3); an economic evaluation (WP4); and dissemination strategy (WP5). The impact of the involvement of patients and public will be independently evaluated. Ethics and Dissemination This study is sponsored by the University of Oxford and granted ethical approval from the Health Research Authority (21/SC/0204). The outputs from this study will be shared through several local and national channels

Careif Global Position Statement: Mental Health, Human Rights and Human Dignity "Magna Carta for people living with Mental Illness".

Careif is an international mental health charity that works towards protecting and promoting mental health and resilience, eliminating inequalities and strengthening social justice. Our principles include working creatively with humility and dignity, and with balanced partnerships in order to ensure all cultures and societies play their part in our mission of protecting and promoting mental health and wellbeing. We do this by respecting the traditions of all world societies, whilst believing traditions can evolve, for even greater benefit to individuals and society. Careif believes that knowledge should not only be available to those with wealth or those who live in urban and industrialised parts of the world. It considers knowledge sharing to be a basic human right, where this knowledge can change lives and help realise true human potential regardless of their geographical location. Furthermore, there is substantial knowledge to be found in the less developed, rural and poorer areas of the world and this is valuable to the wellbeing of people in areas which are wealthier

Study into COVID-19 Crisis Using Primary Care Mental Health Consultations and Prescriptions Data

The effect of the 2020 pandemic, and of the national measures introducedto control it, is not yet fully understood. The aim of this study was to investigatehow different types of primary care data can help quantify the effect of thecoronavirus disease (COVID-19) crisis on mental health. A retrospective cohortstudy investigated changes in weekly counts of mental health consultations andprescriptions. The data were extracted from one the UK’s largest primary caredatabases between January 1st 2015 and October 31st 2020 (end of follow-up). The2020 trends were compared to the 2015-19 average with 95% confidence intervalsusing longitudinal plots and analysis of covariance (ANCOVA).A total number of 504 practices (7,057,447 patients) contributed data.During the period of national restrictions, on average, there were 31% (3957 ± 269,p < 0.001) fewer events and 6% (4878 ± 1108, p < 0.001) more prescriptions perweek as compared to the 2015-19 average. The number of events was recovering,increasing by 75 (± 29, p = 0.012) per week. Prescriptions returned to the 2015-19levels by the end of the study (p = 0.854). The significant reduction in the numberof consultations represents part of the crisis. Future service planning and qualityimprovements are needed to reduce the negative effect on health and healthcare

Psychotic symptoms in the general population of England--a comparison of ethnic groups (The EMPIRIC study).

BACKGROUND: There is considerable evidence that incidence of schizophrenia and other psychoses varies across ethnic groups in the UK, with particularly high rates for people of African-Caribbean origin. AIMS: The aims of this shady were to estimate in a community-based sample of people from ethnic minorities: 1) the prevalence of psychotic symptoms; and 2) risk factors for reporting psychotic symptoms. METHOD: Face-to-face interviews were carried out with a probabilistic sample of 4281 adults from six ethnic groups living in the UK. Psychotic symptoms were measured using the psychosis screening questionnaire (PSQ). RESULTS: There was a twofold higher rate of reporting psychotic symptoms on the PSQ in Black Caribbean people compared with Whites. Adjustment for demographic factors had little effect on this association. CONCLUSION: Prevalence rates of psychotic symptoms were higher in people from ethnic minorities, but were not consistent with the much higher first contact rates for psychotic disorder reported previously, particularly in Black Caribbeans