Students, inclusion, help-seeking and compassionate caring

Purpose – The purpose of this paper is to focus on students, trainee nurses, early career psychologists, and other mental health professionals and their response to mental distress or the stresses of working in mental health. Design/methodology/approach – Three journal articles are summarised. The first highlights mental distress in university students and their reluctance to seek counselling. The second paper focuses on addressing the impact that the work of mental health workers can have on them and how this can jeopardise compassionate care. The third paper presents a model of inclusive and caring nurse education. Findings – University students may be more likely to seek counselling for mental distress if they have information about its usefulness and it is normalised rather than stigmatised. Mental health workers including early-career psychologists need to know about “compassion fatigue” and “compassion satisfaction” and need safe places to reflect on the personal impact of hearing about their clients’ traumatic experiences. A whole-organisation model of nurse education that emphasises belonging and inclusiveness may increase nurse retention and nurses’ personal resilience. Originality/value – The paper on students’ help-seeking is the first meta-analysis of several studies on this topic (involving similar variables and measures) in several years. The paper on mental health workers and compassion fatigue and compassion satisfaction is rare in looking at this across different professions in one setting. It highlights important ways of maintaining workers’ ability to deliver compassionate care. The model of nurse education is based on recent research evidence and may help increase retention and foster reflection, self-awareness, and resilience in nurses

School inclusion for children with mental health difficulties

Purpose – The purpose of this paper is to highlight research on the exclusion from school of children with disabilities, and especially those identified as experiencing emotional disturbance. Two studies of schools that are inclusive are then described in order to examine how they achieve good results. Design/methodology/approach – Three papers are summarized. The first examines things that predict children with disabilities being excluded from school, including characteristics of children and of schools. The second is a qualitative study of four English schools involved in a national programme aimed at improving children’s mental health. The third is a case study of one American school identified for its high inclusivity and excellent educational results. Findings – In the first study, children with emotional disturbance, and African-American children were most likely to be excluded from school. The study of four English schools suggested that implementation of the national programme was variable but leadership and planning seemed vital, as well as whole-school commitment. The high-performing inclusive American school had whole-school commitment, high quality planning alongside flexibility, on-going further training for teachers, and close pupil tracking. Originality/value – The study of school exclusion was the first to examine children and schools together, as well as different disabilities and ethnicity. The study of English schools highlights the experiences of those directly involved in implementing a national programme to promote children’s mental health. The study of a high-performing inclusive school in America discovered much in common with inclusive high-performing schools in England, suggesting that some practices can be identified across the two cultures that aid successful inclusion of children with disabilities including mental health difficulties

Mental health, human rights and social inclusion for adults and children

Purpose – This article considers three recent articles relating to human rights and applicable to adults or children given mental health diagnoses. Design/methodology/approach – The first article discussed how to measure progress in different countries in their policy changes to abide by the UN Convention on rights of persons with disabilities, and discussed how all relevant groups could be involved. The second paper considered the problem of children’s rights being eroded by over-use of the mental health diagnosis of ADHD when they are restless. The third paper reported on an evaluation of how well advocacy services are enabling people who are sectioned to have a say in their care. Findings – When assessing how well countries are doing in ensuring the rights of people with disabilities, the first paper’s authors concluded that all groups must participate in the evaluation, even though there are many different agendas. The second paper reported on how professionals and parents could come to a shared understanding of how children might be wrongly given a diagnosis of ADHD and jointly suggested some solutions. The third paper illustrated how important advocacy is, and the difference it can make to the lives of people who are sectioned. Originality/value – The first paper’s authors are engaged in ground-breaking research to assess whether disabled people’s rights under the UN Convention are being honoured. The second paper raised vital questions about the misuse of diagnosis, contravening the UN Convention on the rights of the child, and illustrated how parents and professionals can come together in support of these rights. The third paper reported on the first systematic national study on the implementation of advocacy services to defend the rights of people who are sectioned to have a say in their care

Do clinicians and clinical researchers do enough to foster social inclusion?

Purpose – The purpose of this paper is to raise questions about the social issues involved in mental and physical health. It highlights how, even where social issues are evident, clinicians and clinical researchers often focus mainly on individual people and what has gone wrong with them. This has the effect of making it less likely that social exclusion and adversity will be taken into account or that clinicians will help to change these. Design/methodology/approach – Three journal papers are summarised. The first one reports an attempt to test whether depression is a result of people feeling defeated and trapped. The second paper reports the results of analysing medical writing about domestic abuse. The third paper discusses the need for trainee clinicians to be made more aware of social conditions that affect people's lives. Findings – It does appear that people who feel defeated and trapped are more likely to become depressed. However, the life circumstances that lead to feeling trapped need more attention. Medical writing about domestic abuse may need to incorporate the broader context so that it is not just seen as a “women's problem”. It may be worth training clinicians about social conditions and how they might help to change them. Originality/value – These papers highlight important links between social exclusion and mental and physical health. There is a key role for clinicians and clinical researchers to be more part of the solution where they sometimes unwittingly help maintain the problems

Coping with cognitive behaviour therapy for psychosis, adapting it for another culture, and community inclusion

Purpose – The purpose of this paper is to highlight what helps and what is difficult about cognitive behaviour therapy for psychosis (CBTp) in relation to recovery and social inclusion, how it can be adapted for a non-western culture, and how inclusion in communities in which people feel comfortable can help their recovery. Design/methodology/approach – Three journal articles are described. The first summarises six small qualitative studies involving interviews with UK service users about what they found helpful and challenging about CBTp. The second article reports on a pilot trial of CBTp adapted for the culture in Pakistan, where families are seen as more involved in service users’ care. The third article describes USA-based participants’ engagement with different communities as part of their recovery. Findings – UK service users appreciated feeling equal to their therapist in CBTp, receiving an understandable explanation of their difficulties, and support for gradual steps towards activities they valued. However, it was difficult revisiting traumatic pasts to understand their difficulties, and UK mental health culture may hamper taking an active role in treatment. In Pakistan, CBTp can be successfully adapted to include a key family member and local spiritual beliefs. In a USA context, service users developed competencies in community groups they valued, and these could be minority or service user communities where people felt comfortable and could make a contribution. Originality/value – The experiences of service users of CBTp are rarely collated from several qualitative studies, and important themes came from doing so. It may be important to understand current barriers to doing CBTp homework and the effect of some aspects of mental health services on people’s readiness to take an active role. Studies of adapting CBTp for non-western cultures are rare, but it seemed successful in Pakistan, adopting a bio-psycho-spiritual-social model. The qualitative study of people’s engagement in US community groups highlights the importance of not dismissing engagement in minority groups for people’s recovery, rather than only the “wider” community

Do computers increase older people’s inclusion and wellbeing?

Purpose – This article considers two recent studies on computer use by older people, who may become increasingly isolated due to infirmity and sensory impairments. Older people are less likely to use computer technology yet it has been suggested that it may help reduce isolation. These studies inquired into older people’s experience with computers. Design/methodology/approach – The first article discussed here explored how a sample of older people in the USA acquired a computer and whether it contributed to their well-being. The second article was about a similar study with a sample of older people in the UK. Findings – In the USA sample, people who saw tablet computers being used by a friend or family member were more likely to purchase one. In the UK sample, people seemed to have had to overcome more fears of using computer technology, but in both samples, once initial difficulties were overcome, people were enthusiastic about using them. In both, people felt more able to keep up hobbies and interests through finding information or connecting with interest groups online, and able to keep connected with family members. Originality/value – In light of increasing migration of services and information to the internet, these studies explored what helps and hinders older people in using computers, in order to address the digital divide, whereby those unable to use them can be left isolated. These studies explored personal meanings of computer use and specific fears and difficulties, which are important to understand in planning for training and support for older people who are not yet on line. They demonstrated that, alongside face-to-face interaction, being online was experienced as reducing isolation and enhancing lives

BAAT Guidelines on Art Therapy for people with a psychosis-related diagnosis

This document is in three parts. Part 1 presents the guidelines on key art therapy practices for people with a psychosis-related diagnosis. There are 10 broad areas of practice, summarised very briefly on the next page. Art therapists’ core practice is adapting to individuals in context, within these broad principles. In Part 1 we illustrate these principles with examples. Comments from service user consultation are included.Part 2 explains how we developed these guidelines. Part 3 describes how we understand psychosis. Both Parts 2 and 3 make reference to the research evidence and theory upon which these guidelines are based. The reference list is attached to Part 3

Research watch: mental health services supporting social inclusion

Purpose – To examine three recent papers on mental health services and social inclusion. Design/methodology/approach – A search was carried out for recent papers on mental health and social inclusion. I selected three papers that each spoke to a similar theme, from slightly different angles, and that seemed to advance understanding of how social inclusion might be supported to a greater degree in mental health services. Findings – One paper vividly describes some of the blocks to social inclusion, and what that can feel like from a service user perspective, and also points to ways for peer workers to support service users’ social inclusion. A second illustrates how mental health professionals and peer workers can choose to stand up for people’s human rights despite lack of organisational support for such actions. The third paper describes pioneering co-designed work to build dedicated support for social inclusion alongside mental health services. Originality/value – All three papers highlight the on-going need for better support for social inclusion in mental health services across different countries. They also show how such support can be implemented and even made more mainstream. This raises hope for wider progress in mental health services becoming real enablers of social inclusion

Dyslexia: is it genetic and what does this mean for social inclusion?

Purpose – This paper starts by considering what it means if dyslexia has genetic or environmental causes. The author also explains phrases used by genetic researchers and the kind of things they look for in genetic material. The purpose of this paper is to discuss two recent studies on dyslexia that shed light on either genetic or environmental causes. Design/methodology/approach – One study was a thorough exploration of possible genetic differences that could be present in children experiencing reading and language difficulties. The other study examined a large sample of the Canadian public to see whether there was a link between dyslexia and having experienced physical abuse as a child or teenager. Findings – The study on genetic differences found no evidence for some previously suggested genetic causes of dyslexia. Although previous studies have suggested dyslexia runs in families, the genetic contribution may have been overestimated. The study on the Canadian public found that people who reported experiencing physical abuse in their younger years were six to seven times more likely also to have a diagnosis of dyslexia. Childhood trauma is known to affect brain development. Originality/value – Although this paper only discusses two papers in detail, they are two of the most recent explorations of genetic and environmental links to dyslexia. There could be a case for greater attention to possible traumatic experiences in children identified as dyslexic. Physical abuse is one possibility but should never be assumed. Families can be under strain and may need more support. However, dyslexia and the mental health difficulties that can result from childhood trauma can reduce a child’s current and future social inclusion. Early intervention may avert this outcome

Art therapy-based groups for work-related stress with staff in health and social care: an exploratory study

Numerous approaches have been developed to address work-related stress (work-stress) but evidence of their efficacy is sparse. This is also the case for art therapy-based approaches, whose processes are also poorly explicated and understood. This study therefore attempted an initial exploration of the potential therapeutic mechanisms within art therapy-based groups for work-stress with staff in health and social care. Data were gathered from staff at four health and social care sites (N = 20) in an exploratory embedded multiple case study design. The process involved art-viewing and art-making in small groups. Art-viewing supported relational processes, expression of emotionality and playfulness, in turn facilitating therapeutic engagement. Art-making, often initially experienced as intimidating, was reported as revealing true emotions linked to work-stress issues, which for some participants led to action to alleviate their impact. This study suggests that art-viewing, hitherto a neglected component of art therapy, may be important for that practice or practices based on it. The study also suggests a greater potential for art therapy-based to be used as an approach to address work-stress in health and social care