Decolonising the curriculum is an ongoing and collective effort: Responding to Townsend (2020) and Gibson and Farias (2020)

This paper responds to Townsend (2020), and Gibson and Farias (2020), who were invited to write commentaries regarding Simaan’s (2020) ‘Decolonising occupational science education through learning activities based on a study from the Global South’. My reply acknowledges work done by scholars in the Global North and South, both in and outside occupational science, that critiques Western-centric hegemony in academia. It recognises the multiple aspects of decolonial work in occupational science education, and its collective and continuous nature. I argue that my objective of stimulating reflections and discussion about decolonising occupational science education and knowledge has been achieved by this collective effort to extend this discourse. Future reflections, research, and activism in this area are of paramount importance if we are to truly decolonise occupational science

Least restrictive practice: its role in patient independence and recovery

One of thefive overarching principles of the Mental Health Act: Code of Practice is to provide patients with care and treatment which is least restrictive whilst encouraging recovery and promoting independence. However, there is limited research which explores the application of these principles within a medium secure unit. The aims of the research were to explore what are patient’sexperi- ences of least restrictive practices and to what extent do they perceive that least restrictive practices maximise their independence and recovery. Semi-structured interviews were carried out with 12 male inpatients within a medium secure unit. Five themes were evident: Positive Changes, Perceived Lack of Transparency, Social Isolation, Institutionalisation and Normality. It was found that patient’s perceived that there was lack of shared understanding between staffand patients of what is considered least restrictive. Patient recovery was promoted through positive risk-taking, the reduction in the use of seclusion and through the promo- tion of meaningful activities that resembled life in the community. Nevertheless, patients perceived that there was a lack of opportunities to socialise with patients from other wards. Due to the security level of the hospital patients perceived that independence was not achievable

How best to engage users of forensic services in research: literature review and recommendations

Guidance on service user involvement is available to help researchers working with people with mental health problems, but there is currently no comprehensive guidance relating to forensic settings where additional issues arise. This rapid review aims to summarise the currently available information on how best to engage users of forensic mental health services in the research process, and to make appropriate recommendations. Medline and five other databases were searched to May 2016 using relevant keywords and Medical Subject Headings, supplemented by a general Internet search. Eleven peer-reviewed journal papers and 12 reports or web-based documents were identified, the majority containing information derived using a qualitative methodology. Five areas of particular relevance to forensic settings were identified: power relations & vulnerability issues (including ethical treatment; informed consent; attitudes of staff and other service users; support), practical difficulties (including ‘consultation fatigue’; tokenistic inclusion; tensions over security and risk management; access; payment; co-authoring); confidentiality and transparency; language and communication and training issues. Recommendations on engaging service users in forensic mental health research are presented

Experiences of User Involvement in Mental Health Settings: User Motivations and Benefits

Introduction: Despite guidance promoting user involvement, meaningful involvement continues to be debated within services. To effectively implement involvement, it is important to acknowledge why users devote time to such activities. Aim: This study explores user representatives’ experiences of involvement, including motivations and personal benefits. Method: Thirteen user representatives involved in activities such as staff training and interviews were recruited from a UK National Health Service mental health Trust during 2015. Themes within semi-structured interviews were developed using constructivist grounded theory analysis. Memo-writing, process and focused coding, and core categories supported development of the conceptual framework of being a user representative. Findings: Being a user representative was inextricably linked to wellness, yet staff governed opportunities. Making a difference to others and giving back were initial motivating factors. Experiences depended on feeling valued, and the theme of transition captured shifts in identity. Discussion: User representatives reported increased confidence and wellbeing when supported by staff. However, involvement triggered mental health difficulties, and identified need for regular monitoring and reflection of involvement activities and practice. Implications for practice: Services should consider coproduction, where users and staff agree together on involvement definitions. Dedicated involvement workers are crucial to supporting individual wellbeing and monitoring involvement