Using co-production within mental health training when working with refugee or migrant community groups

This paper will discuss examples of mental health training developed and co-produced in active partnership with two communities, one in Britain and one in Sri Lanka. This work has taken place in community settings, not within the consulting room. The learning had a bi-directional flow; through these partnerships, both partners/groups shared and developed their understanding of diverse cultures, idioms of distress, explanatory mental health models and ways of dealing with these. This expanded everyone’s knowledge, understanding and repertoires of practice. The work in Britain was audited through a range of psychometric tests and that in Sri Lanka through questionnaires. Semi-structured interviews also took place with both groups as did meetings with a range of key informants. Working beyond the clinic can benefit people, who have obliquely been labelled, as ‘hard to reach’ groups and who may find it difficult to access mental health services or who find services inappropriate. Therefore, community groups may be well positioned to bridge this gap in non-stigmatising, accessible and culturally appropriate ways. Evidence has begun to emerge suggesting that mental health services developed in conjunction with service users and the wider community may lead to better usage, more appropriate and accessible services, and to an improved sense of inclusivity. The implications of this for the global mental health debate will be briefly considered as will health pluralism and the importance of language and using a mother tongue

Therapists' Experience of Working with Interpreters in NHS settings: Drawing Upon a Psychoanalytic Theoretical Framework to Contextualize the Findings of an IPA Study

NHS therapists are required to work with interpreters. Therapy with an interpreter may take longer and aspects of the work may be challenging. Surveys of NHS mental health staff, particularly those working in Improving Access to Psychological Therapies (IAPT) services, indicate that they are experiencing burn‐out, low morale, and increasing stress and depression as a result of ever‐increasing targets and workload demands. This study aimed to gain an understanding of the impact of the context of therapy on the experiences of therapists in the NHS of working with interpreters. Semi‐structured interviews were conducted with 10 qualified therapists working within an IAPT or secondary care psychology service from one NHS Trust. The verbal data were analysed using interpretative phenomenological analysis (IPA) methodology. The key finding of the study was that participants’ experience of their organizational context (whether supportive or pressured and demanding) appeared to drive how they related to the interpreter. Previous literature has applied a psychoanalytic framework to understanding organizational, group and individual responses to stress in healthcare settings, including IAPT. Following the initial analysis, aspects of psychoanalytic theory were used to contextualize the findings. Epistemological and ethical tensions in making links to theoretical frameworks within an IPA study are acknowledged and discussed

Therapeutic work with clients living in poverty

Background: Financial inequalities appear to be increasing and poverty is becoming ubiquitous. Poverty affects mental health but its impact on mental health and wellbeing is rarely highlighted within health research. Aims: The Covid-19 pandemic, the Ukrainian invasion and other international and national events have led to a cost-of-living crisis for many people. This is likely to lead to an increase in related referrals and therefore active consideration of the relevant issues relating to poverty appears vital. This paper reports a study which sought to understand how therapists experienced their work with clients who self-refer due to living in poverty. Method: Eight therapists participated in semi-structured interviews analysed using Interpretative Phenomenological Analysis (IPA). Results: Three superordinate themes were elicited: firstly ‘Resilience in the struggle to engage with therapeutic work’, secondly ‘Struggling to promote social activism’ and thirdly, ‘Navigating multiple challenges and barriers’. Each superordinate theme contains two or three sub themes. Conclusions: Issues of structural inequality (including but not limited to poverty) impact significantly on people’s lives but are often ignored or minimised in therapeutic work. It is important that therapists are aware of poverty and take this into account when working with clients

Preparing for a conference, doctoral or professional presentation

At some stage of their career development, doctoral candidates, qualified psychologists and other professionals are called upon to make formal presentations at conferences or in work or clinical contexts. For many people, public speaking can be anxiety provoking. Thorough preparation and forethought can help manage anxiety so the speaker can feel empowered to develop confidence, new experiences and skills. A successful presentation on research findings, systemic or clinical issues, or innovative recommendations for service provision can have a significant impact for service users, other psychologists, professional organisations, policy makers or commissioners, who all potentially stand to benefit. Giving a presentation can also have various professional advantages, including creating opportunities for collaborations, networking, developing new ideas, the raising of a professional or organizational profile and even potential employability opportunities. This paper will discuss strategies to help the potential presenter ensure they meet designated or pre-set requirements, hone skills, convey the intended message and optimize professional opportunities. This paper will focus upon: being clear about the aim of presenting; the importance of a dissemination strategy; selecting the most appropriate context to deliver your presentation; preparing an abstract or presentation summary; explanations and recommendations on how to deliver a successful presentation (be that poster presentation, individual presentation, symposium, or workshop); the presentation delivery; answering questions from the audience; and maximising the associated opportunities

The experience of self-harming behaviours that inflict external injuries to the body in UK-based Bangladeshi, Indian and Pakistani women: a literature review

Studies carried out on self-harm in the UK have consistently reported a higher level of self-harm among women with South Asian heritage resident in the UK when age-compared with other British women. The reasons for this variation are many including but not limited exclusively to family environment and gender role expectations. These studies have also shown that these women are also least likely to seek psychological support from mental health professionals again with a number of explanations including stigma against help-seeking, notions of shame and other culture-specific factors. However, previous studies have clustered this large group together based on geographical heritage, regardless of the differences between religious and heritage groups and have reported on all types of self-harming behaviours as similar and predominantly carried out quantitative studies which while providing important statistical data have not always looked at the meaning of this experience for the participants. This paper presents a review of the relevant literature within the area of self-harm among Bangladeshi, Indian, and Pakistani women living in the UK. It is noteworthy that many studies discussed are dated, this appears to reflect an apparent lack of recent interest in the topic

A qualitative study to explore the help seeking views relating to depression among older Black Caribbean adults living in the UK

Numbers of older adults are rising globally. In the UK, rates of mental ill-health are thought to be higher in Black Asian and Minority Ethnic community than in the white population. Older adults from BAME groups are an under researched group. It is important to understand the experiences and beliefs that underlie help seeking behaviour among BAME older adults to deliver effective, culturally appropriate and accessible services. This study aims to explore help seeking views and strategies utilised in relation to depression among older Black Caribbean people in the UK. Semi-structured interviews were conducted with 8 UK Black Caribbean participants, aged between 65-79 years. Transcripts were analysed using Interpretative Phenomenological Analysis. Three master themes emerged from the analysis: 1. “If you don’t know, you don’t seek help 2. ‘..I knew I was depressed”: 3. “You have to decide”: Attitudes to help seeking and mental health service use. Participants’ past personal experiences of coping with depression, including migratory histories, cultural and religious views and personal relationships influenced their help seeking views and preferred coping methods for depression

A Critical Review of the Evolution of a Multi-level Community-based Children's Play Activity Programme Run by the Family Rehabilitation Centre (FRC) Throughout Sri Lanka

This paper discusses one psychosocial intervention, a children's play activity programme, which has been run in a number of refugee camps within Sri Lanka since 1992 to the present. It is a multi-level intervention which works with children, their carers, health and education professionals and community leaders, some of whom later take over the running of the programme. The programme has changed and evolved in a number of ways as the result of participant feedback and evaluations. This paper discusses the intervention and its theoretical underpinnings. The play activity programme is one of a series of interlocking programmes run by the Family Rehabilitation Centre (FRC), a Sri Lankan non-governmental organization whose aim is to assist those affected by armed conflict in all areas of Sri Lanka irrespective of ethnicity, religion and political ideology. Objectives include promoting non-violence, ethnic harmony and the prevention of torture. The intervention is based on the FRC philosophy, which holds that well-being is multi-faceted and that psychological health is embedded in a matrix of well-being. A holistic or psychosocial model has evolved which views psychological health as being embedded in a matrix of factors. These may include social, community, spiritual, and socio-political issues. How an individual construes all these factors is likely to be important, particularly in the context of a civil war with a possible return to peace-time