Promoting young people’s musical identities to facilitate recovery from mental illness

The new ‘youth mental health paradigm’ (IAYMH. 2015. “International Association for Youth Mental Health.” Accessed February 15, http://www.iaymh.org/) promotes the need for youth-friendly mental health options. Music therapy initiatives offer innovative modes of working towards young people’s recovery in ways that align with the ethos of these services (McCaffrey, Edwards, and Fannon. 2011. “Is There a Role for Music Therapy in the Recovery Approach in Mental Health?” The Arts in Psychotherapy 38 (3): 185–189). This paper details a participatory research project investigating how and why promoting young people’s musical identities can facilitate their recovery from mental illness. Young people accessing a music therapy programme in a youth mental health service in Australia participated in collaborative qualitative interviews that were analysed using constructivist grounded theory techniques. Cycles of action and reflection resulted in a grounded theory explaining the recovery of musical identity, and mapping young people’s community-based music needs for wellbeing. We propose that promoting young people’s musical identities facilitates recovery through: the construction of a health-based identity; facilitating meaning-making; and supporting social participation. Findings are discussed in relation to recovery literature and social justice issues that arise in response to findings about young people’s needs for appropriate music access.     

‘Recovery work’ and ‘magic’ among long‐term mental health service‐users

Based on an extended period of qualitative research with mental health service‐users in north‐east England, this article considers the various forms of ‘magical work’ and ‘recovery work’ that emerge in the lives of people living with severe mental health problems. Given the now sizeable body of literature which seeks to problematize traditional conceptual boundaries of work, the article asks to what extent these hidden and unusual work‐forms might also be considered legitimate members of the category. Rather than argue for the expansion of the construct to accommodate these activities, the paper attempts simply to problematize the extent to which so‐called ‘mad’ forms of work are irresolvably different to more conventional forms of occupation. In challenging notions of the psychiatric patient as inevitably inactive, new vocabularies for service‐user work are explored. Concluding remarks are also directed to recent policy debates concerning ‘back‐to‐work’ welfare reform for long‐term out of work service‐users.     

Lay theories and criticisms of mental health news: elaborating the concept of biocommunicability

Abstract

This article examines how mental health service users/consumers, advocates, professionals and researchers interpret and theorise the impacts of mental health news. It focuses on the following themes: Creating fears about mental illness by focusing on criminal and violent acts; Reinforcing power imbalances by privileging biomedical issues and sources; and Sanitising mental health issues through the selective use of personal narratives. The study draws upon the concept of biocommunicability, which casts light on the performative power of health news in reinforcing ideas and expectations about the appropriate role for different actors to adopt in relation to health knowledge. Previous research on health news has identified biomedical authority, patient-consumer and public sphere as three predominant models of biocommunicability and this article examines how these are bound up with criticisms of mental health news. The findings are related to the ‘mediatisation of psychiatric culture’ as one of extremes and perspectives from Mad Studies.     

Constructions of ‘vulnerability’ in comparative perspective: Scottish protection policies and the trouble with ‘adults at risk’

This paper places Scottish adult support and protection (ASP) policy in the context of debates about the nature of ‘vulnerability’ and its usefulness as a defining concept in law and social policy. It examines the construction of ‘adults at risk’ in ASP policy, using a comparison with the construction of children in Scottish child protection policy, on the one hand, and women in Scottish domestic abuse policy, on the other, to illuminate the nature of the vulnerability that ASP considers itself to be addressing. It then problematises this construction, drawing both on the social model of disability and on an ethic of care. It concludes that current ASP policy remains underpinned by unhelpful assumptions about disabled people, older people and people with mental or physical health problems. A more inclusive understanding of vulnerability would be more empowering to these people and others, in policies concerned with mistreatment and abuse.     

Mental health social work in Northern Ireland and the Republic of Ireland: challenges and opportunities for developing practice

Drawing on their experience of mental health social work in Northern Ireland and the Republic of Ireland, the authors examine the impact of current legislative and policy change in both jurisdictions. The paper applies Lorenz's theoretical framework to develop a comparative analysis of how global and country specific variables have interacted in shaping mental health social work. The analysis identifies linkages between factors and indicates similarities and differences in mental health social work practice. The paper highlights emerging discourses in this field and explores the impact on practice of developments such as de-institutionalisation, community care, and ‘user rights’ versus ‘public protection’. The article concludes with a review of key challenges facing social workers in both jurisdictions and identifies opportunities for developing mental health social work in ways that can positively respond to change and effectively address the needs of mental health service users and their carers. The analysis provides an opportunity to evaluate Lorenz's theoretical framework and the paper includes a brief critical commentary on its utility as a conceptual tool in comparative social work.     

Research,policy and funding – academic treadmills and the squeeze on intellectual spaces1

In recent years, there has been a great deal of collective rumination about social scientists' role in society. In the post‐1997 UK context, public policy commitments to ‘evidence‐based policy’ and ‘knowledge transfer’ have further stimulated such reflections. More recently, Michael Burawoy's 2004 address to the American Sociological Association, which called for greater engagement with ‘public sociology’ has reverberated throughout the discipline, motivating a series of debates about the purpose of sociological research. To date, most such contributions have been based on personal experience and anecdotal evidence. In contrast, this paper responds directly to Burawoy's suggestion that we should ‘apply sociology to ourselves,’ in order that we ‘become more conscious of the global forces’ driving our research ( Burawoy 2005 : 285). Drawing on an empirical research project designed to explore of the relationship between health inequalities research and policy in Scotland and England, in the period from 1997 until 2007, this paper discusses data from interviews with academic researchers. The findings suggest that the growing pressure to produce ‘policy relevant’ research is diminishing the capacity of academia to provide a space in which innovative and transformative ideas can be developed, and is instead promoting the construction of institutionalized and vehicular (chameleon‐like) ideas. Such a claim supports Edward Said's (1994 ) insistence that creative, intellectual spaces within the social sciences are increasingly being squeezed. More specifically, the paper argues we ought to pay far greater attention to how the process of seeking research funding shapes academic research and mediates the interplay between research and policy.     

Questioning the professionalization of recovery: a collaborative exploration of a recovery process

While the recovery concept strongly resonates in clinical mental health care today, it first arose in service user-led contexts. A major risk of this professionalization shift is that recovery primarily becomes defined by treatment providers. This study aims to keep the debate on recovery alive through a collaborative exploration of Pete’s recovery process by means of a bricolage approach. This resulted in an idiographic portrait of Pete’s experiences of recovery and treatment, clustered around four themes: life rebuilding, identity, continuity of care and the role of drugs. His experiences illustrate a number of contradictions in the operationalization of the recovery ethos in today’s mental health care; whilst recovery appears as a hopeful vision of empowerment, it also risks being reduced to a tokenistic model that fails to address the social realities of people in recovery and in which the assumption that mental illness is chronic is still latently present.     

Supporting the sustainability of Mad Studies and preventing its co-option

Mad Studies is emerging as a new force in ‘mental health’ discourse and developments. Given the way in which other would-be progressive developments associated with attempts to include experimental knowledge in this field, such as ‘recovery’ and ‘peer support’, have been subverted, this article considers whether it is possible for Mad Studies to avoid this. Drawing on developments in Disability Studies and in relation to the social model of disability, we explore what can be done in order to safeguard the distinctiveness of Mad Studies and foster its unique contribution.     

Third Sector Social Policy Research in Australia: New Actors,New Politics

Human service NGOs have become central actors in contemporary welfare states. The broadening of the role of NGOs in Australia as both providers of the human services that are an integral part of the welfare state and as lobbyists or advocates and agents of social change has been widely acknowledged; however, this paper focuses on a recent deepening of the role of human service NGOs in the Australian welfare state by exploring an additional dimension of their growth. Based on a recent study, it is evident that there has been increasing involvement by human service NGOs in the production of social policy knowledge through ‘policy research’ activities. The research mapped policy research activities, policy research infrastructure and policy research resources in human service NGOs, and also captured NGO policy researchers’ perceptions of the rationales and motivations driving NGOs in this direction. It was clear that this shift is based on strong beliefs that researchers located within human service agencies are best placed to produce the kind of knowledge that should form the basis of social policies responding to human need. Other drivers identified by policy researchers suggest, however, that the inclusion of third sector organizations in policy processes cannot simply be understood as the ‘opening up’ or ‘democratization’ of social policy processes to include Third Sector participants. The motivations for human service NGOs moving into social policy knowledge production in Australia are thus complex and diverse. Drawing on the findings of our study, Researching the Researchers, this paper reflects on the implications of this reconfiguration of welfare state politics. Who produces the knowledge that influences, moulds, and even determines the allocation of resources for the delivery of human services, and how this knowledge is produced have been ongoing concerns in social policy scholarship. We suggest, that in the case of human service NGOs in Australia, entry into the field of social policy research can be understood as a reconfiguring of the democratic system of policy determination. It may also be one in which the NGOs become ‘experts’ on citizens’ needs through research practices that are fundamentally less, rather than more inclusive, of the subjects of social policy. The implications of a possible shift in power to influence and in some cases determine who gets what in the welfare state is of deep concern in relation to future models of social protection and ultimately the redistributive and democratic processes of nation states. This paper seeks to question the often-unquestioned ascendancy of the third sector in welfare and asks whether this shift is in keeping with the democratic process and whether it is the best way to determine and satisfy human need.     

Quality in services for disabled children and their families: what can theory,policy and research on children's and parents' views tell us?

Many discourses surround the concept of ‘service quality’, however, it continues to remain partial and ambiguous. This paper seeks to unpack ‘quality’ in services for disabled children and their families. Theoretical models are initially reviewed and then considered in relation to key policy guidelines, empirical data drawing upon parents' and children's experiences of ‘quality’ in services are presented. This paper demonstrates the many different levels within the concept of ‘quality’ and highlights the importance of recognising and respecting that children and parents frequently value different aspects of ‘quality’. Copyright © 2001 John Wiley & Sons, Ltd.     

An equality of condition framework for user involvement in mental health policy and planning: evidence from participatory action research

Discussions about user involvement in the mental health services tend to throw up four major areas of concern: the capacity of service users to participate, their lack of participation skills, the need for a positive organisational culture and the need for arenas of participation. This article presents evidence from participatory action research with Irish mental health service users which explored how they could more equally participate in advisory committees. Participants identified barriers to their equal participation due to unequal cultural, physical, mental and economic resources, time, power, ‘stigma’(prejudice) and lack of respect for their experiential knowledge and emotional expression. These barriers fall within the ‘equality of condition framework’ developed by Baker and colleagues. Enabling equal user involvement in strategic decision‐making requires more than arenas of participation – it requires comprehensively addressing service users’ structural disadvantages throughout the process of involvement.     

An Integral Approach to Mental Health Recovery: Implications for Social Work

The term recovery has become increasingly popular in the area of mental health care. Recently, it has been described by policy makers as the guiding vision for transforming the mental health system. Problematic, however, is that a lack of clarity continues to exist regarding how recovery is to be defined. Definitional attempts often appear to have competing opinions about what the concept exactly stands for. This causes confusion for both professionals and consumers desiring to adopt a recovery approach. Ken Wilber's integral theory is presented as a framework for organizing and connecting various viewpoints related to the “recovery” concept. Implications for social work are discussed.     

Expert views of children's knowledge needs regarding parental mental illness

Children of parents with a mental illness are at significant risk of developing a mental illness. This risk may be reduced if appropriate interventions are provided that include information and knowledge about mental illness. While there are some interventions for children of parents with a mental illness, research is lacking about the type of mental health information children need and why they need that knowledge. This study presents the perspectives of a purposive sample of international research experts in the field of parental mental illness about the kind of mental health literacy information children with parents with a mental illness need. Twenty-three participants completed a self-constructed short answer questionnaire about the knowledge needs of children of parents with a mental illness. The qualitative data indicates that ‘identifying information’, ‘making sense of parents behaviour’, ‘coping better’ and ‘respecting safety’ are key knowledge needs of children. Given the views presented, these findings suggest that health care professionals should advocate for policies that support individual-, peer-, and family-focused programs driven by strong evaluation and rigorous research. If this is done, children of parents with mental illness may experience ‘myth busting’ of incorrect information about mental illness.     

A cross-national and comparative classification of in-country awareness and policy responses to ‘young carers’

The reality for many families where there is chronic illness, mental health problems, disability, alcohol or substance misuse is that children under the age of 18 are involved in caring. Many of these children – known as ‘young carers’ – will be providing regular and significant care, either episodically or over many years, often ‘hidden’ to health, social care and other welfare professionals and services. These children have most often been invisible in social policy and professional practice. What are the reasons why some countries recognize young carers as a priority for social policy while others (most) do not? What are the key factors that influence a country’s awareness and responses to these children? This article provides an original classification and analysis of country-level responses to young carers, drawing on published research, grey literature, policy documents and the authors’ extensive engagement in policy and practice networks for young carers and their families in a wide range of countries. The analysis identifies two of the key factors that influence the extent and nature of these policy responses, focusing on the importance of a reliable in-country research base and the contribution of influential national NGOs and their networks.     

How Social Movements Move: From First to Second Wave Developments in the UK Field of Psychiatric Contention1

In this paper I seek to unpack the notion of ‘movement’, addressing the question of what it means to say that social movements ‘move’. The concept of ‘movement’ is often used in social science to refer to change, I note, and this is clearly an appropriate usage in relationship to social movements, which often seek to bring about and/or manifest within themselves social changes. At the same time, however, movements move in the respect that the cultural forms and resources they generate are diffused (they move) across both time and space. The cultural components of a movement move in the way that, for example, a virus moves, between individuals in a ‘vulnerable’ population. The paper explores these ideas by way of an examination of the second wave of radical mental health activism in the UK.     

The mental health problems of mothers experiencing the child protection system: identifying needs and appropriate responses

This article presents the findings of a small pilot study which examined the needs of 13 mothers with severe mental health problems whose children were involved in the child protection system. The use of the diagnosis of ‘personality disorder’ in relation to this group of women is discussed and the finding that all these women had experience of domestic violence is considered in the context of other research findings. The extent to which child protection social workers and mental health professionals worked together on these cases was explored and only limited evidence of good communication and collaboration was found. The need for effective inter‐professional and inter‐agency coordination is argued, but differing conceptions of maternal mental health problems and their relationship to children's needs may make for difficulties in professional communication and decision‐making. The article seeks to identify the differing approaches to maternal mental health problems which appear to be developing out of different groups of research studies and argues that practitioners need to be explicit in identifying their perspectives on the associated issues of maternal mental health problems and child protection. Copyright © 1999 John Wiley & Sons, Ltd.     

Survivor research and Mad Studies: the role and value of experiential knowledge in mental health research

The body of knowledge referred to as ‘survivor research’ has grown significantly in recent years, challenging the basis of mainstream mental health knowledge and most recently manifesting in the emerging field of enquiry known as ‘Mad Studies’. The roots of these developments lie in the experiential knowledge of service users engaged in sharing their experiences and knowledge, often through peer support. I aim to challenge some of the assumptions underlying what we think we know about mental health from the mainstream mental health disciplines; and to demonstrate the value of experiential knowledge in helping us to reach a better understanding of mental health and mental distress. This article explores the nature of, and challenges to, mental health knowledge and evidence, drawing on the work of survivor researchers and people contributing to the emerging discipline of Mad Studies.     

Legal capacity and the mental health social worker role: an international comparison

ABSTRACT

New capacity laws have been introduced to many jurisdictions over the last decade. These laws have substantially changed the way in which mental health social workers and other professionals approach decisions about, and for, clients. Most notably, there is now an expectation that mental health social workers engage more in supported decision-making to prevent the need for substitute decision-making. This article describes the legal and policy drivers that have led to these changes in practice, with a particular emphasis on the significance of the United Nations Convention on the Rights of Persons with Disabilities (the UNCRPD) and the importance of recovery approaches in mental health services. It then uses selected literature to explore the efficacy of the laws and decision-making in this area. The second part of the article identifies the role that mental health social workers can play in supporting legal capacity, drawing from the authors’ experience and knowledge of mental health social work and law in four jurisdictions: Victoria, Australia; Ontario, Canada; England and Wales; and Northern Ireland. It is concluded that mental health and other social workers need to refine skills, knowledge and values to accommodate this paradigm shift in law, policy and practice.