Moving Beyond Routines in Teaching and Learning: Releasing the Educative Potential of Published Eating Disorder Memoirs

Learning from the lived experience of disordered eating is vital for contemporary mental health practitioners. While mental health practitioners need to understand the psycho-biological issues that impact the person and family with an eating disorder, there is much about this complex condition that eludes and escapes a bio-medical perspective. Use of an aesthetic lens on the issue can illuminate various challenges, tensions and insights that people with disordered eating experience along the journey of their ill-health and on to their recovery, but which often remain unstated in the clinical context. Scholars within the creative arts discipline are experts in making judgements about the quality of artworks they encounter and have highly developed aesthetic knowing. Yet, the central skills and knowledges embodied in creative arts activity are not widely utilized outside that sphere. This article reports on how aesthetics can be applied to sensitize mental health practitioners to appreciate the lived experience of a mental health challenge such as an eating disorder. Such mental health practitioners play an important role in the health service, yet the widespread diffusion of the bio-medical model into mental health, once characterized for its equal emphasis on the psycho-social-cultural, has led to criticisms of an over-focus on illness identification, at the expense of accommodating the meanings of subjective and unique experiences of mental health, struggle and recovery. Using Kate Grenville's typology of the elements of effective creative writing, we show how these elements contribute to the aesthetic power and impact of particular eating disorder memoirs.     

The effect of work on people with severe mental illness in Taiwan using a stress-social support model: an exploratory study

Satisfaction with quality of life is one aspect of a positive and successful life, and this remains true in the rehabilitation of people with severe mental illness. This study explores the meaning and impact of work on people with severe mental illness in Taiwan and, specifically, the value of encouraging people with severe mental illness to work to enhance their quality of life. We apply stress-social support theory (a Western model) to examine daily life and work stressors in an Eastern cultural environment (Taiwan). We use multiple regression models to analyze predictive factors for their effect on life quality. There are five categories: socio-demographic characteristics, mental illness history, current work status variables (as controls), stress variable and social support variable. Unlike Western studies, current work status, in itself, did not lead to better satisfaction with quality of life, but the stress-social support model did. The implications for rehabilitation success are discussed.     

Psychosocial treatments for people with co-occurring severe mental illness and substance misuse: systematic review

Title. Psychosocial treatments for people with co‐occurring severe mental illness and substance misuse: systematic review. Aim. This study is a report of a systematic review to assess current evidence for the efficacy of psychosocial interventions for reducing substance use, as well as improving mental state and encouraging treatment retention, among people with dual diagnosis. Background. Substance misuse by people with a severe mental illness is common and of concern because of its many adverse consequences and lack of evidence for effective psychosocial interventions. Data sources. Several electronic databases were searched to identify studies published between January 1990 and February 2008. Additional searches were conducted by means of reference lists and contact with authors. Review methods. Results from studies using meta‐analysis, randomized and non‐randomized trials assessing any psychosocial intervention for people with a severe mental illness and substance misuse were included. Results. Fifty‐four studies were included: one systematic review with meta‐analysis, 30 randomized controlled trials and 23 non‐experimental studies. Although some inconsistencies were apparent, results showed that motivational interviewing had the most quality evidence for reducing substance use over the short term and, when combined with cognitive behavioural therapy, improvements in mental state were also apparent. Cognitive behavioural therapy alone showed little consistent support. Support was found for long‐term integrated residential programmes; however, the evidence is of lesser quality. Contingency management shows promise, but there were few studies assessing this intervention. Conclusion. These results indicate the importance of motivational interviewing in psychiatric settings for the reduction of substance use, at least in the short term. Further quality research should target particular diagnoses and substance use, as some interventions may work better for some subgroups.     

High expressed emotion: precipitating relapse in substance misuse disorders

There is a considerable body of evidence on the effect of high expressed emotion on individuals suffering severe mental illnesses; there is also considerable work on those people suffering the dual diagnosis of severe mental illness and substance use disorders. However, in the latter, the majority of studies appear to concentrate on the mental illness aspect of the condition. Literature searches identified that there were few scholarly articles on how expressed emotion affects relapse in those people with a substance use disorder, and yet there is a great deal of evidence regarding the disruption substance use can have on a family and on the individual. This article intends to provide an evaluation on the reasons why high expressed emotion should be addressed in substance use disorder and suggests that, if the benefits of reducing high expressed emotion in these disorders are as significant as in severe mental illness, then there is a sound basis for the increased use of family interventions in substance use disorders.     

Development of an instrument to measure self-efficacy for social participation of people with mental illness

Promoting social participation is consistent with the principles of psychiatric rehabilitation of people with severe mental illness, but lack of self-efficacy in social participation is a major barrier to the community integration of these people. The purpose of this study was to develop an instrument in the form of a mental illness scale (self-efficacy for social participation [SESP]) to measure self-efficacy in social participation among Japanese people and to evaluate the scale's reliability and validity. Devised from a content analysis of interviews with 12 patients regarding their participation in socialization programs, the scale consisted of 37 items. The scale's validity and reliability were tested in a total of 340 community-dwelling individuals with severe mental illness. The final scale consisted of four dimensions with 27 items. Internal consistency of the overall SESP-27 was excellent (α = .96). The scale demonstrated adequate criterion and construct validity and was psychometrically sound. The scale may offer clinicians a tool for planning how to help individuals with mental illness boost their self-efficacy in social participation and community integration.     

Family‐focused recovery: Perspectives from individuals with a mental illness

Family members often provide significant support and care to their relative who has a mental illness. Nonetheless, how family members might be part of an individual's mental health recovery journey is rarely considered. The aim of this study was to investigate how those with a mental illness define ‘family’ and the role of family (if any) in their recovery journey. A qualitative approach was used. Purposive sampling and snowballing were used to recruit and conduct semi‐structured interviews with 12 people who have been diagnosed with a severe mental illness. Participants defined family in various ways with some being very inclusive and others more selective. There was acknowledgement that family contributed to the individual's recovery in a myriad of ways, although the need for boundaries was stressed. While no participants suggested that their family might become active treatment facilitators, they did want clinicians to support them in talking to their family about their mental illness. A multifaceted approach is needed to promote family‐focused recovery practice. The needs of different family members and the needs of the family as a group should be considered concurrently alongside the individual's needs in their recovery plan. Individual and relational components of recovery should be embedded in policy and clinical practice.     

Attitudes towards people with mental illness: a cross-sectional study among nursing staff in psychiatric and somatic care

Stigma and discrimination have been identified as important obstacles to the integration of people with mental illness in society. In efforts to reduce stigma and discrimination, health professionals play an important role as they have frequent contact with and responsibility for treatment and rehabilitation of consumers. The aim of the present study was to investigate attitudes towards mental illness and people with mental illness among nursing staff working in psychiatric or somatic care. The sample consisted of 120 registered or assistant nurses who were interviewed about intimacy with mental illness and attitudes about seven different mental illnesses. The results showed that nursing staff in somatic care, to a higher degree than nursing staff in mental health, reported more negative attitudes with regard to people with schizophrenia as being more dangerous and unpredictable. In contrast, professional experience, intimacy with mental illness and type of care organization were found to be more associated with attitudes to specific mental illnesses concerning the prospect of improvement with treatment and the prospect of recovery. In conclusion, attitudes among nursing staff are in several respects comparable with public opinions about mental illness and mentally ill persons. In order to elucidate if negative attitudes about dangerousness and unpredictability of persons with specific mental illnesses are associated with realistic experiences or with prejudices further studies with a qualitative design are suggested.     

Beliefs towards mental illness in Turkish physiotherapy students

Abstract

Mental health is a new area of specialization for physiotherapists. However, they usually meet patients with psychiatric co-morbidities secondary to other chronic diseases. It is important to explore the beliefs of future physiotherapists regarding mental illness in order to implement effective strategies to avoid possible stigmatizing attitudes that may interfere with the rehabilitation process. Moreover, the psychiatric field should be introduced to physiotherapists as a clinical and research area. Therefore, we aimed to question the beliefs of physiotherapy students regarding mental illness using the Beliefs towards Mental Illness Scale in two different universities in Turkey. The total score of 524 students was 46.5?±?14.5 out of 105 while the Dangerousness Subscale score was 21.2?±?5.8/40; Incurability and Poor Social and Interpersonal Skills Subscale score was 24.2?±?9.3/55 and Shame Subscale score was 1.1?±?1.9/10. Students who had a relationship with an individual having a mental problem and students who had consulted a psychiatrist/psychologist for any mental problem showed more positive beliefs. Future physiotherapists should be informed and trained regarding people with mental illness both to avoid stigma and to be aware of this area in physiotherapy settings. Therefore, it is important to implement new curricula for schools providing physiotherapy education including courses, lectures and clinical practices in the psychiatry field.     

Individual placement and support - a model to get employed for people with mental illness - the first Swedish report of outcomes

Lack of participation in the open labour market is highly prevalent for people with a mental illness across countries, and the proportion of people who get some kind of sickness benefit because of mental illness is steadily growing in Europe. Vocational rehabilitation through individual placement and support (IPS) has been shown to be effective and is evidence-based for people with severe mental illness. In Sweden, the method is used but not scientifically evaluated. The aim was to investigate vocational and nonvocational outcomes at a 1-year follow-up and the relationships between these outcomes, at two different sites in the north of Sweden. The participants were 65 men and women, mostly younger than 30 years of age and with a mental illness. Occupational situation, psychiatric symptoms, self-esteem, quality of life and psychosocial functioning were assessed. The vocational outcome during 1 year was that 25% of the participants were employed, and 14% were in education. Most of the participants moved from unemployment to work practice for a prolonged time. Participants in employment, education or work practice at follow-up showed higher satisfaction with their occupational situation than those without regular activities outside home. Among the participants in work practice, improvements in psychiatric symptoms and global functioning were identified. This attempt is the first to evaluate supported employment according to the IPS model for persons with mental illness applied in the Swedish welfare system. There is a need for a longer follow-up period to evaluate whether interventions such as further education and work practice actually will lead to real work.