Editorial

Citation

Carson, J. (2024), "Editorial", Mental Health and Social Inclusion, Vol. 28 No. 2, pp. 113-115. https://doi.org/10.1108/MHSI-02-2024-135

This is our second issue of 2024 and once more contains a wide range of exciting papers that Mental Health and Social Inclusion attracts.

The first paper is from Tuija Viking and Lena Nilsson from Sweden. This is the “most downloaded” paper on our Early Cite system, with over 1,000 downloads. It focuses on how peer support workers can facilitate interprofessional learning in mental health teams. They argue that peer support workers primarily provide emotional and practical support and help bridge the “them and us” divide. They suggest that peer support workers can draw on their lived experience and contribute towards teams adopting more of a psychosocial perspective on mental health problems, as opposed to a biomedical approach. There were no peer support workers in any of the teams I was involved with, now over a decade earlier. Tuija and Lena show how peer support workers can add unique value to community mental health teams.

Jan de Vries and colleagues report on an online survey they conducted into the experiences of people who identify as transgender in Ireland. This group experiences higher levels of mental health problems. Some 279 participants took part in the survey. The researchers identified six overarching themes from their results. These were that participants felt there was more stigma expressed towards them. They felt that mental health services either did not know how to work with them or were biased against them. They felt there was a need to educate services and also the wider population about transgender identity. Participants reported that peer acceptance and support were protective, as was self-acceptance of their orientation. Finally, participants felt that more needed to be done by the wider society to aid social inclusion.

Sophie Soklaridis and colleagues reported on a co-produced research project across several Canadian recovery colleges. For readers not familiar with the concept of recovery colleges, these have been described as “[…] mental health and well-being centres designed to support people who self-identify as being on personal recovery journeys in pursuit of their wellness goals[…] (within) […] an adult educational framework.” They first conducted a scoping review to see if recovery college evaluations had involved service users in their evaluations. The second part of their work used participatory action research. They recruited 29 people who accessed recovery colleges, who then were trained to interview another 29 people to ask them how recovery colleges should be evaluated. All aspects of their study were co-produced as they commented from “the research proposal to manuscript writing.” Their scoping report suggested that the best approach to evaluation would be based on mixed methods. This would incorporate large surveys alongside narrative accounts.

Our fourth paper is by Raluca Ioana Pascale and colleagues, and reports on the phenomenon of human trafficking, an issue currently pre-occupying politicians and the wider public in many developed countries. Interestingly on most of the news bulletins in the UK, you seldom hear mention of the effects of human trafficking on its victims. These authors note there were 20 million cases of human trafficking in 2016. The individuals most often affected are women and young girls, who account for 80% of the total number of victims. Some 50% of these girls are underage. Typically, women are trafficked for sexual exploitation and men for forced labour. This paper presents a systematic review of the research literature on human trafficking. Twelve research studies are presented in depth. The largest of these had over 1,000 participants. This study revealed that 60% of victims showed evidence of depression, 48% of anxiety and 39% of PTSD. The prevalence of mental disorders is not surprisingly higher than that of the general public, but the authors claim it is even higher than that of the psychiatric population. While they also review the psychological therapies that are offered to this group, they conclude that group-based approaches are probably better at encouraging healing in creative environments than one-to-one therapies.

Our next paper moves us from the world of systematic literature reviews to lived experience. In this instance, it is the incredibly moving autoethnographic account of dealing with the death by suicide of a sibling. Angela Woods writes movingly about the suicide of her sister. As an academic, Angela found that she needed to find a research theory that would help her make sense of the “chaos” she found herself in. “I often describe it as having a bomb go off in your life.” She notes that she now has “lived experience”. She further comments, “I have been very keen since my sister’s death not to shy away from conversations about suicide. In many ways I have used this to process my own thoughts and emotions […] I sometimes use it to work out who will stick around and who will walk away.” This process of disclosure she feels is a critical part of her own healing. Prior to her death, her sister had agreed to be an organ donor. Within 24 h of her being declared dead, her organs had been used to change four lives. Angela comments, “At her funeral, I spoke about her organ donation and used this to celebrate her success in a life cut short by mental illness.” This moving paper speaks to the power of the lived experience narrative and why as editors we always need to ensure that lived experience always has a central role in this journal.

Professor David Lester writes a short paper on suicide attempts as turning points. David is one of the world’s leading suicidologists. Since conducting his PhD on the topic of suicide, David has spent over 50 years researching the topic. I was privileged to meet David during a short visit to the UK from the States in December 2023. In this paper, David presents the cases of two individuals who made serious suicide attempts, yet still went on to live productive lives. He also presents the findings of a Wikipedia search, where he looked at which celebrities who had made suicide attempts. He provides a list of famous people who attempted to kill themselves. The list includes people from Martin Luther King, to Marianne Faithful, Eminem and Billy Joel. He concludes that a suicide attempt does not necessarily impair a person’s life trajectory and may in fact mark a turning point, that leads to a more satisfying and productive life.

Kirsty Lilley has crafted another very evocative paper on her experiences. In this paper, she describes how she has often been failed in the past by our so-called helping services. She comments, “Therapeutic professionals stand proudly behind their ever-growing qualifications […] and […] forget it seems that the relationship provides the bedrock for change and being able to move forward.” Kirsty recounts a number of meetings with therapists over the years, most of which ended with her not being understood or helped. She describes an encounter with a therapist when she had an eating disorder as leaving her with the feeling that she was “[…] taking up a valuable appointment for someone else who was really ill.” She goes on to say, “I grieve for that young girl who could have been helped differently […] therapy had compounded my view of myself as being worthless.” Ironically, she was turned down by the Improving Access to Psychological Therapies service. They told her that her problems were too complex and that she would require more intensive work than their service provided. She questions the value of all the form-filling exercises which ask nothing about a person’s strengths, achievements, hopes and dreams. Eventually, she accepted “[…] the inevitability of being ignored and shrank further into herself.” A final fruitless encounter with a therapist via an Employee Assistance Program (EAP) culminated in the therapist throwing a tennis ball at her. The therapist said this would help her focus on something other than her distress and would help her regulate her emotions. A complaint to the management of the EAP led to the admission, “We also recognise that the throwing of a tennis ball as an emotional regulation strategy is not a recommended or evidence-based technique!” Eventually, Kirsty found a therapist who provided her with a trusting and safe relationship. Her conclusion is salutary. “There are many in the therapeutic field who have seen me as a bag of symptoms, a bag of misguided choices and behaviours, and, most of all, complicated.”

The final paper in this issue is another in our series of Remarkable Lives, now curated by my talented colleague Robert Hurst. It recounts the story of Robyn Clegg-Gibson. Robyn’s story reached the national press. She had been stabbed and was nearly killed by her boyfriend, only being saved by the timely intervention of a policeman. That was only the start of an ordeal that involved criminal proceedings, interviews, clinical examinations and eventually appearing in court to give evidence against her attacker. The account of her trauma focuses on the various aspects of the process. She laments, “I wish the professionals had more of an understanding of what it’s like to be a victim.” She also had the unique experience of having her own story told to her by people who did not realise she was the actual person they were discussing! And yet out of these horrendous experiences hope emerges. She comments, “[…] taking the opportunity to celebrate life. Because I lived. Against all the odds I lived.” Later she notes, “I truly believe the meaning of life is to have a good time and leave the world a little better than you found it.”

Robyn’s comment about “leaving the world a little better than you found it,” can be extended to all the papers in this issue. Each of our contributors through their work is trying to leave the world a little better. This issue has covered an incredibly wide range of groups and issues. We have had papers on peer support workers, difficulties faced by people identifying as transgender, participatory action research in recovery colleges and a review of the mental health impact of human trafficking. The other four papers have looked at coping with the death of a sibling through suicide, suicide attempts as turning points, how helping professionals often fail to help and finally recovery from physical trauma. Each paper with a hope to try and improve the lives of others through their research, insights and lived experience. A veritable treasure trove of knowledge and experience. Enjoy.

Professor Jerome Carson

Editor in Chief