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1 – 10 of 412Benjamin Thomas Gray and Matthew Sisto
The purpose of this viewpoint article is to describe the experience of recovery houses and peer work from the perspective of a service user (Ben). The current profile and…
Abstract
Purpose
The purpose of this viewpoint article is to describe the experience of recovery houses and peer work from the perspective of a service user (Ben). The current profile and visibility of recovery houses on mental health wards is low. Indeed, since Ben’s first diagnosis in 2003 and during the last 17 months as a peer worker the importance of recovery houses has not even been mentioned once by staff or service users. It should be noted that this article expresses the view of the first author (Ben) and not the co-author (Matthew).
Design/methodology/approach
This is also a service user narrative by Ben. He was diagnosed with paranoid schizophrenia in 2003 and spent two years in and out of the mental health unit where he is now a peer worker. Ben had a relapse in 2013 for about six months and then attended Ron Coleman’s and Karen Taylor’s Recovery Champions course and their recovery house on the Isle of Lewis, Scotland, where he first heard of the recovery approach and which improved Ben’s mental health. Ron and Karen’s organisation is called Working to Recovery. Ben is currently a peer worker on the same unit where he was once a patient and working with the Director of Patient Experience, Matthew Sisto. This article is based on lived experience as a service user and peer worker.
Findings
This article makes a case for and a case against the proposal to incorporate recovery houses more into the fabric of NHS mental health care as well as a possible alternative to psychiatric units. The main argument in this article is to suggest making recovery houses more mainstream, more of them and more accessible to those currently in traditional mental health units. Currently there are no formal mechanisms of discharge from hospital to recovery houses. Not one person on the wards where I was a patient since 2003 or peer worker in the last 17 months has been discharged to a recovery house. Recovery houses are a therapeutic alternative or complement to traditional psychiatric care. They could also have other potential benefits, such as decreasing bed blocking on psychiatric wards (service users who are well and waiting for accommodation), reducing risk of relapse and remedying the loneliness and isolation that is often faced by service users on discharge to the community (changing from being around a lot of people on the ward to no one and isolation at home). Recovery houses are in short supply and in need of scaling up (more of them). There is the need to increase the referral and accessibility of recovery houses for service users on mental health wards. Currently recovery houses offer short-term support, only a matter of weeks or months. They would be better if they offered longer periods and also ongoing support. Recovery houses would also benefit people with mental illness, their carers and others if they incorporated elements of peer support.
Originality/value
Recovery houses and peer support are relatively new approaches in the mental health journeys of people with mental illness. This article is important because it makes a case for/ case against and addresses the feasibility of incorporating the recovery approach and recovery houses into the quite antiquated and slow to change fabric of the conventional NHS. It considers traditional and alternative pathways of care and steps for change to make recovery houses more mainstream and accessible to NHS psychiatric patients (and even perhaps to replace conventional psychiatric care in the long run).
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Benjamin Thomas Gray, Matthew Sisto and Renee Conley
The purpose of this service user narrative and viewpoint article is to describe interprofessional and interpersonal barriers to peer support on a men’s mental health ward over the…
Abstract
Purpose
The purpose of this service user narrative and viewpoint article is to describe interprofessional and interpersonal barriers to peer support on a men’s mental health ward over the course of a year from a lived experience perspective.
Design/methodology/approach
A reflective journal was kept and participant observation was conducted over the course of the year.
Findings
There is sometimes a fissure and binary of “Us” and “Them” on the ward. In other words, staff can sometimes perceive peer support workers to be “one of us” (a member of staff) or “one of them” (a service user). For service users, the opposite is sometimes true: “one of us” (a service user) or “one of them” (a member of staff). Peer support workers must bridge this gap and strive to be “one of us” with both these groups, which is no easy task. A good ward manager or peer team leader can smooth over interprofessional differences and support the peer worker in their efforts of care towards the recovery of people with mental health problems.
Originality/value
Little has been written on this topic in a mental health inpatient setting as most papers address community peer support work, which is very different from peer support in hospital. This paper addresses one of the first peer support pilot projects in hospital of its kind in NHS England so is quite innovative and perhaps even unique.
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Benjamin Thomas Gray, Matthew Sisto, Renee Conley and India Sisto
The purpose of this paper is to explore the bias of psychiatrists and other healthcare staff’s perception of “presenting psychosis”. The purpose of this paper is twofold: first…
Abstract
Purpose
The purpose of this paper is to explore the bias of psychiatrists and other healthcare staff’s perception of “presenting psychosis”. The purpose of this paper is twofold: first, to suggest that psychosis, rather than residing in the individual, can be triggered by a hostile ward environment (e.g. very loud emergency alarms) as well as the negative attitudes of staff and friction with other service users; second, to argue that psychosis is not just in the person’s mind but interpreted and negatively labelled by psychiatrists and other healthcare professionals.
Design/methodology/approach
This paper is based on the lived experience of Ben, who was first diagnosed with schizophrenia in 2003 (when he spent two years in and out of a mental health unit). Ben had a relapse in 2013 and spent six full months in the same unit. Ben has been working as a peer worker on the same ward he was on as a patient for the last 17 months. This paper is informed by participant observation as a patient and peer worker, particularly reflecting on the general ward environment, ward reviews and punitive action faced by Ben and other service users. The title of this paper is based on occasions when Ben has been told that he cannot interact or take service users on leave off the ward, because they were “presenting psychosis”.
Findings
Ways of judging whether someone is presenting psychotic behaviour sounds straightforward enough but in fact can be quite complex. Whether someone is presenting psychotic behaviour is open to interpretation. Psychotic behaviour is perceived as latent or inherent within the individual by psychiatry. This paper makes the case that presenting psychotic behaviour is in fact a construct or interpretation by psychiatrists that works to limit people’s freedom, coerce them, take away their leave off the ward and voice, and which expresses power imbalances between staff and service users. The impact for service users of psychiatrists and staff’s decision-making can lead to service users being angry and upset, a negative ward environment and feelings of unfreedom. A good example is that service users present psychotic behaviour due to a hostile and frightening ward environment, with loud emergency alarms (like sirens) and the threat of restraint, restrictive practice and seclusion in de-escalation rooms being used as a threat.
Originality/value
People with mental illness, particularly schizophrenia like Ben, can be stereotyped as psychotic, aggressive and dangerous or a risk to themselves and others. While this can sometimes be the case the majority of people with mental illness that Ben has interacted with for over 20 years could be described as “broken” and in need of care, fixing and giving them hope in their recovery. This paper is of value because it draws on over twenty years of experience of the lived experience of Ben and his diagnosis of the harmful label of schizophrenia. It describes the added value of peer work in an in-patient mental health unit. It also introduces the new idea of “clemency”.
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Benjamin Thomas Gray and Matthew Sisto
The purpose of this service user paper and narrative is to highlight that peer support is not a continuous, easy or uniform process but given to disruption, fragmentation…
Abstract
Purpose
The purpose of this service user paper and narrative is to highlight that peer support is not a continuous, easy or uniform process but given to disruption, fragmentation, breakdowns in relationships and hurdles. This is illustrated in a summary of the case of “Christopher”.
Design/methodology/approach
A reflective journal was kept, and participant observation was conducted for just under a year on the ward where Christopher was under Section.
Findings
Peer support can be given to fissure, breakages in relationships and discontinuity. This can negatively impact the mental health of peer support workers. With this in mind, it is vitally important to ensure that the people who take up this role are appropriately trained, supported and supervised. There needs to be a focus on “restorative” supervision and supervision by someone with experience of the peer support role as well as buddying between peer workers.
Originality/value
There is an abundance of literature and research on peer support in the community but little in the inpatient setting, making this paper novel and a contribution to understanding peer support on mental health wards.
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Benjamin Thomas Gray and Matthew Sisto
The purpose of this study is to describe peer support work in a men’s mental health unit from a lived experience and service user’s perspective. The intertwining of process (a…
Abstract
Purpose
The purpose of this study is to describe peer support work in a men’s mental health unit from a lived experience and service user’s perspective. The intertwining of process (a lived experience perspective) and subject (the therapeutic value of peer support) leads to greater knowledge and insight into peer support for people with mental health problems.
Design/methodology/approach
This service user narrative draws on the extracts from a reflective journal of interactions and conversations with people with mental health problems as well as feedback from service users and staff about the value of peer support. These methods allow a first-person, service user’s, reflective and narrative account of peer support work.
Findings
Peer support work, particularly hearing voices sessions, are found to be highly therapeutic and worthwhile. They promote insight and create feelings of safety and hope in what can sometimes be a frightening and hostile ward environment. Peer support provides emotional and practical support. Sharing stories and experiences of mental illness with people leads to trust, feelings of being valued, heard and accepted as well as better experiences of care and being seen as a person first. Due to their shared experiences, peer support workers are able to befriend people with mental health problems on the ward. Peer support work bridges the gap and vacuum of care between people with mental health problems and staff. It compensates for understaffing to provide more holistic and person-centred care and support.
Originality/value
Lived experience/ service user perspectives and narratives on peer support are rare, particularly in a hospital setting. This article provides a rich, perhaps overlooked and hidden narrative on the nature of peer support work. People with mental health problems, like Ben, are often excluded from society, health and social care, education, employment and research. This narrative opens up a pathway to understanding peer support from a service user perspective.
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Benjamin Thomas Gray and Matthew Sisto
The purpose of this service user narrative is to highlight the stigma and prejudice that is often targeted at people with schizophrenia and severe mental illness, which causes…
Abstract
Purpose
The purpose of this service user narrative is to highlight the stigma and prejudice that is often targeted at people with schizophrenia and severe mental illness, which causes fear and isolation. The therapeutic effect of peer support is further explored as offering hope, connection, aspirations, advocacy, autonomy and openness for service users as well as the possibility of recovery and a reduction in feelings of stigma, prejudice and exclusion.
Design/methodology/approach
Ben was diagnosed with paranoid schizophrenia in 2003, so this paper draws on over 20 years of experience of the harmful label of schizophrenia. In the last 15 months, he has been working as a peer worker on a men’s mental health ward in the East of England. He has kept a reflective journal and conducted participant observation on the ward, which informs this paper and its findings.
Findings
There are observations based on peer support on the ward in the last 15 months and over 20 years as a schizophrenic. People with schizophrenia and severe mental illness are stigmatised and experience discrimination and prejudice. This paper introduces the new idea and neologisms of schizophobia and insanophobia that people with severe mental illness will experience in their daily lives, in health and social care settings (such as the men’s ward), in education and in employment. People with mental illness are also often discriminated against as being a danger or a risk to themselves and others. They are often considered as aggressive or violent. Their diagnosis can stop them from getting a job, a mortgage or even from travelling to some places in the world. But this paper details the violent assault by a nurse on a patient while Ben was working on a long stay ward in a large psychiatric asylum in 1990. It is pertinent to note that things have progressed since the 1990's but there continues to be the stigmatisation of people with a severe mental illness, which requires societal and systemic change. In Ben’s experience, people with mental illness seem far more likely to experience violence upon their person rather than being violent towards other people, such as staff, members of the public, family or carers.
Originality/value
This service user narrative is a first person account, so it is original. It is of further value because it outlines the ways in which peer support can help with feelings of stigma and exclusion as well openness about hearing voices/ seeing things (hallucinations) and strange thought or beliefs (delusions).
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It is now forty years since there appeared H. R. Plomer's first volume Dictionary of the booksellers and printers who were at work in England, Scotland and Ireland from 1641 to…
Abstract
It is now forty years since there appeared H. R. Plomer's first volume Dictionary of the booksellers and printers who were at work in England, Scotland and Ireland from 1641 to 1667. This has been followed by additional Bibliographical Society publications covering similarly the years up to 1775. From the short sketches given in this series, indicating changes of imprint and type of work undertaken, scholars working with English books issued before the closing years of the eighteenth century have had great assistance in dating the undated and in determining the colour and calibre of any work before it is consulted.
Anna Pistoni and Lucrezia Songini
This chapter intends to contribute to the debate on the determinants of corporate social responsibility (CSR) and their impact on performance measurement and communication…
Abstract
Purpose
This chapter intends to contribute to the debate on the determinants of corporate social responsibility (CSR) and their impact on performance measurement and communication systems. It aims at analyzing the relationship between the reasons why firms adopt CSR and the importance given to voluntary CSR disclosure.
Methodology
Two main categories of CSR determinants have been identified: the external ones, coming from the environment outside the firm, and the internal determinants, which are linked to some specific characteristics of the enterprise and to the objectives it pursues.
The analyzed sample consists of 120 large Italian manufacturing and nonmanufacturing enterprises. The research hypotheses concerning the relationship between external and internal determinants of CSR and CSR disclosure were verified using an independent sample t-test, evaluating the equal variances of clusters using the Levene’s test.
Findings
Main results point out that in companies giving importance to CSR disclosure, the internal drivers are more relevant than the external ones in determining the attitude toward CSR. Among the internal determinants, drivers related to company and management values and ethics are quite relevant.
Research limitations
This study is subject to the limitations that generally apply to cross-sectional survey-based research.
Originality/Value of chapter
Our research findings show that legitimacy theory represents the most relevant theory in explaining CSR disclosure practices of Italian large firms, as well as the operational implementation of stakeholder theory, such as stakeholder management. On the contrary, institutional theory only partially explains CSR disclosure, with respect to the pressures coming from financial markets.
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Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Term. 37203. Mrs. Cheney does not sell the books listed here. They are…
Abstract
Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Term. 37203. Mrs. Cheney does not sell the books listed here. They are available through normal trade sources. Mrs. Cheney, being a member of the editorial board of Pierian Press, will not review Pierian Press reference books in this column. Descriptions of Pierian Press reference books will be included elsewhere in this publication.