Social Work and Social Sciences Review

Relationships and a relational understanding in mental health research

Michael Clark — Thu, 11 Apr 2024 00:00:00 -0700

In engaging in this article with the far-reaching scholarly work of Peter Huxley, I focus on the foundations he has laid in developing a stronger social basis to understanding mental health and the forms of support that those experiencing mental health problems want and need. I will argue that mental health research and policy have barely embraced nor developed this foundation, let alone taken it to the core of knowledge in the way needed. To do this we need to follow the relational turn in scholarly work, a theoretical perspective I expand on in the article. Through these discussions I seek to lay directions for the development of mental health knowledge and policy to better understand the full social context of people’s experiences and of practice to support them.

Historical applications of the Goldberg and Huxley Pathway to Psychiatric Care Model

John Hall — Tue, 16 Apr 2024 00:00:00 -0700

The Pathway to Psychiatric care Model was published by David Goldberg and Peter Huxley in 1980, based on practice within the British NHS from 1948, and on epidemiological data mostly from Europe and the USA. The ‘filters’ in the model were derived from assumptions about practice, and levels of care, at that period. This paper explores the implications of applying the model historically to patterns of English psychiatric care firstly from 1834/1845 to 1959, with parallel public, philanthropic and private systems of healthcare; and secondly to patterns of care after c.2000. The model is a powerful conceptual tool for understanding how mental health systems function, and the central importance of referral and transition decisions. This analysis points to the influence of changing ‘regulatory cultures’, at one remove from the immediate clinical encounter, and to the implications of a much wider range of mental health practitioners than in 1980

Breaking boundaries

Ben Hannigan — Tue, 16 Apr 2024 00:00:00 -0700

This paper begins with an overview of Peter Huxley’s work across four areas: access to mental health care; understanding mental health and illness through a biosocial lens; social inclusion; and quality of life. Interconnected themes revealed in this body of research are then addressed, focusing particularly on: the commitment to interdisciplinarity; the value of conducting investigations which have demonstrable real-world application; measurement; and collegiality. The paper then moves to a personal reflection on Peter Huxley’s rock-solid support for growing a programme of mental health services research in Wales, before concluding with a forward-looking account of the lasting impact of his contribution

Entering into, departing from and working within the psychiatric domain

Wulf Livingston — Tue, 16 Apr 2024 00:00:00 -0700

This article is a Festschrift contribution which maps out the similarities in the career trajectories of Professor Peter Huxley and myself. It begins by exploring the key considerations of our common profession; social work, and its relationship with mental health. It then explores how a social orientation has enable us to reframe understandings of dual diagnosis. The second half of the article then explores the key lesson learnt from these interactions. The findings of the contribution are centred around the need for better understanding of the social detriments of mental health and substance use. In reaching these conclusions, the article summarises the importance of seeing individuals for the problems they encounter and working with them in partnership to arrive at more empowered responses.

‘Hidden epidemic’ of neurological deaths in the major Western nations in the 21st Century

Colin Pritchard — Tue, 16 Apr 2024 00:00:00 -0700

In the first international comparative study of neurological mortality, which found that between 1989 and 1997, and based on the latest WHO available data, twelve of the twenty-one Western countries had substantial increases in neurological deaths (Pritchard et al., 2004) and by 2021 every-one of the twenty-one Western nations had significant rises in neurological deaths (Pritchard et al., 2013, 2017). In this new study presented here, we use WHO data (WHO, 2020) and the ONS (ONS, 2022) data for England and Wales up to 2020. Previously, increases have been assumed largely due to demography and improved accurate diagnostics (the Gompertzian hypothesis). Our results challenge the idea that the increases are mainly due to demography. We explore the multi-interactive environmental factors that have probably contributed to the rising neurological morbidity, ranging from petrochemicals, organophosphates, endocrine-disruptive chemicals, food additives, plastics, heavy metals in water and human breast milk.

Quality of life as a basis for system change

Nina Maxwell — Tue, 16 Apr 2024 00:00:00 -0700

his paper celebrates Peter Huxley’s contribution to placing quality of life at the centre of service planning and responses. Drawing on our research findings with 81 patients from Community Mental Health Teams, this paper argues that patient outcomes are improved when their voices are used to inform service design. Using the Manchester Short Assessment Quality of Life (MANSA), patients prioritised three of the eight domains: employment, financial stability and leisure activities. These findings were used to inform system change by addressing patient needs to increase their financial and social inclusion. This paper seeks to demonstrate the continued relevance of Peter’s work with reference to two examples: mental health needs arising from COVID-19 and the needs of criminally exploited children and young people. It concludes that Peter’s legacy provides the tools needed to ensure that services work together efficiently and effectively to address unmet needs and enhance quality of life

The Health Variations Programme revisited

Anne Rogers — Tue, 16 Apr 2024 00:00:00 -0700

This contribution focuses on a period between 2000 and 2004 and centres on collaborative work funded by the ESRC health variations programme. This programme of research represented a shift in Peter’s work away from mental health in formal health settings towards a focus on the social determinants and amelioration of mental health problems. The social origins of mental health problems and how to tackle them has traditionally been a poor relation to the medical clinical institutional way in which most research and attention is placed. Thus this study marked a departure from the study of mental anguish in the closed systems of medicine including primary care to more open systems of the causes and potential solutions of mental health problems. It came at a point of optimism about regeneration and the social democratic social and welfare policies of new labour.

Web-based mindfulness course for staff working in care homes in Wales for older people with dementia

Tue, 16 Apr 2024 00:00:00 -0700

Design and intervention: Before-and-after evaluation of web-based mindfulness training
for staff caring for people living with dementia in care homes. Stepped-wedge cluster
randomised design.
Setting and participants: Random sample of 31 care homes for people living with dementia.
Homes started mindfulness training at a random time over 35 weeks. From these
homes 172 staff volunteered, 151 (88%) started training, and 111 (67%) completed
questionnaires after 20 weeks.
Methods: Questionnaires completed at baseline, 8 and 20 weeks included job stress (WSI)
and health and well-being (SF-12).
Results: There were significant reductions in job stress of 0.07 (95% confidence interval
[CI]: 0.02, 0.13) at 8 weeks and 0.06 (95% CI: 0.01, 0.11) at 20 weeks; and improvements
of 2.49 points (95% CI: 0.81, 4.17) in the SF-12 Mental Component Score at 8 weeks
and 3.41 (95% CI: 1.88, 4.94) at 20 weeks.
Conclusions: Web-based mindfulness training improved the psychological well-being
of care home staff and reduced their stress with small to moderate effects in both short
and medium term

Measuring quality of life of people with severe mental illness: Evaluation of the Dutch version of the Manchester Short Assessment of Quality of Life (MANSA) in three different populations and a look into innovative opportunitiesMeasuring quality of life

Chijs van Nieuwenhuizen, M. Annet Nugter, Ilja L. Bongers — Tue, 16 Apr 2024 00:00:00 -0700

Purpose. The Manchester Short Assessment of Quality of Life (MANSA; Priebe et al., 1999) is one of the most widely used QoL-measures in psychiatry. We aimed to investigate the psychometric properties of the Dutch version of the MANSA in a broad sample of people with severe mental illnesses (SMI). Method. QoL-data from three studies were available (total n = 806). Internal consistency and construct validity were assessed. Furthermore, it was investigated whether the 12 subjective MANSA-items were capable of discriminating between specific psychiatric disorders. Results. Cronbach’s alpha ranges from 0.78 to 0.85; overall convergent and divergent validity of the MANSA is good. For people with SMI, their financial situation, mental health and life as whole are the most important QoL-domains. Conclusions. The psychometric properties of the MANSA are good and the instrument can be used to discriminate between important QoL domains within people with SMI.

The social inclusion of mental health service users in Brazil: Applying SCOPE-B scale

Jussara Santos, Peter Huxley — Tue, 16 Apr 2024 00:00:00 -0700

The study aimed to culturally adapt and validate the SCOPE scale for Brazil, focusing on measuring social inclusion among adults in community psychosocial centers in São Paulo. Utilizing a cross-sectional sample survey and the adapted SCOPE-B scale, it assessed 255 patients, revealing their low social inclusion levels. Findings highlighted the negative correlation between social inclusion and aspects like race, economic status, and employment, alongside a positive association with physical and mental health. The SCOPE-B scale demonstrated reliability, internal consistency, and construct validity, supporting its application in diverse cultural contexts

Families and Recovery: Beyond clinical and social inclusion perspectives

Robert Bland, Marianne Wyder — Tue, 16 Apr 2024 00:00:00 -0700

This paper explores the theoretical connections between principles of social inclusion and the recovery moment in mental health, identifying points of convergence and divergence. Social inclusion and recovery, while developing from different starting points, converge in recognizing the broader personal, family and community contexts, in which mental health problems emerge, and the impacts of those problems. A significant part of the context for recovery and measures to achieve social inclusion, remains the person’s family. Current models of recovery probably overlook the distress of families in the recovery journey. The paper considers the extent to which families have a role both in supporting the recovery of a family member, and in making their own recovery journey. The paper further suggests the need for ongoing research to explore the way the family recovery journey changes over time

Improving mental health and wellbeing of communities in the modern world: New approaches

Vimal Sharma — Tue, 16 Apr 2024 00:00:00 -0700

Services for people with mental disorders in the communities around the world remain less than satisfactory. This service gap can be reduced by enhancing skowledge and skills of frontline health workers in detection and managing mental ill-health of the people they serve. GMHAT/PC tool and training package, as outlined in the article, if used by primary care health workers, can be a way forward to implement community mental health programs.

Editorial: Celebrating the work of Peter Huxley

Rob Poole, Catherine Robinson — Tue, 16 Apr 2024 00:00:00 -0700