People with SMIs and Exercise

Our paper on an exercise intervention for people with serious mental illness has been published in Health Expectations Open Access: An International Journal of Public Participation in Health Care and Health Policy.

Abstract

People with severe mental illness (SMI) often have poorer physical health than the general population. A co-produced physical activity intervention to improve physical activity for people with SMI in Northern Ireland was evaluated by co-researchers (researchers with lived experience of SMI) and academic researchers using a new approach to participatory data analysis called Participatory Theme Elicitation (PTE). Co-researchers and academic researchers analysed the data from the pilot study using PTE. This paper aims to compare these analyses to validate the findings of the study and explore the validity of the PTE method in the context of the evaluation of a physical activity intervention for individuals with SMI. There was alignment and congruence of some themes across groups. Important differences in the analyses across groups included the use of language, with the co-researchers employing less academic and clinical language, and structure of themes generated, with the academic researchers including sub themes under some umbrella themes. The comparison of analyses supports the validity of the PTE approach, which is a meaningful way of involving people with lived experience in research. PTE addresses the power imbalances that are often present in the analysis process and was found to be acceptable by co-researchers and academic researchers alike.

Yap, J., McCartan, C.,  Davidson, G., White, C., Bradley, L., Webb, P., Badham, J., Breslin, G. & Best, P. (2020) An exercise intervention for people with serious mental illness: findings from a qualitative data analysis using participatory theme elicitation, Health Expectations, 00: 1 – 15. https://doi.org/10.1111/hex.13141

Physical Activity for Bipolar Disorder

A further Cochrane Systematic Review – Qualitative Protocol– is available on the factors that influence participation in physical activity for people with bipolar disorder.

Abstract

Main objective: To identify the factors that create barriers or facilitate physical activity for people with a diagnosis of bipolar disorder from the perspectives of service users, carers, service providers and practitioners to help inform the design and implementation of interventions that promote physical activity.

The overall aim of this review is to identify, appraise, and synthesise qualitative research evidence on the barriers and facilitators to engaging in physical activity in general lifestyle settings or as part of an intervention designed to increase physical activity for people with bipolar disorder. This will allow us to identify factors that create barriers and facilitators of physical activity in this population to inform the development, design, and implementation of future interventions. We will communicate our findings to public health commissioners and other stakeholders.

McCartan  CJ, Yap  J, Firth  J, Stubbs  B, Tully  MA, Best  P, Webb  P, White  C, Gilbody  S, Churchill  R, Breedvelt  JJF, Davidson  G. (2020) Factors that influence participation in physical activity for people with bipolar disorder: a synthesis of qualitative evidence. Cochrane Database of Systematic Reviews Issue 3. Art. No.: CD013557. DOI: 10.1002/14651858.CD013557.

Components of Supported Decision Making

Our paper on the key components of supporting and assessing decision making ability was published today in the International Journal of Law and Psychiatry.

Abstract

People’s ability to make decisions may be impaired for a wide range of reasons, including by mental health problems and learning disabilities. Individual autonomy, the ability to make decisions about our own lives, is a fundamental tenet of democratic societies. This has been reinforced by laws governing substitute and supported decision making and most significantly by the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). Article 12 of the UNCRPD requires everyone to have equal recognition before the law and, to achieve this, the necessary support and safeguards must be available. There has been considerable debate about the important theoretical and philosophical issues involved and growing research about the practice complexities of supporting and assessing decision making ability or mental capacity. This article aims to present some of the key components of the support and assessment process to inform further service development and training in this area. The key components were identified as part of a qualitative, participatory research project which explored the decision making experiences of people with mental health problems and/or learning disabilities. The conventional approach to the assessment of capacity is to consider four main components, whether the person is able to: understand, retain, use and weigh, and communicate the information needed to make the decision at that time. The findings from this research study suggest that people generally don’t usually talk about their experiences of decision making in terms of these four components and approaches to supporting people to make decisions don’t necessarily break the support down to explicitly address the assessment process. However, considering support for all aspects of the functional test may be helpful to ensure it is as comprehensive as possible. The challenges involved in providing effective support and assessing decision making ability are discussed and the article concludes with some of the implications for training, service development and practice.

Webb, P., Davidson, G., Edge, R., Falls, D., Keenan, F., Kelly, B., McLaughlin, A., Montgomery, L., Mulvenna, C., Norris, B., Owens, A. & Shea-Irvine, R. (2020) Key components of supporting and assessing decision making ability, International Journal of Law and Psychiatry, 72, C, 101613. https://doi.org/10.1016/j.ijlp.2020.101613

 

 

Physical Activity for Anxiety & Depression

An interesting, and useful, Cochrane Systematic Review – Qualitative Protocol – is now available on the factors that influence participation in physical activity for anxiety and depression:

Abstract

Main objective: To identify the factors that create barriers or facilitate physical activity for people with a diagnosis of anxiety or depression from the perspectives of service users, carers, service providers and practitioners to help inform the design and implementation of interventions that promote physical activity.

The overall aim of this review is to identify, appraise, and synthesise qualitative research evidence on the barriers and facilitators to engaging in physical activity in general lifestyle settings or as part of an intervention designed to increase physical activity for people with anxiety and depression. This will allow us to identify factors that create barriers and facilitators of physical activity in this population to inform the development, design, and implementation of future interventions. We will also integrate the findings from the QES with the two associated effectiveness reviews (Cooney 2014; Larun 2006). We will communicate our findings to public health commissioners and other stakeholders.

McCartan, C., Yap, J., Firth, J., Stubbs, B., Tully, M., Best, P.,  Webb,  P., White,  C., Gilbody,  S., Churchill,  R., Breedvelt  J.J.F., Davidson, G. (2020). Factors that influence participation in physical activity for anxiety and depression: a synthesis of qualitative evidence. Cochrane Database of Systematic Reviews Issue 3. Art. No.: CD013547. DOI: 10.1002/14651858.CD013547.

Paper on Supported Decision-Making

Great to see that our first paper on supported decision-making has been published in Health and Social Care in the Community!

Abstract

This article presents the findings from a qualitative, participatory research project which explored how people with intellectual disabilities and/or mental health problems have, or have not been, supported to make their own decisions. The aim of the research is to help inform how supported decision‐making, as required by Article 12 of the UN Convention on the Rights of Persons with Disabilities, can be effectively operationalised. The project provides an overview of experiences of support as well as identifying which supports are valued. It was conducted between July 2017 and July 2018 and was a partnership between disabled people, service providers and a University. It involved peer researchers interviewing 41 people with mental health problems and/or intellectual disabilities, in community settings, about their experiences and views of support. The key findings include that decision‐making is a central aspect of people’s lives. Participants discussed the positive role which decision‐making can have but also how it felt when they were not supported to make their own decisions. Participants said that there were three main things that make decision‐making harder: the type of decision; the role of other people; and what the outcome might be. Time was consistently identified as a very important factor. In terms of support, people said that they would like: practical support including more accessible information; emotional support including someone to talk to; and sometimes the options to choose from. There was very little mention of existing, more formal processes of support such as advance decisions or care planning. The peer researcher aspect of the project was valued by participants. The main implications of the research are for how support for decision‐making should be provided including the need for an individualised approach as the support needed varies across decisions, time and people.

Webb, P., Davidson, G., Edge, R., Falls, D., Keenan, F., Kelly, B., McLaughlin, A., Montgomery, L., Mulvenna, C., Norris, B., Owens, B., Shea Irvine, R. (2020) Service users’ experiences and views of support for decision making. Health Soc Care Community.  00:1–10. https://doi.org/10.1111/hsc.12961