Wellbeing & Learning New Things

Teaching yourself something new can have substantial benefits for your wellbeing. Here’s a podcast which I and a colleague gave on this subject.

The podcast forms part of a series from Redbridge Talking Therapies.

Each of these podcasts…. will guide you in strategies for coping with worry, low mood, isolation, loneliness, relaxation and mindfulness.

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

Short Film: Supported Decision Making

A short film is now available of our inspirational team giving a presentation at the Annual Social Work and Social Care Research in Practice Conference which took place at Belfast Castle on the 6th March 2019 on the theme of supported decision making.

To view the film, please go to the link here.

Perspectives on Co-Production

Colleagues from our research team gave a wonderful presentation on their experiences of working on a co-produced research project at the Annual Social Work and Social Care Research in Practice Conference on the 6th March at Belfast Castle.

Here’s the abstract for the presentation:

Making decisions about your own life is a key aspect of independence, freedom and human rights. Mental health law has previously allowed compulsory intervention even when a person has the decision making ability to decline intervention. This discriminates against those with mental ill health and intellectual disabilities. The Mental Capacity Act (Northern Ireland) became statutory law in May 2016 and will replace rather than run in parallel to a mental health law. A core principle of the new act is that people are “not to be treated as unable to make a decision…unless all practicable help and support to enable the person to make a decision about the matter have been given without success” (Article 1(4)). There are people who, without support, would be assessed as incapable of making certain decisions but with the appropriate support are capable of making those decisions, and so to not provide that support infringes their rights, undermines their autonomy and reinforces their exclusion from society.

The study was funded by Disability Research on Independent Living and Learning (DRILL) and was a multi-agency partnership between Praxis Care, Mencap NI and Queen’s University of Belfast. The study was designed because there is limited research evidence about people’s experiences of the different approaches which can support decision-making, Four peer researchers were therefore employed for the duration of the project and 41 interviews were conducted with people with mental ill health and intellectual disabilities in order to understand their experiences of supported decision-making, their preferences and ideas for how decision-making should be supported. This presentation will look at the process of co-production and the pros and cons of conducting co-produced studies which involve people with mental ill health and intellectual disabilities. Suggestions for how to overcome the barriers to successful co-produced projects will be given.

Edge, R., McLaughlin, A., Norris, B., Owens, A., Webb, P. (2019) Perspectives on co-production: supported decision making – experiences, approaches and preferences. In Public Health Agency, Health and Social Care Board, Building Research to Evaluate Complex Interventions in Social Work and Social Care: A Consideration of Methodological Issues, 6th Annual Social Work and Social Care in Practice Conference, Belfast Castle, Belfast, UK, 6th March 2019.

Supported Decision Making Report: Recommendations

Support for decision making needs to be individualised.

Our co-produced research report on supported decision making for people with intellectual disabilities and mental ill health made a number of recommendations.

Take a look at page 44 of the report for further information.

Davidson, G. Edge, R., Falls, D., Keenan, F., Kelly, B., McLaughlin, A., Montgomery, L., Mulvenna, C., Norris, B., Owens, A., Shea Irvine, R. and Webb. P. (2018) p. 44

Supported Decision Making Report: Key Findings

  • Our co-produced research report is now available on supported decision making with people with intellectual disabilities and mental ill health.
  • An easy read report is also available.

Key Findings

Decision making is a central aspect of people’s lives. Participants discussed the positive role which decision making can have in their life but also how it felt when they are not supported to make their own decisions.

Participants said there were three 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 making decisions.

In terms of support, people said they would like: practical support including more accessible information; emotional support including someone to talk to; and sometimes the options to choose from.

The peer researcher aspect of the project strengthened the research process and was valued by participants. This is an evolving area of research practice that needs further critical exploration of the issues involved.

Davidson, G. Edge, R., Falls, D., Keenan, F., Kelly, B., McLaughlin, A., Montgomery, L., Mulvenna, C., Norris, B., Owens, A., Shea Irvine, R. and Webb. P. (2018) p. 6

Supported Decision Making at KESS

Our four peer researchers gave a wonderful presentation of findings so far for the supported decision making research project at the Knowledge Exchange Seminar (KESS), Parliament Buildings, Stormont, Belfast on the 7th February 2018.

A policy briefing, the slides and a video of their talk is now available!