Mental illness or mental distress; stigma and concealment in University students - a discussion paper

This discussion paper addresses the issue of mental distress, sometimes mis- perceived or misinterpreted as mental illness. The
focus is on positive psychology. Reflecting in part on a UK-based study with younger University students studying to health
related degrees, nursing, midwifery and medicine (N = 12), many of the students were apparently suffering dis-stress with
disordered eating at least in part being used as a coping mechanism. However notwithstanding that they were at the end of
their first year studies in health, a significant number of the students interpreted their approach to eating as a mental illness.
Consequently, many within the study felt stigmatised and were reluctant to acknowledge certainly to the University health care
authorities that there was an issue; perceiving both academic and career/professional consequences of mental health labelling. The
paper approaches the issue of mental health from a health promoting perspective, reflecting against the theory of salutogenesis
and its focus within the three dimensions of comprehensibility, manageability and meaningfulness as an approach to building
resilience and managing stressors to better facilitate a sense of coherence. Complex manifestations of distress and poor coping
mechanisms can in some cases be misinterpreted or miss perceived as mental illness. Promoting mental health and reducing the
stigma of mental illness or the misperception of mental distress as mental illness, would need to be addressed in order to more
effectively outreach certainly to younger University students who might be at risk. The focus should be on how better to promote
their sense of coherence.

Cancer and serious mental illness – patient, caregiver and professional perspectives: study protocol

Aim: To explore the experience of serious mental illness and cancer from the perspective of patients, significant others and healthcare professionals involved in their care. Background: Serious mental illness is associated with poorer cancer outcomes. Those suffering from this comorbidity receive fewer specialist interventions and die earlier than the general population. Prior qualitative research in this area has comprised of a single study focussing on healthcare professionals and there is little evidence regarding the experiences of patients and caregivers.Design: A qualitative exploration using approximately 36 semi-structured interviews.Methods: Semi-structured digitally recorded interviews conducted with: adults living with serious mental illness and diagnosed with cancer; those providing them with informal support and care; and healthcare professionals. Questions will focus on the experience of having cancer and serious mental illness or caring for someone with this comorbidity, experiences of healthcare and priorities for patients and carers. Framework analysis will be used. Research Ethics Committee and Trust Research & Development approval was obtained. A steering group comprising six people with experience of either cancer or mental illness provided feedback and ratified the patient information sheets and interview schedules. Discussion: There is a paucity of research addressing stakeholder perspectives on the experience of cancer and of cancer services for people with serious mental illness. Dissemination of findings will inform practice relating to the care of an often neglected population, informing better support for their significant others and the professionals involved in their care.

Risk, Recovery and Capacity: Competing or Complementary Approaches to Mental Health Social Work

Mental health social workers have a central role in providing support to people with mental health problems and in the use of coercion aimed at dealing with risk. Mental health services have traditionally focused on monitoring symptoms and ascertaining the risks people may present to themselves and/or others. This well-intentioned but negative focus on deficits has contributed to stigma, discrimination and exclusion experienced by service users. Emerging understandings of risk also suggest that our inability to accurately predict the future makes risk a problematic foundation for compulsory intervention. It is therefore argued that alternative approaches are needed to make issues of power and inequality transparent. This article focuses on two areas of practice: the use of recovery based approaches, which promote supported decision making and inclusion; and the assessment of a person’s ability to make decisions, their mental capacity, as a less discriminatory gateway criterion than risk for compulsory intervention.

Findings from a systematic review: ‘Cancer and people with Serious Mental Illness.’

Mental Health Nurses' Family Focused Practice with Parents who have Mental Illness, their Children and Families in Adult Mental Health Services in Ireland

Introduction: While it is recommended that mental health professionals engage in family focused practice (FFP), there is limited understanding regarding psychiatric nurses’ practice with parents who have mental illness, their children and families in adult mental health services.

Methods: This study utilized a mixed methods approach to measure the extent of psychiatric nurses’ family focused practice and factors that predicted it. It also sought to explore the nature and scope of high scoring psychiatric nurses’ FFP and factors that affected their capacity to engage in FFP. Three hundred and forty three psychiatric nurses in 12 mental health services throughout Ireland completed the Family Focused Mental Health Practice Questionnaire (FFMHPQ). Fourteen nurses who achieved high scores on the FFMHPQ also participated in semi-structured interviews.

Results: Whilst the majority of nurses were not family focused a substantial minority were. High scoring nurses’ practice was complex and multifaceted, comprising various family focused activities, principles and processes. Nurses’ capacity to engage in FFP was determined by their knowledge and skills, working in community settings and own parenting experience.

Conclusions: Generally, low levels of family focused practice suggest the need for organizations to develop and implement guidelines, policies and training to support mental health professionals to adopt a whole family approach.