Supporting recovery from mental ill health

Submitting Institution

Anglia Ruskin University

Unit of Assessment

Social Work and Social Policy

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Studies In Human Society: Policy and Administration


Download original

PDF

Summary of the impact

Our research has directly informed the development of services that are supporting recovery from mental ill health by enabling mental health service users to:

  • Return to or gain employment
  • Experience improved levels of wellbeing and social inclusion through engaging in creative activity.

Underpinning research

The impact summarised above stems from research in two main areas:

1. Studies focusing on mental health service users' aspirations to gain employment and the support needed to do so.

Supporting people with disabilities to gain or regain employment is a significant strand of UK government welfare policy. Across disability groups, however, mental health service users are amongst the least likely to be in competitive, paid employment. Historically, it has been assumed that this group neither want nor are able to work, and service provision has therefore focused on sheltered work, often unpaid, or on lengthy work preparation that rarely leads to employment.

Secker's studies (from 2002 to the present) broke new ground in discovering that, contrary to established assumptions, mental health service users do aspire to paid work and are able to achieve their aspirations with appropriate support. A survey carried out by Secker in 2004 in collaboration with service user co-researchers who subsequently formed the South Essex Service User Research Group (SE-SURG) confirmed that aspirations to work were high amongst service users in South Essex (SE-SURG et al., 2006). Subsequent replication of the survey during 2007 in Pavia, Italy, by Secker in collaboration with colleagues at the University of Pavia found similar aspirations amongst people receiving mental health services in that region (Cirillo et al., 2009). But despite service users' aspirations, the SESAMI (Social inclusion through Employment Support of Adults with Mental Illness) study, carried out between 2004 and 2006 by Secker with Boyce and colleagues from Durham and City Universities indicated that provision of effective employment support remained rare across England (Boyce et al., 2008).

2. Research aimed at developing the evidence base for arts participation as a means of promoting mental wellbeing and social inclusion.

Although there is a wealth of qualitative evidence suggesting that mental health service users benefit from engaging in creative activity, reviews have consistently identified a lack of robust quantitative evidence to support the allocation of scarce resources to participatory arts initiatives.

Between 2005 and 2007 Secker led a study with Kent (service user researcher) and colleagues from the University of Central Lancashire, commissioned by the Department of Health and the Department for Culture Media and Sport to address that problem. The study provided the first substantial evidence of quantifiable outcomes for service users from participation in creative activity (improved mental health, empowerment and social inclusion), as well as identifying a range of eight processes through which those outcomes were achieved (Hacking et. al., 2008). Further studies undertaken by Secker with Kent and Margrove have supported these results, with significant improvements shown in mental wellbeing and social inclusion in a two-year uncontrolled evaluation (Secker et al., 2011), subsequently replicated in a waiting list controlled evaluation completed in 2011 (Margrove et al., 2012).

Key researchers

Jenny Secker, Professor of Mental Health (October 2002 to present) Lyn Kent, Service User Researcher / SE-SURG Administrator (June 2004 to present) Melanie Boyce, Research Fellow (April 2004 to present) Kerrie Margrove, Research Fellow (August 2010 to present)

References to the research

1. Employment and mental health

SE-SURG, Secker J. and Gelling L. (2006) Still dreaming: service users' employment, education & training goals. Journal of Mental Health 15: 1: 103-111. doi:10.1080/09638230500512508

 
 
 

Boyce M., Secker J., Floyd M., Grove B., Johnson R., Schneider J and Slade J. (2008) Factors influencing the delivery of evidence-based supported employment in England. Psychiatric Rehabilitation Journal 31 (4): 360-367. doi:10.2975/31.4.2008.360.366

 
 
 
 

Cirillo I., Politi P., Rampi E., Secker J., Brascia F. and Severino A. (2009) Employment status, aspirations and perceptions of support amongst psychiatric service users in Pavia, Italy. Epidemiologia e Psichiatria Sociale 18 (1): 40-47. (Can be supplied by the HEI on request.)

 
 

2. Developing the evidence base for arts participation

Hacking S., Secker J., Spandler H., Kent L. and Shenton, J. (2008) Evaluating the impact of participatory arts projects for people with mental health needs. Health and Social Care in the Community 16:6: 638-648. doi: 10.1111/j.1365-2524.2008.00789.x

 
 
 
 

Secker J., Loughran M., Heydinrych K. and Kent L. (2011) Promoting mental well-being and social inclusion through art: evaluation of an arts and mental health project. Arts & Health, 3: 1, 51-60. doi: 10.1080/17533015.2010.541267

 

Margrove K., SE-SURG, Heydinrych K. and Secker J. (2012) Waiting list controlled evaluation of a participatory arts course for people experiencing mental health problems. Perspectives in Public Health. (Online First) October 3, doi:10.1177/1757913912461587

 
 
 
 

Quality of the research

The outputs listed are all published in peer reviewed academic journals. The SESAMI (Social inclusion through Employment Support of Adults with Mental Illness) study (Boyce et al., 2008) was funded following peer review by the Higher Education European Social Fund and the research reported by Hacking et al. (2008) was funded following peer reviewed competitive tender by the Department for Culture Media and Sport and the Department of Health (DCMS Agreement No. D3/539). In 2009 Secker and colleagues were awarded the Royal Society for Public Health Arts and Health Award for Research for the latter study.

Details of the impact

1. Employment and mental health

Our research into employment for mental health service users revealing that the majority aspire to paid employment has been cited in national policy reviews (e.g. HM Government, 2009; Perkins et al, 2009) in support of the development of vocational services that are now a central strand of mental health strategy implementation and welfare reform.

At a local level, results from the 2004 survey of service users' vocational aspirations carried out by Secker with service user co-researchers, together with evidence from the SESAMI study, convinced the South Essex Mental Health Joint Commissioning Team and senior managers at the South Essex Partnership University NHS Trust (SEPT) of the need for an evidence-based vocational service embedded within the Trust's clinical teams. The service was one of the first in the UK to fully implement the principles of the Individual Placement and Support approach to employment support, and as such was singled out as an example of good practice in national commissioning guidance (Department of Health, 2006), which we highlight because it remains current and has been influential in promoting subsequent developments in other localities (e.g. East Sussex Health, 2009
(http://www.eastsussexhealth.org/pdf/HOSC19March09/Item%206%20App%201%20Day%20and%20Voc%20MH%20Briefing%20Paper.pdf).

Between 1 January 2008 and 31 July 2013 the SEPT service has supported 396 service users into work and 427 into education (vocational service performance data).

An additional employment-related impact stems from Secker's establishment of SE-SURG at Anglia Ruskin University in 2005. As well as contributing to further service developments via commissioned studies, the group provides employment and skills development opportunities for members. Membership has remained consistent at around eight since 2005, with some members moving on to take up further employment and education opportunities and others joining the group. Two members (Lyn Kent and Maxine Nightingale) have achieved employment at Anglia Ruskin University on 50% FTE contracts as service user researchers/SE-SURG administrators.

Our research has therefore achieved both national impact through influence on government policy and local impact in terms of improved welfare outcomes for mental health service users in our region.

2. Engagement in creative activity

The impact of our research into the role of creative activity in recovery is demonstrated in terms of its reach by citation in two House of Lords debates (Lords Hansard 6 March 2008 & 25 July 2013). In terms of significance, impact on policy is evidenced by citation in a speech later that year by the then Secretary of State for Health (16 September 2008).

The September 2007 launch of the research at Tate Modern was attended by the Chief Executive and members of the Executive Team at SEPT, whose support on learning of the results from the study was instrumental in the subsequent development of Open Arts, a participatory arts and mental health project established at SEPT in 2008. The project aims to promote wellbeing and social inclusion through running 12-week, community-based introductory arts courses, with an emphasis on skill development and follow-on opportunities to pursue individual goals.

From the inception of Open Arts in 2008 to July 2013, 615 people have completed an introductory course, 225 have achieved National Open College Network accreditation at levels 2 or 3 and 24 now work with Open Arts as volunteers (Open Arts performance data).

Significant improvements on measures of wellbeing and social inclusion were recorded for course completers in the two-year evaluation study led by Secker from 2009 to 2010 (Secker et al., 2011). These results were recently replicated in the waiting list controlled evaluation reported by Margrove et al. (2012). The latter study has received considerable attention, with local reach demonstrated by an interview on BBC Radio Essex (reach 75,000) and a full page article in the Essex Chronicle (reach 26,327), including headline billing on the Chronicle's advertising boards across Essex. Wider reach is demonstrated by coverage in the Daily Telegraph (reach 555,817) and the Huffington Post UK (reach 197,964).

In 2012 the positive evaluation results contributed to a successful bid to Essex County Council for seed funding of £9,211 to establish a studio space where introductory course completers could continue their art work more independently for six months, with support from a professional artist. The studio opened in October 2012 and 15 members who completed their six-month placement in May 2013 have now formed a constituted group, renting studio space together in order to continue their work. Evaluation of the studio outcomes is on-going but preliminary results are promising, with further significant improvements identified in wellbeing and social inclusion.

Sources to corroborate the impact

In advance of his retirement on 8 October 2013, the former Chief Executive of the South Essex Partnership University NHS Foundation Trust (SEPT) provided a statement confirming the impact of our research for the Trust's service users. His letter is available on request. Additional corroborative sources are as follows.

1. Labour market participation

2. Engagement in creative activity