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Potential and limitations of policies promoting choice, flexibility and control

Summary of the impact

This case study concerns a body of research by Dr Julie Ridley, Dr Helen Spandler and Dr Karen Newbigging into Self-directed Support (SDS) and Direct Payments (DPs), which examines perspectives and experiences of policies to promote choice, control and flexibility in social care, and provides a critique distinguishing between rhetoric and reality. Early qualitative and action research focused specifically on mental health, including work for the Scottish Executive (Ridley) and the Department of Health (Spandler), leading to cutting-edge policy critiques (Spandler), engagement with the field to distil key implementation themes (Newbigging) and later, to broader based evaluation of SDS policy implementation in Scotland. Collectively and over time, this work has had a direct influence on social care policy and law across the UK, as outlined below.

Submitting Institution

University of Central Lancashire

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

Mental health: solutions to complex care needs

Summary of the impact

The Centre For Community Mental Health (CCMH) is a research team within the Centre for Health and Social Care (CHSCR). CCMH develops and supports research that reduces stigma and social exclusion and which empowers people with mental health problems to lead fulfilling lives in their own communities. The impact of this research has challenged prevailing beliefs and practices and led directly to changes in practice, organisational processes and service design across the world.

Our studies of voice hearing, in adults and children, have shown that it may not always be associated with mental illness and that cognitive behavioural therapy is effective for many people. Our work has led to the development of the Hearing Voices Movement and the International Hearing Voices Network, which now spans 22 countries and which enables people who hear voices to find bespoke solutions and lead normal lives.

The impact of our work on community-based approaches to the management of acute and long term mental ill health led, first, to the development of assertive outreach and crisis resolution teams that reduced hospital admissions by treating people at home; second, our work has led directly to service redesign in many different countries.

Our studies of special and underserved social groups in relation to mental ill health have demonstrated the multiple barriers to services that many people experience. The impact of these studies has included changes in organisational practices to promote greater engagement with service users.

Submitting Institution

Birmingham City University

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Recovery in Mental Health: Generating, Translating and Evaluating Evidence in Policy, Practice and Education

Summary of the impact

University of Nottingham research in the field of recovery has had a major influence on changes in mental health policy. It has led to a new model of service provision both in the UK (including through NICE guidance and the NHS's outcomes framework) and internationally (including in Western Europe, Scandinavia, Canada, Australia and Asia). The work has contributed to a reduction in the use of mainstream services and has enhanced the quality of life enjoyed by people with mental health problems. It has also been central to the Department of Health's Implementing Recovery through Organisational Change programme, which has pioneered the use of Recovery Colleges and peer support workers in mental health care in the UK.

Submitting Institution

University of Nottingham

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Empowering mental health service users

Summary of the impact

Impact resulted from the unit's sustained research in the field, including the leadership of a large EU Framework 6 action project `EMILIA' - the Empowerment of Mental Illness Service Users: Lifelong Learning, Integration and Action, and the follow up project, PROMISE. The findings identified how to reduce social exclusion among people with serious mental illness through lifelong learning and by improving participation in service delivery, education and training, as well as paid employment. The research recommendations were included in a joint EU/WHO policy statement and subsequently rolled out across European Union Member States. The research impacted on the development of European and national policies regarding mental health service users and, through further knowledge transfer activities and the incorporation of the recommendations by a network of providers in 43 countries, also impacted on the profession and mental health service users directly.

Submitting Institution

Middlesex University

Unit of Assessment

Social Work and Social Policy

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Child and Adolescent Mental Health in Primary Care Contexts

Summary of the impact

The CAMHS team at the University of Northampton have built expertise in CAMHS research that have regional, national and international impact, which has had an influence on regional practice in CAMHS, and through our training initiatives, has had an international reach. A key national priority for mental health service development and delivery for children has been widening access to the service to enable better interaction between specialist and universal services — enabling ease of referral, preventative mental health work, and a smoother experience of service provision for young people entering CAMHS. Expertise at Northampton builds on research evaluating the use of Primary Mental Health Workers (PMHWs) in Youth Offending Teams (YOTs) and with LAC (LAC), as well as research on professional training for mental health professionals more broadly. This research highlighted the importance of joined up working at the interface of primary and specialist services, to young people's access to mental health services, and to increase the responsiveness and appropriateness of these services in meeting young people's needs. Impact includes training of CAMHS workers, through both CPD initiatives and a Masters programme in CAMHS which has trained professionals from the UK and EU, as well as professionals from India and several African countries, who have used this expertise in CAMHS and primary care contexts around the world.

Submitting Institution

University of Northampton

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Transforming attitudes to mental health: using art festivals to access hard-to-reach communities

Summary of the impact

Research conducted at Strathclyde has shown that current pathways which focus on education and public information are failing to transform attitudes to mental health amongst low-income communities and black & ethnic minorities. Drawing on this research, an annual Mental Health Arts Festival has been created. Since 2008 the event has engaged over 40,000 people, and is now one of the largest arts and social justice festivals in Europe. The Festival has affected the ways in which these `hard to reach' groups are involved in addressing stigma and mental health, has changed approaches to the delivery of mental health awareness lessons in schools and communities, has led to NHS boards building the festival into their health improvement policies and strategies, and has been a central part of the Scottish Government's national anti-stigma `see me' campaign. The idea of a dedicated arts festival has been replicated elsewhere in the UK and internationally, and is transforming the attitudes and behaviour within black and minority ethnic and low-income communities to mental health.

Submitting Institution

University of Strathclyde

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

Arts, Health and Wellbeing Research

Summary of the impact

This case study describes the reach and significance of research conducted by members of the interdisciplinary Sidney De Haan Research Centre for Arts & Health. The examples below focus on the impact of singing as a health and wellbeing intervention for adults within clinical and non-clinical populations. The research has shown that singing has had a beneficial impact on individuals and influenced fields of professional practice in health and social care in the UK and US, service delivery in the UK, and policy development in the UK through the work of the Royal Society for Public Health.

Submitting Institution

Canterbury Christ Church University

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

From research into mental capacity to clinical practice via Parliamentary statute: informing and implementing the Mental Capacity Act 2005 - Holland

Summary of the impact

In the context of Law Commission reports on legislation in mental capacity, in 1999, Tony Holland published a ground-breaking review on capacity and an empirical study of the capacity of people with mental disorders. Through Holland's role as one of two expert advisers to a Parliamentary Pre-legislative Scrutiny Committee in 2003, this work directly informed the Mental Capacity Act 2005 and the Code, both of which remain current. With full implementation of the Mental Capacity Act in 2007, Holland's studies from 2008 refined concepts of capacity and best interests for clinical practice; and have examined other aspects of the Mental Capacity Act including advocacy, the Mental Capacity Act in different clinical settings, and the Deprivation of Liberty Safeguards.

Submitting Institution

University of Cambridge

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Legal

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Law and Legal Studies: Other Law and Legal Studies

Improving management of schizophrenia and severe mental illnesses in general practice

Summary of the impact

Our research has led to major changes in the management of people with severe mental illness (SMI) in general practice. Our findings that people with schizophrenia are at greater risk of cardiovascular diseases informed NICE guidance in the UK and international guidelines. The Department of Health's strategy on Mental Health was influenced by our work on the interface between physical and mental health. Recommendations in the NICE guidance have now been taken up by the NHS Quality Outcomes Framework (QoF) in England and Scotland. General practitioners are specifically required to monitor BMI (Body Mass Index), blood pressure, and glucose and serum lipids levels in all registered patients with SMI.

Submitting Institution

University College London

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Improving access to mental health care in low- and middle-income countries

Summary of the impact

Research carried out by LSHTM into mental disorders in low- and middle-income countries has promoted new approaches to mental health care and influenced donors, practitioners and policy-makers, contributing to changing global priorities in this area. WHO launched a flagship action plan based on the research, governments and NGOs made substantial financial allocations for implementing the research innovations, and the findings have been translated into treatment guidelines used to train health workers in managing mental illness in many countries.

Submitting Institution

London School of Hygiene & Tropical Medicine

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

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