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Our research has directly informed the development of services that are supporting recovery from mental ill health by enabling mental health service users to:
Recent NHS policy has prioritised improving access to cost-effective psychological interventions for people with mental health problems. Research by Lucock at the Centre for Health and Social Care Research (CHSCR) has contributed to meeting this challenge by developing and evaluating self-help interventions which can be provided by a range of NHS staff without professional psychotherapy or mental health training. This work has resulted in the creation of the Self-Help Access in Routine Primary Care (SHARP) initiative, a programme that gives practitioners materials and training which enable them to deliver brief self-help interventions supported by a dedicated website and a range of leaflets that recognise service users' need for easy-to-understand material. Feedback from practitioners on the website and training has been positive. There is evidence of positive impacts of the training on practitioners' confidence in their ability to deal with anxiety and depression, and in greater use of Cognitive Behaviour Therapy (CBT) approaches with patients. Evidence from testimony demonstrates impact on practice. Research also provides evidence of benefit to patients in terms of reduction of anxiety and depression and goal attainment. The research has also influenced national guidance on best practice.
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.
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.
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.
The importance of person-centred social support has been recognised by successive governments as central to the development of effective and supportive social care services. The research led by Brunel and funded by the DoH and the Joseph Rowntree Foundation, made a substantial contribution to the enhancement of UK social care policy and practice in relation to the personalisation agenda. Parliamentary committees and policy consultation used the research to develop new social care policy. Standards of service care delivery were developed and implemented in partnership with service users; these were adopted at a policy and practice level. The development and use of evidence based practice guides, training programmes and web resources facilitated the successful adoption and implementation of person-centred support nationwide. In summary, public debate was influenced, equality and empowerment for service users was advanced, national policy and practice enhanced, health and welfare improved and economic impacts achieved.
This case study focuses on the research conducted by members of the UoA examining the services offered to service users and carers in secure settings. This includes forensic mental health services and prisons. It has had a significant impact on the development of professional practice in secure settings based on the views, experiences, and needs of service users and carers. It has established service user and carer engagement in research conducted in secure settings. It has also informed service and policy developments in the United Kingdom and internationally.
Brunel's research identified the ways in which electrically powered indoor/outdoor chair (EPIOC) use improves the quality of life (QoL) of people with disabilities; key findings have been used to inform public policy, enhance professional standards and international evidenced based guidelines for professional practice and improve the health and social welfare through the empowerment of disabled person's organisations. The impacts are based on the newly gained recognition, based on the research findings, that young people need an EPIOC to provide opportunities for social inclusion, positive risk taking behaviours, successful transition into the work environment and to enable general healthy development and capacity for independent living. Older people need EPIOCs to reduce the physical and emotional stress on elderly carers. The impacts have ensured more effective policies are developed, professional practice is enhanced and more appropriate assessment and prescription services are provided for these service users.
The importance of public and user involvement in the development and delivery of research, policy and practice is now widely recognised. Nonetheless, service providers continue to experience difficulties in meaningfully involving service users and carers in their work in spite of the fact that this is a legal and policy requirement. Researchers, policy makers and providers do not always have the knowledge and skills effectively to involve the public and service users and carers. This case study describes the very significant impact of one piece of research designed to address these challenges in Northern Ireland. This research is presented as an example of impact because it has resulted in significant changes to the policies and practices of the three key organisations funding the research.
Primary research with people with multiple sclerosis and their carers, led by Brunel, has had positive impacts on service user and government organisations internationally; research has improved practice in relation to the nature and effect of self-management strategies of people with Multiple Sclerosis, as well as enhancing therapy for the condition and raising awareness of the needs of carers. The research has shaped evidence-based guidelines, consensus papers, reports and policies, which have in turn enhanced the effectiveness of professional practice and service delivery. Through developing the evidence base and sharing best practice the research has resulted in improved health and welfare benefits for people with multiple sclerosis and their carers.