NIHR Three Research Schools - Seminar Series
Improving mental health and wellbeing in underserved populations through collaborative research
The Three Schools Mental Health Programme was formed with the specific intention of addressing challenges of improving involvement and participation in mental health research in a wide range of underserved groups. Together, over 50 projects were funded spanning a rich mix of methodological approaches, participatory techniques and underserved populations.
The programme aims to foster shared learning, capacity-building, and cross-disciplinary collaboration. We convened a monthly online seminar series to support these goals. The programme was curated to ensure representation of each of the three schools, awards made and seniority of the award holder. The resulting programme provides a rich mix of methodological and participatory approaches, underserved populations, and research questions and features both prospective and retrospective reflections.
The online seminars were open to all award holders, their extended team and members of any of the Three Research Schools. Award holders and presenters were encouraged to invite public contributors to participate in the seminars and to co-present. All presentations were recorded (with permission) and will be posted below as they become available. Accompanying the recording is a summary of the content, a brief biography of the speaker, a commentary from the series convenor and a list of resources.
Please address enquiries, and requests to join the any of the below seminars, to Krysia Canvin, k.canvin@keele.ac.uk
Previous Seminars
Embedding and evaluating trauma-informed and co-production approaches with people who've experienced multiple disadvantage
Speakers
Michelle Farr and Tracey Stone, University of Bristol & Thomas Traub and Rebecca, peer researchers
Summary
Changing Futures is part of a government funded programme aimed at improving the lives of adults experiencing multiple disadvantages. Changing Futures in Bristol is working with organisations and people with lived experience to:
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Improve the way that local services work, so people can access the support they need more easily
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Promote trauma-informed approaches, equality and diversity, and co-production, working together with people with lived experience of multiple disadvantage
We will discuss how we are evaluating this work, sharing our learning to date, and explore how systems can be changed to promote more equality, co-production and trauma-informed care.
Using the Nominal Group Technique for organising a workshop for carers of people who have been discharged by mental health hospitals.
Speakers
Maria Panagioti & Natasha Tyler, University of Manchester
Summary
We will talk about the use of Nominal Group Technique for organising a workshop for carers of people who have been discharged by mental health hospitals. We will talk about how the technique has helped us develop topic areas, facilitate the workshop date and develop a set of research priorities for a future grant application.
Speaker biographies
Maria Panagioti is Senior Lecturer at the University of Manchester and won a 3-schools award for the workshop ‘Supporting informal carers of people with mental health after discharge to improve patient safety and maintain the carers own well-being’.
Natasha Tyler is |Research Associate at the University of Manchester.
References and resources
- Codesigning a Mental Health Discharge and Transitions of Care Intervention: A Modified Nominal Group Technique - PMC (nih.gov)
- What does safety in mental healthcare transitions mean for service users and other stakeholder groups: An open‐ended questionnaire study - Tyler - 2021 - Health Expectations - Wiley Online Library
- Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis - PMC (nih.gov)
- Developing a core outcome set for interventions to improve discharge from mental health inpatient services: a survey, Delphi and consensus meeting with key stakeholder groups | BMJ Open
- Interventions to improve the experience of caring for people with severe mental illness: systematic review and meta-analysis | The British Journal of Psychiatry | Cambridge Core
Collaborating to develop holistic health support for people living with severe mental illness
Speakers
Emily Oliver & Ilaria Pina, Newcastle University, and Sue Webster, peer researcher
Summary
Our three schools’ funded project, WHOLE-SMI, explores holistic health promotion for people living with severe mental illness, an underserved population who have not typically been well-represented in research involvement and engagement. Here we present, with our peer researchers and community advisory group members, learning from this research.
Speaker biographies
Emily Oliver is Professor of Behavioural Sciences at the University of Newcastle and holds the award for the study ‘WHOLE-SMI: Wellbeing and HOListic health promotion for people with Severe Mental Illness’. Ilaria Pina is a Research Associate at the University of Newcastle.
References and resources
- Evaluating the clinical and cost effectiveness of a behaviour change intervention for lowering cardiovascular disease risk for people with severe mental illnesses in primary care (PRIMROSE study): study protocol for a cluster randomised controlled trial | Trials (biomedcentral.com) (biomedcentral.com)
- The Consolidated Framework for Implementation Research – Technical Assistance for users of the CFIR framework (cfirguide.org)
- https://sphr.nihr.ac.uk/news-and-events/how-we-can-support-physical-health-for-people-living-with-severe-mental-illness/
How we are involving parent carers of children with special educational needs and disabilities in our research, and what impact that has had on the SPaCE Project
26 April 2023
Speakers
Sharon Foxwell and Annabel McDonald, parent carer co-investigators, and Gretchen Bjornstad, University of Exeter
Summary
It can be challenging to meaningfully involved people with lived experience in epidemiological studies from inception, so this would provide an opportunity to highlight some examples of how these parent carers have shaped the project, including involvement in defining the populations that we include, selecting predictors of mental health outcomes to include in the analyses, selecting the mental health outcomes to focus on, and thinking through the implications of our findings. We are also planning to involve parent carers in innovative dissemination strategies, including leading one of our papers and including specific subsections within the discussion sections of all of our papers for our parent carer co-investigators to describe their reflections on the findings.
Speaker biographies
Gretchen Bjornstad is Senior Research Fellow at the University of Exeter and leads the 3-schools funded project “An investigation of the prevalence of mental health problems in parent carers in England and pathways to support and treatment”.
Sharon Foxwell and Annabel McDonald are parent carer co-investigators for the study.
Seminar series editor commentary and highlights
In this presentation, Sharon and Bel took the lead in describing their role in the Space project. Of particular significance was the way in which they drew on their personal stories to contextualise their contribution to this specific project, and indeed many previous projects. This was made all the more poignant when Sharon reflected on how she acted as a voice for the community, not to share her specific story. In doing so, Sharon highlights the delicate balance required in the transformation of personal experience into professional expertise.
Unusually, Sharon and Bel are co-investigators on the project and their presentation brings into focus how this provides a platform for influence and how public participants have a wealth of transferable skills and knowledge that they can bring to the research arena. Their presentation raises important questions for all of us around our positionality, how we draw on personal experiences and the implications for our research.
References and resources
Supported Volunteering at Ripon Museums: 'De-researchifying' research processes and methods in a sensitive way
27 March 2023
Speakers
Martin Webber, Beth Casey & Helen Thornton
Summary
Supported volunteering provides a way for people who require additional support to access volunteering opportunities. However, limited research has been conducted on supported volunteering so we do not know enough about how, and if, it might help people. This presentation reports on the qualitative methods used for an evaluation of supported volunteering at Ripon museums, a collaboration between the International Centre for Mental Health Social Research (ICMHSR) at the University of York and the Ripon Museum Trust (RMT). A range of methods have been utilised in order to provide a choice for participants and to facilitate participation. This included having conversations with volunteers about their experience of support (rather than more formal interviews); observing support provided; and giving volunteers the opportunity to complete an audio or written diary about their experiences. The presentation will reflect on the ‘sensitive’ research approach taken; uptake and experience of participating in different methods and comparisons between the data produced. The presentation will conclude with practical considerations and researcher reflections on the methods used.
Speaker biographies
Martin Webber and Beth Casey
Martin Webber is Professor of Social Work at the University of York and Senior Fellow of the NIHR School for Social Care Research. He writes a blog - Musings of a social work academic – and produces the Social Work Research Podcast.
Beth Casey is Research Associate at the University of York.
Seminar series editor commentary and highlights
This innovative project evaluates a supported volunteering scheme for people with mental health problems. The presentation brings to light the process of translation that is often required when undertaking research in new settings and with people who may not be familiar with research terminology. Beth and Martin describe this as ‘de-researchifying’. Beth and Martin highlight, however, that ‘de-researchifying’ is not just a matter of making research procedures understandable, but also one of reducing threat and anxiety. Such procedures might raise questions about how research is represented to participants and whether this is ethical or not. There seems to be a balance between ensuring that the most underserved groups are represented in research and making such research accessible and non-threatening whilst maintaining transparency about the implications of their involvement. As Beth and Martin point out, however, in the field of social there is perhaps more flexibility around such apparent conflicting principles. Moreover, the approaches they adopted prioritised choice.
Assisting with this process was the Advisory Group for the project, comprising a range of stakeholders including volunteers, practitioners from the heritage sector, and representatives from the National Academy for Social Prescribing, performing the role of critical friend at every stage of the process.
References and resources
Developing research priority areas to improve treatment pathways and outcomes for people with co-occurring mental health problems and alcohol use disorders
23 January 2023
Speaker
Laura Goodwin, University of Lancaster & Phil Parkes, public contributor (Expert Citizens)
Download the presentation slides (.pdf)
Summary
In the presentation we will discuss the outcomes of two workshops which involved people with lived experience of co-occurring mental health and alcohol use disorders and public and third sector professionals. We will provide a summary of the findings, which includes i) an overview of the positives and negatives of the four different treatment pathways offered to this group and ii) the development of a top 10 list of research priority areas.
Speaker biographies
Laura Goodwin is a Senior Lecturer in Mental Health at Lancaster University. She is affiliated to the Liverpool and Lancaster Universities Collaboration for Public Health Research in the NIHR School for Public Health Research. Her research focuses on the comorbidity of mental health and alcohol use disorders. Laura won funding from the 3-schools programme to run a workshop with professionals and members of the public to identify and develop research priority areas to improve treatment pathways and outcomes for people with co-occurring mental health problems and alcohol use disorders.
Phil Parkes is Volunteer Coordinator for Expert Citizens (Home - Expert Citizens), a community interest company (CIC) built by and for people with lived experience. He worked with Laura in the workshops and is co-investigator on the programme development grant that was co-developed from that work.
Seminar series editor commentary and highlights
Laura and Phil’s presentation takes us closer to the beginning of the public involvement in research journey. The workshops permitted exploration of the ways that mental ill-health and harmful alcohol use can be a barrier to accessing services, with the different treatment pathways available to people in this situation bringing both advantages and disadvantages. Despite the breadth of issues identified in the first workshop, they worked with stakeholders to prioritise a series of research questions in this area. Moreover, they produced a series of cartoon-style illustrations of the pros and cons suitable for dissemination across public, patient and professional networks. The budget included funds to pay a professional company to produce the artwork, helping to bring the messages to life in accessible, bitesize and engaging way.
One highlight of the presentation was Phil’s summary of stakeholders’ positive and negative observations of the different treatment pathways. Phil’s slides were accompanied by the cartoons described above, but Phil also offered poignant reflections using his own lived experience. In doing so, Phil achieved several things: he reminded us that the issues being presented in this academic setting are not abstract ideas but real experiences; his reflections also added to the authenticity of the issues described, giving them weight and increasing their impact.
Laura and Phil are to be congratulated on winning a programme development grant to further develop research in this area. The 3-schools programme funded these workshops with a view to enabling researchers and the public to co-produce research questions and subsequently apply for research funding together. This early development work and the time required to sufficiently build relationships and trust between researchers and the public to enable them to develop ideas and priorities and ways to execute these is fundamental to undertaking co-production. It is especially important when working with groups who may be distrustful of services or researchers, given their experiences of being unable to access some services, as described in the presentation.
References and resources
Paper on the co-occurrence of mental health and alcohol use disorders by Puddephatt and colleagues:
Guidance on better care for people with co-occurring problems by Public Health England:
People with co-occurring conditions: commission and provide services - GOV.UK (www.gov.uk)
Guidance from the James Lind Alliance on priority setting:
How public involvement led the project to focus on the mental health needs of carers
12th December 2022
Speaker
Clarissa Giebel, Senior Research Fellow, University of Liverpool, SPHR
Download the presentation slides (.pdf)
Summary
Heavily co-produced research with people with dementia, unpaid carers, health and social care professionals, and Charity providers into the impacts of the pandemic on dementia care in the community and in care homes has generated the idea for this funded study into the unmet mental health needs of paid and unpaid carers for older adults. The talk will give a brief overview of the original COVID-19 research, how lived experts and care providers were involved, and provide an overview of the ongoing NIHR-funded study.
Speaker biography
Clarissa Giebel is a Senior Research Fellow at the University of Liverpool. Her research focuses on enabling people living with dementia to live well and independently at home for as long as possible, whilst addressing inequalities in accessing the right care. In addition to working with international collaborators. In addition to holding a Career Development Award from the 3-schools programme, Clarissa leads several dementia and health inequalities projects, including the first Covid-19 dementia study in the country (Impact of COVID-19 on dementia social care - Aging & Mental Health).
Clarissa leads the European INTERDEM Taskforce on Inequalities in Dementia Care and the Liverpool Dementia & Ageing Research Forum, hosting bi-monthly free public seminars. You can hear Clarissa talk about science and ageing at The Ageing Scientist podcast.
Seminar series editor commentary and highlights
In her presentation, Clarissa provided a masterclass on how to engage with an underserved, seldom-heard group, in this case, people with dementia and the people who care for them. Clarissa’s approach reminds us, however, that engaging meaningfully with people requires time: it is not a short-term fix, but a long-term investment. For Clarissa, this means embedding this approach into multiple aspects of her work. This involves facilitating the Liverpool Dementia & Ageing Research Forum and producing The Ageing Scientist podcast. In doing so, Clarissa places her work squarely in the public domain, improving its accessibility by giving a platform to these less formal ways of sharing research ideas and findings.
Clarissa’s work also demonstrates how members of the public can be involved in the mechanics of research at multiple stages. She describes how they provided new research ideas, undertook data analysis and co-authored a journal article. Again, this raises issues around resourcing, for example, public contributors were given training to undertake the analysis. As Clarissa points out, however, these types of activities have a potentially empowering impact on public contributors by building their capacity and confidence. Reciprocity can be much broader than payment alone.
References and resources
Co-produced research paper from the project:
Involving the public in data analysis:
Thinking more widely about reciprocity:
Exploring the impact of Patient, Public and Community Engagement and Involvement in the design and development of the Evaluation of the Recovery Navigator Programme in the North East and North Cumbria
23rd November 2022
Speakers:
Emma-Joy Holland, Newcastle University & Fiona Tasker, public contributor
Project Summary
Background: People who come to emergency departments on a regular basis with alcohol problems have high levels of need, often due to their mental ill-health. However, there is currently limited evidence on how to effectively support the transition from hospital to community-based support for heavy drinkers. This study seeks to evaluate a new role, Recovery Navigators, that will provide enhanced support regarding transition back into the community across the North East and North Cumbria (NENC) Integrated Care System (ICS). Recovery Navigators will offer bespoke support to address what matters to the client, e.g. housing, benefits or welfare, and will guide care within hospitals and, crucially, post-discharge.
Methods: Mixed-methods evaluation based in six Acute Hospital Trusts and their associated community services. The evaluation comprises four work packages (WPs): WP1&2 - analysis of key routinely collected data to quantify the impact of the scheme; WP3 - semi-structured interviews with health and social care professionals, patients and carers from across NENC ICS; WP4 - region-wide staff survey. Three Patient, Public and Community Engagement and Involvement (PPCEI) groups have been established to support to evaluation including people with lived experience of heavy drinking, their carers and members of the public.
Findings: This presentation will focus on the PPCEI work conducted to date as part of WP3, the qualitative evaluation of the Recovery Navigator role. The lead qualitative researcher will discuss the impact of PPCEI discussions on the study design, in particular the recruitment strategy and materials. A PPCEI representative involved in the study will discuss their background to research involvement, their role in the study, and reflect on the changes they have helped shape.
Conclusion: This presentation will provide valuable ideas on how we lay foundations for long-term relationships with communities and public contributors in populations with high levels of need.
Speaker biography
Emma-Joy Holland is a research associate at Newcastle University and affiliated to the NIHR School for Primary Care. Emma-Joy, who has previously worked in stroke research, joined the team at Newcastle University to facilitate the qualitative arm of the Recovery Navigator evaluation project. This practitioner-led project is funded through the NIHR Three Research Schools Mental Health Practice Evaluation Scheme and aims to evaluate the newly established Recovery Navigator role in supporting the transition from hospital to community-based support for heavy drinkers, often with co-occurring mental health difficulties.
Fiona Tasker is an Expert by Experience and is passionate about using her poor experiences to make a positive change for others. During her recovery from her last bout of Mental Health Difficulties she accessed ReCoCo (the Recovery College Collective) and now works there, providing a warm welcome to anyone coming to the building and helping those who are feeling anxious into the session they have arrived for.
Seminar series editor commentary and highlights
In their presentation, Emma-Joy and Fiona introduce the Recovery Navigator project and how public involvement has been implemented so far. In the first part of the presentation, Emma-Joy, a researcher on the project begins by introducing the background to the project, an evaluation of an intervention to improve access to services for people with mental ill health and alcohol related harm. In the second part of the presentation, Fiona and Emma-Joy adopt a novel ‘in conversation’ approach, with Fiona reflecting on her contribution to the project as an expert-by-experience in response to prompts from Emma-Joy.
Emma-Joy and Fiona’s presentation illuminates multiple ways in which research can be responsive and flexible to accommodate public contributors’ suggestions and make research more accessible. The evaluation has developed multi-faceted involvement strategy, comprising different groups with different types of expertise by experience performing different roles. Emma-Joy also highlights two areas where the research team made changes upon the recommendations of the public contributors, including producing study information in more accessible language and formats. And they then go on to lead by example by taking a different approach to presenting.
In her reflections, Fiona reminds us that impact goes in both directions, and involvement in research can be mutually beneficial for research and public contributors, particularly the value of having influence. Fiona also draws attention to the importance of being able to share both her experience of public involvement but also her expertise by experience by meeting other people in a similar position to whom she can “pass the baton”.
References and resources
Blackwood (2020) gives some context around patients who are regularly admitted to hospital due to alcohol-related illness: Prevalence and patterns of hospital use for people with frequent alcohol‐related hospital admissions, compared to non‐alcohol and non‐frequent admissions: a cohort study using routine administrative hospital data - Blackwood - 2021 - Addiction - Wiley Online Library
COVID-19 and the Northern Powerhouse -NHSA report - Demonstrates the impact of COVID-19 on various issues across the North East: NP COVID REPORT 101120 (thenhsa.co.uk)
Braun & Clark (2019) – interesting paper around analysis – we are using this approach to begin our analyses: Reflecting on reflexive thematic analysis: Qualitative Research in Sport, Exercise and Health: Vol 11, No 4 (tandfonline.com)
May (2009/2011) around Normalisation Process Theory:
Recovery College Collective website (ReCoCo) www.recoverycoco.com
The challenges of accessing and working with marginalised, vulnerable young people.
18th October 2022
Speaker
Rhiannon Barker, London School of Hygiene and Tropical Medicine
Rhiannon.barker@lshtm.ac.uk
Download the presentation slides (.pdf)
Summary
My research is focused on exploring links between mental health, experience of school and gang membership of 11-18 year olds across England. I am currently in the scoping phase of the research, involving extensive consultation with a range of stakeholders including policy, practitioners, experts by experience and academics. I will discuss the innovative qualitative methodologies I am planning to use reflecting on both the challenges and opportunities. In particular I will look at issues of reflexivity and positionality reflecting on my position as a white, middle aged, entitled woman.
Speaker biography
Rhiannon Barker is a research fellow at London School of Hygiene and Tropical Medicine and affiliated to the NIHR School for Public Health. Rhiannon, who has previously worked in the statutory and third sector, was awarded a fellowship by the NIHR mental health in underserved communities programme for her project, “Exploring the links between mental health, school exclusion and gang culture from the perspective of young people”. The focus of her present study on gang involvement grew out of interviews with teachers and young people undertaken as part of a NIHR-funded exploration of the relationship between school culture and mental health. Rhiannon’s PhD research, a realist evaluation of national policy for end-of-life care took her to the opposite end of the lifecourse.
Seminar series editor commentary and highlights
In her presentation, Rhiannon reflects on what she, with her specific biographical and social characteristics, brings to her fellowship and her research with this particularly marginalised group of gang-involved young people. Specifically, she considers how her positionality affects her credibility and subsequently her access to and ability to engage young people. Rhiannon’s observation that different agendas and perspectives will lead to different outcomes is a particularly important one, emphasising the need to avoid conflating difference with value or quality.
Rhiannon speaks from the perspective of someone still in the scoping phase of the project, where she is building networks and relationships and working with advisory groups to shape her approach. Although ongoing, Rhiannon explains how this foundational work has already had an impact: the advisory group has interrogated her positionality and encouraged her adoption of less traditional research methods and outputs.
References and resources
Beals, F., Kidman, J. and Funaki, H., 2020. Insider and outsider research: Negotiating self at the edge of the emic/etic divide. Qualitative Inquiry, 26(6), pp.593-601.
Dwyer, S.C. and Buckle, J.L., 2009. The space between: On being an insider-outsider in qualitative research. International journal of qualitative methods, 8(1), pp.54-63.
Haraway, D. 1988. Situated Knowledges: The Science Question in Feminism and the Privilege of Partial Perspective. Feminist Studies , Autumn, 1988, Vol. 14, No. 3 (Autumn, 1988), pp. 575-599
Harding, S.G. ed., 2004. The Feminist Standpoint Theory Reader: Intellectual and Political Controversies (routledge.com). Psychology Press.
Hellawell, D., 2006. Inside–out: analysis of the insider–outsider concept as a heuristic device to develop reflexivity in students doing qualitative research. Teaching in higher education, 11(4), pp.483-494.
Rose D. Patient and public involvement in health research: Ethical imperative and/or radical challenge? Journal of Health Psychology. 2014;19(1):149-158. doi:10.1177/1359105313500249