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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

Upcoming Seminars

27 March 2023 1pm-2pm

Supported Volunteering at Ripon Museums: 'De-researchifying' research processes and methods in a sensitive way 

Martin Webber, Beth Casey & Helen Thornton 

26 April 2023  11am-12pm

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 

Gretchen Bjornstad, University of Exeter 

3 May 2023 12pm - 1pm

Collaborating to develop holistic health support for people living with severe mental illness 

Emily Oliver & Ilaria Pina, Newcastle University, and Sue Websterpeer researcher 

24 May 2023  12pm - 1pm

PPI in the PRIORITY* study  

*Health inequalities in People with seveRe mental Illnesses: Impact of antipsychOtic tReatments and social Inequalities on long Term phYsical health 

Juan Carlos Bazo Alvarez, UCL 

12 June 2023 1pm-2pm

Use of Nominal Group Technique for organising a workshop for carers of people who have been discharged by mental health hospitals 

Maria Panagioti and Natasha Tyler, University of Manchester 

12 July 2023 12pm-1pm

Embedding and evaluating trauma-informed and co-production approaches with people who've experienced multiple disadvantage 

Michelle Farr, University of Bristol & Thomas Traub, peer researcher 

Previous Seminars

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 Inquiry26(6), pp.593-601.

Dwyer, S.C. and Buckle, J.L., 2009. The space between: On being an insider-outsider in qualitative researchInternational journal of qualitative methods8(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 education11(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

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 

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 

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: 

 

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: