Similarly, the scientific evidence for supporting self-management (challenge 1) is compelling. Other challenges have a strong evidence base indicating that they improve people’s experience of services. The positive experiences of students at Recovery Colleges (challenge 3) and the beneficial impact on experience of more involvement in safety planning (challenge 6) are clear. This paper makes the Business Case for supporting recovery. We believe that this should be informed by three types of data: evaluative research (such as randomised controlled trials); the perceived benefits for service users – what might be termed ‘customer satisfaction’; and best evidence about value for money.

There is a raft of policy guidelines indicating that mental health nurses should be increasing the social inclusion of mental health service users. Despite this there is no universally accepted definition of social inclusion and there is a dearth of empirical evidence on the successful outcome of increasing inclusion for mental health service users. Recognizing the lack of clarity surrounding the concept we have a produced a social inclusion framework to assist mental health professionals and service users to co-produce social inclusive outcomes. Although we agree that social inclusion can be a positive aspect of recovery, we question the extent to which mental health nurses and service users in co-production can overcome the social, economic and political structures that have created the social exclusion in the first place. An understanding and appreciation of the structure/agency conundrum is required if mental health nurses are to engage with service users in an attempt to co-produce socially inclusive outcomes.

Background/Objectives: Whilst there are many examples of good practice in the area of recovery-orientated services, many mental health service providers have made little progress in this area and there is no clear guidance or consensus or strategy as to how we might develop comprehensive services which are based on recovery principles. We aim to outline our project (Implementing Recovery – Organisational Change (ImROC)) which has developed 10 key organisational challenges that face mental health services that wish to transform their organisation and delivery of services to become ‘recovery-orientated’.

This study is an evaluation of the implementation of the Chief Nursing Officer for England's Review of mental health nursing in mental health trusts (MHTs). The authors employed instrumental case studies in six MHTs. The results showed evidence of acceptance of the Review and some evidence of subsequent actions to implement the Review recommendations, but these were not widespread. A lack of an evidence-based implementation plan hampered the implementation as did an apparent lack of strategic nursing leadership in many MHTs. In conclusion, the vision for mental health nursing reported in the Chief Nursing Officer Review prompted various changes, directly and indirectly, among mental health nurses and the development of areas of good practice in education, practice and leadership. The positive changes evident in some areas may become widespread by a systematic policy implementation plan from the centre, supported by local leadership in practice.

Journal of Psychiatric and Mental Health NursingVolume 11, Issue 3 p. 368-373 Our experience of collaborative research: service users, carers and researchers work together to evaluate an assertive outreach service S. ALLAM, S. ALLAM Members of Linc-Up University of Sheffield & Sheffield Care TrustSearch for more papers by this authorS. BLYTH, S. BLYTH Members of Linc-Up University of Sheffield & Sheffield Care TrustSearch for more papers by this authorA. FRASER, A. FRASER Members of Linc-Up University of Sheffield & Sheffield Care TrustSearch for more papers by this authorS. HODGSON, S. HODGSON Members of Linc-Up University of Sheffield & Sheffield Care TrustSearch for more papers by this authorJ. HOWES, J. HOWES Members of Linc-Up University of Sheffield & Sheffield Care TrustSearch for more papers by this authorJ. REPPER, J. REPPER University of Sheffield & Sheffield Care TrustSearch for more papers by this authorA. NEWMAN, A. NEWMAN University of Sheffield & Lincolnshire Partnership Trust UKSearch for more papers by this author S. ALLAM, S. ALLAM Members of Linc-Up University of Sheffield & Sheffield Care TrustSearch for more papers by this authorS. BLYTH, S. BLYTH Members of Linc-Up University of Sheffield & Sheffield Care TrustSearch for more papers by this authorA. FRASER, A. FRASER Members of Linc-Up University of Sheffield & Sheffield Care TrustSearch for more papers by this authorS. HODGSON, S. HODGSON Members of Linc-Up University of Sheffield & Sheffield Care TrustSearch for more papers by this authorJ. HOWES, J. HOWES Members of Linc-Up University of Sheffield & Sheffield Care TrustSearch for more papers by this authorJ. REPPER, J. REPPER University of Sheffield & Sheffield Care TrustSearch for more papers by this authorA. NEWMAN, A. NEWMAN University of Sheffield & Lincolnshire Partnership Trust UKSearch for more papers by this author First published: 13 May 2004 https://doi.org/10.1111/j.1365-2850.2004.00755.xCitations: 20Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume11, Issue3June 2004Pages 368-373 RelatedInformation

Whereas unemployment is clearly linked to mental health problems, employment can improve quality of life, mental health, social networks and social inclusion. Yet in the UK only 15% of people with serious mental health problems are employed--despite an overwhelming consensus from surveys, case studies and personal accounts that users want to work. This paper aims to challenge common misconceptions surrounding employment, work and mental health problems. Drawing on a range of research evidence and legislative guidance it discusses significant barriers to work and proposes feasible solutions. The need for mental health staff and services to become involved in the provision of work opportunities is considered, as is the vital role they can play in changing communities. The potency of work as a vehicle for improving the social inclusion and community tenure of people with mental health problems is highlighted.

In order to inform the development of a specialist 'suicide prevention nurse' to work in an Accident and Emergency; department (A&E), a review of literature in the area was undertaken.Priority was given to papers describing well specified interventions with a carefully defined client group. Only eight such studies were identified and, although they do have clear implications for practice, they provide inadequate information regarding the targeting of all clients at risk of suicide.The review was therefore broadened to include all UK; literature on suicide and parasuicide at population and individual levels. Three distinct groups of A&E attendees at particular risk of suicide were identified: patients attending A&E following deliberate self-harm; attendees with specific physical problems, and attendees with a known history of mental health problems.The needs of each of these groups are described, with their implications for the role of a 'suicide prevention nurse' in A&E.In conclusion, action to reduce suicide needs to be taken at all levels of the organization and the role of the suicide prevention nurse needs to include support, training and development as well as specific time limited therapy with a highly targeted group of patients at specific risk.

Tameside and Glossop rehabilitation team (in England) have developed a progressive and targeted service for people with serious mental health problems through the systematic implementation of research-based evidence in practice and service configuration. This study was undertaken to provide a method of auditing the clinical outcome of the service and monitoring staff morale in a manner which could be integrated in the day to day delivery of services, and which could inform future service developments. Changes in the functioning of the total population of rehabilitation team clients were assessed over a 1-year period by Health of the Nation Outcome Scales (HoNOS) ratings at 6-monthly intervals. Factors causing stress and stress levels among all staff were assessed using the Mental Health Stress Questionnaire. The findings give clear indications of areas of the service which needed improving or changing, and identify ways in which the ongoing process of data collection might be refined.

Within mental health services there are fewer women than men with serious mental health problems and there is evidence that their needs are relatively neglected resulting in specific deleterious effects. In research, as in services, the abilities of women with serious mental health problems appear to be under-estimated, and there is almost a total absence of research into the views and experiences of such women. This study aimed to explore the lives of women with serious ongoing mental health problems and their experience of services, to develop understanding of the context and impact of mental distress. In a series of 5 focus group interviews, the women, who were using a range of services for people with long-term mental health problems, described lives which, even before the onset of mental health problems, were marked by material, social and personal disadvantage. Their mental health problems led to numerous losses: loss of homes, jobs, relationships, children and loss of 'normality', yet the women retained hopes and aspirations for the future. The women clearly identified aspects of the service that they valued, in particular the support and company of women workers and other women service users. The implications of these findings are discussed in relation to planning and providing mental health services for women.

In the present drive towards evidence-based health care it is essential for nurses to be able to define and measure their contribution in the health services and thereby ensure that resources are deployed to provide maximum improvement in the health of the population. Yet there exist few rigorous studies which examine the impact of the nursing contribution on patient health gain. One explanation for this is the sheer complexity of outcome measurement. This paper considers the multitude of factors which must be taken into account when designing studies to measure the impact of interventions for people with serious mental health problems. The heterogeneous nature of the population, the range of services these people might use, the composite of possible interventions and the paucity of adequate measurement tools are among the issues to be tackled. Although no single methodology can be prescribed, a number of principles are offered to guide study design.

In 1994 the Department of Health commissioned project work and reviews to inform the development of a National Strategy to enhance the capacity of the NHS workforce to contribute to Research and Development. This paper reports one aspect of this review: a preliminary study mapping the difficulties experienced by clinicians and managers who sought to develop their research skills. A range of professionals were included in the sample, all of whom had applied for funding to undertake research education or training through a variety of schemes offering differing levels of support. There was a remarkable degree of consistency between the professional groups in terms of their level of training, success in achieving funding and their perception of the difficulties they faced in pursuing funding for research training—which they ranked in the same order of importance. However, two major significant differences arose: nurses and therapists rated their managers as less helpful, and they felt that completing application forms for research training was a skill that they lacked. The ranking of areas of difficulty, and the additional comments made by all respondents highlight issues that need to be addressed within a coherent strategic framework to reduce the difficulties experienced by those professionals wishing to pursue funding for research training.

Despite an increase in the literature on women with less disabling or transitory mental health problems, there is little relating to women with serious and ongoing difficulties. In considering the means by which the needs of this population might be studied, tension arises over methodology. Research comparing the clinical, functional and service use characteristics of women and men might demonstrate their different mental health problems but would neither elucidate women's particular needs nor examine the social reasons for this difference. A feminist methodology would, however, offer a means of exploring the experiences of women, a framework for understanding sex differences, and generate findings that would be beneficial to women. The present study gives an insight into ways in which the exploration of sex differences can be combined with a study of women for women without compromising the relevance and impact of the findings.

Recent developments in services and strategies for helping people with serious mental health problems represent a watershed in mental health provision. This has implications not only for specialist mental health nursing, but also-- as increasing numbers of people with serious mental health problems live in the community-- for nurses working in all areas of health care, who will have to play a role in meeting their needs. This article describes current developments in policy and practice, and seeks to explain the basic principles of working with people in this client group.

The literature on Munchausen Syndrome by Proxy (MSP) is reviewed to assess the extent of existing knowledge and the incidence of this syndrome among health care workers. Although use of this diagnosis appears to be increasing and broadening, it was not until the Beverly Allitt case in the United Kingdom in 1993 that this syndrome was used to explain the behaviour of a health care worker who harmed people in his/her care. However, a review of available details of previous health care workers accused of murder reveals that five shared some of the distinctive features of MSP. Although care must be taken when applying diagnoses, in view of the risk of morbidity and mortality which MSP poses for the people involved, it is important that health care workers become more informed and involved in understanding and detecting MSP.