Rethink Mental Illness

BackgroundPatient and Public Involvement and Engagement (PPIE) is important in secure psychiatric research because it can help ensure that research is relevant and meaningful, and a positive experience for those participating. However, there are significant challenges to embedding PPIE in research in secure hospital settings, including practical barriers to involvement. A lack of reporting of PPIE practices makes it harder for researchers to learn from previous projects, leading to missed opportunities to improve PPIE in secure settings, and there are no current setting-specific guidelines for best practice.The CORAS study aims to examine collaborative risk assessment within secure psychiatric settings. In this study, PPIE is fully integrated throughout the research cycle, and this protocol describes the PPIE methodology being adopted. By highlighting these approaches and principles, this protocol is intended to be used as a transferrable framework for developing best practice for PPIE in research in these settings.MethodThis protocol describes the ways in which we will ensure that PPIE remains central to each stage of the research project, from the formation of a smaller grant application PPIE group, through to dissemination of outputs. We discuss principles of recruitment into the PPIE group, ensuring that all areas of the secure mental health pathway are represented, and formally embracing equality, diversity and inclusion principles through the use of an Equality Impact Assessment. We also describe the core activities of the PPIE group, including the co-design of the research materials, recruitment strategies and dissemination plans, how the impact of PPIE will be examined, and practical elements such as around reimbursement and ensuring the wellbeing of PPIE group members.ConclusionsPPIE in secure mental health service research is important and challenging. This protocol outlines how we will address these challenges and ensure that PPIE is fully embedded in the design and delivery of a large study in secure settings. Although the prospective nature of this protocol precludes the sharing of outcomes and learning from the PPIE, it can nevertheless serve as a transferrable framework for the development that is urgently required in this clinical research field, as well as allow transparent future reporting of what was achieved.

Unmittelbar nach dem 24. Februar 2022, dem Tag des Überfalls der Russischen Föderation auf die Ukraine, war das Wort vom Westen wieder in aller Munde: als Synonym für Liberalität, Rechtsstaatlichkeit, Demokratie, aber auch militärische Potenz und geopolitischen Machtanspruch. Bemerkenswert war und ist dies insofern, als die Rede vom Westen vor jenem historischen Tag zumindest unter kritischen Intellektuellen ausschließlich im Modus der postkolonialen, identitätspolitischen, rassismuskritischen usw. Infragestellung statthaft erschien -oder aber unter dezidierter Betonung des Krisenhaften: Der Niedergang des Westens wurde seit dem Brexit und der Wahl Donald Trumps in der internationalen Publizistik schließlich so konsequent beschworen, dass man fast den Eindruck gewinnen konnte, die Leitartikel in den großen Zeitungen verstärkten unwillkürlich genau das, was sie eigentlich nur beschreiben und bezeichnen wollten. Davon, dass sich die gestern noch hitzig geführten Debatten von einem auf den anderen Tag als nichtig erwiesen hätten, ist aber nicht auszugehen, zumal sie Kritikpunkte aufgreifen, die seit jeher, wenn auch in wechselndem begrifflichem Gewand und mit divergierendem politischen Akzent, gegen den Westen vorgebracht worden sind. Angesichts der gegenwärtigen Situation, der gewaltsamen Umgestaltung der politischen Weltordnung durch eine imperiale, autokratische und zu allem Übel mit Atomwaffen ausgerüstete Großmacht, die ausdrücklich die westliche Moderne und die offene Gesellschaft zu ihrem Feind erklärt hat -angesichts dieser Lage scheint den Bewohnerinnen und Bewohnern der liberalen Demokratien vielmehr bewusst zu werden, dass allein diese die Bedingungen gewährleisten, die ihre kritische Infragestellung allererst ermöglicht. Das neu aufkommende diskursive Spannungsverhältnis zwischen Westen und Osten auszuloten, das Zusammenwirken von Abwehr und Annäherung in unterschiedlichen historischen Konstellationen seit 1945 zu vermessen -darin bestand die Aufgabe einer kleinen Tagung an der Universität Münster im Dezember 2022. Für diese Ausgabe von andererseits wurden einige der Beiträge ausgewählt und zu einem Schwerpunkt zusammengestellt. So geht zunächst Anna Artwińska (Leipzig) auf die Sonderrolle der Staaten Polen, Ungarn und der Ukraine vor und nach dem 1 Vgl. https://rethinkingthewest.de.

This study was conducted to determine the effect of breathing and relaxation exercises training on psychological well-being and sleep quality in individuals diagnosed with schizophrenia. This study was conducted at a community mental health center between October 2022 and April 2023 as a randomized controlled study with a pretest-posttest control group. The study's participants were 64 individuals diagnosed with schizophrenia (31 in the experimental group and 33 in the control group). The Descriptive Characteristics Form, the Psychological Well-being Scale, and the Pittsburg Sleep Quality Index were used to collect data. The individuals in the experimental group underwent 6 sessions of breathing and relaxation exercises training in the form of group training, and no training was applied to the individuals in the control group. It was determined that the individuals in the experimental group had an increase in the total mean score of psychological well-being and a decrease in the total mean score of sleep quality after breathing and relaxation exercise training. In addition, a statistically significant difference was found between the posttest psychological well-being and sleep quality total mean scores of the experimental and control groups ( P <.05). It can be said that breathing and relaxation exercises training can be used as an effective intervention to increase the psychological well-being and sleep quality of individuals diagnosed with schizophrenia and can be used in addition to pharmacological treatment.

Despite a growing evidence base on the effectiveness of community-based physical activity interventions for mental health, there is a lack of studies that focus on those affected by severe mental illness (SMI), who often experience poorer physical health, and are less physically active than the wider population. The use of peer support groups in this context is also understudied, despite benefits being documented in other contexts. This study examined the impact and process of a nationwide project to embed physical activity into peer support groups for those affected by SMI. Following the embedding of physical activity within peer support groups, interviews and focus groups were conducted to explore the experiences of those involved with the project and analysed using reflexive thematic analysis. The key findings related to: 1) the social aspects of embedding physical activity in the groups; 2) the focus on peer support and informal physical activity (rather than organised sport) being beneficial; 3) doing things differently and lessons to learn; and 4) the impact of the COVID-19 pandemic. Overall, we found that peer support is an important feature to include in projects encouraging those severely affected by mental illness to become more physically active.

Reading Well Books on Prescription for dementia is a book list of qualityassured reading to support people with dementia, and their carers and relatives, through living with dementia. The scheme is part of the wider UK national Reading Well Books on Prescription programme which was developed by the Reading Agency in partnership with the Society of Chief Librarians (SCL) and is delivered through public library services across England. The concept of the programme is simple yet effective: providing book-based support to people living with a range of conditions which is then available for them to borrow free from their local library. Users can either receive a recommendation of a title from a health or social care professional or they can self-refer to the scheme simply by visiting the library and taking one of the books off an open shelf. There are also Reading Well Books on Prescription lists to support adults with common mental health conditions, young people's mental health and wellbeing, and people with long-term physical health conditions and their carers.

Connectedness is a central dimension of personal recovery from severe mental illness (SMI). Research reports that people with SMI have lower social capital and poorer-quality social networks compared to the general population.AimsTo identify personal well-being network (PWN) types and explore additional insights from mapping connections to places and activities alongside social ties. We carried out 150 interviews with individuals with SMI and mapped social ties, places and activities and their impact on well-being. PWN types were developed using social network analysis and hierarchical k-means clustering of this data. Three PWN types were identified: formal and sparse; family and stable; and diverse and active. Well-being and social capital varied within and among types. Place and activity data indicated important contextual differences within social connections that were not found by mapping social networks alone. Place locations and meaningful activities are important aspects of people's social worlds. Mapped alongside social networks, PWNs have important implications for person-centred recovery approaches through providing a broader understanding of individual's lives and resources.Declaration of interestNone.

BackgroundPeople with psychosis have a reduced life expectancy of 10–20 years, largely due to cardiovascular disease. This trial aimed to determine the effectiveness of a modular health promotion intervention (IMPaCT Therapy) in improving health and reducing cardiovascular risk in psychosis.MethodsA multicentre, two arm, parallel cluster RCT was conducted across five UK mental health NHS trusts. Community care coordinators (CC) were randomly assigned to training and supervision in delivering IMPaCT Therapy or treatment as usual (TAU) to current patients with psychosis (cluster). The primary outcome was the physical and mental health subscales of the Short form-36 (SF-36) questionnaire.ResultsOf 104 care coordinators recruited, 52 (with 213 patients) were randomised to deliver IMPaCT therapy and 52 (with 193 patients) randomised to TAU. Of 406 patients, 318 (78%) and 301 (74%) attended 12- and 15-month follow-up respectively. IMPaCT therapy showed no significant effect on the physical or mental health component SF-36 scores versus TAU at 12 or 15 months. No effect was observed for cardiovascular risk indicators, except for HDL cholesterol, which improved more with IMPACT therapy than TAU (Treatment effect (95% CI); 0.085 (0.007 to 0.16); p = 0.034). The 22% of patients who received >180 min of IMPACT Therapy in addition to usual care achieved a greater reduction in waist circumference than did controls, which was clinically significant.ConclusionTraining and supervising community care coordinators to use IMPaCT therapy in patients with psychosis is insufficient to significantly improve physical or mental health quality of life. The search for effective, pragmatic interventions deliverable in health care services continues.Trial registrationThe trial was retrospectively registered with ISRCTN registry on 23/4/2010 at ISRCTN58667926; recruitment started on 01/03/2010 with first randomization on 09.08.2010 ISRCTN58667926.