Engage Aotearoa

Category Archives: Engage Consideration

Teen Recovery Website: By Youth for Youth

A young woman in Wellington with lived experience of recovery has created a website to help other teens on their road to recovery from mental-health issues. Verity, the creator of the site, writes “It started off just being a resource for my friends at the unit to use. I had posted the link to my Facebook and as the months went by, Teen Recovery …[was] noticed by organizations such as Youthline and Live For Tomorrow.

At Teen Recovery, young people can find out about recovery strategies like distractions and breathing techniques, learn more about things like anxiety attacks, self-care after self-harm and finding reasons to stay alive, and read recovery stories or share a recovery story themselves. There’s an FAQ page that answers some of the common questions young people might have about recovery. There’s a Support Services link that lists all the nationwide helplines and a Websites link that lists a bunch of useful websites.

The Teen Recovery website also recommends other young people connect with their public Child and Adolescent Mental Health Service (CAMHS) if they would like more support. Every DHB has a CAMHS, though some services go by different names. If you search online for ‘CAMHS’ and the region you live in, you should be able to find the service nearest to you. Each service has different referral pathways – at some, young people and their families can self-refer for a first appointment; at other services, you may need to see your GP or School Guidance Counsellor to arrange a referral for a first appointment at your local CAMHS. You can always give the service a call to find out if you aren’t sure.

Visit Teen Recovery and explore for more info

Engage Consideration: Dutch initiative challenges mainstream thinking about psychosis

This post highlights a relatively new Dutch initiative that works to promote a helpful way of thinking about experiences of psychosis. The team at Engage Aotearoa recently stumbled across it on Facebook and thought it was full of information others might like to consider – either in their own recovery or in their efforts to support others seeking recovery.

Jim van Os and others have created a website, manifesto and set of audio-visual ‘explanimations’ to help people understand psychotic experiences in a way that allows for meaning-making and hope for recovery.

Much of the website is in Dutch, but an English-language version of the core resources on the “Schizophrenia Doesn’t Exist” website is available. It’s a provocative title, but the project creators do not mean to say that extreme experiences like hallucinations and delusions do not exist.

If you are not much for reading, you can watch Jim van Os’s TED Talk and get it all in a 15-minute nutshell or explore the 2-minute ‘explanimations‘ about psychosis and recovery on the website.

Visit the Schizophrenia Doesn’t Exist English-language webpage to find everything in one place. 

The Manifesto outlines “14 Principles for Good Care of Psychosis”. The first 7 principles address current thinking that frames psychosis as a brain disorder called schizophrenia and set out evidence for an alternative – Psychosis Spectrum Syndrome or PSS. The final 7 principles set out a vision for recovery-based practice, these state…

“8: To recover from PSS, a person must be offered hope and perspective from the very first moment. Recovery is a psychological process. It is a process of learning to adapt and develop a new perspective. With support from people with lived experience of psychosis and, where necessary, from doctors and therapists who support the process of recovery.

9: Every person with PSS should have access to a person with lived experience of psychosis from the earliest phase of treatment. A person with lived experience is in a unique position to offer perspective and hope (‘I was able to recover as well’).

10: The primary goal of treatment is return to the person’s environment, education and/or work. Education and work are prerequisites for recovery: even if residual symptoms remain, people can start picking up where they left off. The practice to wait for full recovery is counterproductive.

11: Anyone who enters the mental health system with PSS should be encouraged to talk about their psychosis. The content of the psychosis should be seen as meaningful, and may represent the key to underlying issues.

12: Psycho-education should not introduce an unproven biomedical model of brain disease as a central theme.

13: Anyone who suffers from psychosis should have access to psychotherapy by an experienced therapist.

14: Antipsychotics may be necessary to reduce psychosis but do not correct an underlying biological abnormality. Antipsychotics are no cure. Much more attention is required for individual dose optimisation to reach the lowest possible dose and to avoid irrational polypharmacy.

Schizophrenia does not exist, which is a good thing.
Because much can be done about PSS.”

~ Quoted from, Manifesto: 14 Principles for Good Care of Psychosis. Schizophrenia Does Not Exist website, 12 July 2015.

 

 

Research Evidence on Peer Support Work

In light of the recent media attention on Peer Support Work, the team at Engage Aotearoa thought it timely to share some research on peer support, should members of the community want to get some more information on the topic.

In a review published last year researchers cite a meta-analysis of 11 studies evaluating peer support against case management and clinical professionals in support roles, which concluded “No significant differences in symptoms, hospital admissions, service use, psychosocial functioning or client satisfaction were found. In a second category, six trials compared usual care with services with PSWs in adjunct roles, four with PSWs in mentoring or advocacy roles. There were no significant differences in quality of life, social relations, client satisfaction, hospital admissions, but a small reduction in emergency service use and a larger number of met needs. With these small benefits and no adverse effects found for PSW, Pitt et al. conclude in their review that PSW’s support was noninferior to support by mental health professionals” (emphasis added).

Reference: Mahlke C, Krämer UM, Becker T, Bock T, (2014). Peer support in mental health services. Current Opinion in Psychiatry, 27/4, 276-81. doi: 10.1097/YCO.0000000000000074

In a 2011 review researchers noted that “it seems prudent to mention that a result of no difference demonstrates that people in recovery are able to offer support that maintains admission rates (relapse rates) at a comparable level to professionally trained staff” (emphasis added). They also point to several studies that reported improvements in empowerment, sense of independence,  self-esteem,  hope and community integration along with reduced internalised stigma.  Authors outline several challenges that face peer support workers in the execution of their roles, which require training and organisational support and go on to conclude that peer support workers “have the potential to drive through recovery-focused changes in mental-health services.”

Reference: Repper, J., & Carter, C., (2011). A review of the literature on peer support in mental health services. Journal of Mental Health, 20/4, 392-411.

A 2012 study of peer support worker perspectives of their work, showed that peer support workers are aware of the many challenges they face and highlight the value of their training in enabling them to deal with such challenging issues as self-disclosure and managing boundaries.

Reference: Kemp, V., & Henderson, A.R., (2012). Challenges faced by mental health peer support workers: peer support from the peer supporter’s point of view. Psychiatric rehabilitation journal, 35/4, 337-40.

There is a notable lack of evidence to suggest that peer support work carries risks that are not inherent to any work in the mental-health field and which cannot be overcome without adequate training and supervision. In 2014, Te Pou launched a set of core competencies for peer support workers in New Zealand, to help define the role and help regulate who is able to practice as a peer support worker in mental-health and addictions services. Importantly, in Mary O’Hagan’s 2010 paper, we hear service-users’ own answers to the question “What are the benefits of peer support to you?
  • Knowing you are not alone. Seeing that you are able to live with a mental health diagnosis and still go to school, get degrees, have a job, have a relationship and family. Feeling you are more ‘normal’ or ‘okay’.
  • If it were not for peer support, I wouldn’t be alive.
  • My life was turned around.
  • It was my passage way to getting better, pretty much the only one.
Reference: O’Hagan, M., Cyr, C., McKee, H., & Priest, R. (2010). Making the Case for Peer Support. Mental Health Commission of Canada. Cited in O’Hagan (2011). Peer Support in Mental Health and Addictions: A Background Paper Prepared for Kites Trust.

Find out more about Peer Support in NZ at Kites Trust, the Peer Workers Association or Mind and Body Learning and Development.

Engage Consideration

Hello from Engage.

I often notice, not only in the media but around family, friends and strangers, the pejorative use of the terms of mental illness – people use ‘crazy’ to mean ‘bad’ all the time. “You drove drunk? You must be insane!” “She stole all the money even though she knew she’d be caught – crazy!” “The only reason you would kill a person is if you were mad.”

Bad things are often crazy. Crazy things are rarely bad. I have read some fine pieces encouraging the use of phrases such as “crazy good” and “mad fun”, and I love these phrases and want to hear them more. The comparison I want to make briefly here though is to the use of the word ‘gay’ to mean ‘bad’, which is appropriately frowned upon. People seem to understand now that using the denomination of a group of people as a catchword for the negative is just not on. So I hope it may go for ‘crazy’ some day.

If somebody uses crazy to mean bad, call them out on it. Say to them, “Being bad may be crazy, but being crazy isn’t bad.”

Daniel Larsen-Barr
Engage Aotearoa Information Manager
info@engagenz.co.nz