Volume 8, numéro 2, été 2025

EN :

This study examines the viability of songwriting as a recovery program for patients in a mental health hospital setting. Using the Basic Psychological Needs Satisfaction Scale (BPNSS) as a tool for measuring one’s sense of autonomy, relatedness and competence, first-time participants were asked to complete the scale before and directly following a one-hour songwriting session, with open-text questions included in the post-intervention scale.

Forty-nine participants from two different inpatient units - Crisis and Critical Care (CCC) and Medical Withdrawal Services (MWS) - volunteered to take part in the study. Results indicated that only participants from CCC saw a statistically significant increase in competence mean scores, with open-text responses from both units supporting this finding. Common sentiments from open-text responses included growth in confidence and self-belief, elevation in mood, and expression of emotions through creative practice. Developing a sense of competence can be important when entering into recovery and can lead to an increase in confidence. While the initial findings from this pilot study are promising, further research is needed to determine the efficacy of songwriting as a mental health support.

EN :

Objective: A good therapeutic alliance (TA) positively influences many outcomes in the treatment of people with severe mental illness (SMI). However, there is little evidence-based advice on how to build and maintain a good TA with SMI clients, with clients' perspectives largely missing from current literature.

Research Design and Methods: The views of clients, peer support workers (PSW) and other mental health care professionals (MHCP) on the TA in multidisciplinary mental health care teams are investigated through 13 open-ended focus groups with three separate types of stakeholders: clients, PSWs and other MHCPs from five Dutch psychiatric institutes. Transcriptions were analyzed qualitatively using grounded theory, with an open coding approach and inductive thematic analysis.

Results: In the collected data, four main domains were identified: authenticity, trust and reliability, shared treatment goals and availability. To build a good TA all parties should communicate transparently and MHCPs should be reliably available, listen actively to the needs of the client and build trust before discussing treatment goals. Showing authentic interest helps maintaining a good TA, as well as adapting to clients’ changing needs, stability in contact and being available in case of need.

Conclusions: Investing in long-term TA is needed, which can be achieved by building trust over time, being available as a team and by genuinely listening to a client in order to understand and find agreement on their treatment goals. Clients’ needs with regard to the TA may change while they move through various stages of recovery, to which MHCP should adapt.

EN :

Participation of those with lived and living experience is central to recovery-oriented philosophies and practices within mental health services. Such participation provides a bridge to improving understanding between service providers and people accessing services. In doing so, lived and living experience workers often contribute to more tailored service provision and, ultimately, better outcomes for service users. Due to the siloed nature of the mental health care system, little is known about how peer work varies over the lifespan. This paper was developed and written by a combination of lived experience experts and experts by training, through a collaborative, reflexive methodology. It considers the roles of consumer and carer peer workers across the age spectrum within a single, multi-faceted, large public mental health service. We examine the shared experiences of peer workers in different parts of the service from both peer worker and non-peer worker perspectives, as well as some of the unique challenges which characterise specific cohorts. We worked collaboratively to draw out these themes, and then identify their implications for practice for other services. We also illustrate some of the potential pitfalls in implementation and development of the peer workforce within clinical settings.

EN :

Background: Peer support is becoming a common feature of mental health service provision. In England most NHS mental health services now employ peer support workers (PSWs). Little is known about how the institutional context in which PSWs operate shapes their roles and identities.

Aim: To develop an understanding of PSWs’ perceptions of their identity in the context of an NHS mental health service.

Methods: Eighteen NHS PSWs were interviewed, and their transcripts were studied repeatedly during in-depth thematic analysis resulting in 5 themes.

Results: Four of the resulting themes related to different peer worker identities (empowered survivor, not peer enough, flaky and unstable & tokenistic). The fifth related to how PSWs resist and manage the identities available to them within an institutional context. The institutional context of NHS mental health services complicates the PSW identity because of its medical construction of lived experience, as well as its dominant cost-saving agenda.

Conclusions: The study furthers the understanding of how the medical, hierarchical, financially scarce context of mental health services impact PSWs’ perceptions of their identity, which is an under-explored area of research. A shift in focus away from PSWs, and onto the context that they are employed within is called for.

EN :

Introduction: Recovery Colleges (RC) are community-based learning centers. They offer courses in mental health, well-being and recovery. RC courses are co-constructed and co-facilitated by two trainers with complementary knowledge. Learners come from diverse backgrounds ensuring a variety of expertise and experiences. Studies have demonstrated the benefits of RC courses for learners. The mechanisms of action specific to RC explains the benefits. Studies about the mechanisms of action of RC show the importance of the social environment of RC. The Centre d'apprentissage Santé et Rétablissement (CASR) is a Canadian French-language RC offering free online courses to the public. Objectives: The study aims to answer two research question: 1- How do learners of CASR’s online courses describe their learning experience? 2- How do learners of CASR’s online courses describe the relationships they experienced? Methods: An exploratory qualitative study consisting of ten individual interviews followed by a thematic analysis was conducted. Results: Participants describe their learning experiences in terms of the characteristics of the CASR course space: inclusive and benevolent learning space; connected, supportive, and egalitarian space for interaction; collaborative and co-constructed knowledge space. Participants describe the relationships in terms of: equality; respect and non-judgment; recognition and belonging; collaboration and mutual support. Conclusion: The results confirm the existence of mechanisms of action in CASR courses like those identified in previous studies. The learning context of the CASR prompts some participants to prioritize their personal roles over their professional roles during courses. By exposing their vulnerability, they show humility and encounter equal relationships.

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Psychiatry has powerfully influenced how mental health issues are conceptualised and addressed internationally. Many people report benefits from mental health assessment and treatment, but other individuals report being harmed by the mental health system. In this regard, mental health services are distinct from other areas of health care. For example, no other area of medicine has an equivalent of a psychiatric survivor movement. This article identifies ten embedded assumptions within psychiatry, which may account for some of these negative experiences. They are myths, in the sense of being beliefs which are widely held, often un-noticed and un-challenged, and routinely applied as if universally true despite being either wholly untrue or only sometimes true. They are also harmful, both in creating direct damage and in consuming patient, clinician, and societal resources which could be better spent in other ways. The myths are: Mental health problems are individual; Mental ill-health is fundamentally biological; A clinician knows what is in the patient’s best interests; A clinician can predict the patient’s future; Diagnosis is fact; Treatment is always justified; Patients need to be trained for social roles; Side effects are peripheral; Improvement is always due to treatment; and Supporting recovery is ‘business as usual’. Approaches to developing new knowledge about mental health are then proposed: learning from people living with mental health issues and not using services; developing a salutogenic knowledge base about wellness to balance our current pathogenic knowledge base about illness; and using standpoint epistemologies to develop more inclusive approaches to knowledge creation.