Poverty, pathology and pills: moral narratives and the medicalisation of distress
Lead Research Organisation:
University of Exeter
Department Name: University of Exeter Medical School
Abstract
The provision of effective treatment and support for mental distress is a stated aim of the Department of Health and civil society organisations e.g. Mind. Yet despite a stated need to tackle health inequalities, current strategies e.g. Closing the Gap: Priorities for Essential Change in Mental Health (DoH 2014), frame mental distress as a psychological problem that lies within the individual concerned. This not only suggests that distress can be 'corrected' through medical treatment, but also masks the factors that often underlie the root causes of suffering e.g. poor living conditions, unemployment. At the same time, policies in place to restrict welfare support, and popular media e.g. Benefits Street, draw on moralising narratives that promote the idea that people are responsible for their own actions and circumstances. This research aims to explore how these moralising narratives impact on the ways that people in low-income communities perceive and respond to mental distress caused by material deprivation and social disadvantage, and to examine the impacts of this on their wellbeing. This will be achieved through in-depth research in two low-income communities in the South West, which seeks to understand: i) the way that moral narratives are defined and used or resisted in people's everyday lives in relation to mental distress; ii) the influence of moral narratives on people's decisions to seek medical support for distress; iii) how moral narratives manifest within GP consultations and influence treatment decisions and patient wellbeing; and iv) which responses to mental distress have the potential to effectively support vulnerable populations, and to inform ethical debates on the medicalisation of distress in a way that benefits patients, and assists practitioners and policy makers seeking to support low-income communities.
This 30 month programme of research consists of two linked stages:
1) 96 people from 2 targeted low-income areas will participate in focus groups to explore how moral narratives are defined and used/resisted in people's daily lives. Groups will be divided by gender and age to identify any differences across groups. Information collected in Stage 1 will provide informed contextualisation for data collection and analysis in Stage 2.
2) Secondary analysis of 60 video-recorded consultations will enable insight into the contexts in which GPs and low-income patients discuss mental distress. In-depth analysis of 30 consultations will identify how GP-patient interaction influences decision-making to prescribe/accept or withhold/reject treatment. Further insights will be gained through interviews with 10 GPs in the study sites and repeat interviews with 40 people from low-income communities who have attended a GP consultation for mental distress. The first interview will focus on the person's experiences of distress and the role of moral narratives in i) their decision to seek medical consultation, and ii) their responses to the treatment or intervention prescribed/accepted or withheld/rejected. The second interview will enable participants to reflect on their experiences of mental distress within the wider context of daily pressures e.g. poor living conditions, their decision to seek medical support, and the outcome of the GP consultation.
The research programme is intended to have strong and distinctive impacts for user groups by informing policy and practice regarding the development of effective, meaningful and non-stigmatising responses to mental distress in low-income communities. This will be achieved by advancing understanding of i) people's use/resistance of moral narratives of responsibility (why? when? how? where? with who?); ii) the relationship between moral narratives and the medicalisation of distress; iii) the ethical implications of prescribing antidepressants for distress induced by poverty/deprivation; iv) identification of GP-patient interactions that enable positive wellbeing.
This 30 month programme of research consists of two linked stages:
1) 96 people from 2 targeted low-income areas will participate in focus groups to explore how moral narratives are defined and used/resisted in people's daily lives. Groups will be divided by gender and age to identify any differences across groups. Information collected in Stage 1 will provide informed contextualisation for data collection and analysis in Stage 2.
2) Secondary analysis of 60 video-recorded consultations will enable insight into the contexts in which GPs and low-income patients discuss mental distress. In-depth analysis of 30 consultations will identify how GP-patient interaction influences decision-making to prescribe/accept or withhold/reject treatment. Further insights will be gained through interviews with 10 GPs in the study sites and repeat interviews with 40 people from low-income communities who have attended a GP consultation for mental distress. The first interview will focus on the person's experiences of distress and the role of moral narratives in i) their decision to seek medical consultation, and ii) their responses to the treatment or intervention prescribed/accepted or withheld/rejected. The second interview will enable participants to reflect on their experiences of mental distress within the wider context of daily pressures e.g. poor living conditions, their decision to seek medical support, and the outcome of the GP consultation.
The research programme is intended to have strong and distinctive impacts for user groups by informing policy and practice regarding the development of effective, meaningful and non-stigmatising responses to mental distress in low-income communities. This will be achieved by advancing understanding of i) people's use/resistance of moral narratives of responsibility (why? when? how? where? with who?); ii) the relationship between moral narratives and the medicalisation of distress; iii) the ethical implications of prescribing antidepressants for distress induced by poverty/deprivation; iv) identification of GP-patient interactions that enable positive wellbeing.
Planned Impact
The project is designed to include key stakeholder's perspectives from the outset and to maximize opportunities for co-production of impact and knowledge exchange through engagement with low-income communities, healthcare professionals, policy makers and civil society organisations (see also Pathways to Impact):
Low-income communities: incorporating patient's perspectives to improve healthcare provision is a core priority of the UK government. Involvement of low-income residents on the project Advisory Board will ensure engagement and impact with low-income communities from the outset. An Introductory workshop in the study sites will enable local communities to negotiate ways of working and participating in the research that will increase the applicability and utility of the study. A Knowledge Co-Production workshop in each site once data is collected will enable communities to discuss findings and i) agree methods of dissemination to other low-income communities e.g. via national C2 network, ii) agree key findings and priorities to inform guidelines on good practice for health practitioners, iii) guide the focus and aims of, and share experiences and ideas at, a high-impact two-day Research-Policy Briefing Seminar in London alongside presentations by experts in the fields of social inequalities, mental health, and community wellbeing e.g. What Works Centre for Wellbeing, Joseph Rowntree Foundation, McPin Foundation.
Health professionals: identification of GP practice (relating to mental distress) that enhances patient wellbeing will be developed into guidelines on good practice for health professionals working in low-income communities. Health professionals will draw on their experiences to refine the guidelines at a Regional Practitioner workshop, and agree a dissemination strategy that maximizes their utility for the health sector. Participation in the workshop by local authorities charged with health provision e.g. Teignbridge DC & Plymouth CC, will ensure findings feed in to local health plans e.g. Devon Joint Health and Wellbeing Strategy. Networks developed during the project will lead to oral presentations at practitioner-focused events and regional clinical commissioning groups. Impact will be evidenced through changes to working practice amongst GPs that enhance wellbeing in low-income communities.
Civil society groups: valuable relationships will be built through networks of the project Advisory Board (AB) whose members represent key user groups and stakeholders (see Pathways to Impact for confirmed membership). AB members will provide ongoing feedback on the research to their organisations/communities, and develop networking opportunities with other potential user groups e.g. Mental Health Foundation, Young Foundation, Turning Point. User groups will be encouraged to contribute discussion and case studies to the project website, and will promote the research and its findings on their websites. Involvement in the Research-Policy Briefing Seminar will enable academic and user group networking and collaboration, and identify how research findings can be practically and effectively implemented to support low-income communities.
Policy: Joining up understandings of mental distress with the broader social and structural context in which they are experienced will provide key policy makers (with whom links will be fostered via the AB) e.g. Dept. of Health, Dept. for Communities & Local Government, Dept. for Work & Pensions, as well as the cross sector Mental Health Taskforce and public bodies e.g. Social Mobility & Child Poverty Commission, Fairness Commissions, with an evidence base to inform implementation of key strategies e.g. No Health Without Mental Health Implementation Framework (Centre for Mental Health et al. 2012). Internationally, findings will inform the WHO Europe Health 2020 policy to reduce health inequalities via Thomas's (PI) work with WHO on cultural determinants of health (see Pathways to Impact).
Low-income communities: incorporating patient's perspectives to improve healthcare provision is a core priority of the UK government. Involvement of low-income residents on the project Advisory Board will ensure engagement and impact with low-income communities from the outset. An Introductory workshop in the study sites will enable local communities to negotiate ways of working and participating in the research that will increase the applicability and utility of the study. A Knowledge Co-Production workshop in each site once data is collected will enable communities to discuss findings and i) agree methods of dissemination to other low-income communities e.g. via national C2 network, ii) agree key findings and priorities to inform guidelines on good practice for health practitioners, iii) guide the focus and aims of, and share experiences and ideas at, a high-impact two-day Research-Policy Briefing Seminar in London alongside presentations by experts in the fields of social inequalities, mental health, and community wellbeing e.g. What Works Centre for Wellbeing, Joseph Rowntree Foundation, McPin Foundation.
Health professionals: identification of GP practice (relating to mental distress) that enhances patient wellbeing will be developed into guidelines on good practice for health professionals working in low-income communities. Health professionals will draw on their experiences to refine the guidelines at a Regional Practitioner workshop, and agree a dissemination strategy that maximizes their utility for the health sector. Participation in the workshop by local authorities charged with health provision e.g. Teignbridge DC & Plymouth CC, will ensure findings feed in to local health plans e.g. Devon Joint Health and Wellbeing Strategy. Networks developed during the project will lead to oral presentations at practitioner-focused events and regional clinical commissioning groups. Impact will be evidenced through changes to working practice amongst GPs that enhance wellbeing in low-income communities.
Civil society groups: valuable relationships will be built through networks of the project Advisory Board (AB) whose members represent key user groups and stakeholders (see Pathways to Impact for confirmed membership). AB members will provide ongoing feedback on the research to their organisations/communities, and develop networking opportunities with other potential user groups e.g. Mental Health Foundation, Young Foundation, Turning Point. User groups will be encouraged to contribute discussion and case studies to the project website, and will promote the research and its findings on their websites. Involvement in the Research-Policy Briefing Seminar will enable academic and user group networking and collaboration, and identify how research findings can be practically and effectively implemented to support low-income communities.
Policy: Joining up understandings of mental distress with the broader social and structural context in which they are experienced will provide key policy makers (with whom links will be fostered via the AB) e.g. Dept. of Health, Dept. for Communities & Local Government, Dept. for Work & Pensions, as well as the cross sector Mental Health Taskforce and public bodies e.g. Social Mobility & Child Poverty Commission, Fairness Commissions, with an evidence base to inform implementation of key strategies e.g. No Health Without Mental Health Implementation Framework (Centre for Mental Health et al. 2012). Internationally, findings will inform the WHO Europe Health 2020 policy to reduce health inequalities via Thomas's (PI) work with WHO on cultural determinants of health (see Pathways to Impact).
Publications
Thomas F
(2018)
Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform
in Palgrave Communications
Thomas, F
(2019)
Practical Justice: Principles, Practice and Social Change
Hansford L
(2019)
The impact of the Work Capability Assessment on mental health: claimants' lived experiences and GP perspectives in low-income communities
in Journal of Poverty and Social Justice
Byng R
(2019)
From mental disorder to shared understanding: a non-categorical approach to support individuals with distress in primary care
in British Journal of General Practice
Thomas F
(2020)
How accessible and acceptable are current GP referral mechanisms for IAPT for low-income patients? Lay and primary care perspectives.
in Journal of mental health (Abingdon, England)
Thomas F
(2020)
The violence of narrative: embodying responsibility for poverty-related stress.
in Sociology of health & illness
Ford J
(2020)
Use of the Patient Health Questionnaire (PHQ-9) in Practice: Interactions between patients and physicians.
in Qualitative health research
Thomas, F.
(2020)
The violence of narrative: embodying responsibility for poverty-related distress
in Sociology of Health and Illness
McCabe R
(2021)
When patients and clinician (dis)agree about the nature of the problem: The role of displays of shared understanding in acceptance of treatment.
in Social science & medicine (1982)
O'Keeffe S
(2021)
Experiences of care for self-harm in the emergency department: comparison of the perspectives of patients, carers and practitioners
in BJPsych Open
Thomas F
(2021)
An engaged approach to exploring issues around poverty and mental health: A reflective evaluation of the research process from researchers and community partners involved in the DeStress study.
in Health expectations : an international journal of public participation in health care and health policy
Ford J
(2021)
Asking about self-harm and suicide in primary care: Moral and practical dimensions
in Patient Education and Counseling
| Title | Article on BBC Radio 4 PM |
| Description | A ten minute radio piece focusing on the findings of the DeStress project. This involved project researchers and participants working with a BBC reporter to develop the article. |
| Type Of Art | Film/Video/Animation |
| Year Produced | 2019 |
| Impact | Radio broadcast at primetime news slot (Monday evening Radio 4 PM programme) which has a weekly audience of 6 million. This led to requests for interviews and information from other media outlets and mental health organisations including the Centre for Mental Health and Mad in America. The broadcast also generated positive responses from members of the public who wrote to confirm their experiences relating to the project's core findings. |
| URL | http://destressproject.org.uk |
| Title | Community co-created film |
| Description | A film about lay experiences of distress directed and produced by community members in the study sites |
| Type Of Art | Film/Video/Animation |
| Year Produced | 2017 |
| Impact | The film highlighted mental stress experienced in the study sites and helped community members openly discuss having issues of stress and anxiety. This linked more people in to local peer support groups and also led to a further community member being recruited onto the project Advisory Board. This film has been used at a Advisory Board meeting where it generated considerable discussion amongst members from third sector, commissioning and practitioner backgrounds around biomedical and social models of mental health. It will also be used as the basis for health practitioner training on experience of distress within low-income communities. |
| URL | https://youtu.be/o30xL7HrK8g |
| Title | GP training film clips |
| Description | A series of film clips on the experiences of low-income patients attending GP consultations for mental health issues |
| Type Of Art | Film/Video/Animation |
| Year Produced | 2018 |
| Impact | The film clips were developed by community members on the project advisory board. They have been used as training materials at two workshops for health professionals (one group of medical students, one group of established GPs and health professionals); at a conference workshop for health professionals; and at the project conference in London. Feedback from, and evaluations of, these events have identified the film clips as having powerful impacts on the ways that health professionals understand the experiences of low-income patients. Health professionals have stated in evaluations that this will influence their clinical practice, in particular, through making them less judgemental and more understanding of the anxieties people may have attending a consultation for mental health, and in thinking through how best to provide more personalised and potentially non-medical forms of support. The film clips will also be used as part of the GP training we will be developing with the Royal College of GPs over the coming year. |
| Description | The role of narratives of responsibility in the medicalization of distress: Three types of narrative were identified as impacting on mental health and wellbeing in low-income communities: a 'neoliberal narrative', which leads to feelings of guilt and helplessness; a 'shame narrative', which leads to fear of judgement and avoidance of help seeking; and a 'medicalization narrative', where distress is considered a pathological issue requiring medical intervention. These narratives were pervasive in people's everyday lives, impacting adversely on behaviour and identity, and reducing people's trust and willingness to seek support. These narratives and the current system of welfare rules feed into a paradoxical situation where people feel blamed and unable to seek care, yet where drivers exist to push people into care that is inappropriate and often disempowering, and where GPs feel they have few options available to them that do not exacerbate the over-medicalisation of poverty-related stress. How welfare reforms and austerity impact on mental health: The complexity of welfare reform was widely reported as a key source of stress. To avoid the shame and stigma of poverty, people feel pressure to 'legitimise' poverty-related distress to their families, friends and key services e.g. job centres. The medicalization of distress is greatly exacerbated by the need to medically legitimise welfare claims, encouraging people to seek medical help, and invest in narratives around the 'normalcy' and 'need' to see and act on themselves as in need of treatment. People felt a need to be seen as 'taking control' of their lives - either through avoiding support services, or through adhering to expert advice - or risk being seen as irresponsible and undeserving. How mental health treatments are used in low-income communities: People face difficulties accessing mental health support, and when they do, it is often inappropriate to their needs. Use of Conversational Analysis alongside narrative methods identified widespread dissatisfaction with the medical model for mental health amongst GPs and low-income patients. GPs face considerable pressures (reiterated through medical education and NICE guidelines) to 'fix' patients through mental health diagnosis and treatment. Antidepressants have low effect rates and can be harmful, yet are commonly used long-term in low-income communities. IAPT (talking therapy) is rarely considered helpful by people experiencing poverty-related distress and self-referral is a significant barrier to uptake. Lack of GP endorsement for antidepressants and IAPT is common, and has negative implications for patient wellbeing and for GP stress and burnout. How can people experiencing poverty-related distress be better supported? GPs need to be better supported to adopt a role that recognises the bio-psycho-social and is aware of non-medical forms of support. Responsibility for poverty-related distress needs diluting away from GPs to other sectors, as well as to communities themselves. Recognition of a 'third way' between blaming neoliberalism and absolving people from all responsibility for their lives is required. Whilst not condoning the current situation of poverty and austerity in any way, there is a need to recognise that people can overcome adversity through action that does not resort to unnecessary over-medicalisation. |
| Exploitation Route | We have worked with Health Education England and the Royal College of GPs to refine and accredit the GP training materials. They are now being used as training for GPs working with low-income patients across the UK. The training materials may also be used in postgraduate and undergraduate medical education. Research findings also have the potential to inform mental health commissioning relating to the provision of more personalised IAPT (talking therapies). Key findings on dissatisfaction with, and low endorsement of, existing mental health treatments may be used to inform new styles of primary care consultation that focus on a more holistic and supportive bio-psycho-social approach, reduce over-medicalisation, and work more effectively with community-based assets. The project has demonstrated the value of combining narrative and conversational analysis to elicit in-depth understanding of the ways that social interactions impact on lived experience of mental wellbeing. Key areas that might be taken forward within academic research relate to missed opportunities for action within GP consultations, and in-depth understanding on how treatments are prescribed and taken up. Findings also demonstrate the value of co-creating research with communities and project stakeholders, and may help inform researchers keen to undertake engaged research. |
| Sectors | Communities and Social Services/Policy,Education,Healthcare,Government, Democracy and Justice |
| URL | http://destressproject.org.uk |
| Description | The research process and findings from the DeStress (Poverty, Pathology and Pills) project have been used and achieved impact beyond academia through: Sustained engagement with project stakeholders has maximised opportunities for co-production of impact and knowledge exchange across low-income communities, healthcare professionals, policy makers and civil society organisations. Participation on the project Advisory Board enabled a wide collaborative network to develop across the fields of health equity and community wellbeing, mental health support, policy and applied healthcare. Requests to attend project Advisory Board meetings were made by representatives from Public Health England and mental health commissioning, as well as from former lead on health inequalities at the Department of Health. Networking has also been supported through the project website http://destressproject.org.uk, which has promoted project information, events, blogs, podcasts and resident-led film to over 4000 individual users, and via social media, with over 220 twitter followers. The project has also had significant media attention (e.g. via a featured piece on Radio 4 PM and You and Yours; podcast on Mad in America) ensuring wide public reach. The involvement of low-income residents (experts by experience) on the Advisory Board has been crucial in guiding the project to understand and address the concerns of this population group, and in enabling the engagement of other low-income communities in England. This has involved a series of resident-initiated community exchange visits in which experiences of supporting mental wellbeing have been shared; resident involvement in the C2 Connecting Communities national learning event; involvement of residents from other low-income communities in the UK as speakers at the DeStress project conference; joint publications; resident involvement in other research projects. The project has also had impact for mental health policy. Presentations on findings made to health care commissioners have influenced discussions on IAPT provisioning in the south-west, with initial steps now being made towards more personalised support for people experiencing poverty-related distress. Findings have also fed into discussions on the need for better provisioning for community mental health teams in the most deprived areas of Plymouth. Earlier findings from the project have also been used to feed into the redesign of early help support for families facing statutory intervention in Plymouth, with Plymouth City Council now committed to involving vulnerable families in the co-creation and commissioning of services. Findings from the project have been used to develop training materials for primary health care professionals working with people experiencing poverty-related distress. These materials include film clips developed by residents involved in the study. The materials were presented at two Regional Health Practitioner workshops, one targeted at medical trainees, one at established health professionals. They were also presented to health professionals and policy makers at the DeStress conference. Feedback has been extremely positive, with health professionals identifying a number of areas in which they have acquired new knowledge that they feel will lead to a change in clinical practice e.g. being less judgemental of low-income patients; questioning diagnosis and prescribing for poverty-related distress; seeking non-medical forms of support personalised towards patients. With support from Health Education England we have refined and received RCGP accreditation for our online training materials, ensuring that they are available and promoted to GPs across the UK. RCGP have also produced a '5 minutes to change your practice' podcast based on our project findings. Monthly download and completion rates for this training are significantly above average and are nationwide. NIHR funding (£298,012) has now been secured to roll-out this training nationally. Training is being undertaken by teams comprising GPs and low-income community partners. Impact has also been achieved via the project's two-day research-policy conference held at the Wellcome Collection, London in January 2019. This event attracted considerable interest, with over 120 people signing up (plus waiting list), and 94 attendees. Attendees comprised policy makers, health professionals, civil society and academics. Speakers included Helen Stokes-Lampard (Chair, RCGP), Paul Farmer (CEO, Mind), Gregor Henderson (Mental Health Lead, Public Health England) and Kate Cornford (Mental Health Policy Lead, OECD). Feedback on the event has been extremely positive, with formal requests for more information on the project from Public Health England, OECD and the McPin Foundation. Evaluations of the event also identified a range of ways that the project findings and conference discussion had influenced thinking and practice. In particular, areas that influenced thinking and practice related to the project's approach to community engagement and co-creation; the use of antidepressants for poverty related distress; and the ways that health professionals could revise clinical practice to provide more supportive and personalised care to patients in a way that did not over-medicalise poverty-related distress. Presentations from the event are available on the project website in slide and film format, ensuring that the event will have impact beyond the lifespan of the project funding. |
| First Year Of Impact | 2018 |
| Sector | Communities and Social Services/Policy,Education,Healthcare,Government, Democracy and Justice |
| Impact Types | Cultural,Societal,Economic,Policy & public services |
| Description | Contributing to re-design of mental health services in Plymouth |
| Geographic Reach | Local/Municipal/Regional |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Description | GP workshop |
| Geographic Reach | Local/Municipal/Regional |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | Workshop at East London NHS Foundation Trust (City & Hackney) to discuss DeStress paper 'Ford, J., Thomas, F., Byng, R. and McCabe, R., 2020. Asking about self-harm and suicide in primary care: Moral and practical dimensions. Patient education and counseling'. Attendees - 19 doctors, 2GP trainees, 12 trainee psychiatrists, 5 consultant psychiatrists. Helped inform health professionals on asking about self harm and suicide and provided an opportunity for peer discussion and support. |
| Description | Informing working practice of Mind |
| Geographic Reach | Local/Municipal/Regional |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | The findings of the DeStress project have led Plymouth and District Mind to support their clients to 'Find the Words' they need to speak with their GP about their mental health. This is supported by a printed resource that they can take with them to their GP. Current feedback to Mind has shown that this resource is helpful in ensuring that the consultation meets the needs of the patient. Plymouth and District Mind also delivers services from GP surgeries in some of the most deprived areas of Plymouth, where they report that they have been able to embed learning from the project into practice. |
| Description | RCGP accreditation of DeStress training resources |
| Geographic Reach | National |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | The training materials we have developed have been accredited by the RCGP and are available for use by GPs across the UK. RCGP also released a 5 minutes to change your practice screencast based on our findings. |
| Description | RCGP developed learning materials for GPs based on project findings. |
| Geographic Reach | National |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | We worked with RCGP to develop an e-learning tool advising GPs on how to better support mental health in low-income communities. The tool has been positively received by RCGP and has been regularly downloaded by GPs across the UK. RCGP data show that the screencast has had significantly higher levels of download and completion than their average figures. We have received a number of emails from GPs who have commented positively on this and the wider project materials. |
| URL | https://elearning.rcgp.org.uk |
| Description | Training primary health care teams |
| Geographic Reach | National |
| Policy Influence Type | Contribution to new or improved professional practice |
| Impact | GPs receiving our DeStress training were asked to consider amending their consultation practice to take on board key messages from our training. We then sought patient feedback where GPs had done this. We have received 76 patient responses from across three regions of England (SW, North West Coast, North Thames), all of which are positive about the consultation they received. |
| Description | Workshop training GPs |
| Geographic Reach | National |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | The training materials were developed in consultation with low income patients to improve the mental health and wellbeing support for this patient group through providing more personalised bio-psycho-social approaches within primary care consultations. GPs who have received the training have already reported changes in their own practice. |
| Description | Write-up of project findings in Pulse magazine |
| Geographic Reach | Multiple continents/international |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | A paper we published in the Journal of Mental Health was picked up by a journalist from Pulse magazine - one of the main magazines targeted at GPs in the UK and further afield - who then published the findings in Pulse. This led to a number of GPs contacting the project team to request further information, and to share their thoughts on them. |
| URL | http://www.pulsetoday.co.uk |
| Description | Written submission for the Visit by the United Nations Special Rapporteur on extreme poverty and human rights to the United Kingdom |
| Geographic Reach | National |
| Policy Influence Type | Contribution to a national consultation/review |
| Description | A development and feasibility study for an RCT of nature-based social prescribing for mental health |
| Amount | £70,000 (GBP) |
| Funding ID | NIHR203452 |
| Organisation | National Institute for Health Research |
| Sector | Public |
| Country | United Kingdom |
| Start | 06/2022 |
| End | 05/2023 |
| Description | DeStress-2 training development |
| Amount | £12,000 (GBP) |
| Organisation | Health Education England |
| Sector | Public |
| Country | United Kingdom |
| Start | 01/2022 |
| End | 09/2023 |
| Description | Developing and Evaluating a Stepped Change Whole-University approach for Student Wellbeing and Mental Health |
| Amount | £3,819,281 (GBP) |
| Funding ID | MR/W002442/1 |
| Organisation | Medical Research Council (MRC) |
| Sector | Public |
| Country | United Kingdom |
| Start | 09/2021 |
| End | 08/2025 |
| Description | Devon Community Assets Research Collaborative - developing, understanding and linking within integrated care systems |
| Amount | £196,625 (GBP) |
| Funding ID | AH/X006085/1 |
| Organisation | Arts & Humanities Research Council (AHRC) |
| Sector | Public |
| Country | United Kingdom |
| Start | 11/2022 |
| End | 08/2023 |
| Description | ESRC IAA Co-creating early support for families with complex needs |
| Amount | £15,535 (GBP) |
| Organisation | ESRC Impact Acceleration Account Cambridge |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 04/2018 |
| End | 03/2019 |
| Description | Engaged Research Exploratory Award |
| Amount | £2,910 (GBP) |
| Organisation | University of Exeter |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 01/2019 |
| End | 06/2019 |
| Description | Engaged Research Exploratory Award |
| Amount | £2,930 (GBP) |
| Organisation | University of Exeter |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 01/2018 |
| End | 07/2018 |
| Description | Engaged Research Exploratory Award |
| Amount | £4,385 (GBP) |
| Organisation | University of Exeter |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 05/2017 |
| End | 07/2017 |
| Description | GCRF Facilitation Fund |
| Amount | £22,891 (GBP) |
| Organisation | United Kingdom Research and Innovation |
| Department | Global Challenges Research Fund |
| Sector | Public |
| Country | United Kingdom |
| Start | 12/2018 |
| End | 07/2019 |
| Description | Health Education England |
| Amount | £10,495 (GBP) |
| Organisation | Health Education England |
| Sector | Public |
| Country | United Kingdom |
| Start | 04/2018 |
| End | 12/2020 |
| Description | MRC TRACES FUND |
| Amount | £24,955 (GBP) |
| Organisation | Medical Research Council (MRC) |
| Sector | Public |
| Country | United Kingdom |
| Start | 02/2018 |
| End | 02/2019 |
| Description | The Role of Staff and Team Communication in Reducing Seclusion, Restraint and Forced Tranquilisation in Acute Inpatient Mental Health Settings |
| Amount | £241,868 (GBP) |
| Funding ID | NIHR201508 |
| Organisation | National Institute for Health Research |
| Sector | Public |
| Country | United Kingdom |
| Start | 10/2021 |
| End | 09/2024 |
| Description | The role of research and reflection in third sector responses to complex and fast-changing contexts: Using action learning methodologies to examine responses to supporting people with complex needs during Covid-19 and implications for future practice |
| Amount | £23,143 (GBP) |
| Funding ID | 221495/Z/20/Z |
| Organisation | Wellcome Trust |
| Sector | Charity/Non Profit |
| Country | United Kingdom |
| Start | 10/2020 |
| End | 04/2021 |
| Title | DeStress database |
| Description | This dataset comprises transcripts from 16 focus groups (participation n=97); 80 semi-structured interviews with patients; 10 semi structured interviews with GPs. The database is currently being formatted for submission to UKDS by end of April 2019. |
| Type Of Material | Database/Collection of data |
| Year Produced | 2019 |
| Provided To Others? | No |
| Impact | Use of database to analyse project findings for presentations and papers. |
| Description | Collaboration with National Institute for Mental Health, Czech Republic |
| Organisation | The National Institute of Mental Health |
| Country | Czech Republic |
| Sector | Charity/Non Profit |
| PI Contribution | The methodology and narrative approach used in Destress has been of interest to partners at NIHM and WHO Europe who are looking to understand how cultural factors influence mental health and mental health reform. |
| Collaborator Contribution | NIMH worked with the DeStress PI and WHO Europe to run a collaborate workshop on the cultural aspects of mental health reform in Central and Eastern Europe. |
| Impact | A two day workshop on the cultural aspects of mental health reform in Central and Eastern Europe was held by the collaborators in Klecany, Czech Republic. This was a multi-disciplinaly collaboration involving: psychiatrists; psychologists; social scientists; historians; economists and focused on the value of using narrative, participatory and qualitative approaches to understanding lived experiences of mental health and mental health related policy making. The discussions from the workshop have been published as a WHO report (2018) in English and Russian. As a result of this work, the PI is also working with workshop participants from Belarus and Ukraine to develop further work on using narrative approaches to understand lived experience. |
| Start Year | 2017 |
| Description | Health Education England training |
| Organisation | Health Education England |
| Department | Health Education England Thames Valley |
| Country | United Kingdom |
| Sector | Public |
| PI Contribution | We have been funded by Health Education England to produce training materials for GPs. This has included the delivery of two workshops for GPs and health professionals across the south west. |
| Collaborator Contribution | Health Education England have funded the development of training materials. They also funded a ST3 medical student to work with us to develop these materials for half a day a week for a year. |
| Impact | Training workshop for approximately 25 medical students from in and around Plymouth. Training workshop for approximately 30 GPs and health professionals from across the South West. Both workshops were run jointly by the research team and community members and both included film clips made by community members on our project advisory board. Both workshops received excellent feedback and have led to discussion on incorporating the materials into the medical curriculum. We are also working with the Royal College of GPs to accredit the training materials. The collaboration is multidisciplinary, involving the following disciples/sub disciplines: medicine; psychology; anthropology; youth and community work; public health and also involves members of the public co-creating training materials. |
| Start Year | 2018 |
| Description | Implementing effective primary care responses to poverty-related mental distress (DeStress-2) |
| Organisation | Health Education England |
| Department | Health Education South West |
| Country | United Kingdom |
| Sector | Public |
| PI Contribution | Collaboration around delivery of training to GPs across the SW |
| Collaborator Contribution | Assisting with GP trainer recruitment |
| Impact | Funding from NIHR Health Inequalities Consortium; Training of 21 GPs and 17 community partners to deliver training to GP practices in three areas of the UK on adapting consultations for patients experiencing poverty-related mental distress. |
| Start Year | 2021 |
| Description | Plymouth City Council |
| Organisation | Plymouth City Council |
| Country | United Kingdom |
| Sector | Charity/Non Profit |
| PI Contribution | Developed and ran a co-created project on providing support for families at risk of having their children taken into care. |
| Collaborator Contribution | Developed and ran a co-created project on providing support for families at risk of having their children taken into care. |
| Impact | Development of new training for service providers working with families at risk of having children taken into care. Development of a short animation made by parents who have received early help and now being used as a national raining tool by Barnardos. A forum event bringing together approx 80 service providers from across Plymouth and nearby regions to discuss co-creation of research and work with families. |
| Start Year | 2018 |
| Description | Supporting families in Plymouth |
| Organisation | Barnardo's |
| Country | United Kingdom |
| Sector | Charity/Non Profit |
| PI Contribution | Developed and ran a co-created project supporting families at risk of having children taken into care. |
| Collaborator Contribution | Developed and ran a co-created project supporting families at risk of having children taken into care. |
| Impact | New training for service providers assessing families at risk of having children taken into care. A short animated film made by parents at risk of having their children taken into care, and now being used as a national training tool by Barnardo's A forum event for approx 80 service providers (and families) to explore how to co-create work with families in and around Plymouth. |
| Start Year | 2018 |
| Description | 3rd Resistance Day at Loughborough University |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Professional Practitioners |
| Results and Impact | Resistance Day is a biannual, one-day meeting which focuses on the theme of interactional resistance. A data extract from the DeStress Project on this theme was presented at the 3rd of these meetings, with attendees (comprising academics who specialise in conversation analysis and related methodologies) invited to comment on how the interaction played out. Outcomes included additional insights into existing analytic points, as well as suggestions of new analytic points that could be pursued. |
| Year(s) Of Engagement Activity | 2018 |
| Description | BBC online article on the project |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Media (as a channel to the public) |
| Results and Impact | An online article on the BBC Health website about the focus and findings of the DeStress project. This was linked to a Radio broadcast on Radio 4's PM programme and led to requests to participate in other media opportunities. |
| Year(s) Of Engagement Activity | 2019 |
| URL | https://www.bbc.co.uk/news/health-48258907 |
| Description | C2 learning event |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Public/other audiences |
| Results and Impact | Involvement in a C2 Connecting Communities event with low-income residents from across the UK. This helped to raise awareness of the Destress project, providing opportunities for low-income residents to share experiences of poverty-related distress and responses to this, and to attract community 'experts by experience' to speak at the DeStress project conference. |
| Year(s) Of Engagement Activity | 2018 |
| Description | Co-production of newsletter with study site communities |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Public/other audiences |
| Results and Impact | Co-development and production of community newsletters (x2) with residents in the project study sites. The second newsletter focuses on peer support, with residents identifying organisations in their locality that provide support for poverty-related distress. This information has been requested by health professionals working in Plymouth so that they can refer patients to community based support. |
| Year(s) Of Engagement Activity | 2017,2018 |
| URL | http://destressproject.org.uk/newsletter/ |
| Description | Collaborative workshops with low-income families and service providers to influence the formation of Plymouth's Chlid Poverty Strategy |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Public/other audiences |
| Results and Impact | Building on relationships developed with local parents through the DeStress project and with the Children's Centre (run by Barnardo's) we ran a series of workshops bringing together low income parents, local service providers and Plymouth city council policy makers and commissioners to discuss the implementation of the city-wide Child Poverty Action Plan. As a result parents views and opinions were taking into account and the plan was reviewed, and PCC are committed to ensuring parents' voices are heard in future service plan developments. Also as a direct result of feedback from parents in the workshops Barnardo's have introduced two new parent drop-in sessions in two local areas to increase accessibility to their support services (Coffee and Craft session at Four Woods Children's Centre and Community Café at The Barn). |
| Year(s) Of Engagement Activity | 2017 |
| Description | Community exchange visit |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Study participants or study members |
| Results and Impact | Following the initial 2 meetings of the DeStress Advisory board, community members from the two study sites community members expressed a wish to get to know each other and to learn and exchange ideas around peer support groups. Three community members of the Advisory group from Plymouth and a Housing Officer from DCH, travelled to Teignmouth in September 2017 to meet various groups at the local Teignmouth hub - the Pow Wow café, (approximately 25 people in total). The Teignmouth community hosted this visit to meet key community leaders and the members of 2 peer support groups, Crafters of the Round Table (operating from the café, they have created an informal drop in that anyone can join that is a very popular peer support group for mental health). They also met with the Advisory members from Teignmouth - the Helping Hand Low Moods group to hear from the wider members how they started the group and their ingredients for success. The outcome of the day was that the Low Moods Group offered to come to Plymouth and to support the community in setting up their on version of a community support group, sharing all the experiences gained on their journey (detailed further in DeStress community newsletter). This follow up support happened in November with six members of the Helping Hands groups offering support and mentorship to the gathering of eight people who had self selected to try and create their own support group |
| Year(s) Of Engagement Activity | 2017 |
| Description | Creation of community networks |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Study participants or study members |
| Results and Impact | The DeStress project team was introduced the Creative Minds Art Group in Plymouth via an Advisory Group member. In collecting stories for the newsletter to highlight effective peer support groups in the local areas the project attended the group to introduce the project and to ask if they would like to talk about their group for an article. The group agreed and in meeting them and understanding their plans to reach a wider audience, have connected them to Townstal Community Partnership group to share funding ideas for their group that could reach out to, and support more people with mental health issues. |
| Year(s) Of Engagement Activity | 2017 |
| Description | DeStress Project Twitter account |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | The Twitter account was set up to disseminate materials both from and relevant to the DeStress Project and its aims, and to network with other individuals working in related areas. It currently has 226 followers. It was of particular use during the January 2019 DeStress Conference, where it was used to live tweet presentations and discussions. These tweets received a lot of engagement (likes and retweets) from both conference attendees and individuals following the conference on Twitter. Attendees also sent praise, both for the conference and the project as a whole, to the account. |
| Year(s) Of Engagement Activity | 2017,2018,2019 |
| URL | http://twitter.com/destressexeter |
| Description | Dean's Lecture |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Professional Practitioners |
| Results and Impact | More than 100 people attended a public lecture "Words are the Most Powerful Drugs" at City, University of London. |
| Year(s) Of Engagement Activity | 2019 |
| URL | https://www.city.ac.uk/news/2019/october/words-most-powerful-drug |
| Description | Developing an ideal primary care mental health system for areas of deprivation |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | A workshop on 'Developing an ideal primary care mental health system for areas of deprivation' at the Universal Health for All conference, held in Malta, Dec. 2018. The workshop was run by project Co-I, Richard Byng (a GP) in collaboration with one of the residents who sits on the project advisory board. It sparked questions and discussion and the audience reported that they would consider changes in working practice with patients from low-income communities experiencing mental health related issues. |
| Year(s) Of Engagement Activity | 2018 |
| URL | https://uhmhcongress2018.net/assets/files/CongressBook.pdf |
| Description | Discourse Bee seminars at University of Exeter Medical School |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Postgraduate students |
| Results and Impact | Discourse Bee is a series of fortnightly meetings focusing on the analysis of interactional data. Data extracts from the DeStress Project were presented at two of these meetings, with attendees invited to comment on how the interaction played out. Outcomes included additional insights into existing analytic points, as well as suggestions for new analytic points that could be pursued. |
| Year(s) Of Engagement Activity | 2018 |
| Description | Discourse and Rhetoric Group Meeting at Loughborough University |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Postgraduate students |
| Results and Impact | The aim of this meeting was to present data from the project for a group of academics who specialise in conversation analysis and related methodologies. Outcomes included additional insights into existing analytic points, as well as the suggestion of new analytic points that could be pursued. |
| Year(s) Of Engagement Activity | 2018 |
| URL | http://www.lboro.ac.uk/departments/socialsciences/research/darg/ |
| Description | Discourse and Rhetoric Group meeting at Loughborough University |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Other audiences |
| Results and Impact | The aim of this meeting was to present data from the project for a group of academics who specialise in conversation analysis and related methodologies. Outcomes included additional insights into existing analytic points, as well as the suggestion of new analytic points that could be pursued. |
| Year(s) Of Engagement Activity | 2017 |
| URL | http://www.lboro.ac.uk/departments/socialsciences/research/darg/ |
| Description | Exeter Collaboration for Academic Primary Care (APEx) seminar |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | This was a presentation given as part of the Exeter Collaboration for Academic Primary Care (APEx) seminar series. The goals were to explain the research, solicit feedback on data, and to recruit interview participants. |
| Year(s) Of Engagement Activity | 2017 |
| URL | http://medicine.exeter.ac.uk/media/universityofexeter/medicalschool/research/healthservicesresearch/... |
| Description | Facilitating a peer support group for low-income patients experiencing mental distress |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Patients, carers and/or patient groups |
| Results and Impact | We have facilitated the set-up of an online peer support group for the community partners involved in DeStress-II. This meets twice a week and provide a forum for discussion and support for community partners across three regions of England. |
| Year(s) Of Engagement Activity | 2022,2023 |
| Description | GP academic workshop |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | East London NHS Foundation Trust local academic workshop attended by 19 doctors, 2 GP trainees, 5 consultant psychiatrists, 12 trainee psychiatrists. The workshop involved discussing 'Ford, J., Thomas, F., Byng, R. and McCabe, R., 2020. Asking about self-harm and suicide in primary care: Moral and practical dimensions. Patient education and counseling' to initiate discussion and peer learning around asking about self harm and suicide within clinical practice. |
| Year(s) Of Engagement Activity | 2020 |
| Description | GP training workshops |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Professional Practitioners |
| Results and Impact | We ran two workshops for GPs and health professionals from across the South West. One workshop was targeted at GP trainees; one workshop was targeted at more established health professionals. The workshops focused on how GPs and health professionals can more effectively respond to patients from low-income backgrounds experiencing poverty related distress and were co-delivered by the research team and residents from low-income backgrounds who are involved in the project advisory board. The workshops also provided an opportunity to trial our training materials and receive feedback on how we can most effectively disseminate these materials to GPs and health professionals across the UK. Evaluations from the workshops were extremely positive, with health professionals reporting that they would implement the learning from the workshop into their clinical practice. The main areas where the workshop added to knowledge related to ways that health professionals could better communicate and inter-relate with patients; give patients hope; work with patients in a non-judgemental way; the challenges facing patients self-referring to talking therapy; how GPs could respond to poverty-related distress with over-medicalising; and better understanding of the low efficiency of antidepressant medications. The main ways that health professionals reported that they would change their practice was to prescribe fewer antidepressants; to support rather than seek to 'fix' patients with drugs; to elicit hope in their patients; to not make assumptions about their patients; to consider non-medical treatments for poverty-related distress. Health professionals were also keen to receive information put together by residents on our Advisory Board on the availability of local support organisations. GPs reported that they planned to use this information to refer patients to appropriate support. |
| Year(s) Of Engagement Activity | 2018 |
| URL | http://destressproject.org.uk/upcoming-events/ |
| Description | Information Stall at Exeter's Respect Festival |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Public/other audiences |
| Results and Impact | We held an information stall at Exeter's Respect Festival, which is attended by around 20,000 local people, to raise awareness of relevant research - both opportunities to participate and findings. Many people stopped to engage in conversation and many were interested in mental health and the findings of the DeStress project. We were also able to talk with represenatitves from third sector organisations dealing with poverty and mental health. |
| Year(s) Of Engagement Activity | 2019 |
| URL | https://exeter-respect.org/ |
| Description | Interview and 10 minute focused programme piece during national news |
| Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Media (as a channel to the public) |
| Results and Impact | The research team and our community collaborators developed a 10 minute broadcast on the DeStress project with a reporter from Radio 4's PM programme. This included political commentary on the project findings from Sarah Wollaston MP, as well as an official government statement on the findings. This programme has a weekly audience of over 6 million people. In response to this programme, we had increased use of the project website as well as invitations to take part in other national and international media and social media opportunities. We also received responses from members of the public who felt that the findings resonated with their own experiences. This radio piece was shortlisted as part of Radio 4's submission for the 2019 Mind Media Award for the Best Radio piece on mental health. |
| Year(s) Of Engagement Activity | 2019 |
| URL | https://www.bbc.co.uk/programmes/b006qskw/clips |
| Description | Interview for BBC Radio Devon |
| Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Media (as a channel to the public) |
| Results and Impact | Live interview on the BBC Radio Devon Janet Kipling afternoon programme discussing the topic of Stress. Interview covered the purpose of the research project and how stress impacts on low-income communities, resulting in discussion in the following phone-in debate. |
| Year(s) Of Engagement Activity | 2017 |
| URL | http://www.bbc.co.uk/programmes/p039zh4c |
| Description | Interview for ITN Productions |
| Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Media (as a channel to the public) |
| Results and Impact | Interview with ITN Productions for their broadcast of the New NHS Alliance Summit 2017 which led to requests for further information on the project, and follow-up meetings with third sector and health practitioners. |
| Year(s) Of Engagement Activity | 2017 |
| URL | https://itnproductions.wistia.com/medias/jgqsh0wl1m |
| Description | Interview for regional radio programme |
| Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Media (as a channel to the public) |
| Results and Impact | Interview for Radio Devon's religion and ethics show on the impact of 'poverty-porn' programmes on the representation and mental wellbeing of people living in low-income communities. |
| Year(s) Of Engagement Activity | 2019 |
| Description | Interview on national radio |
| Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | Featured piece on Radio 4's You and Yours programme. Focus of the discussion was on inequalities in accessing talking therapy services and was picked up after a related project publication in the Journal of Mental Health and in Pulse (GP magazine). Felicity Thomas (PI) discussed research findings with the presenter and a GP. This sparked discussion with the presenter and GP and led to feedback from the general public and GPs. |
| Year(s) Of Engagement Activity | 2019 |
| URL | https://www.bbc.co.uk/sounds/play/m000bfsg |
| Description | Invited talk University of Helsinki |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Other audiences |
| Results and Impact | Expert panel on Narcissism and the Self in Social Interaction - one of a selected small group of invited international experts - generated plans for future acitivity |
| Year(s) Of Engagement Activity | 2018 |
| Description | Meetings with CoLab director and other staff to talk about DeStress findings and outputs, and future research |
| Form Of Engagement Activity | Participation in an open day or visit at my research institution |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | Colab Exeter is an integrated wellbeing and innovation hub that works in collaboration with agencies across sectors to strengthen local services and achieve positive whole community outcomes around homelessness, addiction, (re)offending, and health inequality. Held several meetings with practitioners from different organisations interested in the research findings and attended the open day, building new relationships for engagement in future research. |
| Year(s) Of Engagement Activity | 2018 |
| Description | Participation in Childrens centres Advisory Board |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | Invited to participate in Barnardo's Childrens centres Advisory Board, to talk about the engagement work we had done with parents and families locally and to contribute to discussions about local strategies which may impact on families. |
| Year(s) Of Engagement Activity | 2018 |
| Description | Presentation at Exeter's Mental Health Awareness Weekend at Phoenix Arts Centre |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Public/other audiences |
| Results and Impact | Took part in a panel presenting different university research projects related to mental health. Generated much interested discussion and requests for further information and involvement. |
| Year(s) Of Engagement Activity | 2019 |
| URL | https://www.exeterphoenix.org.uk/events/mha-2019/ |
| Description | Presentation at New NHS Alliance Summit |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Professional Practitioners |
| Results and Impact | Plenary session presentation delivered to an audience of approx. 200 health professionals, policy makers, third sector organisations and patient groups which sparked questions and discussion around the role of antidepressant prescribing within low-income communities. The presentation also received significant interest on social media. |
| Year(s) Of Engagement Activity | 2017 |
| URL | http://www.nhsalliance.org |
| Description | Presentation at SW Society for Academic Primary Care conference |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Professional Practitioners |
| Results and Impact | Presentation at SW Society for Academic Primary Care conference on developing ideal primary care consultations in areas of deprivation - presented as part of resource training for health care practitioners. |
| Year(s) Of Engagement Activity | 2019 |
| Description | Presentation at South West Hospices Community Engagement Network meeting |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Professional Practitioners |
| Results and Impact | Gave a presentation at the first meeting of the Hospices South West Community Engagement Network, using the DeStress project findings as an example of health inequalities to spark discussion about inequalities in access to end of life care. Established contact with practitioners in hospices involved in community engagement who are interested in being involved in future research as part of my fellowship post. |
| Year(s) Of Engagement Activity | 2019 |
| Description | Presentation at South West Regional Network for Medical Humanities |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Professional Practitioners |
| Results and Impact | Gave a presentation on DeStress as 'Research that impacts on Public Policy' at a network meeting of around 30 researchers and health professionals, which generated interest and discussion and requests for more details of project findings from interested healthcare professionals/researchers. |
| Year(s) Of Engagement Activity | 2019 |
| URL | http://waitingtimes.exeter.ac.uk/2019/05/23/how-to-influence-public-policy-south-west-regional-netwo... |
| Description | Presentation at a workshop for mental health practitioners and commissioners across the south west |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Professional Practitioners |
| Results and Impact | Presented on the findings of the project at a meeting for mental health practitioners and commissioners which sparked questions and discussion around models of mental health treatment in Plymouth and Torbay CCGs. The meeting led to a series of recommendations on reforming the model of provision for IAPT. |
| Year(s) Of Engagement Activity | 2018 |
| Description | Presentation at an Engaged Research workshop for community partners |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | Gave presentation at a workshop focussing on Engaged Research attended by community partners including Exeter City Council, Exeter City Futures and various third sector organisations. Resulted in discussion of the mutual benefits of partnership between researchers and the local community and networking with key practitioners and organisations interested in involvement and dissemination of our findings. |
| Year(s) Of Engagement Activity | 2017 |
| Description | Presenting DeStress findings to medical students as part of a 'Lifestyle Medicine' module |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Undergraduate students |
| Results and Impact | Presented the DeStress study, rationale and findings to 2 cohorts of undergraduate medical students as part of a 'Lifestyle Medicine' module. The presentation prompted questions and debate about appropriate healthcare professionals responses to people presenting with poverty-related mental distress. |
| Year(s) Of Engagement Activity | 2019,2020 |
| Description | Project stand at South West Academic Health Science Network social prescribing event |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Professional Practitioners |
| Results and Impact | We ran a project stand at the South West Academic Health Science Network social prescribing event, which sparked discussion and follow up work with policy makers and third sector organisations. |
| Year(s) Of Engagement Activity | 2017 |
| Description | Project website |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Engagement focused project website, detailing project aims and approach, findings, events, blogs, film clips, twitter feed. Since February 2018, the project has had almost 400,000 hits, with over 7000 visits and 4158 individual users ('unique visitors'). |
| Year(s) Of Engagement Activity | 2018,2019 |
| URL | http://destressproject.org.uk |
| Description | Running DeStress conference |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Ninety four people attended the DeStress project research, policy and practice conference that we held in London on 15th-16th January 2019. The audience comprised health practitioners, policy makers, third sector organisations, and academics from across the UK, as well as participants from Europe. The event attracted a range of high profile speakers including Paul Farmer, CEO, Mind; Gregor Henderson, Mental Health Policy Lead, Public Health England; Jessica Allen, Institute of Health Equity; Vanessa Pinfold, CEO, McPin Foundation; Lynne Freidli, Centre for Welfare Reform, and Kate Cornford, Mental Health Lead, OECD. Speakers also included representatives from community groups and residents with lived experience of poverty-related distress. Evaluations and feedback from the event has been extremely positive and has led to a number of potential follow-on collaborations. The main messages that people reported taking from the event were: understanding of the link between austerity and mental health; the importance of community co-creation and empowerment; the potential for new approaches in clinical practice that shift away from 'fixing' patients via medications to more personalised and non-medical approaches. The parts of the event that people found most useful were: findings from the DeStress project, in particular it's approach to project co-creation with local communities and the training materials for GPs that we have developed; insights into lived experience from the community/resident speakers; the potential of conversation analysis to provide insights into clinical interactions; ways of reconceptualising responses to poverty-related distress; local initiatives from practitioners and communities. Aspects of their work that people felt they would change as a result of the event included: engaging people with lived experience in the co-creation of practice and policy initiatives; greater awareness of social determinants and early life trauma; disseminating DeStress project findings through their networks. The event was filmed and is available on our project website destressproject.org.uk ensuring that the information generated is available to an unlimited audience. The event also attracted a significant level of attention on twitter where presentations were discussed and the event received high levels of praise. |
| Year(s) Of Engagement Activity | 2019 |
| URL | http://destressproject.org.uk |
| Description | Sassi Talks |
| Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Media (as a channel to the public) |
| Results and Impact | Youtube broadcast on communication which has just been released on 11th March 2022 so no impact yet https://www.youtube.com/watch?v=El6Rd6PNXIA&feature=youtu.be |
| Year(s) Of Engagement Activity | 2022 |
| URL | https://www.youtube.com/watch?v=El6Rd6PNXIA&feature=youtu.be |
| Description | Training GPs to deliver training on supporting patients experiencing poverty-related mental distress |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Professional Practitioners |
| Results and Impact | A team of GPs were trained to deliver training to primary healthcare teams on supporting patients experiencing poverty related mental distress. They have worked with low-income community partners and researchers to deliver this training to >450 health professionals across three regions of England. Both the trainers and those trained have reported a change in their understandings of the issues and how to more effectively support patients. |
| Year(s) Of Engagement Activity | 2021,2022,2023 |
| Description | Training community partners to deliver training to primary healthcare teams |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Patients, carers and/or patient groups |
| Results and Impact | A team of low-income community partners have received training to deliver training to primary care health teams. This training focuses on improving consultations for poverty-related mental distress and are co-delivered by community partners, GPs and researchers. Over 450 health professionals have been trained and we have received positive feedback on changes they will make within their practice. |
| Year(s) Of Engagement Activity | 2022,2023 |
| Description | Website engagement led to fund-raising |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Patients, carers and/or patient groups |
| Results and Impact | An individual user of the DeStress website decided to crowdsource funding for one of the groups featured in the DeStress conference. The person was unknown to the group, and had acted after seeing the conference footage. |
| Year(s) Of Engagement Activity | 2021 |
| URL | https://www.gofundme.com/f/speak-up-cic-marathon-in-a-month |
| Description | Workshop presentation |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Postgraduate students |
| Results and Impact | Presentation at a workshop on waiting in health care which sparked discussion amongst participants on the range of ways in which austerity has impacted on waiting and stress. |
| Year(s) Of Engagement Activity | 2019 |
| Description | Write up of research paper on US website |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Postgraduate students |
| Results and Impact | Write up of findings from 'Ford, J., Thomas, F., Byng, R. and McCabe, R., 2020. Asking about self-harm and suicide in primary care: Moral and practical dimensions. Patient education and counseling' in The Academic Times |
| Year(s) Of Engagement Activity | 2021 |
| URL | https://academictimes.com/docs-asking-questions-the-right-way-key-in-preventing-suicide-self-harm/ |