Research Proposal

As the largest single source of health burden in the UK, mental ill-health is associated with poorer physical health, unemployment, and lower levels of income and education (Das Gupta and Guest 2002, Scottish Government 2012, 2016a, Scottish Mental Health Partnership 2016). The individual and social impact is reflected in an economic cost of £105 billion per year in England (Royal College of Psychiatrists 2010). With increasing numbers of people reporting poor mental wellbeing these costs can only escalate.

Aims
-To critically explore how self-management is represented in mental health policy, and experienced in practice;
-To create opportunities for dialogue with those engaged with self-management on ways forward;
-To create a set of knowledge exchange resources based on the research recommendations.

Research Questions
-What do policy and existing accounts from practice have to say about self-management in mental health?
-What do people using or promoting self-management in everyday practice think are the optimal conditions for it to thrive?
-What models of practice do people using or promoting self-management think might be helpful to move self-management forward?

Context
Contemporary policy in mental ill-health emphasises the co-production of healthcare, including the need to promote self-management through collaboration and power-sharing between those using and providing care. This message is not new. It is important to understand why an approach to mental health which is nearly 30 years old continues to experience significant challenge regarding its translation into practice (Parkes 2002). Indeed, Masterson and Owen (2016) have queried whether the term has become meaningless rhetoric, and Hamilton et al (2016) ask whether power-sharing is a genuine attempt to empower PWLE, or a cynical abrogation of responsibility and shifting of risk. Perhaps the reasons are less malign, more complex (Cairney 2012)? Street-level bureaucracy studies (Lipsky 1980) show that these policy-practice gaps are sometimes problems of translation, with people on the ground trying to make practical sense of abstract political notions.