Emotional and mental health

Research combines applied ‘real world’ empirical research with a range of theoretical and conceptual models of what we mean by the terms mental illness and mental/emotional health, using insights from, community psychology, medical sociology, social policy and social work, counselling and psychotherapy to influence policy and practice.

The researchers have a common approach in developing critical perspectives of the often narrow and limited definitions of medically defined mental illness and disorder. Recent work engages with the controversies over diagnosis through the classificatory systems of the Diagnostic and Statistical Manual (DSM) and International Classification of Diseases (ICD) and emphasises the psychosocial nature of emotional distress and mental illness. There is an emphasis on the lived experience of those diagnosed with what are often stigmatising conditions and the foregrounding of user involvement in understanding experience of services and healthcare. In turn, collaboration with the statutory health and social care providers impacts on policy and in developing values-based and person-centred practice.

An enduring problem is the artificial division between mental and physical health, both conceptually and in the provision of healthcare. The term ‘emotional health’ is increasingly being used to address an ever-increasing range of consultations, which involve distressing symptoms that combine mental, physical and social aspects of health and wellbeing.

Practitioners despair of being able to treat these complex conditions with traditional biomedicine, as they are often manifested through medically unexplained symptoms (MUS), hence the turn to more holistic or integrated models of health and illness, which are now permeating many areas of medical education and healthcare practice.

Our ongoing research projects sit within the following research descriptions:

Social epidemiology of mental health and social causation of mental illness
Compulsion, criminal justice and mental health
User perspectives, lived experience and inter-agency working in integrated healthcare
Psychosocial interventions and approaches to wellbeing and emotional health
Suicide prevention

Due to the inter-disciplinary nature of our work, research cuts across other research themes within the Care, Health and Wellbeing research area.

Social epidemiology of mental health and social causation of mental illness

Our research allows a unique perspective on the social and psychological issues pertaining to mental health.

Dr. Carl Walker examines the link between increased personal debt and its associated strain, particularly on those with lower incomes. He challenges the status quo in his analysis of institutions that construct, negotiate and benefit from personal debt in the UK and suggests a more critical community psychology through his work ‘Community approaches to mental health and framing of distress; impact of debt and austerity’.

Our research into mental health and LGBT experiences is well-documented and Dr. Katherine Johnson continues her exploration in this area with her examination of LGBT mental health vulnerabilities and suicidal distress.

Dr David Bott and Pamela Howard have analysed the social impact in psychotherapeutic models whilst Dr Julia Stroud has conducted psychosocial analyses of child homicide and filicide and the association with mental disorder.

Meanwhile, the connections between migration, citizenship and mental health are discussed in Dr Nichola Khan’s work on cultural psychiatry and anthropology of ‘mental disorder’.

Our research contributes insights to the work on Age and Ageing within the CHEW research area.

Research projects

The problem of personal debt and mental health

A report into mental health and the UK credit industry

Compulsion, criminal justice and mental health

The role of the criminal justice system in mental health treatment and interventions is highly controversial and two NIHR funded projects have investigated practice and outcomes for those affected.

Professor Gillian Bendelow and Claire Warrington are working in collaboration with Sussex Police and Sussex Partnership Trust with regard to the high rates of detention, often in police custody, of severely distressed individuals under Section 136 of the Mental Health Act 1983. The research links the narrative ‘lived experience’ of sufferers and service users to developing good practice across inter-agency emergency mental health responses and the researchers have participated in a Home Office Roundtable Consultation, influencing future policy.

Similarly, Dr Julia Stroud has conducted the research focusing on service user and practitioner experience of Community Treatment Orders (CTOs). After an initial period of adjustment, most service users appreciated the structure and reassurance that came with compulsory treatment, but identified the need for clearer, more accessible information. Practitioners’ opinions varied greatly and were dependent on individual case experience. Where CTO’s had improved service user level of engagement, practitioners were supportive, but less so where they sensed that having to enforce the order had a detrimental effect on the therapeutic relationship.

The study into child to parent violence being carried out by Dr. Paula Wilcox, also has resonance under this theme, given that we must consider the emotional health and wellbeing of parents and children affected and consider the legal context for violent behaviour.

Sharing mental health expertise poster

Research projects

Responding to child to parent violence (CPV)

A multi-agency action learning research project led by the University of 91快活林

Section 136 in Sussex

An examination of the high rates of detention of severely distressed individuals under Section 136 of the mental Health Act 1983

Service user and practitioner experiences of community treatment orders (CTOs)

This study investigated experiences of CTOs, exploring the tension between autonomy and compulsion

Social factors, care and Community Treatment Orders (CTOs)

This study investigates the discharge and renewal of CTOs, closely examining the social, environmental and care factors and experiences associated with decisions

User perspectives, lived experience and inter-agency working in integrated healthcare

Our work aims to probe beyond current practice and explore both the lived experience of users and collaboration between practitioners. We aim to illuminate debate, reveal learning points and identify ways to improve healthcare.

Professor Marian Barnes and Dee MacDonald collaborated with Kings College and Imperial College on the ENSUE project which evaluated user involvement in three mental health NHS trusts. It addressed the ways in which changes in the organisation and provision of services is impacting involvement. In particular, it considered goals being set by user groups and whether these were achieved. Our researchers explored the experiences and impact of user governors within foundation trusts, and how the introduction of individual budgets affects service users’ experiences of being able to shape services

Dee Macdonald and Vanessa de Guzman are studying self-defined coping strategies for people with a learning disability in relation to adults and children respectively and used this to inform good clinical practice.

David Watson has focused on finding out what motivates practitioners to become Approved Mental Health Practitioners (AMHP).

Chronic pain and medically unexplained symptoms (MUS) represent an area of significant interest. Professor Gillian Bendelow continues to contribute to the debate by exploring ‘contested’ conditions, expert patients and self-management.

Stress cartoon saying There are only two times I get stressed, Day and Night

Research projects

ENSUE

Evaluating service user involvement in mental health services in England

Health Trainers in West Sussex

An evaluation of the health trainers programme in West Sussex, assessing the current situation and making recommendations for improvements.

Making a meal of collaborative learning

An innovative pilot involving service user participation in social work training

Warmth for wellbeing

An evaluation of a multi-partner intervention to address fuel poverty in 91快活林 and Hove

Psychosocial interventions and approaches to wellbeing and emotional health

Blending expertise from a psychologist and psychotherapist from the University of 91快活林, used ecotherapy and nature-based therapy to provide outdoor activities for people with experience of mental distress. Dr Matt Adams received funding from the Community University Partnership Programme to collaborate with the Grow organisation and improve physical and mental wellbeing for all participants.

For over a decade, Professor Diane Waller has carried out extensive research into the benefits of art therapy interventions for people with wide-ranging experiences, from substance abuse issues, to Parkinson's, chronic schizophrenia, eating disorders, stroke and dementia. Using randomised control trials and qualitative studies, she has evaluated its impact on mental health, wellbeing and rehabilitation.

Research projects

The Grow Project

A collaborative partnership project with local charity, Grow, to evaluate the impact of their programme.

Researching discrimination through poetry: Developing a method of 'collaborative poetics'

A pilot study using poetry to explore lived experiences and understandings of discrimination

Resilience and friendships

A preliminary study analysing whether better perceived close friendship quality significantly predicted subsequent psychological resilience

Suicide prevention

Currently, our researchers Gillian Bendelow, Katherine Johnson and Carl Walker are working to develop a mental health clinical research group, specialising in suicide prevention in community settings. We are collaborating with the emergency services (mental health professionals, police, ambulance, local authority and public health) and community groups (Mindout, Grassroots, Samaritans) in a joint bid to the National Institute for Health Research (NIHR). Research will look into the causes, prevention and management of suicidal behaviour with the aim of supporting the implementation of the National Suicide Prevention Strategy.

Research team

Professor Gillian Bendelow

Dr Karolina Doughty

Professor Flis Henwood

Dr Katherine Johnson

Dr Nichola Khan

Dee Macdonald

Naomi Smith

Dr Julia Stroud

Professor Diane Waller

Claire Warrington

David Watson

Student researchers

Jay Beichman

Lindsay Hill

Martin Jordan

Julie May

Nick Marks

Alexandra Papamichail

Michael Stephenson-Huxford

Outputs

Selected publications

Johnson K (2014) Sexuality: A Psychosocial Manifesto. Cambridge: Polity Press.

Khan N (2014) On the limits of empathy: a note on psychoanalysis and a case of extreme violence in Pakistan. In: Clio's Psyche. Special Issue: Anthropology And Psychoanalysis: Intersections Of The Intrapsychic And Social (Eds) A. Denham, pp. 408-412.

Menkes D and Bendelow G (2014) Determining vulnerability and ‘dangerousness’: police use of Section 136 in England and Wales. Journal of Public and Mental Health 13 (2) pp. 1–13.

Rose D, Barnes M, Crawford M, Omeni E, MacDonald D and Wilson A (2014) How do managers and leaders in the National Health Service and social care respond to service user involvement in mental health services in both its traditional and emergent forms? The ENSUE study. Health Services and Delivery Research 2 (10).

Kokanonvic R, Bendelow G and Philip B (2013) Depression: the ambivalence of diagnosis Sociology of Health and Illness 35 (3) pp. 377-390

Stroud J, Doughty K and Banks L (2013) An exploration of Service User and Carer Experiences of Community Treatment Orders.

Stroud J and Warren-Adamson C (2013) Multi-agency child protection. Can risk assessment frameworks be helpful? Social Work and Social Sciences Review 16 (3) pp.37-49

Bott D and Howard P (2012) The therapeutic encounter: a cross-modality approach Sage Publications, London.

Johnson K and Browne K (2012) Trans and Intersex Issues in Health and Care (Guest Editorial), Diversity and Equality in Health and Care 10 (1).

Walker C (2012). Personal debt and cognitive delinquency: Neoliberal constructions of financial inadequacy in the UK. Journal of Community and Applied Social Psychology, 22, pp. 33-538

Walker C, Johnson K and Cunningham L (Eds) (2012). Community Psychology And The Economics Of Mental Health: Global Perspectives. London: Palgrave Macmillan.

Walker C, Johnson K and Cunningham L (Eds) (2012) Community Psychology And The Socio-Economics Of Mental Distress: International Perspectives. London: Palgrave Macmillan.

Wilcox P (2012) Is parent abuse a form of domestic violence? Social Policy and Society, 11(2) pp. 277-288.

Jordan M & Marshall H (2010) Taking counselling and psychotherapy outside: Destruction or enrichment of the therapeutic frame? European Journal of Psychotherapy and Counselling, 12 (4) pp. 345-359.

Jordan M, Stevens P & Milton M (2010) Editorial: Ecopsychology: Past, present and future European Journal of Ecopsychology, 1, pp. 1–3.

Bendelow G (2009) Health Emotion and the Body. Cambridge: Polity Press

Sources/links

Grow website

Collaborations

Sussex Partnership Foundation Trust

91快活林 and Hove CC

East Sussex Public Health and LA

Grassroots Suicide Prevention

Imperial College, London

Kings College, London

MIND

MindOut

ReThink

Samaritans

South East Coast Ambulance and Coastguard Services

Funding

Gillian Bendelow: S136 in Sussex (British Academy/NIHR), £37,500/ £56,000

Julia Stroud: Service User and Practitioner Experiences of Community Treatment Orders (NIHR), £13,000; AMHP Experiences of CTOs (NIHR SSCR), £30,000

Di Waller: Art Therapy with Stroke Patients (EPSRC), £8,250

Paula Wilcox: Child to Parent Violence (EU Daphne), € 970,000

Dee Macdonald: Learning Disability Peer Support (SPFT), £15,000

Awards, recognition, impact

August 2014: Dr. Julia Stroud was invited to present with Professor Christopher Cordess from the University of Sheffield on Medea: Motives and Murder at the National Theatre, London.

April 2014: Professor Gillian Bendelow and Claire Warrington participated in the Home Office Department for Safeguarding Vulnerable People/ Department of Health Roundtable Consultation on the operation of Section 136 (s136) of the Mental Health Act 1983. Recommendations will be reported to Parliament.

March 2014: Professor Gillian Bendelow presented on her s136 study to the FBI National Association UK Chapter at West Mercia Police Headquarters.

May 2013: Dr. Julia Stroud was invited to give a keynote presentation: Addressing Filicide: Inaugural Conference for Cross National Dialogue, Monash University, Prato, Italy, 30 May.

June 2011: Dr Katherine Johnson was invited on to the panel for the Sussex Salon Series to discuss What differences have civil partnerships made? Discussing same-sex issues – from partners to parenting, with gay rights activist, campaigner and writer Peter Tatchell; campaigner, writer and broadcaster Simon Fanshawe; Dr Craig Lind (Law, University of Sussex) and Dr Ben Fincham (Sociology, University of Sussex) at the Pavilion Theatre.