Meet the team: Rewriting Psychosis
- Martha Sneyd (previously a mental health service user, and now a Recovery Navigator)
- James Robinson (Peer Support Worker, Second Step)
- Dr Simon Downer (Consultant Psychiatrist, Avon and Wiltshire Mental Health NHS Partnership)
- Dr Sarah Sullivan (Research Fellow, Centre for Academic Mental Health, UoB)
- Dr Michelle Farr (Senior Research Associate, Ethnography team, CLAHRC West)
“From the dual perspective of having been a patient and now working in mental health it’s clear that for many people, being in hospital is more traumatic than the experience of psychosis itself. This needs to change”.
Martha Sneyd, Co-lead for project
For people who have experienced symptoms of psychosis, negative hospital experiences can lead to stigma, isolation, loss of confidence and potentially rejection of services. Messages of hopelessness received from staff and unequal power dynamics can cause disempowerment, low self-esteem and resentment of the system.
We need to improve experiences of mental health in-patient wards for service users, their families and staff.
“Any crisis contains within it the seed for transformation. Psychosis is no different and we believe that peer support on inpatient wards could be a crucial first step in facilitating this process”.
Martha Sneyd, Co-project lead and Dr Michelle Farr, Co-project lead
A study found that 61% of people with diagnoses of psychosis or schizophrenia were told by mental health providers that recovery was impossible. Peer supporters can provide positive role models, to show that recovery is possible after a mental health crisis.
We want to co-design a peer support scheme on in-patient wards with service users, those close to them, staff and peer support workers. Through using appreciative inquiry techniques, we will build on people’s strengths, values and ideas, learning from examples of peer support in inpatient settings that people have shared with us, and exploring diverse, culturally sensitive understandings of psychosis symptoms.
Our conceptual framework stems from Martha’s current MSc in Transpersonal Psychology with the Alef Trust. Transpersonal psychology involves studying human transformation, and Martha’s learning in this, as well as lived experience of transformative recovery has informed the roots of the project. We will draw on post traumatic growth models that outline thriving and resilience as a potential outcome for crisis and explore how these concepts can be applied to the co-design of peer support, where space is created within wards for narrative, meaning and hope, so that breakdowns can become breakthroughs.
- Use peer support literature (including Recovery Colleges) to help us design the support scheme.
- Conduct telephone interviews with those who have developed similar schemes in other parts of the country.
- Conduct telephone interviews with grassroots organisations (such as Emerging Proud) to gain their perspectives.
- Building on this review and interviews we will use co-design methods to run six workshops involving service users, those close to them, peer workers, and mental health practitioners to develop peer support.
- We will write a blog through the project to communicate to everyone involved how the process is evolving, and what we have learnt so far.
Details of the six workshops
- People who have experienced symptoms of psychosis and spent time in an inpatient ward will discuss what they would have appreciated from a peer support scheme whilst they were in hospital.
- Families and carers will provide their perspectives on priorities for peer support.
- Existing mental health peer support workers will discuss their experiences of providing peer support, and how potential peer workers strengths and interests could contribute to peer support work on wards.
- Potential in-patient wards at AWP NHS Trust where peer support could be developed will be identified. Staff will be invited to explore what works well on wards and how peer supporters could engage with people staying on wards.
- We will bring together attendees from the first 4 workshops to co-design peer support through two workshops.
- Further work will be done to complete the peer support design. We aim to apply to the NIHR Research for Patient Benefit to implement and evaluate the effectiveness of the peer support.
Our proposal has been inspired by a public involvement event Rewriting Psychosis – run by the Psychosis Health Integration Team. This event, attended by over 130 people, showed the film CrazyWise, a documentary about different cultures’ definitions and responses to psychosis. This proposal is one of the outcomes of the event discussions and develops Martha Sneyd’s ideas to co-design peer support in inpatient wards.
We have confirmed that no similar local work is underway. We will draw together learning from examples of peer support that people have shared with us, to generate ideas to establish peer support schemes in inpatient wards focusing specifically on psychosis. This work will be based on a post traumatic growth model, firstly that psychosis is a traumatic experience, and secondly that if successfully resolved can lead to greater levels of wellbeing. We hope that this can be of national, and possibly international relevance. We are connecting with similar initiatives and researchers around the country, to share learning and expertise.
We’ve made connections with the local provider of peer support in other settings who will be collaborators in the project. NIHR CLAHRC West will be project partners so that this work can contribute to research evidence, we can write a research article on the co-design of this type of peer support, and apply for further funds to evaluate the effectiveness of the peer support. The Chief Executive of Avon and Wiltshire Mental Health NHS Partnership, where this project will be based, is supportive of this idea, and sees co-production and peer support as vital within services. We have connected with colleagues at the Sussex Partnership NHS Foundation Trust about a related, but smaller scale project. We are in touch with Rethink to build links with family and carer networks. We have discussed the project with the Founding Director of The Alef Trust who suggested using appreciative inquiry techniques to build on people’s strengths and values in the peer support co-design. We’ve had support from professionals developing mental health strategies for our local Sustainability and Transformation Partnership, and Thrive Bristol (a City Council initiative to create a whole city approach to wellbeing).
- People with experience of psychosis: Peer support in mental health has been associated with improved quality of life, self-efficacy, trust and empowerment, as well as reduced hospital use.
- Staff on wards: Additional support and exposure to people with experience of psychosis who are thriving outside of hospital settings.
- Peer support workers: A carefully planned framework for supporting peer support workers on wards.
- Q community: A ‘best practice’ model for peer support development which can be applied to other areas. We will share blogs, highlight to our local and other Q networks. We will also offer placement opportunities and visits for Q members to learn and contribute to the project. We also aim to generate additional interest from service users in becoming Q members.
How you can contribute
- Sharing experience of peer support in hospital settings
- Expressing appetite to implement a similar project
- Promoting the work and generating enthusiasm among networks
Why diagram (DOCX, 37KB)
This is a great project because…
There is a real commitment to co-design and collaboration in this project with co-leadership from someone who was previously a patient and now works in mental health. The team have already engaged widely with Q members and it was great to see the project design develop following those conversations and connections. The plans for sharing learning back to the Q community are well developed.
By the time of the event we encourage the project team to think more about…
Although connections into formal research are a strength for the project, we want to team to make sure there is sufficient focus on developing and delivering the intervention. We are also interested to hear more about their plans for sustainability beyond this funding.