Moderator of 3 Sessions
Presenter of 5 Presentations
MENTAL HEALTH TRIALOGUE – EVIDENCE, EXPERIENCE, ETHICS
Abstract
Abstract Body
The active involvement of service users and their relatives and friends is essential for the development of recovery-oriented and rights-based mental health policy, practice and research. There is an urgent need for collaborations between mental health care users and user activists, family and informal carers, and mental health professionals and policy makers outside traditional clinical encounters. Trialogue groups are training grounds for working together on an equal basis in a context of non-discrimination. The Trialogue experience in German speaking countries is indicative of our capacity for surviving and gaining from discussions of adverse issues as well as the opportunities of cooperative efforts and coordinated action. International interest and experiences are growing fast. Data show that Trialogue groups facilitate a discrete and independent form of acquisition and production of knowledge and may go some way to tackling stigma and discrimination. They function as basis and starting points for trialogic activities on different levels - e.g. serving on quality control boards or teaching in trialogic teams - and different topics - e.g. a task force on stigma busting or a work group on reducing coercion. The currently often hidden knowledge of a large part of the community – namely that of families and friends of people with mental health problems as well as the expertise of those who are dealing with or have overcome such problems in their own lives – can be validated and shared for the benefit of all.FAMILY AND INFORMAL CARER BURNOUT'
Abstract
Abstract Body
Burnout is a considerable risk for informal and family carers. It affects their mental and physical health as well as their care capacity. Data on prevention, assessment, coping and treatment of burnout suggest beneficial effects of individual and group strategies as practiced and promoted by family and informal carers in self-help and advocacy settings of local and international organizations. Unfortunately, despite ongoing family advocacy the situation in most psychiatric care settings is still characterized by significant unmet needs and lack of resources and expertise in working with families and informal carers. A partnership approach as formulated in WPA’s recommendations on Best Practice in Working With Service Users and Carers has the potential of improving this situation in terms of better understanding determinants of family and informal caregiver burnout as well as developing strategies for prevention, recognition and treatment. Current research efforts focus on integrating pertinent concepts such as caregiver burden, stressors, coping strategies and resources under different circumstances, which include for example different types of relationships, diagnoses, life stages, and socioeconomic situations. Consequences and determinants of family and informal carer burnout can be identified on different levels, such as personal and interpersonal as well as environmental and sociocultural and warrant a multilevel response. Psychiatrists and other mental health professionals are essential players within the complex network of efforts necessary to improve the situation of family and informal carers and strengthen their resilience.
GENERAL DISCUSSION: FOCUSED DISCUSSION ON WHAT PRACTICAL ACTIONS PARTICIPANTS MAY TAKE IN THEIR COUNTRY OR PRACTICE
IMPLEMENTING RECOVERY-ORIENTED PRACTICES IN MENTAL HEALTH SYSTEMS
Abstract
Abstract Body
Recovery-orientation is widely endorsed as a guiding principle of mental health policy. Implementation warrants an understanding of the resulting new clinical and scientific responsibilities. Recovery-orientation brings new rules for services, e.g. user involvement and person-centred care, as well as new tools for clinical collaborations, e.g. shared decision making and psychiatric advance directives. Alternatives to conventional services, pertaining to e.g. acute crisis interventions and vocational rehabilitation need to be implemented in the context of scientific evidence as well as human rights obligations with regard to self-determination and social inclusion of persons with psychosocial disabilities. These developments are supported by anti-discrimination legislation and a call for participatory approaches. The collaboration between researchers with and without lived experience of mental health conditions is paramount for meeting the scientific responsibilities of recovery-orientation. Such collaborations have consequences with regard to research topics (e.g. user defined outcome measures), methods (e.g. mixed methods) as well as dissemination (fast and broad). New clinical responsibilities also entail the inclusion of the lived experience in service planning, delivery and quality assurance. Data show peer support is feasible and effective in different forms. Trialogue and other participatory approaches bring together major stakeholders in mental health, who share the responsibility for overcoming conceptual reductionism and unjustified prognostic negativism and strengthen rational and optimistic efforts towards recovery-orientation and system transformation.