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  • 1. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth Caerdydd Researching community mentalhealth care: experiences from the UK Dr Ben Hannigan Reader in Mental Health Nursing Cardiff School of Nursing and Midwifery Studies
  • 2. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddSummarised, this is what I do: • Use social scientific ideas to understand policy, practice, and the organisation and delivery of mental health services, particularly in the community • Using qualitative methods, study mental health work and the experiences of people using services • Collaborate with colleagues on large-scale, mixed methods, studies and conduct evidence reviews • Teach mental health nurses and supervise research students
  • 3. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddI blog about my work (and other thingsbesides)
  • 4. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddHow did we get to where we are now?• Ad hoc community care developments The water tower at• New opportunities for workers Warlingham Park Hospital• 1970s: interprofessional, locality, CMHTs Photo taken by Roger Haworth, as a preferred, but contested, model licensed for reuse• 1980s and 1990s: interrelated network of community care and hospitals, with resources tied up in institutions• Competing policy imperatives, lack of clarity around agency and organisational responsibilities, concerns over underfunding and risk Ty Siriol, Caerphilly (Hannigan 1999; Hannigan and Allen 2006) Photo taken by John Grayson, licensed for reuse
  • 5. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddWork and workers: findings from anethnographic investigation and a survey Health and Social Care: • Mental health systems populated by a complex mix of occupation, fulfilling roles in fluid ways reflecting local organisational features (Hannigan and Allen 2011)… • …with relatively invisible contributions being made by workers (paid and unpaid) on the periphery (Hannigan and Allen, in press) All Wales CMHN stress study: • High levels of stress and burnout (Burnard et al 2000; Coyle et al 2000; Edwards et al 2000a, 2000b, 2001; Fothergill et al 2000; Hannigan et al 2000)
  • 6. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddWhat about policy and services from aroundthe turn of the century? Wicked problems in complex systems: • Unprecedented policy activism from the late 1990s • Mental health as a complex and ‘untamed’ arena, replete with ‘wicked problems’ • Rapid changes in problem formulation and solution… • …beginning with a focus on the failure of community care… • …and then problems with everyday working practices... • …and more recently moving towards a concern with public mental health (Hannigan and Coffey 2011)
  • 7. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddWhat about policy and services from aroundthe turn of the century? New law, new roles: • Approved mental health professionals (Coffey and Hannigan, in press) Mental health systems: the case of crisis services • New teams and services in the community… • …underpinned by a disputed evidence base • High-quality care, but… • …triggering significant ‘waves of consequences’ (Hannigan, in press)
  • 8. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddNew projects: COCAPP Simpson A., Hannigan B., Coffey M., Jones A., Faulkner A., Jančová J. Cross-national comparative study of recovery-focused mental health care planning and coordination. NIHR HS&DR Programme • A mixed methods study combining a meta-narrative mapping and policy analysis with the generation of quantitative and qualitative data • Concerned with the relationships between care planning, care coordination, recovery and personalisation
  • 9. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddNew projects: COCAPP • Meta-narrative mapping: how care planning and coordination is conceptualised in different research traditions; key theories; preferred designs; main findings • Data generation in six sites in England and Wales: – questionnaires (Recovery Self Assessment Scale; Scale To Assess the Therapeutic Relationship; Empowerment Scale) – interviews with key informants, document review – interviews with service users, carers and care coordinators, and review of care plans
  • 10. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddNew projects: COCAPP • Project Advisory Group and Lived Experiences Advisory Group • Recruitment of Services User Research Assistants, with roles including recruitment and interviewing of participants • Fieldwork to commence in the Spring
  • 11. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddNew projects: RiSCHannigan B., Edwards D., Evans N.,Gillen E., Pryjmachuk S., Trainor G. andLongo M. An evidence synthesis of riskidentification, assessment andmanagement for young people usingtier 4 inpatient child and adolescentmental health services (CAMHS). NIHRHS&DR Programme• A two phase evidence synthesis in the area of risk for young people moving into, through and out of mental health hospital• Phase 2 review informed by the views and experiences of people working in, and using, CAMHS
  • 12. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddReferences and reading Burnard P., Edwards D., Fothergill A., Hannigan B. and Coyle D. (2000) Community mental health nurses in Wales: self-reported stressors and coping strategies. Journal of Psychiatric and Mental Health Nursing 7 (6) 523-528 Coffey M. and Hannigan B. (in press) New roles for nurses as approved mental health professionals in England and Wales: a discussion paper. International Journal of Nursing Studies Coyle D., Edwards D., Hannigan B., Burnard P. and Fothergill A. (2000) An exploration of the coping strategies used by community psychiatric nurses in Wales. Nursing and Health Sciences 2 (1) 59-67 Edwards D., Burnard P., Coyle D., Fothergill A. and Hannigan B. (2000a) Stress and burnout in community mental health nursing: a review of the literature. Journal of Psychiatric and Mental Health Nursing 7 (1) 7-14
  • 13. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddReferences and reading Edwards D., Burnard P., Coyle D., Fothergill A. and Hannigan B. (2000b) Stressors, moderators and stress outcomes: findings from the all-Wales community mental health nurse study. Journal of Psychiatric and Mental Health Nursing 7 (6) 529- 538 Edwards D., Burnard P., Coyle D., Fothergill A. and Hannigan B. (2001) A stepwise multivariate analysis of factors that contribute to stress for mental health nurses working in the community. Journal of Advanced Nursing 36 (6) 805-813 Fothergill A., Edwards D., Hannigan B., Burnard P. and Coyle D. (2000) Self- esteem in community mental health nurses: findings from the all-Wales stress study. Journal of Psychiatric and Mental Health Nursing 7 (4) 315-321 Hannigan B. (1999) Joint working in community mental health: prospects and challenges. Health and Social Care in the Community 7 (1) 25-31 Hannigan B. (in press) Connections and consequences in complex systems: insights from a case study of the emergence and local impact of crisis resolution and home treatment services. Social Science & Medicine
  • 14. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddReferences and reading Hannigan B. and Allen D. (2006) Complexity and change in the United Kingdom’s system of mental health care. Social Theory & Health 4 (3) 244-263 Hannigan B. and Allen D. (2011) Giving a fig about roles: policy, context and work in community mental health care. Journal of Psychiatric and Mental Health Nursing 18 (1) 1-8 Hannigan B. and Allen D. (in press) Complex caring trajectories in community mental health: contingencies, divisions of labor and care coordination. Community Mental Health Journal doi: 10.1007/s10597-011-9467-9 Hannigan B. and Coffey M. (2011) Where the wicked problems are: the case of mental health. Health Policy 101 (3) 220-227 Hannigan B., Edwards D., Coyle D., Fothergill A. and Burnard P. (2000) Burnout in community mental health nurses: findings from the all-Wales stress study. Journal of Psychiatric and Mental Health Nursing 7 (2) 127-134
  • 15. Cardiff School of Nursing and Midwifery Studies Ysgol Astudiaethau Nyrsio a Bydwreigiaeth CaerdyddContact Email: • hanniganb@cardiff.ac.uk Web: • http://www.cardiff.ac.uk/sonms/contactsandpeople/acad emicstaff/hannigan-ben-overview_new.html Blog: • http://benhannigan.com