Editorial

Citation

Carson, J. (2024), "Editorial", Mental Health and Social Inclusion, Vol. 28 No. 1, pp. 1-3. https://doi.org/10.1108/MHSI-12-2023-134

I am writing these words as we approach the end of 2023. This is the first issue of 2024. This year the journal increases from four issues per year to six. This reflects the continued growth of the journal and the increasing numbers of quality submissions that we are receiving. It also marks 24 years since the journal was first published under its previous name of “A Life in the Day”. In fact, I published three papers in the journal in 2009, before it changed its name in 2010. I have published more papers in the journal than anyone else, which I suppose meant becoming the co-editor with Dr Julie Prescott was a natural progression for me. It is my hope that I will continue as editor for at least another decade. The journal has changed a lot since those early days, as has the field of mental health policy and practice. One thing the journal still champions is the voice of people with lived experience of mental health problems and this issue demonstrates our commitment to the user voice, sometimes referred to as first-person accounts. The issue also demonstrates the breadth of papers that are submitted to the journal, from new theoretical models to research-based papers. Let me whet your appetite?

The first paper is from Ian Platt. This introduces his P3p Model which now guides interventions with young people being delivered as part of the Hummingbird Project. He argues that interventions should consider young peoples’ Past, Present and Potential (3P’s). The work complements the “HERO Within Model”, of Hope, Efficacy, Resilience and Optimism. Ian’s work suggests that multi-component interventions are more likely to be helpful as they enable young people to select those elements that are best suited to their own needs. The Hummingbird Project has now been delivered in both primary and high education settings in the UK and as Ian comments is particularly urgent given the escalating mental health crisis among young people in the UK.

The second paper is from Jo Mullen. Jo has written for the journal for a number of years and is on the editorial board. In this paper, she outlines the principles of co-production, drawing on the framework established by the New Economics Foundation. Jo describes how she developed a support group with two other women who had been diagnosed with borderline personality disorder and her community mental health nurse, Lisa. Jo’s experience led to her and other members of the group presenting at a number of conferences and running workshops to help others set up similar groups. The support group helped its members gain control of their substance abuse and also eating disorders, to the surprise and delight of local clinicians. Jo suggests the keys to success were being more self-accepting and developing confidence in relating to others. The group relied on Lisa’s willingness to step outside her traditional nursing role and comfort zone, to work as both “a travelling companion and as an equal partner”, a rare event in mental health services where many people report feeling disempowered.

Another expert by experience, Peter Bullimore, is the subject of the third paper. This paper features a number of tributes to the work that Peter has been doing both nationally and internationally, to raise awareness of voice hearing. The first tribute is from Sally Bramley, an occupational therapist, who was pivotal in helping Peter move from being a sufferer with a long-term mental illness to becoming a trainer and mental health activist. Kate Crawford and Shaun Hunt, both work as trainers with Peter and share the influence that Peter has had on their lives. There are also contributions from colleagues working in Australia, Greece, Denmark, the USA and of course the UK, each testifying to Peter’s ongoing and humble involvement in helping develop new services across the world for voice hearers. In his own commentary Peter reflects, “By my mid 20’s I had lost my business, my family, my home, everything. The voices just encompassed my life. I had to get out of the psychiatric system to recover”. He states his main aim being “…to create a system in a society where people who experience mental health problems are valued, respected, listened to and heard”. He ends the tribute with a call to arms. “I urge you all to come and be part of the last great civil rights movement”. I consider myself blessed to be known as one of Peter’s friends.

The next paper addresses one of the major problems in many developed countries, that of homelessness. Elias Barreto and Peter Cockersell describe the findings of a qualitative study conducted in Lisbon, Portugal on the links between “…attachment disorder, trauma and social dysfunction or disadvantage”. This is the first study that has looked at the attachment styles of homeless people. They argue that many homeless people display ambivalent and disorganised attachment behaviours. Being trauma informed, although important, is not sufficient. They interviewed 21 rough sleepers and found that none of them had a “secure” attachment style. They also found using the Thrower Family Circle, that “…homeless people tend to represent themselves in peripheral, distant and undifferentiated positions in relation to their families”. The authors suggest that these understandings affect how homeless people engage with and receive help. Services need to be “attachment informed”, providing “…consistency, continuity of care and support, patience and time”. Services where individuals have the same support worker throughout their involvement have the best outcomes. The authors also make the vital point that people who are homeless have “…fallen out of their place in society as much as out of a fixed and stable residency”. Re-establishing positive relationships is therefore part of the “treatment” for homelessness.

The fifth paper describes a large international research study, which surveyed almost 18,000 Jamaican and Ugandan young people. Agata Debowska and her colleagues examined child abuse and neglect in a questionnaire survey conducted in school settings. Emotional abuse and neglect correlated most with poorer mental health outcomes. Being slapped on the face, head or ears was reported by 40%–50% of the sample. Being hit with a fist or kick was mentioned by 10%–15% of participants. Sexual abuse figures were much lower, whereas emotional abuse was more frequent. Some 23%–30% of the sample felt they were not shown “enough love”. While some of these figures may be lower than one might expect, they are likely to have long-term effects on the children into adulthood. It would be interesting to replicate this excellent study in other countries.

Naome Al-Saqaff conducted an online survey looking at the relationship between host country contact and mental health in 136 Ukrainian refugees, living temporarily in Holland. Participants were asked, “How much contact do you currently have with Dutch citizens?” and “How positive or negative has your contact with Dutch citizens been so far?” They also completed a five-item mental health checklist and were asked if they experienced discrimination or prejudice. The quality or quantity of social interaction had no affect on the mental health of participants, but whether they experienced discrimination or prejudice did. It would be interesting to see if these findings would be repeated in other countries that have large numbers of Ukrainian refugees, such as Poland. Qualitative research would also help elucidate some of the key issues affecting refugees.

Kirsty Lilley writes of the role of shame in her own life. Few people write as evocatively as Kirsty. She comments, “Behind the smile is a creeping sense of fear that once I am known, they will see that I am at fault, unclean in some way and unwanted”. She notes that “…shame leaves us unable to enjoy (supportive relationships) in any meaningful way”. “Each time I have spoken up, it has been viewed with disdain and misunderstanding”. When I read Kirsty’s work, I am filled with a sense of awe. Few people have the ability to communicate so powerfully in writing as Kirsty. Certainly not me!

The final paper in this first issue of 2024, is another in the series of Remarkable Lives curated by Robert Hurst. In this issue, he talks with Laura Scranage. She tells of her lifelong love of horses. “Throughout both primary and high school, I was bullied mercilessly. The stables was my haven. My horse my listener, counsellor, friend. I could vent my problems, cry into her mane without judgement or teasing”. Later on in her life, after a surgical procedure that went wrong, Laura found recovery and comfort with a new horse, Rosey. “Rosey is truly my heart horse. We communicate, support, and protect each other silently”. Laura has found great comfort through her bond with horses. She would love to see Equine-Assisted Therapy as a positive psychology intervention.

This first issue of Mental Health and Social Inclusion for 2024 provides us with a tremendous range of perspectives on mental health. Ian Platt started with his P3p model for working with young people. Jo Mullen told us about a co-production initiative with her community mental health nurse. Peter Bullimore was the focus of a set of tributes from across the globe on his work as a mental health activist and trainer. Elias Barreto and Peter Cockersell talked of the central role of attachment theory in working with homeless people. Agata Debowska and colleagues shared the findings of their very large study on young people from Jamaica and Uganda and their experiences of child abuse and neglect. Naome Al-Saqaff showed how discrimination and prejudice affect the mental well-being of Ukrainian refugees in Holland. Kirsty Lilley eloquently described the pervasive effects of shame on mental health. Finally, Luara Scranage spoke to Robert Hurst about the healing power she has experienced from horses. These papers provide us all with interesting insights that we can take forward into 2024. I wish you all every success for the year ahead.

Professor Jerome Carson,

Editor-in-Chief.