Co-PACT Newsletters

Co-PACT Study Newsletter – February 2023

Dear all

It’s been a while since we’ve been in touch, but we can now update you on what we’ve been doing since November. The project team has made significant progress with analysing the data ready for co-design, which starts this month. This newsletter is longer than normal, but we felt it was important to fully convey the depth and breadth of work in preparation for the co-design phase of the project.

1. Data analysis update: the bulk of the data analysis has now been done and presented at a data interrogation away day in January for Co-Investigators and PPI Research Group members. The final iteration following feedback from the away day will be completed in readiness for the start of the co-design workshops in February. Analysis of this innovative data was more complex than for traditional studies and we ensured this was done in a rigorous manner which honoured participants’ contributions to the study.

2. Themes emerging - journeys through the mental health process: we organised the broad themes by mapping them out as the journey through the mental health process from pre- to post-detention, and the experiences that participants had on that journey were richly woven into these themes. As we coded the transcripts, we constantly checked original text to ensure we were not misrepresenting anything. The overarching theme that emerged was the desire to be seen as human, and to convey that poor mental health can happen to anyone.

The themes map out the mental health journey, from pre-detention to post-detention, such as mental health stigma, prevention and failed help seeking attempts; the detention process itself, comparisons between different hospitals; coercive care, the availability of talking therapies. There is a large theme around staff interactions, the availability of activities when sectioned; the concept of detention as a traumatic experience; care available in the community; the importance of family support and involvement, and the experience of taking part in the photovoice research process.

Within these themes we developed cross cutting themes, which is a non-traditional way of presenting thematic analysis. Communication featured prominently as a cross cutting theme, especially one to one communication and interactions. There was data about the environment and the need for green spaces; units being compared to prisons and zoos, and the impact of being in that type of environment, as well as socio-economic environmental factors. Another cross-cutting theme was system constraints such as bed availability and staffing at a systems wide level.

3. Co-Investigator and PPI away day 12^th January: this was a very productive event with rich and open discussions about the analysis results. We had copies of photos, captions, and transcripts on the table so that the group could check that what they read in the transcripts was captured in the summary of findings. The group reviewed the data, ensuring that nothing had been missed and that lived experience was foregrounded. The feedback from the day has been incorporated into the analysis for a further iteration of the thematic analysis. There were a few themes the group felt were missed out or not as clear as they could be: under the environment concept they wanted to make sure we were representing the factor of people’s needs not being met more clearly - and also the experience people had if they tried to complain There was a lot of content about detention as a traumatic experience so we’ll separate that out a bit more to make sure voices aren’t lost - such as the concept of the environment around detention being very dehumanising, and the processes contributing towards that dehumanisation, as well as the experience of stress. We will add an individual factors theme rather than badging these strands under communication.

4. Planning for co-design meetings: we are working with the eight local sites to arrange co-design meetings in February and April at which the results will be presented. The first meeting takes place in Birmingham on 3^rd February. The team held a briefing session with local PIs to check that all the NHS Trusts are on the same page with regard to what co-design actually consists of as it can be challenging to communicate that effectively to people. The teams will dovetail co-design into existing initiatives whenever possible, so it isn’t seen as a focus group. We will honour photovoice methodology and principles in the blueprint for co-design, ensuring all teams are on the same page, that participant lists can be drawn from existing groups locally and that lived experience is foregrounded in the process.

5. Oxford Policy Engagement Network funding: we have secured £20k funding for in-person photographic exhibitions of our photovoice work at three sites across the country in June. We have partnered with Andre Tomlin of Mental Elf on this initiative. The exhibitions will invite policy makers to interact with our data, engage them in photovoice, and optimise dissemination of research results.

6. National knowledge exchange event: a national knowledge exchange event will be held in July, bringing together the findings and outcomes from the eight local sites and engaging national level policy makers in recommending changes to the Mental Health Act. This event will be covered live across social media by Andre Tomlin which will be a positive addition to the project and ensure maximum dissemination of this important and innovative work.

7.Help end everyday racism– a tree remembers, the axe forgets: Professor Kam Bhui will be a panellist at this University of Oxford hybrid event on Wednesday 8^th February at 6pm. The event will look at experiences of everyday racism, methodology of solidarity to end everyday racism and imagining what could work to help end everyday racism. Details here on how to join online or in person:
Details: https://www.sbs.ox.ac.uk/events/help-end-everyday-racism-oxford

Registration: https://oxfordsaid_heer.eventbrite.com/?aff=HEER

Finally, thank you for your continued support and engagement in the Co-PACT study.

If you would like to attend a meeting to hear about the findings from the photovoice work or would like to be involved in the co-design, please do get in touch with us at co-pact@psych.ox.ac.uk . You can also follow us on Twitter @co_pact or check out our website.

All the very best,

The Co-PACT Research Team

September 2022 Newsletter

Co-PACT Newsletter September 2022

Dear all

We’re pleased to be back in touch with some exciting information and news from the Co-PACT study. We’ve been busy in September with data analysis so that we can start planning the next phase of the project - the co-design meetings.

Highlights

In some good news, the NIHR has approved an extension for the Co-PACT study to 31^st August 2023 (the original end date was 28^th February 2023), bringing the project back on track for completion after delays.

Data analysis update

A review of face to face versus online photovoice workshops has produced pros and cons of both, with these differences considered in the data analysis. This experience will be written up to inform future research.

Data analysis from the photovoice workshops is nearing completion. It began with participants developing captions for their images in the second workshops and discussing similarities and differences in their experiences in the third workshops.

Analysis of photographs with participant captions, transcripts of discussions in the third workshops, roadmaps demonstrating key events in a participant’s life, researcher field notes and demographic information, all ensured that voices of lived experience were captured in this process. The ‘about me’ spider diagrams produced in the second workshops provided rich information for demographic analysis including comorbidity, childhood trauma and age of onset.

Data from staff photovoice workshops and staff focus groups is still to be analysed - the research team’s initial focus has been on core analysis from participant workshops to inform co-design.

Initial findings

Photos and captions developed by workshop participants demonstrate the power of photovoice in raising the impact of hospital regimes and poor communications by staff and service providers, and powerfully communicating experiences pre- and post-detention. Cross-cutting themes have emerged providing clear examples of the system failing people, which will be carried forward into the co-design meetings, along with site-specific experiences.

Planning for co-design meetings

Conversations have started in each of the eight sites to set up the first co-design meetings. The aim is to have these completed by the end of April 2023, leaving four months for write up and dissemination. The original intention was to conduct three face to face meetings of key stakeholders. However, this plan has been revised in anticipation of likely problems with securing consistent attendance at all three meetings. Instead, we will hold initial feedback meetings locally, followed by a main one-day event for each site, and a final knowledge exchange event at national level. If you know of people who would like to be involved in this process, please contact the research team.

Three phases of co-design

Starting in October, initial feedback meetings will be held at each site (online and/or face to face) with staff, service users and carers, voluntary sector representatives, commissioners etc, to present the data and agree priorities for the main co-design events.

The main co-design one day events will run from December 2022 to March 2023 and will involve stakeholders for each site, considering evidence that speaks to how inequalities manifest and are perpetuated in the implementation of the Mental Health Act. From these events will come clear and realistic plans to develop and pilot interventions or approaches to reduce detentions and ethnic inequalities in the use of the Act, drawing upon lived experiences.

The final event will be a national level knowledge exchange event, bringing together local stakeholders from the eight sites alongside national stakeholders, to share experiences and determine how what has been learnt from the study translates to changes to the Mental Health Act.

Finally, we’d like to thank you for your ongoing support and engagement in the Co-PACT study. We will be back in touch in November with updates on the co-design meetings and events.

Please do get in touch with us at copact@psych.ox.ac.uk if you have any questions or queries. You can also follow us on Twitter @co_pact or check out our website.

All the very best,

The Co-PACT Research Team

August 2022 Newsletter

Co-Pact Newsletter August 2022

Hello all

We hope you’ve enjoyed the summer. With autumn approaching, we’re pleased to be back in touch with the latest Co-PACT news and information on upcoming plans.

Highlights

Data collection finished in May. Thanks again to everyone who provided us with a wide range of photographs, insights and personal stories. Since we were last in touch in May we have been busy with the first phase of analysis of this exciting and innovative data, which has yielded a rich variety of information for co-design.

Data analysis

We initially hoped to recruit 20 service users per site, but there were problems with reaching this target. A focus group has been conducted with recruiting teams to review lessons learned on recruiting this population. Despite this shortfall, we have gathered a lot of rich, detailed, informative and emotive data. Participants shared thoughtful and powerful experiences and reflections through photographs, captions, poems and life roadmaps. This data (along with workshop transcripts, field notes and demographic information) has provided a set of insightful information from which we can now plan the co-design process.

Our first task was to work out how to organise the data, i.e. by photograph or person. What become clear was that organising by person enabled themes to emerge that told powerful stories of individual experiences of being detained. We then organised and coded the data to allow review by different elements or variables. Images, captions and transcripts were linked and coded to form themes and touchpoints. We wanted to ensure that voices of lived experience were captured in this process. Analysis was initially conducted at site level so that we could compare emerging themes across sites. Separately, our PPI group will work with us to understand and analyse feedback from workshop participants.

Co-design meetings

Now the initial analysis has been completed, our priority is to ensure that people with lived experience are involved in the next phase of the project. We’ve started talking to those involved with the eight sites to identify who would be interested in joining our co-design workshops and who we need to engage with to make them a success. The workshops will include a variety of stakeholders including service users and carers, staff members, and policymakers. We are planning a series of half or one day workshops and will let you know more details when we have them.

And finally, we’d like to thank you for your ongoing support and engagement in the Co-PACT study. We will be back in touch in September with updates on the co-design workshops.

Please do get in touch with us at copact@psych.ox.ac.uk if you have any questions or queries. You can also follow us on Twitter .

All the very best,

The Co-PACT Research Team

May 2022 Newsletter

Co-Pact Newsletter May 2022

Hello all,

We are pleased to share our May 2022 round-up with the study’s latest updates.

HIGHLIGHTS

We are excited to share that data collection for the service user Photovoice workshops has officially concluded. Once again, we would like to extend our heartfelt thanks to the local PIs and teams at our seven sites (Bradford, Derby, Lancashire, Leeds, London, Manchester, and Oxford) for their dedication and hard work throughout this important phase of the study, as well as to all of the participants for sharing their experiences and contributing invaluable insights.

The completion of the Photovoice workshops is a big milestone within Co-PACT. We look forward to bringing its learnings to the next phase of the study, which features experience-based co-design workshops involving a variety of stakeholders including (but not limited to) service users, staff members, and policymakers.

CURRENT FOCUS

As we transition out of data collection, we will begin the data cleaning and a period of multi-modal data analysis to prepare for the experience-based co-design workshops in a few months’ time. Data analysis will be a collaborative effort between the central research team alongside lived experience experts, to ensure rigour and integrity within this important process.

We will be in further touch about opportunities to participate in the experience-based co-design workshops as recruitment for these workshops take place over the next several months.

We are also planning to hold a focus group with staff from local teams (ex. clinical support officers) who we worked with during this first phase of the study; we look forward to discussing their experiences of the recruitment process, to gain a better understanding of any barriers and/or facilitators they may have encountered.

Finally, thank you for your continued support and engagement in the Co-PACT study.

As always, please e-mail copact@psych.ox.ac.uk if you have any questions or queries.

All the very best,

The Co-PACT Research Team

December 2021 Newsletter

As the year draws to an end, we’d like express gratitude towards everyone in our growing network. Conducting face to face this year has not been without its challenges, especially with the concerning news about the Omicron variant. It has never been so important to express our gratitude and warm wishes to our NHS colleagues, who work in a variety of roles, and play a vital part of delivering the Co-PACT study.

We’d like to thank our committed and resourceful Clinical studies Officers in Leeds, Birmingham, Manchester, Derby and Bradford – Alice Locker, Kiren Bains, Di Baines, Ashley Jones, Jill Cashin, Audrey Williamson, Rochelle Rhodes, Graham Spencer and Iftikhar Khan.

We’re lucky to have generous and passionate local PI’s: Nuwan Dissanayaka (Dis) (Leeds), Roshelle Ramkisson (Manchester), Kopal Tandon (Derby), and Laura Dixon (Bradford).

We’re grateful for the valuable contributions made by our brilliant Co-Investigators: Karen Newbigging, Raghu Raghavan, Rose McCabe, Paul McCrone, Nusrat Husain and Doreen Joseph.

Thank you to Suzi Laws for all your hard works and admin support. We couldn’t have done this without you. Thank you to all the venue staff at St George’s Conference Centre (Leeds), Earl Mill (Oldham), CNet (Bradford), Derby QUAD (Derby) and the Uffculme Centre (Birmingham).

We are so thankful for all the participants that have taken part from the five systems we have been recruiting from. Their contributions are more than just valuable data, they have submitted thoughtful and compelling photographs and captions that are beautifully creative and evocative. We feel privileged that we get to work so hard to use their data to make change happen.

We look forward to further collaboration with our NHS colleagues, co-investigators and participants in 2022. We also look forward to welcoming three new sites: Oxford, London and Lancashire. Although we may face ongoing challenges due to the pandemic, we look forward to tackling them with persistence and compassion. We also have our first webinar, in collaboration with the World Psychiatric Association on 25^th January. The webinar will be chaired by Kam and Clair and presented by Gulamabbas Lakha (A DPhil student at University of Oxford and a member of the CHiMES research group. Here is the link to register: https://www.eventbrite.com/e/faith-based-adaptations-to-therapeutic-interventions-for-depression-tickets-228508644507?aff=estw&utm-campaign=social&utm-content=attendeeshare&utm-medium=discovery&utm-source=tw&utm-term=listing

We’d like to send warm wishes to our everyone in the CHiMES research group.

Happy Holidays and warm wishes for 2022!

From the Co-PACT Team

November 2021 Newsletter

2 December 2021

In November we completed our first set of all three workshops, in snowy Leeds. The NHS Team in Leeds have been incredibly committed to Co-Pact and have really put their all in to recruiting for the project. This means we now have our first batch of data to upload and we can start thinking about analysis. It’s exciting to start thinking and planning for the next stage of the study.

We have our introductory workshop in Birmingham on Friday 3^rd December. This means we will have run introductory workshops in Leeds, Derby, Bradford, Manchester and Birmingham. We are on track to complete all three workshops in each of these sites before Christmas. After Christmas we will be running workshops in Oxford, London and Lancashire.

We have also held the first Staff photovoice workshop and are looking forward to receiving their images and captions. We are also going to be running more staff workshops in January. If you are interested in taking part or know someone who might be, please email: co-pact@psych.ox.ac.uk.

The first CHiMES webinar will be held on 8^th December at 10-11 on Zoom. Dr Katie Melvin will be talking about her recently published paper: ‘The feeling, embodiment and emotion of hallucinations in first episode psychosis: A prospective phenomenological visual-ecological study using novel multimodal unusual sensory experience (MUSE) maps’. If you would like to attend the webinar, please email clair.dempsey@psych.ox.ac.uk for the Zoom link.

October 2021 Newsletter

2 November 2021

This past month has seen several of our seven localities kick into gear, with the research team working closely alongside local study officers to finalize the logistics around the first service-user Photovoice workshops, as well as organize dates for the remaining two workshops at each site. Currently, we aim to run introductory workshops in London, Leeds, Manchester, Derby, and Bradford over the first two weeks of November, with the remaining workshops to take place by the end of December.

Staff workshops

As mentioned in previous newsletters, a reminder that we aim to hold the introductory staff Photovoice workshop on Thursday, the 11^th of November and the second staff workshop on Thursday, the 25^th of November. We are still recruiting staff members for these workshops involving professionals who have been involved in using the Mental Health Act to detain someone. Examples of staff/professionals include (but are not restricted to) mental health nurses, psychiatrists, and relevant police officers. If you know of anyone who you think would be eligible and would like to take part, or know of any groups we can present to for recruitment, please send an e-mail to Dr. Clair Dempsey, the post-doctoral researcher on the project, at clair.dempsey@psych.ox.ac.uk.

How to keep up with the study

We continue to hold a weekly Zoom drop-in session from 13:00-13:30 PM BST every Thursday; this session is aimed at anyone who is either already involved in the project or who wishes to be (including but not limited to, service users, mental health nurses, psychiatrists and academics). If you are interested to attend this online session, please click this Zoom link at the aforementioned time.

The CHiMES Collaborative–the Co-PACT study research group–will also be hosting its first webinar on Thursday, 11^thof November from 12:30-13:30 PM BST. This session will feature a discussion about Photovoice by a lived-experience expert and a researcher in the field, alongside an opportunity for further Q&A. More information about the event will be sent out shortly.

As always, please feel free to send us an e-mail with any questions or queries, and to keep up with the study’s progress via our Twitter feed at @co_pact for updates between now and the next newsletter issue at the end of November.

September 2021 Newsletter

We are very excited to announce that the first workshop of the study has now been conducted in Leeds. Co-PACT’s first group of participants is now in the process of capturing their experiences of detainment under the Mental Health Act with the disposable cameras given to them at the introductory workshop; the research team have received several completed cameras back in the post and will be processing these images in preparation for discussion at the second workshop, which will be taking place in the upcoming weeks. We would also like to commend the hard work of the staff from the local trust as they were instrumental to the introductory workshop’s success.

As the Leeds site continues to recruit and facilitate the second and third workshops, five sites are also actively recruiting as preparations are being made for their introductory workshops to take place.

Further, dates have now been set for the online staff Photovoice workshops: the introductory staff Photovoice workshop will take place on Thursday, the 11th of November and the second workshop will take place on Thursday, the 25th of November. We are still recruiting staff members for these workshops involving professionals who have been involved in using the Mental Health Act to detain someone. Examples of staff/professionals include (but are not restricted to) mental health nurses, psychiatrists, and relevant police officers. If you know of anyone who you think would be eligible and would like to take part, or know of any groups we can present to for recruitment, please send an e-mail to Dr. Clair Dempsey, the post-doctoral researcher on the project, at clair.dempsey@psych.ox.ac.uk.

A member of our research team will also be holding a weekly Zoom drop-in session from 13:00-13:30 PM BST every Thursday; this session is aimed at anyone who is either already involved in the project or who wishes to be (including but not limited to, service users, mental health nurses, psychiatrists and academics). If you are interested to attend this online session, please click this Zoom link at the aforementioned time.

Finally, the postponed webinar for the The CHiMES Collaborative–the Co-PACT study research group–will be taking place on Thursday, 11thof November from 12:30-13:30 PM BST. This session will feature a presentation about Photovoice by an expert in the field, alongside an opportunity for further discussion. More information about the event will be sent out in the upcoming weeks.

As always, please feel free to send us an e-mail with any questions or queries, and to keep up with the study’s progress via our Twitter feed at @co_pact for updates between now and the next newsletter issue at the end of October.

August 2021 Newsletter

There has been a lot of exciting activity this past month throughout our seven local systems; Leeds is the first site to be officially opened and is now recruiting participants for the site’s first Photovoice workshops. Progress is also steady at all other sites, which are at varying stages of initiation and recruitment.

The research team has put together several videos about Photovoice on our Co-PACT website featuring Ms. Doreen Joseph, our Patient and Public Involvement Lead and Expert by Experience, as well as Mr. Raf Hamazia, a previous Photovoice participant. Both videos offer an insightful snapshot into what Photovoice is and what the research process entails. The videos can be found here.

We are currently in the process of recruiting participants for Photovoice workshops involving professionals who have been involved in using the Mental Health Act to detain someone. Examples of professionals include (but are not restricted to) mental health nurses, psychiatrists, and relevant police officers. If you know of anyone who you think would be eligible and would like to take part, or know of any groups we can present to for recruitment, please let us know.

A member of our research team will be holding a drop-in Q&A session about Photovoice at 1 pm on Thursday, September 9^th; this session will be aimed at anyone who is either already involved in the project or who wishes to be (including but not limited to, service users, mental health nurses, psychiatrists and academics). If you are interested to be involved and/or to attend this online session, please let us know at co-pact@psych.ox.ac.uk and we will follow-up with a Zoom link. We would also appreciate if you could share this within your respective circles to hopefully reach additional individuals who fall within this criteria and who may be interested.

We are also excited to announce that the inaugural event for The CHiMES Collaborative–the Co-PACT study research group–webinar series will be taking place on Thursday, September 30^th and will feature a presentation about Photovoice by an expert in the field, alongside an opportunity for further discussion. More information about the event will be sent out in the upcoming weeks.

As always, please feel free to send us an e-mail at co-pact@psych.ox.ac.uk with any questions or queries, and to keep up with the study’s progress via our Twitter feed at @co_pact for updates between now and the next newsletter issue in September.

July 2021 Newsletter

Welcome to the inaugural newsletter update for the “Experience-based investigation and Co-design of approaches to Prevent and reduce Mental Health Act use” study, also known as Co-PACT. As a brief introduction, Co-PACT explores the disproportionate sectioning of racialised populations under the Mental Health Act in the UK, using photovoice as a novel and creative policy-research tool that engages service users as co-researchers. Funded by the NIHR Policy Research Programme and lead by Prof. Kam Bhui and Dr. Roisin Mooney (based at the University of Oxford), the research takes place within seven cities across the UK and will involve multi-stakeholder engagement for the co-designing of a new systems approach that seeks to reduce the inequalities related to compulsory detentions under the Mental Health Act.

The project officially began in February 2021, and will run for a period of 25 months. At the current stage, ethics approval has been granted and recruitment will begin once capacity and capability has been acquired from the eight participating NHS trusts. Members of the research team have undertaken photovoice training, and we hope to have completed all the workshops by December 2021.

This study promises to bring forth innovative and important insights, in regards to both content and method. We look forward to updating you on the progress of this exciting work through future newsletters, as well as through webinars and other engagement initiatives. If interested, please do give us a follow on Twitter @co_pact. If you have any queries, comments or ideas please do not hesitate to contact co-pact@psych.ox.ac.uk

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