Co-designing psychosis peer support in mental health inpatient wards

Mental health inpatient wards can be traumatising for people with psychosis. Bristol Health Partners, CLAHRC West and the Psychosis Health Integration Team (HIT) want to co-design peer support to address the root causes of this and help rewrite the psychosis narrative.

We applied for funding to the Q Exchange, and were excited to be one of the 25 shortlisted projects, from 139 applications. The final decision on funding was made via votes from attendees at the national Q event on 19 September, where we discussed our project with other people interested in quality improvement in health services. Sadly our project wasn’t supported, but the team gained lots of great new contacts and ideas. We are investigating other funding avenues and are developing the project further based on our experiences of the Q event.

The challenge

“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.

The idea

“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.

Our project is inspired by a public involvement event called 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 project is one of the outcomes of the event discussions and develops Martha Sneyd’s ideas to co-design peer support in inpatient wards.

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, so that breakdowns can become breakthroughs.

What will the project aim to do?

Using appreciative inquiry, and building on people’s strengths, values and ideas, we will:

• Conduct a literature review on peer support in similar settings
• Conduct telephone interviews with grassroots organisations and people who have implemented peer support in inpatient wards.
• Facilitate four workshops with:
  • Service users: what would they have appreciated from a peer support scheme whilst they were in hospital?
  • Families & people’s networks: what are their priorities for peer support?
  • Peer support workers: how can peer workers’ strengths and interests contribute to peer support work on wards?
  • Mental health hospital staff: how can peer supporters engage with people staying on wards
• Facilitate two co-design workshops, involving all previous workshop participants, to co-design the peer support
• Write up workshops and research publication
• Finalise the peer support design and work with partners and wards to deliver. Link with local commissioners and apply for longer-term funding for implementation and evaluation

Get in touch

We want to build connections with others to:

• Share experience of peer support in hospital settings
• Link with existing work and different mental health organisations
• Hear from mental health service users about their own experiences and what they would prioritise to co-design peer support for people with psychosis
• Promote the work and generate enthusiasm among networks

Contact details

• Oliver Watson, Bristol Health Partners, [email protected]
• Michelle Farr, CLAHRC West, [email protected]
• Martha Sneyd, Peer Director Psychosis Health Integration Team and Recovery Navigator, [email protected]