Process and content words

You are being asked to write a report that provides a justification for the planned mental health services. The key process word here is therefore ‘justification’ – or ‘justify’. This means that you need to provide evidence and arguments that support the claims you make about the interventions that your organisation wishes to provide.

The important content words are ‘mental distress’ and the ‘interventions’ that are designed to improve ‘mental health’.

So, you will need to demonstrate some awareness of the debates about the nature of these difficulties and what alleviating them might mean. Remember that there might be different perspectives on this – there might be differences between the point of view of mental health professionals, the users of the services, and the wider community.

You will need to write in a balanced way that demonstrates your ability to evaluate evidence and arguments and to show awareness of counter-evidence and counter-arguments.

Structure

The report should have the following structure (the word lengths should be used as a guide):

• Introduction (200 words):

  This should briefly explain the background to the report, and summarise its important points, including a brief rationale and purpose of the interventions that would be provided.

• Peer support and a collaborative approach (1000 words):

  This section should provide a justification for why your organisation seeks to provide an intervention based on peer support and takes an approach of working collaboratively with people who have experience of mental distress and what can be gained from this way of working. A good answer will show critical awareness of the significance of the service-user movement and the way it has emerged from dissatisfaction with aspects of mental health service delivery. It will include awareness of the ethical and practical advantages of service-user involvement, alongside some of the potential obstacles and difficulties that can be encountered.

• Community activism/campaigning (1000 words): those responsible for funding are particularly interested in your organisation’s support for approaches that do not solely rely on professional mental health interventions, but instead seek to strengthen the capacity of communities to cope with crises and support individuals who are impacted. They have asked you to:

  • explain this community-orientated approach, using theory and evidence to explain why this is preferable to relying solely on individual therapeutic interventions
  • give some examples of work in this area
  • suggest one community-based intervention to alleviate the difficulties experienced by people who have had experience of detention, whether in prison or hospital.

  You need to briefly describe the community-based intervention – what it is and what it aims to do. You will need to use relevant literature and research evidence to justify the approach. Remember that you are being asked to provide a rationale for the intervention that you are proposing. You need to explain the rationale of a community-level intervention and why you believe that it would work, and the expected impact of taking this approach on mental health. The impact might need to include, for example, particular factors, such as social cohesion, inequality or racism.

  You will want to emphasise particular issues that have been identified as significant to mental distress that is associated with detention in hospital or prison. For example, these might include experiences of trauma and high levels of stigma and exclusion.

  You will also want to consider what characteristics of communities seem more likely to be associated with poorer, or better, mental health. For example, interventions might aim to equip the community to provide better support – and be better equipped to ameliorate the impact of trauma and stigma.

  You should avoid spending too much time describing the community-based intervention, as higher marks will be awarded for your use of theory and evidence that provide the rationale for the intervention. The rationale might include the positive impact on the mental health of individuals suffering from distress and might also include the benefits to the community.

• Conclusion (200 words): summarise the main arguments for the approaches that you have adopted.

Approaching the task

An important element of writing this part of the EMA is to remember your audience and write appropriately for them. Your audience has been identified as not necessarily experts in the field, so you should not assume familiarity with psychological concepts, theories or terminology. If you use specialist terminology, you should define the term first. You should also use a format that is appropriate for a report, presenting your material in an appropriate style and using the structure outlined above so that it is clear and concise. You do need to demonstrate that you have a good understanding of the debates in this area and that you are using evidence and theory to back up the claims you are making.

You may use sub-headings, which will be included in the word count. You can use non-textual elements if they help to convey your points, such as tables, graphs, figures or diagrams. However, words associated with figures will count towards the word count, so do make sure that any such elements serve a useful function in your report: do not include them just for the sake of it. The highest marks will still be possible for reports which don’t use them. If you use non-textual elements, make sure you put them in the main body of your report (not in an appendix) and explain and reference them sufficiently in the text.

For good marks you should draw on material from across the module, so when selecting which material to cover make sure you demonstrate a breadth of knowledge (e.g. don’t draw exclusively, or very heavily, on just one topic, no matter how interesting you find it).

Independent research

An important part of this EMA is that you demonstrate your ability to carry out your own independent reading and research. You should draw on at least two additional sources of material that you have found through your own independent research to help illustrate your points. It is likely that those awarded higher marks will use more sources than this. The sources might be recent research papers that you have found through the Open University Library, for example. The material used should be relevant and credible. Two of the skills activities from Block 1 should be helpful in finding and evaluating material: Week 2, Section 5.2 ‘Finding and handling information’  and Week 5, Section 4 ‘Quality of sources’.

The significance of service-user involvement and peer support

It is important to show that you understand some of the context of debates about the importance of service providers working collaboratively with people who have had experience of mental distress and of using mental health services. In Block 1 you will find important material that introduces some of the debates about the mental health system and some of the difficulties encountered by service users.

Week 2  presents some of the key contrasting claims made about mental health services and the extent to which they have developed in order to support and/or control people. Week 2 and Chapter 1 present some of the ethical dilemmas of mental health service delivery – notably those concerning issues of liberty and confinement.

Week 3 looks at some of the major criticisms of psychiatry by academics, from within the professions and by service users. Chapter 2 looks directly at the service-user movement. Week 5 looks at some of the negative experiences that people can have of being diagnosed, which might also help you answer this question.

Presenting problems

The task requires that you consider the particular needs of people who have been detained under the Mental Health Act 2007. It is worth noting that many of the needs of this group will be common to others experiencing mental distress. You might want to focus particularly on either the experience of detention in hospital or the experience of prison, or you might choose not to confine your focus to only one of those. Whatever your chosen emphasis, your focus should be on how interventions aimed at the community level might be deployed to support the needs of those who have had experience of detention.

While you will not need to spell out the powers of the Mental Health Act in your report, it will be important that you demonstrate an understanding of the powers of the Act and their implications. Some of the details of the powers of the Act are set out in Chapter 18, Section 2 ‘The legal framework and the Mental Health Act’. Particular attention is given to the ‘powers of detention’ in Section 2.1.

You might also consider some of the fears of detention that were raised by Fariha in Week 23, Section 3.1 and the related discussion about the damage that might be associated with involuntary detention, which might be relevant to your report.

The general issue of mental disorder and the criminal justice system is discussed in Chapter 18, Section 3. Week 23, Section 5 looks at the issue of mental disorder and the prison system. Section 5.2 looks at the impact that prison can have on people and the possible similarities with institutionalisation (discussed in Week 3, Section 3.2 ‘Institutionalisation and identity’).

It is clear that experiences of hospitalisation and prison can be stigmatising in themselves. The role that stigma can play in mental health is discussed in Week 5, Section 3.1.

Some of the material in Week 23 clearly suggests that experiences of prison can themselves be traumatic and might at least exacerbate issues and symptoms of mental distress. This might be something you want to emphasise. There is material in Block 2 introducing perspectives on the significance of trauma on mental health (see Week 8 and also Chapter 6 of the textbook).

Activism and the significance of community

You should demonstrate that you have a good understanding of the issues that are raised in Block 5. You are being asked here not to think about interventions and treatments that are aimed at individuals but to consider the social context of mental health. This means thinking about not only how social conditions might cause or exacerbate mental distress (Week 24  and Chapter 19), but the reciprocal relationship between good mental health and social conditions. Some of this material might help you think about how different communities might be more resilient than others.

Week 24 provides a detailed focus on thinking beyond the level of the individual in theorising interventions to support mental health, with Sections 4.2, 4.3 and 4.4 focusing particularly on justifying the rationale for community-level interventions.

Chapter 19 ‘Individual or social problems?’ gives a detailed account of how symptoms of mental ill health can very often be understood as emerging from the social context in which people live. These themes are explored further in Week 24 of the VLE.

Section 4.4 provides guidance on structuring a report and includes three examples of Mind reports addressing the impact on mental health of lack of access to psychological therapies, lack of access to legal support, and building resilient communities.

Week 25 and Chapter 20 look at the potential significance of how society itself might have been shaped by some of the ideas we have about the nature of mental health – some of the pros and cons of this impact might be considered here.

Community and trauma

Material in Week 25  looks at the experience of trauma at Aberfan (Section 6) and Grenfell Tower (Section 7). Both of these events are discussed in relation to the significance of ‘therapeutic culture’ (which is explored in some detail in Chapter 20 of the module textbook). Both of these include different examples of community response. Week 25, Section 6.3 discusses the importance of community support in times of crisis and the concept of ‘community resilience’ in particular.

Student notes for Part 2

Focus of the task

A key theme of D241 is ‘diverse experiences’, and this is developed further in Week 1, Section 2.2, under the heading of ‘Reflexivity’.

Use an example of a client’s experiences drawn from the module material (the experiences of Helen or Peter or Laura) to illustrate your understanding of the interconnected themes of diversity and reflexivity. If this person were a service user you were working alongside, what might you need to be reflexively aware of in relation to your own similar and different experiences?