Clare Knighton – Fostering hope on an acute psychiatric ward through Peer Support

Hope. It’s a word often used in day to day conversation; I hope I win the lottery, I hope my partner has put the washing on when I get home. When we use the word hope in conversation, we are usually expecting something good or positive to happen but often it’s used without any action or thought to make the intended outcome a reality.

Well I’m going to talk about a different kind of hope. A hope that needs time, attention, nurturing and care. A hope that you can’t leave to fend for itself or ignore. I have blogged before, about the magic of peer support, of how transformative it has been for me and my personal journey. As I settle into this role, now well into my second year, other questions begin to surface, and I share them with you here.

I was a ‘frequent flyer’ to mental health wards before becoming a peer support worker. Now, somehow, magically I visit these places only as a staff member. Working side by side with the very people who have cared for me, seen me at my lowest, and seen me behave in a very distressed manner and now I’m part of the team. I really feel it. They check up on me, joke with me, and best of all, ask my opinion on how best to help someone. What more could anyone ask for? This integration into the team fosters my own hope and it grows daily.

I do spend some time helping people to understand what peer support is, but I’m happiest when I’m showing them what it is. How I can sit with someone in distress, and story share small bits to give them hope, that there is a way out of the darkness they find themselves in. How I can talk about my experiences of medication, when it worked well for me, when I resisted and how I got to a position to make my own choices. Or how I can suggest social activities that are going on outside of the ward, that can help give people other identities than that of’ mental health patient’.

Peer support on an acute psychiatric ward is all about growing hope. It’s fast paced; you never know how long you have to work with someone, how long they will be there, or even how ready they are for peer support. Even those who say they don’t want peer support, I can still help. Sitting with someone in silence is still a way to show them that you are there for them, and the hope sits there with me, waiting for them, being there for someone when they need it. Hope is also fostered in the language you use – positive affirmations, compliments and a genuine belief that someone is so much more than their diagnosis. Many people I see have lacked positive support in their lives, and who doesn’t want someone to believe in them? We all benefit from that and just because someone is detained under the mental health act doesn’t mean they can’t have hope; I am living proof!

An acute psychiatric ward may seem a place where there isn’t much hope that it’s all about control and dis-empowering people. I know different. Without being sectioned I wouldn’t have found peer support, I wouldn’t have been encouraged to apply to do the training, and ultimately change my life. All the staff want the same thing, for the person to recover and now with peer support on the team, I do all I can to prevent a ward becoming a revolving door, like it was for me for so many years.


Clare is an accredited peer support worker based in Worcestershire, a passionate coach, mentor, cat owner and lover of kindness..NHS champion..survivor….expert by experience. You can follow her on Twitter @knightonstar for daily tweets about peer support.

You can also read more of her other fantastic posts here


Note from editor:

If this post has sparked your interest in peer support, you might like to know about our specialist peer support training course which starts in London in June.  The Institute of Mental Health was the first nationally accredited education provider in the field of peer support training. A key element of the training is the model of co-production, co-learning and co-facilitation, whereby all training is delivered by two trainers who between them have clinical expertise and lived experience of distress. These experiences are grounded in an academic understanding of recovery and peer support. This authentic approach to training, enhances the learning experience and offers an opportunity to role model effective co-working of people with different backgrounds, demonstrating effective peer working. The training helps organisations to embrace the Recovery agenda and support the development of skilled Peer Supporters.
Closing date for applications: 5 May 2017




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First INDUCT School was a success!

INDUCT teamIn January 2017 the INDUCT (Interdisciplinary Network for Dementia Using Current Technology) team got together in Maastricht, a city in the south of the Netherlands, for the first INDUCT school. It was a great opportunity to finally meet, in person, all of our fellow PhDs on the programme. We were only able to meet each other virtually before, one of the wonders of technology, during an online course offered by INTERDEM (Early Detection and Timely Intervention in Dementia).

As the week progressed, our bond became stronger, not only because we could share and relate to each other’s challenges and struggles of starting a PhD, but also because we shared moments of joy and intellectual and personal growth. It was an intense week with multiple sessions providing us opportunities to learn new and exciting things. Have a look below for a brief overview of the week.

Monday: We kicked off the week with a session of elevator pitches in which every PhD student was required to explain his/her research in 90 seconds. It was an interesting moment for many, since it was just the beginning of the week and it was challenging to explain a huge amount of information in a short amount of time. The presence of 20 people you did not know very well contributed to the nerves. However, it was a safe environment which meant that people were given the space to think and take time. This feeling of safety set the tone for the rest of the week. The day continued with wonderful presentations on different methods to use technology in dementia research by Dr. Marco Blom and Rob Groot Zwaaftink from Alzheimer Nederland. Joris Wiersinga from Silverfit talk to us about the use of exergaming in dementia care to promote physical activity among people with dementia. We concluded the day with an interactive session by Phil Joddrell and Yvonne Kerkhof on making better use of touch-screen applications (apps) and how to make these more accessible for people with dementia.

Tuesday: The second day started with a session by Marc Wortmann from Alzheimer Disease International on global dementia policy which was followed by a talk by Professor Anne Margriet Pot on the World Health Organisation (WHO) dementia policy and an online, worldwide tool developed by the WHO for carers of people with dementia. We continued with a fun and enlightening role playing activities coordinated by our fellow ESRs, in which each of us took on the role of a different stakeholder when talking about ethics and the involvement of people with dementia. The last session about Patient and Public Involvement (PPI) with Dr. Nancy Preston informed us about PPI work in the UK and its importance for research.

Wednesday: On day three we enjoyed some workshops and were joined by members from the INTERDEM academy. The first workshop, led by Professor Rose-Marie Dröes from the VUmc in Amsterdam, covered the MRC (Medical Research Council) Framework and its application to piloting interventions. We had the opportunity to develop our own potential feasibility study in dementia care. In the afternoon we had a lecture and a workshop on the Theory of Change and the MRC framework led by Dr. Graham Moore, Professor Lieve Van der Block, Dr. Lara Pivodic and MSc. Joni Glissen.

Thursday: This day stood out as we had the participation of Alzheimer Europe, represented by Project Officer Ana Diaz, and the EWGPWD (European Working Group of People with Dementia), with Chris Roberts and Alv Orheim. After an inspiring talk Ms. Diaz and Mr. Roberts, we had the chance to ask Mr. Roberts and Mr. Orheim about how to involve people living with dementia in our PhDs. This session was great and provided us with a lot of useful and directed feedback.

Friday: The snow did not stop us from having a great last day. We started with a lecture given by Rosalie van Knippenberg and Dr. Lizzy Boots about the use of technology in their research. This was a relatable session because we could learn from their experience; the do’s and don’ts in dementia research while using technology. We also had the participation of second level partners (Betawerk and Eumedianet) who showed us their work and told us more about implementation of technology in health care settings (as well as dementia care).

On Friday it was also time to say goodbye. This was a great week for all of us, with a lot of learning and networking. The whole week was a fantastic experience and we just can’t wait for the next INDUCT school in September this year in Salamanca, Spain.


Aline Cavalcanti Barroso and Harleen Rai are Marie Sklodowska-Curie Researcher Fellows for INDUCT and PhD candidates at the Institute of Mental Health, University of Nottingham.
Contact: and



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A day in the life of Joy Rooney, Peer Support Worker

blogI work for two days a week as an intentional peer support worker (PSW, 07:00 – 15:00, Worcestershire Health and Care NHS Trust) in a recovery unit offering:  facilitated training group work, along with spending time with people on a one to one basis (1:1s), practical and emotional support.  People with longer term stays can develop their interests in, and benefit from the hearing voices group, bite size psychology group, peer group using the PeerZone free materials (from Mary O’Hagan in New Zealand), and the early warning signs course (written by Prof Jo Smith and Dr Tom Barker).  There’s also the gardening project which I initiated – growing vegetables and flowers in dedicated beds.  Other types of groups are run by the second intentional PSW who works on the other three days.

The day starts with the nursing handover, moves on to preparation for the days’ groups and 1:1s and then really gets going with 1:1s recovery orientated conversations with people, practical and emotional support.  The groups of up to nine people run at 11:00 and 14:00 for up to 45 minutes and I write case notes and make diary entries after the groups and 1:1 conversations.  It’s a hectic two days a week and reflection, refinement and lesson planning are taken home but not dwelt overly on.  There is a group meeting/ supervision with the other seven peer support workers across the county for two hours once a month and line management supervision from the ward manager too.

I really enjoy relating little chunks of my relevant experiences of poor mental health and how I coped with being in hospital in an empathetic way to people when I hear their stories. I know that holding hope for them to recover will see them improve and be discharged to live a self-determined life away from the hospital ward with the tools they need to prevent re-admission or at least reduce its longevity.

Within Worcestershire PSWs have typically worked exclusively with people with mental distress, but I have also met families and friends during the evening so that they can understand the ethos of recovery from its beginnings. By doing so I am able to help and support them in applying recovery principles when visiting and living with their loved ones.

The peer support I offer is unique because it flows from my personal experience of 38 years in secondary mental health services (now discharged), all its ups and down across four acute inpatient wards including three of the old asylums around England with multiple admissions as a ‘revolving door patient’. These chunks of relevant personal experience come from more than half a lifetime of mental distress. I am seen as a role model, someone that’s been there and got the t-shirt. Not many other mental health practitioners have that sort of experience “from the other side” – to know what it feels like to recover a life, trying to cope alone with lots of systems.

Although I have worked in many fields (notably as an agricultural research scientist for 16 years) in a number of roles and organisations, none has matched what I feel I am giving back to others with mental health difficulties as a PSW. I feel it gives me a sense of achievement when these people have ‘light bulb’ moments around the recovery principles and what it means to them. It especially gives me great joy when they are discharged.

Along with my recent academic successes both within the Trust and the University of Worcester in the Institute of Health and Society as an associate lecturer and research stemming from the IMPACT group of service users and carers (SUAC), I feel I am making a contribution to the knowledge base around peer support and SUAC, student and staff perceptions of SUAC involvement in higher education through peer reviewed publications. I am also a student again, taking a part-time Diploma in Education and Training to benefit my practice around teaching recovery in group sessions and teaching research, recovery and mental health, advocacy and long term conditions within the University of Worcester.

Being an intentional peer support worker is really important to my own wellbeing.

Dr Joy M Rooney is a project leader and peer support worker with Worcestershire Health and Care NHS Trust and an associate lecturer and researcher at the University of Worcester. Contact: or


Recent Publications/ conferences:

Rooney, J. M., Osborne, N. and Unwin, P. F. (2015). “The impact of IMPACT – reflections on the first seven years of a service user and carer (SUAC) group at the University of Worcester, UK”. Conference paper: Where’s The Patient’s Voice in Health Professional Education – 10 years on, 13/11/2015, Vancouver, Canada.

Rooney, J. M., Miles, N., and Barker, T. (2016a). “Patients’ Views: Peer Support Worker on Inpatient Wards.” Mental Health and Social Inclusion 20(3) 160-166. doi 10.1108/MHSI-02-2016-0007.

Rooney, J. M. and Unwin, P. (2016b). “Transformative or Tokenistic – Can involving service users and carers in the training of health and social care professionals promote social justice?” Social Justice Conference 26/06/2016 University of Worcester.

Rooney, J. M., Unwin, P. F. and Osborne, N. D. (2016c). “Gaining by Giving? Peer Research into Service User and Carer perceptions of Inclusivity in Higher Education.” Social Work Education. 35(8) 945-959.

Rooney, J. M. (2017). “HQUIP Case Study. Patients value peer support worker in their recovery. ”

Unwin, P., Rooney, J. M. and Cole, C. (2017, in press). “An evaluation of the impact of service user and carer involvement on students’ classroom learning in higher education.” Journal of Further and Higher Education.

Unwin, P., Rooney, J. M., Osborne, N., and Cole, C. (201x, accepted). “Are perceptions of disability changed by the involvement of service users and carers in the qualifying training of health and social work professionals?” Disability and Society.



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New book deal for IMH staff! Positive psychotherapy for psychosis

We are pleased to announce the publication of a new book called Positive Psychotherapy for Psychosis, by Mike Slade, Tamsin Brownell, Tayyab Rashid and Beate Schrank. The book describes a new psychological intervention, which for the first time applies emerging research from the field of positive psychology specifically to psychosis. It is a guide and manual for clinicians, divided into two sections: theory and intervention manual. The intervention is based on methodologically rigorous research and case studies, and gives detailed aims and instructions for clinicians and therapists. The structured, step-by-step manual, for use with clients, includes downloadable handouts, session materials, activities, guides and therapist tips. The book also contains guidance on adapting the approach for use in individual treatments, and on providing part of the intervention, either as individual sessions or by integrating Positive Psychotherapy for Psychosis sessions into other treatments.

Positive Psychotherapy for Psychosis will be of interest to mental health clinicians working with people with psychosis, as well as clinical and counselling psychologists, psychiatrists, mental health nurses, psychotherapists, social workers, occupational therapists, support workers and peer support specialists. The aim is for the manual to be a practical, positive and innovative resource for mental health professionals, providing all the material needed to deliver this evidence-based approach that is designed to improve wellbeing and reduce symptoms experienced by people living with psychosis.

Mike Slade commented “there is a growing interest within society about positive psychology and wellbeing approaches such as mindfulness, character strengths, forgiveness and gratitude. In developing this intervention we started with the assumption that what people living with psychosis need in order to get on with their life is in many, but not all, ways similar to what everyone else needs to live well. So we looked at the small ways in which positive psychology approaches need to be modified for people who experience psychosis, and then evaluated and further refined these approaches using randomised controlled trial and qualitative methodologies. The hope is that this type of intervention – based on research and focused on supporting people with psychosis to ‘live well’ rather than having their problems fixed – is part of a broader movement towards citizenship for people living with psychosis.

The book has been endorsed by international leaders. Prof Bob Drake from Dartmouth Medical School said “This book should become required reading for all of us who treat people with serious mental illness” and A/Prof Lindsay Oades from the Centre for Positive Psychology at University of Melbourne said “The Positive Psychotherapy for Psychosis intervention represents state-of-the-art psychological practice”.


IMH blog readers can get an exclusive 20% off! Just follow the link to the publishers website and use the discount code  IRK71

More information about the development and evaluation of the intervention is at:



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Professor Mike Slade introduces Refocus on Recovery 2017

Refocus on Recovery 2017 is an exciting international scientific conference which is coming to the Institute of Mental Health. It is the largest regular scientific conference on recovery in the world, and will take place on 18-20 September 2017. This is the first time the conference has been held outside London, and we know Nottingham will do us proud!

The conference is all about recovery for people with mental health problems, and is presenting world-leading research about how people can live well with illness. It is being organised by the Institute of Mental Health, School of Health Sciences (University of Nottingham), Nottinghamshire Healthcare NHS Foundation Trust, ImROC, Making Waves and Mental Health Foundation.

Keynote speakers come from the UK (Steve Gillard, Isabella Goldie, Jayasree Kalathil, Anu Singh, Mike Slade) as well as from India (Manoj Kumar), Canada (Kwame McKenzie), Germany (Jasna Russo) and Norway (Mark Hopfenbeck). We will also hear from Jenny Edwards (Chief Executive, Mental Health Foundation) and Ruth Hawkins (Chief Executive, Nottinghamshire Healthcare NHS Foundation Trust).

It promises a great opportunity for learning and networking. For the three previous Recovery conferences, around 500 people came from 25 countries.

There is a lively social programme, as well as the Gala Dinner, we have exciting creative opportunities such as the boomwhacker percussion energiser event, a ‘Story Shop’ offering a range of stories from people with lived experience and more….

The conference has four themes:

Theme 1: Recovery for different groups: The meaning of, and support for, recovery in long-term conditions (physical and mental). Recovery in marginalised groups, e.g. culturally-sensitive services. Understanding and supporting recovery in mental health systems, e.g. Open Dialogue, REFOCUS, Individual Placement and Support. Organisational and individual influences on Peer Support Workers, including the meaning of ‘peer’.

Theme 2: Re-situating recovery: Engaging with culture and community to make recovery a reality. Mainstreaming recovery, and links with other community initiatives, e.g. dementia-friendly communities. The role of family and supporters – what is a family in recovery? Improving access, e.g. digital interventions. Recovery Colleges as a bridge between mental health system and community. Insights from Mad Studies about recovery.

Theme 3: Prevention of mental ill-health: Supporting the development of resilience in individuals and communities. Creating inclusive communities. Inter-sectoral understandings of stigma and discrimination. National and local anti-stigma campaigns. Supporting self-management, including peer-led approaches. The role of inter-dependence. The impact of language and embedded assumptions. Developing new narratives, e.g. Mad lit, Photovoice.

Theme 4: Allocating resources: How money is spent, and with what effect. Service models and structures which foster or hinder recovery. Co-production and co-development approaches. The role of volunteers. Providing services in resource-poor settings. The contribution of health and social policy to recovery. The impact of legislation and commissioning arrangements.

Get on board!

  • Find out more about the expert workshops and the conference at com/ror2017
  • Submit an abstract (don’t miss the deadline: 28 February 2017).
  • Come along – register now, with a limited number of reduced rates for ‘early bird’ registrations.
  • Spread the word! This is such a great opportunity we don’t want to keep it to ourselves. Please feel free to send a link to this blog or the website to colleagues who may be interested.
  • Join the conversation on Twitter using the hashtag (#RonR2017).

We hope to see you there.

Mike Slade is Professor of Mental Health Recovery and Social Inclusion at the University of Nottingham, based in the School of Health Sciences in the Faculty of Medicine and Health Sciences, and working at the Institute of Mental Health.


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IMH annual research day: 9th May, 2017. Call for papers

The Institute of Mental Health (IMH) will be hosting its Annual Research Day to highlight the work of the Institute’s doctoral candidates, Managed Innovation Networks (MINs), and early-career researchers (including research assistants, research fellows, and research-active clinicians and service users).

There will be prizes for best oral presentation and best poster. The event is being promoted to all IMH members and we anticipate a good selection of speakers presenting and a good range of people in the audience — both local and national health researchers and practitioners plus IMH members. The event will be chaired by Professor Peter Bartlett and Dr Jenelle Clarke. There will also be plenary sessions from inspiring and established experts.

This Annual Research Day focuses intentionally on those at the beginning of their research careers, and represents a welcoming and career-developing forum for researchers (it is wonderful for the CV and excellent presentation practice in a friendly setting).

We expect the format to resemble that of a conference with 20 minute oral presentations per paper with 10 minutes for questions from the floor.

Please submit a title and 250 word abstract to:
Dr Jenelle Clarke (
By Monday 3rd April 2017


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Alessandro Bosco: Alzheimer Europe conference 2016


Can we create a dementia-friendly society? This was the question around which people with dementia, carers, professionals and academic researchers gathered during the 26th Alzheimer Europe conference in Copenhagen.

A large representation from the Institute of Mental Health (IMH) attended the event to promote the innovative (and diverse) research that the Institute is nationally and internationally renowned for and contribute with their ideas and expertise to the scientific discourse around dementia. All the attendees had unique networking opportunities with colleagues from all over the world and many of us presented their work through posters and oral presentations. Professor Martin Orrell, director of the IMH and Head of the division of Psychiatry and Applied Psychology, was present to promote the work of the institute and to create new European partnerships in dementia research.

Professor Tom Dening, head of the IMH Centre for Dementia, gave an oral presentation during the INTERDEM session entitled, ‘Where’s the happiness in dementia?’, which led to a lively discussion about the emotional experiences of people with dementia. He gave an oral presentation on a parallel session about   (The Arts and Dementia), a programme of the Nottingham-Worcester doctoral training centre funded by the Alzheimer’s Society. Tom also exhibited a poster on the NIHR Optimal project on effective health care for older people resident in care homes. A Medical student, Imogen Ovenden, who Tom supervises for her BMedSci, displayed a poster entitled ‘Bowling for Dementia’

Professor Justine Schneider and Alessandro Bosco co-presented a Social return on investment analysis of the Imagine study on arts interventions for people with dementia. People with dementia and their carers reported positive outcomes in relation to the mental wellbeing of participating individuals following involvement in arts programmes. These findings call for consistent integration of diverse arts activities in the care setting.

An example of art performance which promotes the mental wellbeing and quality of life of people with dementia was illustrated by Dr Orii McDermott, who presented on the development and preliminary evaluation of the CHORD (CHOrus Research in Dementia) Manual. This project aims to identify music therapeutic techniques that are transferable to facilitators of music activities and to develop a standardised singing manual.

Quality of life was central to the work that Déborah De Oliveira presented, entitled ‘Identifying meaningful aspects of quality of life for older family carers of people with dementia in focus groups’. Deborah also had a poster on the ‘Development and psychometric evaluation of the dementia quality of life scale for older family carers – DQoL-OC’. Our colleague Lucy Perry-Young presented ‘Broadening our understanding of good home care for people with dementia’.

Some PhD students also attended the conference. Aline Cavalcanti Barroso and Harleen Rai had an opportunity to collect ideas around their PhD projects on assistive technology in dementia. Claudio Di Lorito discussed and promoted his PhD project on the mental health of forensic psychiatric patients with dementia.

Having just begun with my doctoral studies, this was a spectacular first taste of my journey in dementia research. Indeed, I considered this my baptism of fire, as I had the opportunity to co-present my work in front of a large and technical audience during a parallel session. This was a fulfilling experience and a professionally enriching one, as I was able to challenge my stage fright, build up confidence and master my presentation. The audience responded engagingly to my talk and I was thrilled to receive very positive feedback from members of the audience at the end.

Although there were several poster and oral presentations on quality of care, little was dedicated to the models of person-centred care in dementia. Does the support people with dementia receive respect their personhood? Are the current models inclusive of the experience of the carers? During my first year, I aim to gather the existing evidence in this crucial area through a scoping review around person-centred care models. Given the centrality of personhood and the role of carers in delivering the care, it is timely that this concept is acknowledged and addressed if we aim to build a dementia-friendly society. I hope I will have the opportunity to present the findings of my review during the conference next year and share good practice with colleagues from different countries at the INTERDEM academy meetings to come.

Hoping that an even larger representation of researchers and people from the public will attend next year’s conference, we invite you to join us as ambassadors for dementia at the Alzheimer Europe conference 2017 in Berlin, Germany.

Alessandro Bosco is a postgraduate researcher and an Economic and Social Research Council PhD candidate in Mental Health & Wellbeing at the Institute of mental Health, University of Nottingham. Contact:



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