Dr Stefan Rennick-Egglestone, Institute of Mental Health
A big change seems to have occurred in our society over the last few decades. Mental health problems, once somewhat more private, are now openly discussed by many.
This has included public figures such as Alaster Campbell, who has openly talked about his experiences of both psychosis and severe depression in his biography. The Time To Change anti-stigma campaign promoted personal experience sharing, through road shows and hundreds of recorded videos. It found an association between campaign awareness and help seeking, raising a possibility that greater openness about mental health might enable more people to seek help. A range of organisations have been examining whether sharing narratives describing mental health problems and recovery can help others to recovery. These include Recovery Deveon, who published two books of recovery narratives, and the Scottish Recovery Network, who have published recovery narratives online.
Click here to view these publications on recovery narratives.
Researchers in the Institute of Mental Health have now published the findings of the world’s first clinical trial looking at whether access to mental health recovery narratives helps people affected by mental health problems. Our findings were published in World Psychiatry, which is the world’s most impactful psychiatric journal. For the NEON-O Trial, we recruited 1,023 participants, who were experiencing mental health problems, but who had never experienced psychosis. We gave half of those participants immediate access to a collection of 659 mental health recovery narratives, that we had assembled from around the world. The remaining participants received access after one year. Narratives were accessed through the NEON Intervention, a web-application that incorporated an algorithm recommending narratives to participants, drawing on theories that we have developed since starting our Narrative Experiences Online (NEON) study in 2017.
Click here to read more about the NEON programme.
Our trial found that access to mental health recovery narratives improved participants’ quality of life. This is an important finding, because the research concept of quality of life assesses concepts that really matter to people, such as their satisfaction with their relationships and health. We also found that access to narratives increased participant’s perception that their life had meaning, important when feeling that your life has meaning can protect against a range of mental health challenges. These benefits were provided at a cost that was substantially less than a threshold that the National Health Service in England will routinely pay for treatments. For the subset of trial participants who were already being treated by specialist mental health services (such as community mental health teams) then access to recovery narratives saved NHS resources without causing harm, including through less meetings with psychiatrists and psychologists. We hope that these positive findings will influence clinical practice, and intend to explore this through future grants.
Our NEON-O Trial findings contribute to a wider exploration of recovery narratives and the benefits that they can provide to others, in which the IMH has real expertise. The KLIFAD study has begun to examine whether alcohol misuse recovery narratives can help people who are drinking harmfully. It reported some positive preliminary findings in Lancet eClinicalMedicine. We hope to continue this work through a large trial in alcohol treatment services. We have produced and published a guide for good practices around using recovery narratives in interventions, which focuses on how to avoid misusing what can be very personal and meaningful accounts.