Citizenship and recovery orientated practice and care: developing international networks, collaborations and funding proposals

CRISP secondment and conference, 19 July 2019, Yale University/New York University

A blog by Nicola Cogan, Clinical Psychologist/Lecturer, University of Strathclyde

I had the privilege of being a CRISP secondee at the Program of Recovery and Community Health (PRCH), Yale School of Medicine, University of Yale in the summer of 2019.

During my CRISP secondment at PRCH I had the opportunity to engage and network with peer researchers, world leading academics and health and social care practitioners ‘trail blazing’ the way forward in ‘recovery’ and ‘citizenship’ orientated research, policy and practice. Having worked many years as a practicing clinical psychologist in adult mental health in the NHS, I have always questioned the dominance of the biomedical model and symptomatic focus in mental health services in the UK. An overly individualistic and clinical approach can mean we risk losing sight of all the other things that need to be in place for people to get their lives back on track following a major life disrupting event, such as experiencing a psychiatric hospitalisation.

My time at PRCH has helped me to develop my understanding of the social and cultural contextual determinants of mental health. As part of a working collaborative led by Professor Michael Rowe, PRCH, I have come to understand how citizenship can be defined as a person’s connection to the “5 Rs” of rights, responsibilities, roles, resources, and relationships that a democratic society offers to its members through public and social institutions. Along with these 5 R’s is the need for a sense of belonging in one’s community and in society. For ‘belonging’ to be real, people need the recognition of others and to experience a sense of having socially valued roles. Professor Larry Davidson, PRCH, explores how ‘citizenship’ can counterbalance an overly individualistic interpretation of recovery with the introduction of citizenship-orientated care and practice; from this stance we can begin to consider the whole person, as a citizen of their community. With this in view, I have come to realise that we need a different ethos and set of outcome measures in health and social care practice in order to capture this broader understanding.

In working in partnership with my colleagues at  the University of Strathclyde (UoS) and PRCH, I have engaged in collaborative, international community based participatory research (CBPR) to develop a model and measure of citizenship to be applied in health and social care practice in Scotland. I now have a stronger appreciation of the strengths and unique challenges of conducting CBPR with peer researchers and the mechanisms for ‘good practice’ in adapting our methodologies to ensure meaningful participation for all. I have gained a deeper understanding of the importance of promoting social inclusion and raising awareness of the social and attitudinal barriers that people with lived experience of mental health problems and other life disrupting events (e.g. substance use, homelessness) often face.

Furthermore, I have had the opportunity to develop and strengthen relationships with international partners at both Yale and New York University (NYU) and we are currently developing international funding proposals to continue our working partnerships and research networks, building upon the work of CRISP. Having disseminated research findings, along with my UoS colleagues, Dr Gillian MacIntyre and Neil Quinn, at the CRISP Conference at NYU in July 2019, we benefitted from learning from our colleagues at NYU and seek to broaden our research and knowledge exchange partnerships moving forward.

It is envisaged that this work will further our cross cultural understandings of citizenship and recovery in making sense of people’s lived experiences. Finally, we aim to showcase ground-breaking research and practice to have emerged through CRISP at our forthcoming conference to be held at the UoS in August 2019. I am excited to see how the work to have emerged through CRISP will be implemented in policy and practice and have ‘real world’ impact in the future.

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