06132650 dissertation 2016 uh

Dissertation: An interpretative phenomenological analysis of the social capital

provided by community events for families living with depression: A

Hertfordshire Case Study

Programme: MSc International Tourism and Hospitality Management

Student’s Family Name: Watkins

Students Given Name(S): Nicola Anne

Student Number: 06132650

Supervisor: Dr Raphaela Stadler

Dissertation Module Leader: Dr Adrienn Sandor

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University of Hertfordshire Business School

MSc International Tourism and Hospitality Management

An interpretative phenomenological analysis of the social capital provided by community events for families living with depression: A Hertfordshire Case Study

Dissertation: BSITH 7BSP1136-0909

Nicola Anne Watkins

Student No: 06132650

Supervisor: Dr Raphaela Stadler

Submission Date: 8th September 2016

Final word count: 14,939

Ethics Number: BUS/PGT/UH/02208

Acknowledgements

Firstly, the researcher would like to thank the organisations and people whom participated

within this project for their valuable insight, expertise and contributions:

Rachel Kelly, Author, Ambassador for SANE and a vice president of United

Response.

Steve Mallen, The MindEd Trust

Seth Hunter, The Dragon Café

Dr Susan J. Noonan

Leavesden Green Jmi School

Professor Ben Fletcher, University of Hertfordshire

Dr Raphaela Stadler, University of Hertfordshire

Dr Allan Jepson, University of Hertfordshire

Dr Alina Congreve, University of Hertfordshire

Teresa Heritage, District and County Councillor, Hertfordshire County Council

Hertfordshire County Council – Health and Wellbeing Board – Five Ways to

Wellbeing

Lucy Bailey, How to Thrive

Amy Stickings, Hertfordshire Mind

Gary Foley, Everyone Active, Watford

Alison Goodchild, Active Herts

Usborne Books Independent Organiser

Jigsaw Performing Arts School

Hertfordshire Inclusive Theatre

Jade, featured on BBC in the Mind series

The families whom participated from Leavesden Green Jmi School

I would also like to thank my mentor Liz Quick, whom has always supported me

throughout my academic studies and encouraged me to pursue postgraduate studies. I

dedicate this to my wonderful family and friends for their continued support.

Abstract

An interpretive phenomenological analysis into the social capital provided by community

events for families living with depression. The study worked with multiple qualitative

methods mainly utilising in-depth interviews, an action research, small scale live

community event with natural setting observation field notes and an event feedback

survey (Lyons and Coyle, 2016). The research examined the social capital family quality

of life with a qualitative approach, initially from an individual perspective then the effect on

the family as a whole (Stadler and Jepson, In press). Only three dimensions of the social

capital were investigated due to time restriction of the project. The social and emotional

wellbeing element showed improved mental health wellbeing such as social community

relationships and improved emotional resilience, the family interpersonal relations element

looked at the internal family group which also led to interpreting this from a social

psychology perspective, looking at the social identity of the family, the community identity

and the event temporary community identities to fully comprehend the subject matter

(Hogg and Vaughan, 2014, Altinay and Paraskevas, 2008). Finally, recovery or prevention

from the symptoms of depression, discovering how community events can play a key part

in recovery and prevention for symptoms of the mental illness depression. Examining

mental health meant the project had to examine mental health awareness and stigmatism,

which community events can take a social support network approach and raise

awareness to reduce stigmatism which is needed, this was looked at from a community

psychology perspective (Kloos et al. 2014).

Contents

1.0 Chapter One: Introduction

1.1 Project Initiation……………….…………………….……………………………………....1 1.2 Background of the research………………………………………………………….……2 1.3 Aims and Objectives……………….………………………………………………………..3 1.4 Research contribution to knowledge…………………………………………………….4 1.5 Project structure………………….………………………………………………………….4 2.0 Chapter Two: Literature Review

2.1 Community events for social capital……………………………………………………..5 2.2 The social capital, family quality of life……………………………..............................7 2.1.1 Family Interpersonal Relations …………………………………….………………..…8 2.1.2 Social and Emotional Wellbeing………………………………………………….…...10 2.1.3 Recovery or Prevention…………………………………………………………...…….12 2.3 Community and Social Psychology theoretical framework………………………...14 2.2.1 Social Identity theory………………….....................................................................15 2.2.2 Social influence and social groups………………………………………………...…15 2.2.3 The influence of community psychology……………………………………..……..17 3.0 Chapter Three: Research Methodology

3.1 Research Philosophy………………………................................................................19 3.1.1 Research design …………………………………………………………..………..…...20 3.1.2 Research ethics……………………………………………………………………..……21 3.1.3 Selection of methods and target samplerationale…...........................................21 3.2 Primary research methods……………………………………………………………..…22 3.2.1 In-depth interviews……………………….................................................................23 3.2.2 Action Research – Wellbeing Event in Watford, Hertfordshire………………….24 3.2.3 Natural setting event observation and field notes ……………............................24 3.2.4 Event feedback survey………………………………………………………………….25 3.3 Research assessment, critique and analysis…….……………………...…………...26 4.0 Chapter Four: Data Analysis, findings and discussion

4.1 Social and Emotional Wellbeing…………………………………………………..….…27 4.2 Family Interpersonal Relations……………………………………………………..…...32 4.3 Recovery or Prevention………………………………………………………………...…35 4.4 Discussion………………………………………………………………………………......38 Chapter Five - Conclusion and Recommendations 5.1 Conclusion and recommendations……………………………………………………..40 Chapter Six – Personal Reflections 6.1 Lessons Learned……………………………...…………………………………...41 Reference List……………………………………………….............................................….42 Appendices: Appendix A: The MindEd Trust “NHS England Statistics”……………………………...48 Appendix B: Bertram and McDonald’s (2015) Framework………………………………50

Appendix C: Event Case Study: Applying the MAUDE framework to Changing Minds Festival Launch and The MindEd Trust Conference……………………………………..53 Appendix D: Postgraduate First Information Form…………………………………….…61 Appendix E: Ethics Application……………………………………………………………...67 Appendix F: Phase One - Dr. Susan J. Noonan, MD, MPH Expertise Interview…....101 Appendix G: Interview Questions………………………………………………….…...….105 Appendix H: Phase Two - Action Research – Live Community Event Plan……...…106 Appendix I: Phase Two - Summarised Field notes……………….………………….….113 Appendix J: Phase Two - Event Feedback Survey…………………………………...…121 Appendix K: Dissertation Log………………………………………………………………126 Appendix L: Transcripts………………………………………………………………...…...131 List of Figures Figure 1: FQOL Domains for families with disabilities…………………………….……...7 Figure 2: Henderson, (2016) Public of Health England “Six principles to shape our thinking about young people’s health”……………...………………...............................11 Figure 3: Community centred approaches to wellbeing…………………………..…….10 Figure 4: Social Action Model adapted from Holland, (1992) Models………………...18 Figure 5: Research Phase Design……………………………………………………………22 Figure 6: Attendee Social Identities at School Community Events……………..….…39 List of Tables Table 1: The invalidation and validation framework applied to FQOL….………..…...12

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University of Hertfordshire Dissertation

1.0 Chapter One: Introduction

1.1 Project Initiation

Mental health distress such as depression has become a global widespread epidemic,

one in four adults will experience at least one diagnosable mental illness in any given

year. One in ten children aged five to sixteen will have a diagnosable disorder, a

population sample representative of three to four children in every classroom (MHT,

2016). Half of all mental illnesses will have established by the age of fourteen, rising to

seventy-five percent by the age of twenty-four (MHT, 2016, DoH and NHSE, 2015).

Depression has no prejudice and will affect people from all demographic segmentation

(Dan et al, 2011). Depression can often be hidden and disabling, gripping people from all

walks of life (MHT, 2016). Families are often left to cope with no support or subjected to

long waiting lists of thirty-two weeks in 2015/16 (MHT, 2016). Family members can be

sent miles away from home for treatment. This has a detrimental effect on the family

interpersonal relationships, resulting in having to travel long distances to see the member

in mental health care services due to insufficient inpatient services and limited outpatient

community services on discharge (MHT, 2014, Young Minds, 2014) which leads to a

challenging recovery for the individuals in distress and the family members supporting

them (MHT, 2016, Young Minds, 2014). The current national statistics in the UK, indicate

an urgent social need to find sustainable prevention methods as well as intervention.

Current government reports state that mental illness costs the economy an estimated

£105 billion a year, which provides an economic incentive for the current methods to be

revisited, refer to appendix A (The MindEd Trust, 2016a, MHT, 2016, DoH and NHSE,

2015).

The purpose of this interpretative phenomenological study was to empower the voice of

families with members whom have depression within communities, reducing the

stigmatism and to discover how community events could be part of a future strategy to

prevent social isolation. The study interpreted the social capital provided by community

events for families living with depression and the objective was to discover if community

events would improve wellbeing and current interpersonal relationships with family

members thus enhance the quality of life (QOL) for the individuals in distress and the

family as a whole (Stadler and Jepson, In Press). The project focused upon the social

capital providing an opportunity to gain a supportive network and reduce social isolation to

the families, raising awareness and reducing stigmatism. The core stimulus of the project

ii

University of Hertfordshire Dissertation 2016

examined three dimensions of the social capital, family quality of life: Social and

Emotional Wellbeing, Prevention or Recovery and Family Interpersonal relations (Stadler

and Jepson, In Press).

1.2 Background of the Research

Historically, society has been fascinated by the variety of different personalities, the

particular interest captivating the brilliant minds throughout the centuries is; What can be

done to intervene when a person’s mind tragically turns against them? (Foerschner,

2010). Although, modern viewpoints have evolved positively from ancient measures such

as asylums, there is still a stigma present. Patients with a physical illness are accepted,

whereas there is a lack of public understanding towards mental illness (Cromby et al.

2013). Unsurprisingly, the people experiencing distress become trapped within a cycle

and are reluctant to seek support through fear of stigmatism (Jorm, 2012, McManus,

2013). The condition will deteriorate and result in further pathology such as low self-

esteem, withdrawal, and will no longer engage within the community and connections are

lost (Kranke et al. 2015). Arcodia and Whitford (2006) defined the social capital provided

by community events by utilising community resources and social cohesiveness.

Community events provide the social capital as a platform to enhance the social

environment within the host community and provide opportunities for strengthening

community bonds and relationships (Stevenson, 2016).

The study was an interpretive phenomenological analysis into the social capital provided

by community events for families living with depression. The study worked with multiple

qualitative methods mainly utilising in-depth interviews for rich data, but also field work

natural setting observation at community events, an action research live community event

with natural setting observation field notes and an event feedback survey (Lyons and

Coyle, 2016). The research examined the social capital family quality of life with a

qualitative approach, initially from an individual perspective then the effect on the family as

a whole (Stadler and Jepson, In Press). Over the past twenty years, conceptualising

Quality of Life (QOL) has been a measurable currency in assessing the outcome on a

variety of medical conditions including psychiatric disorders globally (Dan et al. 2011).

Poston et al. (2003) conducted an in-depth study into family quality of life for families with

members whom have disabilities which included a sample of families with and without

disabilities for a broad scale of different individual and family QOL perspectives. The

research discovered eight domains for quality of life for individuals with disabilities which

iii


were; emotional wellbeing, social inclusion, rights, personal development, material

wellbeing, interpersonal relations, physical wellbeing and self-determination (Posten et al.

2003). Only three dimensions of the social capital, family quality of life were investigated

due to time restriction in this project. The family interpersonal relations element looked at

the internal family group which also led to interpreting this from a social psychology

perspective, looking at the social identity of the family, the community identity and the

event temporary community identities to examine how prejudice and stigmatism occurs

(Hogg and Vaughan, 2014). Discovering how community events can play a key part in

recovery and prevention for symptoms of the mental illness depression. The examination

of mental health meant the project had to examine mental health awareness and

stigmatism, which community events can take a community led social support network

approach and raise awareness to reduce stigmatism and social isolation which is needed,

this was looked at from a community psychology perspective (Kloos et al. 2014).

1.3 Aims and Objectives

The interpretive phenomenological analysis examined how community events can provide

the positive social capital of improved Family QOL for families with members living with

depression (Lyons and Coyle, 2016). The research aimed to articulate the use of

community events as a preventive method and for sustainable recovery from the

symptoms of depression within communities and as an educational method for mental

health resilience to school communities. The events would aim to reduce mental health

stigmatism, raise awareness, provide educational preventive strategies and have the

potential to prevent social isolation (Mair and Duffy, 2015). The project focused upon

applying social and community psychology theories to events social studies and how the

findings could be adapted for future strategies for community events such as school

community events held annually for example, the summer fairs. The approach would work

as a practical whole school community framework, working with families, staff and the

children’s wellbeing (Getz, 2012, Weare and NCB, 2015). The interpretative

phenomenological approach aimed to find small samples for an in-depth analysis using

multiple qualitative methods working with individuals whom have experienced depression

and attend community events or are employed by community event organisations, five

families were recruited from within the Leavesden Green Jmi School community in

Watford, Hertfordshire, UK following an action research, small scale live community event

iv


which specialised in wellbeing for the project (Creswell, 2014, Smith et al. 2009, Lyons

and Coyle, 2016).

The research questions pursued were:

What are the social capital benefits provided by community events for families

living with depression?

What are the best target host communities for prevention and early intervention of

depression?

1.4 Research contribution to knowledge

To consider, the continuous development of the modern technology and environment from

which community events are staged, the potential for growth and development is only

defined through continuous research within events social development studies (Getz,

2012). The potential for social capital transfer is one of the poorest understood themes,

such as the attendee’s personal development dimension from the event experiences and

is the least researched within event studies (Stevenson, 2016). Mair and Duffy (2015)

reviewed events research for social capital as limited and still in development. Stadler and

Jepson (In Press) agreed there is a significant gap within family quality of life research

within events social studies, although has been widely utilised within other fields such as

medicine as a measurable currency for social development. This has led the researcher to

find that community events could be utilised for community development, early

intervention and have the potential to elevate symptoms of depression and aid with the

recovery to isolated families within host communities.

1.5 Project structure

The project was constructed into three phases to breakdown the objectives to achievable

and measurable segments. The first phase gathered secondary theoretical expertise and

frameworks presented in Chapter Two. The second phase built upon first phase findings

from known philosophies and worked with multiple qualitative methods refer to Chapter

Three and the final phase collaborated phase one and phase two findings for the final

interpretative phenomenological analysis which is presented in Chapter Four. The final

chapters include recommendations for further study and lessons learned.

v


2.0 Chapter Two: Literature Review

The following section will present a review of literature to support the research agenda

with relevant theoretical concepts to interpret the social capital Family QOL provided by

the engagement within community events. Community and Social Psychology theoretical

frameworks have been applied to event audiences and host communities.

2.1 Community events for social capital

Community event objectives were set to minimise social isolation, and strengthen

participation by all, the objectives are to facilitate diversity in the understanding of

differences, as a response to local government policy for social justice in communities.

The event must invoke a greater sense of community spirit and acceptance for all (Mair

and Duffy, 2015). Current research is aware of the clear economic benefits for the host

communities, such as stimulation to the local economy and tourist attraction appeal.

However, community events also are predominantly a social phenomenon with the

potential to provide a variety of social capital (Mair and Duffy, 2015). Many local

authorities have heavily invested in community events without the knowledge, nor is there

an understanding for whom is to be represented in ‘the community’ (Stevenson, 2016), or

how to portray what the role of such an event is trying to achieve with a measurable focus,

such as eradicate stigmatism, improve wellbeing or educate mental health resilience

(Arcodia and Whitford, 2006, Mair and Duffy, 2015).

The research of community festivals requires a consideration of the political agenda

influence within the decision making process in the creation of the community based

cultural event strategies from a multitude of stakeholders such as local councils,

government policy and public service organisations (Jepson and Clarke, 2015 in Yeoman

et al. 2015). The concept of community festivals is perceived as a platform for escapism

and education through entertainment providing a unique and desirable recreational time

for the audience (Jepson et al. 2013). The planning process for community festivals

should incorporate community values to encourage growth and invoke a hunger for a

deeper understanding of the potential for social capital provided to the host communities

as a result. The intangible social benefits to the host community provided as a result of

these specialist events are a dominant feature (Jepson et al. 2013). The strategic policies

and design concepts can be engineered to provide further expansion to the minority

vi


isolated groups within communities thus enhancing the Quality of Life (QOL) within

modern society encouraging communities to thrive rather than just survive (Jepson et al.

2013). The research of the cultural phenomenon of festivals and public celebrations is still

in development portrayed as an insight into the host community’s symbolic way of life,

such as the political and economic trends through the social engagement (Farber, 1983 in

Jepson et al. 2013). The socialisation between the audience are an important part of the

event experience and satisfaction, which can be divided into three main categories; the

known family group, the audience temporary community, and external host community.

The framework for designing events will be to integrate and enhance the social

experience in the event planning by an analysis of design themes, settings and

experience design combinations (Berridge, 2011, Nordvall et al. 2014). These elements

construct a future strategic framework for designing events to enhance family group

socialisation and maximum post event intangible benefits for the quality of life to the host

community (Richards et al. 2015, Mackellar, 2014).

Community events form as a nucleus for intensified community relationships, which

displays as social networks, changes in perceptions and behaviour, deeper interpersonal

relationships, community pride, and mutual understanding to unite communities from a

shared interactive experience (Wilks, 2013 in Richards, et al. 2013). These community

bonded phenomena have evolved into an important social foundation within modern

society (Jepson et al. 2013), the complexity of the event objectives therefore are being

creatively designed to fulfil social strategic objectives such as community cohesion

(Richards et al. 2013). The social benefits from community events are still under

researched and in development stages, social justice is the source which underpins

policies that encourage participation by all (Mair and Duffy, 2015). Community event

objectives are to seek to minimise social isolation, provide an opportunity for interaction

and facilitate greater understanding towards the minority segment groups within

communities (Stevenson, 2016). These ideas of social capital are transformed through

strategies of community development which emphasise the well-being of all residents.

The community engagement and the cultural exchanges facilitated through the arts

become a visual expression with deeper meanings and representation of the resident’s

core values (Lee et al. 2012 cited in Mair and Duffy, 2015).

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2.2 The social capital, family quality of life

Social capital can be defined as an intellectual asset, an intangible source which cannot

be measured by physical definition, but rather behavioural differences. The examination of

social capital can be complex as has been utilised through various components and

memberships (Arcodia and Whitford, 2006, Stevenson, 2016). The vast concept is not

defined by an economic financial boundary. Rather is a shared communal currency which

is free to all and found within the heart of communities (Mair and Duffy, 2015). Social

capital resides in social relationships, merging individuals to a group hierarchy. There are

many components which shape the concept such as social justice, community cohesion,

relationship bonding between people, trust and unity (Arcodia and Whitford, 2006). Social

capital is the connection between groups such as families, this leads the project to focus

upon the social capital element family quality of life as a measurable currency. Traditional

research into quality of life has tended to be focused upon individual rather than the family

base (Richards, 2014, Stadler and Jepson, In Press). Hoffman et al. (2006) found the

dominant factors which influence the family quality of life (FQOL) of families with members

whom have disabilities have been defined in figure 1

Figure 1: Family Quality of Life (FQOL) Domains for families with disabilities

(Hoffman et al. 2006).

Family Interpersonal

Relations

•Social

•Relaxation

•Connection

•Awareness

•Supportive network

Parenting

•Bonded

•Strong relationships

•Educative

•Reassurance

•Empathetic

Emotional

Wellbeing

•Positive

•Supportive social network

•Social interaction

•Inspired

•Motivated

Recovery

•Disability Support

•Service Programme Success

•Relapse prevention

•Research development

•Peer support

Physical

Wellbeing

•Health

•Fitness

•Security

•Energetic

•Encouragement

•Monitored

viii


Figure 1 represents the various domains of family quality of life the Hoffman et al. (2006)

study discovered which were defined in five categories: Recovery, Physical wellbeing,

emotional wellbeing, family interpersonal relations and parenting. The time restriction

meant only three areas could be covered which were family interpersonal relations,

recovery and emotional wellbeing these were essential to family quality of life for families

with members whom have disabilities (Hoffman et al. 2006).

2.2.1 Family Interpersonal relations

Stadler and Jepson (In Press) family quality of life study defined a family base with an

inclusion of the extended family, these were individuals whom had no legal connection

such as blood relation or marriage bonding. Nevertheless, they still had a nurturing,

supportive role in the family and were also considered in this project. Family can be

defined as an interpersonal relationship which has unconditional love and respect for one

another with open communication. By caring for each other on a regular basis, this

remains essential to the family’s quality of life and wellbeing (Stadler and Jepson, In

Press, Richards, 2014). Scholars have noted that mental health appears to be affected by

intimate relationships. People whom are romantically involved have reported a higher

sense of wellbeing (Campbell et al. 1994 cited in Hogg and Vaughan, 2008) and stress

has been found to be reduced through social support (Williams et al. 1981 cited in Hogg

and Vaughan, 2008). The family or extended family will be part of the social support

network, which are intimate members whom care for the individual in distress with support

and reassurance in times of stress (Hogg and Vaughan, 2014). In contrast historically,

mental health researchers following the Second World War, examined the social

environment and family to determine if these had an impact on mental health distress. In

1949, Theodore and Ruth Lidz argued that the family patterns and behaviours can

contribute to the cause of mental health distress suggesting that the family environment

were to blame for the individual developing the disorder (Lidz and Lidz, 1949, cited in

Cromby et al. 2013).

Drawing upon this research, the Bateson et al. (1956) study argued that unresolvable

messages between family members, and conflicting behaviour were a causal factor to an

individual’s distress (Bateson et al. 1956 cited in Cromby et al. 2013). These ideas often

followed that parents were to blame for their children developing mental pathology such

ix


as schizophrenia, autism, and other disorders, with little evidence to support this theory

(Cromby et al. 2013). The parents are still a product of their own parental upbringing and

would not be the only contributing factor. Now these terms are considered taboo to state

that family relationships may be the causal factor in the development of distress

(Johnstone, 1993 cited in Cromby et al. 2013). Any implication for severe mental distress

and the causal role from family relationships would deter attention from the individual in

distress suffering and the reality of their experiences; although clearly relevant in cases of

neglect and abuse (Cromby et al. 2013). Family therapy remains a popular tool in the

treatment for mental health distress, leading to family interpersonal relations as a

therapeutic method for recovery (Cromby et al. 2013). The project examined family

relationships as key to wellbeing and prevention of distress. Henderson (2016) from

Public of Health England (PHE) at The MindEd Trust Conference (refer to case study

Appendix C), presented this key model highlighting ‘relationships’ are at the heart of

young people’s wellbeing and quality of life detailed in figure two (The MindEd Trust,

2016b):

Figure 2: Henderson (2016) PHE “Six principles to shape our thinking about young

people’s health”

Figure two defines young people’s relationships with friends and family as the heart of

their wellbeing, the need for social equality and wellbeing (PHE, 2016a).

(Public of Health England, 2015a, The MindEd Trust, 2016b)

x


2.2.2 Social and emotional wellbeing

To examine the family quality of life dimensions, an assessment must be made on the

impact upon each of the individual’s quality of life on the family group and as a group

examining what is required for a positive life experience as a whole (Posten et al. 2003,

Summers et al. 2005, Stadler and Jepson, In Press). The Posten et al. (2003) study

discovered families with members whom have disabilities strongly require emotional and

social wellbeing, the need to be listened to, and respected by professionals in particular

service professionals such as health care support services and teachers. Many found

more stressful situations occurred when dealing with the service organisations, than

coping with the member’s distress. The respondents reported sadness at not feeling

respected, or listened to by the service professionals whose roles were to support them

(Posten et al. 2003).

The Posten et al. (2003) study found that families with and without disabilities required

social wellbeing and acceptance, and the intensity of the requirement was greater in

families with members whom had disabilities. The Posten et al (2003) respondents

reported that family is a space of love and harmony. Family interaction involves spending

time together and sharing activities which leads to community event engagement as an

important factor in contribution to QOL (Posten et al. 2003, Stadler and Jepson, In Press).

Families with a child whom had disabilities spoke of needing more support to do things

together as a family, and to participate in activities with other children, which could be

found within school community events (Stadler and Jepson, In Press, Posten et al. 2003).

To consider families in contact with mental health support services, it is recognised that

these are the most excluded groups in society (Bertram and McDonald, 2015).

Government policy made statements for QOL for families with members whom had

disabilities, which was issued through The Department of Health (2011) and stated:

“More people will have a good quality of life – greater ability to manage their own lives,

stronger social relationships, a greater sense of purpose, improved chances in education,

better employment rates and a suitable and stable place to live (Department of Health,

2011, p. 6).

Public Health England (2015) have recognised communities strengthened provides a

supportive ‘extended family’ approach to wellbeing for families in distress. Strategies were

xi


introduced in 2014 to work at building empowered communities for prevention and

recovery of distress refer to figure three, therefore, community events can be key to

community development, engagement and social network approaches (PHE, 2015a, PHE,

2015b). School community events are a practical method, the PHE (2015b) report stated:

“Pupils and students are more likely to engage in lessons that focus on emotional

wellbeing if they are of practical application and relevant to them.” (PHE, 2015a p11).

Figure 3: PHE (2015) Community Centred approaches for wellbeing strategic framework

(PHE, 2015b, The MindEd Trust, 2016b)

School community events specialising in wellbeing would provide a practical space for

families to be part of the student’s active learning. The space would also encourage the

family to undertake a healthier lifestyle and prevent mixed messages from family and

education by providing extended support to the children’s families and staff (Weare and

NCB, 2015). These wellbeing themed community events will in turn, raise awareness to

encourage the peer interventions, implementing collaboration partnerships between

schools, supportive therapeutic services such as local Mental Health Support Centres, for

example or allocating school pupil community health champions as a supportive mentor

approach may be another aspect from community event engagement as awareness is

raised and supportive candidates recognise the struggle in others (The MindEd Trust,

xii


2016b). As a society the quality of life for families coping with mental health distress must

be addressed, by removing the stigma associated with mental illness and providing an

interactive, engaging space for socialisation and peer support (Cromby et al. 2013).

Community events will maintain the relationships which are key to QOL as highlighted in

figure three, as an example an introduction of school community events specialising in

wellbeing would provide a practical element to the education for the young people and the

families or carers whom provide support to them. Encouraging recovery to the individuals

in distress and offering prevention strategies to deter families reaching crisis. (Weare and

NCB, 2015).

2.2.3 Recovery or prevention

As Hoffman et al. (2006) stated the sustainability of an individual’s recovery is assessed

on the wellbeing and quality of life factors which should be extended to the family, a key

influential element to the recovery programme for stability and reassurance. The recovery

QOL dimension remains dominant, this aims to help people achieve life goals and be part

of a local community (Bertham and McDonald, 2015). The recovery from mental health

distress is a unique, personal journey and the role of service professionals is to facilitate

this process with the right support (Bertram and McDonald, 2015). However, respondents

in the Bertram and McDonald (2015) study reported emphasis has been on risk

management, monitoring, and medication only. The nature and quality of interpersonal

relationships with peer support such as friendships, family and the support service staff

were crucial in the recovery of the respondents which included access to meaningful

activities. Several reported being able to match their aspirations to activities, increased

wellbeing, helped them feel less isolated and purposeful (Bertram and McDonald, 2015).

The Bertram and Macdonald (2015) validation and invalidation framework remains

relevant within this project detailed in Appendix B and Table 1, to show the positive and

negative conditions influencing the QOL to the family group. Peer support promotes self-

management in difficulties, heightened self-esteem with hope, growth and social inclusion

(Bertram and McDonald, 2015). Social inclusion is not about the disability, it’s how the

individual relates to the world and daily living with support the world for them is brought to

life (Bertram, 2008). A good environment is important, the need to feel safe and have

secure interpersonal relationships (Bertram and McDonald, 2015).

xiii


Table 1: The Bertram and McDonald (2015) invalidation and validation framework applied

to FQOL.

(Bertram and McDonald, 2015)

The relationships surrounding the child are a key element of the social capital such as

wellbeing or family QOL discussed earlier however, there is limited research of this nature

from the contribution provided by community events within events studies. The project

discovered that research into family QOL and the social capital benefits from community

events are still in development. The application of the influence of community psychology

theoretical models has also proven a successful influence at fusing communities together

through engagement (Cromby et al. 2013). The psychology theory can be applied to event

studies by examining the behaviour of the attendees and to aid with the interpretation of

the meaning from the social capital provided by community events to the host

communities.

Validating (Promoting well-being) Invalidating (Creating distress)

A positive home environment: safe,

peaceful and nurturing.

Unstable environment: Homeless, in

hospital/prison, family conflict, lack of

appropriate support services.

Activities: Employment, Education,

fun things to do together such as

community events, day trips, and

social gatherings.

Inactivity: boredom, frustration with

nothing to do, lose hope and

confidence, start to lose boundaries.

Personal and Social Relationships:

family, friendships and peer support

network.

Isolation: Feeling alienated and social

withdrawal

Economic: Comfortable income to

thrive.

Economic exclusion: Not enough

income to survive, debts, and financial

concerns.

Accepted: A member of the

community and society.

Discriminated: rejection and

stigmatised.

Healthy communication:

Understood and heard. Open,

honest communication.

Unhealthy Communication: Conflict,

family arguments, judged by the

community, ignored and talked at/about.

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2.2 Community and Social Psychology theoretical framework

Community psychology is based upon the consideration of the influence the environment

of the individuals’ impacts upon health and wellbeing (Orford, 2008 cited in Cromby et al.

2013). Community psychology examines the social causes of distress, by placing people

in social environments which corrects the individualistic bias of psychology (Cromby et al.

2013). Community psychologists work collaboratively with people whom have been

oppressed and devalued within society through nurturing communities with self-support

systems (Kloos et al. 2014). Community psychologists promote social change through the

engagement of action research, which leads to an observation that Community Festival

Specialists are in fact promoting Community Psychologist values and operate under the

same principles (Cromby et al. 2013, Kloos et al. 2014).

Whereas, Social psychology is the scientific investigation of how thoughts, emotions and

behaviours of individuals are impacted by the presence of others; this can be actual,

imagined or implied in context, a major element of community events and can be applied

to event audiences and host communities (Allport, 1954 cited in Hogg and Vaughan,

2008, Hogg and Vaughan, 2014). Social psychologist’s interests remain with explaining

behaviour and emotions, as behaviour can be observed and measured. These can be

subtle behaviours such as smiling to action behaviour such as dancing. The emotions can

stem from beliefs and attitudes, which are the underlying influences towards certain

behaviours (Hogg and Vaughan, 2014).

The process conceptualises how people are affected by others who are present such as

an audience at an event; also by imagined presence i.e. the anticipation of becoming part

of that events audience; also an implied presence such as how an individual reacts even if

no one is watching, such as not dropping litter or jumping the queue. As a society, there is

a social convention for how behaviour should be transcribed which determines our

individual behaviour, such as law and ethical values or morals (Hogg and Vaughan,

2014). The objectives progressed the project to defining the social capital provided by

community events attendance and how the policy and design are influenced from social

and community psychology theoretical frameworks.

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2.2.1 Social Identity theory

The social identity theory addresses a wide range of social psychological phenomena and

aspects of this theory surfaces in most social psychological profiling used in this project

for looking at the host community and family intergroup behaviour. The origins of this

theory can be found within the work of Tajfel (1969) on social categorisation which

examined stereotyping and prejudice, social comparison and inter group relations was

relevant to the project by looking at mental health stigmatism within communities and

family relationships (Tajfel, 1969 cited in Hogg and Vaughan, 2008). Turner’s research

team examined self-categorisation in groups and the influence on group behaviour which

became known as the social identity of the group theory (Turner et al. 1987 cited in Hogg

and Vaughan, 2008).

Social identity defines two groups of identity; social identity which is the self which is in

group memberships such as the event audience and personal identity which defined the

self in terms of personal relationships and traits such as the family role and relationships.

Social identity is associated with group and intergroup behaviours such as intergroup

discrimination, in-group bias, stereotyping and prejudice (Hogg and Vaughan, 2014).

Individuals have as many social identities as the groups that they feel they belong to, such

as neighbourhood community, school group, family group and employer group and so on.

This is an important aspect of self-concept and self-esteem (Hogg and Vaughan, 2014).

This project examined the family group identity and community identities, and how the

educational influence of community event attendance specialising in mental health

resilience and wellbeing will influence the family quality of life thereafter; and provide

prevention to mental health distress and strengthen interpersonal relationships. Would the

events provide a space to engage the peer social support? How are the families and

communities’ identifying with themselves and each other? The answer is found within the

social influence from different social groups and the individual’s perception (Hogg and

Vaughan, 2014).

2.2.2 Social Influence and social groups.

Social psychologists only apply the study of animal behaviour and human behaviour

through an evolution concept (Hogg and Vaughan, 2014) however, as an observation, the

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author would present humans as pack animals similar to wolves. The social group

occupies the majority of the time and influences cognitive processes such as working,

socialising and opinions are all represented through groups (Hogg and Vaughan, 2014).

There is an overwhelming matrix of influences defining individuals’ cognitive genetics, the

groups differ through many respects such as governing bodies or political parties. So

much so, that in fact, independence and uniqueness is limited and restricted even on an

individual basis (Hogg and Vaughan, 2008, Cromby et al. 2013, Kloos et al. 2014). Social

groups can differ in time, such as the educational years’ groups: primary, secondary and

further education, some are endured for thousands of years such as ethnic groups or

religion (Hogg and Vaughan, 2014).

The social behaviours are different, some social groups are structured and highly

organised for example the government, whereas some are more informally organised

such as a music festival audience. As an example, rock music festival attendees will

behave differently to classical concert attendees. The crowd can be influenced by the

musicians to apply actions such as arm waving, sing along with them and clap to the

music by gestures or vocal prompts, social influence will vary through each social group

and the members’ interpretation (Sherif, 1952 cited in Hogg and Vaughan, 2008). Social

groups can differ in size such as, families will be smaller, whereas some have larger

members such as a nation of people. Some will be concentrated for example, a board of

governors at a school and others will be dispersed such as academics and so on and so

forth (Hogg and Vaughan, 2014).

As discussed previously, a family group can also have an extended family group which

are still a valued relationship. Social psychologists limit the significant dimensions to make

the concept measurable and will focus on group size dynamics and leadership structure

(Hogg and Vaughan, 2014). This project focused upon the family group and the

community social group’s effect from community event engagement. The atmosphere

from the social group is analysed to identify the behaviours and assumptions are made

based upon the findings such as the family QOL impacts from event attendance and the

host community reaction to awareness strategies. These would then be placed into

categories through one general distinction: similarity based groups i.e. the family, and

dynamic groups i.e. the community (Arrow et al. 2000 cited in Hogg and Vaughan, 2008).

xvii


In 1952, Kelley defined reference groups and memberships by clear distinction. The

reference groups are psychologically impacting people’s attitudes and behaviours,

whether positively or negatively. The individuals will base acceptance or oppose members

based upon the reference groups’ influence for example, the family reference group. A

membership group is where the individual is defined and belongs, this could be positive

such as a member of the community or neighbourhood, or a negative, not accepted, and

isolated minority social group which currently are people living with mental illness

disabilities (Kelley, 1952 cited in Hogg and Vaughan, 2008). Social groups can influence

behaviour by people rationalising other people’s behaviour to construct a norm and using

this to determine their own beliefs and behaviour. This indicates that social influence can

change perceptions of some groups, such as raise awareness and education of others to

stimulate change such as removing mental health stigmatism and prejudice. It is believed

that human groups have a fear of the unknown and the unusual (Hogg and Vaughan,

2014).

Evidence suggests that prejudice is learned early in life through parental guidance and

influence as children then develop the same emotional reactions to particular groups

(Tajfel, 1981 cited in Hogg and Vaughan, 2008). The transition of parental prejudices

occurs by example, i.e. the child witnesses the parent express unacceptance or hatred

towards another group, and the child will copy this behaviour. Leading to prejudice being

an intergroup behaviour which forms social psychological responses to select people into

categories and will base assumptions from previous education or influence (Hogg and

Vaughan, 2014). Research indicates that with early prevention and intervention through

the education system and providing community events specialised of this nature to target

not just the children’s development but the families’ connection will assist to prevent mixed

messages (Weare and NCB, 2015).

Stigmatism can also be eradicated in time through the help of school education and

community events to allow access to alternative viewpoints and mental health resilience

can be taught (McManus, 2013). The use of community events can promote community

psychology values and provide a space to gain support and awareness by engaging the

community through education and in an enjoyable manner provides a platform to address

this social issue to the host communities practically through community events in an

entertaining and enjoyable method (PHE, 2015a, PHE, 2015b, The MindEd Trust, 2016a).

xviii


2.2.3 The influence of community psychology

Community psychology originates from the viewpoint that mental health distress is created

from social inequality, so interventions are aimed at a national level rather than focused

on a family individual level (Kloos et al. 2014). It is gaining a strategic change through

policymakers as interventions are required at multiple levels such as through health care,

education and recreation to make a significant impact (McManus, 2013, Cromby et al.

2013). As Community psychologists are interested in community level change, and the

prevention of the causes to distress, this addresses social inequality, injustice and the

acceptance of diversity to promote environmental changes rather than reacting to the

difficulties experienced by people (Kloos et al. 2014). Evidence has found that working

with people in groups at a neighbourhood level has a higher rate of transformative

knowledge transfer than working on an individual basis demonstrating a community event

would reach a higher success then solely changing the young children’s educational

curriculum (Drury and Reciher, 2009, cited in Cromby et al. 2013).

As Jepson et al. (2013) advised community festivals are influenced through the majority of

stakeholders involved such as government policy. This provides further evidence of

community psychology influence upon community events which seek to transfer

knowledge recreationally at a National and International level. An example of this, major

sporting events such as the London 2012 Olympic and Paralympic Games tackled

intangible social issues such as disability rights, women sports equality, as well as the

tangible urban regeneration (Foley et al. 2012, IOC, 2013, UKG and MOL, 2014). The

focus of peer support has been widely researched and revealed that social networks

provide the support through helpful identification from others and opportunities to

encourage social change (Holmes, 2010 cited in Cromby et al. 2013).

An example of successful social action therapy, The White City project headed by Sue

Holland, a clinical psychologist in the 1980’s developed a mental health project for women

in a council housing estate in West London. Holland was a resident of the community and

the four stage project started with individual therapy sessions, which progressed to group

therapeutic work which offered an alternative to pills exploring the reasoning behind the

emotions. The third stage examined the problems from an environmental level looking at

environmental causes which then progressed to the final stage of campaigning for

changes to these conditions to prevent further damage to other people. The White City

xix


project and many other community psychology projects shape respondents learning by a

four stage process shown in figure 4 (Holland, 1992 cited in Cromby et al. 2013).

Figure 4: Social Action Model adapted from Holland (1992)

(Holland, 1992, cited in Cromby et al. 2013)

Figure 4 demonstrates the effective transformation in stages, community events could

provide a sustainable approach to addressing social issues. As discussed earlier,

community events are influenced by political stakeholders, community events can be

utilised to achieve intangible social issues such as social justice, and reducing social

isolation to minority groups (Arcodia and Whitford, 2006, Mair and Duffy, 2015). The

events are a sustainable method due to the potential to obtain sponsorship support, whilst

providing a platform to engage local communities through cultural stimulation. Tourist

appeal is economically stimulating with opportunities to reach national and international

visitors thus enhancing the host city brand image (Mair and Duffy, 2015).

Individual Level 1

• 'Patients on pills'

•Symptom based

•Passively waiting for a 'cure'

•Exploring the roots of the individual problems

Personel Level 2

•Talking therapy

•Exploring the emotions of the past

•Coming to terms with the ghosts

•Identifying root causes in society structure

Social Level 3

•Meeting in groups and sharing experiences

•Identifying changes which need to be made to communties

•Taking action based appeals

Political Level 4

•Demanding changes to school systems, housing and other environmental causes

•National and International policy addresses the findings with strategic changes

xx


3.0 Chapter Three: Research Methodology

This section presents the design of the research and primary data collection methods

used to pursue the research objectives, which were to examine the social capital provided

by community events for families living with depression and the best target communities

for prevention and early intervention from the basis of known research philosophies

(Lyons and Coyle, 2016).

3.1 Research Philosophy

The Interpretative Phenomenological Analysis (IPA) shaped the research to three key

concepts in the areas of knowledge: phenomenology, hermeneutics and idiographic

(Smith et al. 2009, Lyons and Coyle, 2016). The research was adapted from a

phenomenological philosophy which conducted interpretive methods based upon social

behaviours and families (Veal and Burton, 2014). The study based participants as a

starting point and examined a much wider sense of why the behaviours occurred (Altinay

and Paraskevas, 2008). The research agenda included a social constructivist worldview

point developing subjective meanings from the experiences of participants and the

interaction amongst the individual family members to examine the social capital of family

quality of life impacts from community event engagement. Nevertheless, the research has

also covered the advocacy and participatory approach as intertwined with specific

important social issues such as mental health stigmatism and awareness within

communities. The study has provided a voice of empowerment for intended respondents

for recovery and reducing social isolation for families with members living with depression

(Kemmis and Wilkinson, 1998, cited in Creswell, 2009). The approach to phenomenology

was to study the experience, and provides us with ideas about how to examine lived

experience of the families within this study and the phenomenon of social capital such as

an improved FQOL from attending community events together (Smith et al. 2009, Harper

and Thomson, 2011).

The second theoretical underpinning came from hermeneutics which is the theory of

interpretation through a holistic process. It is concerned with the relationship dynamics

such as to understand the whole, the parts must be understood but must also be viewed

as a circular process, and this examined the family quality of life domains from each

individual member as a part, then as a whole which was the family group (Harper and

xxi


Thomson, 2011). The researcher must examine how the phenomenon appears in the

community events, but then must facilitate and understand the appearance in a non-linear

style of thinking. The data must be understood at a number of levels which relate to each

other from different perspectives (Smith et al. 2009, Lyons and Coyle, 2016). This leads to

the third major theoretical influence on the project which is idiographic, which examines

the detail with an in-depth analysis in a systematic process. However, on another level

interprets an understanding of an event or relationship from the perspective of particular

people in a particular context. In this project, families with members whom have

depression attending community events which provides them with social capital such as

improved family quality of life (Bordens and Horowitz, 2013, Lyons and Coyle, 2016).

3.1.1 Research design

The research undertook a qualitative approach constructed into phases over a nine-month

period. The first phase consisted of a content analysis through psychology and event

magazines, social media pages, newspaper articles, journals, books, reports and field

work observation by attending a community festival specialised in mental health and

wellbeing (Lyons and Coyle, 2016). The festival was also utilised for recruitment for

primary qualitative data collection and professional expertise interviews refer to appendix

C, the researcher was unable to attend the second event conference but the organiser

provided a downloadable folder with all presentations, articles and video material utilised

throughout the event, the organiser was also interviewed as part of the first phase data

collection. The second phase of mixed qualitative data collection methods included

producing an action research live community event specialised in wellbeing at a local

primary school in Hertfordshire, UK. This phase built on the first phase findings and

theoretical models using natural setting participant observation and anonymised survey

feedback (Creswell, 2014). The final phase examined both initial phase findings including

in-depth interviews recruiting five families from the school who attended the wellbeing

event and other school community events with an Interpretative Phenomenological

Analysis to conclude with the research findings (Smith et al. 2009). The methodology

remained flexible, as interpretations were gathered from the data therefore, the data

collection was taken from smaller samples with multiple methods to fully comprehend the

subject matter. Refer to appendix D for the initial proposal design (Saunders et al. 2007,

cited in Altinay and Paraskevas, 2008).

xxii


3.1.2 Research ethics

The research topic required a number of careful considerations to operate under ethical

practice which was monitored throughout the duration of the project and reviewed by the

supervisor and the University of Hertfordshire Arts, Social Sciences and Humanities

Committee regularly. A risk assessment was made to ensure no harm would be made to

participants and their families as the topic could have arose sensitive issues (Lyons and

Coyle, 2016). A list of support lines for example, was kept by the researcher for local

mental health charities and local support services for intervention if necessary (Harper

and Thomson, 2011). The questions asked were considered carefully to minimise any

potential upset. The researcher has training within safeguarding, data protection and

confidentiality from previous employment throughout their career, having worked

previously in the security sector. The researcher also obtained an Enhanced DBS

Disclosure clearance for viewing by Participants, University Ethics Committee and Service

Organisations to prove and ensure the researcher was safe to work with vulnerable

people and children. The original application documents and additional approval support

documentation with a copy of the enhanced DBS disclosure can be found in Appendix E

(Creswell, 2014, Smith et al. 2009).

3.1.3 Selection of methods and target sample rationale

An IPA study consequentially utilises the three philosophical key concepts with small,

purposely selected and carefully situated samples to offer a different way of seeking the

generalisation (Harre, 1979 cited in Smith et al. 2009, Lyons and Coyle, 2016). The

project in the first stage examined two community events which were case studied and

used to collect samples for data collection refer to Appendix C. The inductive research

sample has been limited to a small size to be more effective in interpreting the

phenomenon of community events providing the social capital of family quality of life. The

time consuming nature of the process required a reduction in the family quality of life

elements, research ideas were generated throughout the project following analysis within

each phase findings so the methodology remained flexible (Altinay and Paraskevas,

2008). There was a risk that the small selected three elements of family quality of life may

not yield enough data. The access to families with disabilities willing to participate which

were affected by depression may have presented a challenge in recruitment (Altinay and

Paraskevas, 2008).

xxiii


The initial stage also examined an agreed small sample of eight purposely selected

professionals including a medical doctor whom specialises in mood disorder for expertise

insight into the research objectives refer to Appendix F. The second phase worked with

action research and observation with a live community event specialised in wellbeing to

examine five families with and without disabilities at a community event specialising in

wellbeing, the survey provided feedback and recruitment opportunities for the final phase.

The phase design and analysis used for each phase is shown in figure 5.

Figure 5: Research Phase Design

(Stadler and Jepson, In Press, Smith et al. 2009, Creswell, 2014, Lyons and Coyle, 2016).

3.2 Primary research methods

The use of an interpretative phenomenological method has been widely used through

psychology research for working with mental health distress this made the research

method reliable and introduced this method to event social studies (Smith et al. 2009,

Lyons and Coyle, 2016). Therefore, the following primary qualitative methods were

selected:

• In-depth Interviews

• Content Analysis

Phase 1

•Participant observation

•Event survey feedback

•Thematic Analysis

Phase 2•In-depth interviews

•Interpretative Phenemenlogical Analysis

Phase 3

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3.2.1 In-depth interviews

The first phase of interviews was required to gain expertise insight to the research

objectives. The study included participants who had experienced depression and also

included relevant professionals surrounding the topic of mental health distress with

questions such as ‘Do you feel community events could contribute to recovery for

individuals living with depression?’. The third phase gave the families an opportunity to

express their stories, and feelings such as to reflect on their quality of life for example

‘Have there been any difficulties that the family had to overcome to attend community

events?’. The study required rich data, allowing participant’s an opportunity to give an

account of their thoughts and stories expressed towards depression and their family

quality of life after participation in community events. The space was to also to express

any issues surrounding mental health stigmatism and the awareness of the community

from which they live in (Smith et al. 2009, Harper and Thompson, 2011, Lyons and Coyle,

2016).

An in-depth interview was selected for this purpose, some participants needed

encouragement to express deeper disclosure surrounding their experiences and family

life. The aim of the research interviews was to provide a base to discuss relevant topics

and some research questions were pitched at an abstract level so the research objectives

could be found within the analysis (Stadler and Jepson, In Press, Smith et al. 2009, Lyons

and Coyle, 2016). The limitations of this method is the formal nature of the interview and

not in a natural setting. The option to conduct interviews by telephone aided social anxiety

as face to face contact with people unknown can be daunting to the respondents. Most

interviews were therefore conducted by telephone so the respondent could be within their

home and in comfortable surroundings and privacy to ease the interview anxiety ethically

to the researcher and the participant. The researcher had to remain mindful of the

sensitivity of the research topic whilst establishing rapport and trust from the participants.

Some people may not wish to disclose information openly and had to be encouraged to

disclose rich data. The sensitive nature of the topic required careful consideration of the

questions asked so the researcher role did not present bias responses (Creswell, 2014). A

copy of the expertise professional interview questions and participant interview questions

are in Appendix G.

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3.2.2 Action Research – Wellbeing Event in Watford, Hertfordshire, UK.

McNiff (2016) defined action research as a social and cultural method for change, the

research examines a problem and provides a solution to the issue. The action research

produced a community event held at a primary school in Watford, Hertfordshire to support

mental health resilience strategies by methods for wellbeing for healthy bodies and minds

for the children aged 5 to 11, staff and families, the researcher acted as a consultant in

the planning process and organisation. The small scale community event provided a

space to observe families with and without disabilities interactions with the activities

provided by local community businesses. The simplicity allowed families to be observed

individually and as a community without crowded distractions. The sign up to support

programmes after provided a measurable indication if the event had provided awareness

of wellbeing, reduced mental health stigmatism and had given families access to an

improved quality of life thereafter. This also allowed recruitment for the third phase, five

families with and without members whom have depression within that community (Altinay

and Paraskevas, 2008, Creswell, 2014). The limitations of this method was photographs

of the event were not taken due to the nature of working with children within the event as

some parents would not want their child in photographs due to security reasons such as

disclosing location. No photograph material could be used to record activities or the event

for analysis. Private information could have been observed but could not be reported, the

role of the researcher in the event as the organiser meant some observations were

missed whilst working with the event logistics. Care was taken so the researcher was not

intrusive throughout the event (Creswell, 2014, Lyons and Coyle, 2016). The plan for

event can be found in Appendix H.

3.2.3 Natural setting event observation and field notes

The community wellbeing event space provided the researcher opportunities to be part of

the natural setting and work from within the events temporary community as an interactive

observation for the event as the organiser gave links to staff, exhibitors and the families of

the school for detailed perspective of the phenomenon of social capital provided by the

community event (Creswell, 2014). The field notes from the observation provided a

descriptive and reflective account of the wellbeing community event in that particular

space and time for the school community (Jepson et al. 2013, Creswell, 2014). The

participant observation was helpful to understand wellbeing community events improving

the quality of life to the audience through an enjoyable and educational recreation time for

xxvi


the participant’s, staff from the school and community businesses involved (Stadler and

Jepson, 2016, Jepson, et al. 2013). The researcher recorded the behaviour from the

families, exhibitors and environment settings. The group activities were particularly helpful

to view the families interacting as a community such as the drama games, sports

activities, craft stand and relaxation at the book stall colouring the bookmarks for the

competition. The conversations between the audience and exhibitors were also beneficial

insight which provided some rich data to support the research agenda for example,

observing family activities and family bonding such as sports activities together, choosing

books to take home, signing up to fitness centre such as swimming lessons thereafter,

and the parents talking to one and another whilst watching the children during the drama

games (Creswell, 2014, Lyons and Coyle, 2016). The researcher also observed an annual

summer fair to note changes to theme design as the knowledge transferred to the school

community held a month later. The researchers own background has also shaped the

interpretation of the participant’s perception, the family behaviours and the meaning from

it as a whole (Crotty, 1998, cited in Creswell, 2009). The summarised field notes are in

Appendix I.

3.2.4 Event feedback survey

The qualitative survey was produced at the event for feedback with the questions

presented designed to answer research objectives and provide feedback to the school

and the event post box was utilised for participants which were busy with younger

children, this space also allowed confidentiality for disability disclosure ethically. The

survey also provided a space for recruitment of families with members whom have or

have experienced depression for the third phase data collection under confidentiality with

an option to leave contact information to be held after the event, a total of five families

were recruited through this method and three staff members (Creswell, 2014, Smith et al.

2009). Some of the sample questions were ‘What part did you enjoy most at the wellbeing

event?’ and ‘Will you try to use the five ways to wellbeing in the future?’. The limitations to

this method is people willing to fill out the survey during the event or finding time after, the

recruitment for families willing to participate could have presented a challenge, however

not on this occasion. Written surveys do not provide opportunities to encourage rich data

sharing and rapport building, however can be preferred method of communication for

some groups which prefer private methods. A copy of some survey example responses

can be found in Appendix J.

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3.3 Research assessment, critique and analysis

The research has intended to portray a holistic account of the subject matter by identifying

the challenges faced by families with members whom have depression and the concept of

community events being a key instrument to utilise for recovery or prevention and

providing the social capital of positive family quality of life (Lyons and Coyle, 2016). The

researcher has ensured validity of the findings by seeking expertise guidance for events

research through the supervisor regularly throughout the project refer to Appendix K for

the supervisor meeting log. The researcher has also sought mental health distress

expertise guidance through professional participants such as a Medical Doctor

specialising in mood disorder reviewed the project and gave an expertise interview

(Creswell, 2014).

The research analysis from each phase findings shaped the next phase data collection

methods to pursue the research objectives and test the theoretical concepts against the

primary data findings (Creswell, 2014). The first phase gathered expertise interviews

which aided the progression to the second phase of the live event. The analysis consisted

of developing and analysing the themes which emerged from the in-depth interviews with

a total eight professionals were interviewed for an in-depth analysis. This supported the

first phase theoretical frameworks and developed the project for the second phase. The

second phase included feedback from the organisations involved provided a measurable

indication if the event had improved the quality of life thereafter, information provided to

the family support worker to use with the families which they work with at the school, refer

to family support worker feedback survey in Appendix J.

Five families were recruited which included an individual who had depression from the

community where the event was held. The individual was part of the event as a stall

holder so to protect identity of the participant the names were removed from the event

plan and the contact matrix. The transcripts from phase one were revisited as part of

phase three following the new developed insight to the data held, these were analysed

using the IPA method, refer to Appendix L for examples (Creswell, 2014, Veal and Burton,

2014).

xxviii


4.0 Chapter Four: Data analysis and findings

The research sought to provide supportive evidence that engagement within community

events can provide social capital benefits to families living with depression. The research

aimed to articulate that community events can provide sustainable recovery and

prevention from the symptoms of depression, with a particular focus upon young people

and their families within school communities (The MindEd Trust, 2016a). In response to

the national statistics which are that one in four adults and one in ten children will be

diagnosed with a disorder in any given year, seventy-five percent of mental health distress

occurs by the age of fourteen (Young Minds, 2014) indicating school communities are

best targeted for early intervention and prevention to mental health distress. Emotional

resilience can be taught and knowledge transferred at a community level rather than

individual family level through a whole school approach to the host communities through

the annual community events which could be themed around promoting all round

wellbeing and emotional resilience (Weare and NCB, 2015).

There are many social capital benefits which community events can serve such as social

justice, community cohesion, and so on (Mair and Duffy, 2015). However, as relationships

are key to people’s wellbeing and recovery from mental health distress such as

depression, the social capital selected was family quality of life (Henderson, 2016, PHE,

2015, Stevenson, 2016). Three elements of this social capital were selected as were

measurable to examine within the time restriction of the project. These were highlighted

as key foundations of this social capital and the findings will be presented in this section.

Each foundation within the elements sectioned is examined from an individual impact,

then by a family perspective to fully understand the social capitals presence from the

community events and how this currently looks from a National perspective within the UK

and with an International Expertise insight from a medical doctor specialising in mood

disorder based within the USA.

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4.1 Social and Emotional Wellbeing

The social and emotional wellbeing element was analysed from an individual basis then to

the family reference group as a whole to fully comprehend the foundation of the social

capital family quality of life provided by engagement within community events (Lyons and

Coyle, 2016). The social and emotional wellbeing can be transferred through both passive

participation and immersive participation within the community events (Nordvall et al.

2014). A successful community events organisation known as the Dragon Café, which

provides weekly wellbeing focused interactive creative workshops and activities promotes

positive social wellbeing foundations, Seth Hunter, the Project Manager stated:

“The huge part of our success is we reduce social isolation, that is the really big part of it.

We help connect people, we have always been about that. It’s about connecting people

and getting them out of their lonely flats. Getting people talking, getting people creating

and laughing with each other. Our philosophy is the core of mental illness is the isolation

and you are alone. The dragon café has always been about counteracting mental illness

by bringing people together and doing activities, prevents the isolation and feeling alone.”

The core part of the Dragon Café success is engaging the community and reducing social

isolation through creative activities and sharing experiences. These provide clients with a

community or membership group to belong to and care for each other, social and

emotional wellbeing depends upon relationships, friendships are formed which adapt to an

extended family approach and the quality of life to Dragon Café attendees is improved

through weekly community event activities coming together and feeling less alone and

isolated. Another participant whom also has experienced depression and now actively is a

keynote speaker and was part of both case studied events in appendix C found wellbeing

community events engagement important to their social wellbeing and stated

“I love going and hearing what people have to say, sharing experiences you feel less

alone. I’d go to loads of different conferences, and events like these. I love sharing and

hearing what other people are doing. What people are finding is going to work, or not

work. I also have my experience and I think the more things are crowd shared about what

people are finding helpful the better. I think it is a great idea.”

xxx


The respondent reported sharing with others, and finding helpful methods. The immersive

and interactive opportunities engage the event audience, reducing social isolation and

encouraging positive social and emotional wellbeing to the individuals experiencing the

distress and the family members supporting them. The medical doctor whom specialises

in mood disorder expertise confirmed this:

“Yes. It is very important, albeit difficult, for the person who has depression to avoid

isolation, to get out and try to socialize. Community events provide this opportunity, often

in a relaxed and non-threatening atmosphere. These events offer a variety of options that

suit many different tastes.”

Community events provide opportunities for the families to enjoy experiences in an

informal atmosphere. The research also examined this from the families’ impact at the

action research live community event which specialised in wellbeing strategies. Event

feedback surveys responded the part the parents enjoyed the most about the event was:

“Watching the children having fun”

The parents were enjoying from a passive role in the event watching their children’s

participation in the wellbeing themed drama games, with friendship and sibling bonding,

strengthening relationships and creating memories refer to appendix I and J for the field

notes and event survey feedback from a live wellbeing themed school community event.

The activities can be designed for family activities where the parents join in with the

children for active learning. To examine the national level of social and emotional

wellbeing within the UK, the limited community and social care services has created

pressure on the NHS and the school communities. Steven Mallen, the chair of the MindEd

Trust through similar research and community work across Cambridgeshire and

Hertfordshire has found:

“There are people living with depression whom have to be actively suicidal before they are

admitted into care. In this country there were nearly thirty-nine thousand children referred

by GP’s to the NHS for mental health care and they were refused treatment. Now the

reason I am mentioning this is the failings in the public system and also the government’s

austerity agenda which is also seeing a wholesale reduction in social and community care

services particularly through county councils and so on and so forth. The result of that the

xxxi


education system is becoming the basis of psychotherapy by default. Many families are

sending their children to school every morning and the school is having to deal with a Tier

1 and Tier 2 psychological disorder because there are very limited community services

available and that which there is available is being reduced. You have to be very ill before

the Nhs will even go anywhere near you. So obviously, it doesn’t take a genius to work out

if we did better in the education system, we would have happier and healthier

communities. It would also prevent young people in particular reaching crisis. The Nhs is

designed to treat people who are already in crisis, what if we could do something to give

the Nhs less to do in the first place? That is very much the focus of my trust.”

The concept of theming annual events to have a wellbeing focus provides a sustainable

and measurable method to target social isolated communities. Whilst educates

communities through an enjoyable and practical manner which is relevant to them as a

host community and as a family. Interacting and engaging in community events is an

important foundation to the wellbeing and social capital family quality of life, the

participants can feel part of a community within the event and strengthen the sense of

belonging to the host community, which again refers to the social identity of themselves

and attending as a family or reference group to merge within the events temporary

community membership group and strengthening the host community membership group

relationships (Hogg and Vaughan, 2014). This would act a preventive method to mental

health distress through a community social network approach. The community event

provides social network opportunities between parents, staff and the children

strengthening key relationships to families with and without depression. As a society,

there is a well-known recognition that young people are more likely to share any emotional

distress with the school community membership group, rather than the family reference

group, which may be due to fear or lack of understanding for what they are experiencing

(Lawton-Smith, 2013). The community events will encourage preventive strategies, peer

support, and most importantly to seek support prior to crisis. Similarly, Steve Mallen, from

the MindEd Trust reported:

“The reason why my son is not alive is because he didn’t ask for help. I keep coming

across very similar cases, now if we could remove that stigma and increase community

awareness, family awareness, school awareness and so on. Then quite simply young

people in particular will seek help more quickly. In addition to that it is also a complicated

thing, as one of the issues we have got here is physical health it’s very obvious you break

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a bone it is kind of obvious that someone has hurt themselves. If someone has got a

mental problem it isn’t immediately obvious, and it is not immediately obvious to the

people who love them dearly. So you see again, if I look at my own particular case, and

going back to other families that I have been in contact with as well. It is often the case

that a young person might be suffering, their parents can’t see what’s happening, their

friends can’t see what’s happening and their teachers can’t see what’s happening. Now if

they were to increase our mental health literacy, then we will basically be better able to

see the signposts for which they are suffering and also encourage them to get help and

also develop our own pathways. Similarly, a lot of school initiatives one of the strongest

areas will be the peer to peer support. As a young person the first point of reference they

will turn to, is their friendship group, but the problem is that the friendships are not aware

of the problem. If we look at what we have achieved in society with Alzheimer’s, things like

Racism, Homophobia. People say you can’t change values and stigma and so on. Yes,

you can, and we have. The world that you and I grew up is not the same world which our

children are growing up in. If you see what I mean, and that will continue to change. So I

am very much in favour of events, which bring out these issues and educate, which bring

people together to talk and learn.”

As the respondent highlighted the events can focus upon awareness, reducing

stigmatism, the key relationships surrounding the child may be unaware of the distress

developing. Community events can encourage community social wellbeing and assist with

caring for each other’s emotional wellbeing by raising awareness of the symptoms and

triggers which, peers could be experiencing. Specialising school community events to

encourage wellbeing strategies or methods can assist with recovery and prevention to

psychological disorders amongst peers. A medical doctor specialising in mood disorder,

Dr Susan J. Noonan, MD, MPH recommended:

“Yes, I think it should be part of the educational curriculum for students and available as

free adult-education programs in community centres. I would incorporate it as part of

general health and wellbeing as preventive medicine and not split it off as “mental health”

wellbeing. I would suggest teaching the Basics of Mental Health (diet & nutrition, sleep

hygiene, exercise fundamentals, routine and daily scheduling, avoiding isolation and

importance of social contacts, etc.) along with mindfulness, and wellbeing. Present it in a

way such that people will understand it is important to pay attention to for their overall

health and wellness.”

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The importance of building a social and emotional resilient community requires practical

changes which will adopt a whole community approach including all relationships

surrounding young people such as teachers, family, and friendships.

4.2 Family Interpersonal Relations

Relationships are at the heart of quality of life or wellbeing (Henderson, 2016, PHE, 2015).

These foundations provide support in distress and care for each other regularly, attending

community events together provide activities and memories shared together. For an

individual experiencing depression this can provide an escapism from symptoms from the

illness and enjoyment of sharing together. One respondent with depression in this study

reported:

“My partner works a lot, so at weekends we do stuff together. We spend time as a family,

we go to carnivals, fairs, and see what’s on. We don’t intentionally think what shall we do

or where shall we go. If it’s a nice day, we go here or if there are funfairs on. We can enjoy

together as a family.”

The partner works a lot, providing for the family, this gives precious moments at the

weekends to attend together and feel a family, by taking the children to carnivals and

funfairs. Sharing activities together is a key element for family interpersonal relations.

Another parent from the live wellbeing community event feedback highlighted:

“Seeing the two girls enjoying themselves, particularly with Herts Inclusive Theatre”

The two sisters were participating in wellbeing themed drama games together,

strengthening sibling bonding which the parent enjoyed to see them experiencing fun

activities together with their friends. A reference family group within the school

membership groups of year three and year five merged to form the wellbeing events

temporary community membership group (Kelley, 1952 cited in Hogg and Vaughan,

2014). There were children with and without disabilities enjoying the drama games

together, in an inclusive and accepting environment. The project has also considered the

extended family approach, this can be school community membership, local

neighbourhood membership or whichever social group identity individuals can shape

xxxiv


themselves to belong to. The Dragon Café project manager defined the extended family

community at the Dragon Café as:

“Definitely, a lot of friendships have been formed for most people. For me it is a job, but it

is also a passion. There are psychiatrists which come to us and have made genuine

friendships. There has been Facebook groups set up, and people organise other

gatherings outside of the dragon café. There are a lot of support for things like William

Blake for example, there are William Blake nights. There has been a lot of seeds sown as

a result of the Dragon Café, and there are a lot of people who look after each other

outside of the dragon café as we are only open on a Monday.”

The extended family community cares for each other out of the Dragon Café community

weekly creative activities, sharing and laughing together, mental illness such as

depression can put a lot of pressure on relationships, community events provide a space

to forget the worries, albeit temporary relief from symptoms and pressures upon family

relationships. The project manager shared:

“The dragon café is about connection, playfulness, creativity and just trying to build

bridges and relationships for people. Our experience of mental illness is it can devastate

families, individuals can be estranged as it is not talked about, the depressed people can

be forgotten about as no one wants to talk about it. The big thing we done at the Dragon

Café is a series of speaking nights themed to different issues, I don’t know if you have

come across a book called let’s talk about Kevin, it’s a book about a mother who struggles

to love her child which is a taboo topic and arguably there is mental health within this

book. So we did a whole series of we need to talk about evening events, which were: we

need to talk about psychiatry and mental health, we need to talk about mental health and

medication, we need to talk about mental health and anger, we need to talk about mental

health and psychiatric wards. So we did a whole series of taboo busting panels with

questions and answers at the end of it, and we had 100 people attending which we

recorded and turned into podcasts. So again, that comes in line with getting people talking

and getting people thinking to reduce stigma. Encouraging people to gain connections

within their own circles of families and friendships, because as we all know these things

can suffer.”

On the other hand, coming together as a family during difficult moments can strengthen

the bond having overcome the difficulty together, a participant shared:

xxxv


“In a way it has deepened our relationships especially with my husband, and my mother

who came to live with us. I am very grateful to them, so I think in one way it was a good

thing however, on another level it was a very demanding time because anyone who is

seriously ill with depression can be quite a challenging patient for those around them and

their family. Whilst effected with a mental illness and when something goes wrong with

your brain, I think there’s always a feeling that it is also about mood and character

therefore your family can always worry that somehow they are to blame. So I think it is a

challenging time for relationships as well, I didn’t blame them. Depression is not as

straightforward as a physical illness. I think it is hard for the person as they feel guilty and

they feel ashamed. I think that is the very hard extra dimension to depression.”

Community events provide opportunities to strengthen relationships and sibling bonding,

as part of the extended family approach which are important relationships such as

friendships, local community neighbours for example. Providing opportunities for the

extended community to provide support and encouragement so the family doesn’t feel

alone and isolated overcoming the illness. Utilising community events for the social capital

benefits within schools rather than solely fundraising and profit generating purposes

encourages acceptance from the whole school community (Mackellar, 2014).

The need to prevent social isolation to mental health distressed families is important for

recovery to the individual experiencing depression but also to reduce stigmatism which is

the root cause of the social isolation. Dr Susan J. Noonan, MD, MPH advised:

“Sadly, yes. It is present socially and in the workplace, and one has to be very careful

about when and to whom you choose to disclose your illness. It comes from a lack of

understanding of depression as a biologically based illness and not a “character flaw” or

something you have control over getting (although you do have control over how you

manage it).”

Another respondent’s views demonstrated the potential danger caused by stigma as was

fearful of seeking help:

“I think there should be. I have never gone for professional help because you don’t want

the stigma, especially when you have got a family. You worry, that people will think you

aren’t coping and not capable of looking after your daughter, I did get to a stage where I

was really bad and my partner said I have got to go and see someone. I was like I can’t as

you have had problems in the past, and now they see you have had problems and now I

have problems. What is going to happen? So all I ever used to do is go to the doctors and

get put on anti-depressants that is all I ever used to do. Even to this day, he says I wish

xxxvi


you had just gone and seen someone. Then my mum would say I don’t think you should

see someone professional as that is when it gets really serious. I think unless you have

experienced depression, you don’t know how to deal with it. They just say well snap out of

it.”

Again, this returns to social and emotional wellbeing to the host communities and mental

health awareness, the foundations interlink and circulate deep within each other. These

were also key elements within the final foundation recovery or prevention, leading to the

final social capital foundation within the research agenda.

4.3 Recovery or Prevention

Throughout this project, community events have provided a positive contribution to

depression through a number of possible arenas. The Project Manager from the Dragon

Café provided a measurable example of the positive contribution wellbeing creative

focused events have had on his and his client’s recovery and shared:

“My experience of depression and having worked with other depressed people, it can be

quite deskilling and can make you feel like you are a drain on society. You don’t have

much to offer, and you get in the way of stuff. Maybe, you can’t hold down a job and all

these quite negative things. I think by getting people to create like the work we do at the

dragon café, people can feel they have something to contribute. You don’t have to be the

world’s best artist to pick up a pen, you don’t have to be the world’s best writer to create a

verse. Everyone has a creative voice, it’s just a matter of being brave enough to try and

find it. So it has been really helpful for depression in particular I would say, and again, I

would make the point about reducing social isolation. We have been really successful at

getting people together, to give you an idea; on an average Monday at the dragon café,

we see over 200 guests and have 50 volunteers working with us. So over 250 people and

the majority of us have a quite serious mental health diagnosis including clinical

depression. So it is a lot of not very well people coming together to create and socialise in

a positive and constructive way.”

Designing community events with a wellbeing focus has potential to contribute to recovery

for the families within the schools needing additional support, raise awareness through a

community level knowledge transfer, and reducing stigmatism (Kloos et al. 2014). The

wellbeing activities can be presented as an all-round to wellbeing approach as the live

action research community event within this project portrayed. Practical games educating

xxxvii


emotional and mental health resilience alongside physical fitness activities, with creative

craft opportunities providing the information to the host community in a light hearted and

fun way. The Project Manager from the Dragon Café emphasised this with:

“As creativity has always been seen as a pleasant thing and a nice thing, not really an

essential. However, in our experience of mental illness it can be as powerful as the

world’s best medication, without over stating the case. You can be on the perfect

medication, but if you are stuck in a flat, chances are you are going to be depressed and

remain that way. Like anybody, you don’t have to have clinical depression to feel

depressed. So again, creativity, connection, coming together, eating healthy food, doing

art, doing drama, doing massage, doing meditation, all these activities have proven strong

methods of keeping people well.”

A key speaker, Rachel Kelly, a writer, journalist and mental health campaigner at the

Changing Minds Festival and The MindEd Trust conference emphasised the need to

address multiple methods are required for recovery and different methods will suit

different individuals and stated:

“I was on a four-part panel speaking Saturday for the Arts vs. Chemicals, which was

looking at taking a more holistic approach to mental health which we do need and the arts

have an important part to play in that. When you look at the various treatments for mental

health it’s a belief that pills are magic bullets. We had drugs in the nineties, they do work

for some people, and they don’t work for everybody, which adds a sense of failure when

they don’t work. There’s an estimated around 30-40% of people for which the drugs don’t

work. Then we had the talking therapies come through the cognitive behavioural therapy

(CBT), and the government made that their therapy of choice. Again, it’s pretty good it

works for around fifty percent of people. I think the thing coming through now is

mindfulness, everybody is very excited about mindfulness, which again is a similar

process. It doesn’t work for everybody. So my own view is that you need a much more

bespoke, tailor made, tool box of different strategies, one size does not fit all.”

The idea of presenting wellbeing focused community events within schools is to

collaborate with embedded, emotional and mental health resilience programmes.

Undertaking a whole school approach bringing together, the teachers, families of the

pupils and showing as a community acceptance and encouraging families to seek support

without fear of children protection referrals which should be strictly for abuse and neglect

not parents or the child requiring emotional or mental health support, without the fear that

xxxviii


no one will accept them anymore within the community (Weare and NCB, 2015). Steve

Mallen, from The MindEd Trust raised an excellent point on this subject:

“Whilst I welcome anything that brings people together, and makes them happy, stronger

that is not the same as a proper evidence based education system. I find that what has

been happening in the school system is they are doing a bit of this and a bit of that. Now I

welcome that, but it is not the same as having an embedded programme, that is evidence

based, that is measurable and is sustainable over time. Now that is what I am trying to do

with The Trust is to bring schools and communities on a journey so they have actually got

a wellbeing and mental health literacy programme embedded in their curriculum. Now this

isn’t something to just be done a term, this has to be all through the school system from

primary, secondary and through to higher education. It has to be repeatable, and it is no

good just having traditional classroom learning, and at the same time it is no good just

getting everyone to run around the field. You need to look at mind, and body and all sorts

of activities. Now there is some very good science about the use of math, the use of

dance, and the use of PE in terms of improving our mental health literacy. It is not just

about improving our wellbeing, there is an obvious relationship between our physical

health and our mental health. The better we are physically, the more likely we are to be

strong mentally as well.”

The key is to present a brief to the schools for independently run community events to

make the initiative sustainable. Each school should develop their own programmes or

themed annual events in support of these programmes such as the summer fairs for

example, as The MindEd Trust pointed out:

“What you might do in a relatively affluent area, might do be different to a socially deprived

area. You need to develop programme which are sensitive to their environment, but at the

same time I think there is a much deeper reason, if we think about this if you encourage

communities to develop their own programmes. The mere existence of that discussion

and that planning, I think is a good thing, this is one of those areas where the journey is as

valuable as the destination. If you bring together a school to develop an emotional literacy

programme you consult with all the teachers and the parents, and the board of governors.

They ask the students, they do some research, they better the counselling, and they look

at the evidence based work where there are programmes available. They examine

different training programmes for the staff and so on and so forth. Now if they spend 6-9

months doing that, by the time the 9 months is complete what you have is a mental health

literate community. The journey and the discussion is as valuable as the end programme.”

xxxix


Recovery provided by community events can take many forms, including employment,

reintroducing skills and building confidence. A participant with depression whom has their

own children’s book business working on stalls within school summer fairs and similar

family community events reflected:

“I think it’s hard when you have a family, as I wouldn’t have time to go off and do anything

on my own. By the time I could, I am so tired, I just can’t. I just really can’t be bothered. I

think maybe as they get older, I will end up doing more things for myself. Right now, I

think it is just too hard, to get a hobby. My books I have quite enjoyed that. My mum has

said I think you are taking on a bit too much. When I do like a summer fair, it’s my time to

myself. On my own, so I think that is how I am dealing with it at the moment.”

The data findings have confirmed the social capital of improved family quality of life from

an individual perspective and to the family as a whole. The social capital foundations of

social and emotional wellbeing, family interpersonal relations and recovery or prevention

are provided through community event engagement to families living with depression

(Mair and Duffy, 2015).

4.4 Discussion

The interpretive phenomenological analysis revealed the social capital provided by

community events for families living with depression. The foundations for family

interpersonal relations opportunities presented through increased family bonding such as

sibling relationships participating in activities together, the parents enjoyed watching their

children having fun, creating and sharing memories as a family (Stadler and Jepson, In

Press). Community events such as school wellbeing themed community events could

collaborate with an embedded emotional and mental health resilience programme for

young people as a whole school framework bringing the parents, board of governors,

teachers and pupils together to raise awareness of all round wellbeing strategies to

improve social and emotional wellbeing to the host community and a method to raise

awareness and combat mental health stigmatism. The connection with the family, school

community, building strengthened relationships is also a strong supportive element to

recovery or prevention from crisis as the person in distress will seek help more quickly if

the surrounding community whom care for them are aware of the difficulties they may be

facing (PHE, 2015b). The therapeutic methods found within participating in community

event activities whether, as an audience member or providing people with an employment

opportunity to develop skills and restore confidence to the person experiencing

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depression. The findings have discovered community events provide further social capital

value than merely a revenue generator. The principles and philosophies from a

Community Event Specialist represent the same key values as a Community Psychologist

promoting social family quality of life at a community level rather than individual case

basis (Kloos et al. 2014). The research has concluded that school communities such as

primary, secondary and further education communities are best targeted to eradicate

stigmatism and raise awareness. The social capital provided by community events

includes family or extended family interpersonal relations shown though relationship

bonding, sharing experiences together through joint participation which provides wellbeing

through connection thus enhancing the quality of life to families living with depression

engaging within community events. The findings are presented in the model figure 6.

Figure 6: Attendee Social Identities at School Community Events

Figure 6 highlights the social identities and the feeling of belonging and key relationships

are essential to the foundation of social and emotional wellbeing (Hogg and Vaughan,

2014). Community events produce revenue opportunities and can gain sponsorship

support, the school community can theme budgeted annual community events with a

wellbeing focus to reduce pressure on the NHS public health system and the education

system as this targets the vulnerable group where most disorders will establish early and

preventing crisis (The MindEd Trust, 2016a, Weare and NCB, 2015).

Personal Social Identity (Individual - Own Self)

Reference Social Identity Group

(Family Member)

Membership Social Identity Group

(School Community Member)

Membership Social Identity Group

(Temporary Event Community Member)

xli


Chapter Five - Conclusion and Recommendations

5.1 Conclusion and recommendations

To conclude this project, the social capital foundations of improved family quality of life

such as interpersonal relations, social and emotional wellbeing and recovery or prevention

were found within community events and are best targeted within educational

communities for prevention or early intervention. Event social studies of this nature are

still in development and have potential for further development in this area and other

foundations of family quality of life and other methods of social capital (Stevenson, 2016,

Mair and Duffy, 2015, Stadler and Jepson, In Press). The recommendations would be to

examine if themed community wellbeing events could be implemented into primary,

secondary and further education and measure the behavioural changes to the host

community over a period of time to measure the behavioural changes to the host

communities and engage through family support staff and work alongside the public

health support services. Collaborating the value of whole school community approaches

with scientific wellbeing strategies and educational emotional resilience programmes

(Weare and NCB, 2015) as an example, this develops community spirit with the

collaboration of community organisations and supporting local businesses, perhaps this is

another element which could be examined further.

This research had limitations only working with one primary school, a larger sample of

school communities would be recommended such as three to five primary, secondary and

further education facilities to have the potential to gather larger samples for analysis,

different areas of social deprivation could be examined, which works better in which type

of demographic areas for example. The possibilities for further development has excellent

potential for positive changes to tackle the problem with mental health distress in young

people and their families, the agenda for change can be implemented through community

collaboration and social support networks (PHE, 2015a, PHE, 2015b).

xlii


Chapter Six – Personal Reflections

6.1 Lessons learned

The project was enlightening and at times quite challenging as a researcher and as a

person. My own background influenced my choice of selecting this topic having lived and

suffered with depression. The experiences and value I have found through education and

community events made me more determined to provide further mental health literacy in

assisting others whom may experience the illness or support others who do. A number of

skills were utilised throughout the project which will assist in future education or

employment. Working with community organisations to produce a small scale event for

example, the knowledge of knowing people in hardship in the Leavesden Green School

community will benefit through engagement with these organisations and adopt some new

methods of thinking with their families and make some behavioural changes was a

pleasure. The project introduced a new method of qualitative approach for me, as I had

never worked with an interpretive phenomenological analysis before. I visited the material

and findings multiple times and gave me a deeper understanding of different elements to

community events which you would overlook or not notice previously. Speaking with

different people with different experiences and knowledge developed my own written work

immensely when I look at work from a year ago to present day. I enjoyed the field work

and experiencing different aspects of the events and was more mindful than I would have

been previously, the strategies I researched I will try to incorporate within my own family

which I think will improve our wellbeing so I have found a lot of value and social capital

from this project as well as producing the final academic report.

xliii


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Dragon Café (2016a) “The Dragon Café” [Online] Available at: http://dragoncafe.co.uk/


Dragon Café (2016b) “The Dragon Café Changing Minds Photos” [Online] Available at:

https://www.facebook.com/thedragoncafe/photos/?tab=album&album_id=9708864063361

69 [Accessed: 31/02/16]

Foley, M., McGillivray, D. & McPherson, G. (2012), Event policy: from theory to strategy,

London, Routledge.

Foerschner, A. M. (2010), “The History of Mental Illness: From Skull Drills to Happy Pills.”

Student Pulse, Vol. 2, No.9 pp.1-4 [Online] Available at:

http://www.studentpulse.com/a?id=283 [Accessed: 15/02/16]

Getz, D. (2012), Event studies: theory, research and policy for planned events, 2nd edn,

London: Routledge.

Harper, D. & Thompson, A.R. (2011), Qualitative Research Methods in Mental Health and

Psychotherapy: A Guide for Students and Practitioners, 1st edn, John Wiley & Sons,

Hoboken.

Henderson, E., and McIlwraith, M. (2013), Ethics and Corporate Social Responsibility in

the meetings and events industry. Hoboken: John Wiley & Sons

https://www.gov.uk/government/publications/improving-mental-health-services-for-young-people


https://www.gov.uk/government/publications/the-mental-health-strategy-for-england

http://dragoncafe.co.uk/



http://www.studentpulse.com/a?id=283

xlv


Hoffman, L., Marquis, J., Poston, D., Summers, J. A., & Turnbull, A. (2006), “Assessing

family outcomes: psychometric evaluation of the Beach Center Family Quality of Life

Scale.” Journal of Marriage and Family, 68(4), pp. 1069-1083.

Hogg, M.A. & Vaughan, G.M. (2014), Social psychology, 7th edn, Harlow: Pearson.

Hogg, M.A. & Vaughan, G. (2008), Social psychology, 5th edn, Harlow: Pearson.

International Olympic Committee (IOC) (2013), ‘Legacies of the Games’ [Online]

http://www.olympic.org/documents/reference_documents_factsheets/legacy.pdf


Jepson, A., Clarke, A. and Ragsdell, G. (2013), "Applying the motivation-opportunity-

ability (MOA) model to reveal factors that influence inclusive engagement within local

community festivals: The case of UtcaZene 2012", International Journal of Event and

Festival Management, 4(3), pp.186-205

Jorm, A.F. (2012), "Mental health literacy; empowering the community to take action for

better mental health", American Psychologist, 67(3) pp. 231-243.

Kloos, B., Nelson, G.B. and Ornelas, J. (2014), Community psychology and community

mental health: towards transformative change, New York: Oxford University Press.

Lawton-Smith, S. (2013), “Peer support in mental health: where are we today?”, The

Journal of Mental Health, Training, Education and Practice, 8 (3), pp. 152-8.

Lyons, E. and Coyle, A. (2016), Analysing qualitative data in psychology, 2nd edn, SAGE,

Los Angeles.

Mackellar, J. (2014), Event audiences and expectations, London: Routledge

McManus, J (2013), “Psychology, public health and the enduring vitality of a discipline”

[Online] Available at: https://jimmcmanus.wordpress.com/2013/03/25/psychology-public-

health-and-the-enduring-vitality-of-a-discipline/ [Accessed: 14/04/16]

http://www.olympic.org/documents/reference_documents_factsheets/legacy.pdf

https://jimmcmanus.wordpress.com/2013/03/25/psychology-public-health-and-the-enduring-vitality-of-a-discipline/

https://jimmcmanus.wordpress.com/2013/03/25/psychology-public-health-and-the-enduring-vitality-of-a-discipline/

xlvi


Mair, J. and Duffy, M., (2015), “Community events and social justice in urban growth

areas”. Journal of Policy Research in Tourism, Leisure and Events, Vol.7 No.3, pp.282-

298. [Online] Available at: http://dx.doi.org/10.1080/19407963.2014.997438 [Accessed:

28/02/16]

McNiff, J., (2016). You and your action research project. 4th Ed, Oxon, Routledge.

Mental Health Taskforce of NHS England (MHT), (2016), “The five year forward view for

mental health” [Online] Available at: http://www.mind.org.uk/taskforce [Accessed:

15/02/16]

Nordvall, A; Pettersson, R; Svensson, B; Brown, S. (2014), “Designing events for social

interaction” Event Management, 18(2), pp. 127-140

Poston, D., Turnbull, A., Park, J., Mannan, H., Marquis, J., & Wang, M. (2003), “Family

quality of life: A qualitative Inquiry.” Journal of Mental Retardation, Vol. 41, No.3, pp. 313-

328.

Public Health England (2015a), “Promoting children and young people’s emotional health

and wellbeing: A whole school and college approach” [Online] Available at:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/414908/Fin

al_EHWB_draft_20_03_15.pdf [07/04/16]

Public Health England (2015b), “A guide to community-centered approaches for health

and wellbeing” [Online] Available at:

https://www.gov.uk/government/publications/health-and-wellbeing-a-guide-to-community-

centred-approaches [Accessed: 10/4/16]

Rethink (2016) “Rethink Mental Illness” [Online] Available at: https://www.rethink.org/


Richards, G., de Brito, P.M., and Wilks, L. (2013), Exploring the social impacts of Events,

London: Routledge

Richards, G. (2014), Eventfulness and the quality of life. Tourism Today, (14), pp. 23-36.

http://dx.doi.org/10.1080/19407963.2014.997438

http://www.mind.org.uk/taskforce

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/414908/Final_EHWB_draft_20_03_15.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/414908/Final_EHWB_draft_20_03_15.pdf

https://www.gov.uk/government/publications/health-and-wellbeing-a-guide-to-community-centred-approaches



https://www.rethink.org/

xlvii


Richards, G., Marques, L., and Mein, K. (2015), Event Design: social perspectives and

practices, London: Routledge

Stadler, R. & Jepson, A. (in press): “Understanding and valuing Festival and Event

experiences and their impacts upon Family quality of Life (QOL)”, in John Armbrecht, Erik

Lundberg, Tommy Andersson and Donald Getz (Eds.), The Value of Events

Smith, J.A., Flowers, P and Larkin, M (2009), Interpretative Phenomenological Analysis:

Theory, Method and Research. London: Sage

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http://www.southbankcentre.co.uk/whatson/festivals-series/changing-minds [Accessed:

01/02/16]

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https://twitter.com/southbankcentre?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ct

wgr%5Eauthor [Accessed: 01/02/16]

Stevenson, N., (2016). “Local festivals, social capital and sustainable destination

development: experiences in East London.” Journal of Sustainable Tourism, Vol. 24, No.

7, pp.1-17.

Summers, J.A., Poston, D.J., Turnbull, A.P., Marquis, J., Hoffman, L., Mannan, H. and

Wang, M., (2005), “Conceptualizing and measuring family quality of life.” Journal of

intellectual disability research, Vol. 49, No.10, pp.777-783.

The MindEd Trust (2016a), Resources [Online] Available at:

http://themindedtrust.org/resources/ [Accessed: 01/04/16]

The MindEd Trust (2016b), Conferences [Online] Available at:

http://themindedtrust.org/conferences// [Accessed: 08/04/16]

http://www.southbankcentre.co.uk/whatson/festivals-series/changing-minds

https://www.facebook.com/southbankcentre/?fref=ts

https://twitter.com/southbankcentre?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor

https://twitter.com/southbankcentre?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor

http://themindedtrust.org/resources/



xlviii


UK Government and Mayor of London (UKG and MOL) (2014), ‘Inspired by 2012: The

legacy from the London 2012 Olympic and Paralympic Games second annual report –

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723_Inspired_by_2012_-_2nd_annual_legacy_report_-_accessible.pdf Accessed:

10/05/2016

Weare, K and NCB (2015), “What works in promoting social and emotional well-being and

responding to mental health problems in schools? – Advice for schools and framework

document” [Online] Available at: http://www.ncb.org.uk/areas-of-activity/education-and-

learning/partnership-for-well-being-and-mental-health-in-schools/what-works-guidance-

for-schools [Accessed: 08/05/16]

Veal, A.J., and Burton, C. (2014), Research methods for Arts and Events Management.

Harlow. Pearson.

Yeoman, I., Smith, K., Robertson, M., Backer, E. & McMahon-Beattie, U. (2015), The

Future of Events & Festivals, London: Routledge Ltd

Young Minds (2014) Young minds report on children, young people and family

engagement [Online] Available at:

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young-people [Accessed: 02/04/16]

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https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/335774/140723_Inspired_by_2012_-_2nd_annual_legacy_report_-_accessible.pdf

http://www.ncb.org.uk/areas-of-activity/education-and-learning/partnership-for-well-being-and-mental-health-in-schools/what-works-guidance-for-schools



https://www.gov.uk/government/publications/imFacebproving-mental-health-services-for-young-people

https://www.gov.uk/government/publications/imFacebproving-mental-health-services-for-young-people

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Appendix A: The MindEd Trust “NHS England Statistics” (MindEd Trust, 2016)

The MindEd Trust 2016 · Charity No: 1163922 [Online] Available at:


Access to Psychological Therapy (IAPT) in the NHS

(NHS England)

“The demand for psychological treatment has escalated dramatically in recent years.

Whilst Improving Access to Psychological Therapy (IAPT) treatments has risen, it has

not kept pace with demand and increasing numbers of referrals are being refused. The

net effect is that treatment thresholds are rising – sufferers have to be in ever deeper

crisis before they can access care. Those accepted for treatment are then faced with

weak pathways and absurd waiting lists, leaving sufferers, families and communities in

despair and anguish. This is unacceptable.” (The MindEd Trust, 2016b)


l


The Minded Trust “Total Beds Available for Mental Illness NHS Statistics” (MindEd Trust,

2016b)

Total Beds Available for Mental Illness (England)

NHS England

The MindEd Trust 2016 · Charity No: 1163922 [Online] Available at:


“The total number of beds available for mental patients has steadily declined in recent years in response to acute funding pressures in the NHS and a latent preference for physical illness over psychosis. This is creating intolerable pressure on families and care in the community resources and frequently results in young people being sent for treatment hundreds of miles from where they live. This is unacceptable.” (The MindEd Trust, 2016b)


li


Appendix B: Bertram and McDonald’s (2015) Validation and Invalidation Framework


lii



liii


Appendix C: Event Case Study applying the MAUDE framework to the Changing

Minds Festival Launch and The MindEd Trust Conference

Event Case Study 1: Applying the MAUDE framework to Changing Minds Festival

Launch (Southbank Centre, 2016a, Henderson and McIlwraith, 2013).

The launch of the new Changing Minds community festival was held on the weekend:

Saturday 6 February 2016 - Sunday 7 February 2016. The talk’s passes were a

successful sell out of the individual day for both days and weekend passes (Southbank

Centre, 2016a) this indicated the popularity of the concept which could support members

with depression to thrive. The attendance to community events with this concept and

design with family would form stronger family relationships, engagement and interaction

with the community audience peers to reduce the feeling of isolation and judgement from

stigmatism, assistance with support through access to alternative holistic care,

participating in talk therapies and enjoyment of the interactive arts thus achieving positive

QOL intangible benefits through community festival and event attendance. Individuals with

mental illness such as depression only social activity can be to see key worker meetings

or going to the local pharmacy which could be so much more fulfilling with better

opportunities more widely available to communities, the MUADE framework tool applied to

Changing Minds has been presented in figure 2 (Henderson and McIlwraith, 2013, MHT,

2016, DoH and NHSE, 2015).

Event policies can ensure a corporate social responsibility through the incorporation of

welcoming diversity, fair employment practices. By demonstrating a consideration of

health and wellness to the community with a fusion of local and international cultural

traditions or values, a framework can be applied to analyse ethical high impact event

practices known as the MAUDE framework (Henderson and McIlwraith, 2013). This aims

to measure if the community project is ‘Meaningful’ to the community, ‘Aligned’ with

community objectives such as economically stimulating to the local economy. The

framework assesses if the project utilises the ‘Unique Skills’ of the community, and

‘Destination specific’ for the local community hosting the event, and finally, ‘Engaging’ are

the local residents engaged with the project planning, operations and attendance

(Henderson and McIlwraith, 2013).

liv


Figure 1: An interpretation of Henderson, and McIlwraith’s (2013) MAUDE

framework model

Henderson and McIlwraith, (2013) MAUDE Framework p81-84.

The MAUDE framework is a tool for identifying meaningful, and engaging community

projects by considering high impact practices. The Maude framework considers how a

community benefits through economic impact to stimulating social coherence. The project

must incorporate the values of the business and be environmentally friendly not

damaging. The skills of the employees must be utilised effectively and will the project gain

future sponsorship support to become sustainable, the event must engage and inspire the

host community through inspiration, enjoyment and be beneficial all important aspects to

consider using this framework (Henderson and McIlwraith, 2013).

This case study reviewed the launch of the Changing Minds Festival 2016 at the London

Southbank Centre which will be presented using the MAUDE framework identifying the

features of the event which would successfully classify as a MAUDE event, an

interpretation of this frame work is presented in figure 1 and the framework is applied to

the Changing Minds Festival in figure 2.

Meaningful

•Community Service

•Sustainable

•Projects positive imagery

Aligned

•Achieves return on objectives

•Promotes corporate values

•Enhances corporate Brand

•Achieves return on investment

Unique Skills

•Utilisises abilities of the community

•Resourceful

•Cost effective

Destination Specific

•Beneficial to environment

•Beneficial to host community

Engaging

•Inspires Partcipants

•Increases sponsorship support.

lv


Meaningful

•Community spirit throughout the event

•Ethical social values

Aligned

•Sat Day, Sun Day and Weekend passes sold out.

•Free Entry was also provided

•First London venue to launch a festival of this kind.

•Achieved return on investment and objectives.

Unique Skills

•Local artists and support groups presented workshops

•Charities attended to showcase their work and support

•Support from Government Labour MP


•Beneficial to London festival reputation

•Beneficial to host community.

Engaging

•Keynote Speakers

•Performing Arts: Performances and Workshops

•Craft stands

•Interactive Exhibitions

Figure 2: Changing Minds Festival MAUDE framework model

(Henderson and McIlwraith, 2013)

lvi


Secondary Resource images from Southbank Centre Changing Minds Festival 2016

(Southbank Centre, 2016b)

The Gong and Gamelan Bath: A Sound-Healing Session led by Cathy Eastburn with

Japanese Gongs and Chimes presented at (The Dragon Café, 2016b).

Exploratory Comments: Lighting was chosen carefully to match event theming, purple and

blue, relaxing colours. Low lighting in relaxation zones. Market place was near entrance

with exhibitors bright welcoming lighting, interactive stands, mainly the support information

stands were located near front entrance/exit. Past the event space where dance

workshops etc. were held, there was another spot for exhibitors such as the Dragon Café

crafts, other support charities with mindfulness colouring stations and artist exhibitions.

Photographs by Belinda Lawley, Southbank Centre and Liz Gorman, Dragon Café

lvii


‘Mindfulness’ interactive Colouring stall from Rethink Mental Illness (Southbank Centre,

2016c, Rethink, 2016)

Exploratory comments: Families enjoying mindfulness colouring interactive stand

together. An activity designed to focus the mind on the present moment and not worry

about the future or focus on past troubles.


lviii



(Southbank Centre, 2016c, Dragon Café, 2016b)

lix


Photographs by Belinda Lawley at Southbank Centre and Dragon Café (Southbank

Centre, 2016c, Dragon Café, 2016b)

lx


“The Talking Body – Creative Dance Workshop’

Dragon Café ‘Mind Space’ at Changing Minds Festival

(Dragon Café, 2016a, Dragon Café, 2016b, Southbank Centre, 2016a)

Exploratory Comments: Expressive dance for connecting and engaging with other. Tai Chi

for relaxation and meditation as a group sharing moments and enjoying themselves. The

Dragon Café, an organisation which provides regularly weekly small scale community

events to the London community worked with the Changing Minds project to produce

workshops and a stall.


lxi


Meaningful

•Community Service

•Sustainable resilience

•Projects positive imagery

Aligned

•Reduces sector fragmentation

•Achieves return on investment

Unique Skills

•Utilisises abilities of the communities

•national and international

•Resourceful


•Beneficial to environment, public health and education

•Beneficial to host community

Engaging

•Inspires Partcipants

•Increases sponsorship support.

Event Case Study 2: Applying the MAUDE Framework to ‘The MindEd Trust

Conference - Mental Illness: Prevention & Early Intervention in Education, St

Catharine’s College, Cambridge – March 18th 2016’ (The MindEd Trust, 2016b).

The focus of the conference was to establish ways to relieve pressure on the public health

system through the introduction of wellbeing and emotional resilience programmes to be

delivered through the education system utilising different technologies and protocols

incorporating the themes; suicide prevention, early intervention and care pathways. The

aim is for the prevention of psychological trauma and disorder in young people by

modifying the public health and education system to produce better outcomes. The event

collaborated National and International expertise from the political, health, education and

academic communities for a broad scale of knowledge transfer, and understanding with a

common agenda: The development of change. The event considered leading practices

from the arenas both national and international with comparison of the best methods and

the reduction of each sector fragmentation. The community event combined the

community expertise and national policy agendas with young people representation to

promote real world context and concerns (The MindEd Trust, 2016b). Figure 1

demonstrates the event applied in a MAUDE framework context.

Figure 1: The MindEd Trust Conference MAUDE framework model

(Henderson and McIlwraith, 2013)

lxii


Appendix D: Postgraduate Dissertation First Information Form

Family Name: ..Watkins.......................... Given Name:

……Nicola…………………………..

Student Registration Number …06132650....Email [email protected]

Programme: MSc International Tourism and Hospitality

Dissertation Module Leader: Mary Quek / Adrienn Sandor

Please provide a brief outline of your dissertation research subject topic

Working title: An interpretative phenomenological study on the social capital provided by

community events for families living with depression

Introduction (Background of research):

The agenda for the research is to empower the voice of families affected by mental illness

within communities, reducing the stigmatism and to discover how community events could

be part of a future strategy to prevent community isolation and to enhance the family

quality of life. There has been a rise in generic, repetitive event replicas particularly in

music festivals, which have failed in the community experience design, as has been

produced for stakeholders rather than the intended audience (Robertson, and Brown,

2015 in Yeoman, et al., 2015). The framework will analyse the impacts of community

events on family unit quality of life exploring different dimensions of event participation

(Stadler, and Jepson, 2015; Richards, 2014). Community festivals and events have

evolved into an important social driver within modern society, the complexity of the

functions therefore are being creatively designed to fulfil business and social strategic

objectives. The effectiveness of the event design must adapt to the macro environment

conditions and craft new opportunities from threats or where nothing previously existed

before (Richards, et al., 2013), although the events have a wide variety of themes, each

have a presence of social interaction between people and forming a community within the

event which although temporary, nevertheless can still manifest outside after the event

has passed. The concept forms a nucleus for intensified community relationships, which

displays as community pride, social networks, changes in perceptions, and mutual

understanding to unite families from a bonded interactive experience (Wilks, 2013 in

Richards, et al. 2013).

There is much to be learned from the cultural phenomenon of festivals and public

celebrations as insight into a community’s political, economic, and symbolic way of life

through social interactions (Farber, 1983, in Jepson, et al. 2013). The events provide a

mailto:[email protected]

lxiii


platform for escapism, and educate through entertainment providing a unique and

desirable recreational time. The planning process incorporates community values and

invokes a hunger for a deeper understanding to encourage growth, and to understand the

intangible benefits from a community which could be engineered into the structure and

policy to provide further expansion to the minority isolated groups within communities

enhancing the Quality of Life (QOL) within modern society (Jepson, et al. 2013).

Development from the factors which influence positive QOL within communities and

society could be applied using positive psychology theoretical models to encourage

growth, unity and a thriving environment rather than just merely survival (Seligman, and

Csikszentmihalyi, 2000, cited in Stadler, and Jepson, 2015). Packer, and Ballantyne’s,

(2010, cited in Stadler, and Jepson, 2015) applied positive psychology theories to uncover

the impact of young people’s social and psychological well-being through festival

attendance.

An in-depth study into family quality of life with families with members who have mental

illness conducted by Poston, et al. (2003) discovered ten domains within family quality of

life, which were divided into subgroups, the research was conducted on families with and

without disabilities for a broad scale of different family QOL perspectives. The

recommendations for further research was to find an ongoing supportive element which

could be found within community events in addition to professional services as a

sustainable recovery tool for families with members with mental illness and their family

quality of life.

Literature Review (Theories and concepts):

Traditional research into quality of life has focused upon individual rather than the family

unit (Richards, 2014; O'Shea, and Leime, 2012, cited in Stadler, and Jepson, 2015)

furthermore a lack of theoretical models to measure quality of life with families affected by

disabilities was discovered by Hoffman, et al. (2006) study. The dominant factors said to

influence the family unit quality of life were social inclusion, emotional wellbeing, personal

interrelationships, disability support and rights, physical wellbeing and personal

development. A service programme and research intervention is assessed on the

improvement of an individual’s quality of life and wellbeing which, should be extended to

the family unit as this will also have a key influential impact on the sustainability of the

recovery and development of the individual with the disability.

The MAUDE framework will be applied to study the community events to identify the

meaningful, and engaging community projects by considering high impact practices and

lxiv


the family QOL impacts to the host community. The Maude framework considers how a

community benefits through economic impact to stimulating social coherence. The project

must incorporate the values of the business and be environmentally friendly not

damaging. The skills of the employees must be utilised effectively and will the project gain

future sponsorship support to become sustainable, the event must engage and inspire the

host community through inspiration, enjoyment and be beneficial all important aspects to

consider using this framework (Henderson, and McIlwraith, 2013).

Research methods (how you plan to collect data; where to collect; when to collect):

The objectives will seek a qualitative approach to data collection in small samples, as well

as secondary research sources from government reports for example may be analysed

where required for a content analysis. The research will target mental health related

community events and festivals to recruit participants once ethics has been approved, and

DBS has been obtained, under supervisor guidance. The researcher will contact various

organisations working in mental health, the respondents will be interviewed their families

and professional workers linked to the family for an in-depth analysis. There will be 5-10

professionals and 5-10 families as a data sample.

Initial planned case study events, organisations and participants.

Event 2: Mental Fight Club: The Dragon Café (National)

The mental fight club founded in 2007 working with the community, hosting events to

pursue recovery from mental illness. The Dragon Café is the latest project.

http://mentalfightclub.com/

https://www.facebook.com/thedragoncafe/ (Over 1000 people on the page).

Event 3: Local Community Events and Festivals (Local)

Examine events in Hertfordshire – St Albans, Watford.

http://www.watfordbigevents.co.uk/

http://www.enjoystalbans.com/whats-on

Event 4: Changing Minds Festival (National)

Community festival based in London for mental health recovery.

Website: http://www.southbankcentre.co.uk/whatson/festivals-series/changing-

minds

Category: Community Event for Mental Health

Table 1: Case Study Events

Organisations linked to mental health research and awareness:

http://mentalfightclub.com/

https://www.facebook.com/thedragoncafe/

http://www.watfordbigevents.co.uk/

http://www.enjoystalbans.com/whats-on



lxv


Organisation: Prince of Wales International Centre for SANE Research

Research centre for causes of mental illness.

http://www.sane.org.uk/what_we_do/research/powic/

Contact: Marjorie Wallace, chief executive of mental health charity SANE

Category: Expertise

Organisation: Mind – Charity working for mental illness awareness

https://www.mind.org.uk/

Category: Awareness,

Organisation: Young Minds – Mental Illness for Young People

http://www.youngminds.org.uk/

Category: Wellbeing in Young People, Research, Awareness, Population Sample

Table 2: Mental Health Charitable Organisations

University of Hertfordshire Expertise

Professor Keith Laws - Psychology

[email protected]

University of Hertfordshire Wellbeing Team

Samantha Soni

[email protected]

Table 3: University Expertise

Working Reference list:

Altinay, L. and Paraskevas, A. (2008) Planning Research for Hospitality and Tourism,

Oxon and New York: Routledge

Creswell, J.W. (2009) Research Design: Qualitative, Quantitative, and Mixed Method

Approaches. 3rd Ed. London: Sage.

Getz, D. (2012), Event studies: theory, research and policy for planned events, 2nd edn,

London: Routledge.

Henderson, E., and McIlwraith, M. (2013), Ethics and Corporate Social Responsibility in

the meetings and events industry. Hoboken: John Wiley & Sons

http://www.sane.org.uk/what_we_do/research/powic/

https://www.mind.org.uk/

http://www.youngminds.org.uk/



lxvi


Hoffman, L., Marquis, J., Poston, D., Summers, J. A., & Turnbull, A. (2006). Assessing

family outcomes: psychometric evaluation of the Beach Center Family Quality of Life

Scale. Journal of Marriage and Family, 68(4), pp. 1069-1083.

Jepson, A., Clarke, A. & Ragsdell, G. (2013), "Applying the motivation-opportunity-ability

(MOA) model to reveal factors that influence inclusive engagement within local community

festivals: The case of UtcaZene 2012", International Journal of Event and Festival

Management, Vol 4, No.3, pp.186-205

Jorm, A.F. (2012), "Mental health literacy; empowering the community to take action for

better mental health", American Psychologist, vol. 67, no. 3, pp. 231-243.

Kranke, D., Jackson, S.E., Taylor, D.A., Landguth, J. & Floersch, J. (2015), "‘I’m loving

life’: Adolescents’ empowering experiences of living with a mental illness", Qualitative

Social Work, vol. 14, no. 1, pp. 102-118.

Leff, J.P. & Warner, R. (2006), Social inclusion of people with mental illness, Cambridge:

Cambridge University Press.

Linhorst, D.M. (2006), Empowering people with severe mental illness: a practical guide,

New York, N.Y. Oxford University Press

Mackellar, J. (2014), Event audiences and expectations, London: Routledge

Poston, D., Turnbull, A., Park, J., Mannan, H., Marquis, J., & Wang, M. (2003). Family

quality of life: A qualitative Inquiry. Mental Retardation, 41(3), pp. 313-328.

Richards, G. (2014). Eventfulness and the quality of life. Tourism Today, (14), pp. 23-36.

Richards, G., de Brito, P.M., and Wilks, L. (2013), Exploring the social impacts of Events,

London: Routledge

Richards, G., Marques, L., and Mein, K. (2015), Event Design: social perspectives and

practices, London: Routledge

Rinaudo, B. & Ennals, P. (2012), "Mental illness, supported education, employment and

recovery: Ben's story", Work, vol. 43, no. 1, pp. 99-104.

Slade, M. (2009), Personal recovery and mental illness: a guide for mental health

professionals, Cambridge: Cambridge University Press

lxvii


Stadler, R & Jepson, A (2015), 'Analysing the Impact of Festival and Event Attendance

upon Family Quality of Life (QOL) - A Qualitative Inquiry Approach' Leisure Studies

Association Conference, Bournemouth, United Kingdom, 7/07/15 - 9/07/15

Veal, A.J., and Burton, C. (2014), Research methods for Arts and Events Management.

Harlow. Pearson.

Yeoman, I., Smith, K., Robertson, M., Backer, E. & McMahon-Beattie, U. (2015), The

Future of Events & Festivals, London: Routledge Ltd

If you have already discussed this topic with a member of staff and they provisionally

agreed to be your supervisor, please include their name: ...Raphaela

Stadler.......................

Please note that the there is no guarantee that the member of staff mentioned above

can be allocated due to their availability and other work contestants.

Indicate the subject area that your dissertation primarily focuses on (tick one box

only):

Accounting & Finance Marketing

Project Management or Information Systems Economics

Human Resource Management Tourism

Strategy OR/ Management Science

Signature ......Nicola Watkins............................................

Date...27/01/2016.........................

This section is being used by the dissertation module leader and Head of Subject

group.

1st Supervisor ...............................................

Internal Moderator .......................................

lxviii


Appendix E: Ethics Application

UNIVERSITY OF HERTFORDSHIRE

FORM EC1: APPLICATION FOR ETHICAL APPROVAL OF A STUDY INVOLVING

HUMAN PARTICIPANTS

(See Guidance Notes)

Office Use only Date Received by

Clerk:

Expedited Review

Approved by Reviewer 1 (sign & date)


Further Action: (tick appropriate box and provide details)

Request Further Information Details:

Refer for Substantive Review

Refer for Full review

Reject

Substantive Review



Relevant ECDA:

Science & Technology

[email protected]

Health & Human Sciences

[email protected]

Social Sciences, Arts & Humanities

[email protected]

x

OFFICE USE ONLY

Protocol Number:

Initial classification:




lxix


Approved by Reviewer 3 (sign & date) Approved by Reviewer 4 (sign & date)

Further Action: (tick appropriate box and provide details)

Request Further Information Details:

Refer for Full review

Reject

Full Review

Request Further Information

Details:

Reject

CONFIRMATION OF APPROVAL

[To be completed by the Chairman or Vice-Chairman of the relevant ECDA, or by

the Chairman of the University Ethics Committee – (see GN 2.1.4)]

I confirm that this application has been approved by or on behalf of the committee

named below.

Name/Sign…………………………………………………………Date……………………..

Name of committee ……………………...

DECLARATIONS

1 DECLARATION BY APPLICANT (See GN 2.1.3)

1.1 I undertake, to the best of my ability, to abide by UPR RE01, ‘Studies Involving

the Use of Human Participants’, in carrying out the study.

lxx


1.2 I undertake to explain the nature of the study and all possible risks to potential

participants, to the extent required to comply with both the letter and the spirit of

my replies to the foregoing questions (including information contained in

Appendices 1 & 2).

1.3 Data relating to participants will be handled with great care. No data relating to

named or identifiable participants will be passed on to others without the written

consent of the participants concerned, unless they have already consented to

such sharing of data when they agreed to take part in the study.

1.4 All participants will be informed (a) that they are not obliged to take part in the

study, and (b) that they may withdraw at any time without disadvantage or having

to give a reason.

(NOTE: Where the participant is a minor or is otherwise unable, for any reason, to

give full consent on their own, references here to participants being given an

explanation or information, or being asked to give their consent, are to be

understood as referring to the person giving consent on their behalf. (See Q 19;

also GN Pt. 3, and especially 3.6 & 3.7))

Enter your name here………Nicola Watkins…………..Date……18/01/16………….

2 GROUP APPLICATION

(If you are making this application on behalf of a group of students or staff, please

complete this section as well)

I confirm that I have agreement of the other members of the group to sign this

declaration on their behalf

Enter your name here ……………………………………………………. Date

…………………

lxxi


3 DECLARATION BY SUPERVISOR (see GN 2.1.3)

I confirm that the proposed study has been appropriately vetted within the School

in respect of its aims and methods as a piece of research; that I have discussed

this application for Ethics Committee approval with the applicant and approve its

submission; that I accept responsibility for guiding the applicant so as to ensure

compliance with the terms of the protocol and with any applicable ethical code(s);

and that if there are conditions of the approval, they have been met.

Enter your name here……Raphaela Stadler…………...Date……19/01/16…………

PERMISSIONS

DECLARATION BY APPLICANT (please refer to Question 7 and GN 2.2.1)

Please select ONE of the following statements and delete the rest:

4 I have yet to obtain permission but I understand that this will be necessary before

I commence my study and that the original copies of the permission letters must

be verified by my supervisor by the time I submit my results (please delete if not

applicable).

Enter your name here ……Nicola Watkins…………………………. Date

…02/02/16……………

lxxii


1. THE STUDY

Q1. Please give the title (or provisional title) of the proposed study. (NB – you will be

asked for further details later)

An interpretive phenomenological analysis of the social capital provided by community

events for families living with depression

2. THE APPLICANT

Q2. Please answer either Q2.1 or Q2.2 by providing the information requested. Q2.1

should be answered by individual applicants, both staff and students, who require

protocol approval for work which they themselves intend to carry out. Q2.2

should be answered by academic staff requiring approval for standard protocols

governing classroom practical work (or equivalent work) to be carried out by a

specified group of students. (See GN 2.2.2)

Q2.1. Name of applicant/(principal) investigator

…………Nicola Anne

Watkins……………………………………………………………….

Student registration number (or staff number for staff application)

…………06132650……………………………………………………………….

Email address

…………[email protected]……………………………………………………

………….

lxxiii


(in the case of a group application, please list the names, registration numbers

and email addresses of all members of the group, starting with the lead applicant)

Status:

(a) undergraduate

(b) postgraduate (taught/research)

(c) academic staff

(d) other - please give details here

School/Department:

If application is from member of staff or student NOT based at University of

Hertfordshire, please give the name of the institution:

Name of Programme MSc International Tourism and Hospitality Management

Module name and module code Dissertation 7BSP0316

Name of supervisor Raphaela Stadler

Supervisor’s contact details (email, extension number) [email protected],

x5877

Name of Module Leader if applicant is undertaking a taught programme/module:

Nika Balomenou

Name of Programme Tutor:

Mary Quek

Q2.2. Class Protocol Applications Only.

X


lxxiv


(do NOT use this section if you are a group of students undertaking a joint project,

instead, complete Q2.1 and list the names of all students involved in the project,

together with their student registration numbers. It is assumed that just one

member of staff will be responsible for supervision.)

Name of applicant/(principal) investigator (member of staff)

School/Department

Programme of study or award (e.g. BSc/MA)

Module Title and Code

Year/group to be governed by the protocol

Number of students involved in study per academic year

Programme Tutor (if different from the applicant)

University of Hertfordshire E-mail address

Please note: Risk Assessment Form EC5 (or subject specific risk assessment) is

mandatory for all Class Protocol Applications and must accompany this

application.

lxxv


DETAILS OF THE PROPOSED STUDY

Q3.1 Is it likely that your application will require approval by a National Research Ethics

Service (NRES) ethics committee whereby completion of an IRAS form would be

required? (See GN 2.2.3)

If you are unsure whether your application should be referred to a National

Research Ethics Service (NRES) ethics committee, please use the NHS decision

tool. The ECDA clerks have the details. Should you receive an indication that it

is not necessary to submit your application to an NRES ethics committee, or if the

application is being submitted to NRES by a collaborating institution, please

continue to complete Form EC1.

YES NO

(If YES, please answer 3.2 and 3.3)

(If NO, please continue on to Q4)

Q3.2 Please confirm whether your research involves any of the following:

Exposure to any ionising radiation

NHS or Social Care patients

NHS or Social Care staff*

Note, it is not always necessary to refer studies involving

this group of participants to the NRES for approval: students

should consult their supervisor concerning use of NHS decision tool

Clinical Trial of an Investigational Medical product

X

x

x

lxxvi


Clinical Trial of a Medical Device

Exposure to any ionising radiation

Adults who lack the capacity to consent

Human Tissue (see GN 2.2.3)

Q3.3 If your study is considered to be a Clinical Trial of an Investigational Medical

Products (CTIMP) or Clinical Trial of a Medical Device, please indicate if the study

involves any of the following categories: (See GN 2.2.3)

Children under 5

Pregnant women

A trial taking place overseas

A trial with more than 5,000 participants

If you have answered ‘Yes’ to any of the above questions in (b), you will most

probably require NRES ethics committee approval and a sponsor. You will need to

apply for NRES ethics committee approval using an IRAS form. For University of

Hertfordshire sponsorship, you will need to complete Form SP1, which is obtainable as

well as further advice regarding IRAS from [email protected].


lxxvii


DO NOT complete this form any further but submit it to your relevant ECDA now.

Please note, you will be issued with a UH Protocol Number but this will not be

valid until you have sent your relevant ECDA a copy of your NRES ethics

committee approval letter and copy of the synopsis of the study.

Q4. Please give a short synopsis of your proposed study; stating its aims and

highlighting where these aims relate to the use of human participants. (See GN

2.2.4)

Please enter details here.

The agenda for the research is to empower the voice of families affected by mental

illness disabilities within communities, reducing the stigmatism and to discover how

community events could be part of a future strategy to prevent repeat hospitalisation

and community isolation.

The aim of this study is to analyse the benefits from regular community event

engagement from families with mental illness disabilities and to establish how this

enables a better quality of life to both the family and the host community. The study will

conceptualise family quality of benefits and discover full impacts of the community event

engagement including key research from professionals working within the industry and

within events research. The core stimulus of the research will focus on how the findings

could be adapted to future event policies, and how event designers could integrate new

design concepts into future strategies for positive QOL within community events and

festivals.

Q5. Please give a brief explanation of the design of the study and the methods and

procedures used, highlighting in particular where these involve the use of human

participants. You should clearly state the nature of the involvement the human

participants will have in your proposed study and the extent of their commitment.

Thus you must complete and attach the Form EC6 (Participant Information Sheet)

(see Appendix 2). Be sure to provide sufficient detail for the Committee to be

clear what is involved in the proposed study, particularly in relation to the human

participants. (See GN 2.2.5)

lxxviii


The objectives will seek a qualitative approach to data collection in small samples, as

well as secondary research sources from government reports for example may be

analysed where required for a content analysis.

Q6.1 Please give the starting date 28/01/2016

Q6.2 Please give the finishing date. 05/09/2016

(For meaning of “starting date” and “finishing date”, see GN 2.2.6)

7. Where will the study take place?

Please refer to the Guidance Notes (GN 2.2.1) which set out clearly what

permissions are required; ensure that you complete the Permissions box near the

front of this application form and indicate in Appendix 2 (last page of this

application form) which permissions you are attaching to the application.

Please enter details here.

University pre booked room, health professionals place of work

Q8. It might be appropriate to conduct a risk assessment of the proposed location for

your study (in respect of hazards/risks affecting both the participants and/or

investigators) – this would be particularly relevant for off-campus locations but

please consider potential hazards on-campus as well (Question 11 also refers).

Please use Form EC5 which is an example of a risk assessment OR use a

subject specific risk assessment form provided by your School or Supervisor (See

GN 2.2.7 and Section 4 of the Guidance Notes).

If you do not consider it is necessary to make a risk assessment, please give your

reasons:

EC 5 form attached.

lxxix


Q9.1 Will anyone other than yourself and the participants be present with you when

conducting this study? (See GN 2.2.8)

YES NO

If YES, please state the relationship between anyone else who is present other

than the applicant and/or participants (e.g. health professional, parent/guardian of

the participant)

Some participants may request a family member or health professional present.

Q9.2 Will the proposed study be conducted in private? If NOT, what steps will be taken

to ensure confidentiality of the participants’ information. (See GN 2.2.8)

All interviews with vulnerable adults will be conducted in a private booked study room at

the university, or a private location at the participant’s place of work, NHS Professional

practice such as meeting room within health professional’s place of work. Permission to

use these rooms will be sought before the interview is scheduled.

3. HARMS, HAZARDS & RISKS

Q10. Will this study involve invasive procedures on the human participants? (See GN

2.2.9)

Yes No

(If YES, please fill out Appendix 1 – Increased Hazards and Risks.

Once this is complete, move on to Q15)

(If NO, answer Q11, Q12, Q13 and Q14)

Q11, Q12, Q13 & Q14 - NON INVASIVE STUDIES ONLY

Note: You are advised to read GN 2.2.10, 2.2.11, 2.2.12 & 2.2.13 carefully before you

answer the following questions.

X

X

lxxx


Q11. Are there potential hazards to participant(s) and/or investigator(s) from the

proposed study? (See 2.2.10)

YES NO

If YES,

Indicate their nature here.

Indicate here what precautions will be taken to avoid or minimise any adverse

effects.

Q12. Will or could the study cause discomfort or distress of a mental or emotional

character to participants and/or investigator(s)? (See GN 2.2.11)

YES NO

If YES,

Indicate its nature here.

The topic does involve mental illness however no clinical research is to be undertaken

and non-invasive questions will be asked. Please see attached list of interview

questions.

Indicate here what precautions will be taken to avoid or minimise such adverse

effects.

The participant’s responses will be confidential listed as p1, no potentially distressing

questions will be asked within this study, the intended outgoing

emails/mail/telephone script/interview questions will all be shown to the

supervisor before sending to any external agencies or people.

Q13. Will or could medical or other aftercare and/or support be needed by participants

and/or investigator(s) as a result of the study? (See GN 2.2.12)

YES NO

X

X

X

lxxxi


Q14 Please describe in appropriate detail what you would do should the adverse

effects or events which you believe could arise from your study, and which you

have mentioned in your replies to the previous questions, occur.

(See UPR RE01, S 2.3 (ii) and GN 2.2.13)

Contact information for any vulnerable adults, family and health professionals will be

taken prior to any interview taking place and seen by them before and possible

request to be present during interview to witness and ensure protection to both

the participant and the researcher.

lxxxii


4. ABOUT YOUR PARTICIPANTS

Q15. Please give a brief description of the kind of people you hope/intend to have as

participants, for instance, a sample of the general population, University students,

people affected by a particular medical condition, children within a given age

group, employees of a particular firm, people who support a particular political

party, and state whether there are any upper or lower age restrictions.

Only people over the age of 18 will be contacted in this study. The study will include

interviews with 5-10 professionals working within mental health, as well as 5-10

participants with recovered mental illness (with full mental capacity under the mental

capacity act 2005). Full compliance under the Mental Health act 2007 will be taken at all

times. The researcher is aware of the government regulations and will be strictly under

these guidelines at all times.

Q16. Please state here the maximum number of participants you hope will participate in

your study.

Please indicate the maximum numbers of participants for each method of data

collection.

See qu. 15

Q17. By completing this form, you are indicating that you are reasonably sure that you

will be successful in obtaining the number of participants which you hope/intend to

recruit. Please outline here your recruitment (sampling) method and how you will

advertise your study. (See GN 2.2.14)

Participants will be contacted via email or telephone; the researcher will also attend

local community events in order to recruit potential participants. For a list of potential

events and organisations to contact, see document attached below. Snowball sampling

will be used to identify further participants.

lxxxiii


6.CONFIDENTIALITY AND CONSENT

[For guidance on issues relating to consent, see GN 2.2.15 & Pt. 3.]

Q18. Is it intended to seek informed consent from the participants?

YES NO

(See UPR RE01, S 2.3 & 2.4 and GN 3.1)

If YES, please attach a copy of the Consent Form to be used (See Form EC3 & EC4

for reference and GN 3.2), or describe here how consent is to be obtained and

recorded. The information you give must be sufficient to enable the Committee to

understand exactly what it is that prospective participants are being asked to agree to.

If consent is implicit or to be provided by someone other than the participant (such as

a parent or guardian), please provide details here.

If NO, please explain why it is considered unnecessary or impossible or otherwise

inappropriate to seek informed consent.

See EC3 form attached.

Q19. If the participant is a minor (under 18 years of age), or is otherwise unable for any

reason to give full consent on their own, state here whose consent will be obtained

and how? (See especially GN 3.6 & 3.7)

No people under the age of 18 will be included in this study, unless at request of the

participant full permission from parent or guardian will need to be obtained

prior to participation and only applicants above the age of 16 will be

considered.

Q20. Are personal data of any sort (such as name, age, gender, occupation, contact details

or images) to be obtained from or in respect of any participant? (See GN 2.2.16) (You

will be required to adhere to the arrangements declared in this application concerning

confidentiality of data and its storage. The Participant Information Sheet (EC6 or

equivalent) must explain the arrangements clearly.)

X

X

lxxxiv


YES NO

If YES, Give details here of personal data to be gathered, and indicate how it will be

stored.

Age, gender and occupation information will be obtained, all personal data will be

anonymised and confidentiality maintained (names will be changed). (see

EC6 form).

Interviews will be audio recorded, they will be stored under secured password lock on pc,

which also has an access password that only the researcher can access.

Any personal notes will be stored under lock and key; all personal data will

be destroyed securely by shredder or deleted on pc.

State here what steps will be taken to prevent or regulate access to personal data

beyond the immediate investigative team, as indicated in the Participant Information

Sheet?

All personal data will be disposed of securely shredded and thrown in mixed recycling.

Indicate here what assurances will be given to participants about the security of, and access

to, personal data, as indicated in the Participant Information Sheet.

Please see EC6 form

State here, as far as you are able to do so, how long personal data collected during

the study will be retained, and what arrangements have been made for its secure

storage, as indicated in the Participant Information Sheet.

The personal information will be deleted after research completion, details are shown on the

consent form

Q21. Is it intended (or possible) that data might be used beyond the present study? (See

GN 2.2.16)

YES NO

X

lxxxv


If YES, please give here an indication of the kind of further use that is intended (or

which may be possible).

If NO, will the data be kept for a set period and then destroyed under secure

conditions?

YES NO

If NO, please explain here why not.

Q22. If your study involves work with children and/or vulnerable adults, you will require a

satisfactory Disclosure and Barring Service (DBS) Disclosure. (See GN 2.2.17)

Please indicate as appropriate:

(a) DBS Disclosure not required

(b) DBS Disclosure required and obtained

Please do not embed your DBS Disclosure within the (paper) application documentation. It

is recognised that the DBS Disclosure is a confidential document: If a satisfactory DBS

Disclosure is required, a copy of this must be forwarded to the ECDA Clerks for review by

the Chairman of the relevant ECDA who will note this on a Register which will be kept in a

secure place. (Note: only the relevant ECDA Clerk and Chairman will see this document.)

Declaration of Disclosure and Barring Service disclosure

Please state the date on which your most recent DBS Disclosure was obtained: Form has

been submitted, waiting for approval and will be sent to Ethics Committee once obtained.

I declare that I have received NO convictions, cautions, reprimands or final warnings or

driving offences resulting in a criminal conviction and that I am not involved with ongoing

police investigations since my most recent DBS screening.

I understand that ethics approval is given on the understanding that the three-year validity

of my most recent DBS Disclosure will cover the period in which this study will be conducted

x

x

lxxxvi


and that, as a student, I will renew the declaration I make within the School in which I am

registered on an annual basis.

I also understand that it is my responsibility to inform the ECDA as soon as a conviction or

investigation arise during the period of the study to be conducted.

Enter your name here …Nicola Watkins………………….. Date ………18/01/16……………

7. REWARDS

Q23.1 Are you receiving any financial or other reward connected with this study? (See

UPR RE01, 2.3)

YES NO

If YES, give details here.

Q23.2 Are participants going to receive any financial or other reward connected with the

study? (Please note that the University does not allow participants to be given

financial inducement (See UPR RE01, 2.3.))

X

lxxxvii


YES NO


Q23.3 Will anybody else (including any other members of the investigative team)

receive any financial or other reward connected with this study?

YES NO


8. OTHER RELEVANT MATTERS

Q24. Enter here anything else you want to say in support of your application, or which

you believe may assist the Committee in reaching its decision.

The research will not cause any harm to participants or the research team. The

researcher has been trained in safeguarding children and vulnerable adults from

previous employment and references to confirm employment can be made by the ethics

committee if required the researcher will supply previous employment information,

previous SIA licence number (expired in Sept 2014) no security work or intervention will

be required. All participants will have mental capacity and this will be confirmed with the

participant’s health professional/family member before any research is carried out

x

x

lxxxviii


APPENDIX 1 – INCREASED HAZARDS AND RISKS

This section is to be completed if your answer to Q10 affirms the USE OF INVASIVE

PROCEDURES in your study.

Note: You are advised to read GN 2.2.10, 2.2.11, 2.2.12, 2.2.13 & 2.2.18 carefully before

you answer the following questions.

QA1. Please give details of the procedures to be used (e.g. injection of a substance,

insertion of a catheter, taking of a blood or saliva sample), and any harm,

discomfort or distress that their use may cause to participants and/or

investigator(s). (See GN 2.2.10)

n/a

2. Will the study involve the administration of any substance(s)? (See GN 2.2.10)

YES NO

QA3. Are there any potential hazards to participant(s) and/or investigator(s) arising from

the use of the proposed invasive procedures? (See GN 2.2.10)

YES NO

QA4. Will or could the study cause discomfort or distress of a mental or emotional

character to participants and/or investigator(s)? (See GN 2.2.11)

YES NO

QA5. Medical or other aftercare and/or support must be made available for participants

and/or investigator(s) who require it where invasive procedures have been used in

the study. Please detail what aftercare and/or support will be available and in

what circumstances it is intended to be used. (See UPR RE01, S 2.3 (ii) and GN

2.2.12)

X

X

X

lxxxix


The researcher will ensure the health professional of vulnerable adult care is notified on

completion of interview and to telephone and check on the participant.

QA6.1 Please state here previous experience (and/or any relevant training) of the

supervisor (or academic member of staff applying for a standard protocol) of

investigations involving hazards, risks, discomfort or distress as specified. (See

GN 2.2.13)

Researcher has been trained in safeguarding children and vulnerable adults from

previous security officer employment at West Herts College at Watford and

Dacorum Campus. Also received DBS disclosure at University West London for

Project Leader on one project involving vulnerable adults the elderly.

QA6.2 Please describe in appropriate detail what you would do should the adverse

effects or events which you believe could arise from your study, and which you

have mentioned in your replies to the previous questions, occur.

Very unlikely to occur however, the researcher will report immediately to supervisor at

UH once safe to do so, health professionals and if believe the participant is at risk

to their self or others will contact the local emergency services, will stay with the

participant until the emergency services have arrived. No intervention will be

taken on the researcher’s part other than reporting the situation and the interview

data will be deleted securely under emergency officer/s witness or handed over to

the emergency officer.

Please revert to Q15.

xc


FORM EC3 (event attendees)

University of Hertfordshire

CONSENT FORM FOR STUDIES INVOLVING HUMAN PARTICIPANTS

I, the undersigned [please give your name here, in BLOCK CAPITALS]

………………………………………………………………of [please give contact details here,

sufficient to enable the investigator to get in touch with you, such as a postal or email

address]

…..……………………………………

hereby freely agree to take part in the study entitled: An interpretative phenomenological

study on the social capital provided by community events for families living with

depression

1 I confirm that I have been given a Participant Information Sheet (a copy of which is

attached to this form) giving particulars of the study, including its aim(s), methods

and design, the names and contact details of key people and, as appropriate, the

risks and potential benefits, and any plans for follow-up studies that might involve

further approaches to participants. I have been given details of my involvement in

the study. I have been told that in the event of any significant change to the aim(s)

or design of the study I will be informed, and asked to renew my consent to

participate in it.

2 I have been assured that I may withdraw from the study at any time without

disadvantage or having to give a reason.

3 I have been given information that there are no risks involved and that all

interviews will be carried out in an office environment and in privacy.

4 I have been told how information relating to me (data obtained in the course of the

study, and data provided by me about myself) will be handled: how it will be kept

secure, who will have access to it, and how it will or may be used.

5 I have been told that I may at some time in the future be contacted again in

connection with this or another study.

6 I understand that my participation will be audio recorded and I consent to use of

this material as part of the project, the recording is for research purposes only and

will be destroyed on completion of the research paper.

xci


7 I understand that the information I have submitted may be published as a research

paper and I will be sent a copy. I understand that responses will be under full

anonymity for the purposes of this research.

8 I understand I can have someone present for the duration of the interview, such as

a family member or professional support worker.

Signature of

participant…………………………………………………………………Date……………………

…….

Signature of (principal) investigator………………………………………………………

Date…………………………

Name of (principal) investigator NICOLA WATKINS

UNIVERSITY OF HERTFORDSHIRE: ETHICS COMMITTEE FOR STUDIES INVOLVING

THE USE OF HUMAN PARTICIPANTS (‘ETHICS COMMITTEE’)

FORM EC6: PARTICIPANT INFORMATION SHEET (Event attendees)

Title of Research

An interpretative phenomenological study on the social capital provided by community

events for families living with depression

Introduction

You are being invited to take part in a research study. Before you decide whether to do

so, it is important that you understand the research that is being done and what your

involvement will include. Please take the time to read the following information carefully

and discuss it with others if you wish. Do not hesitate to ask anything that is not clear or

for any further information you would like to help you make your decision. Please do take

your time to decide whether or not you wish to take part. Thank you for reading this.

What is the purpose of this study?

The aim of this study is to analyse the benefits from regular community event engagement

from families with mental illness disabilities and to establish how this enables a better

quality of life to both the family and the host community. The study will conceptualise

family quality of benefits and discover full impacts of the community event engagement

including key research from professionals working within the industry and within events

xcii


research. The core stimulus of the research will focus on how the findings could be

adapted to future event policies, and how event designers could integrate new design

concepts into future strategies for positive QOL within community events and festivals.

Do I have to take part?

It is completely up to you whether or not you decide to take part in this study. If you do

decide to take part, you will be given this information sheet to keep and be asked to sign a

consent form. Agreeing to join the study does not mean that you have to complete it. You

are free to withdraw at any stage without giving a reason.

What will happen to me if I take part?

If you decide to take part in this study, you will be involved in it for up to four months

involving one interview (audio recorded, approximately 60 minutes) and a possibility of a

follow up meeting. You will be notified if this may occur.

What are the possible disadvantages, risks or side effects of taking part?

Unlikely to occur but questions throughout the study may cause some emotional upset,

the researcher will be aware of this and will ensure professional mental health support

workers are notified, and will supply contact information for support lines.

What are the possible benefits of taking part?

The study is exploring family quality of life benefits, participation may establish bonding

and stronger interpersonal relationships between family members, and improve

confidence to attend community events, assisting with the recovery from mental illness.

How will my taking part in this study be kept confidential?

Although names will be taken they will be anonymised in transcriptions and presentation

of findings and all personal data will be kept in a secure location for authenticity purposes

at the University of Hertfordshire. At the end of the interview you can review the notes and

change parts you do not agree with and do not feel the researcher has understood you

correctly. When the project is completed your responses will be securely destroyed.

What will happen to the results of the research study?

The results will be summarised in my MSc dissertation and may also be published as an

academic article in a research journal.

Who has reviewed this study?

xciii


This study has been reviewed by my supervisor, Dr Raphaela Stadler, and the University

of Hertfordshire Social Sciences, Arts and Humanities Ethics Committee with Delegated

Authority.

Who can I contact if I have any questions?

If you would like further information or would like to discuss any details personally, please

get in touch with me by phone or by email: Mobile: 07825712973 E Mail:

[email protected]

Although we hope it is not the case, if you have any complaints or concerns about

any aspect of the way you have been approached or treated during the course of

this study, please write to the University Secretary and Registrar. Thank you very

much for reading this information and giving consideration to taking part in this

study.

FORM EC3 (Health professionals)

University of Hertfordshire

CONSENT FORM FOR STUDIES INVOLVING HUMAN PARTICIPANTS

I, the undersigned [please give your name here, in BLOCK CAPITALS]

………………………………………………………………………………………………………

………………….

of [please give contact details here, sufficient to enable the investigator to get in touch

with you, such as a postal or email address]

…..……………………………………………………………………………………………………

……………… ..

hereby freely agree to take part in the study entitled: An interpretative phenomenological

analysis of the social capital provided by community events for families living with

depression

1 I confirm that I have been given a Participant Information Sheet (a copy of which is

attached to this form) giving particulars of the study, including its aim(s), methods

and design, the names and contact details of key people and, as appropriate, the

risks and potential benefits, and any plans for follow-up studies that might involve

further approaches to participants. I have been given details of my involvement in

the study. I have been told that in the event of any significant change to the aim(s)


xciv


or design of the study I will be informed, and asked to renew my consent to

participate in it.

2 I have been assured that I may withdraw from the study at any time without

disadvantage or having to give a reason.

3 I have been given information that there are no risks involved and that all

interviews will be carried out in an office environment and in privacy.

4 I have been told how information relating to me (data obtained in the course of the

study, and data provided by me about myself) will be handled: how it will be kept

secure, who will have access to it, and how it will or may be used.

5 I have been told that I may at some time in the future be contacted again in

connection with this or another study.

6 I understand that my participation will be audio recorded and I consent to use of

this material as part of the project, the recording is for research purposes only and

will be destroyed on completion of the research paper.

7 I understand that the information I have submitted may be published as a research

paper and I will be sent a copy. I understand that responses will be under full

anonymity for the purposes of this research.

Signature of

participant…………………………………………….………………………Date………………

………….

Signature of (principal) investigator………………………………………………………

Date…………………………

Name of (principal) investigator NICOLA

WATKINS……………………………………………………...

UNIVERSITY OF HERTFORDSHIRE: ETHICS COMMITTEE FOR STUDIES INVOLVING

THE USE OF HUMAN PARTICIPANTS (‘ETHICS COMMITTEE’)

FORM EC6: PARTICIPANT INFORMATION SHEET (Health professionals)

Title of Research

An investigation into the family quality of life benefits post community event engagement

from the perspective of families with members whom have depression.

Introduction

xcv


You are being invited to take part in a research study. Before you decide whether to do

so, it is important that you understand the research that is being done and what your

involvement will include. Please take the time to read the following information carefully

and discuss it with others if you wish. Do not hesitate to ask anything that is not clear or

for any further information you would like to help you make your decision. Please do take

your time to decide whether or not you wish to take part. Thank you for reading this.

What is the purpose of this study?

The agenda for the research is to empower the voice of families affected by mental illness

disabilities within communities, reducing the stigmatism and to discover how community

events could be part of a future strategy to prevent repeat hospitalisation and community

isolation. The aim of this study is to analyse the benefits from regular community event

engagement from families with mental illness disabilities and to establish how this enables

a better quality of life to both the family and the host community.

Do I have to take part?

It is completely up to you whether or not you decide to take part in this study. If you do

decide to take part, you will be given this information sheet to keep and be asked to sign a

consent form. Agreeing to join the study does not mean that you have to complete it. You

are free to withdraw at any stage without giving a reason.

What will happen to me if I take part?

If you decide to take part in this study, you will be involved in it for up to four months

involving one interview (audio recorded, approximately 60 minutes) and a possibility of a

follow up meeting. You will be notified if this may occur.

What are the possible disadvantages, risks or side effects of taking part? none

What are the possible benefits of taking part?

Contribution to knowledge and a better understanding of how event attendance may

enhance a family’s QOL, specifically families affected by mental illness disabilities.

How will my taking part in this study be kept confidential?

Although names and occupation will be taken they will be anonymised in transcriptions

and presentation of findings and all personal data will be kept in a secure location for

authenticity purposes at the University of Hertfordshire. When the project is completed

your responses will be securely destroyed.

xcvi


What will happen to the results of the research study?

The results will be summarised in my MSc dissertation and may also be published as an

academic article in a research journal.

Who has reviewed this study?

This study has been reviewed by my supervisor, Dr Raphaela Stadler, and the University

of Hertfordshire Social Sciences, Arts and Humanities Ethics Committee with Delegated

Authority

Who can I contact if I have any questions?

If you would like further information or would like to discuss any details personally, please

get in touch with me, in writing, by phone or by email: Mobile: 07825712973 E Mail:

[email protected]

Although we hope it is not the case, if you have any complaints or concerns about

any aspect of the way you have been approached or treated during the course of

this study, please write to the University Secretary and Registrar. Thank you very

much for reading this information and giving consideration to taking part in this

study.


xcvii


UNIVERSITY OF HERTFORDSHIRE SOCIAL SCIENCES, ARTS AND HUMANITIES

ETHICS APPROVAL NOTIFICATION

TO

Nicola Anne Watkins

CC

Dr Raphaela Stadler

FROM Dr Timothy H Parke, Social Sciences, Arts and Humanities ECDA

Chairman

DATE 05/02/16

Protocol number: BUS/PGT/UH/02208

Title of study: An interpretative phenomenological study on the social capital provided by

community events for families living with depression

Your application for ethics approval has been accepted and approved

by the ECDA for your School.

This approval is valid: From: 05/02/16 To: 05/09/16

Please note:

Approval applies specifically to the research study/methodology and

timings as detailed in your Form EC1. Should you amend any aspect of

your research, or wish to apply for an extension to your study, you will

xcviii


need your supervisor’s approval and must complete and submit form

EC2. In cases where the amendments to the original study are deemed

to be substantial, a new Form EC1 may need to be completed prior to

the study being undertaken.

Should adverse circumstances arise during this study such as physical

reaction/harm, mental/emotional harm, intrusion of privacy or breach of

confidentiality this must be reported to the approving Committee

immediately. Failure to report adverse circumstance/s would be

considered misconduct.

Ensure you quote the UH protocol number and the name of the

approving Committee on all paperwork, including recruitment

advertisements/online requests, for this study.

Students must include this Approval Notification with their submission.

UNIVERSITY OF HERTFORDSHIRE ETHICS COMMITTEE FOR STUDIES INVOLVING

THE USE OF HUMAN PARTICIPANTS

(‘ETHICS COMMITTEE’)

FORM EC2: APPLICATION FOR MODIFICATION AND/OR EXTENSION TO AN

EXISTING PROTOCOL APPROVAL

1 Protocol Number and Title of original application:

(Please provide the original application and attachments. This application will not

be accepted without them)

Applicant name Nicola Watkins

Student registration number 06132650

Applicant e-mail address [email protected]

Supervisor’s name Dr Raphaela Stadler

xcix


Supervisor’s School & Department Hertfordshire Business School – Events

and Marketing

Supervisor’s e-mail address [email protected]

2 Specify the nature of the modification/extension

I Revised title of study (if applicable) An interpretative phenomenological

study on the social capital provided by community events for families living with

depression

ii Time (specify months and year): From: sept 15 To: sept

16

vi Details of modification: (Please list all changes being made from

the original procedure on a separate sheet)

3 Reason for extension/modification request

(please explain)

Leavesden Green JMI School are hosting a community wellbeing event for the

families and children of Leavesden on June 9th 2016, the researcher has been

working on the project with them. The modification to previous EC1 is to allow

event participant observation, an online anonymised feedback survey from the

event to assess participant views on the specialised community event due to the

nature of requesting if have mental illness disabilities, anonymised survey

protects parent/carer data anonymity, the event is held on the school grounds

and will be managed with school staff and the researcher. The event will also be

used to recruit more participants for interviews as specified on the original EC1

form.

4 Hazards

Does the modification or extension present additional hazards to the

participant/investigator?

YES NO

x


c


If YES, a new risk assessment may be necessary. Subject specific forms may

also be necessary; you should therefore contact your Supervisor or School to see

whether this is the case.

Signature of Applicant ......Nicola Watkins.....................Date……03/05/2016…………

Support by Supervisor Raphaela Stadler Date 05/05/2016

UNIVERSITY OF

HERTFORDSHIRE SOCIAL

SCIENCES, ARTS AND

HUMANITIES

ETHICS APPROVAL NOTIFICATION

TO

Nicola Watkins

CC

Dr Raphaela Stadler

FROM

Dr Tim Parke, Social Sciences, Arts and Humanities ECDA

Chairman

DATE 09/05/2016

Protocol number: BUS/PGT/UH/02208(1)

Title of study: Family quality of life from the perspective of families with

members whom have depression

Your application to modify the existing protocol as detailed below has

been accepted and approved by the ECDA for your School.

Modification: Amended title as above;

Modification as described in EC2 received on 05/05/2016.

This approval is valid: From: 09/05/2016 To: 05/09/2016

ci


cii


Appendix F: Phase One: Dr Susan J. Noonan, MD, MPH Expertise Interview

1. Could you please describe how depression would affect day to day living

and socialisation?

Depression is a biologically based illness that negatively influences the kind of thoughts

and feelings a person has, and the actions he takes, in all the moments of daily life. It

changes his or her view of himself and the world in a negative and sometimes

overwhelming way. Depression impacts, negatively, one’s work, school and family life,

relationships, hobbies/ interests, diet, sleep, and daily routines. For example, an episode

of depression may cause a person to take a leave of absence from work or school,

families may need to participate in Family Therapy, relationships with friends may falter,

nutrition and sleep habits often become unhealthy and daily routines are forgotten. A

person’s ability to think clearly, concentrate, function, and care for themselves may be

impaired. Physical and mental fatigue is also a major component of depression, and that

interferes with the person’s ability to participate in previous work/school/social/pleasurable

activities. It becomes difficult to do even the simple things of life. When depressed, a

person is prone to isolation and often withdraws from the world and his/her friends and

family. This has a negative impact on social relationships. Intimate relationships may fail

due to the strain of one partner who has depression, leaving the other to bear the load of

family, finances, and social life. Persons who have depression often feel hopeless about

the future and in despair that life will ever change for them, and may feel suicidal.

2. What impact could this have on the individual’s relationships and family?

Friends and family may tire of the person’s changing or depressed moods, and may be

impatient with having to coax him or her into joining in on social activities. A person’s

depression may put a strain on family/friend relationships, family finances, sharing of

household responsibilities and childrearing, routines and schedules, and recreational

activities. Spousal intimacy may be lost due to the depressed person’s loss of interest

from depression and lost sexual drive from certain antidepressant medications. In some

cases, where friends or family do not understand depression as an illness, certain

relationships may be lost.

3. Do you feel community events could contribute to recovery for individuals

living with depression?

Yes. It is very important, albeit difficult, for the person who has depression to avoid

isolation, to get out and try to socialize. Community events provide this opportunity, often

ciii


in a relaxed and non-threatening atmosphere. These events offer a variety of options that

suit many different tastes.

4. Do you feel more awareness should be made and access to alternative

support services should be more widely available?

Yes, enhanced community awareness is always beneficial to those who are suffering from

depression. It makes a person feel less alone, and that what they are experiencing is

valid, legitimate, and treatable. Enhanced awareness also reduces the stigma attached to

depression and other mental illness. Access to alternative support services, such as peer

and community support, is extremely helpful and I believe should be more widely

available.

5. Do you feel there still a mental health stigma present today?

Sadly, yes. It is present socially and in the workplace, and one has to be very careful

about when and to whom you choose to disclose your illness. It comes from a lack of

understanding of depression as a biologically based illness and not a “character flaw” or

something you have control over getting (although you do have control over how you

manage it). I think the stigma is perhaps more prevalent in older age groups, as the

younger generation has had the benefit of educational programs on depression and

suicide prevention in school and tend to be more understanding and open minded.

6. What could be done to improve ease of people with mental illness attending?

Ways to improve ease of people who have mental illness attending community events:

Those who have mental illness want to feel the same as everyone else. They don’t want

to feel or be treated “different.” I often hear the complaint from people who have

depression that “everywhere I go I have to take “me” with me” and they want a break from

that. They want a respite from depression. Remember: depression does not define the

person – he or she is more than his depression. He is a person with traits, skills, talents,

personality, and accomplishments. The best approach is to treat a person normally, as

you would anyone else, and not make his/her depression or mental illness the focus of

your thoughts or conversation with this person. However, you do need to understand that

some situations may be overwhelming for him at first, and may need to proceed in small

steps or take it slow.

civ


7. Would they feel more part of the community as a result of attending

community events in your opinion?

Yes, it’s often possible that attending community events would make a person who has

depression feel more part of the group, of the community. But it’s a mixed bag. Friends

and family can draw a person in by engaging him in community activities as he is

interested and able. That is often quite helpful and a good distraction from his illness. But

at the same time it is not unusual for the person to look around at all of the other people in

the community enjoying themselves, as he perceives them to be, and having things he

yearns for (such as a spouse and children, better job, more spending money, nicer

clothes, car or home). Then he gets more depressed comparing himself to others whom

he perceives as “having it all.” So, attending community events, or family outings or

holiday parties, can sometimes backfire and a person may feel more depressed

afterwards. (this is where a good therapist is helpful)

8. What difficulties would the individual have to overcome at any time attending

these events?

First, it depends on the size of the crowd at the event, the noise factor, the amount of

commotion, etc. It would be difficult for any person who has depression to go out for the

first time in a large, busy crowd. A small, quieter group would be easier at first. Then

there are two things that affect individuals who have depression that could present

difficulties in their attending community events. The first is the fact that anxiety affects

approximately half of those who have depression, and that could be a barrier to them

getting out of the house and being out in a busy public place such as a community event.

Anxiety can be managed and treated. The second factor is that one common feature of

depression is isolation. If a person has been withdrawn from life for a period of time,

avoiding friends and family and life events, it would be difficult for him to get out and be in

a busy public venue such as a park, shopping centre or community event. This person

would have to be highly motivated and would have to take things in small steps, going out

where there were just a few people initially to get used to it, then increase his tolerance of

being in busy places with noise, commotion and larger groups of people.

cv


9. Would there be any difficulties within the family to overcome to attend

community events?

The family must reset their expectations to be realistic for what the person who has

depression is able to do NOW. They have to understand that it is a temporary

modification because of the episode of depression and not a permanent way of being. It

is important for them to understand that the person has lost interest in things going on

around him, in things he used to be interested in, is fatigued, has difficulty with focus and

concentration, and may feel socially awkward. It may be a huge effort just to get dressed

and out of the house. Families must learn to be patient with these things, yet also be

gently persuasive and encourage the person to participate. In some families who don’t

understand it this creates tension and arguments. If the person comes home feeling more

down, families may feel that their efforts to help and get him out of the house were not

appreciated. That is not the case.

10. Do you feel current policies are doing enough to raise awareness for mental

illness such as depression?

There are many programs in the United States to raise awareness for depression and

bipolar disorder, but it is just beginning to have an effect and there is much more work to

be done to reach out to the community. I cannot speak to what is available in the UK,

although my guess is that there is also a need to do more.

11. Do you feel there should be more community events specialising in mental

health wellbeing?

Yes, I think it should be part of the educational curriculum for students and available as

free adult-education programs in community centres. I would incorporate it as part of

general health and wellbeing as preventive medicine and not split it off as “mental health”

wellbeing. I would suggest teaching the Basics of Mental Health (diet & nutrition, sleep

hygiene, exercise fundamentals, routine and daily scheduling, avoiding isolation and

importance of social contacts, etc.) along with mindfulness, and wellbeing. Present it in a

way such that people will understand it is important to pay attention to for their overall

health and wellness.

cvi


Appendix G: Interview Questions

Professional Interview Questions

1. Could you please describe how depression would affect day to day living and

socialisation?

2. What impact could this have on the individual’s relationships and family?

3. Do you feel community events could contribute to recovery for individuals living with

depression?

4. Do you feel more awareness should be made and access to alternative support services

should be more widely available?


6. What could be done to improve ease of people with mental illness attending?

7. Would they feel more part of the community as a result of attending community events in

your opinion?

8. What difficulties would the individual have to overcome at any time attending these events?

9. Would there be any difficulties within the family to overcome to attend community events?

10. Do you feel current policies are doing enough to raise awareness for mental illness such as

depression?

11. Do you feel there should be more community events specialising in mental health

wellbeing?

Participant and Family Interview Questions

1. Could you please describe how your/family member’s depression has affected you in the

past with your day to day living?

2. What impact has this had on your relationships and family?

3. Do you feel more awareness should be made and access to alternative support services



5. Are people in your community aware of your/their illness?

6. If so has this changed how they treat you or have they remained the same?

7. What is your favourite part of attending community events?

8. Do you feel your family relationships have improved for the better or worse since you have

been participating in community events?

9. Can you describe how community event participation helps with your recovery?

10. Do you feel more part of the community as a result of attending community events?

11. Have there been any difficulties you have had to overcome at any time attending these

events?

12. Have there been any difficulties within your family you have had to overcome to attend

community events?

cvii


Appendix H: Phase Two - Action Research Community Event Plan.

Leavesden Green JMI School and University of Hertfordshire Wellbeing Event

9th June 2016 15:15 until 17:00pm

Meeting Log: (Leavesden Green School Head, Deputy Head and Researcher)

19/04/2016 at 15.15pm

10/05/2016 at 14.30pm

06/06/2016 at 15.15pm

Contents

1. Introduction……………………………………………………………….….1

2. Event Objectives………………………………………………….…………1

3. Event Theme………………………………………………….………………2

4. Parent Engagement…………………………………………………..…….3

5. Group Activity Stations…………………………………………………….3

6. Healthy Body and Mind Market Place…………………………………….3

7. Event Post-box……………………………………………………..………...4

8. Conclusion……………………………………………………………………4

9. References……………………………………………………….……………5

cviii


1. Introduction

The Wellbeing community event aims to promote a community spirit with an awareness at

age appropriate level. As children we are taught to seek help if we fall over and hurt our

knee, it should also be taught that it is ok to share emotions which they may be struggling

with. National statistics indicate that one in four adults will have a mental health problem

within any given year, and one in ten children aged five to sixteen will have some form of

disorder (MHT, 2016). This as you know, indicates a potential three to four children in

every classroom at Leavesden Green JMI School, and potentially one in four parents, or

someone close to them needing additional support. The proposal for this family

community event is to provide a space for the staff and families of Leavesden Green Jmi

School to have a creative and entertaining way of educating the staff, children and

families how to look after their minds as well as their bodies. The activities will be

designed to be child friendly and engaging for the child, staff and the parent/carers to

enjoy as a community. This project will promote health and wellbeing to the school and

family relationships in a fun and supportive space designed for enjoyment and education

through engagement. The definition of wellbeing is:

"Well-being is a dynamic state in which the individual is able to develop their potential,

work productively and creatively, build strong and positive relationships with others, and

contribute to their community. It is enhanced when an individual is able to fulfil their

personal and social goals and achieve a sense of purpose in their society.” (Huppert,

2008 cited in Hertfordshire County Council, 2016a)

The event aims to provide a supportive space to encourage positive wellbeing for the

Leavesden Green Jmi School community and show support for anyone in the school

whom may be affected by mental illness disabilities.

2. Event Objectives

July 2015 to July 2016 is the Hertfordshire Year of Mental Health this year for

Hertfordshire County Council has been dedicated to removing mental health stigma,

ensure better access to care and to improve the lives for those around us with mental

health distress (Hertfordshire County Council, 2016b). The main objectives for this school

community event are:

Improve wellbeing to the staff, children and their families

Teach mental health and emotional resilience in a practical way which is

relevant to them

cix


Engage the parents/carers with the school whilst supporting small local

businesses.

Raise funds for the school and selected mental health charities

Provide information for local Child and Adolescent Mental Health Services,

Family support services, and information point.

As evidence suggests, wellbeing improves learning and other aspects of young people’s

lives. As a school, working together to look after each other’s wellbeing are key to

strengthening the relationships which are at the heart of the children’s and our own

wellbeing, these small steps will also provide healthy and more emotionally resilient

students. To help act as a prevention to mental health distress later on in life. As an

example, research evidence states:

“Young people with a good level of wellbeing are more likely to perform well at

school and be physically healthy” (Department of Health, 2011).

“Enabling young people to develop awareness about the importance of looking

after their wellbeing could offer benefits for their mental health in the future

because we know that 75% of adult mental health problems begin before the age

of 18” (CMO, 2012).

“Pupils and students are more likely to engage in lessons that focus on emotional

wellbeing if they are of practical application and relevant to them.” (Public Health

England, 2015 p11).

3. Event Theme

The event theme will be based upon ‘Five ways to wellbeing’ this will look at everyday

activities which can be done as an individual, together as a school or as a family providing

a 360 support network for the pupil. This will raise awareness for the peers, the family,

and staff as a school community. Word of mouth, will simply take care of the rest. The five

ways to wellbeing are to connect, take notice, give, be active, and to keep learning. This

event aims to be of a practical application to the educational teaching of wellbeing, with

this in mind, the activities and stalls will have based upon this format with relevant

methods used from evidence based research findings.

“The Five Ways to Wellbeing Framework was developed by the New Economics

Foundation as a set of five evidence based actions that promote wellbeing. Based on the

cx


latest scientific evidence the simple actions, if taken regularly, can improve wellbeing and

enhance quality of life”. (Hertfordshire County Council, 2015 p2)

The Five Ways to Wellbeing are to:

• Connect – connecting with others

• Give – giving – looking outward as well as inward

• Be active – doing something active

• Take Notice – taking notice of the world around you

• Keep Learning – learning new things

(Hertfordshire County Council, 2015 p2)

These actions can be undertaken collectively as part of everyday activity or as an

individual. Five ways to wellbeing have agreed to give leaflets, some pens and banners

free of charge for the event, the banners will need to be collected and dropped off.

“The Five Ways to Wellbeing may help young people:

• Make the most of opportunities and deal with stressful situations by taking time out and

learning how to cope when things get tough.

• Increase their interpersonal skills, empathy and communication skills through giving and

seeing themselves as part of the wider community.

• Increase their chances of employability and self-worth by taking notice of what they are

good at and what they have to offer others.”

(Hertfordshire County Council, 2015 p2)

4. Parent Engagement

As with other Leavesden Green events, giving parents an option to help out with the

school provides an opportunity for engagement with this event. Also offering a business

space for them such as a market stall will support their small local business and

encourage them to thrive. This picture on the right is a photo of a recent event stall held

by a year 2 parent which encourages reading of beautiful books. Stalls such as this,

provide learning and supports the parent’s business. Win, Win situation.

cxi


5. Group Activity Stations

The Five Ways to Wellbeing Tool Kit recommends these group activities which can be

part of the event activities for the staff, parents and children to do together. (See Five

Ways Tool Kit). The key themed message may nice as an Art Activity Station. Big sheets

of paper, pens and write together ways they think they could achieve the five ways as a

school, a family and as individuals refer to Appendix 2 for activity stations.

6. Healthy Body and Mind Market Place

As discussed briefly in section 4, the school hall could host a variety of stall run by the

parents and local charities which engages local support groups and the parents of

Leavesden Green Jmi School.

‘Read a book’ – Usborne Book Stall with raffle prizes

‘Colouring’ – Art space with colouring pens both adult and children materials

provided.

Gardening Corner – Grow your own veg with kits to take home.

‘Healthy Eating’ – A stall with healthy treats (gluten free options, vegan etc.)

‘Dance’ – interactive dance workshops with local dance school

Art Exhibition Space – A display of live event Art paintings etc. by the children on

‘wellbeing’ and ‘family’

Support space and Information Point:

Local School wellbeing information

Local Charities such as Home Start which help local families

Community support groups information

Local active fitness activities

7. Event Post-box / Follow Up Interviews

Anonymous feedback forms see Appendix 1 for event feedback questions, an online

version through survey monkey will be updated prior to the event to be emailed out after

the event, and possible interviews if people wish to do so and to contact N Watkins for

follow up. (BUS/PGT/UH/02208 approved by ECDA at the University of Hertfordshire)

8. Conclusion

The team met regularly working together on the project.

cxii


References

Active Herts (2016) Active Herts [Online] Available at:

http://www.watfordfccsetrust.com/active-herts [Accessed: 19/04/2016]

Department of Health and NHS England, (2015) “Future in mind: Promoting, protecting

and improving our children and young people’s mental health and wellbeing report”

[Online] Available at: https://www.gov.uk/government/publications/improving-mental-

health-services-for-young-people [Accessed: 15/02/16]

Hertfordshire Council (2015) Five Ways to Wellbeing Tool Kit [Online] Available at:

http://www.hertsdirect.org/docs/pdf/f/fivewaytoolkit.pdf [Accessed: 19/04/2016]

Mental Health Taskforce of NHS England (MHT), (2016) “The five year forward view for

mental health” [Online] Available at: http://www.mind.org.uk/taskforce [Accessed:

15/02/16]

Appendix 1: Stations, Speakers and Activities

Be Active Station:

Active Herts is a project aimed at working with Inactive people in Hertfordshire,

who are at risk from cardiovascular disease and/or mild to moderate mental health

issues, helping them become active. We aim to do this by providing face to face

consultations, delivered by our Get Active Specialists lasting for up to a year,

individuals will look at why they would like to become active, what barriers they

might face, establish their goals and confidence levels and action plan with them

for success. Active Herts is coordinated locally by Herts Sports Partnership and

Watford Football Club Community Sport and Education Trust in conjunction with

several other partners including Public Health and Herts Valleys Clinical

Commissioning Group. The Get Active Specialist for Watford is Alison Goodchild

(Active Herts, 2016).

Alison Goodchild has kindly agreed to provide a talk and activities with the families

and children. Everyone Active – Local sports and fitness centre will be joining the

event.

http://www.watfordfccsetrust.com/active-herts



http://www.hertsdirect.org/docs/pdf/f/fivewaytoolkit.pdf

http://www.mind.org.uk/taskforce

cxiii


Appendix I: Phase Two - Summarised field notes –

Wellbeing Event 9th June 3.15-5pm and Annual Summer Fair 8th July 3.15-5pm

Attendee Social Identities at the Wellbeing Community Event

(Kelley, 1952 cited in Hogg and Vaughan, 2008, Hogg and Vaughan, 2014)

Attending the school community event as a family forms four personal social identities;

two reference and two membership identities merged into one space and time: Reference

Identities: Own self – Personal Social Identity as an individual. Reference Social Identity –

Family member such as Mother or Father. Membership Identities: School community

member such as education year group or parent of child and the temporary event

community member identity. The attendees have formed a new temporary community

within the event space for the duration of the event (Bordens and Horowitz, 2013).

Personal Social Identity (Individual - Own Self)

Reference Social Identity

(Family Member)

Membership Social Identity

(Leavesden Green School Community Member)

Membership Social Identity

(Temporary Wellbeing Event Community Member)

Figure 1 Event Social Identities

cxiv


Figure 2 Research Objectives

Social Identity

•Personal social identity

•Membership group -Herts Inclusive Theatre Member

•Membership Group -Leavesden Green Jmi School Pupil

•Reference Group -Sibling, Family

Community Psychology

•Knowledge Transfer

•Awareness

•Reducing Stigmatism

•School community rather than individual strategy

Social Capital

•Increase confidence

•Relationship bonding

•Trust

•Connection with others

(Hogg and Vaughan, 2014)

Healthy Body and Mind Market Place

Five Ways to Wellbeing: Connect with Herts Inclusive Theatre –

The interactive performance / half hour workshop with the

children. The field notes are presented in two figures: Figure 1

shows the event objectives achieved and figure 2 shows how

they relate to the research agenda.

Drama

•Drama games based upon 'emotions' - experiences and their take on it

•Boys and girls partcipated of various age groups

Ethical

•Work with children of all abilities (With and without disabilities)

•Local community project

Wellbeing

•Connect - drama games -creating together and laughing

•Engaging the audience and each other

Figure 1 Event Objectives

Themes: Social and

emotional wellbeing,

family interpersonal

relations and

recovery or

prevention

cxv


Social Identity


•Membership group -Jigsaw Dance and Theatre Member



•Awareness



Social Capital



•Trust

•Connection with others


(Hogg and Vaughan, 2014)


Five Ways to Wellbeing: Connect with Jigsaw Dance and

Theatre – Information point for local dance and theatre

school (comparison to Herts Inclusive: Not as popular as

the interactive workshop). The field notes are presented

in two figures: Figure 1 shows the event objectives

achieved and figure 2 shows how they relate to the research agenda.

Drama•Drama and Dance School

•Leaflets and marketing material

Ethical

•Supports local business


•Stall holder had learnt at the school since was 5 now teaches.

Wellbeing

•Connect - drama games -creating together and laughing

•Dance and performing arts information


Themes: Social and



relations and recovery or

prevention

cxvi


Social Identity


•Membership group -Active Herts Member





•Awareness



Social Capital


•Remove barriers to fitness

•Learn new skills/ development


(Bordens and Horowitz, 2013)


Five Ways to Wellbeing: Keep Active with Active Herts –

Fitness consultation point, looking at overcoming the

barriers holding families back from being more active.

Figure 1 shows the event objectives achieved and figure

2 shows how they relate to the research agenda.

Active

•Information on the programme

•Works with GP services in local area

•Offering free 12 week passes to local fitness centres

Ethical

•Encouraging all demographics into active fitness


Wellbeing•Keep Active.

•Regular exersize

•Confidence building


Themes: Social and




prevention

cxvii


Social Identity


•Membership group -Everyone Active Member

•Membership Group -Leavesden Green Jmi School




•Awareness



Social Capital



• Learn new skills/ development


(Cromby et al. 2013)


Five Ways to Wellbeing: Keep Active with Everyone

Active – Fitness Centre Information point and fitness

group activities. Figure 1 shows the event objectives

achieved and figure 2 shows how they relate to the

research agenda.

Active

•Interactive Fitness Activities

•Works through two centres -Central and Woodside

•Membership and Swimming Lesson Access

Ethical

•Encouraging all demographics into active fitness


Wellbeing•Keep Active.

•Regular exersize

•Confidence building


Themes: Social and



relations and recovery

or prevention

cxviii


Social Identity


•Membership group -Usborne Books Organiser Member





•Awareness



Social Capital


•Relationship bonding -Reading together

•Learn new skills/ development




Five Ways to Wellbeing: Keep learning with Usborne

Books – Social area for children colouring in

competition and adult’s relaxation area. Figure 1 shows

the event objectives achieved and figure 2 shows how

they relate to the research agenda.

Learning

•Fiction and Non Fiction Books and more

•Boys and girls partcipated of various age groups

Ethical•Supports parent business


Wellbeing

•Keep Learning - New books, learn new skills.

•Encourage young readers

•Creative - colouring bookmarks


Themes: Social and




prevention

cxix


Social Identity


•Membership group -Herts Mind member





•Awareness



Social Capital


•Strengthen communitites

•Connect with others

•Creative arts courses




Five Ways to Wellbeing: Take Notice with Hertfordshire

Mind – Information point for local therapeutic services.

Figure 1 shows the event objectives achieved and

figure 2 shows how they relate to the research agenda.

Take Notice

•Mindfulness Courses

•Take notice of the surroundings - look after each other and your environment

Ethical

•Supports parent business


Wellbeing

•Keep Learning - New books, learn new skills.

•Encourage young readers

•Creative - colouring bookmarks


Themes: Social and

emotional wellbeing, family

interpersonal relations and

recovery or prevention

cxx


Social Identity


•Membership group -Leavesden Green School Board of Governors





•Awareness



Social Capital


•Strengthen communitites

•Connect with others

•Creative arts

•Developing new enjoyable skills - Growth



Five Ways to Wellbeing: Keep Learning with Leavesden

Green Board of Governors – Knitting Craft stall. Figure

1 shows the event objectives achieved and figure 2

shows how they relate to the research agenda.

Keep Learning

• French Knitting Craft

• Keep learning and developing new skills for growth

Ethical

• School board of governors engaging with the school community

Wellbeing

• Keep Learning - learn new skills.

• Relaxing hobby

• Creative - creating new knitted crafts


Themes: Social and

emotional wellbeing, family

interpersonal relations and

recovery or prevention

cxxi


Reflection on the wellbeing event and summer fair follow up

The wellbeing event was small scale with families from a range of year groups, many just

walking through but not participating, the ones who participated enjoyed the event and

feedback has noted that the marketing for the event by the school could have been better

only emailing and notifying the parents the day before. The drama games were about

emotions and had props which the children enjoyed, the fitness activities such as football

and running were also popular. The parent’s area was by the book stall as had tables and

could see the activities while socialised with each other. The researcher also attended a

follow up observation at the summer fair held a month later and observed a change within

the annual summer fair design and represented the five ways to wellbeing below, the

researcher attended with their family and acted as a natural setting observer. Figure 1

shows the exploratory comments observed without having to help with event logistics.

Keep Learning

•Usnorne Books had a stall with learning activities

Connect

•Annual summer fair had a wellbeing theme with pampering stall

•Leavesden Green Parade

Give •The School made £1400 in fundraising profit

Keep Active

•Each Year Group did a dance with their teachers

Take Notice

•Games stands with prizes for the children

•Parents socialised

Figure 1 Five Ways Themed to Summer Fair 2016

cxxii


Appendix J: Phase Two – Some Event Survey Feedback Analysis Examples.

Wellbeing Event 9th June 3.20pm to 5pm at Leavesden Green Jmi School Event

Feedback

1. Are you

A staff - yes – School-based family worker

2. How did you find the community wellbeing event?

It was a well organised event

3. Which part did you most enjoy?

I enjoyed talking to the different agencies and was able to take lots of information to give

out to parents I work with.

4. Which could have been improved?

The attendance by families attending the event.

5. Do you feel the event has raised awareness of wellbeing strategies?

Yes, I do – there was lots of information.

6. Will you try as a family to include the five ways in future?

Yes

7. Would you like to see more events like this locally?

Yes – I feel that an event like this would be attended more at a school summer fair.

Exploratory Comments

THE FAMILY SUPPORT WORKER FOUND THE

EVENT BENEFICAL DESPITE LOW NUMBERS FELT

WAS A SUCCESS. LOTS OF INFORMATION AND

FAMILY ACTITIVIES. TOOK SUPPORTIVE

INFORMATION TO WORK WITH FAMILIES

PRIVATELY REGARDING ACCESS TO THERAPUTIC

SERVICES WHICH THE FAMILY SUPPORT

WORKER WORKS WITH AT THE SCHOOL. WILL

TRY TO USE THE FIVE WAYS TO WELLBEING IN

OWN HOME FAMILY LIFE IN FUTURE.

Themes: Social and emotional

wellbeing, family interpersonal


prevention

cxxiii


Themes: Social

and emotional

wellbeing, family

interpersonal

relations and

recovery or

prevention


PARENT WITH TWO CHILDREN WITHOUT DISABILITIES (YR3 AND YR5): THE

PARENT ENJOYED WATCHING CHILDREN HAVING FUN AND PARTCIPATING IN

THE DRAMA GAMES. THE FEEDBACK WAS THAT THEY FOUND THE EVENT

INTERESTING AND ACTIVITIES GOOD. THEY WILL TRY AS A FAMILY TO

INCLUDE FIVE WAYS OF WELLBEING AT HOME AND IN THE FUTURE. THE

EVENT PROVIDED SOCIAL CAPITAL FAMILY QUALITY OF LIFE THREE PARTS

BY: SOCIAL AND EMOTIONAL WELLBEING, THE CHILDREN ENJOYING

ACTITIVITIES TOGETHER SIBLING BONDING, THE PARENT ENJOYED SEEING

THEM PARTCIPATE. FAMILY RELATIONSHIPS HAVE CREATED MEMORIES

TOGETHER. FEELING CLOSER AS A FAMILY AND PART OF THE SCHOOL

COMMUNITY.

cxxiv



PARENT WITH ONE CHILD WITH DISABILITIES (YR6): THE PARENT ENJOYED WATCHING

THE CHILD ENGAGE WITH ACTIVITIES BUT FELT COULD NOT PARTCIPATE DUE TO

ILLNESS. THE SCHOOL EVENT ADVERTISING COULD HAVE BEEN IMPROVED. THE

PARENT HAS AGREED TO TRY USE THE FIVE WAYS TO WELLBEING IN THE FUTURE.

THE EVENT SUCCESSFULLY PROVIDED THE SOCIAL CAPITAL: FAMILY QUALITY OF

LIFE, THREE KEY PARTS: SOCIAL WELLBEING SEEING THE CHILD HAVING FUN WITH

PEERS, ALLOWING PARENT TIME TO TALK WITH OTHER PARENTS, STRENGTHENING

COMMUNITY RELATIONSHIPS AND JOY AT WATCHING HER CHILD ACCEPTED AND

PARTCIPATING IN THE VARIOUS ACTIVITIES.

Themes: Social

and emotional

wellbeing,

family

interpersonal

relations and

recovery or

prevention

cxxv


Themes: Social

and emotional

wellbeing, family

interpersonal

relations and

recovery or

prevention


PARENT WITH ONE CHILD WITHOUT DISABILITIES (YR2): THE PARENT

ENJOYED WATCHING THE EVENT AND FOUND THE HERTFORDSHIRE MIND

STALL VERY HELPFUL. ENJOYED DOING THE ACTIVITIES AS A FAMILY AND

WILL WORK ON USING THE FIVE WAYS TO WELLBEING STRATEGIES IN THE

FUTURE. THE EVENT PROVIDED THE SOCIAL CAPITAL BY PROVIDING FUTURE

INFORMATION FOR FAMILY ACTITIVIES, ENJOYING THE EVENTS COMMUNITY

SPIRIT AND ACTIVITIES. PROMOTE QUALITY OF LIFE WELLBEING STRATEGIES

IN THE INFORMATION POINTS AND IDEAS FOR FUTURE USE.

cxxvi



PARENT WITH ONE CHILD WITHOUT DISABILTIES (NURSERY): THE PARENT FOUND

THE EVENT INTERESTING BUT DID NOT CATER FOR YOUNGER CHILDREN AS COULD

NOT PARTCIPATE IN ALL ACTIVITIES. THE PARENT FOUND FINDING OUT ABOUT

SERVICES THEY DIDN’T KNOW ABOUT, AND WILL TRY TO ADOPT THE FIVE WAYS TO

WELLBEING IN THE FUTURE. THE EVENT FEEDBACK GIVES IMPROVEMENT FOR

FUTURE EVENTS. THE SOCIAL CAPITAL PROVIDED FOR THIS FAMILY WAS SOME

IDEAS FOR FUTURE WELLBEING STRATEGIES, SOME FAMILY PARTCIPATION AND

INFORMATION FOR FUTURE COMMUNITY FAMILY ACTIVITIES HAS BEEN PROVIDED.

Themes: Social and



relations and recovery

or prevention

cxxvii


Appendix K: Dissertation Log

UNIVERSITY OF HERTFORDSHIRE

Hertfordshire Business School

DISSERTATION LOG

Student Name:

Nicola Anne Watkins

Supervisor’s Name:

Dr Raphaela Stadler

Dissertation Topic: An interpretive phenomenological analysis into the social capital

provided by community events for families living with depression. The study worked

with multiple qualitative methods mainly utilising in-depth interviews, an action

research, small scale live community event with natural setting observation field notes

and an event feedback survey (Lyons and Coyle, 2016). The research examined the

social capital family quality of life with a qualitative approach, initially from an individual

perspective then the effect on the family as a whole (Stadler and Jepson, In press).

Only three dimensions of the social capital were investigated due to time restriction of

the project.

The social and emotional wellbeing element showed improved mental health wellbeing

such as social community relationships and improved emotional resilience, the family

interpersonal relations element looked at the internal family group which also led to

interpreting this from a social psychology perspective, looking at the social identity of

the family, the community identity and the event temporary community identities to fully

comprehend the subject matter (Hogg and Vaughan, 2014, Altinay and Paraskevas,

2008). Finally, recovery or prevention from the symptoms of depression, discovering

how community events can play a key part in recovery and prevention for symptoms of

the mental illness depression. Examining mental health meant the project had to

examine mental health awareness and stigmatism, which community events can take a

social support network approach and raise awareness to reduce stigmatism which is

needed, this was looked at from a community psychology perspective (Kloos et al.

2014).

cxxviii


SECTION A. MONITORING STUDENT DISSERTATION PROCESS

The plan below is to be agreed between the student & supervisor and will be

monitored against progress made at each session.

Activity Milestone/Deliverable Date

Final details of proposal to be

agreed between student and

supervisor

23/10

Suggest milestones are:

1 Refine initial proposal 23/10

2 Complete literature review 27/11

3 Complete methodology section 10/3

4 Complete data collection 25/7

5 Complete data analysis 25/7

6 Complete conclusions and

recommendations 25/7

7 Submit draft for feedback 25/7

SECTION B. ETHICS

Ethics form protocol number (Primary Research Only) BUS/PGT/UH/02208

SECTION C. RECORD OF MEETINGS

The expectation is that students will meet their supervisors up to seven times and these

meetings should be recorded.

cxxix


Date of

Meeting

23 October 2015

Progress Made FIF discussed

Supervisory expectations discussed

Agreed Action First draft of literature review

Student

Signature

Supervisor's

Signature

Date of Meeting 27 November 2015

Progress Made First draft of literature review

Agreed Action Presentation for PG symposium

Ethics forms

Student

Signature

Supervisor's

Signature

Date of

Meeting

18 January 20 1 6

Progress

Made

Ethics forms submitted

Agreed

Action

Data collection, interviews, events

Student

Signature

Supervisor's

Signature

cxxx


Date of

Meeting

10 March 2016

Progress

Made

Methodology draft

Agreed Action Data collection, analysis

Rewrite literature review

Student

Signature

Supervisor's

Signature

Date of

Meeting

09 June 2016

Progress

Made

Live community event specialised in wellbeing

Agreed Action Field notes and event feedback survey analysis,

Phase 3 Data collection, analysis

Student

Signature

Supervisor's

Signature

cxxxi


Date of

Meeting

25 July 2016

Progress

Made

Full Draft

Agreed

Action

Revise and submit

Student

Signature

Supervisor's

Signature

Signature of

Student

Date

27/07/2016

Signature of

Supervisor

Date

27/07/2016

Ethics Protocol Number

BUS/PGT/UH/02208

Date

Original:

05/02/2016

Review:

09/05/2016

cxxxii


Appendix L –Transcripts

Interview 1 – Seth Hunter,

Project Manager at Dragon

Café, Mental Fight Club

NW: Firstly, could you please tell me about

The Dragon Café project and Mental Fight

Club and the work which you do for

communities?

Exploratory

Comments

Recovery

Prevention

Social/Emotional

Wellbeing

SH: The dragon café is part of Mental Fight

Club, which has been going for 12 years or

so. Originally it was a collective group of

people and we would do pop up events

around London, mainly in Southwark with a

mental health focus. We have always had

the view that creative expression can be

very good for mental health, whatever kind

of mental health issue that is. The Dragon

Café was to give us a base, as we were

forever popping up around London and we

wanted to be in one place. Sarah Wheeler,

who is the founder came up with the idea,

of creating a recovery café that served

good quality, locally sourced vegetarian

food which runs a series of creative

activities. The café is aimed at everyone

really, but particularly ones with wellbeing

issues and mental health issues.

Recovery support

organisation

utilising the

creative arts for

prevention and

recovery.

Reducing repeat

hospitalisation.

Serving Healthy,

vegetarian food

which is ethical.

Theme NW: Yes, that sounds brilliant. How

successful were your pop events and the

café, did you feel they helped people?

Exploratory

Comments

Recovery

Prevention

Extended Family

Interpersonal relations

SH: It is low budget, run by volunteers but

we have got some high calibre people, we

would often put a small event on in a

church and 100-200 people would turn up.

We were very popular from the beginning.

People really seemed to get what we were

about.

Utilising skills of

the volunteers,

regaining

confidence and

self-esteem.

Theme NW: That’s fantastic, how do you feel the

events aid with recovery and prevention?

Were the events attended regularly?

Exploratory

Comments

cxxxiii


Recovery

Prevention

Community Cohesion

Social/Emotional

Wellbeing

Extended Family

Interpersonal

Relations

SH: I would say very successful, we have

two academics currently one doing a

masters and one doing a PhD which

measure the effectiveness of our project.

We are getting much more interest trying to

measure how successful we are. The huge

part of our success is we reduce social

isolation, that is the really big part of it. We

help connect people, we have always been

about that. It’s about connecting people and

getting them out of their lonely flats. Getting

people talking, getting people creating and

laughing with each other. Our philosophy is

the core of mental illness is the isolation

and you are alone. The dragon café has

always been about counteracting mental

illness by bringing people together and

doing activities prevents the isolation and

feeling alone.

Social inclusion,

connecting clients

and providing

interactive

support weekly.

Reducing

isolation to

London

community.

Sharing and

expressing

themselves

safely,

therapeutic

expression.

Key relationships

for recovery and

prevention of

repeat

hospitalisation.

Theme NW: Yes, I first came across the Dragon

Café when I attended the Changing Minds

Festival. You were part of the Mind project

to introduce a mental health focused

festival. I thought it was brilliant, have you

found in your experience that community

events can contribute to prevention and

recovery from depression?

Exploratory

Comments

Recovery/Prevention

Social/emotional

wellbeing

Extended family

interpersonal relations

SH: Yes, definitely. I have suffered from

depression and am bipolar, so part of that

emotional landscape I go through is

depression. My experience of depression

and having worked with other depressed

people, it can be quite deskilling and can

make you feel like you are a drain on

They are more

than just their

illness.

Contributing to

society through

creative arts,

crafts, poetry and

cxxxiv


Community peer

support/social

network

Community cohesion

society. You don’t have much to offer, and

you get in the way of stuff. Maybe, you can’t

hold down a job and all these quite negative

things. I think by getting people to create

like the work we do at the dragon café,

people can feel they have something to

contribute. You don’t have to be the world’s

best artist to pick up a pen, you don’t have

to be the world’s best writer to create a

verse. Everyone has a creative voice, it’s

just a matter of being brave enough to try

and find it. So it has been really helpful for

depression in particular I would say, and

again, I would make the point about

reducing social isolation. We have been

really successful at getting people together,

to give you an idea; on an average Monday

at the dragon café, we see over 200 guests

and have 50 volunteers working with us. So

over 250 people and the majority of us have

a quite serious mental health diagnosis

including clinical depression. So it is a lot of

not very well people coming together to

create and socialise in a positive and

constructive way.

drama. Reducing

social isolation.

Volunteers

gaining work

experience and

giving back to the

community.

Community social

network and

support through

peers. An

extended family

approach to

recovery and

prevention.

Feeling

connected and

part of a

community and

caring for each

other’s needs in

and outside of the

community

events.

Theme NW: Brilliant, do you feel more awareness

should be made and more alternative

support services, like yourselves should be

more widely available?

Exploratory

Comments

Recovery/prevention

Social/emotional

wellbeing

Extended Family

Interpersonal

Relations

SH: Definitely, there is not much out there

which has been NHS approved. There is

Cool Tan Arts, have you spoken with them

at all? They are another organisation based

within London with a big emphasis on

creativity. As creativity has always been

seen as a pleasant thing and a nice thing,

Providing a safe

environment and

past time. The

client self-

motivates to get

ready, travel,

interact with

cxxxv


Community peer

support and social

network

Positive changes

not really an essential. However, in our

experience of mental illness it can be as

powerful as the world’s best medication,

without over stating the case. You can be

on the perfect medication, but if you are

stuck in a flat, chances are you are going to

be depressed and remain that way. Like

anybody, you don’t have to have clinical

depression to feel depressed. So again,

creativity, connection, coming together,

eating healthy food, doing art, doing drama,

doing massage, doing meditation, all these

activities have proven strong methods of

keeping people well.

people positively

and strengthen

health and

relationships.

Medication alone

cannot improve

quality of life and

wellbeing, a

combination

should be

prescribed such

as medication

and referral to

community led

support services.

Theme NW: Yes, I totally agree with you. Within my

research I have found that, with some

people there may be an anxiety of

attending. What have you found effective in

easing the anxiety of people attending?

Exploratory

Comments

Recovery/ Prevention

Social/ Emotional

wellbeing

Extended Family

Interpersonal

relations.

SH: Yes, some people can be a bit

nervous. We try to make ourselves a very

friendly service. So, for example some

people phone me up as the project

manager. I have support workers phone me

up, and say I have this potential client, they

are a bit nervous about coming along. So

some people, I will personally greet at the

door. So I will be particularly friendly and

welcoming, that’s not always possible as

some people don’t have the assertiveness

to phone ahead. We have people on

reception, that welcome you in when you

first arrive, names and emails are taken for

internal marketing and statistic purposes.

Then also, we have a volunteer whose

specific role is to show people around the

Welcoming

service to reduce

social anxiety,

symptoms of

mental illness.

Internal

marketing and

repeat visitation

monitoring

through greet

service.

Safe positive

environment.

cxxxvi


project. They will spend fifteen minutes

giving them the highlights of the project and

they will show the facilities such as where

the kitchen, toilets etc. are and making

people feel welcome.

Theme NW: Have you felt like a community

working on this project café together?

Exploratory

Comments

Extended Family

Interpersonal

Relations

Social and Emotional

Wellbeing

Recovery/prevention

Community social

identity/ reference

group

SH: Definitely, a lot of friendships have

been formed for most people. For me it is a

job, but it is also a passion. There are

psychiatrists which come to us and have

made genuine friendships. There has been

Facebook groups set up, and people

organise other gatherings outside of the

dragon café. There are a lot of support for

things like William Blake for example, there

are William Blake nights. There has been a

lot of seeds sown as a result of the Dragon

Café, and there are a lot of people who look

after each other outside of the dragon café

as we are only open on a Monday.

Virtual social

network,

alternative

support groups.

Communities

sharing interests

and caring for

one another.

Community led

support through

weekly

community

wellbeing events.

Theme NW: Do you feel current policies are doing

enough to raise awareness of mental

illness?

Exploratory

Comments

Mental Health

Awareness

Recovery/prevention

Mental Health

Stigmatism

SH: No, if you think about the official

statistic being 1 in 4 of us will suffer from

mental illness in any given year. This

suggests that most of us will at some stage

in our lives suffer with some form of mental

illness. I don’t know about you, but I don’t

know any people in my network which

hasn’t had some form of mental illness

which they haven’t had to deal with. I still

think it is viewed that if you have got a

mental illness, there is something

profoundly wrong with you. That is just

Poor mental

health funding in

previous years.

Mental Health

Epidemic

Lack of public

understanding

Recovery,

sharing mental

health

cxxxvii


simply not the case. It can be normal to

suffer from depression, or something more

significant such as psychosis. I know plenty

of people who have experienced psychosis

and have come out the other side and are

fine now. They can hold down responsible

jobs and have families. I still think there is

an incredible stigma surrounding mental

health. People are quite relaxed about

having a physical illness, we are at the level

where cancer thirty years ago was not

really talked about, it was quite a shameful

thing to have. People wouldn’t speak about

cancer, now people do runs and marathons

for cancer. Now it is out in the open and

spoken about, people are quite positive that

you can have cancer and still recover. It’s

disappointing to find that we are thirty years

behind in the mental health service. There’s

a lot to be done.

experiences and

stories, talking

about the

problems.

There is a lack of

advancement in

mental health

support and

research due to

lack of funding,

and lack of

awareness in

comparison to

physical illness

cancer.

Theme NW: Yes, in this past year, there has been

a lot of changes and positive

improvements. I myself, have had severe

depression over the years. What impact

does mental illness such as depression

have on individuals and their family

relationships in your opinion?

Exploratory

Comments

Family Relationships

Mental Health

Awareness

Community

connections

Prevention/Recovery

SH: The dragon café is about connection,

playfulness, creativity and just trying to

build bridges and relationships for people.

Our experience of mental illness is it can

devastate families, individuals can be

estranged as it is not talked about, the

depressed people can be forgotten about

as no one wants to talk about it. The big

thing we done at the Dragon Café is a

series of speaking nights themed to

Speaking about

mental health

issues can be

therapeutic to the

individual as well

as raising

awareness to

reduce

stigmatism and

create public

cxxxviii


Social/emotional

wellbeing

Family interpersonal

relations

different issues, I don’t know if you have

come across a book called let’s talk about

Kevin, it’s a book about a mother who

struggles to love her child which is a taboo

topic and arguably there is mental health

within this book. So we did a whole series

of we need to talk about evening events,

which were: we need to talk about

psychiatry and mental health, we need to

talk about mental health and medication,

we need to talk about mental health and

anger, we need to talk about mental health

and psychiatric wards. So we did a whole

series of taboo busting panels with

questions and answers at the end of it, and

we had 100 people attending which we

recorded and turned into podcasts. So

again, that comes in line with getting people

talking and getting people thinking to

reduce stigma. Encouraging people to gain

connections within their own circles of

families and friendships, because as we all

know these things can suffer. I, myself,

grew up with a dad that was bipolar, and he

was very unwell and not very pleasant at

times. In my own life, I didn’t see him for

two and a half years, which is a real tragedy

as that was part of my childhood. So I think,

we recognise that mental health can be

very disruptive to family life.

understanding. It

is easy to view an

illness and not

see the person

behind it. The

speaking events

series were

popular and could

be offered

nationally.

Sadness at

fathers’ memory,

a difficult part of

the interview.

Relationships can

be lost, and

effects children in

different ways.

Lost childhood

bond

momentarily.

Relationships can

become

impossible to

maintain.

Families with no

alternative

support services

nationally,

medication alone

cannot change

behaviour.

cxxxix


Interview 2 – Steve Mallen,

Chair at the MindEd Trust

NW: Firstly, could you please tell

me about The MindEd Trust and the

work which you do for schools and

communities?


Prevention and

Recovery

Social and emotional

wellbeing.

SM: Yes, the Trust was created

following the very tragic death of my

son last year, whom took his own

life following the onset of severe

depression. The Trust is quite

simply designed to improve

emotional resilience and the mental

health literacy for young people and

children throughout the education

system. Targeting primary,

secondary and higher education

with a particular emphasis on

prevention and early intervention.

Whilst also strengthening care and

support pathways for young people

that are experiencing difficultly. It is

a very small charity but it has a very

high profile as you probably know.

High profile mental health

educational charity,

working with public

health, education and

schools within

Hertfordshire and

Cambridge to achieve

better mental health

support within the

education system.

Theme NW: Yes, I have researched your

work. I have been discussing a

community mental health wellbeing

event at a local school in

Hertfordshire, which aims to teach

emotional resilience at an age

appropriate level to the children,

staff and families.


Community

Psychology

SM: Yes, I saw that paper and

thought it was excellent. It is exactly

the kind of initiative which there

should be more of, and it is exactly

the kind of initiative which would

gain the support of the Trust, and

there are many other charities who

National level changes

rather than case by case

basis, promoting social

changes through

government initiatives

and policy.

cxl


would be very keen to support that

kind of initiative and so on. Frankly,

it is the kind of thing which should

be enshrined in government policy.

That is part of what I am also doing.

There are two divisions to my Trust,

as it were. One division is working

with schools with an emphasis on

Cambridgeshire and Hertfordshire,

because that is where we come

from and where this story is based.

The other part is also agitating the

political system and as you know, I

have good contacts now with the

Prime Minister, The Cabernet Office

at the unit at number 10, and of

course the Department of Health

and the Department of Education.

These seemingly small and local

initiatives, I think are very important

and it is my intention to give those

initiative’s National airtime. I now

talk direct to the Ministers of Health

and the Ministers of Education, and

I think these kind of initiative’s they

should be more aware of so well

done to you.

Theme NW: Thank you Steve, which was

going to be one of my questions to

you. Do you feel there should be

more alternative support services

available to communities?


Recovery/Prevention

SM: Yes, absolutely. There are all

sorts of complex issues here.

Firstly, as we know, there are all

sorts of problems within the Public

Health system and the NHS and

Lack of community

support system placing

pressure on the

education system and

communities.

cxli


Family and extended


relations

Social/Emotional

Wellbeing

Mental health

awareness

Mental Health

Stigmatism

Community peer

support and social

network

Social Action Charity

– Community

psychology at

political level

(Holland, 1992)

getting treatment particularly for

younger people, and as we know

the demands for services is

escalating. This means that the

thresholds for treatment is

increasing and you have to be

evermore ill to get treatment. We

keep coming across stories about

recurrent anorexics being told to go

away and lose some more weight

before they get treated and so on

and so forth. There are people living

with depression whom have to be

actively suicidal before they are

admitted into care. In this country

there were nearly thirty-nine

thousand children referred by GP’s

to the NHS for mental health care

and they were refused treatment.

Now the reason I am mentioning

this is the failings in the public

system and also the government’s

austerity agenda which is also

seeing a wholesale reduction in

social and community care services

particularly through county councils

and so on and so forth. The result

of that the education system is

becoming the basis of

psychotherapy by default. Many

families are sending their children to

school every morning and the

school is having to deal with a Tier

1 and Tier 2 psychological disorder

because there are very limited

community services available and

that which there is available is being

reduced. You have to be very ill

Only severe high risk can

be treated due to lack of

resources.

Prevention strategies are

currently not succeeding

in making a significant

impact.

Working with schools to

promote better mental

health to young people

and early intervention to

mental health distress.

Prevention of crisis and

mental health epidemic.

cxlii


before the Nhs will even go

anywhere near you. So obviously, it

doesn’t take a genius to work out if

we did better in the education

system, we would have happier and

healthier communities. It would also

prevent young people in particular

reaching crisis. The Nhs is

designed to treat people who are

already in crisis, what if we could do

something to give the Nhs less to

do in the first place? That is very

much the focus of my trust and that

is very much the focus of the

dialogue I have with politicians and

so on.

Theme NW: Yes, absolutely, I do 100%

agree that prevention is better than

intervention. Do you still feel there

is a mental health stigma present

today?


Recovery

Prevention

Government Policy

Mental health

awareness

Mental Health

Stigmatism

Community peer

support

SM: I do, but I will say that I think it

is changing. I think that is one of

those issues that has seen a

tremendous change just in the past

12-24 months. I think there is a

growing awareness of the burden

that mental health on society, and I

am certainly finding many groups,

many families, many communities,

are more open to discuss these

things than they would have been

just a couple of years ago. I think it

is a bit like the dam has burst in that

sense, there are so many tens of

thousands of children particularly

that are suffering. That suddenly it

Mental health awareness

has dominated the

media; communities are

more open to discuss

than before.

Government speeches

and NHS findings have

highlighted the current

crisis and the

development to eradicate

stigma has begun.

Social media campaigns

have risen from mental

health charities. People

cxliii


has become ok to discuss this, and

what is also important of course in

that shift is there has been very

expensive campaigns run in

newspapers particularly The Times

as you know, The Sunday Times.

We have seen a lot of programmes

on Television, The BBC had two

weeks of mental health

programming a couple of months

ago, which I am sure you know. We

have also seen very importantly of

course, Government Ministers

including the Prime Minister on

television talking about mental

illness, and to be honest if we went

back two or three years, you would

not have got senior politicians on a

television programme to talk about

mental illness. That has now

changed, there is a whole series of

initiatives which are government

backed The Time to Change

programme and so on. There’s big

use of social media, there’s daily

blogs and daily messages and so

on and so forth. So in answer to

your question, the stigma is still an

incredibly large problem but it is

starting to change.

with mental health

distress have been

utilising YouTube for

example with videos

holding up paper signs

with written messages.

Support pages have risen

in popularity.

Facebook has made

reporting distress

available to users.

Theme NW: I do agree, the mental health

taskforce five year forward thinking

report has the five-year plan to

make some significant changes

which will bring improvements.

What impact do you feel this will

have on the families and their


cxliv


relationships trying to cope with

depression?

Recovery/Prevention

Family and extended


relations

Social/Emotional

Wellbeing

Mental health

awareness

Mental Health

Stigmatism

Community peer

support/social

network

SM: Well obviously the more people

who talk about the problems and

the issues they have, the better the

outcomes are likely to be. The

reason why my son is not alive is

because he didn’t ask for help. I

keep coming across very similar

cases, now if we could remove that

stigma and increase community

awareness, family awareness,

school awareness and so on. Then

quite simply young people in

particular will seek help more

quickly. In addition to that it is also a

complicated thing, as one of the

issues we have got here is physical

health it’s very obvious you break a

bone it is kind of obvious that

someone has hurt themselves. If

someone has got a mental problem

it isn’t immediately obvious, and it is

not immediately obvious to the

people who love them dearly. So

you see again, if I look at my own

particular case, and going back to

other families that I have been in

contact with as well. It is often the

case that a young person might be

suffering, their parents can’t see

what’s happening, their friends can’t

see what’s happening and their

teachers can’t see what’s

happening. Now if they were to

increase our mental health literacy,

then we will basically be better able

to see the signposts for which they

The person in distress

has trouble seeking help,

with more awareness

friends, family, teachers

can spot the signs and

encourage them to seek

help.

If people sought help in

early stages may prevent

high risk crisis.

People in distress are

good at hiding their

illness at times, however

more awareness and less

stigmatism in

communities would

prevent the fear of

seeking support.

The peer support network

is essential to wellbeing.

Young people and adults

will seek peer support in

first instance however, if

the community is

unaware of the signs

support cannot be

granted.

cxlv


are suffering and also encourage

them to get help and also develop

our own pathways. That are actually

appropriate in terms of caring for

people. There are worries in this

country, that you can train to be a

teacher in physics but you do not

have to take any kind of

qualification regarding the wellbeing

of the students that you are

teaching. In my world every teacher

would have to do compulsory, a

term or a paper or something on

mental health literacy. Similarly, a

lot of school initiatives one of the

strongest areas will be the peer to

peer support. As a young person

the first point of reference they will

turn to, is their friendship group, but

the problem is that the friendships

are not aware of the problem. If we

look at what we have achieved in

society with Alzheimer’s, things like

Racism, Homophobia. People say

you can’t change values and stigma

and so on. Yes, you can, and we

have. The world that you and I grew

up is not the same world which our

children are growing up in. If you

see what I mean, and that will

continue to change. So I am very

much in favour of events, which

bring out these issues and educate,

which bring people together to talk

and learn.

Society has overcome

many problems such as

racism, homophobia,

elderly mental health,

changes can be made to

mental health and

eradicate stigma.

Theme NW: Yes, with community events

specialising in wellbeing which

could be all round wellbeing looking


cxlvi


at physical health, and mental

health wellbeing would give

community education, awareness

and support. It is about extending a

social support network, which

brings the community together

which I feel should be implemented

into schools, and into communities.

Social and

Emotional Wellbeing

Recovery and

Prevention

SM: Yes, I think you are right, one

of the things I was unsure of when I

was reading through your

questions, was one asked do you

feel community events could

contribute to the recovery of

depression? That is a very difficult

question, because one answer to

that is absolutely no, as if

somebody has severe depression,

the last thing they are going to do is

turn up to a community event, and

also even if they did turn up, the last

thing they would do is to share and

engage and so on and so forth. I

think when it comes to prevention

and intervention it very much

depends on the stage of the illness.

If somebody is starting to feel

depressed and is starting to trend

into tier 1 of the mental illness.

Then yes, community events,

education, learning, concerts, away

days, must be good. The strength in

that individual for removing the

stigma, but there does come a

point, by the time you get to tier 3

and certainly tier 4, the community

events will have very limited value

Some tier 4 candidates

would benefit from

community events to

reduce isolation; creative

expression is beneficial

for symptoms of the

illness. Music therapy for

example is creating

music together and using

to express how they are

feeling. Art has proven

successful. Creative

events could achieve this

and at a community level

rather than individual.

cxlvii


as that individual will simply not

engage in that space.

Theme NW: Yes, the community events

would be aimed at targeting the

early stages to prevent the

escalation to the higher tiers, and

encouraging the individuals to seek

help before they get to that

extreme.


SM: That is exactly right, the other

thing is you have to be careful here,

as this is a very complicated

science. I have come across some

self-groups here in Hertfordshire

actually, basically what that is they

have a church hall, they get some

tea and biscuits, and people with

psychological problems and

challenges and so on. Get together

on a Monday night or a Tuesday

night to talk and share their

problems. Now on the face of it, it’s

quite a good thing but it’s also very,

very dangerous.

Local support groups,

good or potentially

damaging?

Theme NW: Do you feel they could get

ideas from each other on different

destructive methods?


Recovery

Social Wellbeing

SM: Exactly right, if there is no

clinical expertise in the room. How

does one determine, if those

activities and those discussions are

actually therapeutic or actually

potentially damaging? So obviously

community events are very

important, we would obviously

welcome that, but they need to be

very carefully thought through. Just

Scientific research or

methodology should be

present within community

event planning, must be

careful not to add to the

stigma or to encourage

destructive habits.

cxlviii


filling up a room and saying let’s

talk about our mental health

problems, there needs to be some

science under that. That I find is

often lacking.

Theme NW: The event I am planning will be

looking at therapeutic methods such

as art, dance, and methods which

have proven to improve wellbeing.

Interpretive Comments

Recovery/Prevention

Family and extended


relations

Social/Emotional

Wellbeing

Mental health

awareness

Mental Health

Stigmatism

Community peer

support/social

network

Recovery/Prevention

Social/Emotional

Wellbeing

SM: That is good, and things you

need to implement into your

studies, as I have seen an awful lot

of methods which aren’t evidence

based. Don’t get me wrong, there is

a lot of well intentioned, very kind

people, whether they are

individuals, small companies and

charities and so forth. That are

offering services and programmes

which go across a whole range of

wellbeing that offer everything from

diet, to exercise, to yoga, dance,

traditional learning such as online

therapy and so on and so forth.

Now I welcome that, but a lot of it is

not evidence based. Now we have

to be very careful, if we are looking

at population level intervention. In

other words, if we are looking at

rolling at policies, the school

systems, we have got to make sure

that those policies and those

programmes are absolutely

appropriate and are grounded in

evidence. I have come across a lot

which without sounding derogatory,

just happy, clappy stuff. Whilst I

Sustainable and

measurable wellbeing

improving event

activities. Reviewed by

psychologists, medical

expertise?

The educational

curriculum should include

mental health in a

practical way, public

health England and

public education advised

that emotional wellbeing

is better done practically

cxlix


welcome anything that brings

people together, and makes them

happy, stronger that is not the same

as a proper evidence based

education system. I find that what

has been happening in the school

system is they are doing a bit of this

and a bit of that. Now I welcome

that but it is not the same as having

an embedded programme, that is

evidence based, that is measurable

and is sustainable over time. Now

that is what I am trying to do with

The Trust is to bring schools and

communities on a journey so they

have actually got a wellbeing and

mental health literacy programme

embedded in their curriculum. Now

this isn’t something to just be done

a term, this has to be all through the

school system from primary,

secondary and through to higher

education. It has to be repeatable,

and it is no good just having

traditional classroom learning, and

at the same time it is no good just

getting everyone to run around the

field. You need to look at mind, and

body and all sorts of activities. Now

there is some very good science

about the use of math, the use of

dance, and the use of PE in terms

of improving our mental health

literacy. It is not just about

improving our wellbeing, there is an

obvious relationship between our

physical health and our mental

health. The better we are physically,

in a way that is relevant

to them.

Introducing community

events with curriculum

activities for the families

to do together to talk

about mental health,

physical health, an

awareness to look after

themselves and each

other.

cl


the more likely we are to be strong

mentally as well. The other thing

that the education system misses I

think is that people are forever

criticising current academic policies

of government which see, ever a

greater pressure placed on young

people. Now this is a difficult one,

because, I do believe their

academic performance is extremely

important. That is how we grow and

evolve as a society, and so on and

so forth.

Recovery/Prevention

Social/Emotional

Wellbeing

It is obviously, not appropriate to

subject young people to the most

ridiculous amounts of pressure and

are then unable to cope and then

develop an illness. So getting that

balance right is important, what I

have seen in the literature is, never

mind all this concentration on

league tables as it were, let’s put all

our emphasis on wellbeing and

making people happy and healthy.

Of course, I welcome that, but it

isn’t the right way of thinking. There

is an obvious relationship between

academic performance and

happiness. The happier and

healthier the child, the more likely

they are to succeed academically.

So I don’t see, mental health

literacy and academic excellence

being exclusive. I think they are

actually part of the process; they

are actually one thing not two

things. You will see people saying

less this and more this when

The balance should

remain, do excellent

grades ensure happiness

and wellbeing to the

student? Perhaps.

However, the pressure to

maintain may become a

burden. Or the lack of

progression could also

damage students. The

individual strengths and

weaknesses should not

make the child feel

inferior to others. The

person could hide true

feelings.

cli


actually there is a bigger picture.

The bigger picture is the whole

school experience, and the whole

school experience of the individual.

Theme NW: Yes, I do agree, assessments

should be made on a case by case

basis, which it appears they seem

to think one size fits all, which isn’t

the case.


Recovery/Prevention

Family and extended


relations

Social/Emotional

Wellbeing

Mental health

awareness

Mental Health

Stigmatism

Community peer

support/social

network

SM: Definitely not. It doesn’t take a

genius to work out, what you do at

primary school, is different to what

you do at secondary school. What

you do for boys is different to what

you might do for girls. In a state

school might be different to what

happens in a private school. What

you might do in a relatively affluent

area, might do be different to a

socially deprived area. You need to

develop programme which are

sensitive to their environment, but

at the same time I think there is a

much deeper reason I think Nikki, if

we think about this if you encourage

communities to develop their own

programmes. The mere existence

of that discussion and that planning,

I think is a good thing, this is one of

those areas where the journey is as

valuable as the destination. If you

bring together a school to develop

an emotional literacy programme

you consult with all the teachers

and the parents, and the board of

governors. They ask the students,

they do some research, they better

An experienced

community event planner

would adapt to the target

market appropriately.

The initiation of training

and staff is excellent,

however, a whole school

approach which includes

the family of the children

encourages a community

led approach to

wellbeing, reduce stigma,

and raise awareness.

The child can have

excellent teaching, an

excellent programme,

however if told conflicting

messages at home, then

could be confusing.

Therefore, a whole

school community led

approach which includes

everyone would achieve

the best results.

clii


the counselling, and they look at the

evidence based work where there

are programmes available. They

examine different training

programmes for the staff and so on

and so forth. Now if they spend 6-9

months doing that, by the time the 9

months is complete what you have

is a mental health literate

community. The journey and the

discussion is as valuable as the end

programme, and this is why I am

really keen that the government

doesn’t just give its own tool kit as it

won’t work. If you try and parachute

things into schools, the teachers are

going to go, not another

government directive, we are

already overworked and underpaid.

This isn’t just another PC lesson. I

don’t want the government to roll

out another one size fits all

programme, but I would like to see

the government roll out lots of

resources and lots of subsidies to

enable those schools and

communities to develop

programmes which are appropriate

for its community. I think if we did

that on a national basis within five

years we will have completely

eradicated all of the stigma

surrounding mental illness. Imagine

if we could put this into twenty-five

thousand schools in two years, and

by the time we have done that we

would have mentally literate

communities and also this stigma

If community events run

by the school following

the programmes and

training this would

achieve the school and

home life balance which

is needed to succeed to

show the change which is

needed.

Agreed, the community

and whole school

approach events must

run combined with a solid

mental health education

programme and support

structure within the

school.

cliii


which we so worry about which is

still so prevalent will start to

evaporate.

Theme NW: I totally agree and very much

support the work The Trust is doing

and the benefits this will mean to

the future generations.


Recovery/Prevention

Family and extended


relations

Social/Emotional

Wellbeing

Mental health

awareness

SM: Yes, it doesn’t take a genius to

work out, that happy children will

turn into happy adults, as you know

seventy-five percent of all

psychological illnesses predates

higher education. So if three

quarters of the problem is before

higher education then that is where

we need to focus our resources on

and so on and so forth. As those

people will then grow up to be

happier and healthier people which

will make a stronger economic, and

cultural contribution. There will be

less of a burden on social welfare

and the health system, they will also

live longer. People with mental

illness tend to have an average

lifespan of twenty years less than

the average person. As you know, if

the next generation are happier and

resilient, then their children will be

mentally healthier and resilient,

when my son died I was completely

lacking any knowledge on the

subject. If I knew then what I know

now he would still be alive, that is

despite all I am very well educated

and highly experienced and despite

Healthy social and

emotional wellbeing in

childhood follows with the

transition into adulthood.

Preparing for the adult

life challenges in a

resilient manner.

Improving all round

wellbeing to communities

will improve quality of life

and reduce the need for

health care within

communities. A grieving

father despite his

excellent education and

life experience was

unaware of his son’s

illness due to lack of

knowledge of mental

health and the warning

signs.

cliv


all those things I didn’t know

anything about it.

Theme NW: My condolences, unfortunately

there wasn’t much awareness for

mental health at that time, or real

conversations.


Political Influence

and strategies within

community

approaches.

Mental Health

Awareness and

stigmatism

Prevention

SM: That is now changing, and I

actually think that this year 2016 will

go down as a pivotal year for when

it started to change. There is a

tremendous amount of activity in

the government at the moment. All

three political parties are aligned on

this and we have a shadow minister

for mental health Luciana Berger,

she’s great I have spent good time

with her. The department of Health

is also very, very focused on this.

Norman Lamb continues to

campaign as you know. Even in the

media sense we have seen the

Duke and Duchess of Cambridge

supporting young people who are

talking about difficult issues

associated with anorexia, suicide,

and bullying and so on and so forth.

All of the things which shape

people’s environments, and then

there’s Ruby Wax and Stephen Fry.

This year our approach to mental

health is changing, right in front of

us this year. I think we will see this

year as being the point at when it

turned.

A difficult point in the

interview, a family let

down by the mental

health care system.

Political campaigns have

dominated the media, the

produced mental health

taskforce report showed

a failed mental health

system. The political

parties then took to

highlighting the problems

and making government

led initiatives

Theme NW: Yes, I do agree, it has been a

very positive year.


clv


Mental Health

Awareness and

stigmatism

Prevention

Emotional and social

wellbeing

SM: Obviously, we still have a long

way to go, as with everything there

usually is. The underfunding in the

public health system, beggar’s

belief frankly. How we have

managed to create this in a

supposedly civilised society is

beyond me. It is an incitement on

our society that young people are

being treated this way. This should

never have happened but obviously

you have to start the change

progress somewhere. I think there

is very strong momentum for

change, there is attention from the

education system, the media. The

media has been very helpful here,

very helpful. The programmes

about mental health, the

programmes about suicide, they

may not be wonderful science,

sometimes there was too much

focus on human misery rather than

science and solution. These things

are very important in removing

stigma, and increasing our currency

and awareness.

Lack of mental health

funding has created an

avoidable epidemic of

loneliness.

The media has helped

with raising awareness,

now we must look for

solutions and recovery.

Highlighting prevention

and strengthening

communities.

clvi


Interview 3: Rachel Kelly:

Writer, Journalist and

Mental Health Campaigner

NW: Could you please describe how

your depression has affected you in the



Depression RK: Day to day living as I had known it

was just impossible. I was incredibly ill,

all normal day to day living was

suspended really, I had meals brought

to me, and I was in bed and unable to

function.

Social withdrawal and

feeling unable to cope

with simple life tasks.

Theme NW: I have been there myself, could

you describe what impact this had on

your relationships and family?


Family

Interpersonal

Relations

RK: In a way it has deepened our

relationships especially with my

husband, and my mother who came to

live with us. I am very grateful to them,

so I think in one way it was a good

thing however, on another level it was a

very demanding time because anyone

who is seriously ill with depression can

be quite a challenging patient for those

around them and their family. Whilst

effected with a mental illness and when

something goes wrong with your brain,

I think there’s always a feeling that it is

also about mood and character

therefore your family can always worry

that somehow they are to blame. So I

think it is a challenging time for

relationships as well, I didn’t blame

them. Depression is not as

straightforward as a physical illness.

A challenging time for the

relationships surrounding

the patient. The family

feeling helpless and to

blame, seeking support

and guidance.

Coming together to

support the patient,

assisting with family

duties, the family

strengthens and

becomes bonded

overcoming the difficult

time.

Theme NW: I know, it can be difficult to

understand as it is not visible and you

can’t see it.


clvii


Social Wellbeing RK: Yes, and I think it is hard for the

person as they feel guilty and they feel

ashamed. I think that is the very hard

extra dimension to depression.

Not wanting to ask for

help or feel a burden on

the family, and society.

Theme NW: It is difficult, research has found

that people find the arts such as

creative writing, painting and music

have been effective with helping

through the illness. I think people are

still unaware of these alternative

services and therapies. Do you feel

more awareness should be made and

access to alternative support services



Recovery and

Prevention

RK: Yes, I find creative writing very

helpful and I wrote a memoir about my

experience, which was about making

something positive out of it. Creating

something I found was really helpful for

me and I believe it could be helpful for

others as well. Through the arts and

creating something very differently, I

think you are right and the NHS is

really stretched. It’s hard to provide

these types of holistic services, lots of

people would like them and would take

advantage of them. It’s just not widely

available.

Finding a therapeutic

recovery source and

creating something

positive in the darkness.

The illness becomes light

as patient engages and

connects with

surroundings through

creative expression.

Theme NW: What support services have you

found have a positive effect on your

recovery?


Recovery and

Prevention

RK: I did lots of different things; I first

did a CBT course which I found helpful

then I had therapy as well on a one to

one basis. I also had an 8-week

mindfulness course, which I found very

helpful. Then I started going to some of

Connecting with people

who understand helps

regain self-esteem and

confidence. No longer

feel alone and isolated,

clviii


the Mental Health charities which run

support groups, I went to the Mind

Workshops and the Depression

Alliance. Then I started running

workshops for them myself. I liked

connecting with other people as they

understood and I found that very

helpful.

wondering…what is

wrong with me?

Theme NW: The Changing Minds Festivals

launched at the weekend which

showed people access to these

services and run therapeutic classes

with various talks and stands. I

attended on Saturday.


Recovery and

Prevention

Social and

emotional wellbeing

Community

interpersonal

relations and family

quality of life.

RK: Yes, I was on a four-part panel

speaking Saturday for the Arts vs.

Chemicals, which was looking at taking

a more holistic approach to mental

health which we do need and the arts

have an important part to play in that.

When you look at the various

treatments for mental health it’s a belief

that pills are magic bullets. We had

drugs in the nineties, they do work for

some people, and they don’t work for

everybody, which adds a sense of

failure when they don’t work. There’s

an estimated around thirty to forty

percent of people for which the drugs

don’t work. Then we had the talking

therapies come through the cognitive

behavioural therapy (CBT), and the

government made that their therapy of

choice. Again, it’s pretty good it works

for around fifty percent of people. I

think the thing coming through now is

mindfulness, everybody is very excited

The medication doesn’t

work for everybody and

even when successful if

the behaviour hasn’t

changed then the patient

can remain stuck in a

void.

Creative expression or

arts can provide a space

for engaging with others,

creating something

positive and seeing

beauty in the different

forms. Music, Art, Poetry

and Performing arts such

as dance or drama.

Regaining confidence

and sharing with others.

A combination of

medication and

alternative therapies

clix


about mindfulness, which again is a

similar process. It doesn’t work for

everybody. So my own view is that you

need a much more bespoke, tailor

made, tool box of different strategies,

one size does not fit all. There have

been some exciting changes, people

like Paul Farmer the chief executive of

Mind are showing that a reform to

mental health services is needed, and

there is a sense now that we do need a

broader, holistic approach just to take

into account that everyone is different

and individual. I feel this is starting to

emerge now.

could provide a better

solution, what if talking

therapy does not achieve

the healing? Learning

new methods and

promoting change.

Theme NW: As a family would you attend

events like the Changing Minds

Festival?


Recovery and

prevention

Social and

emotional wellbeing

Community social

network

RK: I love going and hearing what

people have to say, sharing

experiences you feel less alone. I’d go

to loads of different conferences, and

events like these. I love sharing and

hearing what other people are doing.

What people are finding is going to

work, or not work. I also have my

experience and I think the more things

are crowd shared about what people

are finding helpful the better. I think it is

a great idea.

Sharing helpful strategies

to overcome symptoms

of depression. Gaining a

supportive social network

at community events.

Reducing social isolation.

Theme NW: Yes, I think more opportunities like

this would be helpful. Do you feel there

still a mental health stigma present

today?


Mental Health

Stigmatism

RK: Definitely, I think there is still a

stigma present today, celebrity backing

has helped such as Stephen Fry. It is

The illness is stigmatised

that only certain

demographic groups can

clx


Mental Health

Awareness

difficult people within the arts are

viewed as up and down, and bit crazy.

The issue is if you have real social

deprivation, need to put food on the

table and real financial worries you

might have depression, however there

is a middle section of people running

their own businesses, Lawyers,

Bankers, people who don’t obviously

have anything to be depressed about.

There is a hidden epidemic of stress

related anxiety and depression, a lot of

those people are really struggling, there

is a stigma there, which I know is true

from my workshops and running talking

groups it is a topic which arises.

be effected. Successful

business or corporate

groups can also feel

depression. Celebrities

such as successful

actors, musicians,

corporate executives. It

can affect all.

Theme NW: I agree, more needs to be done to

tackle the stigma and the awareness.

Do you feel your family relationships

have improved since you have been

participating in these events?


Mental Health

Awareness

RK: Yes, I think that I was really

ignorant and didn’t understand that

there was this thing called mental

illness, the thing I am most pleased

about is my children have not been

brought up like that. They are aware of

mental illness, my daughter has

volunteered for SANE, and my other

daughter has done bake sales

fundraising for mental health charities.

They think it’s perfectly normal to talk

about these issues, we need to make

changes. I think that is the positive part

of my family that for the next generation

at least. We are really on this topic.

Family has new

awareness and fundraise

to support mental health

charities, the next

generation will be

supportive and

understanding towards

mental illness.

clxi


Theme NW: Do you think that more community

events like these will help reduce

isolation?


Social and

emotional wellbeing

RK: Yes, there is an epidemic of

loneliness, the more people can

connect the more people will realise

that they are not alone. Life can be

difficult, and it is ok to feel vulnerable.

You get a sense of liberation, as you

get a real shiny image of people’s lives

on social media, it all looks fine,

nothing but holidays, but of course it is

not always like that. I think the more

you are connecting with people and

sharing actual happiness. You can

have really real conversations, and it is

brilliant.

Reducing social isolation

and connecting with

others. Strengthened

relationships, and

support through

community as an

extended family and

family support. Creating

memories and sharing

experiences. Reducing

loneliness and bonding

communities.

Theme NW: Has there been any difficulties you

have had to overcome to attend these

events?


Social and

Emotional

Wellbeing

RK: For me, my trigger is I can take on

too much. I am a bit careful with my

time and try not to take on too much as

I can become overwhelmed. These

things are great and I like them, they

can be quite intense as well, you are

trying to help people who are quite

fragile and you have to keep an eye on

your own mental health as well as you

can take on too much. Well I do

anyway.

Knowing the trigger

points and making steps

to avoid those situations.

Caring for yourself as

well as helping others is

important.

Theme NW: I think with a lot of people; it may

be something that they need to build up

into overtime.


Social and

emotional wellbeing

RK: Yes, and also as people are not

getting enough help on the NHS so you

have situations where people who are

The issue with limited

NHS resources is people

whom should be in

clxii


very, very ill end up in hospital. You

have people trying to manage as best

as they can, when some are really

quite unwell. You have to be careful.

inpatient care are not

getting the support they

need. The illness

progresses to dangerous

level or extremes.

Theme NW: Yes, I can agree with my illness I

go to a GP and get advised sorry

unless you are hurting yourself or are a

danger to anyone else we can’t help

you, and you are given a prescription. I

guess I think, surely people should not

have to get to that extreme. There are

other alternative solutions which I

believe could be found in community

events.


Recovery RK: Absolutely, I think there needs to

be an alternative to not just to be given

pills, which we are aiming to be more

widely available.

A national strategy with

different supportive

networks and methods

for recovery and

prevention.

clxiii


Interview 4: Jade, 18 –

Featured on BBC inside the

Mind Series

NW: Could you please describe how

your depression has affected you in the



Depression P1: I just felt worthless. Not feeling adequate in

society

Theme NW: What impact has this had on your

relationships and family?


Mental Health

Awareness

Reference Group

P1: Yes, it has impacted my

relationships and family. They just don’t

understand.

Feeling isolated from the

family, odd one out.

Theme NW: Yes, it can be difficult when it is

not something you can see it’s not like

a physical illness. Do you feel more

awareness should be made and access

to alternative support services should

be more widely available?


P1: In what way?

Theme NW: There has been research in to the

positive contribution through the arts for

example on recovery from mental

illness such as depression. What

support services have you found have

a positive effect on your recovery?


Recovery P1: I have found some therapy helpful,

things like art therapy.

Seeking support through

therapy.

Theme NW: If there were opportunities

available such as community events

with opportunities to network with

people with and without mental illness

would this be something that you would

attend?


Community social

network

P1: It would be but, the thing is in my

area there are no community events,

and if there are any I do not get told

about them. So if any have happened, I

hear about them after and have missed

the opportunity.

Lack of availability, not a

national strategy for local

communities. Poor

marketing and

advertisements.

clxiv


Theme NW: So the events were not very well

advertised within your area and you

didn’t know about them?


P1: No.

Theme NW: That’s an interesting point, do you

feel there is still a mental health stigma

present today?


Mental Health

Stigmatism

P2: Yes, I do feel there is a stigma

present today, I am currently doing a

project on suicide and self-harm and

have found that.

Difficult to obtain rich

data from this participant,

building rapport.

Theme NW: Could you tell me a bit about your

current project?


Peer group support

Membership group

P1: I have started a peer support group

called Evolve with a friend which

tackles mental health difficulties.

Talking therapy support

groups run to raise

awareness

Theme NW: That’s great, has it been a

success?


Mental Health

Awareness

P1: I helped my friend set it up, it

provides support for mental health

issues.

Community led social

support.

Theme NW: How have you found this

additional support?


Membership group P1: I feel comfortable amongst my

friends and going anywhere beyond

that is quite scary.

Participant finds comfort

around peers and has

social anxiety in new

situations

Theme NW: It can be daunting at first, are

people in your community aware of

your illness?


Mental Health

Awareness

P1: Yes, people in my community are

aware of my mental health.

Community are aware of

the participant’s mental

health distress

Theme NW: Has this changed how they treat

you or have they remained the same?


clxv


Community support P1: They have been different but in a

subtle way. They have been more

supportive.

Understanding and

support from local

community towards the

participant’s mental

health

Theme NW: That’s good. I am not sure if you

heard, recently there was a Changing

Minds Community Festival based at the

Southbank Centre, which featured lots

of therapies such as Tai Chi, Art

Therapy and various opportunities to

access holistic therapies. If there was

more of these available locally, would

you be interested in attending?


Wellbeing

community events

P1: Yes, if there was more available I

would attend.

The participant

expressed would attend if

was nationally available

to them and would find

them beneficial.

Theme NW: Is there anything you think would

ease other people with depression

attending, as with the illness there can

be social anxiety, withdrawal and other

symptoms?


Recovery or

prevention

P1: I would say go with someone you

really trust, if it turns out it is too much

for you then is no harm in going home

to feel comfortable. If you do want to

attend go with family or friends.

Whatever is needed to feel

comfortable.

Participant suggest

attending with family,

extended family, or peer

friendship to ease any

social anxiety and to feel

comfortable.

Theme NW: Have there been any difficulties

you have had to overcome at any time

attending events or day to day living?


Recovery or

prevention

P1: Yes, there have been times I have

found social events or anything

energetic difficult. If I have been having

Balance is important, do

not pressure the person

with mental health

clxvi


a really down day. I don’t want to do

anything, and my family still don’t

understand and will say its fine.

distress if unable to

attend that day.

Theme NW: Do you feel more educational

material should be available for families

to help them understand, or were they

provided with this?


Mental Health

Awareness

Reference Group

P1: Yes, I feel it is their own choice and

if they don’t want to learn about it, it is

up to them. It would be nice if there

was support for them if they ever

needed it.

Education and

awareness support to

family members whom

are supporting the person

in distress would be

beneficial.

Theme NW: Has that been the main difficulty

within your family you have had to

overcome, the lack of understanding?


Family

Interpersonal

Relations

Reference Group

P1: Well my mother has her own

mental health problem, and they feel

she has passed it down to me.

Another family member

has mental health

distress and ‘they’ feel it

is hereditary? Perhaps

the mother feels guilt and

to blame for the daughter

developing depression.

Theme NW: Have you both got support from

Adult mental health services at

present?


Social and

emotional wellbeing

Reference Group

P1: It is difficult now we are both

classed as adults as there is not as

much support as there is under

CAMHS.

Participant struggles with

the support levels now is

in adult mental health

services. The transition

into young adulthood has

been difficult along with

the illness. Both the

mother and participant

are in receipt of AMHS at

present.

clxvii


Theme NW: How did you find the transition into

Adult Services, have you been

allocated a support worker at the

moment?


Mental Health

Awareness

Social and

emotional wellbeing

P1: I have been allocated a worker but

I have gone from seeing someone once

a week to once every three weeks, and

if I am in crisis I cannot contact them. I

end up sitting in A & E for hours.

Limited community adult

services support means

participant can end up

sat in A and E for hours.

Feels unsupported in

crisis. Poor social and

emotional wellbeing

surrounding adult mental

health services.

Theme NW: That must be difficult for you, have

you found any other support helpful?


Extended Family

Friendship Support

Reference Group

Social and

emotional wellbeing

P1: I spend a lot of time with my

boyfriend which I find helpful, he is very

supportive. I do have a long distance

friend which is supportive and her

parents also, who have offered if I am

ever in trouble to pack up my stuff and

go there for a few days.

clxviii


Interview 5: P2, 30 yrs.

old, LTP, with C1 – 7

yrs. C2 – 2 yrs. C3 –

1yr, from Live Event

NW: Could you please describe how your

depression has affected you in the past with

your day to day living?


Depression

Obsessive

Compulsive

Disorder

Social and

Emotional

Wellbeing

Family

Interpersonal

relations

Recovery

Personal social

identity: Mother

Reference

Group

P2: I think when I had it worse, trying to do

anything was a nightmare. I have had it

since I was a teenager, but when I was

younger I never realised what it was. I didn’t

deal with it in the best way…I was a little bit

destructive but as I have got older and I

have spells of it. It was just trying to get up

and get ready, I couldn’t even do that. With

me, the more down I get the more I get

OCD. All I do is clean and tidy all day long. I

have a thing about cleaning out cupboards,

my dad will say to me, but you did that

yesterday and I will say yeah I am just

doing other ones today. When I get down,

that’s when it affects me, the cleaning gets

out of control. That’s why they are all a bit

obsessive with cleaning, like C2 always has

a cloth in her hand and as soon as the food

is finished the plates will go straight away.

So I know when they get older they will

probably be the same. That’s how it affects

me the most the cleaning and when it really

gets bad just trying to get up and get ready

is an impossible task, but when you have

kids you just have to do it.

The illness causes P2 to

socially withdraw and feel

unable to function, to

counteract the feeling of

helplessness at the

symptoms of depression

and the lack of control over

own thinking and emotions.

P2 cleans and rearranges

the home environment as

that is something P2 can be

in control of to ease the

symptoms and feel better.

The recovery method used

is cleaning surroundings.

P2 has a strong family

bond and committed values

and will continue to function

for the children even on

bad days. The children

ensure functionality for P2,

they are a strong family

group and are learning from

P2. P2 family outside the

immediate family home

also show support.

Theme NW: What impact does this have on your

relationships, friends and family?


Social and

Emotional

Wellbeing

P2: When I see people I am always like Hi,

and people say to me oh you’re always

happy, and you’re so happy all the time.

Yeah I know, sometimes it is a front. I don’t

P2 hides feelings and

symptoms of the illness to

others and takes to

showing a happy carefree

clxix


Family

Interpersonal

relations

Recovery

Anxiety

Reference

Group

Personal Social

Identity: Mother,

Daughter, Wife

want to walk in and say it’s so bad I hate

people feeling sorry for me. People ask me

what can I do, I say nothing just let me just

deal with it on my own, but then you can’t

when you are in a relationship, LTP over

the years has got used to it. He gets it as

well and he gets his moments. So we have

finally found a happy balance, he knows

when I get ill what he needs to do, and I

know when he’s ill what I need to do. As I

can get a bit addictive with bleach and

descale it can smell like a swimming pool in

here. Getting up and doing anything, I

always feel like my minds very chaotic.

When I am like it, every little thing seems

like a big major thing. I think when you are

younger it is hormones and things, like I

never told my mum and dad. I just used to

keep it all to myself and would end up

drinking loads. I would scratch myself on

my arms. I would just scratch and scratch

and scratch. I remember my mum once

saying to me oh you look like the people

which harm themselves. I would always

have an excuse. Oh I fell over when I was

drunk, oh I caught myself on that. I’d always

have an excuse and she never cottoned on.

persona to the community

due to not wanting

sympathy from others.

Perhaps P2 illness

symptoms make P2 believe

that they shouldn’t have

support or empathy from

others? P2 and LTP have a

good balanced relationship

and will support each other

in times of need. Again, the

chaos is out of P2 control

and can be unsettling. The

cleaning has become an

escape from this. Historical

destructive methods also a

method of release and

escape. Making excuses

and hiding from family. Not

wanting to connect and

share the difficult emotions.

Social withdrawal and

weakening connections.

Theme NW: Do you feel more awareness should

be made and more support services should

be more widely available?


Mental health

stigmatism

Mental Health

awareness

Government

Policy

P2: I think there should be. I have never

gone for professional help because you

don’t want the stigma, especially when you

have got a family. You worry, that people

will think you aren’t coping and not capable

of looking after your daughter, I did get to a

stage where I was really bad and LTP said I

Not wanting to seek

support for fear of

stigmatism and relying

solely on medication with

no alternative support such

as therapeutic services.

Medicating the problem

clxx


have got to go and see someone. I was like

I can’t as you have had problems in the

past, and now they see you have had

problems and now I have problems. What is

going to happen? So all I ever used to do is

go to the doctors and get put on anti-

depressants that is all I ever used to do.

Even to this day, he says I wish you had

just gone and seen someone. Then my

mum would say I don’t think you should see

someone professional as that is when it

gets really serious. I think unless you have

experienced depression, you don’t know

how to deal with it. They just say well snap

out of it.

away but not dealing with

the root cause, delaying the

inevitable return of

symptoms?

LTP attempts to encourage

P2 to seek support and

help, but P2 was fearful of

child protective services.

Parents confirming feared

stigmatism and not

encouraging to seek

support. P2 trapped in a

cycle. Unfortunate situation

and lack of awareness and

understanding from

parents, P2 copes alone.

Not every referral into

therapeutic services results

in a child protection referral.

The fear of this is however,

understandable with

present stigma.

Theme NW: Yes, I think the issue remains with

physical illness, they can see it. However,

with mental illness you can’t see it. There is

a lack of understanding and not enough

awareness currently.


Mental health

stigmatism

Mental Health

awareness

P2: Yes, it is still such a taboo subject. You

can say you’re depressed but as you get

further into it, it’s a little more complicated

than that. It can come for a hard day, then it

was like five weeks. Every day, then

sometimes I can have one horrific day then

the next day I can wake up and be oh I’m

alright. Or sometimes I’ll be really good,

then sometimes I wake up and will be

like…What is wrong with me? It is literally

Public misunderstanding

regarding the illness after

time parents have learnt to

understand it. The illness

still results in social

withdrawal and coping

without support. As P2 has

intermittent periods, P2

feelings and emotions can

clxxi


like a brick wall. I can be argh, over the

years my mum and dad have got to

understand it. They will ask if I am alright

and I will say no I am having bad day,

please just leave me alone, please stop

phoning me. They are a bit judgemental

with my life choices. My family life choices,

they are a bit old fashioned. They will say is

this a good decision, and I will be like yes,

this is my decision.

be difficult to explain and

control.

P2 relationship choices are

not accepted by parents,

leading to further

disconnection at times.

Theme NW: Have you found anything helpful with

your depression?


Recovery and

prevention

Social and

emotional

wellbeing

Social identity

Community

event

membership

group

P2: Cleaning, cleaning does make me feel

so much better. It is therapeutic. LTP would

go to work and would come home and

wouldn’t know where anything was. As I

would have moved the whole kitchen

around, every cupboard was different, the

draws had changed. He used to come in

and go. Where is the bread today? He just

asks. I think it’s hard when you have a

family, as I wouldn’t have time to go off and

do anything on my own. By the time I could,

I am so tired, I just can’t. I just really can’t

be bothered. I think maybe as they get

older, I will end up doing more things for

myself. Right now, I think it is just too hard,

to get a hobby. My books I have quite

enjoyed that. My mum has said I think you

are taking on a bit too much. When I do like

a summer fair, it’s my time to myself. On my

own, so I think that is how I am dealing with

it at the moment.

Working the stall at

community events provide

some time where P2 can

be P2 and have time to

their self-have own social

identity as well as mother,

partner etc. Increasing self-

esteem, building their own

business and feeling a

sense of achievement. P2

finds a release and

relaxation time, aids

recovery and acts as

prevention from symptoms

of depression in a

constructive way.

Increasing skills and

confidence in their self.

Contributing to society and

helping with learning selling

children’s books which

bring joy to other families.

Theme NW: That’s good, and you get to run your

own business as well.


clxxii


Recovery P2: I think as they get older, I will probably

find something.

The business has achieved

this.

Theme NW: Are people around you aware of your

illness?


Recovery/

Prevention

Family/extended

family

Interpersonal

relations

Social and

emotional

wellbeing

Reference

Group

P2: Yes, I would say people are aware,

people like family now. It is mostly close

family and my friends, because I haven’t

been really bad in so long, people can

forget. I think as I have been good for so

long, I did have a bit of a wobble after I had

C3, but I think it was just the hormones and

the stress of everything. After a week or so

it went, I know it’s not that quick usually. It

hangs around a lot longer than a week.

Most friends, and most family know. They

asked me if I was alright and I said, no, no

I’m not. I think I have post-natal depression

again. I would rather give it a miss if that’s

ok. It is nice, that people do know, and offer

help and support. I am quite open about it

now, I will talk to anyone and everyone

about anything. I am quite an open person.

I think it is better to talk than not say

anything and keep everything to yourself. I

don’t think that gets you anywhere. I think

that has come with age as I have got older.

I have found it easier to talk to people.

Family and extended family

provided support in times of

distress as were aware at

C3.

Feeling able to express and

share feelings.

Strengthened relationships

and assist with prevention

of further escalation of the

illness. Relationships are

vital in recovery and in

times of distress. Social

isolation and needing to

withdraw in darkened

moments, allowing the

balance and space.

Expressing the need for

support and asking for help

comes with age and

experience.

NW: Do you attend community events

together as a family?


Family

interpersonal

relations

Family social

identity

Group

membership,

event audience

P2: LTP works a lot, so at weekends we do

stuff together. We spend time as a family,

we go to carnivals, fairs, and see what’s on.

We don’t intentionally think what shall we

do or where shall we go. If it’s a nice day,

we go here or if there are funfairs on. We

can enjoy together as a family.

Community festivals and

events provide fun things to

do together as a family,

precious time as LTP works

a lot and can share

moments and memories.

Time together is precious

so activities and sharing

clxxiii


and local

community

laughter. Seeing children

enjoy the fun fair rides,

watch the carnival parades,

enjoy being part of a temp

community and being a

family group within that

community strengthen

family bonds, social

wellbeing and ensure family

quality of life together.

Theme NW: Has there been any difficulties you

have had to overcome as a family?


Social and

emotional

wellbeing

Family

interpersonal

relations

Recovery and

prevention

P2: Not really, obviously it does put

pressure on a relationship. I think when I

was really bad after C1, me and LTP,

hadn’t been together that long and he didn’t

know what was wrong. He was like what is

wrong and I don’t know what you want.

Over the years, it has got so much better.

He understands it, he is like right this is

what’s happening and this is what I have to

do. I think as my mum and dad are there a

lot more. It has never affected any sort of

relationships, as well, as I am such a

people pleaser. I don’t like to make a big

issue out of everything and would rather

just deal with it and tell everyone what they

want to hear. Rather than say, this is what I

think and this is what I feel etc. I think the

girls have always been so small, they are

unaware of it. I think C1, is starting to

become more aware. I am never just subtle.

If I have just tidied up and then they come

in and mess it up. She picks up on little

things like that but nothing has ever been

that major that she has said what’s going

on? I think being young they are unaware.

LTP and P2 relationship

have had challenges as all

relationships do. Children

are unaware and are kept

separate from any distress

symptoms which P2 or LTP

may be experiencing.

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