“Our study provides a window into what young people think about the mental health services they receive and what they feel helps and hinders their well-being…feedback will lead to…services that they will find engaging, meaningful and effective”
The phenomenon of resilience
The American Psychological Association describes resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress — such as family and relationship problems, serious health problems or workplace and financial stressors. It means ‘bouncing back’ from difficult experiences.” And it’s clear that being in good health means more than feeling physically well; it also means feeling mentally well.2
The phenomenon of resilience has attracted a surge of attention in mental health and social services practice, policy, and research.1 Recent research by Shalina Lal (et al)1 into resilience, in youth with first episode psychosis, adopted a socio-ecological definition of resilience that defined resilience as:
a process of an individual’s efforts to navigate and negotiate towards resources considered meaningful for well-being in the presence of adversity, and the environment’s concurrent capacity to support individual efforts (Boyden and Mann 2005; Ungar 2011)
In other words, resilience is not just about the individual; it’s about the environment around that individual. But within the field of early intervention for psychosis, “few studies have focused on service-related experiences and perspectives of young people diagnosed with first-episode psychosis and how services support and hinder their process of achieving well-being.” 1
Research focusing on mental health services, youth, and first episode psychosis
“The groups were very helpful for getting me to acknowledge that I actually had an illness,”
said Kevin, one of the youth participating in the research
Shalini Lal, an assistant professor in the School of Rehabilitation at Université de Montréal, is interested in improving access and quality of youth mental health interventions and service. Dr. Lal’s recent research highlights the impacts of mental health services on young people who have experienced symptoms of psychosis, including their interactions with psychiatrists, case managers, social workers and supports for housing, recreation, and employment.
Our study provides a window into what young people think about the mental health services they receive and what they feel helps and hinders their well-being…Eliciting young people’s feedback will lead to better planning and coordination of services that they will find engaging, meaningful and effective. — Dr. Shalini Lal
The study, Impact of Mental Health Services on Resilience in Youth with First Episode Psychosis: A Qualitative Study, identifies many different types of supports the youth found helpful, including group therapy and positive interactions with peers and peer support workers.
“The groups were very helpful for getting me to acknowledge that I actually had an illness,” said Kevin, one of the youth participating in the research.
“(The peer support worker) explained that with the right combination of medications or professional help, you could actually treat the symptoms and live a normal life… a good role model to see that you could recover from it,” said Jake, another youth involved in the study.
Other types of support the youth identified as helpful were accompaniment to appointments, providing help in completing employment assistance forms and facilitating the process of returning to school. Youth also appreciated emotional support like signs of genuine kindness, hope and encouragement from service providers.
“Even small gestures were seen as helpful, ones we may take for granted, like a care manager shaking their hand when they walked in the door,” said Dr. Lal. “That gesture of respect has a lot of meaning for someone stigmatized by mental illness.”
We speak with Shalini Lal.
Left-click to listen; right-click to save.
— People First Radio (@peoplefirstrad) March 13, 2017
About Shalini Lal
Principal Scientist, Assistant Professor, School of Rehabilitation, Faculté de Médecine, Université de Montréal
Research interests — Improving access and quality of youth mental health interventions and services:
- Development, implementation, and evaluation of innovative models to increase access to mental health care for youth and their families
- Leveraging information and communication technologies to support and augment the delivery of mental health care to youth and their families
- Knowledge translation and implementation science
- Mental health policy and mental health service delivery
- Understanding the impact of services on youth resilience, recovery, and service engagement based on patient and family perspectives
- Program evaluation, stakeholder engagement, and participatory research leveraging qualitative, quantitative, arts and technology-based methods
Shalini Lal is involved in research projects with collaborations in Canada, India, and Australia, and is one of the Principal Leads of ACCESS-Canada, a pan-Canadian network that is implementing and evaluating service transformation in youth mental health in 12 sites across Canada. This network was recently funded by CIHR ($25 million over five years).
1 [S. Lal, et al. (2017). Impact of Mental Health Services on Resilience in Youth with First Episode Psychosis: A Qualitative Study. Adm Policy Ment Health (2017) 44:92–102.]