Brenda M. Gladstone

Issues Encountered in a Qualitative Secondary Analysis of Help-Seeking in the Prodrome to Psychosis

Primary data are rarely used explicitly as a source of data outside of the original research purpose for which they were collected. As a result, qualitative secondary analysis (QSA) has been described as an “invisible enterprise” for which there is a “notable silence” amongst the qualitative research community. In this paper, we report on the methodological implications of conducting a secondary analysis of qualitative data focusing on parents’ narratives of help-seeking activities in the prodrome to psychosis. We review the literature on QSA, highlighting the main characteristics of the approach, and discuss issues and challenges encountered in conducting a secondary analysis. We conclude with some thoughts on the implications for conducting a QSA in children’s mental health services and research.

Understanding help seeking delay in the prodrome to first episode psychosis: a secondary analysis of the perspectives of young people.

First episode psychosis represents a critical period for intervention to prevent future impairments and to initiate optimal interventions. Using an interpretive interactionist framework, a secondary analysis of interview transcripts was conducted based on the narratives of youth experiences of psychosis. Our goal was to better understand the factors involved in the decision to seek help (or not) from the mental health system. Findings suggest that help seeking is a social process involving a wide range of influences; two such influences are highlighted in this paper, an individual avoidant strategy of ignoring and hiding early symptoms, and the persuasive influence of significant others in the social network.

A descriptive review of qualitative studies in first episode psychosis

Aim: The aim of this paper is to provide a descriptive review of published qualitative research studies on first episode psychosis (FEP).

Children's experiences of parental mental illness: a literature review

Aim: This paper provides a review of published qualitative research on childrens experiences of parental mental illness.

The dialectic of friendship for people with psychiatric disabilities.

In the psychiatric literature, the meaning and importance of friendship has remained largely unexplored, subsumed under the rubric of social support or viewed as a component of community integration. Twenty-one qualitative interviews were conducted with individuals suffering from psychiatric disabilities focusing on the meaning of friendship as they described it. Analysis revealed the contrasts, contradiction and paradox of friendship for this group of people. The ongoing struggles of people with psychiatric disabilities regarding the need to connect with others and have friends, and conversely, the need to be alone and to withdraw from others, was highlighted.

Youth at ultra high risk for psychosis: using the Revised Network Episode Model to examine pathways to mental health care

Aim: This paper aims to identify the ways in which youth at ultra high risk for psychosis access mental health services and the factors that advance or delay help seeking, using the Revised Network Episode Model (REV NEM) of mental health care.

Interpreting narratives of motivation and schizophrenia: a biopsychosocial understanding.

BACKGROUND The concept of motivation involves a complex interplay of biopsychosocial and environmental determinants. For individuals diagnosed with schizophrenia, motivation has traditionally been approached from a neuro-biological standpoint, obscuring this complexity. The findings from this study underscore the importance of broadening our understanding of motivation and schizophrenia through an exploration of individual perspectives and identification of the psychosocial factors that clarify the experience of diminished motivation.

Analysis of a Support Group for Children of Parents with Mental Illnesses Managing Stressful Situations

We report an ethnographic analysis of a psycho-education and peer-support program for school-aged children of parents with mental illnesses. We conducted a critical discourse analysis of the program manual and observed group interactions to understand whether children shared program goals predetermined by adults, and how, or if, the intervention was responsive to their needs. Children were expected to learn mental illness information because “knowledge is power,” and to express difficult feelings about being a child of a mentally ill parent that was risky. Participants used humor to manage group expectations, revealing how they made sense of their parents’ problems, as well as their own. Suggestions are made for determining good mental health literacy based on children’s preferences for explaining circumstances in ways they find relevant, and for supporting children’s competencies to manage relationships that are important to them.

Arts-based health research and academic legitimacy: transcending hegemonic conventions

Using the Canadian context as a case study, the research reported here focuses on in-depth qualitative interviews with 36 researchers, artists and trainees engaged in ‘doing’ arts-based health research (ABHR). We begin to address the gap in ABHR knowledge by engaging in a critical inquiry regarding the issues, challenges and benefits of ABHR methodologies. Specifically, this paper focuses on the tensions experienced regarding academic legitimacy and the use of the arts in producing and disseminating research. Four central areas of tension associated with academic legitimacy are described: balancing structure versus openness and flexibility; academic obligations of truth and accuracy; resisting typical notions of what counts in academia; and expectations vis-à-vis measuring the impact of ABHR. We argue for the need to reconsider what counts as knowledge and to reconceptualize notions of evaluation and rigor in order to effectively support the effective production and dissemination of ABHR.

Reflections of young people who have had a first episode of psychosis: what attracted them to use alcohol and illicit drugs?

Aim: To identify factors that contribute to the initiation of alcohol and street drug use from the perspective of people who were enrolled in early intervention programmes for a first episode of psychosis.