Priscilla Ennals

Postsecondary study and mental ill-health: a meta-synthesis of qualitative research exploring students’ lived experiences

Abstract Background: The postsecondary educational experiences of students living with mental health issues are not well understood. Existing studies are generally qualitative, small and context-specific in nature, and individually have limited influence on policy and practice. Aims: To identify and synthesise the findings of qualitative studies exploring student views of studying while living with mental ill-health. Method: A systematic search of six electronic databases including CINAHL, ERIC, PsycINFO and Medline up to March 2013 was conducted. Findings were extracted from included studies and combined using qualitative meta-synthesis to identify core processes. Findings: The search identified 16 studies from five countries, with a total of 231 participants. Meta-synthesis of the findings revealed three common core processes: (1) knowing oneself and managing one’s mental illness, (2) negotiating the social space, and (3) doing the academic work required for successful postsecondary participation. Conclusion: Beyond the learning processes that underpin studying, these findings suggest knowing oneself and negotiating social spaces of educational settings are key processes for students living with mental ill-health seeking to survive and thrive in postsecondary education. With increased awareness of these processes, students and policy makers may conceive new ways to optimise student experiences of postsecondary study.

Supporting Students with Invisible Disabilities: A Scoping Review of Postsecondary Education for Students with Mental Illness or an Acquired Brain Injury

Abstract Students with invisible disabilities such as mental illness or acquired brain injury (ABI) experience multiple barriers that reduce their likelihood of postsecondary course completion. The present study conducted a systematic search of research reporting interventions for students experiencing mental illness or ABI to participate in postsecondary education. Nine databases were searched and a framework for categorising interventions and outcomes was developed. Forty-two studies revealed that most interventions were focused at the individual student level aiming to support students to build skills, grow confidence, or compensate for challenges through educational adjustments. There was wide diversity in research approaches used and a dearth of rigorous research designs. This review offers a more consistent way to define interventions and outcomes to guide future research and facilitate more meaningful comparisons between studies. The impacts of specific interventions on students’ attainment of qualifications and subsequent workforce participation need further investigation.

Postsecondary education: Kindling opportunities for people with mental illness

Education is recognized in many sectors of society as essential for empowerment and better lives, and postsecondary education is increasingly a prerequisite for many occupations. Given its onset in late adolescence and early adulthood, mental illness frequently disrupts secondary or tertiary education, and resulting lower educational attainment contributes to reduced lifetime employment and earning potential. Yet, supporting people with mental illnesses to pursue postsecondary education offers pathways to vocational qualifications and more diverse opportunities for employment and career advancement. While substantial efforts have been made to develop evidence-based interventions to improve employment outcomes for people with mental ill health, less is known about the best ways to enable people with mental illness to successfully return to study and to pursue their educational goals. This paper briefly discusses supported education, an approach designed to provide pathways and supports for reengagement in education; it highlights the potential of modeling educational support on Individual Placement and Support principles used in supported employment programs; and calls for greater efforts in research and practice to enable youth or adults with mental illness to reengage in education so as to improve their educational outcomes and career prospects.Education is recognized in many sectors of society as essential for empowerment and better lives, and postsecondary education is increasingly a prerequisite for many occupations. Given its onset in late adolescence and early adulthood, mental illness frequently disrupts secondary or tertiary education, and resulting lower educational attainment contributes to reduced lifetime employment and earning potential. Yet, supporting people with mental illnesses to pursue postsecondary education offers pathways to vocational qualifications and more diverse opportunities for employment and career advancement. While substantial efforts have been made to develop evidence‐based interventions to improve employment outcomes for people with mental ill health, less is known about the best ways to enable people with mental illness to successfully return to study and to pursue their educational goals. This paper briefly discusses supported education, an approach designed to provide pathways and supports for reengagement in education; it highlights the potential of modeling educational support on Individual Placement and Support principles used in supported employment programs; and calls for greater efforts in research and practice to enable youth or adults with mental illness to reengage in education so as to improve their educational outcomes and career prospects.

Navigating the complexity of disability support in tertiary education: perspectives of students and disability service staff

ABSTRACT Access to education is a right for all students. This right is typically realised through the provision of disability support and reasonable adjustments to enable tertiary students with disabilities to participate on an equal footing with their peers. This paper presents perspectives of disability service staff and students about implementing and using reasonable adjustments. Data were collected at 2 tertiary institutions in Australia through interviews with 25 students with disabilities and 7 disability service staff. Data were thematically analysed. The complexity of and variability in the processes of negotiating and implementing disability support were identified as an overarching theme in the data. These processes involved engaging multiple parties. The task of negotiating reasonable adjustments is used to illustrate some of the complexities inherent in supporting students with disabilities. These findings challenge existing assumptions that support is easily accessible and simply provided. They highlight the complexity of using reasonable adjustments, and the tendency for this to be seen as a student responsibility. Finally, the findings imply that disability services need to reorient from a focus on care and concern towards a rights orientation and foster students’ skills in self-advocacy to better enable them to negotiate without disadvantage.

Bridging Identity "Chasms": Occupational Therapy Academics' Reflections on the Journey towards Scholarship.

ABSTRACT The performative context of higher education demands that practice-oriented academics shift their priorities from preparing practitioners for the profession, towards ‘productive’ scholarship. We present narratives from occupational therapy academics at the end of a year-long journey through an action research project focussed on academic identity and scholarly growth. Our analysis captures subtle and striking shifts in being and becoming, doing and belonging. The findings, re-presented as an adapted Hero’s Journey, also reveal the powerful impacts on identity and practice that are enabled when academics have the opportunity to create spaces for scholarship that are experienced as caring, collaborative and collegial.

Supporting scholarly identity and practice: Narratives of occupational therapy academics:

Introduction Internationally, an increasing number of occupational therapists are making the transition from clinical practice to academia. Many make this transition with strong practitioner identities, limited academic skills, and inadequate preparation for a competitive academic environment. A group of 13 Australian occupational therapy academics participated in blogs as part of a 12-month action research project, with the aim of being and becoming more scholarly academics. Method Throughout an action research project titled Growing Scholarship, co-participants/researchers participated in a closed blog for sharing experiences of being and becoming more scholarly academics. In the present study, qualitative data from the blogs were analysed through an iterative and inductive process and themes generated by the research team. Findings Constructing and reconstructing identity emerged as a key theme during analysis of the blogs, with the sub-themes striving to reach one’s potential and growing through collaboration and support emphasising the significance of individual and macro factors in shaping academic identity formation. Conclusion This study demonstrated how the occupation of blogging can be used to support the scholarly identity and practice of occupational therapy academics. Other professionals facing change and uncertainty in the workplace could consider a similar approach to support the process of identity reconstruction.

Occupational therapy intervention in mental health should be individualised, occupation focussed, promote inclusion and occur in the context of an authentic relationship.

Research objective: To describe perceptions of clients and carers regarding effective interventions used by occupational therapists in mental health. Design: Synthesis of qualitative research studies. Search strategies: CINAHL, AMED, ASSIA and Scopus were searched. Subject and keyword searches were conducted in the areas of: mental health disorders, occupational therapy, interventions used by occupational therapists and qualitative research. Selection criteria: Eligible studies included occupation-focussed interventions, occupational participation and performance tasks and provided detail about the nature of the interventions, the ways in which they were used, adoption of the interventions, and their perceived benefits. Interventions were carried out in settings where mental health occupational therapists work with adult or older adult populations and had a focus on mental health/illness. The studies were primary qualitative research, published between 2000 and 2011 in peer reviewed journals. Methods of review: Studies that met the inclusion criteria were appraised in terms of quality. Appraisal involved completing a four-point rating scale (scores ranged from 0 to 3) for seven criteria. Studies that scored 2 or 3 in at least five of the criteria were included in the analysis. Analysis was conducted in three stages, resulting in three tiers of themes. The analysis involved all three authors and meetings with three steering groups of clients and occupational therapy practitioners to review and help refine the themes at each stage. Main findings: Twenty-two papers met the criteria for inclusion in the analysis. Meta synthesis suggested four themes describing characteristics central to effective intervention: (i) professional artistry: the ability of the therapist to develop authentic trusting relationships and the use of sound professional reasoning and reflection illustrated through pragmatism; (ii) occupational engagement: clients valued creative activities, community focussed integration, vocational and home support and group work which provided opportunity for healing, self-rediscovery, identity formation participation and acceptance in the community; (iii) new horizons: supporting shifts in clients perceptions of themselves and their futures through awareness of client capacity and self belief, appreciation of the wider socio-cultural context, discussion of occupational gains and working through resistance; and (iv) inclusion: promoting client identity, participation and sense of belonging in relation to a range of socio-cultural contexts. Authors’ conclusions: Occupational therapists need to demonstrate their therapeutic effectiveness and impact on clients and carers occupational lives to enable the profession to be recognised for its contribution. Contact details for author of appraised paper: k.wimpenny@coventry.ac.uk

Managing reading and related literacy difficulties: University students’ perspectives

Abstract This study explored the experiences of university students who identified as always having had reading difficulties. Thirty-three participants, all from one Australian university, were surveyed and 10 were also interviewed. Findings revealed that many shared academic challenges related to studying, along with a belief that their difficulties were not well understood by staff or peers. While participants disclosed many similar personal struggles related to completing their studies, positive attributes such as determination and time management strategies were frequently mentioned as instrumental in allowing them to reach university. Experiences were more variable regarding awareness of, access to, and satisfaction with university-based support and academic adjustments. To facilitate optimal inclusive educational practices, this study supports the need for greater awareness among staff about challenges faced by these university students along with a more individualised and targeted approach to providing them with academic supports and accommodations.