all things #womensmentalhealth

Dr Rebekah Shallcross, AKA Mamafeminologist, mum of one, feminist, researcher and clinical psychologist has joined the Mental Health Research team at the School of Healthcare, University of Leeds. Here she talks about her research journey, the projects she’s worked on, and what led to her interest in all things #womensmentalhealth

In 2006 I was assigned my ‘last choice’ supervisor for my BSc undergraduate psychology research project (who knows, maybe I was also their ‘last choice’ student?!). The topic area: Implicit Memory Learning *insert crying emoji*. Safe to say, it was not ‘my bag’, and not the most enthusiastic start to my research career.

“When I proposed to write a review on violence within marital relationships, she responded with enthusiasm!

Despite this, in our final year we could choose between a taught course or completing a research dissertation. I chose the dissertation and this time I struck gold with my supervisor! When I proposed to write a review on violence within marital relationships, she responded with enthusiasm! This was research both she and I could get on board with! I don’t think I’d ever worked so hard and with as much motivation as I did on that project. It was the one piece of undergrad work where I was awarded a 1st and so it was here I think my interest in women’s mental health began…

Since then I have worked on several projects examining areas of health and mental health that predominantly affect women, completing my PhD on ‘Child Development Following in Utero Exposure: A Comparison of Novel and Established Antiepileptic Drug Treatment in Pregnancy’. This study compared the developmental outcomes of children under the age of 5 years who were exposed to antiepileptic medication (either levetiracetam or sodium valproate) in pregnancy. You can read more about it here.

Whilst this project didn’t specifically focus on women’s mental health, it gave me an insight into the way that medical profession can sometimes presume to know what is best for women… a theme that I picked up in my next piece of research, which again focused primarily on women’s physical health: ‘Women’s experience of Vulvodynia: A meta-ethnography of existing literature and an Interpretative Phenomenological Analysis of the journey towards diagnosis’. In this project women talked about their experiences of the medical profession when seeking a diagnosis for vulvodynia (an idiopathic pain experienced in the vulva) – and it was NOT GOOD! Some of the experiences that women had were shocking to me, and in others ways totally predictable (but that’s a whole other blog!)… you can read more about this study here and here.

“I knew I wanted to research perinatal mental health, domestic violence, sexual assault and all things #womensmentalhealth”

At this point, I definitely felt like a theme was developing, although I still wasn’t entirely sure what. It wasn’t until I saw an advert for a Post Doc Research Associate at The Centre for Women’s Mental Health at the University of Manchester that I even knew that Women’s Mental Health as a research topic was a thing! The project was looking at the effectiveness of perinatal mental health services for mothers in the first year of life: The ESMI study. It made me so excited! I applied, and got the job! This led me to work as an honorary researcher at The Section for Women’s Mental Health at King’s College London, where I spied on a desk Dr Kylee Trevillion’s PhD thesis examining how mental health services respond to domestic violence. I thought to myself: “This is the kind of research for me!” That really was a ‘lightbulb moment’ for me – whilst I had been broadly researching women’s mental health, I hadn’t ever really connected the dots in my mind before and named it as such. Now, I knew I wanted to research perinatal mental health, domestic violence, sexual assault and all things #womensmentalhealth. Ever since that realisation or ‘lightbulb moment’, it has been much easier for me to focus my attention on what to research. 

While I was working on the ESMI study, I was introduced to Prof Liz Hughes (@LizHughesDD) and instantly knew I wanted her to be my mentor! As we worked on the MiMoS grant application together, I asked and she said yes! And this really was a turning point for me: having Liz as my mentor has really helped me to focus, clarify my next steps, and envisage the research (and clinical) career that I want, whilst also helping me to gain that ever-so-elusive work-life-balance! Of particular importance with a 1-year old in tow…

Whilst Liz and I (and the rest of the MiMoS team) waited to hear the outcome of the application, I was lucky enough to work on the fantastic REPROVIDE project in Bristol: a study looking at the effectiveness of group programmes as an intervention for men who perpetrate domestic violence against their female partners. It was such a great experience working with researchers who were passionate about improving outcomes for people experiencing domestic violence. The success of the MiMos grant meant that I had to leave the REPROVIDE team, but we are now collaborating on a Research for Patient Benefit (RfPB) grant examining how change happens within these programmes.

It is an honour to be fortunate enough to exercise my passion pursuing research that aims to make a real difference to the mental health service provision of sexual assault survivors across the UK”

So now I find myself back in the North working as a Work Package Lead on the MiMoS study: an NIHR funded study looking at the Effectiveness of Sexual Assault Referral Centres (SARCs), which I helped to develop. It is an honour to be fortunate enough to exercise my passion pursuing research that aims to make a real difference to the mental health service provision of sexual assault survivors across the UK – and a far cry from neuroscience and the world of implicit memory learning!

The following links provide further support relating to the topics discussed in this blog:

You can contact Rebekah directly at mamafeminologist@gmail.com, or follow her on:

The Mimos Study

It’s lovely to have recently returned to the School of Healthcare, University of Leeds where I completed by PhD back in 2011. I have always looked back at my time in the Baines Wing with affection and it feels full circle to be back here working on another exciting project. This time I am working part-time as a Research Fellow on Professor Liz Hughes NIHR funded project “The Effectiveness of Sexual Assault Referral Centres with regard to Mental Health and Substance Use: A National Mixed Method Study” which is due for completion in May 2021. You can learn more about the project by visiting the Mimos website.

Alongside this post I am continuing my role as Researcher at Saint Mary’s Sexual Assault Referral Centre in Manchester where I have been working since 2015. As part of my Saint Mary’s SARC role, I was involved in the recent publication ‘The high prevalence of pre-existing mental health complaints in clients attending Saint Mary’s Sexual Assault Referral Centre: Implications for initial management and engagement with the Independent Sexual Violence Advisor service at the centre.’

The key findings were:

  • Prevalence of self-reported pre-existing mental health complaints in Saint Mary’s Centre adult clients was very high at 69% – the national average is 16 (McManus and colleagues, 2016)
  • Depression and anxiety accounted for most of these mental health complaints
  • Clients with mental health complaints took longer to present to the Saint Mary’s Centre than those without, although there was no difference in the long-term engagement with the Independent Sexual Violence Advisor service at the Centre between the two groups

The findings from this work demonstrate the need for the Mimos study. Being involved in this prevalence work at Saint Mary’s SARC was the catalyst for my involvement with the Mimos study.

Rabiya Majeed-Ariss is a Research Fellow at the University of Leeds and Researcher at St Mary’s Sexual Assault Referral Centre in Manchester. You can contact Rabiya here or directly, and you can follow her @r_majeedariss or on ResearchGate.

References

McManus and colleagues (2016) Mental Health and Wellbeing in England: Adult Psychiatric Morbidity Survey 2014, NHS Digital, Leeds.

Dignity. Period.

You may have seen a lot of news items about period poverty, where lack of money precludes some women from purchasing pads and/or tampons. You may have been shocked to hear that some girls were unable to attend school because they could not afford – or were too worried about their parents’ financial circumstances to ask them – to buy sanitary products. While Foodbanks request donations of pads and tampons, other campaigns, such as Bloody Good Period and Gift Wellness Foundation have been collecting and distributing sanitary products to homeless women, refugees and other vulnerable women. Today, on Menstrual Hygiene Day, The Body Shop have launched an initiative to collect products for Bloody Good Period at some of their stores. A scheme began in 2018 in Scotland to provide sanitary products in schools and Wales and England have recently followed. Unite the Union launched a campaign in 2018 for period dignity, urging employers to make sanitary products freely available in the workplace.

You may be surprised to learn that, at the time of writing, the NHS does not provide free sanitary products for patients, although the government has made a commitment to begin providing them as from July 2019. There is more to period poverty than money, however, as the organisers of Menstrual Hygiene Day hope to convey.

The cost of period poverty

Increased awareness of the potentially prohibitive cost of feminine hygiene products has brought the related costs of not having access to these products into sharp focus. GPs have reported increased rates of urinary tract infections resulting from the use of toilet roll or other makeshift solutions and/or prolonged use of specially designed products (increasing the risk of toxic shock syndrome). As well as health implications, lacking access to these products can disrupt education and employment. And then there is the negative impact on women’s dignity. The World Health Organisation defines dignity (in mental health) as:

Dignity refers to an individual’s inherent value and worth and is strongly linked to respect, recognition, self-worth and the possibility to make choices. Being able to live a life with dignity stems from the respect of basic human rights including: >Freedom from violence and abuse;
>Freedom from discrimination;
>Autonomy and self-determination;
>Inclusion in community life; and
>Participation in policy-making

Earlier this year, we blogged about how Liz Hughes, along with other members of MHNAUK and the Twitter community, issued a call for period dignity in “Seeing Red!”: Why We need Menstruation Awareness in Mental Health Services. The report highlights the challenges of managing menstruation in an unfamiliar setting, where you may not have the resources (or access to them), and documents some of the distressing and degrading experiences recounted by service users. Liz and her fellow authors call for the provision of sanitary products – which has been addressed – but also for more open discussion around menstruation in mental health settings and how mental health nurses can support this.

Mental Health Research in Leeds: Promoting safe, effective and therapeutic mental health care

Liz’ commitment to raising awareness of period poverty and stigma in mental health is just one example of how dignity is at the heart of our research endeavours in the Mental Health Research Group. For us, dignity and safety are intertwined: to protect and promote service user safety and reduce physical and mental harm is to actively demonstrate an individual’s worth. Through our research, whether our focus is on identifying ways to reduce restrictive practices (COMPARE & CONTRAST) or inequality and discrimination (asking about sexual identity), or examining how effective sexual assault referral centres are for people with mental health problems (Mimos Study, blog coming soon) or what happens when service users raise concerns about quality and safety (Mary Smith’s PhD research), our ultimate goal is dignity. Period.