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This Element is the first monograph to focus on the presence and popularity of autofiction in contemporary theatre, a mode characterised by its mixture of autobiographical and fictional materials and generally associated with the cutting edge of literary fiction. To do so, it brings frameworks from literary and theatre studies to bear on a recent upsurge in plays that explicitly mobilise lived experience and its fictionalisation to political ends. Considering a comparative corpus of state-subsidised productions in Britain and Europe since the mid 2010s – both adaptations of literary works and plays written for the stage – this Element attends to autofiction's aesthetics and politics through its negotiation on stage of three conceptual binaries, each the focus of a section: fact/fiction, self/other, and inclusion/exclusion. By probing the mode's critical potential and pitfalls, it sheds light on the stakes of self-fictionalising practices in today's cultural markets and on the role of theatre therein.
Past experiences of mental healthcare which have been perceived as harmful can present significant barriers to accessing treatment again. This article draws upon research and lived experience to consider the ways in which conceptualisations of ‘trauma-informed care’ may better incorporate the role of iatrogenic harm, thus providing more acceptable and equitable treatment for those who have previously found treatment to be harmful. A more restorative approach is offered, founded in shared responsibility and compassionate relationships, to help minimise harms and create a more healing system for patients and clinicians alike.
This article explores the shift in mental health recovery from mere symptom management to a holistic approach via the CHIME framework. It delves into the author’s experience, beginning with the loss of his father, a war veteran with mental health struggles, at 16, thrusting him into the role of primary caregiver for his mother, who also battled mental health issues and eventually took her own life. These events spotlight the shortcomings of traditional mental health care and the urgent need for empathetic, multifaceted services. Advocating for co-creation in mental health services, the article outlines a transition towards a system that integrates recovery principles through stages from co-ideation to co-evaluation, emphasising holistic, person-centred care. It calls for a reimagined mental healthcare system that respects individual journeys and is rooted in co-creation, signalling a critical move towards systemic change.
Age-related changes can affect mental health, but aging-focused mental health research is limited. The objective was to identify the top 10 unanswered research questions on aging and mental health according to what matters most to aging Canadians. A steering group of experts-by-experience (e.g., older adults, caregivers, health and social care providers) guided three phases of a modified James Lind Alliance priority-setting partnership: (1) a broad national survey (n = 305) and a rapid literature scan; (2) a follow-up national survey (n = 703); and (3) four online workshops (n = 52) with a nominal group technique. Forty-two unique questions on aging and mental health resulted, of which 18 were determined to be answered by existing evidence. Of the 25 partially and unanswered questions, 10 were ranked as top priority. Findings can be used to prioritize future research, knowledge mobilization, and funding decisions, and to promote and support collaboration between longstanding siloed research and care fields.
Social contact refers to the facilitation of connection and interactions between people with and without mental health conditions. It can be achieved, for example, through people sharing their lived experience of mental health conditions, which is an effective strategy for stigma reduction. Meaningful involvement of people with lived experience (PWLE) in leading and co-leading anti-stigma interventions can/may promote autonomy and resilience. Our paper aimed to explore how PWLE have been involved in research and anti-stigma interventions to improve effective means of involving PWLE in stigma reduction activities in LMICs. A qualitative collective case study design was adopted. Case studies from four LMICs (China, Ethiopia, India and Nepal) are summarized, briefly reflecting on the background of the work, alongside anticipated and experienced challenges, strategies to overcome these, and recommendations for future work. We found that the involvement of PWLEs in stigma reduction is commonly a new concept in LMIC. Experienced and anticipated challenges were similar, such as identifying suitable persons to engage in the work and sustaining their involvement. Such an approach can be difficult because PWLE might be apprehensive about the negative consequences of disclosure. In many case studies, we found that long-standing professional connectedness, continued encouragement, information sharing, debriefing and support helped the participants’ involvement. We recommend that confidentiality of the individual, cultural norms and family concerns be prioritized and respected during the implementation. Taking into account socio-cultural contextual factors, it is possible to directly involve PWLEs in social contact-based anti-stigma interventions.
This study provides preliminary findings on the experiences of first responders during the opioid crisis and their viewpoints regarding whether clients with opioid use disorder deserve medical rehabilitation. Understanding associations between first responder experiences and viewpoints of client deservedness can help reduce stigma, improve compassionate care, and identify training gaps.
Methods:
Analyses were run with data from a nationwide survey of Emergency Medical Services-providers and law enforcement workers collected from August to November 2022 (N = 3836). The study used univariate statistics and ordered logistic regression to understand first responders’ experiences and viewpoints on client deservedness, as well as the relationship between the two.
Results:
Results show a negative correlation between responding to overdose calls and perceiving clients with opioid use disorder as deserving of medical rehabilitation. Law enforcement, males, and conservatives also had negative viewpoints. Conversely, having a friend experience addiction and believing addiction has had a direct impact on respondents’ lives predicted increases in client deservedness.
Conclusions:
Policy should focus on creating spaces where first responders can have positive interactions with people who use drugs or are in recovery. Better training is needed to help first responders manage on-the-job stressors and understand the complexities of addiction.
This chapter brings the sensory potentialities of material objects used in Roman ritualized activities into discourse concerning the nature and production of ancient religious knowledge. By combining perspectives derived from lived religion and material religion it is argued that religious agency should be understood as the product of the intertwining of human and more-than-human things within assemblages. Lived experiences of this production of agency, in turn, cause people to feel and consequently think in certain ways, ultimately producing what can be categorized as distal and proximal forms of religious knowledge. The chapter uses the example of the frieze of the Vestal Virgins from the Ara Pacis Augustae to argue that different forms of ancient religious knowledge were actively created through a multiplicity of lived experiences of ritualized action that brought human and more-than-human material things together, rather than existing only as something that was expressed through ritual behaviours. Exploring the Vestals’ experience of ritualized encounters with material things makes it possible to establish new understandings of the real-world lived experiences and identities of these priestesses, offering significant insights into how individualized forms of religious knowledge could be sustained even in the context of shared communal or public rituals.
From painted embellishments on altars and temples, marble flooring, dyed sacrificial ribbons and even the colouration of ritual animals, colour was an inescapable aspect of religious experience. Polychromy was not only decorative, it created a visual medium with which those navigating sacred spaces could interact, together with the written word and the language of shape and form. Colour could communicate to the ancient viewer associations of its source; the significance of both where its pigment or dyestuff was harvested and the journey it undertook, both in terms of manufacture and simple geography, in order to arrive before the observer. The very conception of ancient sight, with rays reaching from the eyes in a particularly haptic process of sensory feedback, meant that looking at colours was for the ancient viewer an experience in itself. How would visitors to the sacred spaces of the ancient world have ‘read’ the visual cues surrounding them, and how could the design of colours in ritual spaces influence the reactions and emotions of those witnessing sacred activity? This paper seeks to investigate and unpick some of the chromatic language found in religious spaces to better inform an understanding of ritual activity in Greco-Roman society.
Processions were among the earliest ‘moving pictures’ in which the brain could develop the cognitive process of ‘reading’ a landscape and embedding a memory through sensory experiences. Salutaris’ foundation, a text inscribed outside the theatre at Ephesus which records the organization of a ritual procession for Artemis, tends to be treated as a factual guide by scholars, rather than as aspirational script for an event: repeated legal clauses, claims of control and permanency, and the white marble on which it was carved, underwrite the vivid sensual experience and transiency of a ritual event. This paper endeavors to contextualize Salutaris’ foundation by incorporating directives of the text together with an analysis of the procession as a practical event and an emotional experience. As a sensorial experience, one can explore aspects of the performance that could not be controlled: the weather, the attitude of the audience, and the behaviour of the performers. Did aspirational directives of ritual behavior come to fruition in a ritual event? How did the experience of an event shape its role and meaning? This cognitive approach provides insights to both the ritual event and the ways that processions could be read by the viewer.
How do we experience ritual? What role does this experience play in the perception and codification memory? This chapter begins by considering the relationship between senses, cognition, and memory in ritual experiences, in particular, the complex interplay between ritual performance, emotions, and material objects, together with the limitations of script-based approaches to surviving accounts. Situating the volume within current debates on religious ritual in the ancient world from the perspectives of cognitive science of religion and sensory studies, this chapter explores how variability in ritual experiences can be assessed through cognitive approaches to rituals as lived experiences. Having outlined why this volume is timely, necessary, and how it contributes to challenging established views and furthering debate surrounding ritual experiences in the Roman world, the introduction also addresses the challenges of cognitive assessments and how these challenges are met across the volume, through a variety of different contexts and approaches. Lastly, the introduction briefly presents each of the five case studies, drawing on common themes and issues explored in each case study, and considering the global relevance and transdisciplinary applications of scholarship in this volume.
The study aimed to increase the understanding of the lived experience of patients during the acute phase of a coronavirus disease 2019 (COVID-19) infection.
Method:
A Web-based survey was distributed through established patient and public engagement and involvement groups and networks, social media, and by means of word of mouth. The survey covered questions relating to patient demographics, COVID-19 diagnosis, symptom profile, and patient experience during acute COVID-19.
Results:
The findings demonstrate the varying symptom profiles experienced by people in the acute stage of COVID-19 infection, with participants sharing how they managed care at home, and/or accessed medical advice. Findings also highlight themes that people were concerned with being unable to receive care and believed they needed to rely heavily on family, with extreme thoughts of death.
Conclusions:
Although the urgent threat to public health has been negated by efficacious vaccines and enhanced treatment strategies, there are key lessons from the lived experience of COVID-19 that should be used to prepare for future pandemics and public health emergencies.
This chapter explores some of the practices, interactions, and preferences of readers and fans as part of their lived comics cultures. Engagement with the medium has taken various forms, from casual readership and sharing titles among friendship groups in childhood, through to being a collector. Beyond simply involving reading comics, fandom can incorporate a range of other activities as part of an enhanced commitment to the medium, and various activities are touched upon. Further, it looks at how readers, both historically and today, have accessed their comics in varied formats and across many genres in Britain and the USA, linking their lived experience with production. In looking into these issues, the chapter engages with the work of various publishers, genres, and titles. It also engages with how reading comics and participating in fandom intersects with both age and gender, which this chapter adopts as lenses to look at constructions of childhood and comics reading. A final aspect of the chapter relates to how fan and reader interactions in these spaces and participation in activities often vary according to gender. Indeed, it can be argued that comics reading and collecting has been heavily gendered regarding both production and reception.
There is no disputing the current established global consensus that people with lived experience of a mental health condition (“people with lived experience”) play an integral role in influencing policy and processes in global mental health. Specifically, the role they hold as agents of change through which they can lead and co-lead projects on mental health, alongside a multidisciplinary team, as recommended in the findings of the report of Lancet Commission on ending stigma and discrimination (Thornicroft et al. [2022], “The Lancet Commission on ending stigma and discrimination in mental health”, Lancet, 400, 1438–1480). Immense value is associated with their unique expertise not learned through theoretical concept but based on real-life experience. Appreciating their involvement in processes is a human right, supported by international human rights instruments such as the United Nations Convention on the Rights of Persons with Psychosocial Disabilities (2006). However, there remains an expectation that people with lived experience are expected to be involved in processes and service delivery without receiving remuneration for their expertise. This article will provide the basis for which processes must follow the principle of equity; that lived experience expertise ought to be equally compensated for based on equal pay for equal work. In closing, it will provide a recommendation for stakeholders on how to improve upon effective engagement with people with lived experience, leading to meaningful and authentic contributions.
The introduction outlines the aims, methodology and time frame of the book, explains its structure and briefly introduces readers to the eight individuals whose diaries are the book’s principal source material. A succinct review of the literature on elite and popular ruralism in Britain follows, emphasizing that there has been far more research on the former than the latter. The pathbreaking work of Helen Walker, Harvey Taylor and Alun Howkins on popular ruralism is acknowledged and summarized. Although we now know much about the macro-history of popular ruralism (at least as expressed through the outdoor movement), we know much less about its micro-history – how the countryside fitted into the lived reality of people’s lives. This is the gap which this book aims to fill.
The aims of this study are to identify the challenges faced by non-palliative care professionals (NPCPs) in caring for end-of-life patients; determine how these challenges interact with and influence each other systemically; and advance the theories and practices for supporting NPCPs in the provision of quality end-of-life care beyond the boundaries of palliative medicine.
Methods
A constructivist phenomenological research design with an Interpretive-Systemic Framework of inquiry was adopted. Thirty-five physicians, 35 nurses, and 35 Medical Social Workers who play critical roles in caring for end-of-life patients and belonging to the 9 major medical disciplines of Cardiology, Geriatric, Intensive Care Medicine, Internal Medicine, Nephrology, Neurology, Oncology, Respiratory Medicine, and Surgery were recruited through purposive snowball sampling from 3 major public hospitals.
Results
Framework analysis revealed 5 themes and 17 subthemes that illuminate the individual, relational, cultural, institutional, and structural challenges that NPCPs faced in rendering end-of-life care. These challenges influence each other within the health-care ecosystem, serving to perpetuate or heighten care obstacles.
Significance of results
This is the first known study exploring the systemic challenges of NPCPs spanning 9 major medical disciplines and encompassing 3 professional stakeholders responsible for the care for end-of-life patients, thus ensuring perspective inclusivity across the health-care system. Recommendations that consider the complexity of the interactions between these systemic challenges are presented in detail.
Rural areas tend to be inhabited by more older people and thus have a higher prevalence of dementia. Combined with lower population densities and more sparse geography, rural areas pose numerous barriers and costs relating to support and resource provision. This may leave people with dementia in rural places at a significant disadvantage, leading to a heavy reliance on informal support networks. The present study explores the personal experiences of people living with dementia and carers living in rural areas, seeking to discover both benefits and challenges, as well as recommendations within the literature for improving the lives of those affected by dementia in rural areas. A scoping review following the framework of Arksey and O'Malley identified 60 studies that describe or discuss the personal experience of dementia (either by the person with dementia or carer), in relation to living in rural or remote geographical areas. Four overarching themes were derived, namely the possible benefits of living in a rural community (supportive rural communities), sources of strength described by people affected by dementia in rural areas (managing and coping), detrimental aspects of living in a rural community (rural community challenges) and difficulties with dementia care services. Three further themes yielded recommendations for improving the experience of dementia in rural areas. This review highlights some potential opportunities related to living in rural areas for people living with dementia. These often come with parallel challenges, reflecting a delicate balance between being well-supported and being in crisis for those living in rural areas. Given the limited access to formal services, supporting people with dementia in rural areas requires input and innovation from the people, organisations and services local to those communities.
Best practice requires the treating physician to understand the needs and hopes of his/her patient, particularly in relation to pregnancy and childbirth preferences. This is even more necessary for women with Severe Mental Illness (SMI) because of the complicated decisions they face balancing the need to continue medication in pregnancy to prevent relapse against any possible harm to the foetus. Objectives: To explore what women themselves view as most important when discussing pregnancy and childbirth with psychiatrists and what barriers there are to a) having a meaningful conversation and b) achieving optimum outcomes. Qualitative methods were used to analyse the data from in-depth interviews with 21 women, recruited from a South London NHS organisation (76%) and the UK’s national bipolar charity (24%). The views of 25 health professionals, including 19 psychiatrists, were also collected and analysed. Results: Many themes emerged but principally women wanted: information, continuity of care, better training for health professionals, to co-produce a detailed care plan, access to a Mother and Baby Unit, peer support and more research on medications in pregnancy. Conclusions: This study highlighted the importance of understanding women’s needs and fears and giving them the necessary information to make the difficult decisions that face them. Such understanding is likely to lead to more positive therapeutic relationships and better long-term outcomes.
This chapter introduces the handbook and outlines the volume’s organization, topics, themes, and intended audience. It clarifies the handbook’s goals of including both past and contemporary theory and practice as well as looking toward future trends in material culture studies. The authors discuss disciplinary contributions to material culture and provide the foundation for redefining the field’s relationship to disciplinarity. The guiding questions posed to contributing authors, what is material culture, and what are the implications of material culture scholarship, are presented. The chapter also introduces the geographic scope of the project, addressing and acknowledging differences and similarities that exist between the understanding of, framing of, and study of material culture in an international context.
The story of one African American woman's journey with substance use disorder and recovery. She examines the stigma that is associated with substance use disorder and how various interactions led to self-stigmatizing views.