EMILIA project shows significant improvement in employment and wellness rates for mental health service users Dr Peter Ryan, Professor of Mental Health at Middlesex University’s School of Health and Social Sciences, and colleagues from Middlesex and other European institutions presented results from the largest ever EU funded project on mental health at a recent conference held in Paris. The conference was attended by over 200 mental health professionals, service users and policy makers from across the EU and world-wide.
The project, EMILIA – the Empowerment of Mental Illness Service Users : Lifelong Learning, Integration and Action - attracted funding of 3.4m Euros and was carried out over a period of four and half years. It contributes to the EU’s Lifelong Learning and Social Agenda which aims to create education and work opportunities, and improve access for groups which have experienced social exclusion.
Professor Ryan, Field Leader and cross-national co-ordinator of EMILIA, drew up the project outline in response to a focus in the EU on initiatives which would drive lifelong learning and social inclusion. EMILIA aimed to focus on ways of empowering mental health service users through lifelong learning initiatives by pioneering ways in which socially excluded people can become more included and accepted in their communities. Project outcomes suggest that income and employment opportunities for service users have been enhanced, that the methods which were trialled have worked effectively, and that there may be significant scope to expand such initiatives to other socially excluded groups. EMILIA focused on devising a five-step process aimed at mental health service users – aiding recovery, promoting social inclusion, employment and return to work, and tackling barriers to employment and formal learning which mental health service users often encounter. Members included people with long-term mental health problems such as schizophrenia and bi-polar disorder. The Middlesex research team worked with four local mental health user groups who had links with the University and local NHS Trusts. There was also very close collaboration between the team and Middlesex’s nationally recognised Centre of Excellence (CETL) in Social Work and Mental Health - the CETL offered sessional employment opportunities to EMILIA students, which has considerably enhanced their social inclusion. The process was developed across eight project territories, with input and feedback from mental health service user groups. Other project site locations were a mix of urban and rural settings and included Paris, Warsaw, Barcelona, Boda (Norway), Bosnia and Stroestrum (Denmark). Research strands focused on three areas - the individual experience, the process and barriers to lifelong learning strategies and partnerships, and economic cost analysis.
Training sessions were all designed by service users themselves to be relevant to their own issues and circumstances. An innovative feature was that sessions were also delivered by trainers drawn from within the user groups. For participants, the fact that the trainers had experienced similar mental health issues to themselves gave the sessions added credibility. Many members saw the trainers as potential role models – the experience also gave the trainers themselves more confidence. Researchers observed but did not lead or take an active part in training sessions.
Feedback from participants was highly positive. One attendee praised the ‘versatility and variety of tutors and the fact that we were all mental health service users’, whilst another said: “It was good that the teachers were in the same position as us (i.e. mental health users)...it gave me more of a push to achieve as well”. Finding a job was the main goal for many participants (40%), whilst others wanted to continue their lifelong learning studies and do more training. Statistics showed that in most groups there was an increase of almost 100% in competitive paid employment (from 7.3%% to 14.6% in a 20 month period). Similar increases were seen in voluntary employment levels. Attendance at psychiatric hospital also showed reductions during of the project, dropping from an average of 14 days to 7 days per participant over a 20-month period.
Professor Ryan said: “Empowering users has been a key focus of EMILIA and we have seen some really encouraging activities develop amongst our study groups – students have put together a digital diary, they have been involved in learning training packages and some groups have decided to carry on working together, developing a collective learning group”. Commenting on the overall project outcomes, Professor Ryan said: “Engaging with a socially excluded multiply-disadvantaged group and consulting them about their needs is empowering and enables the individuals – mental health service users in this case - to realise their potential. It also helps those who are currently held back from realising their potential and has demonstrated success in encouraging access for this group. Our work on the EMILIA project has also seen a high level of co-operation develop between member states across borders and we believe this area could be strengthened, through the Lisbon Treaty where mental health is a main driver, to the benefit of other socially excluded and minority groups across EU territories”. Key project outcomes included the development of resources such as a lifelong learning planning tool, training programmes which are available publicly online, and a tool which identifies obstacles and solutions to enable organisations to become effective deliverers of lifelong learning to disadvantaged and socially excluded groups. EMILIA initiatives have also led to the development of new roles for service users such as trainers and personal medicine coaches. Universities and health care centres have also benefited from the experience and knowledge of mental health service users, incorporating mental health service users’ contributions into health care management and education initiatives.
Professor Waqar Ahmad, Deputy Vice-Chancellor Research and Enterprise at Middlesex University, said: “We are delighted to see Professor Ryan, his team here at Middlesex and mental health research colleagues bring this major European research initiative to fruition. It is still all too easy for people with mental health issues to become isolated from their community or society and the EMILIA project has played a significant role in combating this, pioneering new ways of working with mental health service users, which are leading to greater participation in the employment and social arenas for these groups. The research findings have implications across many other sectors and we hope that recommendations within the final project report will help strategists to develop and shape the structure of social initiatives in the future”.
Recommendations in the EMILIA team’s final report include promoting the dissemination of EMILIA learning packages, developing a European network of mental health service providers who can spread out the programme, ensuring that lifelong learning policies and strategies include strategies which will engage the variety of socially excluded groups in EU; and helping disadvantaged people to develop confidence, motivation, self efficacy, hope – all factors which play a large part in enabling people to take up opportunities in education and employment and to benefit fully from social and community interaction.