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Recovery colleges in mental health-care services: an Australian feasibility and acceptability study
- Authors:
- HOPKINS Liza, et al
- Journal article citation:
- Mental Health and Social Inclusion, 26(1), 2022, pp.12-22.
- Publisher:
- Emerald
Purpose: This study aims to evaluate the feasibility and acceptability of establishing a recovery college in an Australian acute and community adult mental health service. Very little has been published on efforts to incorporate recovery colleges in inpatient settings other than forensic. This study offers an evaluation of feasibility and acceptability of this service model within a health-care setting. Design/methodology/approach: Participant feedback and qualitative implementation data, from an acute mental health-care inpatient ward and adult community care were used. Participants were mental health service consumers and staff. The intervention involved a co-produced, co-designed, co-delivered and co-received educational opportunity for mental health consumers, carers, staff and the community. Findings: Feedback from course participants indicates that learning objectives were met by the majority of participants, while stakeholders identified that establishing a recovery college within both the inpatient and community health-care service was feasible at a service level and broadly acceptable to consumers. Originality/value: Establishing an adult recovery college in inpatient and community care is likely to be effective re-orientating mental health-care services as well as improving outcomes for consumers. (Edited publisher abstract)
Linking the past and the present: service users’ perspectives of how adverse experiences relate to their admission to forensic mental health services
- Authors:
- CARTWRIGHT Jessica, LAWRENCE Daniel, HARTWRIGHT Christopher
- Journal article citation:
- Journal of Forensic Practice, 24(1), 2022, pp.63-78.
- Publisher:
- Emerald
Purpose: This study aimed to explore how forensic mental health service users make sense of their past adverse experiences. Secondly, it aimed to explore whether service users considered their adverse experiences to be related to their current stay in a forensic mental health setting. Design/methodology/approach: Interpretative phenomenological analysis was used to analyse interviews with eight service users in low and medium secure care. Six of the participants were male and two were female. Findings: Four super-ordinate themes emerged from the data: “Living amongst adversity”; “Managing adverse experiences”; “Making sense of going into secure care”; and “Coping with the past in the present”. All participants referred to multiple adverse experiences throughout their lives and used harmful coping strategies to manage these. Individual differences in how they related their past experiences to their detention in secure care were evident. Practical implications: Author guidelines state that this section is optional. Implications for clinical practice are discussed at length in the discussion section. Originality/value: This study offers an insight into the way in which forensic mental health service users make sense of their past traumas in relation to their current admission to secure services. To the best of the authors’ knowledge, no research has previously addressed this from the perspective of service users. (Edited publisher abstract)
Cultivating compassion through compassion circles: learning from experience in mental health care in the NHS
- Authors:
- CLARK Michael, et al
- Journal article citation:
- Journal of Mental Health Training Education and Practice, 17(1), 2022, pp.73-86.
- Publisher:
- Emerald
Purpose: This paper aims to discuss the importance of compassion in health care and experiences of Compassion Circles (CCs) in supporting it, placing this into the national policy context of the National Health Service (NHS), whilst focusing on lessons from using the practice in mental health care. Design/methodology/approach: This conceptual paper is a discussion of the context of compassion in health care and a description of model and related concepts of CCs. This paper also discusses lessons from implementation of CCs in mental health care. Findings: CCs were developed from an initial broad concern with the place of compassion and well-being in communities and organisations, particularly in health and social care after a number of scandals about failures of care. Through experience CCs have been refined into a flexible model of supporting staff in mental health care settings. Experience to date suggests they are a valuable method of increasing compassion for self and others, improving relationships between team members and raising issues of organisational support to enable compassionate practice. Research limitations/implications: This paper is a discussion of CCs and their conceptual underpinnings and of insights and lessons from their adoption to date, and more robust evaluation is required. Practical implications: As an emergent area of practice CCs have been seen to present a powerful and practical approach to supporting individual members of staff and teams. Organisations and individuals might wish to join the community of practice that exists around CCs to consider the potential of this intervention in their workplaces and add to the growing body of learning about it. It is worth further investigation to examine the impact of CCs on current concerns with maintaining staff well-being and engagement, and, hence, on stress, absence and the sustainability of work environments over time. Social implications: CCs present a promising means of developing a culture and practice of more compassion in mental health care and other care contexts. Originality/value: CCs have become supported in national NHS guidance and more support to adopt, evaluate and learn from this model is warranted. This paper is a contribution to developing a better understanding of the CCs model, implementation lessons and early insights into impact. (Edited publisher abstract)
Mental health service users’ lived experiences of recovery-oriented services: a scoping review
- Authors:
- LAU Rosalind, HUTCHINSON Anastasia
- Journal article citation:
- Mental Health Review Journal, 26(4), 2021, pp.403-423.
- Publisher:
- Emerald
Purpose: Over the past 15 years, mental health organisations have taken steps to move towards providing services that are more recovery-oriented. This review was undertaken to explore what is known about service users’ experience of services that have introduced a recovery-oriented approach to service provision. There is limited research evaluating consumers’ lived experiences of recovery-orientated care; a scoping review was chosen to provide an overview of the available research in this area (Munn et al., 2018). The purpose of this review was to summarize and synthesize current qualitative research exploring consumers’ experience of recovery orientated mental health care provision. Design/methodology/approach: This scoping review was undertaken as outlined by Arksey and O'Malley (2005). The five steps consisted identifying the research question; searching for relevant studies; selecting the studies; charting the studies; and collating, summarising and reporting the findings. Findings: Three key themes emerged from this review: translation of recovery policy to practice; ward environment; and recovery principles with five subthemes: engagement; not being listened to; shared decision-making; informational needs; and supportive and collaborative relationships. The themes and subthemes identified in each of the 18 studies are presented in Table 3. Research limitations/implications: This review highlights the different degree to which service users have received recovery-oriented recovery care. In the majority of cases, most service users reported few opportunities for nursing engagement, poor communication, inadequate information provision, a lack of collaborative care and mostly negative experiences of the ward environment. Because of the limited studies on mental health service users’ lived experiences of a recovery-oriented service, more clinical studies are needed and in different cultural contexts. Practical implications: On hindsight, the authors should have included service users in this review process as consumer inclusion is progressively emphasised in mental health educational and research activities. This review highlights that not all studies have involved service users or consumers in their research activity. Social implications: Service users need relevant information in a timely manner to participate in decision-making regarding their treatment and care. This review found that either no information was provided to the service users or it was provided in a limited and fragmented manner. This review also found inpatients reported limited opportunities to have meaningful participation in decision-making about their care. These findings have important social implications, as greater consumer engagement in the design and delivery of mental health services will increase community trust in the care provided. This in turn has the potential to facilitate greater community engagement in preventative mental health care. Originality/value: This is the first review to systematically synthesis consumers perspectives on the extent to which service providers are achieving the goal of implementing recovery-orientated practice into their service provision. Despite important policy changes, the findings of this review demonstrate that more work is needed to truly operationalise and translate these principles into practice. (Edited publisher abstract)
Black and ethnic minority carers perceptions on mental health services and support in the United Kingdom: a systematic review
- Authors:
- MILLER Eula, BOSUN-ARJIE Stella Foluke, EKPENYONG Stephen
- Journal article citation:
- Journal of Public Mental Health, 20(4), 2021, pp.298-311.
- Publisher:
- Emerald
Purpose: The purpose of this study was to examine and synthesise the empirical evidence on the perceptions of Black and Ethnic Minority (BAME) carers views on mental health (MH) services and support offered in the UK. Design/methodology/approach: A comprehensive search conducted by searching Medline, Cumulated Index to Nursing and Allied Health Literature and Psychology and Behavioural Sciences Collection served to identify relevant studies that explored the perceptions of BAME carers on MH services. Other key sources and reference list of identified journal articles were searched to ascertain that this review contains all relevant studies and captured studies not indexed in the databases. Using the Critical Appraisal Skills Programme tool, 20 relevant studies published between 1996 and 2020 retrieved were and reviewed. From the reviewed papers five themes emerged which summarised the perception of BAME carers views on MH services and support services offered in the UK. Findings: Critical appraisal of 20 studies that met the ascribed inclusion criteria was undertaken. A total of 18 studies were of qualitative design, one used a quantitative approach and one was a systematic review. Several themes addressing the participants’ views were identified from the studies. The core themes central to these studies were: awareness and utilization of available MH services, language barriers to accessing MH services, positive experience whilst in contact with MH services, negative experience whilst in contact with MH services and difficulties in seeking help. Research limitations/implications: One of the review criteria was to focus on peer-reviewed articles; grey literature was exempted from the search for relevant studies. Although a systematic literature review was conducted, there is the possibility that some appropriate studies were not identified. This could be because of different use of key terms in some of the studies. Papers that identified and acknowledged BAME MH carers and MH services were focused on, which resulted in 20 eligible studies for synthesis. Originality/value: This review revealed the perception of BAME carers on MH services and available support offered. It highlighted that a significant number of BAME carers had limited understanding of the range of available MH services and support on offer within the UK. The review highlighted that fear of stigmatisation, discrimination in conjunction with the formulaic nature of MH services, delayed at best and inhibited at worst BAME Carers from accessing support from MH services, which consequentially had detrimental effects on service users receiving the timely appropriate support needed (Mermon et al., 2016). It is, therefore, a recommended imperative that MH services are deliberate in their endeavour to be inclusive, culturally embracing and accessible, if the MH needs of diverse ethnic minority groups within the UK are to be met appropriately. (Edited publisher abstract)
Change processes within team formulations in intellectual disabilities services: what do multi-disciplinary staff find helpful?
- Authors:
- HYMERS Gemma, DAGNAN Dave, INGHAM Barry
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 15(6), 2021, pp.241-252.
- Publisher:
- Emerald
Purpose: A biopsychosocial case formulation is an important tool for understanding complexity and guiding treatment for people with intellectual disabilities. It has been suggested that formulation meetings develop staff understanding of individuals they support. This study aims to explore the change processes that occur as a result of professional team formulation meetings, and the mechanisms that facilitate and hinder these events. Design/methodology/approach: Eight clinicians who took part in multi-disciplinary team-based formulations in an inpatient mental health service for adults with intellectual disabilities were interviewed. Interviews were examined using thematic analysis. Findings: The key themes identified were: “gaining information”, “altered thoughts” and “focused goals”. These themes were supported by “collaborative working” and “time for reflection” and were hindered by “poor communication and interaction” and inconsistent “staff attendance”. Originality/value: Multi-disciplinary team formulation meetings may have a number of change processes that affect staff knowledge and perception of the people that they support. The facilitation of these processes should be a focus for further development. (Edited publisher abstract)
Research watch: trauma-informed mental health care and avoiding exclusion of people with a psychosis diagnosis from trauma therapies
- Author:
- HOLTTUM Sue
- Journal article citation:
- Mental Health and Social Inclusion, 25(2), 2021, pp.109-116.
- Publisher:
- Emerald
Purpose: This paper aims to highlight emerging research relating to the need to recognise and address trauma in mental health service users. Design/methodology/approach: The author searched for papers on trauma-informed care, published in the past two years. Findings: One paper reports ideas of service users and family members for trauma-informed mental health services. A second paper describes an online survey seeking agreement between staff and service users of early intervention services for psychosis about practices of trauma-informed care. Both papers feature themes about safety and staff having training and support for asking about and responding to trauma. A third paper reports on specific therapies for trauma with people who experience psychosis. It found some evidence for talking therapies but noted that people with a psychosis diagnosis are rarely offered such therapies. Originality/value: These papers highlight an emerging consensus about essential components of trauma-informed care and the need for staff training and support to realise it. The exclusion of people with a psychosis diagnosis from specific trauma therapies might begin to be addressed if services were more able to recognise trauma. There is some evidence that talking therapies for childhood trauma can be helpful for people who have a psychosis diagnosis. However, evidence reviews should be broadened to include a range of distressing experiences recognised to follow childhood trauma irrespective of whether the person has a psychosis diagnosis. (Edited publisher abstract)
Recognizing service users’ diversity: social identity narratives of British Pakistanis in a mental health context
- Authors:
- HUSSAIN Basharat, et al
- Journal article citation:
- Journal of Mental Health Training Education and Practice, 16(3), 2021,
- Publisher:
- Emerald
Purpose: This study aims to investigate how British Pakistani people talk about their social identity, in the context of mental health, and how this shapes their experiences and perceptions of care delivered by the National Health Service, UK. Design/methodology/approach: Eight narrative interviews were conducted among members of the Pakistani community living in a city in the UK. The data were analyzed using a narrative analysis approach using “social identity” as a theoretical lens. Findings: Considering Pakistani service users as a single social entity, and responding with generic approaches in meeting their mental health needs, may not be helpful in achieving equitable treatment. Study participants reject a simple conceptualization of race and ethnicity and how a response based upon stereotypes is woefully inadequate. The study revealed that people from one ethnic or national background cannot be assumed to have a fixed social identity. Originality/value: This study broadens understanding of how people from a single ethnic background may construct and view their social identities markedly different to others from the same ethnic group. This has implications for service providers in understanding how their clients’ social identity is treated and understood in practice. (Edited publisher abstract)
How well do children in the North East of England function after a crisis: a service evaluation
- Authors:
- STAITE Emily, et al
- Journal article citation:
- Mental Health Review Journal, 26(2), 2021, pp.161-169.
- Publisher:
- Emerald
Purpose: Data shows that there is an increasing number of young people in the UK needing access to mental health services, including crisis teams. This need has been exacerbated by the current global pandemic. There is mixed evidence for the effectiveness of crisis teams in improving adult functioning, and none, to the authors’ knowledge, that empirically examines the functioning of young people following intervention from child and adolescent mental health services (CAMHS) crisis teams in the UK. Therefore, the purpose of this paper is to use CAMHS Crisis Team data, from an NHS trust that supports 1.4 million people in the North East of England, to examine a young person's functioning following a crisis. Design/methodology/approach: This service evaluation compared functioning, as measured by the Outcome Rating Scale (ORS), pre- and post-treatment for young people accessing the CAMHS Crisis Team between December 2018 and December 2019. Findings: There were 109 participants included in the analysis. ORS scores were significantly higher at the end of treatment (t(108) = −4.2046, p < 0.001) with a small effect size (d = −0.36). Sixteen (15%) patients exhibited significant and reliable change (i.e. functioning improved). A further four (4%) patients exhibited no change (i.e. functioning did not deteriorate despite being in crisis). No patients significantly deteriorated in functioning after accessing the crisis service. Practical implications: Despite a possibly overly conservative analysis, 15% of patients not only significantly improved functioning but were able to return to a “healthy” level of functioning after a mental health crisis following intervention from a CAMHS Crisis Team. Intervention(s) from a CAMHS Crisis Team are also stabilising as some young people’s functioning did not deteriorate following a mental health crisis. However, improvements also need to be made to increase the number of patients whose functioning did not significantly improve following intervention from a CAMHS Crisis Team. Originality/value: This paper evaluates a young person’s functioning following a mental health crisis and intervention from a CAMHS Crisis Team in the North East of England. (Edited publisher abstract)
When policy fails try something different integrated practice improve outcomes for dual diagnosis co-occurring service users accessing mental health services
- Authors:
- DUGMORE Lois, BAUWERAERTS Saskia
- Journal article citation:
- Drugs and Alcohol Today, 21(2), 2021, pp.157-170.
- Publisher:
- Emerald
Purpose This paper aims to discuss an initiative developed between, Leicestershire Partnership National Health Service Trust and Turning Point, which is the locally commissioned drug and alcohol service in Leicester, Leicestershire and Rutland. The aim was to improve outcomes for clients with dual diagnosis (co-occurring mental health and substance misuse) issues. The purpose of the change in working practice was to engage with local substance misuse agencies more effectively to improve clinical outcomes within this service user group. This was achieved through four interrelated approaches. This comprising providing an integrated service. It included building relationships with substance misuse services, providing specialist dual diagnosis clinics and the introduction of substance misuse workers onto mental health wards and group work specific to substance misuse. The outcomes included easier access to services for service users and greater uptake of service users who were moving onto substance misuse services. This led to a reduction in risk related to prescribing and fewer incidents related to prescribing changes and greater engagement in services. When service users were moving between services better communication led to prescriptions being transferred with no delay and to reduced dropout rates in service. There was improved access to substance misuse services, more referrals and take up of service taking place. There was a greater understanding by staff of co-occurring substance misuse and how to work with this client group. Closer working relationship with substance misuse services and shared skills led to greater confidence in managing this service user group. This demonstrates a cost effective service that can be replicated within similar settings. Design/methodology/approach: Group Substance Misuse programmes. Findings: Working within an integrated model, yet maintaining separate organisations, by offering joint training and clinics has led to a greater understanding of each organisation’s work and increased engagement within the service user group. The introduction of substance misuse workers to acute and rehab mental health inpatient services encouraged service users to engage at the point of admission and to be referred into locally commissioned substance misuse services prior to the point of discharge. Engagement with staff has demonstrated better engagement with substance service by service users following discharge. For clients able to take leave assessment could take place prior to discharge. This led to an increased uptake in services. Due to no opiate substitution given on discharge decreased risk of prescribed medication overdose at point of discharge and led to increase in returning straight to substance misuse services. This meant that service users received medication quicker and the right dose and on discharge ensured reduced risk. The prescribing of Naloxone at discharge is yet to be assessed, but the risk of an overdose within seven days is well-documented and Naloxone is key in reversing this trend. This change in practice can be replicated in any mental health setting and has increased access to services for those using substances. Originality/value: Is original no other services have substance workers or joint clinics across the UK. First inpatient unit to welcome patients back post-discharge to attend groups. (Edited publisher abstract)