51
|
Loranger C, Fleury MJ. Factors Associated with Perceived Continuity of Care Among Patients Suffering from Mental Disorders. Community Ment Health J 2020; 56:670-679. [PMID: 31863224 DOI: 10.1007/s10597-019-00528-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 12/11/2019] [Indexed: 11/29/2022]
Abstract
This cross-sectional study identified variables associated with continuity of care among 327 patients with mental disorders receiving services from a variety of professionals in different Quebec settings. Based on the Andersen's Behavioral Model, a linear regression analysis was performed. Attention deficit and mood disorders were negatively associated with continuity of care, while substance use disorders and quality of life revealed positive associations. Consulting a psychologist was linked to weaker continuity of care whereas visiting a drug rehabilitation center, social support, and satisfaction with services were positively related. Fostering social support, comprehensive and integrated care, and facilitating access to psychologists could lead to improved continuity of care.
Collapse
Affiliation(s)
- Claudie Loranger
- Research Centre, Centre intégré de santé Et Services Sociaux de L'Outaouais, 20 rue Pharand, Gatineau, QC, J9A 1K7, Canada
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montréal, QC, Canada
- Department of Psychiatry, McGill University, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Marie-Josée Fleury
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montréal, QC, Canada.
- Department of Psychiatry, McGill University, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada.
| |
Collapse
|
52
|
Weich S, Fenton SJ, Staniszewska S, Canaway A, Crepaz-Keay D, Larkin M, Madan J, Mockford C, Bhui K, Newton E, Croft C, Foye U, Cairns A, Ormerod E, Jeffreys S, Griffiths F. Using patient experience data to support improvements in inpatient mental health care: the EURIPIDES multimethod study. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
All NHS providers collect data on patient experience, although there is limited evidence about what to measure or how to collect and use data to improve services. We studied inpatient mental health services, as these are important, costly and often unpopular services within which serious incidents occur.
Aims
To identify which approaches to collecting and using patient experience data are most useful for supporting improvements in inpatient mental health care.
Design
The study comprised five work packages: a systematic review to identify evidence-based patient experience themes relevant to inpatient mental health care (work package 1); a survey of patient experience leads in NHS mental health trusts in England to describe current approaches to collecting and using patient experience data in inpatient mental health services, and to populate the sampling frame for work package 3 (work package 2); in-depth case studies at sites selected using the work package 2 findings, analysed using a realist approach (work package 3); a consensus conference to agree on recommendations about best practice (work package 4); and health economic modelling to estimate resource requirements and potential benefits arising from the adoption of best practice (work package 5). Using a realist methodology, we analysed and presented our findings using a framework based on four stages of the patient experience data pathway, for which we coined the term CRAICh (collecting and giving, receiving and listening, analysing, and quality improvement and change). The project was supported by a patient and public involvement team that contributed to work package 1 and the development of programme theories (work package 3). Two employed survivor researchers worked on work packages 2, 3 and 4.
Setting
The study was conducted in 57 NHS providers of inpatient mental health care in England.
Participants
In work package 2, 47 NHS patient experience leads took part and, in work package 3, 62 service users, 19 carers and 101 NHS staff participated, across six trusts. Forty-four individuals attended the work package 4 consensus conference.
Results
The patient experience feedback cycle was rarely completed and, even when improvements were implemented, these tended to be environmental rather than cultural. There were few examples of triangulation with patient safety or outcomes data. We identified 18 rules for best practice in collecting and using inpatient mental health experience data, and 154 realist context–mechanism–outcome configurations that underpin and explain these.
Limitations
The study was cross-sectional in design and we relied on examples of historical service improvement. Our health economic models (in work package 5) were therefore limited in the estimation and modelling of prospective benefits associated with the collection and use of patient experience data.
Conclusions
Patient experience work is insufficiently embedded in most mental health trusts. More attention to analysis and interpretation of patient experience data is needed, particularly to ways of triangulating these with outcomes and safety data.
Future work
Further evaluative research is needed to develop and evaluate a locally adapted intervention based on the 18 rules for best practice.
Study registration
The systematic review (work package 1) is registered as PROSPERO CRD42016033556.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 21. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Scott Weich
- Warwick Medical School, University of Warwick, Coventry, UK
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Sarah-Jane Fenton
- Warwick Medical School, University of Warwick, Coventry, UK
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Sophie Staniszewska
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK
| | | | | | - Michael Larkin
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Jason Madan
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Kamaldeep Bhui
- Centre for Psychiatry, Wolfson Institute of Preventative Medicine – Barts and The London, Queen Mary University of London, London, UK
| | | | - Charlotte Croft
- Warwick Business School, University of Warwick, Coventry, UK
| | - Una Foye
- Centre for Psychiatry, Wolfson Institute of Preventative Medicine – Barts and The London, Queen Mary University of London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Aimee Cairns
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Stephen Jeffreys
- Mental Health Foundation, London, UK
- National Survivor User Network, London, UK
| | | |
Collapse
|
53
|
Juliá-Sanchis R, Cabañero-Martínez MJ, Cabrero-García J, Congost-Maestre N, Escribano S. The Spanish version of the Psychiatric/Mental health clinical placement survey and an assessment of Spanish student attitudes towards mental health. J Psychiatr Ment Health Nurs 2020; 27:185-193. [PMID: 31605650 DOI: 10.1111/jpm.12568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 09/22/2019] [Accepted: 10/09/2019] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The Psychiatric/Mental Health Clinical Placement Survey preplacement, validated in English and widely used, assesses nursing student attitudes towards the mental health field. There are no validated scales in Spanish to assess students' attitudes towards mental health, nor is there evidence of attitudes in Spanish students. WHAT DOES THIS ARTICLE ADD TO EXISTING KNOWLEDGE?: The present study was the first to address the validity of a scale which evaluates nursing student attitudes towards mental health issues, in Spanish. Until now, no knowledge was available on nursing student attitudes towards mental health issues in the Spanish context. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The results provide faculty professors with a validated tool to use to assess attitudinal changes in students, following theoretical and practical training in mental health. To have an up-to-date perspective on student attitudes towards both the field of mental health and people with severe mental illness, thereby providing the opportunity to focus on those aspects requiring improvement. Abstract Introduction The encouragement of positive attitudes towards mental health is necessary in order to improve the quality of healthcare assistance. The attitudes of nursing students towards mental health are unknown, and there are no validated scales for their assessment. Aims To adapt the Psychiatric/Mental Health Clinical Placement Survey (PMHCPS) to Spanish and examine its psychometric properties; to describe the attitudes of nursing students towards the mental health field. Method Confirmatory factorial analysis (CFA), internal consistency and construct validity were performed. An assessment of the students' attitudes was also conducted. Results The CFA showed appropriate fit, and total internal consistency was adequate. With regard to construct validity, knowledge was associated with practicum mark. The students achieved above mid-range scores for all subscales, except negative stereotypes. Gender differences were observed. Discussion The PMHCPS, translated to Spanish, enables the students' attitude towards the mental health field to be assessed, thus identifying those areas of student attitudes and competencies requiring improvement. Implications for practice To provide Spanish nursing faculties with access to a scale, with which to assess changes in student attitudes. The assessment results may then be utilized to formulate teaching methods in order to improve the quality of health care the students might provide as future nursing professionals.
Collapse
Affiliation(s)
- Rocío Juliá-Sanchis
- Nursing Department, Health Sciences Faculty, University of Alicante, Alicante, Spain
| | | | - Julio Cabrero-García
- Nursing Department, Health Sciences Faculty, University of Alicante, Alicante, Spain
| | | | - Silvia Escribano
- Nursing Department, Health Sciences Faculty, University of Alicante, Alicante, Spain
| |
Collapse
|
54
|
Kemp J, Zhang T, Inglis F, Wiljer D, Sockalingam S, Crawford A, Lo B, Charow R, Munnery M, Singh Takhar S, Strudwick G. Delivery of Compassionate Mental Health Care in a Digital Technology-Driven Age: Scoping Review. J Med Internet Res 2020; 22:e16263. [PMID: 32141833 PMCID: PMC7084292 DOI: 10.2196/16263] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 11/19/2019] [Accepted: 12/14/2019] [Indexed: 12/17/2022] Open
Abstract
Background Compassion is a vital component to the achievement of positive health outcomes, particularly in mental health care. The rise of digital technologies may influence the delivery of compassionate care, and thus this relationship between compassion and digital health care needs to be better understood. Objective This scoping review aimed to identify existing digital technologies being used by patients and health professionals in the delivery of mental health care, understand how digital technologies are being used in the delivery of compassionate mental health care, and determine the facilitators of and barriers to digital technology use among patients and health professionals in the delivery of compassionate mental health care. Methods We conducted this scoping review through a search of Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online (MEDLINE), MEDLINE In-Process and EPub Ahead of Print, PsycINFO, and Web of Science for articles published from 1990 to 2019. Results Of the 4472 articles screened, 37 articles were included for data extraction. Telemedicine was the most widely used technology by mental health professionals. Digital technologies were described as facilitating compassionate care and were classified using a conceptual model to identify each digital intersection with compassionate care. Facilitators of and barriers to providing compassionate care through digital technology were identified, including increased safety for providers, health care professional perceptions and abilities, and the use of picture-in-picture feedback to evaluate social cues. Conclusions Implementing digital technology into mental health care can improve the current delivery of compassionate care and create novel ways to provide compassion. However, as this is a new area of study, mental health professionals and organizations alike should be mindful that compassionate human-centered care is maintained in the delivery of digital health care. Future research could develop tools to facilitate and evaluate the enactment of compassion within digital health care.
Collapse
Affiliation(s)
- Jessica Kemp
- Faculty of Science, University of Waterloo, Waterloo, ON, Canada.,Information Management Group, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Timothy Zhang
- Faculty of Science, University of Waterloo, Waterloo, ON, Canada.,Information Management Group, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Fiona Inglis
- Office of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - David Wiljer
- Office of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Education Technology and Innovation, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sanjeev Sockalingam
- Office of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Allison Crawford
- Office of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Brian Lo
- Information Management Group, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Office of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Rebecca Charow
- Education Technology and Innovation, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Mikayla Munnery
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Shuranjeet Singh Takhar
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Gillian Strudwick
- Information Management Group, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| |
Collapse
|
55
|
Abstract
PurposeThe aim of this study was to identify key components of integrated mental health and social care services that contribute to value for service users in Sweden.Design/methodology/approachAn explorative research study design was used, based on data from four group interviews conducted in June and August 2017 with service user representatives.FindingsThe analysis resulted in eight subcategories reflecting components that were reported to contribute to value for service users. These subcategories were grouped into three main categories: (1) professionals who see and support the whole person, (2) organizational commitment to holistic care and (3) support for equal opportunities and active participation in society.Research limitations/implicationsThe findings are primarily transferable to integrated mental health and social care services, as they emphasize key components that contribute to value for service users in these specific settings.Practical implicationsThe complexity of integrated mental health and social care services requires coordination across the individual and organizational levels as well as ongoing dialogue and partnerships between service users, service user associations and health and social care organizations. In this integration, it is important that service users and service user associations not only are invited but also keen to participate in the design of care and support efforts.Originality/valueService User Associations (SUAs) can act as a bridge between county and municipal services through their participation in the development of local activities; at the regional and national levels, SUAs can help achieve more equitable integrated services. It is important that SUAs are not only invited but encouraged to actively participate in the design of such care and support efforts.
Collapse
|
56
|
Rettke H, Petry H, von Känel R, Jordan KD, Ernst J. [Patients with psychiatric comorbidities in the acute hospital - a field of tension with interprofessional need for action - results from a pilot study]. Pflege 2020; 33:85-91. [PMID: 32107967 DOI: 10.1024/1012-5302/a000718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Patients with psychiatric comorbidities in the acute hospital - a field of tension with interprofessional need for action - results from a pilot study Abstract. Background: Psychiatric comorbidities are frequent in patients hospitalized in an acute care hospital. They often remain undetected or, if diagnosed, neglected. As long as the somatic disease can be properly cared for and treated, this usually remains unproblematic. However, the situation can quickly tip over if psychiatric comorbidities interfere with care and treatment leading to a higher level of care and adverse consequences for patients. Aim: We investigated the need for action for this patient group from the nurses' perspective in a Swiss-German university hospital. Method: In two group discussions, nurses described intense situations, followed by an evaluation of determining factors, insights gained and measures taken to control these situations and prevent them. Results: Nurses experience the described situations as stressful and express a great need for action for themselves and for the interprofessional team. Key points are vigilance in everyday clinical practice, specific knowledge acquisition and an easily accessible local support system. Conclusions: In an acute care hospital, psychiatric comorbidities must be taken into account. However, this requires advanced skills and an organizational, interprofessional approach.
Collapse
Affiliation(s)
- Horst Rettke
- Zentrum Klinische Pflegewissenschaft, UniversitätsSpital Zürich
| | - Heidi Petry
- Zentrum Klinische Pflegewissenschaft, UniversitätsSpital Zürich
| | - Roland von Känel
- Klinik für Konsiliarpsychiatrie und Psychosomatik, UniversitätsSpital Zürich
| | | | - Jutta Ernst
- Zentrum Klinische Pflegewissenschaft, UniversitätsSpital Zürich
| |
Collapse
|
57
|
Hsiao CY, Lu HL, Tsai YF. Factors Associated With Primary Family Caregivers' Perceptions on Quality of Family-Centered Care in Mental Health Practice. J Nurs Scholarsh 2019; 51:680-688. [PMID: 31697045 DOI: 10.1111/jnu.12526] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 01/25/2023]
Abstract
PURPOSE This study aimed to examine the quality of family-centered care perceived by primary family caregivers and its influencing factors in mental healthcare practice. DESIGN A cross-sectional, correlational study. METHODS A convenience sample of 121 mental health nurses and 164 primary family caregivers of patients with schizophrenia was recruited from acute psychiatric wards and chronic psychiatric rehabilitation wards in three psychiatric hospitals in Taiwan. Structured questionnaires for mental health nurses were designed to examine nurses' attitudes toward schizophrenia and the importance of families in nursing care. Primary family caregivers were assessed to determine their perceptions of quality of family-centered care. At least one primary family caregiver of patients was matched to a nurse who took major responsibility for the patient during the hospitalization. Data were analyzed with descriptive statistics, Pearson's product-moment correlations, independent t-test, one-way analysis of variance, and stepwise regression analyses. RESULTS Quality of family-centered care perceived by primary family caregivers regarding the provision of general and specific information, as compared to enabling and partnership, coordinated and comprehensive care, and respectful and supportive care, was relatively inadequate. Younger and more educated primary family caregivers, having relatives with schizophrenia in acute wards, less supportive nurses' attitudes toward schizophrenia, and the importance of family in nursing care were correlated with poor primary family caregivers' perceptions of quality of family-centered care. Nurses' supportive attitudes toward schizophrenia and chronic psychiatric rehabilitation wards where patients received care were key factors in determining better quality of family-centered care. CONCLUSIONS Findings provide a platform for the development of effective continuing education and training programs to equip mental health nurses with supportive attitudes toward mental illness and an integration of the family in nursing care, which will ultimately improve mental health care for families experiencing mental health problems. CLINICAL RELEVANCE Efforts in professional training to address stigma and encourage a family-centered approach into recovery-oriented practice for practicing mental healthcare providers, including mental health nurses, are recommended.
Collapse
Affiliation(s)
- Chiu-Yueh Hsiao
- Lambda Beta-At-Large, Professor, School of Nursing, College of Medicine, Chang Gung University, Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Huei-Lan Lu
- Nurse director, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan, Republic of China
| | - Yun-Fang Tsai
- Professor, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, and Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan City, and Department of Psychiatry, Chang Gung Memorial Hospital in Keelung, Keelung City, all in Taiwan, Republic of China
| |
Collapse
|
58
|
Chatzidamianos G, Fletcher I, Wedlock L, Lever R. Clinical communication and the 'triangle of care' in mental health and deafness: Sign language interpreters' perspectives. PATIENT EDUCATION AND COUNSELING 2019; 102:2010-2015. [PMID: 31122818 DOI: 10.1016/j.pec.2019.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/07/2019] [Accepted: 05/14/2019] [Indexed: 06/09/2023]
Abstract
Objective To explore the processes by which therapeutic alliance develops in mental health consultations with Sign Language interpreters. Method Semi-structured interviews with 7 qualified interpreters were transcribed and analysed with interpretative phenomenological analysis. Results Two key themes were generated: (1) Nurturing the triangle of care, where the therapeutic process relied on collaboration, continuity, and trust; and (2) Shared vision and knowledge, in which participants felt misunderstood and unsupported; there was a lack of deaf awareness and clinicians appeared to feel deskilled. Conclusions Interpreters should be viewed as valued members of clinical teams and have access to clinical supervision so that they can be supported in interpreting emotional distressing content. Clinicians can aim to be collaborative with interpreters and improve their knowledge of mental health issues that are relevant to deaf people. Practice Implications An aide-memoire of the role and practicalities of working with SL interpreters should be developed and disseminated to relevant services to support collaborative working with clinicians. A core competence in SL interpreter training is reflexivity. This should be embedded in educational curricula and facilitated through clinical supervision. Funding by commissioning services should be subject to services being deaf aware and interpreters being mental health aware.
Collapse
Affiliation(s)
| | - Ian Fletcher
- Division of Health Research, Lancaster University, UK
| | - Laura Wedlock
- Division of Health Research, Lancaster University, UK
| | - Rachel Lever
- John Denmark Unit, Greater Manchester Mental Health NHS Foundation Trust, UK
| |
Collapse
|
59
|
Makkar N, Jain K, Siddharth V, Sarkar S. Patient Involvement in Decision-Making: An Important Parameter for Better Patient Experience-An Observational Study (STROBE Compliant). J Patient Exp 2019; 6:231-237. [PMID: 31535012 PMCID: PMC6739683 DOI: 10.1177/2374373518790043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background and Aim: Preferences of service users is an important consideration for developing health-care services. This study aimed to assess the experiences of the patients with substance use disorders who were admitted to a tertiary health-care facility in India. Method: This cross-sectional sectional study recruited adult inpatients who stayed for a period of 7 days or more. The Picker Patient Experience questionnaire (PPE-15) was used to gather information about the views of the patients about the care received at the center. Results: Responses were available from 113 inpatients. Majority of the participants were males and were dependent on opioids. The experience was generally positive about being treated with respect and dignity and access to information. The participants were most satisfied with opportunity being given to discuss anxiety and fear about the condition or treatment (91.2% positive response) and least satisfied with differences in responses from doctors and nurses (43.4% positive response). Further attention seemed desired about communication with the staff and patients’ involvement in their own treatment-related decision-making. Conclusion: Efforts need to be made to involve patients in their own treatment-related decision-making and to improve communication with the treatment team. This might lead to better involvement in treatment process, which could enhance the treatment outcomes in this vulnerable population.
Collapse
Affiliation(s)
- Namrata Makkar
- Department of Hospital Administration, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Kanika Jain
- Department of Hospital Administration, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Vijaydeep Siddharth
- Department of Hospital Administration, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Siddharth Sarkar
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| |
Collapse
|
60
|
Ebrahimi H, Movaghari MR, Bazghaleh M, Shirmohammadi N, Mohammadpourhodki R. Parental attitude toward children's mental disorders and its relationship with help seeking behaviors. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2019; 16:/j/jcim.ahead-of-print/jcim-2018-0244/jcim-2018-0244.xml. [PMID: 31433784 DOI: 10.1515/jcim-2018-0244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 03/09/2019] [Indexed: 02/05/2023]
Abstract
Background The purpose of the study was to assess parent's attitudes toward mental illness in children and its relationship with help seeking behaviors. Method This cross-sectional study was conducted in a pediatric psychiatric clinic of under affiliation of Tehran University of Medical Sciences in 2016-2017. All children's parents or guardians who referred for the first time to the clinics were the study population. Convenient sampling was applied and 400 subjects were included by survey method. The data collection tool for this study included a form for demographic data, a questionnaire for assessing parents' attitude toward the causes, behavioral demonstrations and treatment of mental disorders in children, and finally a checklist to determine help seeking behaviors. Descriptive and inferential statistics was applied with SPSS software version 16 for data analysis. Results Of the parents, 93.7% had a good attitude toward mental illness in the three studied realms. Of the parents, 56.25% referred to official sources of help. The results of this research showed that there was a significant difference between the mean scores of parents' attitude (sum of the three areas) in terms of child's gender, parents' marital status, father's job, father's education, and mother's education and there was a significant relationship between help seeking behavior of parents just with fathers' education level (p<0.05). Conclusions The results showed that parents had a good attitude toward their children's mental disorders. However, it should not be overlooked that nearly half of the parents were still referring to unofficial sources of assistance.
Collapse
Affiliation(s)
- Hossein Ebrahimi
- Center for Health Related social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Reza Movaghari
- Department of Nursing, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Milad Bazghaleh
- Department of Nursing, School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Nasim Shirmohammadi
- Department of Nursing, School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Reza Mohammadpourhodki
- Department of Nursing, School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| |
Collapse
|
61
|
Staniszewska S, Mockford C, Chadburn G, Fenton SJ, Bhui K, Larkin M, Newton E, Crepaz-Keay D, Griffiths F, Weich S. Experiences of in-patient mental health services: systematic review. Br J Psychiatry 2019; 214:329-338. [PMID: 30894243 DOI: 10.1192/bjp.2019.22] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND In-patients in crisis report poor experiences of mental healthcare not conducive to recovery. Concerns include coercion by staff, fear of assault from other patients, lack of therapeutic opportunities and limited support. There is little high-quality evidence on what is important to patients to inform recovery-focused care.AimsTo conduct a systematic review of published literature, identifying key themes for improving experiences of in-patient mental healthcare. METHOD A systematic search of online databases (MEDLINE, PsycINFO and CINAHL) for primary research published between January 2000 and January 2016. All study designs from all countries were eligible. A qualitative analysis was undertaken and study quality was appraised. A patient and public reference group contributed to the review. RESULTS Studies (72) from 16 countries found four dimensions were consistently related to significantly influencing in-patients' experiences of crisis and recovery-focused care: the importance of high-quality relationships; averting negative experiences of coercion; a healthy, safe and enabling physical and social environment; and authentic experiences of patient-centred care. Critical elements for patients were trust, respect, safe wards, information and explanation about clinical decisions, therapeutic activities, and family inclusion in care. CONCLUSIONS A number of experiences hinder recovery-focused care and must be addressed with the involvement of staff to provide high-quality in-patient services. Future evaluations of service quality and development of practice guidance should embed these four dimensions.Declaration of interestK.B. is editor of British Journal of Psychiatry and leads a national programme (Synergi Collaborative Centre) on patient experiences driving change in services and inequalities.
Collapse
Affiliation(s)
- Sophie Staniszewska
- Professor of Patient and Public Involvement and Experiences of Care,Division of Health Sciences, Warwick Medical School,University of Warwick,UK
| | - Carole Mockford
- Senior Research Fellow,Division of Health Sciences,Warwick Medical School,University of Warwick,UK
| | - Greg Chadburn
- Researcher,Surrey and Sussex Healthcare National Health Service Trust,UK
| | - Sarah-Jane Fenton
- Comparative Social Policy,PGCert Advanced Research Methods and Skills,PhD Social Policy,Research Fellow,Division of Health Sciences,Warwick Medical School,University of Warwick,UK
| | - Kamaldeep Bhui
- Professor of Psychiatry,Centre for Psychiatry,Wolfson Institute of Preventive Medicine,Barts and The London School of Medicine and Dentistry,Queen Mary University of London,East London National Health Service Foundation Trust,UK
| | - Michael Larkin
- Reader in Psychology,School of Life and Health Sciences,Aston University,UK
| | - Elizabeth Newton
- Consultant Clinical Psychologist,Research Fellow, School of Psychology,University of Birmingham,UK
| | - David Crepaz-Keay
- Head of Empowerment and Social Inclusion,Mental Health Foundation,UK
| | - Frances Griffiths
- Professor of Medicine in Society,Division of Health Sciences,Warwick Medical School,University of Warwick,UK
| | - Scott Weich
- Professor of Mental Health,Division of Health Sciences,Warwick Medical School,University of Warwick;and School of Health and Related Research (ScHARR),University of Sheffield,UK
| |
Collapse
|
62
|
Martínez-Martínez C, Sánchez-Martínez V, Sales-Orts R, Dinca A, Richart-Martínez M, Ramos-Pichardo JD. Effectiveness of direct contact intervention with people with mental illness to reduce stigma in nursing students. Int J Ment Health Nurs 2019; 28:735-743. [PMID: 30693628 DOI: 10.1111/inm.12578] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2018] [Indexed: 11/28/2022]
Abstract
People with mental illnesses are at a higher risk than the general population of suffering from somatic diseases. However, they receive less attention from healthcare services. Some studies have indicated that this situation can be partially explained by the stigmatizing attitudes of health professionals, including nurses. With the objective to improve future nursing professionals' attitudes towards people with mental illnesses, an intervention involving direct contact with people who had lived experience with mental illnesses was designed and its effectiveness was measured. It consisted of a single 90-min session involving a mental health professional, a person with a mental illness, and a family member of someone with a mental illness. The intervention was based on a structured script where they described their experiences with the illness and their history of recovery, and then, they had a discussion with the attendees. The effectiveness of this approach was measured through a quasi-experimental study with a pretest-post-test design. The differences in the scores obtained in the AQ-27-E questionnaire before and after the intervention indicated that there was a decrease in fear, feelings of danger, avoidance, segregation, and coercive attitudes, while positive feelings increased, including a tendency to help and compassion. These results are important for clinical practice because this intervention could improve the quality of care provided to people with mental illnesses.
Collapse
Affiliation(s)
| | | | | | - Andra Dinca
- Técnico de Integración Social de ASIEM (Association for the Integral Health of People with M.D.), Spain
| | | | | |
Collapse
|
63
|
Harris B, Panozzo G. Barriers to recovery-focused care within therapeutic relationships in nursing: Attitudes and perceptions. Int J Ment Health Nurs 2019; 28:1220-1227. [PMID: 31140710 DOI: 10.1111/inm.12611] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2019] [Indexed: 01/23/2023]
Abstract
There are numerous barriers to the therapeutic relationship between nurses and persons with schizophrenia, such as time constraints, communication issues and the requirements of practice policies. The main point of this paper is that the nature of these barriers is such that the nurse may not conceptualize these as barriers or be aware of how his or her responses to these can further entrench existing barriers to relationship or create new ones. If the nurse is not aware of how he or she responds to time pressure, frustration or lack of clarity of practice policy and address this, there is a risk that the patient may perceive the nurse's actions as lacking in care, presence or involvement. As consumers increasingly embrace recovery approaches to mental health that prioritize therapeutic activities within the context of collaborative relationship, psychiatric nurses, with a long tradition of therapeutic relationship, can rise to meet them. It is suggested here that this can only occur if nurses are fully aware of barriers to relationship, their responses to these and the impact of these on relationship with patients. Suggestions for educational and empirical work to further raise awareness and promote understanding of this process are provided.
Collapse
Affiliation(s)
| | - Gina Panozzo
- DePaul University, Chicago, Illinois, USA
- Benedictine University, Lisle, Illinois, USA
| |
Collapse
|
64
|
Averill IRE, Beaglehole B, Douglas KM, Jordan J, Crowe MT, Inder M, Lacey CJ, Frampton CM, Bowie CR, Porter RJ. Activation therapy for the treatment of inpatients with depression - protocol for a randomised control trial compared to treatment as usual. BMC Psychiatry 2019; 19:52. [PMID: 30709391 PMCID: PMC6359820 DOI: 10.1186/s12888-019-2038-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/25/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Inpatients with depression have a poor long term outcome with high rates of suicide, high levels of morbidity and frequent re-admission. Current treatment often relies on pharmacological intervention and focuses on observation to maintain safety. There is significant neurocognitive deficit which is linked to poor functional outcomes. As a consequence, there is a need for novel psychotherapeutic interventions that seek to address these concerns. METHODS We combined cognitive activation and behavioural activation to create activation therapy (AT) for the treatment of inpatient depression and conducted a small open label study which demonstrated acceptability and feasibility. We propose a randomised controlled trial which will compare treatment as usual (TAU) with TAU plus activation therapy for adult inpatients with a major depressive episode. The behavioural activation component involves therapist guided re-engagement with previously or potentially rewarding activities. The cognitive activation aspect utilises computer based exercises which have been shown to improve cognitive function. DISCUSSION The proposed randomised controlled trial will examine whether or not the addition of this therapy to TAU will result in a reduced re-hospitalisation rate at 12 weeks post discharge. Subjective change in activation and objectively measured change in activity levels will be rated, and the extent of change to neurocognition will be assessed. TRIAL REGISTRATION Unique trial number: U1111-1190-9517. Australian New Zealand Clinical Trials Registry (ANZCTR) number: ACTRN12617000024347p .
Collapse
Affiliation(s)
- Ian R. E. Averill
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand ,0000 0001 0040 0934grid.410864.fSpecialist Mental Health Services, Canterbury District Health Board, Christchurch, New Zealand
| | - Ben Beaglehole
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand ,0000 0001 0040 0934grid.410864.fSpecialist Mental Health Services, Canterbury District Health Board, Christchurch, New Zealand
| | - Katie M. Douglas
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand
| | - Jennifer Jordan
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand
| | - Marie T. Crowe
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand
| | - Maree Inder
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand
| | - Cameron J. Lacey
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand
| | - Christopher M. Frampton
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand
| | - Christopher R. Bowie
- 0000 0004 1936 8331grid.410356.5Department of Psychology, Queen’s University, Kingston, Canada
| | - Richard J. Porter
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand ,0000 0001 0040 0934grid.410864.fSpecialist Mental Health Services, Canterbury District Health Board, Christchurch, New Zealand
| |
Collapse
|
65
|
Isobel S. 'In some ways it all helps but in some ways it doesn't': The complexities of service users' experiences of inpatient mental health care in Australia. Int J Ment Health Nurs 2019; 28:105-116. [PMID: 29897669 DOI: 10.1111/inm.12497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2018] [Indexed: 11/30/2022]
Abstract
Recovery-oriented mental health care requires active involvement of service users in the evaluation of care. While experience of care surveys is routinely given out upon discharge, capturing the depth and detail of service users' experiences in such a way to meaningfully improve services may require more in-depth and targeted approaches. This study aimed to gather voluntary and involuntary service users' experiences of care during hospitalization in two acute adult mental health inpatient units, through the collaborative completion of a purpose designed tool. The purpose of the study was to examine broad experiences of care and to identify the utility of proactive approaches to ongoing service evaluation. Overall, 67 participants were interviewed. Findings highlight the complexity of experiences of care including how an admission can seemingly facilitate clinical recovery while not being recovery-oriented. The findings also detail areas for improvement in the way that care is delivered and evaluated. The implications are particularly pertinent for mental health nurses to consider how, within the existing constraints of their roles, they can provide therapeutic care to all service users.
Collapse
Affiliation(s)
- Sophie Isobel
- Mental Health Research, Sydney Local Health District, Concord Centre for Mental Health, Concord, New South Wales, Australia
| |
Collapse
|
66
|
Miller Tate AJ. Contributory injustice in psychiatry. JOURNAL OF MEDICAL ETHICS 2019; 45:97-100. [PMID: 30337450 PMCID: PMC6388905 DOI: 10.1136/medethics-2018-104761] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 09/12/2018] [Accepted: 09/16/2018] [Indexed: 05/25/2023]
Abstract
I explain the notion of contributory injustice, a kind of epistemic injustice, and argue that it occurs within psychiatric services, affecting (at least) those who hear voices. I argue that individual effort on the part of clinicians to avoid perpetrating this injustice is an insufficient response to the problem; mitigating the injustice will require open and meaningful dialogue between clinicians and service user organisations, as well as individuals. I suggest that clinicians must become familiar with and take seriously concepts and frameworks for understanding mental distress developed in service user communities, such as Hearing Voices Network, and by individual service users. This is especially necessary when these concepts and frameworks explicitly conflict with medical or technical understandings of users' experiences. I defend this proposal against three objections.
Collapse
|
67
|
Randomized controlled trial of telephone monitoring with psychiatry inpatients with co-occurring substance use and mental health disorders. Drug Alcohol Depend 2019; 194:230-237. [PMID: 30466040 PMCID: PMC6448768 DOI: 10.1016/j.drugalcdep.2018.09.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 09/13/2018] [Accepted: 09/14/2018] [Indexed: 11/24/2022]
Abstract
Background Psychiatry inpatients frequently have co-occurring substance use and mental health disorders, which are related to poor post-discharge outcomes. Telephone monitoring is effective in specialty substance use disorder treatment settings in increasing continuing care and 12-step program utilization and improving substance use outcomes. This study examined the effectiveness of telephone monitoring among psychiatry inpatients with co-occurring substance use and mental health disorders. Methods This randomized controlled trial (n = 406) compared usual care to usual care plus telephone monitoring (one in-person session during the inpatient stay, followed by weekly telephone contact for three months post-discharge). Follow-ups were conducted at end-of-intervention (three months post-baseline) and nine and 15 months post-baseline (73% followed). Primary outcomes were number of days out of the past 30 of drinking alcohol, using drugs, and experiencing psychological problems. Secondary outcomes were outpatient substance use treatment, and 12-step group, utilization. Results Longitudinal modeling found that patients in both conditions improved over time on each primary outcome. Improvement was comparable between conditions on alcohol and drug use and psychological problems. Receipt of outpatient treatment decreased over the follow-up period and was not related to condition. Likelihood of attending 12-step group meetings did not change over follow-ups, and was not related to condition. Conclusions Improvement over time was evident regardless of condition assignment. Patients maintained attendance at 12-step groups from pre- to post-discharge. Short-term telephone monitoring in addition to usual care for patients with co-occurring substance use and mental health disorders may not be sufficiently intensive to achieve additional improvements on outcomes.
Collapse
|
68
|
Silva SN, Lima MG, Ruas CM. Brazilian Mental Health Services Assessment: user satisfaction and associated factors. CIENCIA & SAUDE COLETIVA 2018; 23:3799-3810. [PMID: 30427450 DOI: 10.1590/1413-812320182311.25722016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 11/11/2016] [Indexed: 11/21/2022] Open
Abstract
Patient satisfaction is an important criterion for assessing the quality of Brazilian mental health services at Psychosocial Care Centers (CAPS - from the Portuguese 'Centro de Atenção Psicossocial'). The aim of this study was to evaluate the satisfaction of users at the main CAPS in a region of Minas Gerais state, Brazil, as well as associated factors. This was a cross-sectional study with 11 CAPS. Patients were interviewed using the Patient Satisfaction with Mental Health Services Scale (SATIS-BR) and a semi-structured questionnaire containing sociodemographic and clinical variables. The users were satisfied with the CAPS, particularly in terms of staff competence and the welcome received and care provided. The physical facilities and comfort at the centers obtained the lowest satisfaction scores on the scale. Almost half of the users were unfamiliar with basic aspects of their drug therapy, such as the name of medicines, and one-third reported inappropriate use of medications. Users of midsize CAPS and those providing treatment for alcohol and drug addiction were more satisfied than patients at mental health or 24-hour CAPS. Although this study identified a need for improvement in physical facilities, mechanisms of participation and patient empowerment, the users were satisfied with the CAPS care model.
Collapse
Affiliation(s)
- Sarah Nascimento Silva
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Departamento de Farmácia Social, Faculdade de Farmácia, Universidade Federal de Minas Gerais (UFMG). Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | | | | |
Collapse
|
69
|
Holm T, Thomsen DK, Bliksted V. Themes of unfulfilled agency and communion in life stories of patients with schizophrenia. Psychiatry Res 2018; 269:772-778. [PMID: 30380593 DOI: 10.1016/j.psychres.2018.08.116] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 08/28/2018] [Accepted: 08/28/2018] [Indexed: 10/28/2022]
Abstract
We examined themes of agency and communion in life stories of individuals with schizophrenia. Twenty-four individuals diagnosed with schizophrenia and 24 control participants matched on age, gender, and education described their life stories in a free format. The life stories were coded for the presence of agency and communion themes and whether or not the themes captured fulfillment of agency and communion needs. In addition, the temporal macrostructure was coded. Individuals with schizophrenia described their life stories with similar levels of temporal macrostructure as controls, but they expressed more themes focusing on unfulfilled agency and communion needs. We suggest possible avenues for using these insights to improve recovery in schizophrenia.
Collapse
Affiliation(s)
- Tine Holm
- Psychosis Research Unit, Aarhus University Hospital Risskov, Denmark.
| | | | - Vibeke Bliksted
- Psychosis Research Unit, Aarhus University Hospital Risskov, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| |
Collapse
|
70
|
Noonan M, Doody O, Jomeen J, O'Regan A, Galvin R. Family physicians perceived role in perinatal mental health: an integrative review. BMC FAMILY PRACTICE 2018; 19:154. [PMID: 30193572 PMCID: PMC6128990 DOI: 10.1186/s12875-018-0843-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 08/27/2018] [Indexed: 02/05/2023]
Abstract
Background Responding to and caring for women who experience mental health problems during the perinatal period, from pregnancy up to one year after birth, is complex and requires a multidisciplinary response. Family physicians are ideally placed to provide an effective response as it is recognised that they are responsible for organising care and supports for women and their families. This paper reports an integrative review undertaken to examine family physicians’ perceived role in perinatal mental health care and concludes with recommendations for health policy, research and practice. Method A systematic search of literature in seven databases from January 2000 to March 2016 identified a total of 1125 articles. Qualitative, quantitative and mixed-method studies were eligible for inclusion if they explored family physicians’ experiences of caring for women who experience perinatal mental health problems. Results Thirteen articles reporting 11 studies met the inclusion criteria for this review and quality of included studies were assessed using published criteria for the critical appraisal of qualitative and quantitative research methods. Cross-study narrative syntheses of quantitative and qualitative findings are presented under three themes: identification of perinatal mental health problems, management of perinatal mental health problems and barriers to care provision. While family physicians recognise their role in relation to perinatal mental health the collective interpretation revealed that; they receive variable levels of preparation for this role, no consistent approach to screening exists, pharmacological management of mood disorders is the main treatment modality and limited access to specialist perinatal mental health services exists which impacts on pharmacology decisions. Conclusion Family physicians require timely access to local integrated care pathways that provide a wide range of services that are culturally sensitive, perinatal mental health specific, support psychological well-being and infant/family mental health. Family physicians are open to incorporating a brief validated screening tool into primary practice supported by succinct guidelines. Research that examines training needs in relation to perinatal mental health could be used to inform family physician training programmes and curriculum development around perinatal mental health.
Collapse
Affiliation(s)
- Maria Noonan
- Department of Nursing and Midwifery, Faculty of Education & Health Sciences Health Sciences Building, University of Limerick, Limerick, Ireland.
| | - Owen Doody
- Department of Nursing and Midwifery, Faculty of Education & Health Sciences Health Sciences Building, University of Limerick, Limerick, Ireland
| | - Julie Jomeen
- Faculty of Health and Social Care, University of Hull, Hull, UK
| | - Andrew O'Regan
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Rose Galvin
- School of Allied Health, Faculty of Education & Health Sciences, Health Sciences Building, University of Limerick, Limerick, Ireland
| |
Collapse
|
71
|
Patel R, Harvey J, Forrester A. Systemic limitations in the delivery of mental health care in prisons in England. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 60:17-25. [PMID: 30217326 DOI: 10.1016/j.ijlp.2018.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 05/17/2018] [Accepted: 06/11/2018] [Indexed: 06/08/2023]
Abstract
There is a high prevalence of mental health need in prisons, much of which is currently unmet. Although considerable research has identified and described this mental health need, there has been limited research focussed on reviewing the delivery of mental health care in prisons. This study uses content analysis to review 36 unannounced prison inspection reports in England to establish whether mental health care was provided to an appropriate standard, and whether it is equivalent to services that are provided in the wider community. The analysis identified four main categories, each of which had further sub-categories: managing the process; staffing; range of services; and quality of service. Numerous concerns were identified, including: delays to service access; lack of appropriate interventions; low staffing levels; limited specialist support; and limited access to supervision, training and reflective practice. Despite these difficulties, many teams had adopted open referral systems to improve service access, had good working relationships and were thought to be providing care of good quality. The delivery of mental health care within prisons is still not equivalent to that which is provided in the community, and this study has identified a number of areas for further improvement.
Collapse
Affiliation(s)
- Ria Patel
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Joel Harvey
- Lecturer in Clinical Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Andrew Forrester
- Consultant and Honorary Senior Lecturer in Forensic Psychiatry, Offender Health Research Network, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
| |
Collapse
|
72
|
Abayneh S, Lempp H, Manthorpe J, Hanlon C. Development of programme theory for integration of service user and caregiver involvement in mental health system strengthening: protocol for realist systematic review. Int J Ment Health Syst 2018; 12:41. [PMID: 30061922 PMCID: PMC6057009 DOI: 10.1186/s13033-018-0220-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 07/18/2018] [Indexed: 11/10/2022] Open
Abstract
Background There is international recognition of the need for service user and caregiver involvement in mental health system strengthening. However, little is known about how best to integrate this approach into the mental healthcare system; what works to advance involvement, under what conditions, how and when does involvement bring added value, and how can it work in resource-poor settings in low and middle-income countries. Objective To describe the methodology for a realist systematic review protocol to synthesise the evidence to explain the contexts, outcomes, and underlying mechanisms for involvement of service users with severe mental health problems and their caregivers in mental healthcare policy-making and planning, advocacy, service development, monitoring and improvement. Methods/designs The proposed realist systematic review will involve five steps: (i) clarifying the review scope, (ii) a systematic search for evidence, (iii) evidence appraisal and data extraction, (iv) data analysis, (v) synthesis of evidence and formation of revised programme theory. Inputs from a formative qualitative study, consultative Theory of Change meetings with key stakeholder groups, and scoping reviews will be used to identify candidate theory/theories that will guide the selection, appraisal and analysis of studies, and refine the Theory of Change model that will be piloted and evaluated. Synthesis of data will be undertaken using realist logic, constant comparison and thematic analysis. In a consultative meeting with stakeholders the Theory of Change model will then be situated with respect to relevant programme theories and adapted to incorporate the synthesized evidence of relevance to the local context. The finalized Theory of Change model will be piloted and evaluated in a primary health care setting in rural Ethiopia. Discussion Realist review methodology has not been applied to the area of mental health service user involvement in low- and middle-income country settings. In this protocol, we describe how this contextualized approach will be applied to identify and refine a theory-driven and transferable model of involvement of service users, embedded in ongoing work in Ethiopia.Systematic review registration PROSPERO CRD42018084595.
Collapse
Affiliation(s)
- Sisay Abayneh
- 1Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Heidi Lempp
- 2Department of Inflammation Biology, Faculty of Life Sciences & Medicine, King's College London, Weston Education Centre, 10, Cutcombe Road, London, SE5 9RJ UK
| | - Jill Manthorpe
- 3Health &Social Care Workforce Research Unit, King's College London, Strand, London, WC2 4LL UK
| | - Charlotte Hanlon
- 1Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,4Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neurosciencem, King's College London, 16 De Crespigny Park, London, SE5 8AF UK
| |
Collapse
|
73
|
Rehner T, Brazeal M, Doty ST. Embedding a Social Work-Led Behavioral Health Program in a Primary Care System: A 2012-2018 Case Study. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2018; 23 Suppl 6 Suppl, Gulf Region Health Outreach Program:S40-S46. [PMID: 28961651 PMCID: PMC5627526 DOI: 10.1097/phh.0000000000000657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The focus of this case study was the implementation of a fully integrated system of care that brought mental health into a federally qualified health center's primary care activities. OBJECTIVE The Mississippi Integrated Health and Disaster Program aimed to increase the federally qualified health center's capacity for providing mental health services and in so doing increase patients' access to mental and behavioral health services in primary care. Included are the historical origins of the program and the context in which these clinics operate, as well as successful processes that reduced barriers between medical providers and social workers and ultimately resulted in improved patient outcomes. RESULTS Data indicated that the Mississippi Integrated Health and Disaster Program's integrated health model significantly improved depression, anxiety, and self-care among chronic care patients. CONCLUSION This integrated health approach transformed the treatment culture of patient care in primary care clinics and improved patient outcomes. This study highlights the benefits possible when behavioral health provided by social workers is fully integrated into primary care. This case study illustrates the importance of developing a care model that meets the patient populations' specific and varied needs while concurrently establishing an integrated service delivery culture within local clinics and within the organization's administrative structures.
Collapse
Affiliation(s)
- Tim Rehner
- The University of Southern Mississippi, Hattiesburg, Mississippi
| | - Michelle Brazeal
- The University of Southern Mississippi, Hattiesburg, Mississippi
| | | |
Collapse
|
74
|
Fortin M, Cao Z, Fleury MJ. A typology of satisfaction with mental health services based on Andersen's behavioral model. Soc Psychiatry Psychiatr Epidemiol 2018; 53:587-595. [PMID: 29450599 DOI: 10.1007/s00127-018-1498-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 02/02/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Patients with mental disorders (MDs) form a highly heterogeneous group, whose satisfaction with mental health services (MHS) may vary according to different variables. Identifying patient subgroups with similar levels of satisfaction may help identify variables that contribute to satisfaction or dissatisfaction with services. This study established a typology of patient satisfaction with MHS that revealed variables specific to each group. METHODS The study included 325 patients with MDs across four health service networks offering integrated and diversified services. Data were collected using five standardized instruments, and participant medical records. A conceptual framework was developed, based on Andersen's Behavioral Model, which integrates socio-demographic, clinical, needs-related and service use variables. Using cluster analysis, a typology of patient satisfaction was created. RESULTS Analyses yielded four patient clusters: two where levels of satisfaction were relatively high and two with lower levels of satisfaction (range 3.74-4.37). Greater care continuity and higher income related to greater patient satisfaction; whereas co-occurring MDs and substance use disorders (SUD), as well as more numerous and severe needs, characterized dissatisfied patients who were frequent users of MHS. CONCLUSIONS Results highlight the need for continuity of care and adequate socio-economic conditions for increasing patient satisfaction with MHS. Lower levels of satisfaction among patients with common MDs and SUDs suggest the importance of addressing their specific needs to enhance satisfaction and MH recovery.
Collapse
Affiliation(s)
- Marilyn Fortin
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Hospital Research Centre, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada
| | - Zhirong Cao
- Douglas Hospital Research Centre, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada
| | - Marie-Josée Fleury
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
- Douglas Hospital Research Centre, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada.
| |
Collapse
|
75
|
Knight F, Kokanović R, Ridge D, Brophy L, Hill N, Johnston-Ataata K, Herrman H. Supported Decision-Making: The Expectations Held by People With Experience of Mental Illness. QUALITATIVE HEALTH RESEARCH 2018; 28:1002-1015. [PMID: 29557294 DOI: 10.1177/1049732318762371] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Supported decision-making (SDM) is a principle guiding mental health service provision, which aims to improve people's ability to make informed decisions about their care. Understanding diverse individual needs is vital to its success. Based on 29 narrative interviews with people diagnosed with mental illness in Australia, we examine how participants reflected on their own experiences of SDM. We find that participants' conceptualization of mental health expertise, their own experiences and sense of agency, and their varying needs for dependence and independence influenced their relationships with mental health practitioners. These factors in turn shaped their expectations about SDM. Four narrative positions emerged: the "Inward Expert," the "Outward Entrustor," the "Self-Aware Observer," and the "Social Integrator." These positionings influenced the type or style of support that participants expected and considered most useful. Our findings are relevant to developing effective approaches to SDM that take into account service users' needs and preferences.
Collapse
Affiliation(s)
| | | | - Damien Ridge
- 3 University of Westminster, London, United Kingdom
| | - Lisa Brophy
- 4 The University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Helen Herrman
- 4 The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
76
|
Sather EW, Svindseth MF, Crawford P, Iversen VC. Care pathways in the transition of patients between district psychiatric hospital centres (DPCs) and community mental health services. Health Sci Rep 2018; 1:e37. [PMID: 30623072 PMCID: PMC6266453 DOI: 10.1002/hsr2.37] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 02/28/2018] [Accepted: 03/13/2018] [Indexed: 11/06/2022] Open
Abstract
RATIONALE AIMS AND OBJECTIVES Patients with mental health problems experience numerous transitions into and out of hospital. Primary care providers have mixed success in identifying and managing patients' needs. This study explores health personnel's experience of care pathways in patient transition between inpatient and community mental health services. METHODS A descriptive qualitative design was chosen. Four focus group interviews with 12 informants from 7 different communities were conducted. Interviews were analyzed thematically. RESULTS Two main themes were identified: integrated care and patient activation. The participants shared their experiences on topics that can affect smooth care pathways in mental health. Six promoting factors were identified for successful patient transition: opportunities for information sharing, implementation of systematic plans, use of e-messages, around-the-clock care, designating one responsible health person in each system for each patient, and the involvement of patients and their families. The following barriers were all found to impede the patients' transition between levels of care: the lack of a single responsible person at each health care level, insufficient meetings, the absence of systematic plans, difficulties in identifying the right staff at different levels, delays in information sharing, and the complexity of welfare systems negatively affecting patient dignity. CONCLUSIONS Systems and procedures should be developed to ensure clear responsibilities and transparency at each stage of the pathways of care. A single person should take charge of ensuring sufficient connection and communication between inpatient and community mental health services. Finally, both patient and staff in community services should be linked through a direct telephone number with around-the-clock availability.
Collapse
Affiliation(s)
- Eva W. Sather
- Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
| | - Marit F. Svindseth
- Faculty of Medicine and Health ScienceNorwegian University of Science and TechnologyAalesundNorway
| | - Paul Crawford
- Faculty of Medicine and Health SciencesUniversity of NottinghamUK
| | - Valentina C. Iversen
- Faculty of Medicine and Health Sciences, Department of Mental HealthNorwegian University of Science and Technology, St Olav's University Hospital HF, Tiller District Psychiatric CentreTrondheimNorway
| |
Collapse
|
77
|
Biagianti B, Quraishi SH, Schlosser DA. Potential Benefits of Incorporating Peer-to-Peer Interactions Into Digital Interventions for Psychotic Disorders: A Systematic Review. Psychiatr Serv 2018; 69:377-388. [PMID: 29241435 PMCID: PMC5988432 DOI: 10.1176/appi.ps.201700283] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Peer-to-peer interactions and support groups mitigate experiences of social isolation and loneliness often reported by individuals with psychotic disorders. Online peer-to-peer communication can promote broader use of this form of social support. Peer-to-peer interactions occur naturally on social media platforms, but they can negatively affect mental health. Recent digital interventions for persons with psychotic disorders have harnessed the principles of social media to incorporate peer-to-peer communication. This review examined the feasibility, acceptability, and preliminary efficacy of recent digital interventions in order to identify strategies to maximize benefits of online peer-to-peer communication for persons with psychotic disorders. METHODS An electronic database search of PubMed, EMBASE, PsycINFO, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Health Technology Assessment Database was conducted in February 2017 and yielded a total of 1,015 results. Eight publications that reported data from six independent trials and five interventions were reviewed. RESULTS The technology supporting peer-to-peer communication varied greatly across studies, from online forums to embedded social networking. When peer-to-peer interactions were moderated by facilitators, retention, engagement, acceptability, and efficacy were higher than for interventions with no facilitators. Individuals with psychotic disorders were actively engaged with moderated peer-to-peer communication and showed improvements in perceived social support. Studies involving service users in intervention design showed higher rates of acceptability. CONCLUSIONS Individuals with psychotic disorders value and benefit from digital interventions that include moderated peer-to-peer interactions. Incorporating peer-to-peer communication into digital interventions for this population may increase compliance with other evidence-based therapies by producing more acceptable and engaging online environments.
Collapse
Affiliation(s)
- Bruno Biagianti
- The authors are with the Department of Psychiatry, University of California, San Francisco. Dr. Biagianti is also with Posit Science Corporation, San Francisco. Dr. Schlosser is also with Verily Life Sciences LLC, Mountain View, California
| | - Sophia H Quraishi
- The authors are with the Department of Psychiatry, University of California, San Francisco. Dr. Biagianti is also with Posit Science Corporation, San Francisco. Dr. Schlosser is also with Verily Life Sciences LLC, Mountain View, California
| | - Danielle A Schlosser
- The authors are with the Department of Psychiatry, University of California, San Francisco. Dr. Biagianti is also with Posit Science Corporation, San Francisco. Dr. Schlosser is also with Verily Life Sciences LLC, Mountain View, California
| |
Collapse
|
78
|
Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: a cross-country qualitative study. Epidemiol Psychiatr Sci 2018; 27:29-39. [PMID: 29113598 PMCID: PMC6998885 DOI: 10.1017/s2045796017000634] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS The aims of this paper are to: (i) explore the experiences of involvement of mental health service users, their caregivers, mental health centre heads and policy makers in mental health system strengthening in three low- and middle-income countries (LMICs) (Ethiopia, Nepal and Nigeria); (ii) analyse the potential benefits and barriers of such involvement; and (iii) identify strategies required to achieve greater service user and caregiver participation. METHODS A cross-country qualitative study was conducted, interviewing 83 stakeholders of mental health services. RESULTS Our analysis showed that service user and caregiver involvement in the health system strengthening process was an alien concept for most participants. They reported very limited access to direct participation. Stigma and poverty were described as the main barriers for involvement. Several strategies were identified by participants to overcome existing hurdles to facilitate service user and caregiver involvement in the mental health system strengthening process, such as support to access treatment, mental health promotion and empowerment of service users. This study suggests that capacity building for service users, and strengthening of user groups would equip them to contribute meaningfully to policy development from informed perspectives. CONCLUSION Involvement of service users and their caregivers in mental health decision-making is still in its infancy in LMICs. Effective strategies are required to overcome existing barriers, for example making funding more widely available for Ph.D. studies in participatory research with service users and caregivers to develop, implement and evaluate approaches to involvement that are locally and culturally acceptable in LMICs.
Collapse
|
79
|
Ajiboye LO, Oboirien M. The Incidence and Association of Mental Depression with Symptomatic Lumbar Degenerative Disc Disease and Treatment Outcome. Health (London) 2018. [DOI: 10.4236/health.2018.1011114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
80
|
Biringer E, Hartveit M, Sundfør B, Ruud T, Borg M. Continuity of care as experienced by mental health service users - a qualitative study. BMC Health Serv Res 2017; 17:763. [PMID: 29162112 PMCID: PMC5698968 DOI: 10.1186/s12913-017-2719-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 11/09/2017] [Indexed: 12/20/2022] Open
Abstract
Background People who struggle with mental health problems can provide valuable insight into understanding and improving the coordination of mental health and welfare services. The aims of the study were to explore service users’ experiences and perceptions of continuity of care within and across services relevant to personal recovery, to elicit which dimensions of continuity of care are most essential to service users, and to generate ideas for improving service users’ experiences of continuity of care. Methods In the context of a hermeneutic-phenomenological approach, ten service users at a community mental health centre were interviewed about their experiences of continuity of care in and across services. Eight of these were re-interviewed two years later. A collaborative research approach was adopted. Data were analysed by means of a data-driven stepwise approach in line with thematic analysis. Results Following the analysis five themes representing experiences of continuity of care were developed. Each theme ranged from poor to good experiences of continuity of care: Relationship – from experiencing frequent setbacks and anxiety due to breaks in relationships, to feeling safe in an ongoing personal relationship; Timeliness – from experiencing frustrating waiting times with worsening of problems, to getting help when needed; Mutuality – from having a one-sided struggle, to a situation in which both professionals and service users take initiatives; Choice – from not having the opportunity to make practical arrangements within the context of one’s everyday life, to having an array of support options to choose from; Knowledge – from feeling confused and insecure because one does not know what is happening, to feeling safe because one is informed about what is going to happen. Participants provided a range of suggestions for improving experiences of continuity of care. Conclusions A discrepancy between aspects of continuity that are essential for service users and their experiences of actual practice was revealed. The valid evidence generated in the present collaborative study therefore offers knowledge to policy makers, professionals and service users that may be of help in their future efforts in orienting primary care, mental health, addiction and welfare services towards recovery. Electronic supplementary material The online version of this article (10.1186/s12913-017-2719-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Eva Biringer
- Helse Fonna Local Health Authority, P.O. Box 2170, N-5504, Haugesund, Norway.
| | - Miriam Hartveit
- Helse Fonna Local Health Authority, P.O. Box 2170, N-5504, Haugesund, Norway
| | - Bengt Sundfør
- Regional Research Network on Mood Disorders (MoodNet), Haukeland University Hospital, Division of Mental Health, P.O. Box 1400, N-5021, Bergen, Norway
| | - Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, P.O. Box 1000, 1478, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, P.O. Box 1171, Blindern, N-0318, Oslo, Norway
| | - Marit Borg
- Faculty of Health Sciences, University College of Southeast Norway, Papirbredden, Drammen kunnskapspark, Grønland 58, 3045, Drammen, Norway
| |
Collapse
|
81
|
Stomski NJ, Morrison P. Participation in mental healthcare: a qualitative meta-synthesis. Int J Ment Health Syst 2017; 11:67. [PMID: 29151851 PMCID: PMC5678577 DOI: 10.1186/s13033-017-0174-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 10/27/2017] [Indexed: 01/14/2023] Open
Abstract
Background Facilitation of service user participation in the co-production of mental healthcare planning and service delivery is an integral component of contemporary mental health policy and clinical guidelines. However, many service users continue to experience exclusion from the planning of their care. This review synthesizes qualitative research about participation in mental healthcare and articulates essential processes that enable service user participation in mental health care. Methods Electronic databases were systematically searched. Studies were included if they were peer reviewed qualitative studies, published between 2000 and 2015, examining participation in mental health care. The Critical Appraisal Skills Program checklist was used to assess the quality of each included study. Constant comparison was used to identify similar constructs across several studies, which were then abstracted into thematic constructs. Results The synthesis resulted in the identification of six principal themes, which articulate key processes that facilitate service user participation in mental healthcare. These themes included: exercising influence; tokenism; sharing knowledge; lacking capacity; respect; and empathy. Conclusions This meta-synthesis demonstrates that service user participation in mental healthcare remains a policy aspiration, which generally has not been translated into clinical practice. The continued lack of impact on policy on the delivery of mental healthcare suggests that change may have to be community driven. Systemic service user advocacy groups could contribute critically to promoting authentic service user participation in the co-production of mental health services.
Collapse
Affiliation(s)
- Norman J Stomski
- School of Health Professions, Murdoch University, ECL 2049 90 South St, Murdoch, WA 6150 Australia
| | - Paul Morrison
- School of Health Professions, Murdoch University, ECL 2049 90 South St, Murdoch, WA 6150 Australia
| |
Collapse
|
82
|
Rosenman ED. Promoting Workplace Safety: Teaching Conflict Management and De-Escalation Skills in Graduate Medical Education. J Grad Med Educ 2017; 9:562-566. [PMID: 29075371 PMCID: PMC5646909 DOI: 10.4300/jgme-d-17-00006.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
83
|
Kortteisto T, Laitila M, Pitkänen A. Attitudes of mental health professionals towards service user involvement. Scand J Caring Sci 2017; 32:681-689. [PMID: 28833316 DOI: 10.1111/scs.12495] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/10/2017] [Indexed: 11/29/2022]
Abstract
Patient-centred care and user involvement in healthcare services are much emphasised globally. This study was the first step in a multicentre research project in Finland to improve service users' and carers' opportunities to be more involved in mental health services. The aim of the study was to assess attitudes of professionals towards service user involvement. The data were collected via an online questionnaire from 1069 mental health professionals in four hospital districts. Altogether, 351 professionals responded. Data were analysed using appropriate statistical methods. According to the results, attitudes of healthcare professionals were more positive towards service users' involvement in their own treatment than in other levels of services. There were also differences in gender, age groups, working places and experiences in the attitudes of professionals concerning service users' involvement in their own treatment. These should be taken into account in the future when planning education for mental health professionals. In spite of governmental guidance on service user involvement and the growing body of knowledge of the benefits associated with it, change in attitudes towards user involvement is slow. Special attention should be paid to the attitudes of professionals working in inpatient care and of those with less working experience.
Collapse
Affiliation(s)
- Tiina Kortteisto
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Minna Laitila
- Hospital District of South Ostrobothnia, Seinäjoki, Finland
| | | |
Collapse
|
84
|
Myklebust LH, Sørgaard K, Wynn R. How mental health service systems are organized may affect the rate of acute admissions to specialized care: Report from a natural experiment involving 5338 admissions. SAGE Open Med 2017; 5:2050312117724311. [PMID: 28839939 PMCID: PMC5546644 DOI: 10.1177/2050312117724311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 07/10/2017] [Indexed: 12/17/2022] Open
Abstract
Objectives: Studies on the dynamics between service organization and acute admissions to psychiatric specialized care have given ambiguous results. We studied the effect of several variables, including service organization, coercion, and patient characteristics on the rate of acute admissions to psychiatric specialist services. In a natural experiment-like study in Norway, we compared a “deinstitutionalized” and a “locally institutionalized” model of mental health services. One had only community outpatient care and used beds at a large Central Mental Hospital; the other also had small bed-units at the local District Psychiatric Centre. Methods: From the case registries, we identified a total of 5338 admissions, which represented all the admissions to the psychiatric specialist services from 2003 to 2006. The data were analyzed with chi-square tests and Z-tests. In order to control for possible confounders and interaction effects, a multivariate analysis was also performed, with a logistic regression model. Results: The use of coercion emerged as the strongest predictor of acute admissions to specialist care (odds ratio = 7.377, 95% confidence interval = 4.131–13.174) followed by service organization (odds ratio = 3.247, 95% confidence interval = 2.582–4.083). Diagnoses of patients predicted acute admissions to a lesser extent. We found that having psychiatric beds available at small local institutions rather than beds at a Central Mental Hospital appeared to decrease the rate of acute admissions. Conclusion: While it is likely that the seriousness of the patients’ condition is the most important factor in doctors’ decisions to refer psychiatric patients acutely, other variables are likely to be important. This study suggests that the organization of mental health services is of importance to the rate of acute admissions to specialized psychiatric care. Systems with beds at local District Psychiatric Centers may reduce the rate of acute admissions to specialized care, compared to systems with local community outpatient services and beds at Central Mental Hospitals.
Collapse
Affiliation(s)
- Lars Henrik Myklebust
- Psychiatric Research Centre of Northern Norway, Nordland Hospital Trust, Bodø, Norway
| | - Knut Sørgaard
- Psychiatric Research Centre of Northern Norway, Nordland Hospital Trust, Bodø, Norway.,Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Rolf Wynn
- Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.,Division of Mental Health and Addictions, University Hospital of North Norway, Tromsø, Norway
| |
Collapse
|
85
|
Doody O, Butler MP, Lyons R, Newman D. Families' experiences of involvement in care planning in mental health services: an integrative literature review. J Psychiatr Ment Health Nurs 2017; 24:412-430. [PMID: 28102020 DOI: 10.1111/jpm.12369] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2017] [Indexed: 11/29/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Current policy advocates for the participation of family carers in care planning. Caring for a person with a mental illness requires a significant commitment from families to support their relative's recovery. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The evidence of family involvement in care planning is generally fraught with conflicting experiences related to different requirements between mental health professionals, families and service users. Confidentiality remains contentious at a practice level in terms of information sharing and decision-making. There is a requirement and need for a shared understanding around care planning between families and mental health professionals. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The provision of written information pertaining to families regarding confidentiality is required at service level. Educational workshops concerning care planning and treatment options should be provided for service users, families and mental health professionals. Further research into effective service-wide strategies that explore with families how their engagement can be positively fostered in mental health services is warranted. ABSTRACT Introduction Mental health service policy stipulates that family carers be involved in care planning. Aim To identify families' experiences of care planning involvement in adult mental health services. Method An integrative review where electronic databases and grey literature were searched for papers published between 01 January 2005 and 10 February 2016. Results Fifteen papers met the inclusion criteria. Thematic analysis generated three themes: (1) families' experience of collaboration, (2) families' perceptions of professionals and (3) families' impressions of the care planning process. Collaborative decision-making is not regularly experienced by families with an 'us' and 'them' divide, perpetuated by a lack of communication, confidentiality constraints and a claim of 'insider knowledge' of service users. When involved, families perceive care planning to be uncoordinated and that their lived experiences are not always appreciated. Discussion Families need to be valued, empowered and engaged in care planning and the partnership distance be addressed. Accommodating the views of family, service user and professionals is preferable but not always possible. Our findings suggest that the key element for professionals is to value all 'insider knowledge' where possible. Implications for Practice Services should develop written information on confidentiality for families and facilitate open communication concerning their involvement in care planning.
Collapse
Affiliation(s)
- O Doody
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - M P Butler
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - R Lyons
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - D Newman
- Cork Intergrative Service, Health Service Executive, Cork, Ireland
| |
Collapse
|
86
|
Cleary M, Lees D, Molloy L, Escott P, Sayers J. Recovery-oriented Care and Leadership in Mental Health Nursing. Issues Ment Health Nurs 2017; 38:458-460. [PMID: 28448230 DOI: 10.1080/01612840.2017.1314738] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Michelle Cleary
- a School of Health Sciences , University of Tasmania , Sydney , NSW , Australia
| | - David Lees
- a School of Health Sciences , University of Tasmania , Sydney , NSW , Australia
| | - Luke Molloy
- b School of Nursing , University of Wollongong , NSW , Australia
| | - Phil Escott
- c Sydney Local Health District Mental Health Service , Sydney , NSW , Australia
| | - Jan Sayers
- a School of Health Sciences , University of Tasmania , Sydney , NSW , Australia
| |
Collapse
|
87
|
Nieminen I, Kaunonen M. Professionals' views on mental health service users' education: challenges and support. J Psychiatr Ment Health Nurs 2017; 24:57-68. [PMID: 28090750 DOI: 10.1111/jpm.12355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2016] [Indexed: 11/29/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Mental health service users (MHSUs) may experience disruptions in their education. However, education has been shown to have a positive influence on their recovery, potentially offering them broader employment opportunities. The literature suggests that providing support for MHSUs in their educational efforts may be beneficial and is wished for by the service users themselves. However, there is a lack of mental health professionals' views on the topic in the setting of a community mental health centre. WHAT DOES THIS PAPER ADD TO THE EXISTING KNOWLEDGE?: In the perception of mental health professionals, the predominance of disease in the life of MHSUs and their marginalization may form barriers to their success in education. Professionals can support MHSUs in their educational efforts by strengthening the MHSUs' internal resources and creating a supportive environment with professional expertise available. A service user-centred education might further help MHSUs to achieve their educational goals. Our findings confirm previous knowledge of a recovery-oriented approach to supporting MHSUs' education. This study explored the topic from the professionals' perspective in the context of community mental health centres, which is a fresh view in the research literature. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings suggest which types of support professionals perceive to be required for MHSUs to advance their studies. Knowledge of adequate forms of support can be applied in the mental health nursing practice to develop support measures for service users to advance in their studies. All levels of the community mental health centres should be aware of and adopt a recovery-oriented approach. MHSUs and professionals need to have a shared opinion on the definition of recovery orientation. This requires mutual discussion and the more active involvement of MHSUs in the design of their own rehabilitation process. ABSTRACT Introduction Studies show the importance of providing support for mental health service users' (MHSUs') education. However, none of these studies explored this support in the community mental health centre setting. The range of MHSUs' educational activities identified in this study varied from participation in courses at the mental health centres to independent studies at different levels of education outside the centres. Aim (1) How do mental health professionals perceive the challenges that may limit service users' potential when they apply for, and complete, their education? (2) How do the professionals describe the methods of rehabilitation aimed at supporting the service users in achieving their educational goals? Method The data were collected from 14 mental health professionals using focus group interviews. Inductive content analysis was then performed. Results Professionals perceive that the predominance of disease and marginalization may be barriers to MHSUs' success in education. Strengthening the MHSUs' internal resources, creating a supportive environment with professional expertise available and service user-centred education appeared to support the MHSUs' educational achievements. Our findings confirm previous knowledge of a recovery-oriented approach to support MHSUs' education. However, professionals' views on this topic in the context of community mental health centres have not been investigated previously. Discussion Professionals perceive that a recovery-oriented approach to rehabilitation may support MHSUs in their educational efforts. Implications for practice A recovery-oriented approach should be adopted by all levels of the community mental health centres. MHSUs and professionals need to have a shared opinion on the definition of recovery orientation. This requires mutual discussion and a more active involvement of MHSUs in the design of their own rehabilitation process.
Collapse
Affiliation(s)
- I Nieminen
- Doctoral student, Nursing Science, School of Health Sciences, University of Tampere, Finland
| | - M Kaunonen
- Professor, Nursing Science, School of Health Sciences, University of Tampere, General Administration Pirkanmaa Hospital District, Finland
| |
Collapse
|
88
|
Smylie J, Cywink M. Missing and murdered Indigenous women: Working with families to prepare for the National Inquiry. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2016; 107:e342-e346. [PMID: 28026695 PMCID: PMC6972438 DOI: 10.17269/cjph.107.5969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 11/24/2016] [Accepted: 11/18/2016] [Indexed: 06/06/2023]
Abstract
No abstract available.
Collapse
Affiliation(s)
- Janet Smylie
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON; Dalla Lana School of Public Health, University of Toronto, Toronto, ON.
| | | |
Collapse
|
89
|
Hopia H, Raitio K. Gamification in Healthcare: Perspectives of Mental Health Service Users and Health Professionals. Issues Ment Health Nurs 2016; 37:894-902. [PMID: 27905826 DOI: 10.1080/01612840.2016.1233595] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this descriptive qualitative study is to explore the perceptions and experiences that mental health service users (n = 10) and healthcare professionals (n = 32) have regarding the use of gamification in mental health care. Data was gathered by interviews. The mental health service users described promoting and retarding factors in the use of gamification, while professionals described the requirements for using gamification and changes occurring in the work culture. Additional research is needed on how game-playing elements could be integrated as a systematic part of mental health practice and how the digital skills of professionals could be effectively developed.
Collapse
Affiliation(s)
- Hanna Hopia
- a JAMK University of Applied Sciences, School of Health and Social Studies , Jyvaskyla , Finland
| | - Katja Raitio
- a JAMK University of Applied Sciences, School of Health and Social Studies , Jyvaskyla , Finland
| |
Collapse
|
90
|
Community Treatment Orders-A pause for thought. Asian J Psychiatr 2016; 24:1-4. [PMID: 27931888 DOI: 10.1016/j.ajp.2016.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/15/2016] [Accepted: 08/17/2016] [Indexed: 11/23/2022]
Abstract
Community Treatment Orders (CTO) have been available for several decades in some countries and are being progressively introduced worldwide, with significant uptake in Asian countries as they move more mental health care into the community. However the evidence for the effectiveness of CTOs is limited. The evidence from local audits and evaluations is conflicted with some studies showing clear benefit and others not. The same is the case for uncontrolled before and after studies. The higher levels of evidence such as randomised controlled trials, systematic reviews, and Cochrane reviews have consistently failed to demonstrate benefits from CTO use on key measures such as symptom levels, functioning, and healthcare use. Despite this they are increasingly available internationally and often greeted enthusiastically by clinicians and families who want to ensure care and follow up for the mentally ill. This article briefly discusses the evidence before describing potential alternatives to the use of compulsion that do have an evidence base, such as multidisciplinary community working, housing initiatives, and employment support.
Collapse
|
91
|
The Variability of Nursing Attitudes Toward Mental Illness: An Integrative Review. Arch Psychiatr Nurs 2016; 30:788-796. [PMID: 27888976 PMCID: PMC5127450 DOI: 10.1016/j.apnu.2016.07.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/08/2016] [Accepted: 07/09/2016] [Indexed: 11/20/2022]
Abstract
Mental illnesses are common worldwide, and nurses' attitudes toward mental illness have an impact on the care they deliver. This integrative literature review focused on nurses' attitudes toward mental illness. Four databases were searched between January 1, 1995 to October 31, 2015 selecting studies, which met the following inclusion criteria: 1) English language; and 2) Research in which the measured outcome was nurses' attitudes toward mental illness. Fourteen studies conducted across 20 countries that 4282 participants met the inclusion criteria. No study was conducted in the United States (U.S.). Studies reported that nurses had mixed attitudes toward mental illness, which were comparable to those of the general public. More negative attitudes were directed toward persons with schizophrenia. Results indicate the need for further research to determine whether attitudes among nurses in the U.S. differ from those reported from other countries and to examine potential gaps in nursing curriculum regarding mental illness.
Collapse
|
92
|
Moljord IEO, Helland-Hansen KA, Salvesen Ø, Olsø TM, Gudde CB, Rise MB, Steinsbekk A, Eriksen L. Short time effect of a self-referral to inpatient treatment for patients with severe mental disorders: a randomized controlled trial. BMC Health Serv Res 2016; 16:513. [PMID: 27659102 PMCID: PMC5034559 DOI: 10.1186/s12913-016-1712-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 08/25/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Service user participation is a central principle in mental healthcare, and the opportunity to self-refer to inpatient treatment is used to increase service user involvement and activation. The aim of this study was to investigate the short-term effect of a self-referral system in an inpatient rehabilitation unit at a community mental health center on patient activation and recovery in individuals with severe mental disorders. METHODS A randomized controlled study including 53 patients (41 % females, mean age 40 years). Twenty-six patients in the intervention group were given a contract for self-referral to inpatient treatment, limited to maximum 5 days and a quarantine time of 14 days between each stay. The control group (27 participants) received treatment as usual, and was offered the intervention after 1 year. The Patient Activation Measure was the primary outcome and secondary outcome was the Recovery Assessment Scale. Mixed models were used to assess group differences. RESULTS During the 4 months period, 15 (58 %) of 26 participants in the intervention group used the contract of self-referral to inpatient treatment. The intervention group had more admissions than the control group but both groups had a similar total use of inpatient days and out-patient consultations. The self-referral to inpatient treatment counted for 11 % of all inpatient days for the intervention group. There were no significant differences in the outcome between the groups on patient activation (estimated mean difference 2.7, 95 % confidence interval = -5.5 to 10.8, p = 0.52) or recovery (estimated mean difference 0.01, 95 % confidence interval = -0.3 to 0.3, p = 0.92). CONCLUSIONS Giving persons with severe mental disorders the possibility to self-refer to inpatient treatment did not change their level of patient activation and recovery after 4 months and did not lead to increased use of health services. The cost-effectiveness and long-term effect of self-referral to inpatient treatment should be investigated further. TRIAL REGISTRATION NCT01133587 , clinicaltrials.gov.
Collapse
Affiliation(s)
- Inger Elise Opheim Moljord
- Division of Psychiatry, Nidaros Community Mental Health Center, St. Olav's University Hospital, Østmarkveien 21, Post box 1893 Lade, N-7440, Trondheim, Norway. .,Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. .,Division of Psychiatry, Department of Research and Development, St. Olav's University Hospital, Trondheim, Norway.
| | - Kristel Antine Helland-Hansen
- Division of Psychiatry, Nidaros Community Mental Health Center, St. Olav's University Hospital, Østmarkveien 21, Post box 1893 Lade, N-7440, Trondheim, Norway
| | - Øyvind Salvesen
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Turid Møller Olsø
- Norwegian Resource Center for Community Mental Health, Norwegian University of Science and Technology Social Research AS, Trondheim, Norway
| | - Camilla Buch Gudde
- Forensic Department Brøset, Center for Research and Education in Forensic Psychiatry, St. Olav's University Hospital, Trondheim, Norway.,Department of Social Work and Health Science, Faculty of Social Science and Technology Management, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marit By Rise
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Aslak Steinsbekk
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lasse Eriksen
- Division of Psychiatry, Nidaros Community Mental Health Center, St. Olav's University Hospital, Østmarkveien 21, Post box 1893 Lade, N-7440, Trondheim, Norway.,Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
93
|
Samuelsen SS, Moljord IEO, Eriksen L. Re-establishing and preserving hope of recovery through user participation in patients with a severe mental disorder: the self-referral-to-inpatient-treatment project. Nurs Open 2016; 3:222-226. [PMID: 27708833 PMCID: PMC5050546 DOI: 10.1002/nop2.59] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 04/25/2016] [Indexed: 11/07/2022] Open
Abstract
AIMS The treatment of patients with a severe mental disorder is generally not good enough. The aim of this article was to illustrate some alternative approaches for better understanding and treatment for the individual, besides seeing and interpreting the symptoms. METHODS The context of understanding is regulation of emotions whit a person-based approach. The self-referral-to-inpatient-treatment project is presented and discussed as a possible method of intervention to improve patient involvement. DESIGN Theoretical approach. RESULTS Involvement in genuine decisions, where the individual is in control and feels emotionally robust, is important. The experience of regaining authority through being self-empowered with sufficient environmental support is essential for re-establishing and preserving hope of recovery.
Collapse
Affiliation(s)
- Silje S Samuelsen
- St Olavs University Hospital Nidaros Community Mental Health Center Trondheim Norway
| | | | - Lasse Eriksen
- St Olavs University Hospital Nidaros Community Mental Health Center Trondheim Norway; Norwegian University of Science and Technology Faculty of Medicine Institute of Neuroscience Trondheim Norway
| |
Collapse
|
94
|
Scrandis DA. Innovations in Mental Health Care. Open Nurs J 2016; 10:36. [PMID: 27347253 PMCID: PMC4894943 DOI: 10.2174/1874434601610010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
95
|
Olsø TM, Gudde CB, Moljord IEO, Evensen GH, Antonsen DØ, Eriksen L. More than just a bed: mental health service users' experiences of self-referral admission. Int J Ment Health Syst 2016; 10:11. [PMID: 26918028 PMCID: PMC4766730 DOI: 10.1186/s13033-016-0045-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 02/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several community mental health centres and mental hospitals in Norway now allow users with a diagnosis of severe mental illness to self-refer for admission. This give a group of service users who are well-known to service providers the opportunity to refer themselves for short inpatient stays without contacting their doctor, a duty doctor or emergency department. Evidence on self-referral admissions is lacking. AIM To explore service users' experiences of having the opportunity to refer themselves for a short inpatient stay. METHODS Forty-two qualitative semi-structured interviews were undertaken between 2010 and 2014 in a group of 28 service users with serious mental illness and with or without substance abuse problems. All respondents had a contract which allowed them to self-refer for inpatient treatment. Systematic text condensation was applied in the analyses. RESULTS Self-referral inpatient admission is more than just a bed. It was perceived as a new, unconventional health service, which differed substantially from earlier experiences of inpatient care and was characterised by different values and treatment principles. The differences were related to the content, quality and organisation of treatment. Having the option to decide about admission for oneself and having access to services focusing on individual needs seem to enhance service users' confidence, both in the services they use and in their own ability to cope with everyday life. CONCLUSIONS Self-referral inpatient admission is a concrete example of how a user involvement policy can be implemented in mental health services. It is important to emphasise that the self-referral admission process described here is an offer in development and that we are awaiting findings from a larger RCT study. More evidence is needed to determine what aspects of the service are helpful to service users, the long-term effects, appropriateness and cost-effectiveness, and how the service can be integrated into the mental health system.
Collapse
Affiliation(s)
- Turid Møller Olsø
- Norwegian Resource Centre for Community Mental Health, NTNU Social Research AS, Trondheim, Norway
| | - Camilla Buch Gudde
- Forensic Department Brøset, Centre for Research and Education in Forensic Psychiatry, St. Olavs University Hospital, P.O. 1803, Lade, NO-7440, Trondheim, Norway
| | - Inger Elise Opheim Moljord
- Nidaros Community Mental Health Centre, St. Olav's University Hospital, Trondheim, Norway ; Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gretha Helen Evensen
- Norwegian Resource Centre for Community Mental Health, NTNU Social Research AS, Trondheim, Norway
| | - Dag Øivind Antonsen
- Resource Centre for Service User Experience and Service Development (KBT Middle-Norway), Mental Health, NO-7409, Trondheim, Norway
| | - Lasse Eriksen
- Nidaros Community Mental Health Centre, St. Olav's University Hospital, Trondheim, Norway ; Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
96
|
Grant A. Demedicalising misery: Welcoming the human paradigm in mental health nurse education. NURSE EDUCATION TODAY 2015; 35:e50-e53. [PMID: 26073584 DOI: 10.1016/j.nedt.2015.05.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 05/22/2015] [Accepted: 05/30/2015] [Indexed: 06/04/2023]
Affiliation(s)
- Alec Grant
- University of Brighton, School of Health Sciences, Robert Dodd Building, 49 Darley Road, Eastbourne BN20 7UR, East Sussex, United Kingdom.
| |
Collapse
|