Mental Health First Aid crisis role-plays between pharmacists and simulated patients with lived experience: a thematic analysis of debrief

The power of role play in nursing education: A bibliometric analysis and visualization

AIM

This study aims to conduct a bibliometric analysis of research involving the role play method in nursing education by visualizing global research trends in this area, identifying the journals with the most publications, and examining author and country collaborations.

METHODS

The study utilized data retrieved from the Web of Science (WOS) database and conducted analyses using Vosviewer, Bibliometrix, and custom-written Python scripts. 281 publications were included in the bibliometric analysis.

RESULTS

Research on the role play method spans from 1993 to 2024. The top three research areas are; "Nursing," "Education & Educational Research" and "Health Care Sciences & Services". The dataset includes articles from 119 different journals, with minimal collaboration observed among authors, countries, and institutions.

CONCLUSION

This study thoroughly explored global trends and key areas of role play in nursing research using bibliometric and visualization analyses. The analysis results showed that the role play method is gaining growing recognition in nursing education and the development of clinical skills. Future research is recommended to explore its effectiveness across diverse cultural and clinical contexts and encourage interdisciplinary collaborations to expand the knowledge base.

Insights from the integration of mental health first aid into pharmacy education

INTRODUCTION

Doctor of pharmacy programs are encouraged to proactively promote well-being for students, faculty, and staff. In addition, a need has been highlighted to place greater focus on reducing mental health stigma within the promotion of patient-centered care. Mental Health First Aid (MHFA) is an evidence-based, early-intervention course that teaches participants how to support individuals experiencing a mental health challenge. Incorporation of MHFA into healthcare education has become an interest for many programs to address these needs, however, limited research is available regarding implementation of MHFA into pharmacy curricula. This study aimed to assess the current state of MHFA within existing PharmD programs and present opportunities to facilitate MHFA integration.

METHODS

An online survey was administered to all Accreditation Council for Pharmacy Education (ACPE)-accredited pharmacy programs within the United States (US). Survey questions collected information on institution demographics, whether MHFA training is currently offered, and specifics of the MHFA training program. Questions assessing barriers and successes with MHFA implementation were also included.

RESULTS

Twenty-six of the 52 programs that responded to the survey indicated that they offer MHFA to pharmacy students, with thirteen programs incorporating it as a core requirement within their curriculum. The top identified barriers to implementation included time requirements for training, cost, and curricular structure.

CONCLUSION

Implementation of MHFA is feasible as a required element of pharmacy curricula and aligns with ACPE standards 2025. MHFA training can assist student pharmacists with developing competency in providing care for persons with mental health and substance use challenges.

Lived Experience Participation in Suicide Prevention Activities in Australia, a Scoping Review

INTRODUCTION

Lived experience inclusion is considered best practice in suicide prevention activities. Despite this, research remains limited exploring how individuals with lived experience actively engage in suicide research and prevention activities. The current scoping review aimed to map and summarise the existing literature describing the 'how' of lived experience participation in Australia.

METHODS

A scoping review according to the methodology of Arksey and O'Malley (2005) was undertaken with descriptive (e.g., study aims and methodology) and descriptive analytic data (such as key definitions and participation descriptors) being extracted from included studies.

RESULTS

A total of 42 studies met the inclusion criteria and were published between 2016 and 2023. There were many gaps in the data extracted, with participation descriptors and definitions often not reported in the literature. The included studies lacked clear and consistent definitions and practices when involving people with lived experience.

CONCLUSION

Current processes for reporting experiences of lived experience participation in suicide prevention lack standardisation within peer-reviewed publications. This review notes that there are gaps in the literature; however, the evidence base is growing for research that reports on suicide prevention research and activities that involve people with lived experience.

PATIENT OR PUBLIC CONTRIBUTION

This study was created and undertaken by a PhD candidate with lived experience of thoughts of suicide, suicide attempt and caring for a loved one through suicide. A further team member has lived experience of being a suicide attempt survivor, continued thoughts of suicide and carer of family with suicidal thoughts. The study was informed by a Community Advisory Committee, of which four members have lived experience of suicide, with the remaining two having lived experience in areas where inclusion is paramount such as disability and suicide research. Ethics approval was not required for the participation of the Community Advisory Committee as they were providing advice only on the research conduct.

Co-design and content validation of psychosis care assessment material for medical, pharmacy, nursing, and occupational therapy curricula

BACKGROUND

Despite high disease burden and heightened suicide risk associated with psychosis, psychosis education is lacking in healthcare curricula, potentially hindering students' willingness, and confidence to provide psychosis care as future healthcare professionals. This study aimed to co-design and content validate psychosis care assessment material for medical, pharmacy, nursing, and occupational therapy curricula.

METHODS

A nominal group technique (NGT) meeting was conducted to generate and rank ideas among people with lived/living experience of mental illness. Prioritised ideas were used to create simulated role-play scenarios for each discipline, by discipline experts. The developed scenarios underwent content validation by content experts, whereby the content validity index was computed for relevance and clarity.

RESULTS

The four highest ranked ideas based on rank scores and accumulated rank score sums were selected during the NGT meeting and used to guide the development of four role-play scenarios focusing on antipsychotic medication side effects, suicide risk, paranoia and delusions, and visual hallucinations. Discipline experts created scenario outlines and rubrics for each selected idea. Content validity indices of all items were deemed satisfactory, ranging from 0.8 to 1. Written feedback for each role-play scenario was considered and scenarios/rubrics were modified accordingly.

CONCLUSION

Overall, this study provides a framework for partnering with mental health stakeholders to co-design and validate psychosis care assessment material for healthcare curricula. Through the integral contribution of people with lived/living experience and clinicians, authentic scenarios which reflect real-life practice have been developed. Future research is required to evaluate the newly developed materials in educational setting.

Side Effects of Psychotropic Medications Experienced by a Community Sample of People Living With Severe and Persistent Mental Illness

BACKGROUND

Psychotropic medications are a common treatment modality for people living with severe and persistent mental illness (SPMI). While effective in reducing relapse and hospitalisation, psychotropic medications cause numerous side effects, varying in nature and severity. Identification and management of side effects is crucial in the ongoing management of SPMI.

OBJECTIVE

To characterise the side effects of psychotropic medications, experienced by a sample of consumers living with SPMI, using a validated tool.

SETTING AND PARTICIPANTS

Consumers with SPMI living in the community were recruited from all 25 community pharmacies across four Australian regions, which were allocated to the intervention arm of the Bridging the Gap between Physical and Mental Illness (PharMIbridge) randomised controlled trial (RCT).

MAIN OUTCOME MEASURES

Responses to the My Medicines & Me Questionnaire (M3Q).

RESULTS

Consumers (n = 156) most frequently reported side effects in the categories of sleep-related side effects (80.8%, n = 126), mood-related side effects (75.6%, n = 118) and weight and appetite changes (60.3%, n = 107). Daytime somnolence was the most reported individual side effect (68.6%, n = 107). Mood-related side effects were ranked as the most bothersome, followed by sleep-related side effects and weight and appetite changes. More than one-quarter (29.5%, n = 46) of consumers reported choosing not to take their medications due to side effects. Consumers more frequently told family and friends about the side effects rather than healthcare professionals.

CONCLUSIONS

An overwhelming majority of consumers experienced at least one side effect attributed to their psychotropic medication, with many experiencing multiple. These findings highlight the critical need to regularly engage with consumers to discuss, identify and manage side effects to treatment burden, reduce risk of non-adherence and improve their treatment experience.

PATIENT OR PUBLIC CONTRIBUTION

The PharMIbridge RCT included a training programme and intervention service that was co-designed and co-delivered with people with lived experience of mental illness. The research team, expert advisory panel and mentors who supported the delivery and implementation of the training and intervention included participants who have lived experience of mental illness or caring for someone with mental illness.

TRIAL REGISTRATION

ANZCTR12620000577910.

Community pharmacists' views and experiences of delivering in-pharmacy medication reviews for people living with severe and persistent mental illness: a qualitative study

BACKGROUND

People living with severe and persistent mental illness (SPMI) often take multiple medications and are at risk of experiencing medication related problems. Medication review services have the potential to reduce inappropriate use of psychotropic medications and improve adherence. However, there is limited research regarding pharmacists' perspectives when providing such services.

AIM

To explore community pharmacists' views and experiences of providing an in-pharmacy medication review (MedsCheck) for people living with SPMI.

METHOD

Semi-structured interviews were conducted between November 2021 and May 2022 with community pharmacists participating in the comparator group of the PharMIbridge Randomised Controlled Trial (RCT), which aimed to improve medication adherence and manage physical health concerns for people living with SPMI. Interviews were recorded, transcribed, and analysed using inductive thematic analysis.

RESULTS

Fifteen semi-structured interviews were conducted with community pharmacists including pharmacy owners, managers and employee pharmacists. Most pharmacist participants who were interviewed (n = 10) were aged under 39 and more than half (n = 8) had 10 or more years of pharmacy experience. Five key themes were identified: 1) Pharmacists' roles in the management of SPMI in community pharmacy; 2) Mental health education and training; 3) Pharmacy resources; 4) Challenges with interprofessional collaboration and 5) Impact on professional relationships and consumer outcomes.

CONCLUSION

Pharmacists are motivated to support people living with SPMI. Mental health training, as well as arrangements regarding pharmacy workflow and appropriate remuneration are needed to enable pharmacists to better support people living with SPMI. Referral pathways should be directly accessible by community pharmacists to assist interprofessional collaboration.

Simulated psychosis care role-plays for pharmacy curricula: a qualitative exploration of student experiences

PURPOSE

Mental Health First Aid (MHFA) training is embedded in various tertiary healthcare curricula. However, opportunities for students to practise their newly acquired MHFA skills before entering the clinical practice workforce are lacking. The purpose of this study was to explore pharmacy students' experiences of MHFA training and post-MHFA simulated psychosis care role-plays.

METHODS

Final-year pharmacy students received MHFA training, after which they were invited to participate in simulated patient role-plays with trained actors, whilst being observed by peers, pharmacy tutors and mental health consumer educators (MHCEs). Immediately after each role-play, the role-playing student engaged in self-assessment, followed by performance feedback and debrief discussions with the tutor, MHCE and observing peers. All MHFA-trained students were invited to participate in audio-recorded focus groups to explore their experiences. Audio-recordings were transcribed verbatim and thematically analysed.

RESULTS

MHFA training was delivered to 209 students, of which 86 participated in a simulated patient role-play as a role-player and the remaining students observed. Seven focus groups were conducted with 36 students (mean duration 40 min, SD 11 min). Five themes emerged: scenario reactions, realistic but not real, mental health confidence, MHFA skills application, feedback and self-reflection.

CONCLUSION

Students enjoyed the post-MHFA simulated psychosis care role-plays, which provided opportunities to apply and reflect on their newly-acquired MHFA skills in a safe learning environment. These experiences enhanced students' confidence to support people in the community, experiencing mental health symptoms or crises, and could be an add-on to MHFA training in the future.

What works for whom, how and why in mental health education for undergraduate health profession students? A realist synthesis protocol

INTRODUCTION

It has been shown that mental health education can support positive attitudes of health profession students towards people with mental health challenges, which supports them to provide optimal healthcare to this group. There are many different approaches to designing and delivering mental health education to health profession students. Each has their own advantages and disadvantages, and often mental health education programmes incorporate a multimodal approach in order to reap the benefits of a variety of teaching and learning approaches. The aim of this study is to understand the current landscape of teaching and learning approaches to mental health education for undergraduate health profession students. We will examine the features of successful outcomes for health profession students for:Learning environment.Knowledge development and retention.Confidence.

MOTIVATION

Preparedness for professional practice.

METHODS

For this, a realist synthesis has been chosen in order to review the literature. Realist synthesis lends itself to the review of complex interventions such as mental health education for undergraduate health profession curricula because it seeks to uncover the range of different mechanisms and context configurations that produce different outcomes. Health profession education and education practice, in general, is complex. A patient and public involvement (PPI) group is involved throughout this study and includes undergraduate health profession students, and members of the St John of Gods Hospital Consumers and Carers Council who are involved at every stage of the research. This study will engage with a stakeholder group who will support the refining of the programme theory.

ETHICS AND DISSEMINATION

Ethical approval has been sought and approved by Royal College of Surgeons, Ireland Ethical Committee (REC number: 212622783). We will aim to write up and publish the full synthesis as a journal article. We will also discuss ways of dissemination outside of academia with our PPI group.

Mental Health First Aid as a tool for improving mental health and well-being

BACKGROUND

The prevalence of mental health problems is high, and they have a wide-ranging and deleterious effect on many sectors in society. As well as the impact on individuals and families, mental health problems in the workplace negatively affect productivity. One of the factors that may exacerbate the impact of mental health problems is a lack of 'mental health literacy' in the general population. This has been defined as 'knowledge and beliefs about mental disorders, which aid their recognition, management, or prevention'. Mental Health First Aid (MHFA) is a brief training programme developed in Australia in 2000; its aim is to improve mental health literacy and teach mental health first aid strategies. The course has been adapted for various contexts, but essentially covers the symptoms of various mental health disorders, along with associated mental health crisis situations. The programmes also teach trainees how to provide immediate help to people experiencing mental health difficulties, as well as how to signpost to professional services. It is theorised that improved knowledge will encourage the trainees to provide support, and encourage people to actively seek help, thereby leading to improvements in mental health. This review focuses on the effects of MHFA on the mental health and mental well-being of individuals and communities in which MHFA training has been provided. We also examine the impact on mental health literacy. This information is essential for decision-makers considering the role of MHFA training in their organisations.

OBJECTIVES

To examine mental health and well-being, mental health service usage, and adverse effects of MHFA training on individuals in the communities in which MHFA training is delivered.

SEARCH METHODS

We developed a sensitive search strategy to identify randomised controlled trials (RCTs) of MHFA training. This approach used bibliographic databases searching, using a search strategy developed for Ovid MEDLINE (1946 -), and translated across to Ovid Embase (1974 -), Ovid PsycINFO (1967 -), the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Common Mental Disorders Group's Specialised Register (CCMDCTR). We also searched online clinical trial registries (ClinicalTrials.gov and WHO ICTRP), grey literature and reference lists of included studies, and contacted researchers in the field to identify additional and ongoing studies. Searches are current to 13th June 2023.

SELECTION CRITERIA

We included RCTs and cluster-RCTs comparing any type of MHFA-trademarked course to no intervention, active or attention control (such as first aid courses), waiting list control, or alternative mental health literacy interventions. Participants were individuals in the communities in which MHFA training is delivered and MHFA trainees. Primary outcomes included mental health and well-being of individuals, mental health service usage and adverse effects of MHFA training. Secondary outcomes related to individuals, MHFA trainees, and communities or organisations in which MHFA training has been delivered DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. We analysed categorical outcomes as risk ratios (RRs) and odds ratios (ORs), and continuous outcomes as mean differences (MDs) or standardised mean differences (SMDs), with 95% confidence intervals (CIs). We pooled data using a random-effects model. Two review authors independently assessed the key results using the Risk of Bias 2 tool and applied the GRADE criteria to assess the certainty of evidence MAIN RESULTS: Twenty-one studies involving a total of 22,604 participants were included in the review. Fifteen studies compared MHFA training with no intervention/waiting list, two studies compared MHFA training with an alternative mental health literacy intervention, and four studies compared MHFA training with an active or an attention control intervention. Our primary time point was between six and 12 months. When MHFA training was compared with no intervention, it may have little to no effect on the mental health of individuals at six to 12 months, but the evidence is very uncertain (OR 0.88, 95% CI 0.61 to 1.28; 3 studies; 3939 participants). We judged all the results that contributed to this outcome as being at high risk of bias. No study measured mental health service usage at six to 12 months. We did not find published data on adverse effects. Only one study with usable data compared MHFA training with an alternative mental health literacy intervention. The study did not measure outcomes in individuals in the community. It also did not measure outcomes at our primary time point of six to 12 months. Four studies with usable data compared MHFA training to an active or attention control. None of the studies measured outcomes at our primary time point of six to 12 months.

AUTHORS' CONCLUSIONS

We cannot draw conclusions about the effects of MHFA training on our primary outcomes due to the lack of good quality evidence. This is the case whether it is compared to no intervention, to an alternative mental health literacy intervention, or to an active control. Studies are at high risk of bias and often not sufficiently large to be able to detect differences.