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Menear M, Ashcroft R, Dahrouge S, Silveira J, Booton J, Emode M, McKenzie K. Person-centered care for common mental disorders in Ontario's primary care patient-centered medical homes: a qualitative study of provider perspectives. BMC PRIMARY CARE 2024; 25:278. [PMID: 39095749 PMCID: PMC11295484 DOI: 10.1186/s12875-024-02519-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 07/10/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND For more than a decade, the Patient-Centered Medical Home model has been a guiding vision for the modernization of primary care systems. In Canada, Ontario's Family Health Teams (FHTs) were designed in the mid-2000s with the medical home model in mind. These primary care clinics aim to provide accessible, comprehensive, and person-centered primary care services to communities across Ontario. Their services typically include mental health care for people experiencing common mental disorders, such as depression and anxiety disorders. It remains unclear, however, whether the mental health care delivered within FHTs is consistent with person-centered care approaches. In the current study, we aimed to explore the perspectives of FHT providers on the care delivered to people with common mental disorders to determine whether, and to what extent, they believed this care was person-centered. METHODS We conducted a qualitative grounded theory study involving interviews with 65 health professionals and administrators from 18 FHTs across Ontario. Transcripts were coded using a three-step process of initial, focused, and axial coding that mixed inductive and deductive approaches informed by sensitizing concepts on person-centeredness. RESULTS Practices and challenges associated with the delivery of mental health care in a person-centered way were captured by several themes regrouped into five domains: (1) patient as unique person, (2) patient-provider relationship, (3) sharing power and responsibility, (4) connecting to family and community, and (5) creating person-centered care environments. FHT providers perceived that they delivered person-centered care by delivering mental health care that was responsive, flexible, and consistent with biopsychosocial approaches. They emphasized the importance of creating long-lasting relationships with patients grounded in empathy and trust. Their challenges included being able to ensure continuity of care, adequately prioritizing patients' mental health issues, and meaningfully engaging patients and families as partners in care. CONCLUSIONS Our findings suggest that FHT providers have adopted a range of person-centered practices for people with common mental disorders. However, greater attention to practices such as shared decision making, supporting self-management, and involving families in care would strengthen person-centeredness and bring teams closer to the Patient-Centered Medical Home vision.
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Affiliation(s)
- Matthew Menear
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, Canada.
- VITAM Centre de recherche en santé durable, Quebec City, Canada.
| | - Rachelle Ashcroft
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Simone Dahrouge
- Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Jose Silveira
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jocelyn Booton
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Monica Emode
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Kwame McKenzie
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Wellesley Institute, Toronto, Canada
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Tannerah A, Hazel O, Desson S, Farah R, Kamil‐Thomas Z, Iqbal H, Eames C, Saini P, Bifarin O. Consultations With Muslims From Minoritised Ethnic Communities Living in Deprived Areas: Identifying Inequities in Mental Health Care and Support. Health Expect 2024; 27:e14132. [PMID: 38956944 PMCID: PMC11220172 DOI: 10.1111/hex.14132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/27/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Limited research concerning existing inequities in mental health care and support services in the United Kingdom captures perceptions and lived experiences of the significantly underrepresented Muslim population. METHODS Underpinned by social constructivist theory, we used consultation to facilitate public and patient involvement and engagement (PPIE) to identify inequities in mental health care and support experienced by Muslims from minoritised ethnic communities living in deprived areas in Liverpool, UK. The rationale was to (a) better inform standards and policies in healthcare and (b) provide a psychologically safe space to members of the Muslim community to share perceptions and experiences of mental health care and support services. To ensure trustworthiness of the data, member checking was adopted. This paper describes the procedure to achieving this consultation, including our recruitment strategy, data collection and analysis as well as key findings. FINDINGS Twenty-seven consultees attended the women's consultation and eight consultees attended the men's consultation. Consultees were from Yemeni, Somali, Sudanese, Egyptian, Algerian, Pakistani and Moroccan communities and share the Islamic faith. Four key interlinked themes were identified from consultees' narratives: (1) broken cycle of trust; (2) an overmedicalised model of care; (3) community mental health prevention initiatives; and (4) culturally conscious training and education. CONCLUSIONS The Muslim population has identified numerous barriers to accessing mental health support and there is a need to resource activities that would aid deeper understanding of mental health support needs through continuous and meaningful community initiatives. This would afford mental health practitioners and organisations opportunities for developing realistic anti-racism strategies, effectively adopting social prescription, strengthening partnerships and collaborations aimed at supporting delivery of evidence-based mental health care provisions to tackle mental health inequities. PATIENT AND PUBLIC INVOLVEMENT This paper reports on the involvement and engagement of Muslims from minoritised ethnic communities living in the Liverpool city region.
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Affiliation(s)
- Ashraf Tannerah
- School of Nursing and Advanced Practice, School of PsychologyLiverpool John Moores UniversityLiverpoolUK
- Alder Hey Children's NHS Foundation TrustLiverpoolUK
| | | | - Sheree Desson
- School of Nursing and Advanced Practice, School of PsychologyLiverpool John Moores UniversityLiverpoolUK
- Mersey Care NHS Foundation TrustLiverpoolUK
| | - Rahima Farah
- Central Liverpool Primary Care NetworkLiverpoolUK
- Liverpool City CouncilLiverpoolUK
| | - Zalihe Kamil‐Thomas
- School of Nursing and Advanced Practice, School of PsychologyLiverpool John Moores UniversityLiverpoolUK
| | - Halima Iqbal
- School of Nursing and Healthcare LeadershipUniversity of BradfordBradfordUK
| | - Catrin Eames
- School of Nursing and Advanced Practice, School of PsychologyLiverpool John Moores UniversityLiverpoolUK
| | - Pooja Saini
- School of Nursing and Advanced Practice, School of PsychologyLiverpool John Moores UniversityLiverpoolUK
| | - Oladayo Bifarin
- School of Nursing and Advanced Practice, School of PsychologyLiverpool John Moores UniversityLiverpoolUK
- Mersey Care NHS Foundation TrustLiverpoolUK
- Senior Research Leader ProgrammeNational Institute for Health and Care Research (NIHR)LondonUK
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Ahlstrand A, Mishina K, Elomaa-Krapu M, Joronen K. Consumer involvement and guiding frameworks in mental healthcare: An integrative literature review. Int J Ment Health Nurs 2024. [PMID: 38706160 DOI: 10.1111/inm.13343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/26/2024] [Accepted: 04/14/2024] [Indexed: 05/07/2024]
Abstract
Perspectives of healthcare have, in past decades, focused more on active citizenship, human rights and empowerment. Healthcare consumer involvement as a concept is still unstructured and consumers have no apparent opportunities to participate in their care processes. The focus is often on the expertise of professionals, even if mental health consumers are willing to become involved and have sufficient decisional capacity. The aim of this integrative literature review was to construct an understanding of consumer perceptions and guiding frameworks of consumer involvement. There was no previous synthesis of mental health consumer perceptions combined with guiding frameworks. An integrative review methodology was employed, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the 18 studies included was analysed with the Whittemore and Knafl approach. By following Braun and Clarke's guidelines, an inductive thematic analysis was conducted to collate the themes from the selected papers. Mental health consumers' perceptions of involvement included expectations of person-centred care, such as respect, dignity, equal interaction, supportive environments and being part of a community. This research did not find any single established framework to give clear guidelines for consumer involvement in mental healthcare, but similar determinants describing various frameworks were uncovered. This review also shows how the terminology has changed throughout the years. The perceptions of mental health consumers need to be considered to enable the implementation of person-centredness from guidelines through to practice. Paying more attention to the education of professional mental health caregivers and the involvement of mental health consumers in their care provides better opportunities to co-develop successful mental health services and recovery processes.
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Affiliation(s)
- Anita Ahlstrand
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
- Metropolia University of Applied Sciences, Helsinki, Finland
| | - Kaisa Mishina
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Minna Elomaa-Krapu
- Metropolia University of Applied Sciences, Helsinki, Finland
- Faculty of Social Sciences, Nursing Science, Tampere University, Tampere, Finland
| | - Katja Joronen
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
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Pillen H, Attrill S, Fisher A, Forte S, Brebner C, Robinson S. Educating for supported decision making and shared decision making: a scoping review of educational design and outcomes for education and training interventions. Disabil Rehabil 2024:1-12. [PMID: 38591714 DOI: 10.1080/09638288.2024.2337099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/24/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE To characterise existing knowledge about the design and learning outcomes of education and training programs for supported or shared decision making. MATERIALS AND METHODS A scoping review was performed to identify academic and grey literature, published between January 2006 and February 2022, that reported on the design and/or learning outcomes of supported or shared decision making education or training programs. Eligible literature was mapped across domains of educational design and Kirkpatrick's hierarchy of learning effectiveness, and then qualitatively synthesised using cross-case analysis. RESULTS A total of 33 articles were identified (n = 7 for supported decision making and n = 26 for shared decision making) that provided education or training to supporters of persons with mental illness or substance use disorders (n = 14), dementia or neurocognitive disorders (n = 6), cognitive disability (n = 5), mixed populations (n = 1), and those receiving end-of-life care (n = 7). In their design, most programs sought specific changes in practice (behaviour) via experiential learning. Reported educational outcomes also focused on supporter behaviour, with limited evidence for how changes in learner attitudes, skills, or knowledge might be contributing to changes in supporter behaviour. CONCLUSIONS Future education and training would benefit from a closer engagement with theories of teaching and learning, particularly those oriented towards co-design.
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Affiliation(s)
- Heath Pillen
- School of Allied Health Science and Practice, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Stacie Attrill
- School of Allied Health Science and Practice, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Alinka Fisher
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Sabrina Forte
- Council for Intellectual Disability, Surry Hills, Australia
| | - Chris Brebner
- Office of the Deputy Vice-Chancellor, Flinders University, Adelaide, Australia
| | - Sally Robinson
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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O'Donohue E, Aguey-Zinsou M, Yule E, Fairhurst I, Debaets M. Mental health consumer perspectives of a person-centred multidisciplinary care planning meeting on a rehabilitation inpatient unit. Int J Ment Health Nurs 2023; 32:1701-1712. [PMID: 37477147 DOI: 10.1111/inm.13192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/14/2023] [Accepted: 06/28/2023] [Indexed: 07/22/2023]
Abstract
Mental health consumers are seeking genuine involvement in the planning regarding their treatment and care; however for many consumers in inpatient mental health settings, there is not the opportunity to participate. Current research evaluating person-centred multidisciplinary care planning initiatives in inpatient settings from the consumer perspective is limited. The aim of this study was to explore the consumer perspective of a person-centred multidisciplinary care planning meeting implemented in an Australian inpatient mental health rehabilitation unit. This study used a focused ethnographic design with data collection including fieldnotes, observations of meetings and interviews. Ten individuals participated in the study, with two participating in meeting observations and eight participating in structured interviews. Participants were consumers with a mental health diagnosis admitted to a mental health rehabilitation unit for assistance with achieving their goals for community living. Findings were analysed utilizing thematic analysis. Findings showed that consumers' experiences of the care planning meetings were positive. Themes included; 'It's about you', 'Making decisions and expressing opinions', 'Staff involvement in care planning' and 'Supporting consumer recovery'. These findings add the consumer perspective to the existing evidence base and support the implementation of person-centred multidisciplinary care planning meetings in inpatient mental health settings.
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Affiliation(s)
- Eliza O'Donohue
- Occupational Therapy, School of Allied Health, Faculty of Health Sciences, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Melissa Aguey-Zinsou
- Occupational Therapy, School of Allied Health, Faculty of Health Sciences, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Elisa Yule
- Occupational Therapy, School of Allied Health, Faculty of Health Sciences, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Ian Fairhurst
- South Eastern Sydney Local Health Service, Sydney, New South Wales, Australia
| | - Marcie Debaets
- South Eastern Sydney Local Health Service, Sydney, New South Wales, Australia
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Michail M, Morgan J, Lavis A. Youth partnership in suicide prevention research: moving beyond the safety discourse. BMJ Open 2023; 13:e076885. [PMID: 37890971 PMCID: PMC10619073 DOI: 10.1136/bmjopen-2023-076885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE In this communication article, we discuss coproduction in suicide prevention research, with an emphasis on involving young people. We critically reflect on the lessons we have learned by working alongside young people, and how these lessons may be useful to other research teams. SUMMARY The meaningful involvement of young people in the design, implementation and translation of mental health research has received significant attention over the last decade. For most funding bodies, the involvement of patients and the public in the planning and delivery of research is advised and, in many cases, mandatory. When it comes to suicide prevention research, however, things are slightly different in practice. Involvement of young people in suicide prevention research has often been considered a controversial, unfeasible and even risky endeavour. In our experiences of working in this field, such concerns are expressed by funders, Higher Education Health and Safety committees and practitioners. By presenting an example from our research where the involvement of young people as experts by experience was integral, we highlight key lessons learnt that could maximise the potential of youth partnership in suicide prevention research. These lessons take on particular importance in mental health research against the background of long-entrenched power differences and the silencing of service user voices. Professional knowledge, obtained through education and vocational training, has historically taken priority over experiential knowledge obtained through lived experience, in psychiatric practice and research. Although this hierarchy has widely been challenged, any account of coproduction in mental health research is positioned against that background, and the remnants of those inequitable power relationships arguably take on greater resonance in suicide prevention research and require careful consideration to ensure meaningful involvement. CONCLUSION We conclude that progress in suicide research cannot be fulfilled without the meaningful involvement of, and partnership with, young people with lived experience.
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Affiliation(s)
- Maria Michail
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Jamie Morgan
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Anna Lavis
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Agents of Change for Mental Health: A Survey of Young People's Aspirations for Participation Across Five Low- and Middle-Income Countries. J Adolesc Health 2023; 72:S96-S104. [PMID: 35279363 PMCID: PMC9747181 DOI: 10.1016/j.jadohealth.2021.10.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 08/19/2021] [Accepted: 10/26/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE Effective intervention, policy, and research in mental health and well-being (MHWB) require young people to be understood not only as beneficiaries, but also as active agents in codesigning and implementing initiatives. To identify pathways for young people's participation in promoting MHWB in low- and middle-income countries (LMICs), this study surveyed young people's aspirations for engagement, their spheres of influence, capacity building needs, and key barriers to participation. METHODS Using U-Report, United Nations Children's Emergency Fund's social messaging tool and data collection platform, we distributed a short quantitative survey to a nonrepresentative, but large sample of young people aged 15-29 across five LMICs: Nigeria, Brazil, Jamaica, South Africa, and Burundi. RESULTS A total of 42,689 young people responded, with representation from most or all provinces within each country. Participants' average age was 23.8 years (SD = 3.77). Young people's core aspirations were to join a mental health awareness project and to support their peers. Participants considered schools and community settings to be the most important spheres for engagement. Lack of information about mental health was the main perceived barrier to participation, and mental health classes the main training need. DISCUSSION In many countries, MHWB is not taught or discussed in schools and youth-led mental health interventions are rare. Findings from this study reveal clear aspirations for participatory engagement to promote MHWB among young people in LMICs. To support meaningful participation, policymakers and youth service providers must ensure that young people have access to mental health literacy training and opportunities to raise awareness in schools or community settings.
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Faerden A, Rosenqvist C, Håkansson M, Strøm-Gundersen E, Stav Å, Svartsund J, Røssæg T, Davik N, Kvarstein E, Pedersen G, Dieset I, Nyrud AQ, Weedon-Fekjær H, Kistorp KM. Environmental Transformations Enhancing Dignity in an Acute Psychiatric Ward: Outcome of a User-Driven Service Design Project. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 16:55-72. [PMID: 36567605 PMCID: PMC10133780 DOI: 10.1177/19375867221136558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The goal of the current project was to enhance the feeling of dignity for patients in the seclusion unit in an acute psychiatric ward through environmental design changes and to evaluate the effect of the refurbishment. BACKGROUND Treating people with dignity is essential in all health-related work and important for our mental health. Hospital architecture and design signal values that can promote dignity. Patients who must spend time in seclusion are at their most vulnerable mental state and the often worn-down like environment can challenge the feeling of dignity. How environmental design can promote dignity in seclusion units have not been studied. METHODS To reach suggestions for design changes enhancing dignity, we used service design that included a broad user group. The effect of design changes was evaluated by a questionnaire answered by the nursing staff during a 4-week period pre- and post refurbishment and included a control group. RESULTS The design concepts agreed upon were a welcoming atmosphere, contact with nature, room for privacy, close contact with staff, and a designated smoking area inside the unit. The evaluation found that the environmental design changes significantly supported the patients in their situation and the staff in their work. CONCLUSION We conclude that dignity design concepts are highly applicable also in an acute psychiatric setting and improve the situation of secluded mental health patients, which is much needed. Findings align with other environmental changes in psychiatric wards that improve the patients' well-being and reduce aggression.
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Affiliation(s)
- Ann Faerden
- Department of Acute Psychiatry, Oslo University Hospital, Norway
| | - Christine Rosenqvist
- User Representative Advisory Board, Department of Acute Psychiatry, Oslo University Hospital, Norway
| | | | | | | | | | - Trude Røssæg
- Department of Acute Psychiatry, Oslo University Hospital, Norway
| | - Nils Davik
- Department of Acute Psychiatry, Oslo University Hospital, Norway
| | - Elfrida Kvarstein
- Section for Personality Psychiatry and Specialized Treatment, Oslo University Hospital, Norway
| | - Geir Pedersen
- Section for Personality Psychiatry and Specialized Treatment, Oslo University Hospital, Norway
| | - Ingrid Dieset
- Department of Acute Psychiatry, Oslo University Hospital, Norway
| | | | - Harald Weedon-Fekjær
- Oslo Center for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Norway
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Boerkoel A, Brommels M. The processes involved in the establishment of user-provider partnerships in severe psychiatric illnesses: a scoping review. BMC Psychiatry 2022; 22:660. [PMID: 36289473 PMCID: PMC9608879 DOI: 10.1186/s12888-022-04303-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 10/11/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE With the rising relevance of person-centred care, initiatives towards user-led decision making and designing of care services have become more frequent. This designing of care services can be done in partnership, but it is unclear how. The aim of this scoping review was to identify for mental health services, what user-provider partnerships are, how they arise in practice and what can facilitate or hinder them. METHODS A scoping review was conducted to obtain a broad overview of user provider partnerships in severe mental illness. Data was inductively analysed using a conventional content analysis approach, in which meaning was found in the texts. RESULTS In total, 1559 titles were screened for the eligibility criteria and the resulting 22 papers found relevant were analysed using conventional content analysis. The identified papers had broad and differing concepts for user-provider partnerships. Papers considered shared decision making and user-involvement as partnerships. Mechanisms such as open communication, organisational top-down support and active participation supported partnerships, but professional identity, power imbalances and stress hindered them. Users can be impeded by their illness, but how to deal with these situations should be formalised through contracts. CONCLUSION The field of research around user-provider partnerships is scattered and lacks consensus on terminology. A power imbalance between a user and a provider is characteristic of partnerships in mental healthcare, which hinders the necessary relationship building allowing partnerships to arise. This power imbalance seems to be closely linked to professional identity, which was found to be difficult to change.
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Affiliation(s)
- Aletta Boerkoel
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany. .,Department for Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden.
| | - Mats Brommels
- grid.465198.7Department for Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden
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Renwick L, McWilliams C, Schaff O, Russell L, Ramsdale S, Morris RL. Stakeholder identified research priorities for early intervention in psychosis. Health Expect 2022; 25:2960-2970. [PMID: 36129063 DOI: 10.1111/hex.13604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 08/29/2022] [Accepted: 09/02/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Public resources to answer pertinent research questions about the impact of illness and treatment on people with mental health problems are limited. To target funds effectively and efficiently and maximize the health benefits to populations, prioritizing research areas is needed. Research agendas are generally driven by researcher and funder priorities, however, there is growing recognition of the need to include user-defined research priorities to make research more relevant, needs-based and efficient. OBJECTIVE To gain consensus on top priorities for research into early intervention in psychosis through a robust, democratic process for prioritization enlisting the views of key stakeholders including users, carers and healthcare professionals. We also sought to determine which user-prioritized questions were supported by scientific evidence. DESIGN AND METHODS We used a modified nominal group technique to gain consensus on unanswered questions that were obtained by survey and ranked at successive stages by a steering group comprising users, carer representatives and clinicians from relevant disciplines and stakeholder bodies. We checked each question posed in the survey was unanswered in research by reviewing evidence in five databases (Medline, Cinahl, PsychInfo, EMBASE and Cochrane Database). RESULTS Two hundred and eighty-three questions were submitted by 207 people. After checking for relevance, reframing and examining for duplicates, 258 questions remained. We gained consensus on 10 priority questions; these largely represented themes around access and engagement, information needs before and after treatment acceptance, and the influence of service-user (SU) priorities and beliefs on treatment choices and effectiveness. A recovery SUtheme identified specific self-management questions and more globally, a need to fully identify factors that impact recovery. DISCUSSION AND CONCLUSIONS Published research findings indicated that the priorities of service users, carers and healthcare professionals were aligned with researchers' and funders' priorities in some areas and misaligned in others providing vital opportunities to develop research agendas that more closely reflect users' needs. PATIENT AND PUBLIC CONTRIBUTION Initial results were presented at stakeholder workshops which included service-users, carers, health professionals and researchers during a consensus workshop to prioritize research questions and allow the opportunity for feedback. Patient and public representatives formed part of the steering group and were consulted regularly during the research process.
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Affiliation(s)
- Laoise Renwick
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
| | - Caitlin McWilliams
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
| | - Olivia Schaff
- The Education Campus - Oxford Road, Central Manchester Foundation NHS Trust Library Services, Manchester, UK
| | - Laura Russell
- The Education and Research Centre - Wythenshawe Hospital, Central Manchester Foundation NHS Trust, Manchester, UK
| | - Susan Ramsdale
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
| | - Rebecca Lauren Morris
- NIHR Greater Manchester Patient Safety Translation Research Centre,Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Manchester, UK
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Bejerholm U, Allaskog C, Andersson J, Nordström L, Roe D. Implementation of the Recovery Guide in inpatient mental health services in Sweden-A process evaluation study. Health Expect 2022; 25:1405-1417. [PMID: 35340092 PMCID: PMC9327815 DOI: 10.1111/hex.13480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/27/2022] [Accepted: 03/05/2022] [Indexed: 12/31/2022] Open
Abstract
Background Involving service users in inpatient care and recovery planning has gained interest worldwide. Our purpose was to evaluate the process of implementation of a coproduced Recovery Guide (RG) intervention in 22 inpatient wards in Sweden, in terms of context, implementation process and mechanisms of impact over 12 months. Methods A mixed method design and a process evaluation framework were used to guide data collection and to deductively analyze perspectives and descriptive statistics of delivery from three stakeholder groups. Results Results showed that although initial contextual barriers were present (e.g., lack of resources, and interest, uncertainty in the organization, a dominant illness perspective), it was possible to implement the RG in 14 wards, where 53% of admitted service users received the intervention. Legitimacy of the intervention, engaged managers and staff, capacity of staff and ward organization, coproduction and continuous support from user organization were critical mediators. Mechanisms of impact concerned (1) a new perspective on mental health, well‐being and recovery, (2) capacity building of a recovery approach in inpatient settings and (3) a meaningful outlet for users' thoughts and feelings on recovery, sharing narratives and influencing care and goals. Conclusions The RG intervention has the potential to promote a recovery approach in inpatient mental health services (MHSs). Coproduction among stakeholders created trust and a sustainable implementation that made it possible for wards to resume implementation when contextual barriers had been resolved. Patient and Public Contribution The current study involved stakeholders including a service user organization, the public, first‐line managers and staff (including peer support workers) in inpatient and community MHS and researchers, who greatly contributed to the implementation programme, including codesign of the RG intervention as well as coproduction of the implementation in inpatient MHS. All authors have their own lived experiences of mental health problems as a service user or as a relative.
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Affiliation(s)
- Ulrika Bejerholm
- Department of Health Sciences, Centre of Evidence-Based Psychosocial Interventions, CEPI, Lund University, Lund, Sweden.,Department of Research, Development and Education, Division of Psychiatry and Habilitation, Lund, Sweden
| | - Conny Allaskog
- The Swedish Partnership for Mental Health, NSPH, Skåne, Sweden
| | | | - Linda Nordström
- The Swedish Partnership for Mental Health, NSPH, Skåne, Sweden
| | - David Roe
- Department of Health Sciences, Centre of Evidence-Based Psychosocial Interventions, CEPI, Lund University, Lund, Sweden.,Department of Community Mental Health, University of Haifa, Haifa, Israel.,Department of Clinical Medicine, Psychiatry, Aalborg University, Aalborg, Denmark
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Näslund H, Grim K, Markström U. User-Focused Monitoring as a Strategy for Involvement and Mental Health Service Development: An Analysis of Swedish Monitoring Reports. JOURNAL OF PSYCHOSOCIAL REHABILITATION AND MENTAL HEALTH 2022; 9:303-316. [PMID: 35345414 PMCID: PMC8942048 DOI: 10.1007/s40737-022-00268-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
User-focused monitoring (UFM) is a method of evaluating mental health services, conducted by people with lived experience of mental ill health. Research on UFM and on user involvement focused on service monitoring and evaluation is lacking. This study addresses this knowledge gap by examining UFM as a strategy for user involvement. More specifically, this study aims to synthesize patterns in UFM reports to characterize the phenomenon, as well as to further discuss negotiation processes and political opportunities in UFM. The empirical material consists of 136 Swedish UFM reports that have been analyzed in two steps: All reports were mapped according to general characteristics and a sample of 20 reports were selected to provide additional information on the method. This study has been conducted in collaboration with actors representing the user movement and municipality-based mental health services. Our analysis shows that long-term contracts between user organizations and service providers are important to create a sustainable implementation of UFM. However, strategies to protect user autonomy must be carefully considered and employed in relation to such collaborations. We further highlight the risks of a restricted focus on consumer satisfaction, and discuss the current development towards including follow-ups in the UFM process as a strategy for counteracting tokenism.
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Affiliation(s)
- Hilda Näslund
- Department of Social Work, Umeå University, Umeå, Sweden
| | - Katarina Grim
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
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Badu E, O'Brien AP, Mitchell R, Osei A. A Qualitative Study of Consumers' Experiences of the Quality of Mental Health Services in Ghana. Issues Ment Health Nurs 2022; 43:172-183. [PMID: 34129434 DOI: 10.1080/01612840.2021.1931584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Integrating consumers' experiences into quality mental health service assessment is relevant to improve service outcomes. Despite this, limited studies have attempted to explore consumers' experiences, particularly in developing countries, such as Ghana. This paper aims to explore consumers' subjective experiences of the quality of mental health services. A qualitative method involving in-depth interviews was used to collect data from 21 consumers of mental health services. Thematic analysis was used to analyse the data, which is discussed using a realistic evaluation approach. The study identifies four themes, 33 inductive codes and 594 references. The themes used to interpret the verbatim narratives are the available mental health services, therapeutic interaction with the professionals, competency and skills of the professionals, and the changes experienced in the consumers' lives. The study indicates that the mental health services aim to provide a range of treatments and medications as well as recovery-oriented services, using mechanisms such as ensuring an effective therapeutic relationship and improving technical competency and skills. The contextual factors and the mechanisms have helped to achieve some changes in the lives of consumers (increased satisfaction, reduced symptoms, improved functionality, feeling normal, improved living skills and self-care, work and capabilities, and social inclusion). The study concludes that policymakers and clinicians should integrate evidence-based recovery services, principles and values into the existing mental health services. The mechanisms used to promote quality of mental health services should be strengthened, through periodic monitoring and evaluation, using approaches such as sensor data capturing, to ensure good coordination and continuity.
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Affiliation(s)
- Eric Badu
- School of Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Anthony Paul O'Brien
- School Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Rebecca Mitchell
- Health & Wellbeing Research Unit (HoWRU), Macquarie Business School, Macquarie University, Macquarie Park, NSW, Australia
| | - Akwasi Osei
- Ghana Mental Health Authority, Ghana Health Services, Accra, Ghana
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Speaking Up: How Family Members Advocate for Relatives Living with a Mental Illness. Community Ment Health J 2021; 57:1547-1555. [PMID: 33486676 DOI: 10.1007/s10597-021-00775-z] [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: 07/11/2020] [Accepted: 01/06/2021] [Indexed: 12/14/2022]
Abstract
Consumers with a mental health condition often feel powerless and overwhelmed in interactions with mental healthcare providers. Consumer self-advocacy and advocacy actions undertaken by their family members on the behalf of their relative contribute to a sense of empowerment for both consumers and their family members. This qualitative study explored family member perspectives of advocacy actions they took on behalf of their relatives and themselves. Data analysis of interviews with 20 family members, including parents, partners/spouses, siblings, and adult children, yielded three themes of family member advocacy actions: advocating for a relative's mental healthcare, normalizing mental illness, and engaging in social and political actions. Advocacy frameworks offer useful guidelines for speaking up for individuals who live with a mental illness.
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15
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Hawgood J, Krysinska K, Mooney M, Ozols I, Andriessen K, Betterridge C, De Leo D, Kõlves K. Suicidology Post Graduate Curriculum: Priority Topics and Delivery Mechanisms for Suicide Prevention Education. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9926. [PMID: 34574848 PMCID: PMC8469380 DOI: 10.3390/ijerph18189926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There has been limited attention to the development and delivery of tertiary suicide prevention curricula. The aim of this work was to describe the status of postgraduate suicide prevention education, with specific attention on examining the needs of the suicide prevention sector in Australia. METHOD An online survey was completed by 76 stakeholders in Australia. Current curriculum learning outcomes from Griffith University's postgraduate suicidology programs guided the development of the survey. RESULTS Four key learning domains were rated highest in importance by stakeholders. According to most stakeholders, skills-based qualifications were the most relevant type of qualification, and online modulized education was the most preferred delivery mode. Half of stakeholders supported suicide prevention professional development through a combination of financial support and study leave. CONCLUSIONS The survey provided invaluable feedback regarding the priorities of Australia's suicide prevention sector for content domains and delivery mechanisms for tertiary suicidology education. The findings showed the preferred type of organizational (employer) support that may be provided for employees to undertake such education. These findings will inform the future developments of Griffith University's suicidology programs and may motivate other universities to consider offering same or a similar type of education to support the suicide prevention sector toward saving lives.
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Affiliation(s)
- Jacinta Hawgood
- World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane 4111, Australia; (M.M.); (D.D.L.); (K.K.)
| | - Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne 3010, Australia; (K.K.); (K.A.)
| | - Maddeline Mooney
- World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane 4111, Australia; (M.M.); (D.D.L.); (K.K.)
| | - Ingrid Ozols
- Department of Psychiatry, The University of Melbourne, Melbourne 3002, Australia;
- Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne 3800, Australia
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne 3010, Australia; (K.K.); (K.A.)
| | | | - Diego De Leo
- World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane 4111, Australia; (M.M.); (D.D.L.); (K.K.)
| | - Kairi Kõlves
- World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane 4111, Australia; (M.M.); (D.D.L.); (K.K.)
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16
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Koster L, Nies H. It takes three to tango: An ethnography of triadic involvement of residents, families and nurses in long-term dementia care. Health Expect 2021; 25:80-90. [PMID: 34288293 PMCID: PMC8849257 DOI: 10.1111/hex.13224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 11/28/2022] Open
Abstract
Background Researchers often stress the necessity and challenge of integrating the positionings of residents, family members and nurses in order to realize each actor's involvement in long‐term dementia care. Yet most studies approach user and family involvement separately. Aim To explain how productive involvement in care provision is accomplished in triadic relationships between residents, family members and nurses. Methods An ethnographic study of identity work, conducted between 2014 and 2016 in a Dutch nursing home. Findings We identify four ideal‐typical identity positionings performed by nurses through daily activities. The findings reveal how their identity positionings were inseparable from those of the residents and family members as they formed triads. Congruent, or ‘matching’, identity positionings set the stage for productive involvement. Our systematic analysis of participants' identity work shows how—through embedded rights and responsibilities—their positionings inherently shaped and formed the triadic types and degrees of involvement observed within these relationships. Discussion and conclusion This study both unravels and juxtaposes the interrelatedness of, and differences between, the concepts of user and family involvement. Accordingly, our findings display how residents, family members and nurses—while continuously entangled in triadic relationships—can use their identity positionings to accomplish a variety of involvement activities. To mirror and optimize the implementation of user and family involvement, we propose a rights‐based and relational framework based on our findings. Patient or public contribution Conversations with and observations of residents; feedback session with the Clients' Council.
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Affiliation(s)
- Luzan Koster
- Department of Organization Sciences, Faculty of Social Sciences, VU University, Amsterdam, The Netherlands.,City of Amsterdam, Dep. Mobility & Public Space, Amsterdam, The Netherlands
| | - Henk Nies
- Department of Organization Sciences, Faculty of Social Sciences, VU University, Amsterdam, The Netherlands.,Vilans, National Centre of Expertise for Long-term Care, Utrecht, The Netherlands
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A decade of service development: audit of service users' experience of a rural Psychiatry of Later Life (POLL) service. Ir J Med Sci 2021; 191:347-354. [PMID: 33709308 DOI: 10.1007/s11845-021-02540-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/02/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The HSE "Vision for change", national service plan and other policies emphasise the importance of incorporating the views of service users and carers in the design and delivery of mental health services. AIMS To obtain the views of service users in relation to a rural POLL service. Compare our service to best practice and address issues identified. Repeat the audit cycle based on recommendations. METHODOLOGY New referrals to the POLL service were identified, and a pseudo-anonymised audit tool questionnaire was posted to these patients after initially making a telephone contact and obtaining informed consent. Results were compared to standards set by our team based on local and national policies. We used Microsoft Excel and performed a thematic analysis of qualitative data in the fourth cycle. This audit has been repeated on four occasions: 2012, 2013, 2016 and 2019. RESULTS More than 90% of patients marked as being benefited by the POLL team. Overall, most positive responses pertained to supportive and professional staff, resolution of disease symptoms, psycho-education and attentive follow-up whereas negative responses were in relation to limited access to disabled parking spaces, perceived inadequate discharge planning and non-resolution of disease symptoms in few patients. CONCLUSION Involving POLL patients in audit provided useful insights to improve the quality of service. We resolved the issue of disabled parking access and have developed a service information leaflet and a discharge leaflet. We intend to focus more on psychoeducation and discharge planning based on the results of the current cycle.
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18
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Mundal I, Gråwe RW, Hafstad H, De Las Cuevas C, Lara-Cabrera ML. Effects of a peer co-facilitated educational programme for parents of children with ADHD: a feasibility randomised controlled trial protocol. BMJ Open 2020; 10:e039852. [PMID: 33268416 PMCID: PMC7713204 DOI: 10.1136/bmjopen-2020-039852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Significant numbers of children with attention deficit hyperactivity disorder (ADHD) display problems that cause multiple disabilities, deficits and handicaps that interfere with social relationships, development and school achievement. They may have multiple problems, which strain family dynamics and influence the child's treatment. Parent activation, described as parents' knowledge, skills and confidence in dealing with their child's health and healthcare, has been shown to be an important factor in improving health outcomes. Research suggests that parents need edification to learn skills crucial to the treatment and management of their children's healthcare. Promoting positive parenting techniques may reduce negative parenting factors in families. This study aims to assess the acceptability, feasibility and estimated sample size of a randomised controlled trial (RCT) comparing an ADHD peer co-led educational programme added to treatment as usual (TAU). METHODS AND ANALYSIS Using a randomised waitlist controlled trial, parents of children aged 6-12 years newly diagnosed with ADHD, and referred to a child mental health outpatient clinic in Mid-Norway, will receive TAU concomitant with a peer co-facilitated parental engagement educational programme (n=25). Parents in the control group will receive TAU, and the educational programme treatment within a waitlist period of 3-6 months (n=25). Parent activation, satisfaction, well-being, quality of life and treatment adherence, will be assessed at baseline (T0), 2 weeks (T1) pre-post intervention (T2, T3) and at 3 months follow-up (T4). Shared decision making, parents preferred role in health-related decisions and involvement, parent-reported symptoms of ADHD and child's overall level of functioning will be assessed at T0 and T4. Such data will be used to calculate the required sample size for a full-scale RCT. ETHICS AND DISSEMINATION Approval was obtained from the Regional Committee for Medicine and Health Research Ethics in Mid-Norway (ref: 2018/1196). The findings of this study are expected to provide valuable knowledge about how to optimise family education and management of ADHD and will be disseminated through presentations at conferences and publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04010851.
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Affiliation(s)
- Ingunn Mundal
- Department of Mental Health, Faculty of medicine and health sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Faculty of Health and Social Sciences, Molde University College, Molde, Norway
- Division of Psychiatry, Kristiansund Community Mental Health Centre, Møre og Romsdal Hospital Trust, Kristiansund, Norway
| | - Rolf W Gråwe
- Department of Mental Health, Faculty of medicine and health sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Division of Psychiatry, Nidaros Community Mental Health Centre, St Olav's University Hospital, Trondheim, Norway
| | - Hege Hafstad
- Division of Mid-Norway, Vårres Regional User Involvement Centre, Trondheim, Norway
| | - Carlos De Las Cuevas
- Department of Internal Medicine, Dermatology and Psychiatry, Universidad de La Laguna, San Cristóbal de La Laguna, Tenerife, Spain
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, San Cristóbal deLa Laguna, Tenerife, Spain
| | - Mariela Loreto Lara-Cabrera
- Department of Mental Health, Faculty of medicine and health sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Division of Psychiatry, Tiller Community Mental Health Centre, St Olav's University Hospital, Trondheim, Norway
- Department of Research and Development, Division of Mental Health, St Olav's University Hospital, Trondheim, Norway
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19
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Burr C, Rother K, Elhilali L, Winter A, Kozel B, Weidling K, Zuaboni G. [Roles and Work Content of Peer Workers and Experts by Experience in Mental Health Practice, Education, Research and Development - Results of a Survey in Switzerland]. PSYCHIATRISCHE PRAXIS 2020; 48:135-142. [PMID: 33232979 DOI: 10.1055/a-1287-6074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM OF THE STUDY To identify work contents, roles and tasks of peer workers in mental health services in the German-speaking part of Switzerland. METHODS A survey was conducted among peers in the German-speaking part of Switzerland. RESULTS Most respondents stated that they work mainly in specialized services in the treatment of people with psychoses and affective disorders and in direct contact with service users. "Building bridges" between service users and professionals, conveying hope and confidence, empowerment as well as support in symptom management was most frequently indicated as a work activity. The majority of respondents have job descriptions that correspond to their activities. CONCLUSIONS For mental health services, the challenge is to integrate the new professional group of peers workers as well as possible without undermining their proximity to the service users or their possibly critical perspective with regard to the existing practice.
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Affiliation(s)
- Christian Burr
- Universitätsklinik für Psychiatrie und Psychotherapie, Universitäre Psychiatrische Dienste Bern (UPD), Schweiz
| | - Katja Rother
- Universitätsklinik für Psychiatrie und Psychotherapie, Universitäre Psychiatrische Dienste Bern (UPD), Schweiz
| | - Laila Elhilali
- Universitätsklinik für Psychiatrie und Psychotherapie, Universitäre Psychiatrische Dienste Bern (UPD), Schweiz
| | - Andréa Winter
- Universitätsklinik für Psychiatrie und Psychotherapie, Universitäre Psychiatrische Dienste Bern (UPD), Schweiz
| | - Bernd Kozel
- Universitätsklinik für Psychiatrie und Psychotherapie, Universitäre Psychiatrische Dienste Bern (UPD), Schweiz
| | - Katja Weidling
- Florence-Nightingale-Krankenhaus, Düsseldorf, Deutschland
| | - Gianfranco Zuaboni
- Universitätsklinik für Psychiatrie und Psychotherapie, Universitäre Psychiatrische Dienste Bern (UPD), Schweiz.,Sanatorium Kilchberg AG, Privatklinik für Psychiatrie und Psychotherapie, Kilchberg (ZH), Schweiz
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20
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Nevola A, Morris ME, Felix HC, Hudson T, Payakachat N, Tilford JM. Improving quality of life assessments for high-need adult Medicaid service users with mental health conditions. Qual Life Res 2020; 30:1155-1164. [PMID: 33211222 DOI: 10.1007/s11136-020-02694-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE There is a lack of consensus on how to evaluate health and social service programs for people with mental health (MH) conditions. Having service users be the primary decision makers in selecting outcome measures can inform a meaningful evaluation strategy. We sought to identify the quality of life (QoL) survey preferences of high-need adult service users with MH conditions. METHODS A systematic review identified generic, self-reported QoL surveys with evidence of validity in MH populations of interest. An advisory panel selected the most promising surveys to assess the success of programs like Medicaid for MH service users. Three groups of high-need, adult service users with MH conditions and one group of direct care staff ranked the surveys from the advisory panel, and generated and ranked characteristics that were desirable or undesirable in a QoL survey. RESULTS Twenty-two surveys met the inclusion criteria. Of the six surveys selected by the advisory panel, groups of service users and direct care staff most preferred the Warwick-Edinburg Mental Well-being Scale (WEMWBS). The WEMWBS best embodied the features prioritized by the groups: to have a user-friendly format and positive focus, to be clearly worded and brief, and to avoid presumptive or unrealistic items. Service user groups appreciated survey topics most amenable to self-report, such as satisfaction with relationships. CONCLUSION Using QoL surveys that service users prefer can reduce the chance that deteriorating QoL is going unchecked, and increase the chance that decisions based on survey findings are meaningful to service users.
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Affiliation(s)
- Adrienne Nevola
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, #820, Little Rock, AR, 72205, USA.
| | - Michael E Morris
- Department of Health Policy, Economics, and Management, University of Texas Health Science Center, 11937 U.S. Highway 271, Tyler, TX, 75708, USA
| | - Holly C Felix
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, #820, Little Rock, AR, 72205, USA
| | - Teresa Hudson
- Psychiatric Research Institute, Division of Health Services Research, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Nalin Payakachat
- Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - J Mick Tilford
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, #820, Little Rock, AR, 72205, USA
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21
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Thimm JC, Antonsen L, Malmedal W. Patients' perception of user involvement in psychiatric outpatient treatment: Associations with patient characteristics and satisfaction. Health Expect 2020; 23:1477-1484. [PMID: 32935451 PMCID: PMC7752195 DOI: 10.1111/hex.13132] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The patient's right to be involved in treatment decisions is anchored in guidelines and legislation in many countries. Previous research suggests challenges in the implementation of user involvement across different areas of health care, including mental health. However, little is known about psychiatric outpatients' experiences of being involved in their treatment. OBJECTIVE To investigate how psychiatric outpatients after treatment rate the degree to which they were included in the treatment and explore the associations between perceived user involvement, demographic characteristics of the sample and patient satisfaction. DESIGN Cross-sectional. SETTING AND PARTICIPANTS The sample consisted of 188 psychiatric outpatients (67% female, mean age 42.2 years) who were discharged in the two years prior to data collection. MAIN VARIABLES STUDIED Perceived user involvement in psychiatric outpatient treatment and patient satisfaction as measured by the Psychiatric Out-Patient Experiences Questionnaire. RESULTS About half of the participants rated the overall degree of involvement in their treatment as high or very high. The lowest percentage of participants reporting high or very high involvement was found for sufficient information to contribute to treatment decisions (36%). Female gender, higher education and, to a small degree, younger age were associated with more involvement. Perceived user involvement was strongly associated with treatment satisfaction. DISCUSSION AND CONCLUSION The findings suggest that user involvement in psychiatric outpatient treatment can be improved. Patient information that facilitates user involvement should be given more attention. PATIENT OR PUBLIC CONTRIBUTION The hospital's user panel was involved in the development of items assessing user involvement.
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Affiliation(s)
- Jens C Thimm
- Centre for Crisis Psychology, University of Bergen, Bergen, Norway.,Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Liss Antonsen
- Psychiatric Centre, Helgeland Hospital Trust Mo i Rana, Mo i Rana, Norway
| | - Wenche Malmedal
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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22
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McMillan SS, Stewart V, Wheeler AJ, Kelly F, Stapleton H. Medication management in the context of mental illness: an exploratory study of young people living in Australia. BMC Public Health 2020; 20:1188. [PMID: 32731858 PMCID: PMC7392659 DOI: 10.1186/s12889-020-09237-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 07/12/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Young people face significant challenges when managing a mental illness, such as acquiring treatment autonomy, being inexperienced users of the healthcare system and associated peer-related stigma. While medication use can be challenging in its own right, there is comparatively little information about the associated experiences and needs of young people with mental illness, particularly in the Australian context. This exploratory study will provide valuable insight into how this group is currently supported in relation to medication use. METHODS Young people (aged 14-25 years) who had used a prescription medication for any mental illness for a minimum of 2 months were eligible to participate in this qualitative exploratory study. Semi-structured interviews were conducted between October 2017-September 2018 in consultation rooms at two youth-focused mental health support organisations in Brisbane, Queensland. Interview questions explored how participants managed their medication and related experiences. Interviews were transcribed verbatim and descriptively analysed using thematic analysis. RESULTS Eighteen young people discussed their lived experience during interviews averaging 50 min in duration. Finding the right medication that reduced symptom severity with minimal side-effects was identified as a complex experience for many, particularly when there was a lack of information, support or reduced financial capacity. Young people described a range of strategies to manage medication side-effects, changes and to support routine medication use. CONCLUSIONS Young people persevered with taking medication to manage a mental illness within a healthcare system that does not adequately support this vulnerable population. There remains a clear directive for healthcare professionals to provide credible information that proactively engages young people as healthcare participants, and for policy makers to consider financial burden for this population with limited financial capacity.
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Affiliation(s)
- Sara S. McMillan
- School of Pharmacy and Pharmacology, Quality Use of Medicines Network, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Victoria Stewart
- School of Human Services and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Amanda J. Wheeler
- School of Human Services and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Fiona Kelly
- School of Pharmacy and Pharmacology, Quality Use of Medicines Network, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Helen Stapleton
- School of Human Services and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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Abayneh S, Lempp H, Alem A, Kohrt BA, Fekadu A, Hanlon C. Developing a Theory of Change model of service user and caregiver involvement in mental health system strengthening in primary health care in rural Ethiopia. Int J Ment Health Syst 2020; 14:51. [PMID: 32760440 PMCID: PMC7379363 DOI: 10.1186/s13033-020-00383-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 07/18/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The involvement of service users and caregivers is recommended as a strategy to strengthen health systems and scale up quality mental healthcare equitably, particularly in low-and-middle-income countries. Service user and caregiver involvement is complex, and its meaningful implementation seems to be a worldwide challenge. Theory of Change (ToC) has been recommended to guide the development, implementation and evaluation of such complex interventions. This paper aims to describe a ToC model for service user and caregiver involvement in a primary mental health care in rural Ethiopia. METHODS The ToC was developed in two workshops conducted in (i) Addis Ababa with purposively selected psychiatrists (n = 4) and multidisciplinary researchers (n = 3), and (ii) a rural district in south-central Ethiopia (Sodo), with community stakeholders (n = 24). Information from the workshops (provisional ToC maps, minutes, audio recordings), and inputs from a previous qualitative study were triangulated to develop the detailed ToC map. This ToC map was further refined with written feedback and further consultative meetings with the research team (n = 6) and community stakeholders (n = 35). RESULTS The experiential knowledge and professional expertise of ToC participants combined to produce a ToC map that incorporated key components (community, health organisation, service user and caregiver), necessary interventions, preconditions, assumptions and indicators towards the long-term outcomes. The participatory nature of ToC by itself raised awareness of the possibilities for servicer user and caregiver involvement, promoted co-working and stimulated immediate commitments to mobilise support for a grass roots service user organization. CONCLUSIONS The ToC workshops provided an opportunity to co-produce a ToC for service user and caregiver involvement in mental health system strengthening linked to the planned model for scale-up of mental health care in Ethiopia. The next steps will be to pilot a multi-faceted intervention based on the ToC and link locally generated evidence to published evidence and theories to refine the ToC for broader transferability to other mental health settings.
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Affiliation(s)
- Sisay Abayneh
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, WHO Collaborating Centre in Mental Health Research and Capacity Building, Addis Ababa, Ethiopia
| | - Heidi Lempp
- Faculty of Life Sciences and Medicine, Centre for Rheumatic Diseases, School of Immunology and Microbial Sciences, King’s College London, Weston Education Centre 10, Cutcombe Rd, London, SE5 9RJ UK
| | - Atalay Alem
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, WHO Collaborating Centre in Mental Health Research and Capacity Building, Addis Ababa, Ethiopia
| | - Brandon A. Kohrt
- Department of Psychiatry, George Washington University, Washington, DC USA
| | - Abebaw Fekadu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, WHO Collaborating Centre in Mental Health Research and Capacity Building, Addis Ababa, Ethiopia
- College of Health Sciences, Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
- Department of Global Health & Infection, Brighton and Sussex Medical School, Brighton, UK
| | - Charlotte Hanlon
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, WHO Collaborating Centre in Mental Health Research and Capacity Building, Addis Ababa, Ethiopia
- College of Health Sciences, Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AF UK
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Burr C, Rother K, Elhilali L, Winter A, Weidling K, Kozel B, Gurtner C. Peer support in Switzerland - Results from the first national survey. Int J Ment Health Nurs 2020; 29:212-223. [PMID: 31618530 DOI: 10.1111/inm.12665] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2019] [Indexed: 11/29/2022]
Abstract
Peer work is now known in Switzerland for 10 years and has developed strongly. The aim of the study was to describe peer support specialists' (PSSs') work conditions and job satisfaction, as well as the challenges of integration into the workforce in Switzerland. A further aim was to identify possible development topics in the preparation of PSSs for working with peer support work (PSW) training and interventions within the working field. We launched a survey with a self-developed questionnaire for people with lived experiences with mental illness and recovery who were working as PSSs or experts by experience in education, research, politics, and other areas in the German-speaking region of Switzerland. The survey took place from 1 September 2017 to 15 November 2017. The results show that PSSs were working mostly in 1:1 contact with service users and in education and noticeably less in politics and research. Their work conditions and job satisfaction seemed good. Most PSSs had job descriptions matching their duties, were satisfied with their salaries, and indicated being satisfied or very satisfied with their work. Amongst other aspects, the greatest challenge reported was integration into the inter-disciplinary working team. PSS training should better consider the working areas of experts by experience in the fields of politics and research to reinforce employment opportunities in these work areas. To increase the impacts of PSSs and to improve integration into the workspace, the preparation of professionals and institutions should be improved by means of information sessions, trainings, and guidelines.
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Affiliation(s)
- Christian Burr
- University Hospital of Psychiatry and Psychotherapy, University Berne Psychiatric Services, Bern, Switzerland
| | - Katja Rother
- University Hospital of Psychiatry and Psychotherapy, University Berne Psychiatric Services, Bern, Switzerland
| | - Laila Elhilali
- University Hospital of Psychiatry and Psychotherapy, University Berne Psychiatric Services, Bern, Switzerland
| | - Andréa Winter
- University Hospital of Psychiatry and Psychotherapy, University Berne Psychiatric Services, Bern, Switzerland
| | | | - Bernd Kozel
- University Hospital of Psychiatry and Psychotherapy, University Berne Psychiatric Services, Bern, Switzerland
| | - Caroline Gurtner
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
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Susanti H, James K, Utomo B, Keliat B, Lovell K, Irmansyah I, Rose D, Colucci E, Brooks H. Exploring the potential use of patient and public involvement to strengthen Indonesian mental health care for people with psychosis: A qualitative exploration of the views of service users and carers. Health Expect 2020; 23:377-387. [PMID: 31782266 PMCID: PMC7104636 DOI: 10.1111/hex.13007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/12/2019] [Accepted: 11/12/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Patient and public involvement (PPI) has the potential to strengthen mental health systems in Indonesia and improve care for people living with psychosis. Current evidence from other parts of the world demonstrates the need to understand the contexts in which PPI is to be enacted to ensure optimal implementation. OBJECTIVE To understand service users' and carers' views on the current use and potential applicability of PPI within Indonesian mental health services. DESIGN Qualitative study incorporating focus groups analysed using thematic analysis. SETTING AND PARTICIPANTS Participants included 22 service users and 21 carers recruited from two study sites in Indonesia (Jakarta and Bogor). All participants had experience of psychosis either as a service user or carer. RESULTS Despite the value attributed to PPI in relation to improving services and promoting recovery, current use of such activities in Indonesian mental health services was limited. Participants expressed a desire for greater levels of involvement and more holistic care but felt community organizations were best placed to deliver this because PPI was considered more congruent with the ethos of third-sector organizations. Additional barriers to PPI included stigma and low levels of mental health literacy in both health services and communities. DISCUSSION AND CONCLUSION Participants felt that there was potential value in the use of PPI within Indonesian mental health services with careful consideration of individual contexts. Future aspirations of involvement enactment should ensure a central design and delivery role for third-sector organizations. Facilitators to global collaborative research in the context of the current study are also discussed.
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Affiliation(s)
- Herni Susanti
- Faculty of NursingUniversitas IndonesiaDepokIndonesia
| | - Karen James
- Faculty of Health, Social Care and EducationCentre for Health and Social Care ResearchKingston and St GeorgesLondonUK
| | | | | | - Karina Lovell
- Division of Nursing, Midwifery and Social WorkSchool of Health SciencesFaculty of Biology, Medicine and HealthUniversity of ManchesterManchester Academic Health Science CentreManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - I Irmansyah
- National Institute of Health Research and DevelopmentJakartaIndonesia
- Marzoeki Mahdi HospitalBogorIndonesia
| | - Diana Rose
- Department of Health Services ResearchKings College LondonLondonUK
| | | | - Helen Brooks
- Department of Health Services ResearchInstitute of Population Health SciencesUniversity of LiverpoolLiverpoolUK
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Crossnohere NL, Fischer R, Crossley E, Vroom E, Bridges JFP. The evolution of patient-focused drug development and Duchenne muscular dystrophy. Expert Rev Pharmacoecon Outcomes Res 2020; 20:57-68. [DOI: 10.1080/14737167.2020.1734454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Norah L. Crossnohere
- Department of Health, Behavior and Society, Johns Hopkins School of Public Health, Baltimore, MD, USA
- Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Ryan Fischer
- Parent Project Muscular Dystrophy, Hackensack, NJ, USA
| | | | - Elizabeth Vroom
- Duchenne Parent Project Muscular Dystrophys, Amsterdam, NL, Netherlands
| | - John FP Bridges
- Department of Health, Behavior and Society, Johns Hopkins School of Public Health, Baltimore, MD, USA
- Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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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.
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Abayneh S, Lempp H, Hanlon C. Participatory action research to pilot a model of mental health service user involvement in an Ethiopian rural primary healthcare setting: study protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:2. [PMID: 31934350 PMCID: PMC6951014 DOI: 10.1186/s40900-019-0175-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/19/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Involvement of service-users at all levels of the mental health system is a policy imperative in many countries internationally. However, putting policy into practice seems complex; little is known about how best to involve service users and efforts are often criticized for being tokenistic. In low-and-middle income countries, less attention has been given to the roles of service users within mental health systems. The proposed study is part of a larger project intended to develop service-user involvement in mental health system strengthening in Ethiopia. A Theory of Change (ToC) model has already been developed through a participatory approach. This study protocol aims to describe the theoretical background and methods to pilot this model using participatory action research (PAR) and explore participants' experience of involvement. METHODS The proposed study will apply a PAR approach situated in critical social theory and conduct a phenomenological case study to find out participants' experience of involvement. This will be conducted in three stages. The focus of Stage 1 will be to(i) establish a Research Advisory Group (RAG), and Research Participant Group (RPG) at district and primary healthcare facility levels, respectively, and (ii) identify and prioritize potential areas of concern for involvement in the domains of advocacy, service planning and development, monitoring and improving service quality. In Stage 2, we will work with the RPG to develop a plan of action for the selected area. Stage 3 will aim to assist the RPG to implement and evaluate the plan of action. Process indicators and observation will be combined with in-depth interviews with participants to elicit their experiences of involvement. Thematic content analysis will be used. DISCUSSION The participatory approach to mental health service user involvement in health system strengthening employed by this study will support the implementation of solutions through locally relevant and contextualized actions. Findings from this study will contribute to the body of knowledge towards understanding the complexity of implementation of service user involvement and refine the ToC model for transferability to similar settings.
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Affiliation(s)
- Sisay Abayneh
- College of Health Sciences, School of Medicine, Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, Addis Ababa University, Addis Ababa, Ethiopia
| | - Heidi Lempp
- King’s College London, Centre for Rheumatic Diseases, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, Weston Education Centre, 10, Cutcombe Rd, London, SE5 9RJ UK
| | - Charlotte Hanlon
- College of Health Sciences, School of Medicine, Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, Addis Ababa University, Addis Ababa, Ethiopia
- King’s College London, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF UK
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Frawley T, Carroll L, Casey M, Davies C, Durning J, Halligan P, Joye R, Redmond C, Fealy G. Evaluation of a national training programme to support engagement in mental health services: Learning enablers and learning gains. J Psychiatr Ment Health Nurs 2019; 26:323-336. [PMID: 31188513 DOI: 10.1111/jpm.12535] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/02/2019] [Accepted: 06/07/2019] [Indexed: 11/26/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Patient and public involvement (PPI) is recognized as an increasingly important feature of healthcare research, education and public policy. In mental health, PPI is increasingly seen as evidence of the further democratization of services, which started with de-institutionalization in the 1960s and the recovery movement in the 1990s. While much is known about learning enablers and learning gains on generic community-based training programmes, less is known about PPI-specific programmes in mental health. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Participants at a national training programme to support the engagement of service users, their families and carers in mental health services identified training topics of greatest importance to them and reported on what they learnt and what helped their learning. Patient and public involvement training initiatives aimed at supporting the engagement of service users, their families and carers should emphasize individual needs and local contexts. Training programmes should not make artificial or actual distinctions between the programme participants who are health professionals and those who are non-professionals, such as service users. To our knowledge, this PPI initiative is the first time a national health service provider has sought to develop an engagement structure in mental health on a state-wide basis. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Participants in training programmes designed to support patient and public involvement believe that such programmes should include understanding how conflict is resolved, how committees work effectively and how to develop interpersonal and facilitation skills. Training programmes in mental health involving both professional and non-professional participants requires all the participants to work together in particular at commissioning and design stages to achieve their desired outcome. The evaluation of the training programme to support the roll-out of this initiative offers lessons to others who may wish to pursue similar structures in other jurisdictions. Abstract Introduction The Irish national mental health service provider commissioned a national training programme to support a patient and public involvement (PPI) initiative in mental health services. The programme evaluation afforded an opportunity to describe the learning gains and learning enablers and the factors that support PPI in mental health. Aim We aimed to evaluate a PPI training programme across nine regional administrative units in a national mental health service. Methods We conducted a participant exit survey, using the Student Assessment of Learning Gains (SALG) instrument. We analysed the survey responses using SPSS version 24 software and applied directed content analysis to the narrative comments provided in open-ended questions. Results A total of 54 participants returned the completed questionnaire, yielding a response rate of 60%. The overall mean SALG score yielded was 3.97 (SD 0.66; range 1-5), indicating that participants reported very good to excellent gains in their learning from the programme. Participants who offered narrative comments indicated an overall positive experience but suggested that all stakeholders should work together to co-produce the training. Discussion All the stakeholders in a PPI training initiative to support the engagement of service users, their families and carers in mental health should work together to achieve their desired outcome. This requires co-production in the design, delivery and evaluation of the training initiative, and co-production can impact at both individual and local levels. Implications for Practice PPI training initiatives in mental health should retain a focus on understanding conflict resolution, committee effectiveness, interpersonal and facilitation skills. Ensuring a shared understanding of key concepts, such as co-production, is a necessary prerequisite at the co-commissioning, co-design, co-planning, co-delivery and co-assessment stages of programme development, as is the need to avoid artificial or actual distinctions between health professionals and those who are non-professionals, such as service users. Relevance statement Mental health engagement and PPI are key principles underpinning modern mental health services and may increasingly impact on wider health service provision including policy and research imperatives. This paper discusses the evaluation of a PPI training programme and offers practical insights as to how such initiatives can be improved.
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Affiliation(s)
- Timmy Frawley
- University College Dublin School of Nursing, Midwifery and Health Systems, Belfield, Dublin 4, Ireland
| | - Lorraine Carroll
- University College Dublin School of Nursing, Midwifery and Health Systems, Belfield, Dublin 4, Ireland
| | - Mary Casey
- University College Dublin School of Nursing, Midwifery and Health Systems, Belfield, Dublin 4, Ireland
| | - Carmel Davies
- University College Dublin School of Nursing, Midwifery and Health Systems, Belfield, Dublin 4, Ireland
| | - Jonathan Durning
- Department of Nursing and Health Studies, Letterkenny Institute of Technology, Letterkenny, Ireland
| | - Phil Halligan
- University College Dublin School of Nursing, Midwifery and Health Systems, Belfield, Dublin 4, Ireland
| | - Regina Joye
- University College Dublin School of Nursing, Midwifery and Health Systems, Belfield, Dublin 4, Ireland
| | - Catherine Redmond
- University College Dublin School of Nursing, Midwifery and Health Systems, Belfield, Dublin 4, Ireland
| | - Gerard Fealy
- University College Dublin School of Nursing, Midwifery and Health Systems, Belfield, Dublin 4, Ireland
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Abstract
Traditional ideas of mental health nursing are challenged in contemporary healthcare settings by developments focussed on more partnership and collaboration with people using mental health services. Yet service users have reported limited involvement in planning their own care. The purpose of this research was to explore accounts from multiple perspectives about service user involvement in mental health nursing processes. Qualitative research interviews and focus groups with mental health nursing students (n = 18), qualified nurses (n = 17) and service users (n = 13) were conducted, audio-recorded and transcribed verbatim. Participants' transcribed talk was thematically analysed to examine understandings about service user involvement and mental health nursing. Nursing work was often described as task-focussed, with limited collaboration with service users in areas like care planning. Service user involvement was seldom mentioned by nurses themselves, indicating it did not form an important part of mental health nursing processes. Mental health nurses appear to be complicit in care processes that do not include involvement of service users and may discourage novice practitioners from attempts at engagement.
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Coyle LA, Atkinson S. Vulnerability as practice in diagnosing multiple conditions. MEDICAL HUMANITIES 2019; 45:278-287. [PMID: 29950507 PMCID: PMC6818667 DOI: 10.1136/medhum-2017-011433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/01/2018] [Indexed: 06/08/2023]
Abstract
The paper contributes to contemporary understandings of vulnerability by expanding their scope with an understanding of vulnerability as generated through institutionalised practices. The argument draws on experiential accounts of navigating the practices of diagnosis by people living with multiple conditions of ill-health and disability. Vulnerability as a concept is used widely across different domains and conveys a multitude of meanings. Contemporary biomedicine, and its associated health systems and services, understands vulnerability mostly as inherent to particular physical and mental bodily conditions that put people at risk of ill-health or emotionally fragility. This may combine with a more epidemiological understanding of vulnerability as the experience of certain population groups subject to entrenched structural inequalities. Philosophers and feminists have argued that vulnerability is a universal experience of being human while political commentators have explored its potential as a resource for resistance and action. Diagnosis within medicine and psychiatry has been the subject of extensive social analysis, critique and activism. The paper draws on first-hand experiential accounts collected through face-to-face interviews with people living with multiple conditions about their experiences of diagnosis, mostly at the primary care level. We identify five aspects to diagnostic practice that are harmful and exacerbate the experience of vulnerability: temporal sequencing; diagnostic authority; medical specialisation; strategic symptom selection; medical isolation. However, these diagnostic practices are not best understood only in terms of the power asymmetries inherent to the medical consultation, but are embedded into the very institution of diagnosis. The paper thus proposes a combined approach to vulnerability that recognises it as a universal condition of humanity but one that becomes animated or amplified for some bodies, through their own inherent incapacities or the external structures of inequality, and through the practices of medicine as situated in particular times and places.
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Affiliation(s)
| | - Sarah Atkinson
- Institute for Medical Humanities, Durham University, Durham, UK
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Yoma SM. [User participation in public policies of mental health: an integrative review]. CIENCIA & SAUDE COLETIVA 2019; 24:2499-2512. [PMID: 31340269 DOI: 10.1590/1413-81232018247.14402017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/21/2017] [Indexed: 11/22/2022] Open
Abstract
The scope of this integrative review was to identify and analyze scientific articles regarding user participation in public policies of mental health. A bibliographic search was performed between November 2016 and May 2017 in the Pubmed, Scielo and Lilacs databases. The sample of the integrative review was comprised of seven relevant articles that met the inclusion criteria. The documents obtained were analyzed using Atlas Ti 6.1 hermeneutic analysis software. As a result, the review found a growing legislative and governmental recognition of user participation in public policies of mental health; persistent questions about their "capacity" to participate; several barriers to successful participation; and some strategies to bolster this participation. One of the main challenges identified is to overcome prejudiced and stigmatizing beliefs that operate as barriers to effective user participation, and to build the necessary adaptations that enable people with psychosocial disabilities to participate on equal terms with the rest of the population.
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Affiliation(s)
- Solana María Yoma
- Instituto de Investigación y Formación en Administración Pública, Pública, CONICET, Facultad de Ciencias Sociales, Universidad Nacional de Córdoba. Rondeau 467/2°piso. 5000 Córdoba Argentina.
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Gardner K, Dickinson H, Moon K. Re-orienting health systems through a commissioning approach: finding solutions for improved consumer engagement. Health Res Policy Syst 2019; 17:71. [PMID: 31331334 PMCID: PMC6647255 DOI: 10.1186/s12961-019-0471-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 06/25/2019] [Indexed: 12/03/2022] Open
Abstract
As many developed health systems grapple with the reorientation of their systems to those that are commissioning led, consumer engagement has emerged as an important theme. Despite many governments asserting the importance of consumer engagement in commissioning, an evidence base is yet to be developed to support this approach. This paper identifies the challenges and gaps in the literature relating to consumer engagement and commissioning, before setting out five potential solutions to these challenges. Ultimately, consumer engagement needs clarity of purpose and any approach should be tailored to context. Effective client involvement needs time and investment. To embark on such a process without this effort can be counterproductive.
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Affiliation(s)
- Karen Gardner
- Public Service Research Group, University of New South Wales, PO Box 7196, Canberra, BC, 2610, Australia.
| | - Helen Dickinson
- Public Service Research Group, University of New South Wales, PO Box 7196, Canberra, BC, 2610, Australia
| | - Katie Moon
- Public Service Research Group, University of New South Wales, PO Box 7196, Canberra, BC, 2610, Australia
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Leach JSR. Madness and chaos in the culture of a therapeutic community. THERAPEUTIC COMMUNITIES 2019. [DOI: 10.1108/tc-04-2018-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to explore the perceptions of staff members working in a psychiatric therapeutic community in relation to ideas of “madness” and “chaos”.
Design/methodology/approach
The paper is a qualitative study based on oral history group witness seminars.
Findings
The findings indicate that many of the participants experienced working in a therapeutic community as both exciting and unsettling; some found themselves questioning their own mental health at the time. Despite a sense of “madness” and chaos in the life of the community, there was also a feeling that it provided a containing environment for some very disturbed patients.
Originality/value
This study is unusual in drawing upon staff member’s perceptions of their own relationship to “madness” in response to being involved in the life of a therapeutic community.
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Stewart S, Scholz B, Gordon S, Happell B. 'It depends what you mean by leadership': An analysis of stakeholder perspectives on consumer leadership. Int J Ment Health Nurs 2019; 28:339-350. [PMID: 30281898 DOI: 10.1111/inm.12542] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2018] [Indexed: 01/06/2023]
Abstract
Contemporary mental health policies call for increased involvement of consumers in leadership across mental health service design, delivery, and evaluation. However, consumer leadership is not currently well understood within academia or in mental health services themselves. This study investigates how consumer leadership is currently conceptualized by stakeholders at the service delivery level. To this end, semistructured interviews were conducted with 14 mental health organization members identifying as consumer leaders, colleagues supporting consumer leaders, or organization executives. Interview data were analysed using an inductive thematic analysis to develop a broad understanding of participants' perceptions of consumer leadership. Findings indicate constructions of consumer leadership within mental health organizations can be understood in relation to four themes: consumer leadership roles, requirements, purpose, and process. Inconsistencies across participants' perceptions of consumer leadership were identified as constituting barriers to its development, highlighting the need to better clarify the nature of consumer leadership.
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Affiliation(s)
- Stephanie Stewart
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Brett Scholz
- ANU Medical School, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Sarah Gordon
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Brenda Happell
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
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Ledderer L, Møller A, Fage-Butler A. Adolescents' participation in their healthcare: A sociomaterial investigation of a diabetes app. Digit Health 2019; 5:2055207619845448. [PMID: 31069104 PMCID: PMC6492353 DOI: 10.1177/2055207619845448] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/28/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This article explores how a diabetes app called Diapplo affected adolescents' participation in their healthcare by investigating adolescents' meaning-making in relation to their use of the app. METHODS Using a qualitative single case-study design, we adopted a multimethod responsive approach to data generation that included written data from the app development process, individual and group interviews and observations of the adolescents in the clinical situation. This article presents the results from a qualitative content analysis of group and individual semi-structured interviews conducted with five adolescents diagnosed with type 1 diabetes during and after the four-week test phase of a prototype of the app. RESULTS The adolescents appreciated the diabetes app's design and interface and having an overview of their blood glucose values. However, they stated that the app's content only partly met their needs and they considered several of its features unnecessary. They would have liked the app to have a social platform and emphasized that the app should be compatible with their blood glucose monitors and pumps for them to continue using it. CONCLUSIONS The participants in our study highlighted the value of social platforms integrated in health apps for patient participation, as well as their preference for health app features that reduced the effort of managing their chronic condition and facilitate greater knowledge. Theories of sociomateriality and material participation helped to account for the challenges of integrating users' perspectives, suggesting the value of early, comprehensive identification and prioritization of users' values when developing mobile health technologies.
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Affiliation(s)
- Loni Ledderer
- Department of Public Health, Aarhus University, Denmark
| | - Anne Møller
- Department of Public Health, Aarhus University, Denmark
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Sagsveen E, Rise MB, Grønning K, Bratås O. Individual user involvement at Healthy Life Centres: a qualitative study exploring the perspective of health professionals. Int J Qual Stud Health Well-being 2018; 13:1492291. [PMID: 30010499 PMCID: PMC6052421 DOI: 10.1080/17482631.2018.1492291] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The aim of this study was to explore how professionals experience user involvement at an individual level and how they describe involving users at Healthy Life Centres. Four focus group interviews were conducted with a total of 23 professionals. Data were analysed using systematic text condensation. Four themes were identified: (1) Involving users through motivational interviewing; (2) Building a good and trustful relation; (3) Assessing and adjusting to the user’s needs and life situation; and(4) Strengthening the user’s ownership and participation in the lifestyle change process. Motivational interviewing was described by the professionals as a way to induce and ensure user involvement. However, seeing motivational interviewing and user involvement as the same concept might reduce user involvement from being a goal in itself and evolve into a means of achieving lifestyle changes. The professionals might be facing opposing discourses in their practice and a dilemma of promoting autonomy and involvement and at the same time promoting change in a predefined direction. Greater emphasis should thus be put on systematic reflection among professionals about what user involvement implies in the local Healthy Life Centre context and in each user’s situation. Abbreviations: HLC: Healthy Life Centre; MI: Motivational Interviewing; NCD: Non-communicable diseases; STC: Systematic Text Condensation. SDT: Self-determination theory
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Affiliation(s)
- Espen Sagsveen
- a Department of Public Health and Nursing, Faculty of Medicine and Health Sciences , Norwegian University of Science and Technology , Trondheim , Norway
| | - Marit By Rise
- b Department of Mental Health, Faculty of Medicine and Health Sciences , Norwegian University of Science and Technology , Trondheim , Norway
| | - Kjersti Grønning
- a Department of Public Health and Nursing, Faculty of Medicine and Health Sciences , Norwegian University of Science and Technology , Trondheim , Norway
| | - Ola Bratås
- a Department of Public Health and Nursing, Faculty of Medicine and Health Sciences , Norwegian University of Science and Technology , Trondheim , Norway
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Laitila M, Nummelin J, Kortteisto T, Pitkänen A. Service users' views regarding user involvement in mental health services: A qualitative study. Arch Psychiatr Nurs 2018; 32:695-701. [PMID: 30201197 DOI: 10.1016/j.apnu.2018.03.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/27/2018] [Accepted: 03/11/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Service user involvement is emphasised in many strategies, plans and declarations globally. However, in practice, service user involvement is not always achieved and remains at a tokenistic level. OBJECTIVES To explore the views of service users on user involvement in mental health service. DESIGN Explorative descriptive study design. SETTING The study was conducted in one psychiatric hospital and in two mental health organisations in western Finland. METHODS The data was generated through three focus group interviews and analysed with qualitative content analysis. RESULTS User involvement means that people using mental health services are respected, listened to and can act in co-operation with professionals so than they feel that they can influence their own care and treatment. The participants articulated concrete factors that promote or inhibit user involvement. Service user involvement can be enhanced by strengthening service users´ position, by developing the mental health care system and by specific training for professionals. CONCLUSIONS The views of service users in this study concerning the realisation of user involvement and the factors promoting and preventing it were realistic. They are basic elements of patient-centred care and of all human interaction. Our participants described service user involvement in their own care and treatment. They emphasised the need to have more information, and wanted to be more involved in decision-making about their own care and treatment. They called for better care planning and co-ordination as one way to increase service user involvement. These also have implications for mental health services at the system level.
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Affiliation(s)
- Minna Laitila
- Hospital District of South Ostrobothnia, Hanneksenrinne 7, 60220 Seinäjoki, Finland.
| | - Jalmiina Nummelin
- Hospital District of Kanta-Hame, Ahvenistontie 20, 13530 Hämeenlinna, Finland.
| | - Tiina Kortteisto
- Tampere University Hospital, Department of Internal Medicine, Teiskontie 35, 33521 Tampere, Finland.
| | - Anneli Pitkänen
- Administration Centre, Pirkanmaa Hospital District, Teiskontie 35, 33521 Tampere, Finland.
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Koksvik JM, Linaker OM, Gråwe RW, Bjørngaard JH, Lara-Cabrera ML. The effects of a pretreatment educational group programme on mental health treatment outcomes: a randomized controlled trial. BMC Health Serv Res 2018; 18:665. [PMID: 30157839 PMCID: PMC6114285 DOI: 10.1186/s12913-018-3466-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 08/13/2018] [Indexed: 11/26/2022] Open
Abstract
Background Patients dropping out of mental health treatment is considered a widespread and significant obstacle to providing effective treatment, thus reducing the probability of patients achieving the desired improvement. Here, relative to ordinary treatment, we investigate the effects of providing an educational group programme before mental health treatment on mental health symptomatology and the risk of patients dropping out or prematurely discontinuing treatment. Methods A randomized controlled trial in which adults referred to a community mental health center were randomized to either a Control Group (n = 46) or a pretreatment educational programme followed by treatment as usual (Intervention Group, n = 45). The primary outcome was self-reported mental health symptomatology assessed with BASIS-32. Data were analyzed by multilevel linear regression and Cox’s regression. Results We recruited 93 patients during a 26-month period. Assessments were performed before (0 month, baseline) and after the intervention (1 month, before treatment initiation), and after 4 and 12 months. The net difference in BASIS-32 score between 0 and 1-month was − 0.27 (95% confidence interval CI] -0.45 to − 0.09) in favor of the intervention group. Although both groups had a significant and continuous decline in psychopathology during the treatment (from 1 month and throughout the 4- and 12-month follow-up assessments), the group difference detected before treatment (between 0 and 1 month) persisted throughout the study. Premature treatment discontinuation was partially prevented. The dropout risk was 74% lower in the Intervention Group than in the Control Group (hazard ratio 0.26, 95% CI = 0.07–0.93). Conclusions A brief educational intervention provided before mental health treatment seems to have an immediate and long-lasting effect on psychopathology, supplementary to traditional treatment. Such an intervention might also have a promising effect on reducing treatment dropout. Trial registration NCT00967265, clinicaltrials.gov. Registered August 27, 2009, retrospectively registered.
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Affiliation(s)
- John Morten Koksvik
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Pb 8905 MTFS, 7491, Trondheim, Norway. .,Tiller Community Mental Health Center, Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway.
| | - Olav Morten Linaker
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Pb 8905 MTFS, 7491, Trondheim, Norway.,Department of Research and Development, Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway
| | - Rolf Wilhelm Gråwe
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Pb 8905 MTFS, 7491, Trondheim, Norway.,Department of Research and Development, Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway
| | - Johan Håkon Bjørngaard
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Forensic Department and Research Center Brøset, St. Olavs University Hospital, Trondheim, Norway
| | - Mariela Loreto Lara-Cabrera
- Tiller Community Mental Health Center, Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway.,Department of Research and Development, Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway
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40
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Brooks H, James K, Irmansyah I, Keliat BA, Utomo B, Rose D, Colucci E, Lovell K. Exploring the potential of civic engagement to strengthen mental health systems in Indonesia (IGNITE): a study protocol. Int J Ment Health Syst 2018; 12:49. [PMID: 30159023 PMCID: PMC6109339 DOI: 10.1186/s13033-018-0227-x] [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: 02/10/2018] [Accepted: 08/14/2018] [Indexed: 01/02/2023] Open
Abstract
Background Indonesia has the highest rate of years of life lost to disability or early death from Schizophrenia than any other country in the world. More than 90% of people with mental illness do not get any treatment and tens of thousands of people with psychosis are illegally detained (‘pasung’) in the family home. Civic engagement, a core part of the recent World Health Organisation global strategy, has the potential to address some of these challenges through the development of person-centered models of care. The aim of the study is to develop a testable systems level, culturally appropriate, civic engagement framework for use in Jakarta and Bogor, Indonesia to strengthen local mental health services. Methods A mixed methods study underpinned by a realist approach will be undertaken across four phases in two study sites in Indonesia (Jakarta and Bogor). Phase 1 will explore the use of civic engagement across South East Asia by conducting a systematic review of existing evidence. By surveying 300 mental health professionals, phase 2 will identify the stakeholders, the sources of collaboration and the evidence used by professionals in decision making within local mental health systems and identify potential opportunities for civic engagement within the system. In order to explore the potential use of civic engagement within Indonesian mental health services and identify priorities for a culturally appropriate framework, phase 3 will undertake two focus groups with participants with experience of psychosis or caring for someone with psychosis (n = 20–30). Professionals and other key decision makers in a range of roles across the system at a national (n = 5) and local level (n = 10–15/site) will also take part in semi-structured interviews. Phase 4 will co-produce a civic engagement framework for use in Indonesia by synthesising evidence from phases 1–3 collaboratively with key stakeholders. Discussion Civic engagement is a potential way in which health services in low and middle income countries can address the burden of mental health conditions through the development of person-centred models of care. However, such approaches are underexplored in Indonesia. This study will work with local stakeholders to design a testable civic engagement framework for use in mental health services in Indonesia. Electronic supplementary material The online version of this article (10.1186/s13033-018-0227-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Helen Brooks
- 1Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Karen James
- Centre for Health and Social Care Research, Faculty of Health, Social Care and Education, Kingston and St Georges, London, UK
| | - I Irmansyah
- 3National Institute of Health Research and Development, Jakarta, Indonesia.,Marzoeki Mahdi Hospital, Bogor, Indonesia
| | | | | | - Diana Rose
- 7Department of Health Services Research, Kings College London, London, UK
| | | | - Karina Lovell
- 9Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Dellazizzo L, Percie du Sert O, Potvin S, Breton R, Pelletier JF, Renaud P, Dumais A. Avatar Therapy for persistent auditory verbal hallucinations: a case report of a peer research assistant on his path toward recovery. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2018. [DOI: 10.1080/17522439.2018.1499799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Laura Dellazizzo
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Institut Philippe-Pinel de Montréal, Montreal, QC, Canada
| | - Olivier Percie du Sert
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Institut Philippe-Pinel de Montréal, Montreal, QC, Canada
| | - Stéphane Potvin
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Richard Breton
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Institut Philippe-Pinel de Montréal, Montreal, QC, Canada
| | - Jean-François Pelletier
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Patrice Renaud
- Institut Philippe-Pinel de Montréal, Montreal, QC, Canada
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Alexandre Dumais
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Institut Philippe-Pinel de Montréal, Montreal, QC, Canada
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42
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Horgan A, Manning F, Bocking J, Happell B, Lahti M, Doody R, Griffin M, Bradley SK, Russell S, Bjornsson E, O'Donovan M, MacGabhann L, Savage E, Pulli J, Goodwin J, van der Vaart KJ, O'Sullivan H, Dorrity C, Ellila H, Allon J, Hals E, Sitvast J, Granerud A, Biering P. 'To be treated as a human': Using co-production to explore experts by experience involvement in mental health nursing education - The COMMUNE project. Int J Ment Health Nurs 2018; 27:1282-1291. [PMID: 29377483 DOI: 10.1111/inm.12435] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 12/17/2017] [Indexed: 12/30/2022]
Abstract
Increasingly, experts as deemed by personal experience or mental health service use, are involved in the education of nurses; however, accompanying research is limited and focuses primarily on opinions of nurse educators and students. The aim of this study was to develop an understanding of the potential contribution to mental health nursing education by those with experience of mental health service use. The research was part of the international COMMUNE (Co-production of Mental Health Nursing Education) project, established to develop and evaluate co-produced mental health content for undergraduate nursing students. A qualitative descriptive design was adopted with data collected through focus group interviews in seven sites across Europe and Australia. Experts by experience (people with experience of distress, service use, and recovery) co-produced the project in partnership with nursing academics. Co-production enriched the process of data collection and facilitated the analysis of data from multiple perspectives. Two themes are presented in this paper. The first focuses on how experts by experience can enhance students' understanding of recovery by seeing the strengths inherent in the 'human' behind the diagnostic label. The second highlights the importance of communication and self-reflection on personal values, where students can explore their own thoughts and feelings about mental distress alongside those with lived experience. Interacting with experts by experience in the classroom can assist in challenging stigmatizing attitudes prior to nursing placements. These findings can be used to inform international nursing curricula by increasing the focus on nursing skills valued by those who use the services.
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Affiliation(s)
- Aine Horgan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Fionnuala Manning
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Julia Bocking
- SYNERGY: Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Canberra, Australian Capital Territory, Australia
| | - Brenda Happell
- SYNERGY: Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Canberra, Australian Capital Territory, Australia
| | - Mari Lahti
- Turku University of Applied Sciences, Turku, Finland.,Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland
| | - Rory Doody
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Martha Griffin
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Stephen K Bradley
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Siobhan Russell
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Einar Bjornsson
- Department of Nursing, University of Iceland, Reykjavik, Iceland
| | - Moira O'Donovan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Liam MacGabhann
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Eileen Savage
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Jarmo Pulli
- Turku University of Applied Sciences, Turku, Finland
| | - John Goodwin
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | | | - Hazel O'Sullivan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Claire Dorrity
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Heikki Ellila
- Turku University of Applied Sciences, Turku, Finland
| | - Jerry Allon
- Institute for Nursing Studies, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Elisabeth Hals
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway
| | - Jan Sitvast
- Institute for Nursing Studies, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Arild Granerud
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway
| | - Pall Biering
- Department of Nursing, University of Iceland, Reykjavik, Iceland
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43
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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.
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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
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Mathie E, Wythe H, Munday D, Millac P, Rhodes G, Roberts N, Smeeton N, Poland F, Jones J. Reciprocal relationships and the importance of feedback in patient and public involvement: A mixed methods study. Health Expect 2018; 21:899-908. [PMID: 29654644 PMCID: PMC6186542 DOI: 10.1111/hex.12684] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2018] [Indexed: 11/24/2022] Open
Abstract
Background Reciprocal relationships between researchers and patient and public involvement (PPI) contributors can enable successful PPI in research. However, research and anecdotal evidence suggest that researchers do not commonly provide feedback to PPI contributors thus preventing them from knowing whether, how or where their contributions were useful to researchers and research overall. Aims The aim of this study was to explore the variation, types, importance of, and satisfaction with feedback given by researchers to PPI contributors in six PPI groups in England, and identify the barriers to the process of feedback. Methods An explanatory mixed methods sequential study design with a questionnaire survey followed by semi‐structured interviews with researchers and PPI contributors in six PPI groups. PPI contributors were involved in all stages of the research process. Results Researchers do not routinely give feedback to PPI contributors. Feedback was found to have different meanings: an acknowledgement, impact and study success and progress. PPI contributors who receive feedback are motivated for further involvement; it supports their learning and development and prompts researchers to reflect on PPI impact. The importance of the role of a PPI lead or coordinator to facilitate the process of providing feedback was also highlighted. Conclusion This study found no generic way to give feedback indicating that mutual feedback expectations should be discussed at the outset. PPI feedback needs to become integral to the research process with appropriate time and resources allocated. PPI feedback can be seen as a key indicator of mature, embedded PPI in research.
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Affiliation(s)
| | - Helena Wythe
- CRIPACC, University of Hertfordshire, Hatfield, UK
| | - Diane Munday
- Public Involvement in Research Group, CRIPACC, University of Hertfordshire, Hatfield, UK
| | - Paul Millac
- Public Involvement in Research Group, CRIPACC, University of Hertfordshire, Hatfield, UK
| | - Graham Rhodes
- INsPIRE, Patient and Public Involvement in Research, Bedfordshire and Peterborough, UK
| | - Nick Roberts
- INsPIRE, Patient and Public Involvement in Research, Bedfordshire and Peterborough, UK
| | | | - Fiona Poland
- School of Health Science, University of East Anglia, Norwich, UK
| | - Julia Jones
- CRIPACC, University of Hertfordshire, Hatfield, UK
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Vandewalle J, Debyser B, Beeckman D, Vandecasteele T, Deproost E, Van Hecke A, Verhaeghe S. Constructing a positive identity: A qualitative study of the driving forces of peer workers in mental health-care systems. Int J Ment Health Nurs 2018; 27:378-389. [PMID: 28371127 DOI: 10.1111/inm.12332] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2017] [Indexed: 11/29/2022]
Abstract
There is growing recognition in mental health for the perspective of individuals with lived experience of mental health problems and mental health service use. As peer workers, these individuals can use their specific experience to benefit and support peers and professional caregivers, and to participate at all levels of mental health-care systems. The aim of the present study was to develop a conceptual framework representing the driving forces of peer workers to fullfil their position in mental health-care systems. A qualitative interview approach was employed using principles of grounded theory. Over a period of 5 months in 2014-2015, semistructured interviews were conducted with 14 peer workers in residential and community mental health-care systems. The emerged conceptual framework reveals that peer workers strive towards constructing a positive identity. This process is powered by driving forces reflecting a desire for normalization and an urge for self-preservation. Peer workers realize a meaningful employment by using their lived experience perspective as an asset, liberating themselves out of restrictive role patterns, and by breaking down stigma and taboo. As a precondition to engage in these normalization processes, peer workers perceive they need to secure their self-preservation by balancing the emergence of adverse emotional fluctuations. The conceptual framework can inform the development of work contexts in which peer workers have an authentic and meaningful contribution, while being offered sufficient support and learning opportunities to manage their well-being.
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Affiliation(s)
- Joeri Vandewalle
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Psychiatric Hospital Pittem, Pittem, Belgium.,Research Foundation-Flanders, Brussels, Belgium
| | - Bart Debyser
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Psychiatric Hospital Pittem, Pittem, Belgium.,Department Health Care, VIVES University College, Roeselare, Belgium
| | - Dimitri Beeckman
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Tina Vandecasteele
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department Health Care, VIVES University College, Roeselare, Belgium
| | - Eddy Deproost
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Psychiatric Hospital Pittem, Pittem, Belgium
| | - Ann Van Hecke
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department of Nursing, Ghent University Hospital, Ghent, Belgium
| | - Sofie Verhaeghe
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department Health Care, VIVES University College, Roeselare, Belgium
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46
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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.
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Affiliation(s)
- Tiina Kortteisto
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Minna Laitila
- Hospital District of South Ostrobothnia, Seinäjoki, Finland
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Abayneh S, Lempp H, Alem A, Alemayehu D, Eshetu T, Lund C, Semrau M, Thornicroft G, Hanlon C. Service user involvement in mental health system strengthening in a rural African setting: qualitative study. BMC Psychiatry 2017; 17:187. [PMID: 28521749 PMCID: PMC5437561 DOI: 10.1186/s12888-017-1352-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 05/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is essential to involve service users in efforts to expand access to mental health care in integrated primary care settings in low- and middle-income countries (LMICs). However, there is little evidence from LMICs to guide this process. The aim of this study was to explore barriers to, and facilitators of, service user/caregiver involvement in rural Ethiopia to inform the development of a scalable approach. METHODS Thirty nine semi-structured interviews were carried out with purposively selected mental health service users (n = 13), caregivers (n = 10), heads of primary care facilities (n = 8) and policy makers/planners/service developers (n = 8). The interviews were audio-recorded and transcribed in Amharic, and translated into English. Thematic analysis was applied. RESULTS All groups of participants supported service user and caregiver involvement in mental health system strengthening. Potential benefits were identified as (i) improved appropriateness and quality of services, and (ii) greater protection against mistreatment and promotion of respect for service users. However, hardly any respondents had prior experience of service user involvement. Stigma was considered to be a pervasive barrier, operating within the health system, the local community and individuals. Competing priorities of service users included the need to obtain adequate individual care and to work for survival. Low recognition of the potential contribution of service users seemed linked to limited empowerment and mobilization of service users. Potential health system facilitators included a culture of community oversight of primary care services. All groups of respondents identified a need for awareness-raising and training to equip service users, caregivers, service providers and local community for involvement. Empowerment at the level of individual service users (information about mental health conditions, care and rights) and the group level (for advocacy and representation) were considered essential, alongside improved, accessible mental health care and livelihood interventions. CONCLUSION As Ethiopia increases access to mental health care, a fundamental barrier to service user involvement is beginning to be addressed. Our study identified further barriers that need to be tackled, including a supportive political climate, and receptiveness amongst stakeholders. The findings will inform the development of a model of service user involvement, which will be piloted and evaluated.
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Affiliation(s)
- Sisay Abayneh
- Department of Psychiatry, University College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Heidi Lempp
- 0000 0001 2322 6764grid.13097.3cKing’s College London, Academic Rheumatology, Weston Education Centre, 10, Cutcombe Rd., London, SE5 9RJ UK
| | - Atalay Alem
- Department of Psychiatry, University College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Daniel Alemayehu
- Department of Psychiatry, University College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Tigist Eshetu
- Department of Psychiatry, University College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Crick Lund
- 0000 0004 1937 1151grid.7836.aDepartment of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Rondebosch, Cape Town, 7700 South Africa ,0000 0001 2322 6764grid.13097.3cKing’s College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, London, UK
| | - Maya Semrau
- 0000 0001 2322 6764grid.13097.3cHealth Service and Population Research Department, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Graham Thornicroft
- 0000 0001 2322 6764grid.13097.3cHealth Service and Population Research Department, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Charlotte Hanlon
- Department of Psychiatry, University College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia. .,King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, London, UK.
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Moreno EM, Moriana JA. User involvement in the implementation of clinical guidelines for common mental health disorders: a review and compilation of strategies and resources. Health Res Policy Syst 2016; 14:61. [PMID: 27507569 PMCID: PMC4979121 DOI: 10.1186/s12961-016-0135-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/19/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is now broad consensus regarding the importance of involving users in the process of implementing guidelines. Few studies, however, have addressed this issue, let alone the implementation of guidelines for common mental health disorders. The aim of this study is to compile and describe implementation strategies and resources related to common clinical mental health disorders targeted at service users. METHODS The literature was reviewed and resources for the implementation of clinical guidelines were compiled using the PRISMA model. A mixed qualitative and quantitative analysis was performed based on a series of categories developed ad hoc. RESULTS A total of 263 items were included in the preliminary analysis and 64 implementation resources aimed at users were analysed in depth. A wide variety of types, sources and formats were identified, including guides (40%), websites (29%), videos and leaflets, as well as instruments for the implementation of strategies regarding information and education (64%), self-care, or users' assessment of service quality. CONCLUSIONS The results reveal the need to establish clear criteria for assessing the quality of implementation materials in general and standardising systems to classify user-targeted strategies. The compilation and description of key elements of strategies and resources for users can be of interest in designing materials and specific actions for this target audience, as well as improving the implementation of clinical guidelines.
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Affiliation(s)
- Eliana M Moreno
- Department of Psychology, University of Cordoba, Calle San Alberto Magno S/N, 14071, Cordoba, Spain. .,Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital, Avda Menéndez Pidal s/n, 14004, Cordoba, Spain.
| | - Juan Antonio Moriana
- Department of Psychology, University of Cordoba, Calle San Alberto Magno S/N, 14071, Cordoba, Spain.,Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital, Avda Menéndez Pidal s/n, 14004, Cordoba, Spain
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