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Happell B, Gordon S, Hurley J, Foster K, Hazelton M, Lakeman R, Moxham L, Warner T. It takes it out of the textbook: Benefits of and barriers to expert by experience involvement in pre-registration mental health nursing education. J Psychiatr Ment Health Nurs 2024. [PMID: 38509738 DOI: 10.1111/jpm.13042] [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: 11/26/2023] [Revised: 12/22/2023] [Accepted: 02/27/2024] [Indexed: 03/22/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Service user involvement in mental health nursing education is beneficial in terms of attitudinal change to reduce stigma, clinical skill development and enhancing understandings of recovery-oriented practice. Service users as experts by experience have not been embedded within pre-registration nursing programs. Consequently, they remain limited in number, ad hoc and frequently tokenistic. Nurse academics responsible for the design and delivery of pre-registration mental health nursing curricula have a potentially important role in facilitating expert by experience involvement in mental health nursing education. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE Nurse academics teaching mental health nursing have generally favourable views about the importance of expert by experience involvement. Nurse academics experience significant barriers in supporting the implementation of academic positions for experts by experience, particularly in obtaining funding. The experts by experience could contribute to mental health nursing education does not appear to be clearly understood by nurse academics. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health services aspire to adopt a recovery-oriented approach to practice. Involving experts by experience in mental health nursing education can facilitate increased understanding and appreciation of recovery-oriented practice. Nurse academics could play an important role in supporting the implementation of experts by experience positions in nursing academia. To do so, they require an understanding of the benefits of EBE involvement in academia and the barriers that can be encountered when attempting to facilitate the implementation of such positions. Experts by experience contribute unique expertise, essential to the development of quality mental health services. Conveying this expertise through the educating the future nursing workforce in mental health is essential. ABSTRACT INTRODUCTION: Involving service users in mental health nursing education is ad hoc and minimal, despite growing evidence of its benefits. Insights and experiences of nurse academics teaching mental health to pre-registration students have been underrepresented in the research to date. AIM To seek insights and experiences of nurse academics involved in designing and delivering pre-registration mental health nursing education in Australian universities regarding involving service users in mental health nursing education. METHODS A descriptive qualitative study involving 19 nurse academics from 13 Australian universities, involved in pre-registration mental health nursing education. Data were analysed thematically. RESULTS Participants reported minimal service user involvement. Most sought an increase and identified barriers. Data analysis resulted in five identified themes: (1) value-rich, (2) resource-poor, (3) imperfect processes, (4) 'part, but not all' and (5) unrecognised worth. CONCLUSIONS Increasing meaningful involvement of service-users in mental health nursing education requires support and investment from multiple stakeholders. Nurse academics are crucial stakeholders in understanding the unique expertise service users bring. IMPLICATIONS FOR PRACTICE Service users being central to all aspects of mental health services requires their active participation in the education of health professionals. Nurse academics have an important role in realising this goal.
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Affiliation(s)
- Brenda Happell
- Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
| | - Sarah Gordon
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington South, Wellington, New Zealand
| | - John Hurley
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Mike Hazelton
- School of Nursing and Midwifery, College of Medicine, Health and Well-being, University of Newcastle, Callaghan, New South Wales, Australia
- School of Nursing and Midwifery, University of Newcastle, Callaghan, New South Wales, Australia
| | - Richard Lakeman
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Health and Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Terri Warner
- ANU Medical School, Australian National University, Acton, New South Wales, Australia
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Crosswell R, Norman K, Cassim S, Papa V, Keenan R, Paul R, Chepulis L. Are patients with type 2 diabetes in the Waikato District provided with adequate education and support in primary care to self-manage their condition? A qualitative study. J Prim Health Care 2024; 16:61-69. [PMID: 38546777 DOI: 10.1071/hc23141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/02/2024] [Indexed: 04/02/2024] Open
Abstract
Introduction In Aotearoa New Zealand (NZ), type 2 diabetes (T2D) is predominantly managed in primary care. Despite established guidelines, patients are often suboptimally managed, with inequitable health outcomes. To date, few NZ studies have evaluated the primary care management of T2D at the time of diagnosis. Aim This study aims to explore patients' the provision of education and delivery of care to patients at the time of diagnosis, which is a crucial time in the disease trajectory. Methods Participants were recruited from a Māori health provider in the Waikato District, and diagnosed with T2D after January 2020. Patients were texted a link to opt into a survey (larger study) and then registered interest by providing contact details for an interview (current study). Semi-structured interviews were conducted and were audio recorded, transcribed, and thematically analysed. Results In total, 11 participants aged 19-65 years completed the interviews (female n = 9 and male n = 20); the comprised Māori (n = 5), NZ European (n = 5) and Asian (n = 1) participants. Three overarching themes were identified, including: (1) ineffective provision of resources and education methods; (2) poor communication from healthcare practitioners; and (3) health system barriers. Discussion Evidently, there are difficulties in primary care diabetes mellitus diagnosis and management. Improvements could include locally relevant resources tailored to patients' experiences and cultural identities. Utilising whānau support and a non-clinical workforce, such as health navigators/kaiāwhina, will drastically address current workforce issues and assist patient self-management. This will allow improved diagnosis experiences and better health outcomes for patients and whānau.
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Affiliation(s)
- Rebekah Crosswell
- Waikato Medical Research Centre, University of Waikato, Te Huataki Waiora, School of Health, Private Bag 3105, Hamilton 3240, New Zealand
| | - Kimberley Norman
- Waikato Medical Research Centre, University of Waikato, Te Huataki Waiora, School of Health, Private Bag 3105, Hamilton 3240, New Zealand
| | - Shemana Cassim
- Waikato Medical Research Centre, University of Waikato, Te Huataki Waiora, School of Health, Private Bag 3105, Hamilton 3240, New Zealand; and School of Psychology, Massey University, Auckland, New Zealand
| | - Valentina Papa
- Department of Nursing, University of Waikato, Hamilton, New Zealand
| | - Rawiri Keenan
- Waikato Medical Research Centre, University of Waikato, Te Huataki Waiora, School of Health, Private Bag 3105, Hamilton 3240, New Zealand
| | - Ryan Paul
- Te Whatu Ora Waikato, Hamilton, New Zealand
| | - Lynne Chepulis
- Waikato Medical Research Centre, University of Waikato, Te Huataki Waiora, School of Health, Private Bag 3105, Hamilton 3240, New Zealand
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Scholz B, Kirk L, Warner T, O'Brien L, Kecskes Z, Mitchell I. From a Single Voice to Diversity: Reframing 'Representation' in Patient Engagement. QUALITATIVE HEALTH RESEARCH 2024:10497323231221674. [PMID: 38229426 DOI: 10.1177/10497323231221674] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
There has been a growing emphasis on consumer representation in the development of health policy, services, research, and education. Existing literature has critiqued how discourses of representativeness can disempower consumers working in health systems. The context of the current study is consumer engagement in the development of COVID-19 triage policy and practice in a local health service. Consumer engagement has often been an afterthought in the COVID response, with few examples of consumers in agenda-setting or decision-making roles. In the Australian Capital Territory, 26 consumer, carer, and community groups worked together with academics and clinicians to develop these principles. Interviews were conducted with stakeholders (including consumers, clinicians, and other health professionals) to evaluate the development of triage principles. A discursive psychological approach to analysis was used to explore participants' understandings about and constructions of consumers being representative (or not) and how this may reproduce power imbalances against consumers. The results explore two distinct ways in which participants talked about consumer representativeness: the first drawing on rhetoric about consumers as lay members of the public (as distinct from being professionally engaged in the health sector), and the second in terms of consumer representatives being diverse and having intersectional identities and experiences. Expectations about consumers to be representative of the general population may reproduce traditional power imbalances and silence lived experience expertise. These power imbalances may be challenged by a shift in the way representativeness is conceptualised to requiring health services to seek out diverse and intersectionally marginalised consumers.
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Affiliation(s)
- Brett Scholz
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Lucy Kirk
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Terri Warner
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Lauren O'Brien
- ACT Disability, Aged and Carer Advocacy Service, Canberra, ACT, Australia
| | - Zsuzsoka Kecskes
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Imogen Mitchell
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- Canberra Health Services, Canberra, ACT, Australia
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Parnell T, Fiske K, Stastny K, Sewell S, Nott M. Lived experience narratives in health professional education: educators' perspectives of a co-designed, online mental health education resource. BMC MEDICAL EDUCATION 2023; 23:946. [PMID: 38087347 PMCID: PMC10717857 DOI: 10.1186/s12909-023-04956-0] [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: 08/09/2023] [Accepted: 12/08/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Meaningful involvement of people with lived experience is an invaluable approach to education that facilitates the development of knowledge, skills and attitudes for collaborative, compassionate and person-centred healthcare practice. The purpose of this evaluation was to gain health professional educators' perspectives of an online learning resource that presents the lived experiences of people who have been consumers of the Australian mental health system. METHODS A cross sectional study design was used to survey educators who had registered to use the online education resource. Data were collected using an online survey and follow-up interviews. Two lived experience researchers were involved in the research. Quantitative survey data were analysed descriptively, and qualitative data were analysed thematically. FINDINGS The Listening to Voices online education resource is being used in a range of settings. Educators perceived the content facilitated achievement of learning outcomes related to understanding the experiences of people with mental health issues. The free, online, and flexible design of the resource promoted access and helped overcome barriers to including lived experience experts in education. The powerful impact of the resource and importance of creating safe learning environments when using the resource were highlighted. Suggestions for future developments were provided. CONCLUSION Involving people with lived experience in education of healthcare students and professionals can assist in developing skills for collaborative, compassionate, and person-centred care. Implementation of co-design principles and the use of creative pedagogical approaches can contribute to the development of impactful educational resources that foreground lived experience. Making these resources flexible and freely available online improves their utility.
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Affiliation(s)
- Tracey Parnell
- School of Allied Health, Exercise and Sports Sciences, Faculty of Science and Health, Charles Sturt University, PO Box 789, Albury, NSW, 2640, Australia.
| | - Kate Fiske
- Gateway Health, 155 High Street, Wodonga, Victoria, 3690, Australia
| | - Kellie Stastny
- Intervoice, 21 Warwick Road, Wodonga, Victoria, 3690, Australia
| | - Sarah Sewell
- Listening to Voices, C/- 155 High Street, Wodonga, Victoria, 3690, Australia
| | - Melissa Nott
- Three Rivers Department of Rural Health, Charles Sturt University, Wagga Wagga, NSW, 2678, Australia
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Goodhew M, River J, Samuel Y, Gough C, Street K, Gilford C, Cutler N, Orr F. Learning that cannot come from a book: An evaluation of an undergraduate alcohol and other drugs subject co-produced with experts by experience. Int J Ment Health Nurs 2023; 32:446-457. [PMID: 36478635 DOI: 10.1111/inm.13098] [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] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
Alcohol and other drugs (AOD) use is a significant public health issue and is associated with high mortality and morbidity rates. Despite this, people who use drugs are often reluctant to seek care due to the lack of trauma-informed treatment and harm reduction treatment options, as well as experiences of stigma and discrimination in health services. Arguably, AOD education that is co-produced with people who use alcohol and drugs can enhance future health professionals' ability to practice in ways that support the needs of this population. This paper reports on a qualitative co-evaluation of a co-produced undergraduate nursing AOD subject. The AOD subject was co-planned, co-designed, co-delivered, and co-evaluated with experts by experience, who have a lived experience of substance dependence and work as advocates and peer workers. Following the delivery of the subject in 2021 and 2022, focus groups were undertaken with 12 nursing students. Focus group data indicate that the co-produced subject supported participants to understand and appreciate how stigma impacts on nursing care and how to recognize and undertake 'good' nursing care that was oriented to the needs of service users. Student participants noted that being co-taught by people who use drugs was particularly powerful for shifting their nursing perspectives on AOD use and nursing care and took learning beyond what could be understood from a book. Findings indicate that co-produced AOD education can shift nursing students' perceptions of AOD use by providing access to tacit knowledge and embodied equitable and collaborative relationships with people who use drugs.
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Affiliation(s)
- Mark Goodhew
- The University of Technology, Sydney, New South Wales, Australia
| | - Jo River
- The University of Technology, Sydney, New South Wales, Australia
| | - Yvonne Samuel
- Uniting Medically Supervised Injecting Centre, Potts Point, New South Wales, Australia
| | - Chris Gough
- Canberra Alliance for Harm Minimisation & Advocacy, Belconnen, Australian Capital Territory, Australia
| | - Kevin Street
- Uniting Medically Supervised Injecting Centre, Potts Point, New South Wales, Australia
| | - Candice Gilford
- Uniting Medically Supervised Injecting Centre, Potts Point, New South Wales, Australia
| | - Natalie Cutler
- The University of Technology, Sydney, New South Wales, Australia
| | - Fiona Orr
- The University of Technology, Sydney, New South Wales, Australia
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Thornicroft G, Sunkel C, Alikhon Aliev A, Baker S, Brohan E, El Chammay R, Davies K, Demissie M, Duncan J, Fekadu W, Gronholm PC, Guerrero Z, Gurung D, Habtamu K, Hanlon C, Heim E, Henderson C, Hijazi Z, Hoffman C, Hosny N, Huang FX, Kline S, Kohrt BA, Lempp H, Li J, London E, Ma N, Mak WWS, Makhmud A, Maulik PK, Milenova M, Morales Cano G, Ouali U, Parry S, Rangaswamy T, Rüsch N, Sabri T, Sartorius N, Schulze M, Stuart H, Taylor Salisbury T, Vera San Juan N, Votruba N, Winkler P. The Lancet Commission on ending stigma and discrimination in mental health. Lancet 2022; 400:1438-1480. [PMID: 36223799 DOI: 10.1016/s0140-6736(22)01470-2] [Citation(s) in RCA: 134] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/19/2022] [Accepted: 07/28/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Graham Thornicroft
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; Centre for Implementation Science, King's College London, London UK.
| | | | - Akmal Alikhon Aliev
- National Institute of Mental Health (Czechia), WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
| | - Sue Baker
- Mind international, London, UK; Changing Minds Globally, London, UK
| | - Elaine Brohan
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK
| | | | - Kelly Davies
- Centre for Implementation Science, King's College London, London UK
| | - Mekdes Demissie
- College of Health Sciences and Medicine, School of Nursing and Midwifery, Haramaya University, Ethiopia; Centre for Innovative Drug Development and Therapeutic Studies for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Ethiopia
| | | | - Wubalem Fekadu
- Department of Psychiatry, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Petra C Gronholm
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; Centre for Implementation Science, King's College London, London UK
| | - Zoe Guerrero
- National Institute of Mental Health (Czechia), WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
| | - Dristy Gurung
- Centre for Implementation Science, King's College London, London UK; Transcultural Psychosocial Organization (TPO), Kathmandu Nepal
| | - Kassahun Habtamu
- Addis Ababa University, School of Psychology, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; WHO Collaborating Centre for Mental Health Research and Training, King's College London, London UK; Department of Psychiatry, School of Medicine, College of Health Sciences Addis Ababa University, Addis Ababa, Ethiopia
| | - Eva Heim
- Institut de Psychologie, University of Lausanne, Lausanne, Switzerland
| | - Claire Henderson
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK
| | | | | | - Nadine Hosny
- Institut de Psychologie, University of Lausanne, Lausanne, Switzerland
| | | | | | - Brandon A Kohrt
- Division of Global Mental Health, George Washington University, Washington DC, USA
| | - Heidi Lempp
- Institute of Psychiatry, Psychology and Neuroscience, and Academic Department of Rheumatology, King's College London, London UK
| | - Jie Li
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | | | - Ning Ma
- Institute of Mental Health, Peking University, Beijing, China
| | - Winnie W S Mak
- Department of Psychology, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Akerke Makhmud
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; Centre for Implementation Science, King's College London, London UK
| | - Pallab K Maulik
- George Institute for Global Health, New Delhi, India; University of New South Wales, Sydney, NSW, Australia
| | - Maria Milenova
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; Centre for Implementation Science, King's College London, London UK
| | | | - Uta Ouali
- Razi Hospital and El Manar Medical School, University of Tunis, La Manouba, Tunisia
| | - Sarah Parry
- South London and the Maudsley NHS Foundation Trust, London, UK
| | | | - Nicolas Rüsch
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany; Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Taha Sabri
- Taskeen Health Initiative, Karachi, Pakistan
| | - Norman Sartorius
- Association for the Improvement of Mental health Programs, Geneva, Switzerland
| | | | | | - Tatiana Taylor Salisbury
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK
| | - Norha Vera San Juan
- Health Service and Population Research Department, King's College London, London UK
| | - Nicole Votruba
- and Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Petr Winkler
- National Institute of Mental Health (Czechia), WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
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Scanlan JN, Berry B, Wells K, Somerville J. Learning from lived experience: Outcomes associated with students' involvement in co-designed and co-delivered recovery-oriented practice workshops. Aust Occup Ther J 2022; 69:714-722. [PMID: 35983836 PMCID: PMC10087681 DOI: 10.1111/1440-1630.12837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/10/2022] [Accepted: 08/01/2022] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Learning from individuals with lived experience is considered an important element of developing recovery-oriented practice capabilities in mental health contexts. Additionally, service user involvement in the education of occupational therapy students is a requirement in accreditation standards. Despite this, many barriers to meaningful inclusion of Lived Experience Educators have previously been identified. METHOD This study evaluated the outcomes achieved by students who were involved in a unit of study that incorporated four recovery-oriented practice workshops that were co-designed and co-delivered by Lived Experience Educators and an occupational therapy academic. Change over time was measured using the Recovery Knowledge Inventory (RKI) and the Capabilities for Recovery Oriented Practice Questionnaire (CROP-Q). Change over time was evaluated using paired t-tests. Students also provided qualitative feedback at the conclusion of the workshops. These comments were analysed using interpretive content analysis. RESULTS Students' scores on the RKI and CROP-Q both demonstrated statistically significant improvements from the beginning of the semester to the end of semester (RKI: 53.6-57.7, t = 6.3, P < 0.001; CROP-Q: 75.6-77.0, t = 2.4, P = 0.019). The most common categories included in the qualitative comments were: "Learning from real experiences"; "Learning about how to be a better clinician"; "See the strength and resilience of the educators, reduce stigma"; "Learning about the negative aspects of the mental health system"; and "More effective than other types of learning". CONCLUSION This study has demonstrated that students who engaged with the co-designed and co-delivered workshops improved their recovery knowledge and recovery-oriented capabilities over the course of the semester. Qualitative feedback also suggests that students' attitudes and skills for future practice were also influenced in positive ways by engaging with Lived Experience Educators.
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Affiliation(s)
- Justin Newton Scanlan
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Bridget Berry
- Lived Experience Academic, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Karen Wells
- Lived Experience Academic, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jennie Somerville
- Lived Experience Educator, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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