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Zomer L, van der Meer L, van Weeghel J, Widdershoven G, de Jong I, Voskes Y. Recovery-oriented care in Teams Working with the ART Model in long-term Mental Health care: A Qualitative Study on the Experiences of Service Users and Their Significant Others. Community Ment Health J 2024; 60:1177-1190. [PMID: 38619696 PMCID: PMC11199278 DOI: 10.1007/s10597-024-01269-4] [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: 07/21/2023] [Accepted: 03/16/2024] [Indexed: 04/16/2024]
Abstract
The Active Recovery Triad (ART) model provides a framework for recovery-oriented care in long-term mental health settings. The aim of this study is to gain insight into the experiences and views of service users and their significant others regarding care and support they receive from teams working with the ART model. Semi-structured interviews were performed with nineteen service users and five significant others of teams operating in Dutch long-term mental health care. Data were analyzed using thematic analysis. The three core principles of the ART model formed the deductive basis of the analysis and for every principle themes were identified inductively. Under the principle 'Active', service users mentioned that they feel motivated, work actively on personal recovery goals and have dreams for the future. Service users valued the service as a safe environment, but several service users also preferred to live more independently. Under the principle 'Recovery', participants reported how the dimensions of recovery (health, personal identity, daily life and community functioning) were addressed in care and support. Also, specific conditions for recovery-oriented care were identified, for example regarding specific expertise of care providers. Under the principle 'Triad' the support from significant others, contact with care workers and with other service users were identified as important. The insights regarding what is important for service users and their significant others may contribute to the improvement of care and support in long-term mental health care. In addition, the findings of this study provide directions for the further development of the ART model.
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Affiliation(s)
- Lieke Zomer
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands.
- Altrecht GGz, Zeist, the Netherlands.
| | - Lisette van der Meer
- Department of Clinical & Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
- Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, the Netherlands
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, the Netherlands
| | - Guy Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
| | - Isa de Jong
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
| | - Yolande Voskes
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, the Netherlands
- Impact Care Group, GGz Breburg, Tilburg, the Netherlands
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Vogt KS, Baker J, Kendal S, Griffin BL, Mizen E, Sharp H, Johnson J. 'Safer, Not Safe': Service Users' Experiences of Psychological Safety in Inpatient Mental Health Wards in the United Kingdom. Int J Ment Health Nurs 2024. [PMID: 39030900 DOI: 10.1111/inm.13381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 07/22/2024]
Abstract
Research on patient safety in mental health settings is limited compared to physical healthcare settings. Recent qualitative studies have highlighted that patient safety is more than just physical safety but includes psychological safety. Traditionally, psychological safety has been defined as the belief that it is safe to take interpersonal risks, such as speaking up, without a fear of negative consequences. However, to date, it is not clear what constitutes psychological safety for service users of inpatient mental health settings. To understand this, we conducted 12 interviews with former inpatient mental health service users. Interviews were analysed with Reflexive Thematic Analysis, and five themes were developed. All themes had subthemes. Overall, we found that participants were more readily able to draw on situations where they felt psychologically unsafe, rather than safe. Psychological safety in service users was influenced by (1) healthcare staff attitudes and behaviours towards them, (2) their relationships with other service users, (3) whether they felt they had any control over their environment and medical decision-making regarding their care, (4) their experiences of physically safety, feeling listened to and believed and (5) access to meaningful occupation on the wards. These findings suggest that changes are needed to enhance inpatient mental health service users' general experiences of psychological safety. Further research will need to (1) further develop understanding of the concept of psychological safety for service users and (2) identify interventions, and such interventions should be co-designed with service users.
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Affiliation(s)
- Katharina Sophie Vogt
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- School of Psychology, University of Leeds, Leeds, UK
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - John Baker
- School of Healthcare, University of Leeds, Leeds, UK
| | - Sarah Kendal
- School of Healthcare, University of Leeds, Leeds, UK
| | - Bethany Leigh Griffin
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- School of Psychology, University of Leeds, Leeds, UK
| | - Emily Mizen
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Hannah Sharp
- School of Healthcare, University of Leeds, Leeds, UK
| | - Judith Johnson
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- School of Psychology, University of Leeds, Leeds, UK
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Rocelli M, Aquili L, Giovanazzi P, Puecher A, Goglio MM, Faccio E. 'ALL ABOUT MY IDEAL MENTAL HEALTH SERVICE': Users, family members and experts by experience discussing a co-designed service. Health Expect 2024; 27:e13999. [PMID: 38439208 PMCID: PMC10912534 DOI: 10.1111/hex.13999] [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: 10/30/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 03/06/2024] Open
Abstract
INTRODUCTION Many studies have investigated patients' understandings of how to optimise mental health services. However, only a few studies in the Italian context have involved experts by experience (EbEs), who can be ex-users, family members of ex-users or current service collaborators. Their role is crucial in implementing collaborative service quality assessment projects. METHOD The study investigated the experience of 35 EbEs, users, and family members who carried out a 9-month fortnightly project aimed at imagining an 'ideal service'. The facilitators of the discussion groups (two EbEs) were interviewed; written reports of each meeting were produced with relevant comments, notes and specific suggestions; and content analysis was applied. RESULTS The most important result concerns the effectiveness of the project management method and group leadership carried out by the two EbEs. This approach allowed for complete autonomy of the work, without professional gaze or power imbalance. Also, the ideas and specific contents focused on by the two groups offer strategies to facilitate users' entry and reception in health care centres, to reduce the stigma of mental illness, to improve the centres' physical environment, to improve organisational aspects, to keep family members actively involved and to network mental health services with other territorial services. CONCLUSIONS EbEs have proven to be key figures in ensuring equity of role in the service co-design process. This also concerns a context, the Italian one, where their role has not yet been recognised and legalised. Their contribution and ideas to improve services could be fundamental not only in mental health centres, but also in other health facilities, and could concern the entire service delivery process rather than being limited to quality assurance, according to a virtuous circle based on active participation and transformation of the role of users. PATIENT OR PUBLIC CONTRIBUTION This work resulted from close collaboration between the two EbEs who conducted the groups, users and family members, the university, and the psychiatrist in charge of the service. All of them contributed to the research. The EbEs, researchers and psychiatrist participated in the interpretation of the data and are the co-authors of this paper.
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Affiliation(s)
- Michele Rocelli
- Department of Philosophy, Sociology, Education and Applied PsychologyUniversity of Padua
| | - Ludovica Aquili
- Department of Philosophy, Sociology, Education and Applied PsychologyUniversity of Padua
| | | | | | | | - Elena Faccio
- Department of Philosophy, Sociology, Education and Applied PsychologyUniversity of Padua
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Morgan C, Clarkson L, Hiscocks R, Hopkins I, Berry K, Tyler N, Wood L, Jacobsen P. What should inpatient psychological therapies be for? Qualitative views of service users on outcomes. Health Expect 2024; 27:e13889. [PMID: 37822299 PMCID: PMC10726158 DOI: 10.1111/hex.13889] [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: 06/29/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND There is limited research on what, when and how outcomes should be measured in psychological therapy trials in acute mental health inpatient wards. OBJECTIVES This study aimed to consider what outcomes service users think are important to measure. METHODS This qualitative study explored the views of 14 participants, who had an inpatient admission within the last year, on outcomes of psychological therapies using semistructured interviews. Data were analysed using thematic analysis from a critical realist perspective with both inductive and deductive coding. RESULTS The 126 outcomes that were important to participants were mapped onto an established taxonomy of outcomes across different health areas and the socioecological framework to consider the wider context and help summarise the outcomes. Most of the outcomes were mapped to the intrapersonal and interpersonal level. In addition to the outcome mapping, three themes were constructed from the qualitative data: (1) I am not a problem I am a person, (2) Feeling cared for and loved, (3) What does getting better look like. CONCLUSIONS Our results highlight the need for patient-reported outcomes which are cocreated with service users, disseminating research and training on preventing dehumanising experiences, enhancing psychological safety and therapeutic relationships and improving access to psychological therapy. PATIENT OR PUBLIC CONTRIBUTION The wider People with Personal Experience Involvement Committee at the University of Bath were consulted which included a focus group during the early planning stages. We also collaborated with a person with personal experience, at every stage of the research. This included developing our research question and aims, protocol, participant documents (e.g., information and debrief forms), advertisement and recruitment strategy, interview topic guide, the codes, the final themes and quotes and reviewing the manuscript. People with lived experience of being admitted to an acute mental health inpatient ward participated in our study.
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Affiliation(s)
- Ceri Morgan
- Department of Psychology, University of Bath, Bath, UK
| | - Lucy Clarkson
- Department of Psychology, University of Bath, Bath, UK
| | | | - India Hopkins
- Department of Psychology, University of Bath, Bath, UK
| | - Katherine Berry
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- Department of Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Rawnsley Building Manchester Royal Infirmary, Manchester, UK
| | - Natasha Tyler
- NIHR School for Primary Care Research, University of Manchester, Manchester, UK
| | - Lisa Wood
- Division of Psychiatry, University College London, London, UK
- Research and Development Department, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford, UK
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Mohamed AA, Alomair SM, Alnijadi AA, Abd Aziz F, Almulhim AS, Hammad MA, Emeka PM. Barriers to Mental Illness Treatment in Saudi Arabia: A Population-Based Cross-Sectional Study. Cureus 2024; 16:e53797. [PMID: 38465168 PMCID: PMC10924077 DOI: 10.7759/cureus.53797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Mental illness is a disorder that can cause impairment and disability, affecting mood, thinking, and behavior; therefore, early intervention will reduce morbidity. This study aims to evaluate all the personal, family, societal, and medical barriers that prevent mental health patients from seeking consultation and treatment. METHODS In Saudi Arabia, a cross-sectional study was conducted on 463 individuals aged 18 and above. Data were collected by face-to-face interviews using a validated questionnaire, which consisted of two parts. The first part included sociodemographic data, while the second part contained subsections of society/family, personal, and medical barriers. RESULTS The results showed that 379 (81.9%) indicated that society and family barriers impacted them, whereas 325 (70.3%) believed that personal barriers hindered seeking help. However, 294 (63.5%) opted for medical barriers as a hindrance. Regarding the highest barriers, 120 of the total respondents (25.9%) saw psychiatric illness as a source of shame and stigma, 166 respondents (35.9%) said that the psychiatric patient is seen as crazy, 159 of them (34.3%) believed it is tough for anyone to talk about their feelings and emotions and 183 respondent (39.5%) feared that psychiatric illness would decrease the chance of marriage to the appropriate person. Our findings also indicated a low trust in hospital treatment, hence a loss of confidence in using medications. CONCLUSION The findings of this study indicate that societal stigma is the most common barrier preventing people from seeking mental health consultation. Many barriers differ significantly between males and females.
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Affiliation(s)
- Ahmed A Mohamed
- Clinical Pharmacy, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MYS
| | - Sufyan M Alomair
- Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
| | | | - Fatimatuzzahra Abd Aziz
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MYS
| | - Abdulaziz S Almulhim
- Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
| | | | - Promise M Emeka
- Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
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Glantz A, Sunnqvist C, Örmon K. The time, places, and activities of nurses in a psychiatric inpatient context - A time and motion study with a time-geographic perspective. Issues Ment Health Nurs 2023; 44:387-395. [PMID: 37126738 DOI: 10.1080/01612840.2023.2194990] [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: 05/03/2023]
Abstract
Nurses in psychiatric inpatient care spend less time than desired with patients and investigation of the nature of nursing in this setting is needed. This study explores how nursing activities in psychiatric inpatient wards is distributed over time, and with a time-geographic perspective show how this relates to places. Observations were used to register place, activity, and time. A constructed time-geographic chart mapped the nurses' path which showed that nurses spent little time in places where patients are. There might be constraints that affect nursing. Nurses need to evaluate where time is spent and interventions that facilitate relationships are needed.
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Affiliation(s)
- Andreas Glantz
- Department of Nursing, Faculty of Medicine, Umeå University, Umeå, Sweden
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Charlotta Sunnqvist
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Committee on Psychiatry, Habilitation and Technical Aids, Lund, Sweden
| | - Karin Örmon
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Västra Götaland Region Competence Centre on Intimate Partner Violence, Gothenburg, Sweden
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Liu X, Zhu H. Influencing factors of humanistic care ability and its dimensions among mental health workers during the COVID-19 pandemic: an online cross-sectional study. BMC Psychiatry 2023; 23:186. [PMID: 36944933 PMCID: PMC10029794 DOI: 10.1186/s12888-023-04656-5] [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: 04/11/2022] [Accepted: 03/06/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND In psychiatric services, humanistic care ability significantly affects the quality of the therapeutic relationship and thus affects the therapeutic outcomes for patients. Mental health workers may be confronted with more obstacles in humanistic care during the COVID-19 pandemic wherethe authors aimed to explore the capacity level of humanistic care among mental health workers and its potential influencing factors. METHOD(S) An online cross-sectional survey was conducted among 262 mental health workers working in Chongqing, China, from December 2020 to January 2021. Data were collected by the Caring Ability Inventory (CAI), the Psychological Capital Questionnaire (PCQ-24), the Eysenck Personality Questionnaire-Revised, and the Short Scale for Chinese (EPQ-RSC). Multiple linear regression analysis was used to explore the influencing factors of humanistic care ability. RESULTS Mental health workers' humanistic care ability is at a low level, with a score of 186.47 ± 21.34. Psychological capital is positively associated with humanistic care ability (β[95%CI] = 0.41 [0.46-0.77], p < 0.001), and its two dimensions (cognition: β[95%CI] = 0.51 [0.30-0.47], p < 0.001; patience: β[95%CI] = 0.48 [0.17-0.28], p < 0.001). Psychoticism is negatively associated with humanistic care ability (β[95%CI] = -0.28 [-5.18 - -2.51], p < 0.001) and its three dimensions (cognition: β[95%CI] = -0.12 [-1.57 - -0.17], p < 0.05; courage: β[95%CI] = -0.17 [-1.7 - -0.32], p < 0.01; patience: β[95%CI] = -0.19 [-1.33 - -0.36], p < 0.01). Extroversion is positively associated with humanistic care ability (β[95%CI] = 0.19 [0.69-2.08], p < 0.001), and its two dimensions (cognition: β[95%CI] = 0.19 [0.32-1.05], p < 0.001; courage: β[95%CI] = 0.27 [0.5-1.23], p < 0.001). Neuroticism is negatively associated with humanistic care ability (β[95%CI] = -0.13[-1.37 - -0.19], p < 0.01) and its one dimension (courage: β[95%CI] = -0.25 [-0.98 - -0.35], p < 0.001). CONCLUSION(S) The research has found that the humanistic care ability of mental health workers is at a low level, and the psychological capital and personality traits are significant factors influencing the humanistic care ability and its sub-dimensions. Interventions to improve the psychological capital of mental health workers or to promote the change of personality traits they want are recommended, thereby to promote humanistic practice.
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Affiliation(s)
- Xiaolin Liu
- Rehabilitation Department, Jinzi Mountain Hospital of Chongqing Mental Health Center, No.102, Jinzi Mountain, Jiangbei District, Chongqing, 401147, China.
| | - Hongjin Zhu
- Nursing College of Chongqing Medical University, Chongqing, China
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Adlington K, Vasquez C, Pearce E, Wilson CA, Nowland R, Taylor BL, Spring S, Johnson S. 'Just snap out of it' - the experience of loneliness in women with perinatal depression: a Meta-synthesis of qualitative studies. BMC Psychiatry 2023; 23:110. [PMID: 36849948 PMCID: PMC9970854 DOI: 10.1186/s12888-023-04532-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 01/06/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Pregnancy and the arrival of a new baby is a time of great transition and upheaval. Women often experience social isolation and loneliness at this time and may develop depression, particularly in the postnatal period. Qualitative studies have reported that loneliness is also a feature of perinatal depression. However, until now there has been no attempt to synthesise research exploring the links between loneliness and perinatal depression. This study's aim was to explore existing qualitative evidence to answer two research questions: What are the experiences of loneliness for women with perinatal depression? What helps and what makes loneliness worse for women with perinatal depression? METHODS A qualitative meta-synthesis retrieved primary qualitative studies relevant to the research questions. Four electronic databases were systematically searched (Ovid MEDLINE®; PsycINFO; Embase; Web of Science). Papers were screened according to pre-defined inclusion criteria and assigned a quality score. Thematic analysis was used to identify major overarching themes in the literature. RESULTS Twenty-seven relevant qualitative studies were included. Themes relating to the interaction between perinatal depression and loneliness included self-isolation and hiding symptoms due to stigma of perinatal depression and fear of judgement as a 'bad mother'; a sudden sense of emotional disconnection after birth; and a mismatch between expected and actual support provided by partner, family and community. There was also a double burden of loneliness for women from disadvantaged communities, due to increased stigma and decreased social support. Validation and understanding from healthcare professionals, peer support from other mothers with experience of perinatal depression, and practical and emotional family support were all important factors that could ameliorate loneliness. CONCLUSIONS Loneliness appears to play a central role in the experience of perinatal depression based on the frequency with which it emerged in women's accounts. The findings provide a foundation for the development of further theories about the role of loneliness in perinatal depression and evidence in which future psychological and social intervention design processes can be rooted. Addressing stigma and offering culturally appropriate professional and peer support are potential targets for interventions that could help women with perinatal depression, particularly in disadvantaged communities, feel less lonely. TRIAL REGISTRATION Prospero registration: https://www.crd.york.ac.uk/prospero/display_record.php? RecordID = 251,936.
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Affiliation(s)
- Katherine Adlington
- Division of Psychiatry, University College London, London, UK. .,Section of Women's Mental Health, King's College London, London, UK. .,East London NHS Foundation Trust, London, UK.
| | | | - Eiluned Pearce
- Division of Psychiatry, University College London, London, UK
| | - Claire A Wilson
- Section of Women's Mental Health, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Rebecca Nowland
- School of Health and Midwifery, University of Central Lancashire, Preston, UK
| | | | | | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK.,Camden and Islington NHS Foundation Trust, London, UK
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Reinius M, Steinsaphir Å, Malmqvist Castillo M, Stenfors T. Patients' experiences of Daily Talks: a patient-driven intervention in inpatient mental healthcare. J Ment Health 2023:1-8. [PMID: 36840358 DOI: 10.1080/09638237.2023.2182420] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND Recovery is known to be enhanced by meaningful interactions between patients and mental health staff. However, nurses may become distanced from patients, and patients may spend most of their time in inpatient mental health care alone. AIMS This study aimed to explore how patients experience the intervention Daily Talks, a patient-driven innovation intended to enhance meaningful interactions between patients and staff. METHODS Fourteen in-depth interviews were performed with patients who participated in Daily Talks. The interviews were analysed using reflexive thematic analysis. RESULTS The results of the participants' experiences of Daily Talks are presented in four themes: 1.Interpersonal and active interaction where individual factors matter 2.A patient-controlled space 3.A multi-use intervention and 4.A part of the daily healthcare structure. Participants stated that Daily Talks improved the relationship between patients and their nursing staff, and they stressed the importance of patients having control over both time and content in the Daily Talks. Daily Talks was used to vent emotions and thoughts, handle situations and create strategies, and become part of a helpful structure. CONCLUSIONS The results support the value of Daily Talks, indicating that Daily Talks may facilitate helpful structures and meaningful relationships between patients and nursing staff.
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Affiliation(s)
- Maria Reinius
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Stockholm, Sweden
| | - Åsa Steinsaphir
- User Involvement Coordinator, North Stockholm Psychiatry, Health Care Services Stockholm County, Stockholm, Sweden
| | - Moa Malmqvist Castillo
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Terese Stenfors
- Division of Learning, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Carter L, Isherwood T, Gupta A. The experience of community mental health teams by people with long-term experience of psychosis. PSYCHOSIS 2023. [DOI: 10.1080/17522439.2022.2116474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Lucy Carter
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Tom Isherwood
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Anjula Gupta
- Assertive Outreach and R&R service, Leeds and York Partnership NHS Foundation Trust, Leeds, UK
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11
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Ovuga EBL, Akena DH. Editorial: Mental health in a prison setting: Implementation and practice (mhPIP). Front Psychiatry 2023; 14:1150679. [PMID: 36911110 PMCID: PMC9993436 DOI: 10.3389/fpsyt.2023.1150679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Affiliation(s)
- Emilio B L Ovuga
- Department of Mental Health, Gulu University, Gulu, Uganda.,International Institute of Medicine and Science, Rancho Mirage, CA, United States.,Bomvitae Agro Industries Limited (BAIL), Kampala, Uganda
| | - Dickens H Akena
- Department of Psychiatry, Makerere University College of Health Sciences, Makerere University, Kampala, Uganda
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Duncan K, Winder B, Blagden N, Norman C. "I've Got the Energy to Change, But I Haven't Got the Energy for This Kinda Therapy": A Qualitative Analysis of the Motivations Behind Democratic Therapeutic Community Drop-Out for Men With Sexual Convictions. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:1213-1236. [PMID: 32917108 PMCID: PMC9326789 DOI: 10.1177/0306624x20956957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Prison-based democratic therapeutic communities (TCs) provide an alternative to mainstream prison, where prisoners can work on psychological difficulties and address offending behavior. Research demonstrates TCs are effective at reducing reoffending rates for residents who stay in therapy 18+ months, and those who drop out of TCs offend at a significantly higher rate than those who complete therapy. Thus, it is important to reduce attrition in TCs. No research has yet explored the explanations for TC drop out offered by those with sexual convictions. The present study uses Interpretive Phenomenological Analysis to qualitatively explore the accounts of men with sexual convictions (n = 7) who dropped out of a TC in a UK prison. Results highlight that issues surrounding external responsivity, therapeutic relationships, and treatment readiness were salient in the participants' accounts of drop out. This research has implications for TCs seeking to better understand and address attrition of people with sexual convictions.
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Zhu H, Xie S, Liu X, Yang X, Zhou J. Influencing factors of burnout and its dimensions among mental health workers during the COVID‐19 pandemic. Nurs Open 2022; 9:2013-2023. [PMID: 35434931 PMCID: PMC9190698 DOI: 10.1002/nop2.1211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/10/2022] [Accepted: 04/03/2022] [Indexed: 12/21/2022] Open
Abstract
Aim To examine the demographic and work characteristics of mental health workers associated with burnout during the COVID‐19 epidemic and to examine the relationship between burnout and humanistic care ability. Design Online cross‐sectional design. Methods 270 mental health workers in Chongqing, China, were recruited via WeChat from 1 to 31 December 2020. Online self‐administered questionnaires were used to collect data. Data were analyzed by t‐tests and one‐way analyses of variance, Pearson's correlation analysis, and multiple linear regression analysis. Results During the COVID‐19 pandemic, mental health workers had a high prevalence of burnout and a low level of humanistic care ability. Work factors including profession, work shift, work pressure, work‐family conflict, practice environment satisfaction, salary satisfaction, and humanistic care ability were significantly associated with burnout and its subdimension.
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Affiliation(s)
- Hongjin Zhu
- Nursing College Chongqing Medical University Chongqing China
| | - Shiqi Xie
- Nursing College Chongqing Medical University Chongqing China
| | - Xiaolin Liu
- Chongqing Mental Health Center Chongqing China
| | - Xiaoyun Yang
- Nursing College Chongqing Medical University Chongqing China
| | - Jianrong Zhou
- Nursing College Chongqing Medical University Chongqing China
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Procter S, Harrison D, Pearson P, Dickinson C. Theorising worker–client relations in front‐line service work: Understanding the experience of non‐professionally affiliated workers in UK mental health services. NEW TECHNOLOGY WORK AND EMPLOYMENT 2022. [DOI: 10.1111/ntwe.12212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Smith P, Simpson L, Madill A. Service user experiences of a novel in-reach rehabilitation and recovery service for people with profound and enduring mental health needs. Int J Ment Health Nurs 2021; 30:1106-1116. [PMID: 33772984 DOI: 10.1111/inm.12861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2021] [Indexed: 11/28/2022]
Abstract
This article provides an organizational case study using exploratory qualitative and visual research methods. We address the research question: What are the experiences of service users who use a novel in-reach rehabilitation and recovery service for people with severe and enduring mental health needs? Fifteen purposefully sampled service users were recruited from across a Service that is novel in embedding community sectors within inpatient provision. The sample reflects approximately the demographic of the Service and comprises: 10 men, 5 women; 12 white British, 3 ethnic minority; aged 18-60 years; and across inpatient care and supported community living. Photo-elicitation was used to enrich data collection through lightly structured interviews focused on the images brought by participants. Interview transcripts were analysed using interpretative phenomenological analysis. Analysis indicates that participants oriented towards four 'meta-questions': What does mental well-being mean to you? What difficulties have you encountered? What do you appreciate about the Service? What do you need for change to occur? We also identified six themes which told the story of a journey. The journey begins with challenge and moves towards making connections with others. Here, power dynamics are often experienced and addressed in the development of a greater sense of independence. This then provides opportunities for raised awareness around possibilities of recovery and a new-found hope. Our three main conclusions are all relevant to clinical practice: service users (a) place great importance on building relationships; (b) aspire to make informed choices throughout their recovery journey; and (c) desire greater transparency regarding treatment options.
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Affiliation(s)
- Penn Smith
- School of Psychology, University of Leeds, Leeds, UK
| | - Lisa Simpson
- Community Links part of the Inspire North Group, Leeds, UK
| | - Anna Madill
- School of Psychology, University of Leeds, Leeds, UK
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Martínez-Martínez C, Sánchez-Martínez V, Ballester-Martínez J, Richart-Martínez M, Ramos-Pichardo JD. A qualitative emancipatory inquiry into relationships between people with mental disorders and health professionals. J Psychiatr Ment Health Nurs 2021; 28:721-737. [PMID: 33351223 DOI: 10.1111/jpm.12727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 11/27/2020] [Accepted: 12/11/2020] [Indexed: 12/01/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: A therapeutic alliance with people with mental disorders could help increase the efficacy of treatment. The paradigm shift from a paternalistic model to one that respects the person's autonomy has led to professionals accepting the active role of people with mental disorders making decisions that affect their treatment. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: People with mental disorders perceive paternalistic and stigmatizing attitudes from health professionals, and they do not feel involved in decisions about their health, which can render effective therapeutic alliances difficult. The findings reveal that although people in Mediterranean countries are used to paternalistic treatment from health professionals due to cultural factors, people with mental disorders are increasingly critical of how they are treated and demand greater autonomy and respect in the decision to undergo drug therapy. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: In their interactions with people with mental disorders, health professionals should include efforts aimed at improving shared decision-making capabilities and avoiding paternalistic or stigmatizing attitudes. ABSTRACT: Introduction A therapeutic alliance with people is essential for the efficacy of treatments. However, the traditional paternalistic values of the Mediterranean society may be incompatible with patient autonomy. Aim To explore the therapeutic relationship from the perspective of people diagnosed with mental disorders with health professionals, including nurses. Methods This emancipatory research was performed through focus groups, with people with mental disorders who had a variety of diagnoses and experiences of acute and community-based mental health services and other healthcare services. Data were analysed using the content analysis method. Results Four main themes emerged: stereotypes and prejudice; quality of interactions and treatment; emotional and behavioural impacts; and demands. Discussion According to the participants' descriptions, health professionals are not exempt from prejudice against persons with psychiatric diagnoses. They reported experiencing abuse of power, malpractice, and overmedication. Thus, in the Mediterranean culture, professional attitudes may represent a barrier for an appropriate therapeutic alliance, and people with mental disorders do not feel involved in making decisions about their health. Implications for practice Knowing how people with mental disorders perceive their interactions with health professionals and the effects is necessary to move the care model towards more symmetric relationships that facilitate a therapeutic alliance.
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Affiliation(s)
- Concepción Martínez-Martínez
- Department of Nursing and Physiotherapy, Faculty of Health Sciences, Universidad Europea, Valencia, Spain.,Faculty of Nursing and Podiatry University of Valencia, Valencia, Spain
| | | | | | - Miguel Richart-Martínez
- Nursing Department, Health Sciences Faculty, University of Alicante, San Vicente del Raspeig, Spain
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Stupak R, Dobroczyński B. From Mental Health Industry to Humane Care. Suggestions for an Alternative Systemic Approach to Distress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6625. [PMID: 34202995 PMCID: PMC8296326 DOI: 10.3390/ijerph18126625] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 01/17/2023]
Abstract
The article proposes a rough outline of an alternative systemic approach to mental health issues and of a more humane mental health care system. It suggests focusing on understanding mental distress as stemming from problems in living, using medications as agents facilitating psychotherapy, or as a last resort and short-term help, according to the principles of harm reduction. It argues that understanding drugs as psychoactive substances and studying the subjective effects they produce could lead to better utilization of medications and improvements in terms of conceptualizing and assessing treatment effects. Qualitative research could be particularly useful in that regard. It also advocates a radical departure from current diagnostic systems and proposes a synthesis of already existing alternatives to be used for both research and clinical purposes. Accordingly, a general idea for an alternative mental health care system, based on a combination of Open Dialogue Approach, Soteria houses, individual and group psychotherapy, cautious prescribing, services helping with drug discontinuation, peer-led services and social support is presented. The proposition could be seen as a first step towards developing a systemic alternative that could replace the currently dominating approach instead of focusing on implementing partial solutions that can be co-opted by the current one.
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Affiliation(s)
- Radosław Stupak
- Institute of Philosophy, Faculty of Philosophy, Jagiellonian University, 52 Grodzka St., PL 31044 Kraków, Poland
| | - Bartłomiej Dobroczyński
- Institute of Psychology, Faculty of Philosophy, Jagiellonian University, 6 Ingardena St., PL 30060 Kraków, Poland;
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Taylor BL, Howard LM, Jackson K, Johnson S, Mantovani N, Nath S, Sokolova AY, Sweeney A. Mums Alone: Exploring the Role of Isolation and Loneliness in the Narratives of Women Diagnosed with Perinatal Depression. J Clin Med 2021; 10:jcm10112271. [PMID: 34073903 PMCID: PMC8197355 DOI: 10.3390/jcm10112271] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 11/16/2022] Open
Abstract
In this study, we explore the role that isolation and loneliness play in the narratives of women diagnosed with perinatal depression. Isolation and loneliness are increasingly seen as risk factors for depression, including in the perinatal period, but little is known about whether, and in what ways, women themselves associate isolation or loneliness with perinatal distress. Based on the thematic analysis of semi-structured interviews with fourteen mothers in England, we found that women often connected feelings of depression during and after pregnancy to feeling dislocated from their previous identities and relationships. Women felt lost, confined to their homes, and often unsupported by their partners and families. However, fears of being judged to be inadequate mothers made it difficult for women to make authentic connections with others or to express negative feelings, increasing isolation and depression. We drew on the intersectionality theory to illustrate how the intersect between motherhood and other aspects of women's identities (being young, single, deprived and/or from an ethnic minority) could leave some women particularly isolated and marginalised. Our conclusions emphasise the need to challenge social constructions of the good/bad mother, advocate for social change to lessen pressures on mothers, and develop support that addresses women's interpersonal contexts and social networks.
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Affiliation(s)
- Billie Lever Taylor
- Division of Psychiatry, Faculty of Brain Sciences, University College London, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK;
- Correspondence: (B.L.T.); (A.S.)
| | - Louise M. Howard
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London SE5 8AF, UK; (L.M.H.); (S.N.)
| | - Katherine Jackson
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle NE2 4AX, UK;
| | - Sonia Johnson
- Division of Psychiatry, Faculty of Brain Sciences, University College London, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK;
| | - Nadia Mantovani
- Population Health Research Institute, St George’s, University of London, Cranmer Terrace, London SW17 0RE, UK;
| | - Selina Nath
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London SE5 8AF, UK; (L.M.H.); (S.N.)
- Population, Policy and Practice Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Antoaneta Y. Sokolova
- Lived Experience Advisory Group, University College London, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK;
| | - Angela Sweeney
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London SE5 8AF, UK; (L.M.H.); (S.N.)
- Correspondence: (B.L.T.); (A.S.)
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Hurley J, Hutchinson M, Kozlowski D, Gadd M, van Vorst S. Emotional intelligence as a mechanism to build resilience and non-technical skills in undergraduate nurses undertaking clinical placement. Int J Ment Health Nurs 2020; 29:47-55. [PMID: 31127972 DOI: 10.1111/inm.12607] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/06/2019] [Indexed: 11/28/2022]
Abstract
The environments in which nursing work is undertaken can be highly stressful and complex with resultant harmful outcomes for the health of both nurses and patients reported. Undergraduate nursing students are particularly challenged when on clinical placement through having only partially developed work capabilities, with wide claims that these nurses remain underprepared for work even upon graduation. Over time undergraduate nursing education has arguably not prioritized developing resilience and other non-technical skills required to respond effectively to these challenges. This paper reports findings from a qualitative study of student nurses who received training and coaching in emotional intelligence, a well-established correlate of resilience, just prior to undertaking a mental health or medical/surgical clinical placement. Of that cohort, 12 agreed to qualitative semi-structured interviews that sought to better understand how these students used the knowledge and capabilities from the training within clinical placement contexts. Four themes emerged from the thematic analysis of the interviews: (1) greater experiences of resilience; (2) responding positively to mental health consumers; (3) experiences of greater empathy and compassion; and (4) experiences of improved non-technical work skills. Implications from these findings suggest that student and patient experiences of nursing placement, and mental health nursing placements in particular, would be enhanced by pre-placement emotional intelligence training and coaching. Such training will support nursing graduates to be work-ready upon entering the workforce.
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Affiliation(s)
- John Hurley
- Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Marie Hutchinson
- Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Desiree Kozlowski
- Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Martin Gadd
- Mid North Coast LHD, Coffs Harbour, New South Wales, Australia
| | - Stephen van Vorst
- Southern Cross University, Coffs Harbour, New South Wales, Australia
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