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Eager S, Killaspy H, C J, Mezey G, McPherson P, Downey M, Thompson G, Lloyd-Evans B. A Web-Based Tool to Assess Social Inclusion and Support Care Planning in Mental Health Supported Accommodation: Development and Preliminary Test Study. Interact J Med Res 2024; 13:e45987. [PMID: 38477978 DOI: 10.2196/45987] [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: 01/25/2023] [Revised: 12/08/2023] [Accepted: 02/10/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Individuals with severe mental illness living in supported accommodation are often socially excluded. Social inclusion is an important aspect of recovery-based practice and quality of life. The Social Inclusion Questionnaire User Experience (SInQUE) is a measure of social inclusion that has been validated for use with people with mental health problems. Previous research has suggested that the SInQUE could also help support care planning focused on enabling social inclusion in routine mental health practice. OBJECTIVE This study aims to develop a web-based version of the SInQUE for use in mental health supported accommodation services, examine its acceptability and perceived usefulness as a tool to support care planning with service users, determine the extent of uptake of the tool in supported accommodation settings, and develop a program theory and logic model for the online SInQUE. METHODS This study involved a laboratory-testing stage to assess the acceptability of the SInQUE tool through "think-aloud" testing with 6 supported accommodation staff members and a field-testing stage to assess the acceptability, utility, and use of the SInQUE tool over a 5-month period. An implementation strategy was used in 1 London borough to encourage the use of the SInQUE. Qualitative interviews with 12 service users and 12 staff members who used the tool were conducted and analyzed using thematic analysis. The use of the SInQUE was compared with that in 2 other local authority areas, 1 urban and 1 rural, where the tool was made available for use but no implementation strategy was used. RESULTS Overall, 17 staff members used the SInQUE with 28 different service users during the implementation period (approximately 10% of all service users living in supported accommodation in the study area). The staff and service users interviewed felt that the SInQUE was collaborative, comprehensive, user-friendly, and relevant. Although some staff were concerned that particular questions might be too personal, service users did not echo this view. Participants generally felt that the SInQUE could help identify individuals' priorities regarding different aspects of social inclusion by prompting in-depth conversations and tailoring specific support to address service users' inclusion goals. Some interviewees also suggested that the tool could highlight areas of unmet or unmeetable needs across the borough that could feed into service planning. The SInQUE was not used in the comparison areas that had no implementation strategy. CONCLUSIONS The online SInQUE is an acceptable and potentially useful tool that can be recommended to assess and support care planning to enable social inclusion of people living in mental health supported accommodation services. Despite this, uptake rates were modest during the study period. A concerted implementation strategy is key to embedding its use in usual care, including proactive endorsement by senior leaders and service managers.
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Affiliation(s)
- Sharon Eager
- Division of Psychiatry, University College London, London, United Kingdom
| | - Helen Killaspy
- Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Joanna C
- Division of Psychiatry, University College London, London, United Kingdom
| | - Gillian Mezey
- Population Health Research Institute, St George's, University of London, London, United Kingdom
| | - Peter McPherson
- Division of Psychiatry, University College London, London, United Kingdom
| | - Megan Downey
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Georgina Thompson
- Division of Psychiatry, University College London, London, United Kingdom
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Piat M, Wainwright M, Sofouli E, Vachon B, Deslauriers T, Préfontaine C, Frati F. Factors influencing the implementation of mental health recovery into services: a systematic mixed studies review. Syst Rev 2021; 10:134. [PMID: 33952336 PMCID: PMC8101029 DOI: 10.1186/s13643-021-01646-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 03/22/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Countries around the world have committed in policy to transforming their mental health services towards a recovery orientation. How has mental health recovery been implemented into services for adults, and what factors influence the implementation of recovery-oriented services? METHODS This systematic mixed studies review followed a convergent qualitative synthesis design and used the best-fit framework synthesis method. Librarians ran searches in Ovid- MEDLINE, Ovid-EMBASE, Ovid-PsycInfo, EBSCO-CINAHL Plus with Full Text, ProQuest Dissertations and Theses, Cochrane Library, and Scopus. Two reviewers independently screened studies for inclusion or exclusion using DistillerSR. Qualitative, quantitative, and mixed methods peer-reviewed studies published since 1998 were included if they reported a new effort to transform adult mental health services towards a recovery orientation, and reported findings related to implementation experience, process, or factors. Data was extracted in NVivo12 to the 38 constructs of the Consolidated Framework for Implementation Research (CFIR). The synthesis included a within-case and a cross-case thematic analysis of data coded to each CFIR construct. Cases were types of recovery-oriented innovations. RESULTS Seventy studies met our inclusion criteria. These were grouped into seven types of recovery-oriented innovations (cases) for within-case and cross-case synthesis. Themes illustrating common implementation factors across innovations are presented by CFIR domain: Intervention Characteristics (flexibility, relationship building, lived experience); Inner Setting (traditional biomedical vs. recovery-oriented approach, the importance of organizational and policy commitment to recovery-transformation, staff turnover, lack of resources to support personal recovery goals, information gaps about new roles and procedures, interpersonal relationships), Characteristics of Individuals (variability in knowledge about recovery, characteristics of recovery-oriented service providers); Process (the importance of planning, early and continuous engagement with stakeholders). Very little data from included studies was extracted to the outer setting domain, and therefore, we present only some initial observations and note that further research on outer setting implementation factors is needed. CONCLUSION The CFIR required some adaptation for use as an implementation framework in this review. The common implementation factors presented are an important starting point for stakeholders to consider when implementing recovery-oriented services.
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Affiliation(s)
- Myra Piat
- Douglas Mental Health University Institute, 6875, boul. LaSalle, Montréal, Québec, H4H 1R3, Canada. .,McGill University, Québec, Canada.
| | - Megan Wainwright
- Douglas Mental Health University Institute, 6875, boul. LaSalle, Montréal, Québec, H4H 1R3, Canada.,Department of Anthropology, Durham University, Durham, Canada
| | - Eleni Sofouli
- Douglas Mental Health University Institute, 6875, boul. LaSalle, Montréal, Québec, H4H 1R3, Canada.,McGill University, Québec, Canada
| | - Brigitte Vachon
- School of Rehabilitation, Université de Montréal, C.P. 6128, succursale Centre-ville, Montreal, Québec, H3C 3J7, Canada
| | - Tania Deslauriers
- School of Rehabilitation, Université de Montréal, 7077 avenue du Parc, Montreal, QC, H3N 1X7, Canada
| | - Cassandra Préfontaine
- Université du Québec à Trois-Rivières, 3351 Boulevard des Forges, Trois-Rivières, QC, G8Z 4M3, Canada
| | - Francesca Frati
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, 809, Sherbrooke W, Montreal, Québec, H3A 0C9, Canada
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McPherson P, Lloyd-Evans B, Dalton-Locke C, Killaspy H. A Systematic Review of the Characteristics and Efficacy of Recovery Training for Mental Health Staff: Implications for Supported Accommodation Services. Front Psychiatry 2021; 12:624081. [PMID: 34054593 PMCID: PMC8160251 DOI: 10.3389/fpsyt.2021.624081] [Citation(s) in RCA: 6] [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: 10/30/2020] [Accepted: 04/09/2021] [Indexed: 11/13/2022] Open
Abstract
Evidence suggests a link between recovery-oriented practise and service user outcomes in supported accommodation settings. Current clinical guidelines recommend recovery training for supported accommodation staff, however evidence relating to the effectiveness of this type of training is unclear. This review aimed to describe and compare the characteristics and efficacy of existing recovery training packages for mental health staff. The appropriateness and applicability of the interventions was considered in relation to UK supported accommodation services. Initial search processes returned 830 papers. After duplicate removal, inclusion and exclusion criteria were applied to 489 papers, leaving a final sample of seven papers. Data were reviewed using a narrative synthesis approach. The reviewed papers showed variation in the aims, frequency, and duration of the training interventions, although all included content consistent with the five-domains of the CHIME model. All interventions used direct, in-person teaching, and prioritised interactive, experiential learning, however a number were limited by the absence of feedback, the use of one-off, rather than repeated/follow-up sessions, and a reliance on classroom-based, rather than in-vivo, training. There was limited evidence to suggest a consistent effect of training on staff or service user outcomes, and there was no clear association between the delivery and design characteristics of the interventions and reported outcomes. In considering the development of recovery training for supported accommodation staff, little guidance can be taken from the reviewed literature. Any training package must be developed with consideration of the unique contextual and organisational characteristics of these services. The authors recommend viewing training as one component of a broader goal of service transformation.
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Luigi M, Rapisarda F, Corbière M, De Benedictis L, Bouchard AM, Felx A, Miglioretti M, Abdel-Baki A, Lesage A. Determinants of mental health professionals' attitudes towards recovery: A review. CANADIAN MEDICAL EDUCATION JOURNAL 2020; 11:e62-e73. [PMID: 33062092 PMCID: PMC7522886 DOI: 10.36834/cmej.61273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The attitudes of mental health professionals towards consumers' recovery are far more pessimistic than what is needed for the recovery-orientation to truly permeate systems of care. It has become pressing to depict determinants for these attitudes and how they evolve during professionalization. This, in the hopes to adjust not only medical education, but also ongoing training of professionals. METHODS A systematic search of PubMed and PsycINFO databases was conducted, yielding a net 15 303 records. Twenty-two publications from specific educational journals and reference lists were added. Finally, thirty-four full texts were read, from which twenty-two articles were included. RESULTS From the reviewed studies emerged five main determinants: profession, education, age, clinical experience, and nature of the contact with consumers. Traditional clinical placements during residency, negative experiences with acute patients, younger age and the professional attitudes of psychiatrists seem to all be determining factors for professionals' pessimistic attitudes towards recovery. CONCLUSIONS This review found specific determinants for attitudes in recovery and four out of five can be acted upon. For a recovery-orientation to be implemented across our mental health system, we formulate recommendations within the Canadian context for revision of curriculum, recovery-specific training, and operationalisation through state/provincial technical assistance centers.
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Affiliation(s)
- Mimosa Luigi
- Department of Psychiatry and Addictology, University of Montreal, Quebec, Canada
| | - Filippo Rapisarda
- Department of Psychology, Università degli Studi di Milano-Bicocca, Italy
| | - Marc Corbière
- Department of Education and Pedagogy – Faculty of the Sciences of Education, University of Quebec, Quebec, Canada
| | - Luigi De Benedictis
- Department of Psychiatry and Addictology, University of Montreal, Quebec, Canada
- Program for psychotic disorders, Institut Universitaire en Santé Mentale de Montréal, CIUSSS East-of-Montreal, Quebec, Canada
| | - Anne-Marie Bouchard
- Department of Psychiatry and Addictology, University of Montreal, Quebec, Canada
| | - Amélie Felx
- Mental health and substance abuse program, Institut Universitaire en Santé Mentale Douglas, CIUSSS West-of-Montreal, Quebec, Canada
| | | | - Amal Abdel-Baki
- Department of Psychiatry and Addictology, University of Montreal, Quebec, Canada
| | - Alain Lesage
- Department of Psychiatry and Addictology, University of Montreal, Quebec, Canada
- Research Centre, Institut Universitaire en Santé Mentale de Montréal, CIUSSS East-of-Montreal, Quebec, Canada
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Apostolopoulou A, Stylianidis S, Issari P, Chondros P, Alexiadou A, Belekou P, Giannou C, Karali EK, Foi V, Tzaferou F. Experiences of Recovery in EPAPSY's Community Residential Facilities and the Five CHIME Concepts: A Qualitative Inquiry. Front Psychiatry 2020; 11:24. [PMID: 32116841 PMCID: PMC7031485 DOI: 10.3389/fpsyt.2020.00024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 01/10/2020] [Indexed: 11/13/2022] Open
Abstract
In the context of the reform of psychiatric services in Greece, the debate about the concept of recovery is still growing. Recovery is defined as a path through which individuals facing mental health challenges are enabled to regain and further develop significant relationships with family, friends, the community, and themselves and at the same time to cope with the detrimental effects of stigma through empowerment. The present qualitative study aims to explore the experiences of people living in EPAPSY's (Association for Regional Development and Mental Health) community residential facilities focusing mainly upon the key concepts of the CHIME (connectivity, hope, identity, meaning, and empowerment) conceptual framework of recovery. To this end, semi-structured interviews were conducted with seven participants living and receiving mental health care in a residential facility of EPAPSY. The participants' accounts were analyzed using thematic analysis in a deductive and inductive manner. The research findings highlighted, among others, the challenges the participants faced during their early years in family and school, the experience of the revolving door effect, and the perceived turn their life took when they were transferred to a community residential facility, thus opening a new chapter in their lives. Of the five CHIME concepts, all are present in the participants' accounts, with emphasis given to a meaningful present, a need to feel "normal" again, and a positive outlook for the future, both for themselves and their relationships, despite the persistence of certain difficulties.
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Affiliation(s)
| | - Stelios Stylianidis
- Department of Psychology, Panteion University for Social and Political Sciences, Athens, Greece
| | - Philia Issari
- Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Chondros
- Association for Regional Development and Mental Health (EPAPSY), Athens, Greece
| | - Amalia Alexiadou
- Association for Regional Development and Mental Health (EPAPSY), Athens, Greece
| | - Pepy Belekou
- Association for Regional Development and Mental Health (EPAPSY), Athens, Greece
| | - Charalambos Giannou
- Association for Regional Development and Mental Health (EPAPSY), Athens, Greece
| | - Eleni K. Karali
- Association for Regional Development and Mental Health (EPAPSY), Athens, Greece
| | - Vana Foi
- Association for Regional Development and Mental Health (EPAPSY), Athens, Greece
| | - Fotini Tzaferou
- Association for Regional Development and Mental Health (EPAPSY), Athens, Greece
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Castillo JM, Wolgemuth JR, Ginns DS, Latimer J, Scheel N, McKenna M, March AL, Moulton S, Wang J, Thoman S, Jenkins A, Henson K, Ferron JM. Protocol for the systematic review of research on professional learning to promote implementation of a multitiered system of support in education. BMJ Open 2018; 8:e024057. [PMID: 30498047 PMCID: PMC6278779 DOI: 10.1136/bmjopen-2018-024057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 08/08/2018] [Accepted: 10/31/2018] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION A multitiered system of supports (MTSS) represents a widely adopted public health approach to education in the USA. Researchers agree professional learning is critical for educators to implement the critical components of MTSS; however, professional learning approaches vary in their designs and targeted outcomes. While researchers increasingly focus their inquiries on professional learning for MTSS, no systematic research review exists. OBJECTIVES The primary objectives for this mixed-methods review are to (1) understand how professional learning focused on MTSS has been operationalised (2) determine the impact of professional learning on educator (eg, knowledge) and implementation (eg, data-based decision-making processes) outcomes and (3) understand the contextual variables that influence professional learning in the USA. We aim to determine which elements of professional learning improve educators' capacity to implement MTSS. METHODS AND ANALYSIS We will include studies that use quantitative and qualitative methods. PsycInfo, PubMed, CIHAHL and ERIC will be the primary research databases used to search for studies published from January 1997 to May 2018. We also will search the US Institute for Educational Sciences and Office of Special Education Programs websites, ProQuest, Google Scholar, Science Watch and MSN. Finally, we will search the proceedings of relevant conferences, examine the reference lists of studies that pass full screening and contact authors for additional work. Data extraction will include participant demographics, intervention details, study design, outcomes, analyses and key findings. We will conduct a quality assessment and analyse the data using effect size and thematic analyses. ETHICS AND DISSEMINATION Institutional review board or ethics approval is not needed for this review of already published works. We will disseminate the findings through presentations at state, national and international conferences; presentations to stakeholders and agencies; publication in peer-reviewed journals; and posts to organisational and agency websites.
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Affiliation(s)
- Jose M Castillo
- Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida, USA
| | - Jennifer R Wolgemuth
- Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida, USA
| | - Diana S Ginns
- Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida, USA
| | - Joseph Latimer
- Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida, USA
| | - Nicholas Scheel
- Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida, USA
| | - Meaghan McKenna
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida, USA
| | - Amanda L March
- Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida, USA
| | - Sara Moulton
- Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida, USA
| | - Joy Wang
- Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida, USA
| | - Sarah Thoman
- Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida, USA
| | - Andrew Jenkins
- Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida, USA
| | - Kelli Henson
- Department of Child and Family Studies, University of South Florida, Tampa, Florida, USA
| | - John M Ferron
- Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida, USA
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Wolstencroft KE, Deane FP, Jones CL, Zimmermann A, Cox M. Consumer and staff perspectives of the implementation frequency and value of recovery and wellbeing oriented practices. Int J Ment Health Syst 2018; 12:60. [PMID: 30377442 PMCID: PMC6195683 DOI: 10.1186/s13033-018-0244-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 10/15/2018] [Indexed: 11/10/2022] Open
Abstract
Background Despite advances in our understanding of what mental health systems and services can do to enhance recovery and wellbeing outcomes for people seeking support, there is limited evidence demonstrating that this body of work has translated successfully into mental health service practice. The Collaborative Recovery Model (CRM) is a practice framework that has been designed to support application of recovery and wellbeing oriented principles and practices within mental health service delivery. The aims of this study were to assess consumer and staff perceptions of implementation frequency during service engagement and the value of this approach for assisting recovery within a setting where the CRM approach had been adopted. Methods The setting was a large Australian community managed mental health organisation. The study involved a cross-sectional analysis of consumer (n = 116) and staff practitioner (n = 62) perspectives. A series of paired sample t-tests assessed for differences between consumer and staff perceptions of the: (i) importance of key practice elements for assisting recovery, and the (ii) frequency that key practice elements are utilised during engagement sessions. Spearman's r correlational analysis explored associations between importance, frequency and helpfulness of sessions. Results Key practice elements of the model were applied during service interactions at a high level and perceived by the majority of consumers and staff participants as being important or very important for assisting recovery. Significant moderate correlations were found between the extent that practice elements were valued and the level at which they were applied. Higher levels of implementation of CRM practices were associated with higher ratings of perceived session helpfulness. The strongest association was between 'encouragement to set tasks to complete between support visits' and perceived helpfulness. Conclusions Consumer and staff responses revealed that the key practice elements of the CRM were frequently implemented during service engagement interactions and were seen as valuable for assisting recovery. The level of agreement between raters suggests firstly, that the key practice elements were apparent and able to be rated as occurring, and secondly that the CRM approach is seen as responsive to consumer needs. The results have implications for translating recovery and wellbeing oriented knowledge into mental health service practice.
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Affiliation(s)
| | - Frank P Deane
- 2Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Wollongong, NSW Australia
| | - Cara L Jones
- 3School of Psychology, University of Wollongong, Wollongong, NSW Australia
| | | | - Merrilee Cox
- Mental Health Association of Central Australia, Alice Springs, NT Australia
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