scholarly journals Investigating change in non-government mental health service organisations’ ‘smoke-free’ attitudes and practice in New Zealand

2014 ◽  
Vol 10 (2) ◽  
pp. 124-134
Author(s):  
Penny Marlowe ◽  
Janine Paynter
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Logistic Models ◽  
Cross Sectional ◽  
Response Options ◽  
Attitudes And Practices ◽  
Quit Smoking ◽  
Stop Smoking ◽  
Service Staff

Smoking prevalence amongst service users from the mental health and addictions sectors is higher than the general population. Cross-sectional web- or paper-based surveys comprising open and closed response options were used to examine changes in prevailing attitudes and practices amongst non-government mental health service staff and users. Thematic analysis was used to interpret and present open response answers. Multi-variate logistic models were used to investigate which factors are associated with smoke-free attitudes and practices. Staff who smoke were found to be less likely to provide cessation support to clients (AOR 0.51, 95% CI 0.31–0.82) and gave significantly lower estimates of the percentage of clients who wish to stop smoking (30% vs 44%, p < 0.0001). Those who had completed cessation training also had more positive views about the importance of providing cessation support and service user desire to stop smoking. Staff who had not completed cessation training had significantly lower odds of reporting they carried out quit smoking support often and routinely (AOR 0.33, 95% CI 0.23–0.47) The results suggest that continuing improvement will be enabled by increasing rates of cessation training amongst staff of mental health and addictions non-government organisations. In addition, there is a need for increased incentive and support for staff who smoke to quit.

scholarly journals New ways of working: COVID-19 as a catalyst for change in acute mental health services

BMJ Leader ◽  
2021 ◽  
pp. leader-2020-000366
Author(s):  
Kezanne Tong ◽  
Genevieve Crudden ◽  
Wen Xi Tang ◽  
David McGuinness ◽  
Margaret O'Grady ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Response Times ◽  
New Ways Of Working ◽  
Number Of Patients ◽  
Service Staff ◽  
Alternative Settings ◽  
Quality Response ◽  
Spread Of Infection

BackgroundA need arose to divert patients with psychiatric complaints from the emergency department to alternative settings for psychiatric consultations to reduce footfall during COVID-19. We assessed the effectiveness of alternative referral pathway in reducing COVID-19 infection in our service and its effect on service quality: response time and number of patients leaving before the review. We evaluated the satisfaction of patients, general practitioners (GPs) and mental health service staff with the pathway.MethodsAll patients referred to the mental health service over a 2-month period following the introduction of the pathway were included. Findings were compared against the cohort referred for emergency assessment during the same period in 2019. Feedback surveys were distributed to patients, staff and GPs. χ2 and independent sample t-test were used to compare the variables.ResultsOver 2 months, 255 patients received an emergency assessment via the pathway, representing a 22.3% decrease in the volume of presentations from the same period in 2019. There were no COVID-19 cases among our patients or staff on the roster for assessing patients. In comparison to 2019, response times were improved (p<0.001), and the numbers of patients who left the hospital before the review were reduced by 3.2% during the study period (p<0.001). Patients and GPs were highly satisfied with the referral pathway and believed that the pathway should be retained post-COVID-19. Mental health service staff were divided in their opinions about its sustainability.ConclusionThe pathway was successful in reducing the spread of infection, improving response times and reducing the numbers of patients who left without an assessment. Given the improved outcomes and acceptability, this is a preferable pathway for emergency referrals into the future.

scholarly journals Experience of stigma among mental health service users in Hong Kong: Are there changes between 2001 and 2017?

2018 ◽  
Vol 65 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Ka-Fai Chung ◽  
Samson Tse ◽  
Chit-Tat Lee ◽  
Michael Ming-Cheuk Wong ◽  
Wing-Man Chan
Keyword(s):  
Mental Health ◽  
Hong Kong ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Health Problems ◽  
Cross Sectional Study ◽  
Baseline Survey ◽  
Service Users ◽  
Cross Sectional ◽  
Over Time

Background: Public expenditure on mental health education has grown exponentially in the past two decades. Does the experience of stigma among people with mental health problems improve over time? Our study aims to compare the levels of perceived stigmatization, rejection experiences and stigma–coping among mental health service users in Hong Kong between 2001 and 2017 using longitudinal and repeated cross-sectional study design. Method: The baseline survey was completed by 193 psychiatric outpatients in 2001. They were traced for re-assessment in 2017. Another sample of 193 outpatients matched in age, gender and psychiatric diagnosis was recruited in 2017 for cross-sectional comparison. Participants completed a 39-item questionnaire on stigma experiences, Beck Depression Inventory and Disability Assessment Schedule at both time points. Results: In total, 109 of 193 participants (56.5%) of the 2001 survey were re-assessed. No significant change in perceived stigmatization, rejection experiences and stigma–coping was found among the 109 participants interviewed in 2001 and 2017. For cross-sectional comparison, significant differences in two perceived stigma items were observed upon Bonferroni correction (chi-square test, p < .005) and remained significant after controlling for confounding factors by regression analysis. Improvements in perceived stigmatization were on marriage and friendship, while viewpoints on trustworthiness, dangerousness, devaluation, avoidance and personal failure remained unchanged, and there was no improvement in rejection experiences and stigma–coping. Conclusion: Positive attitude changes over time are unlikely to occur if there is no targeted intervention on stigma. Our findings highlight that evidence-based antistigma interventions are urgently needed.

scholarly journals Comparison of a co‐produced mental health service to traditional services: A co‐produced mixed‐methods cross‐sectional study

2019 ◽  
Vol 29 (3) ◽  
pp. 460-475
Author(s):  
Raffaella Pocobello ◽  
Tarek Sehity ◽  
Luca Negrogno ◽  
Carlo Minervini ◽  
Maddalena Guida ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Mental Health Service ◽  
Health Service ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Coping with stigma and discrimination: evidence from mental health service users in England

2017 ◽  
Vol 27 (6) ◽  
pp. 577-588 ◽  
Author(s):  
A. Isaksson ◽  
E. Corker ◽  
J. Cotney ◽  
S. Hamilton ◽  
V. Pinfold ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Health Problems ◽  
Health Problems ◽  
Mental Health Stigma ◽  
Service Users ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Stigma And Discrimination

Aims.Mental health stigma and discrimination are significant problems. Common coping orientations include: concealing mental health problems, challenging others and educating others. We describe the use of common stigma coping orientations and explain variations within a sample of English mental health service users.Methods.Cross-sectional survey data were collected as part of the Viewpoint survey of mental health service users’ experiences of discrimination (n = 3005). Linear regression analyses were carried out to identify factors associated with the three stigma coping orientations.Results.The most common coping orientation was to conceal mental health problems (73%), which was strongly associated with anticipated discrimination. Only 51% ever challenged others because of discriminating behaviour, this being related to experienced discrimination, but also to higher confidence to tackle stigma.Conclusions.Although stigma coping orientations vary by context, individuals often choose to conceal problems, which is associated with greater anticipated and experienced discrimination and less confidence to challenge stigma. The direction of this association requires further investigation.

scholarly journals Supporting mental health service users to stop smoking: findings from a mixed method evaluation of the implementation of nicotine management policies into two mental health trusts

2020 ◽  
Author(s):  
Susan E Jones ◽  
A. Billett ◽  
S. Mulrine ◽  
H. Clements ◽  
S. Hamilton
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Health Services ◽  
Smoking Prevalence ◽  
Routine Data ◽  
Data Capture ◽  
Service Users ◽  
Stop Smoking ◽  
Management Policies

Abstract Background Life expectancy is 10-20 years lower among people with a severe mental health disorder. Most of these early deaths are due to chronic conditions, including cardiovascular and respiratory diseases. Smoking is a major risk factor for these conditions and introducing nicotine management policies has been recommended to mental health service providers. This paper reports an evaluation of introducing these policy recommendations. Aim To reflect on the process and effectiveness outcomes when introducing nicotine management policies, including smokefree sites, in National Health Service (NHS) Trusts providing mental health services in an English region. Method Process data were collected through semi-structured interviews with staff (n=51), members of partnering organisations (n=5), service users (n=7) and carers (n=2) between November 2016–April 2017. Normalization Process Theory (NPT) was used to design the data collection tools and analyse the data. A framework approach was taken with the analysis using the four concepts of NPT: coherence, cognitive participation, collective action and reflexive monitoring. Aggregate routine quantitative data indicating the smoking status of service users were collected by querying patient administration systems every other quarter between 2013 and 2017. The data were analysed to investigate quality and completeness and to monitor smoking prevalence among service users over time. Results The policy made sense to some staff (coherence) who ‘bought-into’ the idea (cognitive participation) but other staff disagreed. Although nicotine management interventions were operationalised (collective action), sometimes they were opposed. Progress was made, especially in some units, but continued to be resisted in others. Informal appraisal of progress (reflexive monitoring) presented a varied picture. Routinely collected numerical data were of limited quality due to the high proportion of missing values; although there was some evidence of reducing smoking prevalence in both Trusts. Conclusion Some progress has been made in terms of changing entrenched, smoking cultures into one that is smokefree on Trust sites across the region. Systems for accurate, routine data capture of continued smoking and stop smoking journeys need to be established. Perseverance and resourcing over the long-term is required to establish routine data capture and a non-smoking culture in on-site provision of mental health services.

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