A qualitative evaluation of an ACT-based substance misuse treatment programme for service users within a secure mental health setting

2019 ◽  
Vol 12 (3) ◽  
pp. 117-131
Author(s):  
Lacey M. Johnson ◽  
Kelly J. Elsegood ◽  
Charlotte Lennox
Keyword(s):  
Mental Health ◽  
Substance Misuse ◽  
Qualitative Evaluation ◽  
Structured Interview ◽  
Service Users ◽  
Treatment Programme ◽  
Mental Health Setting ◽  
Structured Interviews ◽  
Content Type ◽  
The Impact

Purpose The purpose of this paper is to understand service users’ experience of a new acceptance and commitment therapy (ACT)-based substance misuse programme. The programme is designed for people in secure mental health services, presenting with complex mental health difficulties and co-occurring substance misuse problems. Design/methodology/approach A qualitative approach informed an exploratory pilot of this novel intervention. Service users completing a 16-week ACT programme were invited to participate in the current study. Out of the nine individuals enroled on the programme, six opted to take part in the exploratory pilot and completed semi-structured interviews following part 1 of the programme (eight weeks). Four of these participants proceeded into part 2 of the programme (eight weeks) and completed a further semi-structured interview. Findings The thematic analysis identified five main themes: “Increased awareness of personal values and the impact of substance use on values”, “Taking committed action towards values”, “Coping skills and the application of skills to manage difficult thoughts and feelings”, “Personal development” and “Use of metaphors/analogies”. Research limitations/implications A quantitative evaluation of clinical outcomes is recommended to gauge further programme effectiveness. Practical implications The findings provide preliminary support for the use of an ACT-based substance misuse programme in a secure mental health setting. Originality/value This study evaluates the use of a novel ACT-based substance misuse intervention with people in secure mental health care with co-occurring mental health and substance misuse difficulties. This paper provides an in-depth understanding of service users’ experience of participating in this new treatment programme.

Is co-production working well in recovery colleges? Emergent themes from a systematic narrative review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Karen Louise Bester ◽  
Anne McGlade ◽  
Eithne Darragh
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Social Care ◽  
The Body ◽  
Bibliographic Databases ◽  
Service Users ◽  
Content Type ◽  
Practitioner Attitudes ◽  
Health And Social Care ◽  
The Impact

Purpose “Co-production” is a process in health and social care wherein service users and practitioners work in partnership. Recovery colleges (RCs) are educational establishments offering mental health education; a cornerstone feature is that courses are designed and delivered in parity by both mental health practitioners and “peers” – people with lived experience of mental illness. This paper aims to consider, through the identification of key themes, whether co-production within RCs is operating successfully. Design/methodology/approach The paper is a systematic review of qualitative literature. Relevant concept groups were systematically searched using three bibliographic databases: Medline, Social Care Online and Scopus. Articles were quality appraised and then synthesised through inductive thematic analysis and emergent trends identified. Findings Synthesis identified three key themes relating to the impact of co-production in RCs: practitioner attitudes, power dynamics between practitioners and service users, and RCs’ relationships with their host organisations. As a result of RC engagement, traditional practitioner/patient hierarchies were found to be eroding. Practitioners felt they were more person-centred. RCs can model good co-productive practices to their host organisations. The review concluded, with some caveats, that RC co-production was of high fidelity. Originality/value RC research is growing, but the body of evidence remains relatively small. Most of what exists examine the impact of RCs on individuals’ overall recovery and mental health; there is a limited empirical investigation into whether their flagship feature of parity between peers and practitioners is genuine.

Hitting the right note for child and adolescent mental and emotional wellbeing: a formative qualitative evaluation of Sistema Scotland’s “Big Noise” orchestral programme

2016 ◽  
Vol 15 (1) ◽  
pp. 25-36 ◽  
Author(s):  
Christopher Harkins ◽  
Lisa Garnham ◽  
Aileen Campbell ◽  
Carol Tannahill
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Early Stage ◽  
Qualitative Evaluation ◽  
Qualitative Assessment ◽  
Potential Contribution ◽  
Emotional Wellbeing ◽  
Structured Interviews ◽  
Content Type ◽  
Causal Pathways

Purpose – Previous research emphasises the need for preventative interventions to reduce mental health problems among disadvantaged children and adolescents. There is however little consensus concerning the delivery and impacts of such interventions particularly non-clinical, arts-based models delivered within community settings. The purpose of this paper is to begin to address this deficit through a qualitative assessment of the short- to medium-term impacts to participants’ mental and emotional wellbeing within Sistema Scotland’s Big Noise orchestral programme. Design/methodology/approach – Semi-structured interviews, observation, participant drawing exercise, participatory filmmaking, focus group and analysis of programme engagement were undertaken to examine the mental and emotional wellbeing impacts of the programme which are observable at this early stage of programme delivery and participants’ lives. Findings – The qualitative findings indicate that participation in the Big Noise programme enhances participant mental and emotional wellbeing in three ways; first, the happiness and enjoyment of taking part in the programme and orchestra, particularly from music making; second, the security, belonging and relationships fostered through participation; the quality of musician/participant relationship is important here as is programme design which enables support, routine and structure; and third, increased pride, confidence and self-esteem, as a result of acquiring difficult musical skills, receiving regular praise and having frequent opportunities to demonstrate these acquired skills through regular orchestral performances. Originality/value – There is little evidence or understanding of community-based, preventative, arts interventions like Big Noise: their delivery, their life-course impacts and their potential contribution to mental health and to addressing social and health inequalities. The causal pathways in the field are under-theorised. These early findings are important as they serve as an important basis from which to consider the programme’s wider and longer term impacts, which will be assessed through an on-going longitudinal, mixed method summative evaluation.

scholarly journals Utilising a scholarship program as a workforce strategy for the community-managed mental health sector

2017 ◽  
Vol 12 (6) ◽  
pp. 360-376 ◽  
Author(s):  
Emma Foreman ◽  
Sara McMillan ◽  
Amanda Wheeler
Keyword(s):  
Mental Health ◽  
Workforce Development ◽  
Health Sector ◽  
Mental Health Program ◽  
Work Practice ◽  
Structured Interviews ◽  
Content Type ◽  
University Experiences ◽  
Scholarship Program ◽  
The Impact

Purpose The community-managed mental health sector needs to meet growing workforce demands. Yet, limited research has explored professional development opportunities and effective recruitment and retention strategies to support sector growth. One strategy is the use of a scholarship program to increase skills and training, via a University qualification. The purpose of this paper is to explore the progress of 19 mental health scholarship students and the impact of the scholarship on career intentions. Design/methodology/approach A mixed-methods approach comprising scholarship applications, questionnaires and semi-structured interviews was used to explore the students’ university experiences between February 2013 and January 2015. Course convenors of the Mental Health Program were interviewed. Data were collected across three time-points over 24 months, with each collection informing the next research phase. Data analysis involved thematic analysis and descriptive statistics. Findings Deeper knowledge, recognition of experience, new career pathways and improved work practice were benefits. Managing time and study, and work-life balance were the greatest challenges. Completing students displayed a range of internal attributes and accessed external supports. At the time of the study, the scholarships maintained student motivation and intention to work in the sector. Originality/value This research provides a deeper understanding of the demographics of the sector’s workforce. Insight into the attributes of completing students was obtained. The benefits realized and the challenges faced by the scholarship recipients will inform ongoing workforce development programs for the community-managed mental health sector.

scholarly journals The impact of peer mentoring on students’ physical activity and mental health

2019 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jonathan Glazzard ◽  
Anthea Rose ◽  
Paul Ogilvie
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Peer Mentoring ◽  
Leadership Skills ◽  
Relationship Building ◽  
Self Awareness ◽  
Peer Mentors ◽  
Structured Interviews ◽  
Content Type ◽  
The Impact

Purpose A peer-mentoring scheme was implemented in a secondary school using a physical activity (PA) intervention to improve mental health outcomes of students who were at risk of developing mental ill health. These students are referred to as mentees. The evaluation was a qualitative design using focus groups and semi-structured interviews. The participants reported an increase in PA in both peer mentors and mentees. By the end of the project many of the mentees recognised that they had increased their levels of PA, they were more aware of the benefits of PA and the relationship between PA and their mental health. In addition, mentees reported feeling more confident and were more confident in forming social relationships. Peer mentors reported developing many leadership skills during the project. These included improved communication, confidence, empathy for others, relationship building and improved self-awareness. The paper aims to discuss these issues. Design/methodology/approach Qualitative data were primarily collected from nine case study schools. Each visit included interviews with peer mentors, mentees and the Wellbeing Champion. Findings Mentees developed improved social confidence and were generally more positive after completing the intervention. Mentors developed leadership skills and greater empathy for their peers. Originality/value There is limited research on school-based PA interventions using peer mentoring to improve students’ mental health.

Older adult recovery: “What are we working towards?”

2016 ◽  
Vol 21 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Samantha Rankin ◽  
Stephanie Petty
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Clinical Practice ◽  
Older Adult ◽  
Later Life ◽  
Mental Health Setting ◽  
Personal Recovery ◽  
Structured Interviews ◽  
Content Type ◽  
Inpatient Mental Health

Purpose – The perspectives of frontline clinical staff working with individuals in later life within an inpatient mental health setting, of their role in recovery, have not yet been explored. The purpose of this paper is to understand what recovery means within an inpatient mental health setting for older adults. The authors address clear implications for clinical practice. Design/methodology/approach – Semi-structured interviews were conducted with 11 multidisciplinary participants across two specialist older adult recovery units at an independent hospital in the UK. Thematic analysis was applied to the transcripts. Findings – Three main themes were identified: participants identified their normative task as the promotion of “moving on” (clinical recovery) and their existential task as personal recovery. The context in which recovery happens was highlighted as the third theme. These represented competing workplace goals of clinical and personal recovery. This highlights the need to give permission to personal recovery as the process that enables mental health recovery in older adults. Originality/value – Staff working in a inpatient mental health service for older adults discussed the meaning of recovery and their role in enabling recovery. This has implications for sustainable clinical practice in this setting. Recovery-orientated practice in this setting is required but the detail is not yet understood.

When policy fails try something different integrated practice improve outcomes for dual diagnosis co-occurring service users accessing mental health services

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lois Dugmore ◽  
Saskia Bauweraerts
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Dual Diagnosis ◽  
Service User ◽  
Substance Misuse ◽  
Service Users ◽  
User Group ◽  
Access To Services ◽  
Content Type ◽  
Drug And Alcohol

Purpose This paper aims to discuss an initiative developed between, Leicestershire Partnership National Health Service Trust and Turning Point, which is the locally commissioned drug and alcohol service in Leicester, Leicestershire and Rutland. The aim was to improve outcomes for clients with dual diagnosis (co-occurring mental health and substance misuse) issues. The purpose of the change in working practice was to engage with local substance misuse agencies more effectively to improve clinical outcomes within this service user group. This was achieved through four interrelated approaches. This comprising providing an integrated service. It included building relationships with substance misuse services, providing specialist dual diagnosis clinics and the introduction of substance misuse workers onto mental health wards and group work specific to substance misuse. The outcomes included easier access to services for service users and greater uptake of service users who were moving onto substance misuse services. This led to a reduction in risk related to prescribing and fewer incidents related to prescribing changes and greater engagement in services. When service users were moving between services better communication led to prescriptions being transferred with no delay and to reduced dropout rates in service. There was improved access to substance misuse services, more referrals and take up of service taking place. There was a greater understanding by staff of co-occurring substance misuse and how to work with this client group. Closer working relationship with substance misuse services and shared skills led to greater confidence in managing this service user group. This demonstrates a cost effective service that can be replicated within similar settings. Design/methodology/approach In clinical practice, shared treatment has proved challenging in light of different service models (Laker, 2006). Substance misuse works on the premise of change comes from the individual, where recovery models in mental health offer a formalised approach. One of the challenges faced by services has been the inability for mental health services to recruit and services become overstretched (Rimmer, 2018); this gave an opportunity for a new method of working to be considered. This led to the development of a new service model. These changes were: • Improving the interface with substance misuse services to improve access to community substance misuse services for mental health clients. • To provide specialist staff within the dual diagnosis field to provide a clinic jointly with local drug and alcohol services. • Introduction of substance misuse workers as team members on acute mental health and rehab wards. • Group Substance Misuse programmes. Findings Working within an integrated model, yet maintaining separate organisations, by offering joint training and clinics has led to a greater understanding of each organisation’s work and increased engagement within the service user group.The introduction of substance misuse workers to acute and rehab mental health inpatient services encouraged service users to engage at the point of admission and to be referred into locally commissioned substance misuse services prior to the point of discharge. Engagement with staff has demonstrated better engagement with substance service by service users following discharge.For clients able to take leave assessment could take place prior to discharge. This led to an increased uptake in services. Due to no opiate substitution given on discharge decreased risk of prescribed medication overdose at point of discharge and led to increase in returning straight to substance misuse services. This meant that service users received medication quicker and the right dose and on discharge ensured reduced risk. The prescribing of Naloxone at discharge is yet to be assessed, but the risk of an overdose within seven days is well-documented and Naloxone is key in reversing this trend. This change in practice can be replicated in any mental health setting and has increased access to services for those using substances. Originality/value Is original no other services have substance workers or joint clinics across the UK. First inpatient unit to welcome patients back post-discharge to attend groups.

Impact on staff attitudes of brief personality disorder training for acute psychiatric wards

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Claire McDonald ◽  
Fiona Seaman-Thornton ◽  
Che Ling Michelle Mok ◽  
Hanne Jakobsen ◽  
Simon Riches
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Mental Health Professionals ◽  
Control Group ◽  
Health Staff ◽  
Service Users ◽  
Staff Attitudes ◽  
Content Type ◽  
Acute Psychiatric Wards ◽  
The Impact

Purpose Negative attitudes towards “personality disorder” are common among mental health professionals. This study aims to design a psychoeducational training targeting attitudes to “personality disorder” for staff working in a London psychiatric hospital. Its impact on staff attitudes was evaluated. Design/methodology/approach Mental health clinicians were recruited from five acute psychiatric wards. Feasibility of implementing the training was measured. A free-association exercise explored baseline attitudes to “personality disorder” and visual analogue scales assessed staff attitudes pre- and post-training. Content analysis of staff feedback was carried out. Findings Psychoeducational training was found to be feasible, well-attended and highly valued by ward staff (N = 47). Baseline results revealed negative perceptions of “personality disorder”. Post-training, significant improvements in understanding, levels of compassion and attitudes to working with service users with a diagnosis of a “personality disorder” were observed. Staff feedback highlighted desire for further training and support. Research limitations/implications The sample size was relatively small and there was no control group, so findings should be interpreted with caution. Practical implications The findings highlight the need for support for staff working with service users with diagnoses of “personality disorder” on acute psychiatric wards. Providing regular training with interactive components may promote training as a resource for staff well-being. Planning to ensure service users’ and carers’ views are incorporated into the design of future training will be important. Originality/value This study is innovative in that it investigates the impact of a brief psychoeducational training on “personality disorder” designed for mental health staff on acute psychiatric wards.

scholarly journals Why make the effort? Exploring recovery college engagement

2018 ◽  
Vol 22 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Leanne Harper ◽  
Mick McKeown
Keyword(s):  
Mental Health ◽  
Social Factors ◽  
Design Methodology ◽  
Small Sample Size ◽  
Structured Interview ◽  
Small Sample ◽  
Mental Health Recovery ◽  
Valuable Contribution ◽  
Content Type ◽  
The Impact

Purpose Whilst there is growing evidence to suggest that the recovery college (RC) environment supports students towards their mental health recovery (Meddings et al., 2015b), students’ initial motivations for engagement, alongside factors that may hinder or support attendance, have yet to be exclusively explored. The paper aims to discuss these issues. Design/methodology/approach All new RC students were invited to take part in a semi-structured interview three months following their enrolment. Four participants completed an interview which were later analysed using thematic analysis. Findings Four themes emerged within analysis: making the effort; being “too unwell”; friendly environment; and glad I came. These are discussed alongside the literature, and it is proposed that whilst there is a substantial struggle involved in engagement with a RC, likely related to mental health and social factors, the RC environment, peer support and support of the tutors helps students to overcome the impact of this. Research limitations/implications Due to the small sample size and exploratory stance of this study, additional research into the complexities around engagement with RCs is strongly recommended. Only students who had attended at least one RC course chose to participate in this study, therefore an under-researched population of non-attendees may provide a valuable contribution to further understanding. Originality/value This is one of the first studies to qualitatively explore factors which may support, or hinder, initial and ongoing engagement with a RC. It is proposed that a greater understanding of these important issues could be used to increase RC accessibility and inclusion.

Religion, spirituality and personal recovery among forensic patients

2019 ◽  
Vol 21 (3) ◽  
pp. 190-200
Author(s):  
Emily Glorney ◽  
Sophie Raymont ◽  
Amy Lawson ◽  
Jessica Allen
Keyword(s):  
Mental Health ◽  
Interpretative Phenomenological Analysis ◽  
Recovery Process ◽  
Personal Meaning ◽  
Service Users ◽  
Religion And Spirituality ◽  
Personal Recovery ◽  
Structured Interviews ◽  
Hospital Data ◽  
Content Type

Purpose Religion and spirituality are well-researched concepts within the field of psychology and mental health yet they have rarely been researched in high-secure services within the UK. Research in mental health and prison contexts suggests benefits of religion/spirituality to coping, social support, self-worth, symptoms of depression and anxiety and behavioural infractions. The purpose of this paper is to investigate the role of religion/spirituality in high-secure service users’ personal recovery. Design/methodology/approach Semi-structured interviews were carried out with 13 male patients in a high-secure hospital, with primary diagnoses of mental illness (n=11) or personality disorder (n=2). Participants were from a range of religious/spiritual backgrounds and were asked about how their beliefs impact their recovery and care pathways within the hospital. Data were analysed using interpretative phenomenological analysis. Findings Three superordinate themes were identified: “religion and spirituality as providing a framework for recovery”; “religion and spirituality as offering key ingredients in the recovery process”; and “barriers to recovery through religion/spirituality”. The first two themes highlight some of the positive aspects that aid participants’ recovery. The third theme reported hindrances in participants’ religious/spiritual practices and beliefs. Each theme is discussed with reference to sub-themes and illustrative excerpts. Practical implications Religion/spirituality might support therapeutic engagement for some service users and staff could be more active in their enquiry of the value that patients place on the personal meaning of this for their life. Originality/value For the participants in this study, religion/spirituality supported the principles of recovery, in having an identity separate from illness or offender, promoting hope, agency and personal meaning.

The perspectives of people who use mental health services engaging with arts and cultural activities

2016 ◽  
Vol 20 (3) ◽  
pp. 180-186 ◽  
Author(s):  
Anita Jensen ◽  
Theodore Stickley ◽  
Alison Edgley
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Central Component ◽  
Service Users ◽  
Structured Interviews ◽  
Content Type ◽  
Museum Educator

Purpose – The purpose of this paper is to present a study of arts engagement for mental health service users in Denmark. Design/methodology/approach – The study was completed at Hans Knudsen Instituttet, Denmark. It involved analysis of emerging themes from semi-structured interviews with six participants who had participated in a structured visit to the National Gallery (Statens Museum for Kunst) in Denmark. Findings – Multiple benefits for people who use mental health services engaging in arts activities are reported. Arts activities are described as a central component of everyday life; a way of life and a significant factor in getting through the day. Barriers are identified in the interdisciplinary working between the museum educator and participants. Social implications – This study identifies that the participants benefited from taking part in the arts/cultural activity. Findings also suggest that if museums are offering activities to people who use mental health services they should equip staff with training designed to support appropriate ways of working with this group. This interdisciplinary activity offers a relatively untapped potential arena of support. Originality/value – The paper will be of relevance and value to those working with mental health and arts. The study demonstrates the importance for mental health service users to engage in creative activity and for museum staff to have appropriate skills for inclusion to be successful.

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