Does training adequately equip psychiatrists for intellectual disability?

2020 ◽  
Vol 14 (3) ◽  
pp. 69-82
Author(s):  
Geraldine Lines ◽  
Jodie Allen ◽  
Caryl Jane Marshall
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Mental Health Services ◽  
Health Services ◽  
Online Survey ◽  
Significant Proportion ◽  
Training Programme ◽  
Practical Experience ◽  
Content Type ◽  
The Uk

Purpose People with intellectual disability (ID) experience significant health and social inequality compared to their non-disabled peers. Individuals with ID who access mental health services can have complex comorbidities and presentations. In the UK, a significant proportion of individuals with ID are supported within general adult mental health services not by specialist ID teams. The purpose of this study is to explore whether psychiatry trainees in the Maudsley Training Programme (MTP) feel adequately skilled to support individuals with ID. Design/methodology/approach An online survey of trainee psychiatrists in the MTP was completed to evaluate self-perceived skills and knowledge in the care of individuals with ID in mental health services. Statistical analysis of the results was completed. Findings Experience of working in specialist ID teams is positively associated with greater confidence and skills among trainees in the care of people with ID; this is beyond what would be expected based on seniority alone. Research limitations/implications The response rate was 16.7 per cent; a larger sample size would add strength to the study. Like all online surveys, there exists the risk of selection bias. Practical implications UK Policy states that people with ID should be supported to access mainstream services where possible, including psychiatric care. Practical experience for all psychiatry trainees involving specialist ID services and people with ID could improve the care given to that particularly disadvantaged group. Originality/value This is the only paper known to the authors that has focused specifically on the skills and knowledge of psychiatry trainees in the UK with regards to ID.

scholarly journals Evaluating the Prosper peer-led peer support network: a participatory, coproduced evaluation

2016 ◽  
Vol 20 (2) ◽  
pp. 80-91 ◽  
Author(s):  
Steve Gillard ◽  
Rhiannon Foster ◽  
Kati Turner
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Social Movement ◽  
Peer Support ◽  
Online Survey ◽  
Well Being ◽  
Support Network ◽  
Content Type ◽  
One To One

Purpose – A range of one-to-one, group and online approaches to peer support are increasingly complementing formal mental health service delivery. Evidence is emerging of the potential benefits and challenges of peer support for individuals, communities and organisations. There is more limited evidence describing peer-led peer support networks. The paper aims to discuss these issues. Design/methodology/approach – In an evaluation of Prosper, a peer-led, peer support network and social movement, members of the network played a participatory role in the design, conduct and interpretative work of the evaluation. An online survey, one-to-one interviews and group discussions were used. Findings – The evaluation describes an evolving network with planning and development meetings constituting core activity for many members alongside a monthly training programme supporting people to set up their own activities. There were strong shared values, and consensus that Prosper could strengthen social networks, improve individual well-being and impact on the way people used mental health services. Challenges were identified around feelings of uncertainty and vulnerability in relation to involvement in the network. Research limitations/implications – The participatory nature of the evaluation adds value to the learning offered. This was a descriptive evaluation; potential is indicated for the more formal modelling and testing of peer-led network and social movement initiatives. Practical implications – Clarity is needed on the relationship of the network to statutory mental health services – specifically around taking on a “service provider” role – and on the advantages and challenges of a “hybrid” organisational model that combines traditional, hierarchical and new distributed forms of leadership and structure. Social implications – Prosper demonstrated potential to create a sense of common culture based on sharing lived experience and mutual peer support, providing an alternative to the traditional culture of mental health services. Originality/value – This paper offers wider learning derived from evaluation of a highly original initiative in peer leadership, network structure and interface with statutory mental health services.

Francis, Berwick and culture change – an opportunity to engage patients and increase transparency in mental health

2014 ◽  
Vol 18 (1) ◽  
pp. 13-16 ◽  
Author(s):  
Sophie Corlett
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Policy ◽  
Health Service Provision ◽  
Content Type ◽  
Recent Developments ◽  
The Uk ◽  
Mental Health Service Provision

Purpose – The Policy Watch series reflects on recent and forthcoming developments in mental health policy across the UK. The purpose of this paper is to review recent developments in mental health policy, specifically the implications and learning for mental health services of recent scandals such as Mid Staffordshire and Winterbourne View and the various responses to them. Design/methodology/approach – This paper reviews and summarises recent developments in national mental health policy in England and their implications for mental health service provision. Findings – The paper outlines how learning from recent scandals such as Mid Staffordshire and Winterbourne View can be applied in mental health services. Originality/value – The paper updates and discusses recent policy developments in the NHS and their implications for mental health services.

“We need to slowly break down this barrier”: understanding the barriers and facilitators that Afro-Caribbean undergraduates perceive towards accessing mental health services in the UK

2020 ◽  
Vol 19 (1) ◽  
pp. 63-81
Author(s):  
Tamara Nadine Sancho ◽  
Michael Larkin
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Critical Incident ◽  
Structural Changes ◽  
Barriers And Facilitators ◽  
Future Research ◽  
Sociocultural Factors ◽  
Content Type ◽  
The Uk

Purpose Undergraduates are highly susceptible to the development of mental health difficulties. Afro-Caribbean students are particularly vulnerable to the pressures of university yet are less likely than other ethnic groups to receive early intervention. This paper aims to understand the barriers and facilitators that Afro-Caribbean undergraduates perceive towards accessing mental health services in the UK. Design/methodology/approach Critical Incident Technique was used as the qualitative method because it explores the critical factors that contribute to or detract from a specific experience. Seventeen Afro-Caribbean undergraduates participated in five focus groups. This involved engaging in a novel psychosocial activity that incorporated vignettes to encourage the identification of barriers and facilitators to service access. The data were analysed thematically to generate categories of critical incidents and wish-list items. Findings Analysis revealed rich data from a sub-group rarely researched within UK literature. Fifteen barriers, eleven facilitators and five wish-list items were identified. The importance of mental health literacy, social networks, cultural sensitivity and concerns surrounding services underpinned many categories. Originality/value Findings provide a new perspective on barriers reported in previous literature. Novel facilitators were highlighted where, although psychological and sociocultural factors were deemed valuable, structural changes were most desired. Recommended changes illustrate innovative interventions that could make services accessible for young adult Afro-Caribbean populations. Future research should explore the barriers and facilitators identified by Afro-Caribbean undergraduates across various universities who have successfully accessed and engaged with services. This could provide a holistic perspective on viable facilitators enabling access despite the presence of barriers.

Mental health services for people with intellectual disability in the United Kingdom

2018 ◽  
Vol 12 (3/4) ◽  
pp. 91-98 ◽  
Author(s):  
Bhathika Perera ◽  
Ken Courtenay
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Social Care ◽  
Community Support ◽  
Content Type ◽  
Health And Social Care ◽  
People With Intellectual Disabilities ◽  
The Uk

Purpose Services for people with intellectual disabilities in the UK have evolved over the years from hospital-based care to more community provision. There are multiple reasons for these changes, however, often it was due to changes in social policy or following a scandal in provision. The paper aims to discuss these issues. Design/methodology/approach Providing services to meet the health and social care needs of people with intellectual disabilities is well-established in the four countries of the UK with support from legislation. There are often specialist mental health and social care teams. Dedicated professionals work with people with intellectual disabilities who experience mental health problems with a focus on support in the community. A range of services for children and adults and for offenders exist across the UK that often vary in composition and structure. Findings The challenges in providing mental health services for children and adults with intellectual disabilities in the future include recruitment and training of the workforce with the remit of enhancing community support and reduced in-patient care. Practical implications This paper helps the reader to understand how ID mental health services are organised in the UK. Originality/value This paper gives a summary of the ID mental health services in the UK. Even though there are various papers looking at different aspects of mental health services for people with ID in the UK, this paper brings all that information together to help reader get a better understanding of the mental health services for people with ID.

scholarly journals Mental health services designed for Black, Asian and Minority Ethnics (BAME) in the UK: a scoping review of case studies

2020 ◽  
Vol 24 (2) ◽  
pp. 81-95
Author(s):  
Mariam Vahdaninia ◽  
Bibha Simkhada ◽  
Edwin van Teijlingen ◽  
Hannah Blunt ◽  
Alan Mercel-Sanca
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Outcomes ◽  
Scoping Review ◽  
Asylum Seekers ◽  
Mental Health Outcomes ◽  
Content Type ◽  
The Past ◽  
The Uk

Purpose Mental health disparities exist among Black, Asian and Minority Ethnics (BAME) populations. This paper aims to provide an overview of mental health services designed for the BAME population in the UK, both established BAME communities and refugee/asylum-seekers. Design/methodology/approach A range of electronic databases were searched for peer-reviewed studies conducted within the past decade in the UK. Using the Arksey and O’Malley methodology, data were extracted, analysed and summarised. Findings A total of 13 papers were identified, mostly non-randomised community-based. Studies were very heterogeneous in terms of their sample and service provided. After the initial appraisal, the authors presented a narrative synthesis. Overall, all studies reported positive mental health outcomes and beneficial effects. Research limitations/implications Because of the time limitations and quality of the papers, the authors only included peer-reviewed journal papers. Practical implications Mental health services provided for BAME people, both established and refugee/asylum-seekers are feasible and improve engagement with the services and mental health outcomes. Initiatives are required to facilitate the integration of these targeted services within mental health and community services for BAME in the UK. Originality/value This scoping review is a snapshot of the mental health services designed for BAME people in the UK, either established or refugee/asylum-seekers in the past 10 years and adds to the evidence-based knowledge from these studies.

Embedding third sector psychology services within the probation environment: an alternative to MHTRs

2019 ◽  
Vol 10 (1) ◽  
pp. 16-29
Author(s):  
James C. Fowler ◽  
Robyn Catherine Price ◽  
Kirsty Burger ◽  
Alice Jennifer Mattei ◽  
Ashley Mary McCarthy ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Treatment ◽  
Third Sector ◽  
Mental Health Needs ◽  
Content Type ◽  
General Distress ◽  
The Uk

Purpose The use of mental health treatment requirements (MHTRs) has not proven to be successful at meeting the mental health needs of the probation population in the UK, largely through underuse of the requirement or lack of available services. The paper aims to discuss this issue. Design/methodology/approach This paper investigates a method of meeting those needs without the use of MHTRs by embedding third sector services within the probation environment. Findings Results indicate a significant impact after a six-month follow-up in symptomology across measures of depression, anxiety, general distress and social functioning; also indicated is a significant result on recidivism, with 74 per cent of participants committing no further offences in the 12 months following treatment. Originality/value These results represent the only evaluation of embedded, third sector mental health services in a probation environment in the UK, and highlight a further need to embed specialist mental health services within the probation environment and generalise that practice to other forms of service structure and therapeutic methodology.

Research watch: people of Black African and African Caribbean heritage in the UK and USA – psychosis, racism and inclusion

2020 ◽  
Vol 24 (2) ◽  
pp. 67-74
Author(s):  
Sue Holttum
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Social Inclusion ◽  
Spiritual Beliefs ◽  
Content Type ◽  
Black African ◽  
African Caribbean ◽  
The Usa ◽  
The Uk

Purpose This paper aims to examine three recent papers on psychosis and social inclusion in relation to people of Black African and African Caribbean heritage in the UK and the USA. Design/methodology/approach A search was carried out for recent papers on psychosis and social inclusion in relation to people of Black African and African Caribbean heritage in the UK and the USA. I selected three papers addressing this theme from different angles. Findings The first paper extends previous findings (that psychosis can follow traumatic events) to Black Americans and includes the contribution of societal inequalities and racism. The second paper illustrates Black men’s experiences of mental health services for psychosis in the UK. It finds, not surprisingly, that a lack of listening combined with coercive use of medication reduces trust in services. The third paper offers hope in reporting collaborative work with people of Black African Caribbean heritage in the UK to culturally adapt family intervention for psychosis. The first and third papers both place importance on valuing people’s spiritual beliefs. Originality/value All three papers highlight the on-going need for increased equity and social inclusion in mental health services for people of Black African and African Caribbean heritage, in terms of recognising the role of childhood trauma and later stresses, addressing the potential harm of over-reliance on medication, offering therapy that is collaborative and culturally adapted and respecting valued spiritual beliefs.

Family and caregivers’ experience of mental illness in migrants with intellectual disability – reflections on practice

2019 ◽  
Vol 13 (2) ◽  
pp. 76-88
Author(s):  
Jane Margrete Askeland Hellerud ◽  
Trine Lise Bakken
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Intellectual Disability ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Inpatient ◽  
Community Services ◽  
Cultural Dimensions ◽  
Content Type ◽  
The Impact

Purpose The purpose of this paper is to investigate the families’ and professional caregivers’ experience of mental health services for patients in the migrant population with intellectual disability (ID). Design/methodology/approach To highlight this rarely studied topic, the authors chose a qualitative approach, using a semi-structured interview guide. The authors performed a search for relevant articles. Three families of former patients of a specialized psychiatric inpatient unit and 12 professional caregivers were interviewed. The interviews were taped, transcribed and analyzed using a thematic analysis. Findings In total, 17 themes from the families’ answers and 14 themes from the caregivers’ answers were grouped into four main themes each. Two main themes were identical for both groups: perspectives on mental illness and “the Norwegian system.” Additionally, the families were concerned about the impact on the patient and family and coping strategies. The caregivers highlighted patient–caregiver interaction and family–caregiver interaction. Research limitations/implications Further research should include the patients’ opinions based on the findings of this study. Also, studies including larger samples from both specialist services and community services are needed to develop evidence-based services for these patients. Practical implications Proposed adaptations to enable assessment and treatment of mental illness in migrants with ID should be adapted to cultural preferences. The following adaptations are proposed: inclusion of the entire family, awareness of cultural dimensions, information about the health care system, education in mental illness, the use of interpreters and adequate time spent with the families. Originality/value Mental health services for this group are an understudied topic. Clinical experience indicates that professionals struggle when providing services for such patients.

scholarly journals Participation in developing youth mental health services: “Cinderella service” to service re-design

2017 ◽  
Vol 16 (4) ◽  
pp. 159-168 ◽  
Author(s):  
Rebecca Collins ◽  
Caitlin Notley ◽  
Tim Clarke ◽  
Jon Wilson ◽  
David Fowler
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Youth Mental Health ◽  
Design Data ◽  
Content Type ◽  
Accessible Information ◽  
Novel Approach ◽  
The Uk

Purpose Whilst there are pockets of excellence in the provision of Child and Adolescent Mental Health Services (CAMHS), many services fail to meet young people’s needs. Considering this, the purpose of this paper is to ascertain perceptions of CAMHS provision in a rural county of the UK to inform re-design of youth mental health services. Design/methodology/approach The study comprised of two phases: phase one involved analysis of questionnaire data of youth views of CAMHS. Phase two involved analysis of the “Have Your Say” event data which explored perceptions of CAMHS and future service re-design. Data were thematically analysed. Findings Knowledge of the existence and purpose of CAMHS was variable. Participants wanted accessible information about services, rights, confidentiality and for this to be provided in multiple media. Young people wanted staff who were easy to talk to, genuine, understanding and who valued their insights. Participants wanted to be offered choice about appointments, location and timing. An ideal mental health service was described as a “one-stop-shop” of co-locality and multi-agency collaboration. Young people clearly expressed a desire to influence the design and delivery of the radical service re-design and to be embedded in its development. Practical implications The results highlighted multiple problems with CAMHS provision and provided a clear justification for the re-design of services. Originality/value This was a novel approach demonstrating the importance, utility and power of effective participatory practices for informing the re-design of services.

scholarly journals A three-phased model to support the design and development of core competency education for liaison mental health clinicians

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Gary Lamph ◽  
Claire Bullen-Foster
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Core Competencies ◽  
Core Competency ◽  
Training Programme ◽  
Mental Health Training ◽  
Health Training ◽  
Content Type ◽  
The Uk ◽  
Insight Into

Purpose This paper aims to provide an insight into the design, development and delivery proposals for a first of its kind “Liaison Mental Health Training Programme”. In the UK, there has been a significant investment in Liaison Mental Health Services and an expansion of the workforce (NHS England, 2016). However, the complexity and varied presentations of patients who attend to acute physical health services now requires a dedicated strategy to address any skills deficit in the mental health liaison workforce and to support core competency development (DOH, 2016). Design/methodology/approach This paper provides an overview of preparations to develop a regional educational pilot programme using a three-phased model: Phase 1 – Review of policy and best practice guidelines; Phase 2 – Stakeholder Data Collection; and Phase 3 – Synthesis and Development. Findings An insight into the developmental processes undertaken to shape a core competency liaison mental health training programme is presented. Additionally, the authors provide insight into educational theory and an overview of the LMH Core Competency Curricula. Practical implications This paper provides the reader with an insight into our findings and a focussed core competency training model for those working within LMH services. This programme development was reviewed throughout by both those using LMH services and the LMH practitioners working within them, ensuring the curriculum proposed was endorsed by key stakeholders. The three-phased model has transferable benefits to other training development initiatives. Originality/value To the best of the authors’ knowledge, this training is the first of its kind in the UK and addresses the education of essential core competencies of a regional liaison mental health workforce. The collaboration of clinical and academic expertise and model of co-production makes this endeavour unique.

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