scholarly journals Challenges and possible solutions in cross-disciplinary and cross-sectorial research teams within the domain of e-mental health

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Tine Nordgreen ◽  
Fazle Rabbi ◽  
Jim Torresen ◽  
Yngvar Sigmund Skar ◽  
Frode Guribye ◽  
...  

PurposeMental illness presents a huge individual, societal and economic challenges, currently accounting for 20% of the worldwide burden of disease. There is a gap between the need for and access to services. Digital technology has been proven effective in e-mental health for preventing and treating mental health problems. However, there is a need for cross-disciplinary efforts to increase the impact of e-mental health services. This paper aims to report key challenges and possible solutions for cross-disciplinary and cross-sectorial research teams within the domain of e-mental health.Design/methodology/approachThe key challenges and possible solutions will be discussed in light of the literature on effective cross-disciplinary research teams.FindingsSix topics have been key challenges in our cross-disciplinary and cross-sectorial research team: to develop a shared understanding of the domain; to establish a common understanding of key concepts among the project participants; to involve the end-users in the research and development process; to collaborate across sectors; to ensure privacy and security of health data; and to obtain the right timing of activities according to project dependencies.Research limitations/implicationsThis study focuses to increase knowledge and training in cross-disciplinary and cross-sectorial research, as this is often referred to as an important tool when developing sustainable solutions for major societal challenges.Practical implicationsThis study needs to include theory and skills training in cross-disciplinary research in research training.Social implicationsCross-disciplinary teams have the potential to address major societal challenges, including more perspectives and more stakeholders than single disciplinary research teams.Originality/valueMajor societal challenges require complex and sustainable solutions. However, there is a lack of knowledge about how cross-disciplinary and cross-sectorial research teams may work productively to solve these challenges. This paper shares experiences regarding the challenges and possible solutions for productive collaboration in cross-disciplinary and cross-sectorial research teams within the domain of e-mental health services.

2015 ◽  
Vol 17 (1) ◽  
pp. 21-30 ◽  
Author(s):  
Simon Chu ◽  
Kimberley McNeill ◽  
Karen M. Wright ◽  
Anthony Hague ◽  
Tracy Wilkins

Purpose – From 2012, all high-secure forensic mental health services in England began operating a policy of confining patients to their locked bedrooms overnight to increase service efficiency and reduce costs. The purpose of this paper is to assess the views of staff and patients concerning the policy and examine the specific impact of the policy on patients. Design/methodology/approach – Measures of patients’ sleep hygiene, patients’ behaviour, ward atmosphere, engagement with therapy and adverse incidents were taken both before and after the night confinement (NC) policy was implemented. Both patients and staff also expressed their views of the impact of the NC policy. Findings – Results provide converging evidence that the impact of the NC policy on patients is negligible. There were no consistent negative effects of confining patients overnight. Rather, patients and staff were broadly positive about the impact that the practice had on patients. Practical implications – Confining patients to locked bedrooms overnight does not exert any consistent influence, positive or negative, on patients’ sleep hygiene, behaviour or engagement with therapy, and patients expressed a broadly positive view of the practice of NC. Thus, a NC policy may have a contribution to make to the provision an effective high-secure mental health service. Originality/value – The study provides convincing evidence that secure inpatient mental health services that are considering the adoption of a NC policy may do so without fear of a negative impact on patients.


2017 ◽  
Vol 19 (4) ◽  
pp. 301-308 ◽  
Author(s):  
Maria I. Livanou ◽  
Vivek Furtado ◽  
Swaran P. Singh

Purpose This paper provides an overview of transitions across forensic child and adolescent mental health services in England and Wales. The purpose of this paper is to delineate the national secure services system for young people in contact with the youth justice system. Design/methodology/approach This paper reviews findings from the existing literature of transitions across forensic child and adolescent mental health services, drawing attention to present facilitators and barriers to optimal transition. The authors examine the infrastructure of current services and highlight gaps between child and adult service continuity and evaluate the impact of poor transitions on young offenders’ mental health and wellbeing. Findings Young offenders experience a broad range of difficulties, from the multiple interfaces with the legal system, untreated mental health problems, and poor transition to adult services. Barriers such as long waiting lists, lack of coordination between services and lack of transition preparation impede significantly smooth transitions. Research limitations/implications The authors need to develop, test and evaluate models of transitional care that improve mental health and wellbeing of this group. Practical implications Mapping young offenders’ care pathway will help to understand their needs and also to impact current policy and practice. Key workers in forensic services should facilitate the transition process by developing sustainable relationships with the young person and creating a safe clinical environment. Originality/value Transition of care from forensic child and adolescent mental health services is a neglected area. This paper attempts to highlight the nature and magnitude of the problems at the transition interface in a forensic context.


2015 ◽  
Vol 20 (4) ◽  
pp. 232-241 ◽  
Author(s):  
Eleanor Bradley

Purpose – The purpose of this paper is to provide a brief overview of the literature to date which has focused on co-production within mental healthcare in the UK, including service user and carer involvement and collaboration. Design/methodology/approach – The paper presents key outcomes from studies which have explicitly attempted to introduce co-produced care in addition to specific tools designed to encourage co-production within mental health services. The paper debates the cultural and ideological shift required for staff, service users and family members to undertake co-produced care and outlines challenges ahead with respect to service redesign and new roles in practice. Findings – Informal carers (family and friends) are recognised as a fundamental resource for mental health service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited by mental health professionals or taken into account during decision making. This issue is considered alongside new policy recommendations which advocate the development of co-produced services and care. Research limitations/implications – Despite the launch of a number of initiatives designed to build on peer experience and support, there has been a lack of attention on the differing dynamic which remains evident between healthcare professionals and people using mental health services. Co-production sheds a light on the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer recovery workers across England, there has been little research or service development designed to focus explicitly on this particular dynamic. Practical implications – Despite these challenges, coproduction in mental healthcare represents a real opportunity for the skills and experience of family members to be taken into account and could provide a mechanism to achieve the “triangle of care” with input, recognition and respect given to all (service users, carers, professionals) whose lives are touched by mental distress. However, lack of attention in relation to carer perspectives, expertise and potential involvement could undermine the potential for coproduction to act as a vehicle to encourage person-centred care which accounts for social in addition to clinical factors. Social implications – The families of people with severe and enduring mental illness assume a major responsibility for the provision of care and support to their relatives over extended time periods (Rose et al., 2004). Involving carers in discussions about care planning could help to provide a wider picture about the impact of mental health difficulties, beyond symptom reduction. The “co-production of care” reflects a desire to work meaningfully and fully with service users and carers. However, to date, little work has been undertaken in order to coproduce services through the “triangle of care” with carers bringing their own skills, resources and expertise. Originality/value – This paper debates the current involvement of carers across mental healthcare and debates whether co-production could be a vehicle to utilise carer expertise, enhance quality and satisfaction with mental healthcare. The critique of current work highlights the danger of increasing expectations on service providers to undertake work aligned to key initiatives (shared decision-making, person-centred care, co-production), that have common underpinning principles but, in the absence of practical guidance, could be addressed in isolation rather than as an integrated approach within a “triangle of care”.


Significance While the pandemic has both amplified and illuminated areas of racial, gender and economic inequality, it has also overshadowed a range of worsening societal problems that had already reached crisis levels prior to COVID-19. Impacts Surging firearm sales during the pandemic and changing perceptions of policing will have long-term impacts on violence levels. The impact of the pandemic has reversed some recent success in containing the opioid epidemic and flattening suicide rates. Mental health services are at risk of cuts as they have lower reimbursement rates for providers than other healthcare provisions.


2018 ◽  
Vol 32 (8) ◽  
pp. 980-1001 ◽  
Author(s):  
Timmy Frawley ◽  
Annabel Meehan ◽  
Aoife De Brún

Purpose The purpose of this paper is to examine the impact of organisational and structural change on the evolution of quality and safety in health organisations, specifically in mental health services. Design/methodology/approach Data were gathered through semi-structured interviews. In total, 25 executive management team members in both public and private mental health services were interviewed and data were analysed using Burnard’s framework. Findings Three overarching themes emerged: organisational characteristics, leadership and accountability; sustaining collaboration and engagement with stakeholders; and challenges to and facilitators of quality and safety. Taken together, the findings speak to the disruptive and disorienting impact of on-going organisational change and restructuring on leaders’ ability to focus on, and advance, the quality and safety agenda. Research limitations/implications Typical with qualitative research of this nature, the potentially limited generalisability of the findings must be acknowledged. Practical implications There is a need for strategies to implement change that are informed by evidence and theory and informed by decades of research on this topic, rather than introduced ad hoc. Change agents must pair effective change management and implementation science strategies to specific contexts, depending on what is being implemented and ensure appropriate evaluation of organisational change to bolster the evidence base around quality and safety and inform future decision-making. Originality/value The study explores an identified gap in the literature on the impact of on-going organisational re-structuring and transformation on the evolution of quality and safety in mental health services.


2018 ◽  
Vol 23 (3) ◽  
pp. 121-130 ◽  
Author(s):  
Niki Kyriakidou ◽  
Sofia Triliva

Purpose The purpose of this paper is to focus on how mental health professionals involved in the therapeutic treatment of children in public mental health facilities in Greece experience and talk about the impact of the socioeconomic crises on the psychotherapeutic process. Design/methodology/approach In all, 21 semi-structured interviews were conducted and phenomenologically informed thematic analysis was used in analysing the data. Findings The results coalesced into two all-encompassing thematic structures articulating the following: first, the socioeconomic crises have permeated society and therapeutic praxis like a torrential and chronic rain storm. This has resulted in a deluge in demand for therapeutic services within the public mental health sector; second, mental health professionals describe their positioning and work as “a constant tug-of-war” where they are inundated and often overwhelmed with work, find themselves identifying with service users and taking on several roles simultaneously, and being challenged to find solutions often in dire and complex situations. They describe how creativity and flexibility are in demand in their day-to-day interactions and if they are to intervene in place of a health and welfare system that is faltering. Doing therapeutic work under such circumstances appears to be both emotionally onerous and stimulating with regard to conceptualising new ways of intervening in such complex psychosocial situations. Research limitations/implications The study is limited in that only mental health professionals presented their experiences and service users were not included. The findings do highlight how severe austerity policies impact mental health services and peoples’ lives. Practical implications The study has implications for policy regarding the provision and organisation of mental health services in contexts where crises and economic turmoil prevail. Social implications The results associate severe austerity with major changes in family and community life. Originality/value The paper provides insights and implications on how mental health services are impacted by socioeconomic conditions.


2019 ◽  
Vol 13 (2) ◽  
pp. 76-88
Author(s):  
Jane Margrete Askeland Hellerud ◽  
Trine Lise Bakken

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.


2016 ◽  
Vol 2 (4) ◽  
pp. 210-214 ◽  
Author(s):  
Sue Larch

Purpose The purpose of this paper is to describe the experiences of a mother of a son who was diagnosed with Asperger syndrome and psychosis in adulthood, the impact of this on his behaviour, and her quest to obtain healthcare. Design/methodology/approach Case study. Findings While a striking story in its own right, the experiences described have a number of wider implications for the treatment of mental ill heath in ASD, the exclusion of families and carers from the care of their adult children in services, and the impact of this on the individuals directly affected. Research limitations/implications The paper offers a number of practical recommendations for the understanding and management of autism in generic mental health services, and the involvement of families and carers in the care of their relative. Originality/value This is the first paper to describe mental ill health and offending behaviour in ASD, from the perspective of a mother.


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