scholarly journals The impact of a night confinement policy on patients in a UK high secure inpatient mental health service

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.

2020 ◽  
Vol 19 (4) ◽  
pp. 271-279
Author(s):  
Chris Dayson ◽  
Jo Painter ◽  
Ellen Bennett

Purpose This paper aims to identify the well-being outcomes of a social prescribing model set within a secondary mental health service recovery pathway and understand the key characteristics of a social prescribing referral for producing these outcomes. Design/methodology/approach A qualitative case study of one mental health social prescribing service with three nested case studies of social prescribing providers. Semi-structured interviews were undertaken with commissioners, providers and patients (n = 20) and analysed thematically. Findings Social prescribing makes a positive contribution to emotional, psychological and social well-being for patients of secondary mental health services. A key enabling mechanism of the social prescribing model was the supportive discharge pathway which provided opportunities for sustained engagement in community activities, including participation in peer-to-peer support networks and volunteering. Research limitations/implications More in-depth research is required to fully understand when, for whom and in what circumstances social prescribing is effective for patients of secondary mental health services. Practical implications A supported social prescribing referral, embedded within a recovery focussed secondary mental health service pathway, offers a valuable accompaniment to traditional approaches. Current social prescribing policy is focussed on increasing the number of link workers in primary care, but this study highlights the importance models embedded within secondary care and of funding VCSE organisations to receive referrals and provide pathways for long-term engagement, enabling positive outcomes to be sustained. Originality/value Social prescribing is widely advocated in policy and practice but there are few examples of social prescribing models having been developed in secondary mental health services, and no published academic studies that everybody are aware of.


2017 ◽  
Vol 16 (3) ◽  
pp. 96-99 ◽  
Author(s):  
Sharon A.S. Neufeld ◽  
Peter B. Jones ◽  
Ian M. Goodyer

Purpose The purpose of this paper is to expand upon policy implications of a recent study assessing adolescent mental health service contact and subsequent depression. Design/methodology/approach Review of related evidence from academic and grey literature. Findings Studies assessing the role of mental health services in reducing mental disorder during adolescence are sparse, and even prevalence figures for adolescent mental disorders are out-of-date. Adolescent mental health service contact rates are shown to fall concurrent with budgetary decreases. School-based counselling is highlighted as an important source of help that may be at risk of being cut. Increased training of General Practitioners and school counsellors is needed to improve efficiency in specialist Child and Adolescent Mental Health Services (CAMHS). Practical implications Longitudinal studies of young people’s mental health should include mental health service usage and its relationship with subsequent mental health outcomes. Social implications Funding cuts to CAMHS must be avoided, school-based counselling must be protected, and service referrers should be better trained. Originality/value This paper highlights the need for increased CAMHS data, sustained funding, and improved training for this vital service.


2016 ◽  
Vol 20 (3) ◽  
pp. 180-186 ◽  
Author(s):  
Anita Jensen ◽  
Theodore Stickley ◽  
Alison Edgley

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.


2015 ◽  
Vol 9 (6) ◽  
pp. 352-362 ◽  
Author(s):  
Paddy McNally ◽  
Kimberly McMurray

Purpose – The purpose of this paper is to investigate the experiences of psychologists in considering the barriers to people with intellectual disabilities being able to access mainstream mental health services. Design/methodology/approach – The information relating to participant experiences was gathered by conducting two focus groups: one with psychologists working in the adult mental health service and the second with psychologists working in the learning disability service. A thematic analysis was used to determine the main themes from each of the focus groups. Findings – The overarching themes for the psychologists in the adult mental health service related to: service restrictions; confidence in their ability/skills; and resistance to change. The overarching themes for the psychologists in the learning disability service reflected: future thinking; protection; pessimism; and clarification around mental health and learning disability. Originality/value – The discussion includes consideration of the dynamic positions of the two services and recommendations for an integrated system of working.


2021 ◽  
Vol 41 (9) ◽  
pp. 245-253
Author(s):  
Bukola Salami ◽  
Benjamin Denga ◽  
Robyn Taylor ◽  
Nife Ajayi ◽  
Margot Jackson ◽  
...  

Introduction The objective of this study was to examine the barriers that influence access to and use of mental health services by Black youths in Alberta. Methods We used a youth-led participatory action research (PAR) methodology within a youth empowerment model situated within intersectionality theory to understand access to health care for both Canadian-born and immigrant Black youth in Alberta. The research project was co-led by an advisory committee consisting of 10 youths who provided advice and tangible support to the research. Seven members of the advisory committee also collected data, co-facilitated conversation cafés, analyzed data and helped in the dissemination activities. We conducted in-depth individual interviews and held four conversation café-style focus groups with a total of 129 youth. During the conversation cafés, the youths took the lead in identifying issues of concern and in explaining the impact of these issues on their lives. Through rigorous data coding and thematic analysis as well as reflexivity and member checking we ensured our empirical findings were trustworthy. Results Our findings highlight key barriers that can limit access to and utilization of mental health services by Black youth, including a lack of cultural inclusion and safety, a lack of knowledge/information on mental health services, the cost of mental health services, geographical barriers, stigma and judgmentalism, and limits of resilience. Conclusion Findings confirm diverse/intersecting barriers that collectively perpetuate disproportional access to and uptake of mental health services by Black youths. The results of this study suggest health policy and practice stakeholders should consider the following recommendations to break down barriers: diversify the mental health service workforce; increase the availability and quality of mental health services in Black-dominated neighbourhoods; and embed anti-racist practices and intercultural competencies in mental health service delivery.


2018 ◽  
Vol 23 (2) ◽  
pp. 73-85
Author(s):  
Dominiek Coates ◽  
Patrick Livermore ◽  
Raichel Green

Purpose There has been a significant growth in the employment of peer workers over the past decade in youth and adult mental health settings. Peer work in mental health services for older people is less developed, and there are no existing peer work models for specialist mental health services for older people in Australia. The authors developed and implemented a peer work model for older consumers and carers of a specialist mental health service. The purpose of this paper is to describe the model, outline the implementation barriers experienced and lesson learned and comment on the acceptability of the model from the perspective of stakeholders. Design/methodology/approach To ensure the development of the peer work model met the needs of key stakeholders, the authors adopted an evaluation process that occurred alongside the development of the model, informed by action research principles. To identify stakeholder preferences, implementation barriers and potential solutions, and gain insight into the acceptability and perceived effectiveness of the model, a range of methods were used, including focus groups with the peer workers, clinicians and steering committee, consumer and carer surveys, field notes and examination of project documentation. Findings While the model was overall well received by stakeholders, the authors experienced a range of challenges and implementation barriers, in particular around governance, integrating the model into existing systems, and initial resistance to peer work from clinical staff. Originality/value Older peer workers provide a valuable contribution to the mental health sector through the unique combination of lived experience and ageing. The authors recommend that models of care are developed prior to implementation so that there is clarity around governance, management, reporting lines and management of confidentiality issues.


2020 ◽  
Vol 25 (3) ◽  
pp. 277-288
Author(s):  
Rosie Martin ◽  
Jackie Sturt ◽  
Frances Griffiths

Background Inaccessible services and poor communication are barriers to successful transitions between adolescent and adult mental health services, for which digital communications (DC) offer a possible solution. Aims To investigate the role of DC, including smartphone apps, email and text, given the known barriers and facilitators of mental health service transitions reported in the literature. Methods Use of Neale’s (2016) iterative categorisation technique to undertake a secondary analysis of qualitative data collected for the Long-term conditions Young people Networked Communication (LYNC) study. Results DC were used successfully by young people and staff in ways that ameliorated known barriers to service transitions. They engendered responsibility in young people, promoted service access and contributed to client safety, particularly in times of crisis. DC risks included over-familiarity between young people and staff, and the possibility that messages could go unread. Conclusions DC have the potential to facilitate trust and familiarity during and after transition to adult mental health services. They can strengthen young people’s perceptions of adult services as supportive, empowering and available. DC can be used for frequent ‘check-ins’ and remote digital support for social and personal problems. They provide an additional safety net for at-risk individuals, but require careful boundary setting.


2017 ◽  
Vol 25 (5) ◽  
pp. 466-470 ◽  
Author(s):  
Agatha M Conrad ◽  
Anoop Sankaranarayanan ◽  
Terry J Lewin ◽  
Anna Dunbar

Objectives: Community mental health services are often required to manage people experiencing repeated crises. Personality disorders are not uncommon, accounting for up to one-third of such presentations. These patients are often difficult to treat, leading to a revolving-door phenomenon. This study evaluated the effectiveness of a pilot intervention in reducing psychological symptoms and distress, and examined the impact of the intervention on mental health service utilization. Methods: A pre- versus post-treatment evaluation was conducted of the effectiveness of a 10-week group psychological intervention based on Dialectical Behaviour Therapy skills, conducted in a regional Australian community mental health service with patients diagnosed with either Cluster B personality disorder or a mood disorder. Results: Of those who completed the program ( N = 38 patients), 84% were female, with an average age of 35.13 years. Participants were active clients of the service for an average of 58.3 weeks prior to the program. They demonstrated significant improvements in quality of life and self-control, and a reduction in hopelessness, cognitive instability and dependence on mental health services. Conclusions: Limiting the Dialectical Behaviour Therapy program to a short-term skills-based group component was successful with the targeted patient group; however, more research is required to establish the generalizability of these results.


2014 ◽  
Vol 7 (3) ◽  
pp. 111-121 ◽  
Author(s):  
Jemaima Tiatia-Seath

Purpose – The purpose of this paper is to discuss the engagement of Pacific peoples in mental health services in Aotearoa New Zealand and Pacific strategies for suicide prevention. Design/methodology/approach – This qualitative study involved 22 interviews with Samoans who had made a suicide attempt and/or had suicide ideation, were engaged in a mental health service. Findings – Narratives of mental health services and suicide prevention focused on issues of cultural competency, the importance of family involvement, dichotomous views of western and traditional beliefs around mental illness and the unsuccessful engagement of Pacific youth. Originality/value – This research argues that cultural considerations for Pacific communities are of paramount importance if mental health service engagement and developments towards Pacific suicide prevention strategies are to be effective.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Andrew Healey ◽  
Alexandra Melaugh ◽  
Len Demetriou ◽  
Tracey Power ◽  
Nick Sevdalis ◽  
...  

Purpose Many patients referred by their GP for an assessment by secondary mental health services are unlikely to ever meet eligibility thresholds for specialist treatment and support. A new service was developed to support people in primary care. “the authors evaluate” whether the phased introduction of the Lambeth Living Well Network (LWN) Hub to a population in south London led to: a reduction in the overall volume of patients referred from primary care for a secondary mental health care assessment; and an increase in the proportion of patients referred who met specialist service eligibility criteria, as indicated by the likelihood of being accepted in secondary care. Design/methodology/approach The evaluation applied a quasi-experimental interrupted time series design using electronic patient records data for a National Health Service (NHS) provider of secondary mental health services in south London. Findings Scale-up of the Hub to the whole of the population of Lambeth led to an average of 98 fewer secondary care assessments per month (95% CI −118 to −78) compared to an average of 203 assessments per month estimated in the absence of the Hub; and an absolute incremental increase in the probability of acceptance for specialist intervention of 0.20 (95% CI; 0.14 to 0.27) above an average probability of acceptance of 0.57 in the absence of the Hub. Research limitations/implications Mental health outcomes for people using the service and system wide-service impacts were not evaluated preventing a more holistic evaluation of the effectiveness and cost-effectiveness of the LWN Hub. Practical implications Providing general practitioners with access to service infrastructure designed to help people whose needs cannot be managed within specialist mental health services can prevent unnecessary referrals into secondary care assessment teams. Social implications Reducing unnecessary referrals through provision of a primary-care linked mental health service will reduce delay in access to professional support that can address specific mental-health related needs that could not be offered within the secondary care services and could prevent the escalation of problems. Originality/value The authors use NHS data to facilitate the novel application of a quasi-experimental methodology to deliver new evidence on whether an innovative primary care linked mental health service was effective in delivering on one of its key aims.


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