Cultivating compassion through compassion circles: learning from experience in mental health care in the NHS

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Michael Clark ◽  
Andy Bradley ◽  
Laura Simms ◽  
Benna Waites ◽  
Alister Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
National Policy ◽  
Well Being ◽  
Content Type ◽  
Team Members ◽  
Health And Social Care ◽  
Current Concerns ◽  
The Impact

Purpose This paper aims to discuss the importance of compassion in health care and experiences of Compassion Circles (CCs) in supporting it, placing this into the national policy context of the National Health Service (NHS), whilst focusing on lessons from using the practice in mental health care. Design/methodology/approach This conceptual paper is a discussion of the context of compassion in health care and a description of model and related concepts of CCs. This paper also discusses lessons from implementation of CCs in mental health care. Findings CCs were developed from an initial broad concern with the place of compassion and well-being in communities and organisations, particularly in health and social care after a number of scandals about failures of care. Through experience CCs have been refined into a flexible model of supporting staff in mental health care settings. Experience to date suggests they are a valuable method of increasing compassion for self and others, improving relationships between team members and raising issues of organisational support to enable compassionate practice. Research limitations/implications This paper is a discussion of CCs and their conceptual underpinnings and of insights and lessons from their adoption to date, and more robust evaluation is required. Practical implications As an emergent area of practice CCs have been seen to present a powerful and practical approach to supporting individual members of staff and teams. Organisations and individuals might wish to join the community of practice that exists around CCs to consider the potential of this intervention in their workplaces and add to the growing body of learning about it. It is worth further investigation to examine the impact of CCs on current concerns with maintaining staff well-being and engagement, and, hence, on stress, absence and the sustainability of work environments over time. Social implications CCs present a promising means of developing a culture and practice of more compassion in mental health care and other care contexts. Originality/value CCs have become supported in national NHS guidance and more support to adopt, evaluate and learn from this model is warranted. This paper is a contribution to developing a better understanding of the CCs model, implementation lessons and early insights into impact.

Self-injurious behaviour in forensic mental health care: a study into the prevalence and characteristics of incidents of self-injury

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vivienne de Vogel ◽  
Nienke Verstegen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Suicide Attempts ◽  
Psychiatric Patients ◽  
Forensic Mental Health ◽  
Content Type ◽  
Self Injury ◽  
Forensic Psychiatric ◽  
The Impact

Purpose Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients. Design/methodology/approach All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+). Findings In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients. Practical implications More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self. Originality/value Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.

scholarly journals The familiar stranger of mental health

2020 ◽  
Vol 15 (4) ◽  
pp. 237-247
Author(s):  
Matthew Sydney Long
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Facility ◽  
Health Care Professionals ◽  
Service User ◽  
Health Care Facilities ◽  
Mental Health Facility ◽  
Content Type ◽  
The Impact

Purpose This paper aims to contribute to the debate about the closure of institutional mental health-care facilities, from an experiential perspective of a former mental health inpatient, ongoing service user and campaigner for retention of such facilities. It argues that auto-ethnographic accounts of mental illness by those with multiple social identities can have a greater role in terms of future training of mental health-care professionals. Design/methodology/approach The paper offers an experiential account of the impact of mental health facility bed closures as a patient admitted to institutional mental health facilities; as a mental health campaigner, fighting for the provision of both places of safety and “safe space” within his own local community; and as an ongoing service user. The research is in the interpretivist tradition of social science in taking an auto-ethnographical methodological stance. Findings This paper is underpinned by two key theoretical notions. Firstly, Stuart Hall’s concept of the Familiar Stranger (2017) is used to explore the tensions of self-identity as the author SHIFTS uncomfortably between his three-fold statuses. Secondly, the notion of “ontological insecurity” offered by Giddens (1991) is used with the paper exploring the paradox that admission to a mental health facility so-called “place of safety” is in fact itself a disorientating experience for both patient and carer(s). Research limitations/implications No positivistic claims to reliability, representativeness or generalisability can be made. It is the authenticity of the account which the reader feels should be afforded primacy in terms of its original contribution to knowledge. Practical implications This paper should have practical use for those tasked with developing educational and training curriculums for professionals across the mental health-care sector. Social implications This paper implicitly assesses the political wisdom of the policy of mental health bed closures within the wider context of the deinstitutionalisation movement. Originality/value This paper is underpinned by original experiential accounts from the author as patient, campaigner for places of safety and onging service-user of mental health care provision.

The health and social care of people with disabilities in Germany

2018 ◽  
Vol 12 (3/4) ◽  
pp. 99-104
Author(s):  
Samuel Elstner ◽  
Michael-Mark Theil
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Medical Education ◽  
Mental Health Care ◽  
Health Care System ◽  
General Structure ◽  
Care Needs ◽  
Content Type ◽  
Health And Social Care ◽  
Care System

Purpose The purpose of this paper is to present information on the health care system in Germany with the focus on mental health care in people with intellectual disabilities (ID). Design/methodology/approach The paper is descriptive providing an overview of the general structure of the German health care system with historical and economic background. The paper also provides further information on the general social and health care in Germany for people with ID and medical education in the field of ID is used. Findings There is a highly developed health care infrastructure in Germany but health care for people with ID is not co-ordinated or universal. Mental health care for people with ID is predominantly in in-patient services. Only in recent years, out-patient services for people with ID have been developed. There is a little emphasis in medical education on the health care needs of people with ID. Originality/value The value of this paper is its description of health care in Germany and services for people with ID.

scholarly journals Challenges and opportunities of the COVID-19 pandemic for perinatal mental health care: a mixed-methods study of mental health care staff

2021 ◽  
Author(s):  
C. A. Wilson ◽  
C. Dalton-Locke ◽  
S. Johnson ◽  
A. Simpson ◽  
S. Oram ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mixed Methods ◽  
Service Delivery ◽  
Mental Health Care ◽  
Care Staff ◽  
Health Care Staff ◽  
Health And Social Care ◽  
The Impact ◽  
Perinatal Women

AbstractThe aim of this study was to explore staff perceptions of the impact of the COVID-19 pandemic on mental health service delivery and outcomes for women who were pregnant or in the first year after birth (‘perinatal’ women). Secondary analysis was undertaken of an online mixed-methods survey open to all mental health care staff in the UK involving 363 staff working with women in the perinatal period. Staff perceived the mental health of perinatal women to be particularly vulnerable to the impact of stressors associated with the pandemic such as social isolation (rated by 79.3% as relevant or extremely relevant; 288/363) and domestic violence and abuse (53.3%; 192/360). As a result of changes to mental health and other health and social care services, staff reported feeling less able to assess women, particularly their relationship with their baby (43.3%; 90/208), and to mobilise safeguarding procedures (29.4%; 62/211). While 42% of staff reported that some women engaged poorly with virtual appointments, they also found flexible remote consulting to be beneficial for some women and helped time management due to reductions in travel time. Delivery of perinatal care needs to be tailored to women’s needs; virtual appointments are perceived not to be appropriate for assessments but may be helpful for some women in subsequent interactions. Safeguarding and other risk assessment procedures must remain robust in spite of modifications made to service delivery during pandemics.

scholarly journals Challenges and opportunities of the COVID-19 pandemic for perinatal mental health care: a mixed methods study of mental health care staff

2020 ◽  
Author(s):  
Claire A Wilson ◽  
Christian A Dalton-Locke ◽  
Sonia Johnson ◽  
Alan Simpson ◽  
Sian Oram ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mixed Methods ◽  
Service Delivery ◽  
Mental Health Care ◽  
Care Staff ◽  
Health Care Staff ◽  
Health And Social Care ◽  
The Impact ◽  
Perinatal Women

Purpose: the aim of this study was to explore staff perceptions of the impact of the COVID-19 pandemic on mental health service delivery and outcomes for women who were pregnant or in the first year after birth (perinatal women). Methods: secondary analysis of an online mixed-methods survey open to all mental health care staff in the UK involving 363 staff working with women in the perinatal period. Results: staff perceived the mental health of perinatal women to be particularly vulnerable to the impact of stressors associated with the pandemic such as social isolation (rated by 79.3% as relevant or extremely relevant; 288/363) and domestic violence and abuse (53.3%; 192/360). As a result of changes to mental health and other health and social care services, staff reported feeling less able to assess women, particularly their relationship with their baby (43.3%; 90/208), and to mobilise safeguarding procedures (29.4%; 62/211). While 42% of staff reported that some women engaged poorly with virtual appointments, they also found flexible remote consulting to be beneficial for some women and helped time management due to reductions in travel time. Conclusions: delivery of perinatal care needs to be tailored to the needs of women; virtual appointments are perceived not to be appropriate for assessments but may be helpful for some women in subsequent interactions. Safeguarding and other risk assessment procedures must remain robust in spite of modifications made to service delivery during pandemics.

The risk of risk management: adopting critical theories to explore clinical risk concerns in mental health care

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kris Deering ◽  
Jo Williams ◽  
Rob Williams
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Risk Management ◽  
Mental Health Care ◽  
Social Inclusion ◽  
Management Practices ◽  
Content Type ◽  
Clinical Risk ◽  
Critical Theories ◽  
The Impact

Purpose The purpose of this paper is to outline several critical risk theories and explore their application to risk concerns in mental health care. This will contribute to the on-going debate about risk management practices and the impact these might have on recovery and social inclusion. Notably, while risks like suicide can be therapeutically addressed, risk management may involve paternalistic practices that exclude the participation needed for recovery. Design/methodology/approach A viewpoint of key risk theories will be presented to provide a critical eye about some clinical risk concerns in mental health care. Implications for recovery and social inclusion will then be discussed alongside direction for practice and research. Findings Clinical concerns seemed to involve difficulties with uncertainty, holding onto expertise, and the othering of patients through risk. These concerns suggest the patient voice might become lost, particularly within the backdrop of clinical fears about blame. Alternatively, a relational approach to risk management could have merit, while patient expertise may develop understanding in how to improve risk management practices. Originality/value Clinical concerns appear more than managing potential harms; it can involve appraising behaviours around societal norms, explaining to an extent why mental illness might be addressed in terms of risks. While the points raised in the paper support existing findings about risk management, the underlying reasons drawing on the critical risk theories are less explored.

scholarly journals Person-centred mental health care: the challenge of implementation

2012 ◽  
Vol 21 (2) ◽  
pp. 139-144 ◽  
Author(s):  
L. Gask ◽  
P. Coventry
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Three Dimensional ◽  
Holistic Approach ◽  
Health And Social Care ◽  
Unique Experience ◽  
Three Dimensional Models ◽  
The Individual ◽  
The Impact

Within mental health care, ‘person-centredness’ has been generally interpreted to convey a holistic approach with an attitude of respect for the individual and his/her unique experience and needs. Although it has been possible to demonstrate that professionals can acquire such skills through training, the impact on clinical outcomes has been more difficult to demonstrate in randomized controlled trials. Indeed what is becoming increasingly apparent in the literature is the need to acknowledge and address the degree of complexity that exists within the health care system that militates against achieving satisfactory implementation and outcomes from person-centred mental health care. In addressing this, we must develop and work with more sophisticated and three-dimensional models of ‘patient-centredness’ that engage with not only what happens in the consulting room (the relationship between individual service users and healthcare professionals), but also addresses the problems involved in achieving person-centredness through modifying the way that services and organizations work, and finally by engaging families and communities in the delivery of health care. A truly meaningful concept of ‘people-centredness’ encompasses how the views of the population are taken into consideration not only in healthcare but also in health and social care policy, and wider society too.

Traditional Anishinabe Healing in a Clinical Setting: The Development of an Aboriginal Interdisciplinary Approach to Community-based Aboriginal Mental Health Care

2013 ◽  
Vol 6 (1) ◽  
pp. 18
Author(s):  
Marion A. Maar ◽  
Marjory Shawande
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Services ◽  
Mental Health Care ◽  
Professional Education ◽  
Service Providers ◽  
Aboriginal People ◽  
Well Being ◽  
Traditional Healing ◽  
The Impact

Traditional medicine has been practiced by Aboriginal people for thousands of years at the community level. It is still practiced today outside of the mainstream health system by many Aboriginal people. However, providing this type of care in a clinical, health centre setting and in co-operation with western treatment methods is new, and requires a merging of traditional Aboriginal and western medical world views in order to develop protocols for service delivery that ensure the integrity of both systems. The groundwork required to ensure the safety of clients, providers, and organizations within the new integrated system is still largely undocumented. To address this gap, we studied factors that support the successful integration of traditional Aboriginal healing and western mental health care approaches, and document the experiences of clients and providers. To accomplish this we contextualize 10 years of experience of traditional healing services development with in-depth interviews and focus groups with 17 community service providers and 23 clients. We found that the development of traditional healing protocols, inter-professional education for providers and community members and a focus on client access to traditional Anishinabe health services provide the basis for the integration of western and traditional healing practices in the model under study. Our findings show integrated care resulted in positive experiences for clients and providers. We conclude that traditional healing approaches can be successfully integrated with clinical mental health services. Further research is necessary to improve our understanding of client experiences with this integrated  approach and the impact on wholistic health and well-being.

scholarly journals Towards improving community pharmacy-based mental health services in Nigeria

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Adeboye Olakunle Bamgboye ◽  
Ibrahim Adebayo Hassan ◽  
Yusuff Adebayo Adebisi ◽  
Rachael Oluwatoyosi Farayola ◽  
Theogene Uwizeyimana
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Community Pharmacy ◽  
Well Being ◽  
Adequate Knowledge ◽  
Mental Health Expert ◽  
The Impact

AbstractIn Nigeria, there is a prevalence of aversive life circumstances that frequently assail the mental health and well-being of the citizens, mitigating the impact of which necessitates the institution of psychotherapy and other mental health care methods. These responsibilities, however, appear to be much more for pharmacists in low-resource settings where they are the most accessible healthcare professional. Some of these responsibilities include patient confidentiality as well as counseling patients on medication use, lifestyle as well as other personal matters that may arise in relation to their health. Mental health services including psychotherapy provide a range of therapeutic techniques that enable the patients (individual or groups) to develop effective coping strategies towards emotional and psychological difficulties, via methodic interactions with a mental health expert. In this commentary, we share suggestions on how to improve community pharmacy-based mental health services in Nigeria. With the expanding roles and responsibility for pharmacists beyond medication-related concerns comes the challenge of matching up the training of pharmacists with the broadening scope of practice in Nigeria. However, as pertinent as that might be, there are existing knowledge and competency gaps in keeping up with this trend. To correct these shortfalls, we contend that the training curricula for pharmacists in Nigeria be reviewed and/or expanded to provide adequate knowledge for pharmacy undergraduates and pharmacists about non-drug mental health care which will also impact psychotherapy services during their practice especially in the community settings.

The 10th EAMHID International Congress: integrating different approaches in the neurodevelopmental perspective – the mental health care evolution timeline

2016 ◽  
Vol 10 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Marco O. Bertelli
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Problems ◽  
Full Range ◽  
Autism Spectrum ◽  
International Congress ◽  
Content Type ◽  
Interdisciplinary Approaches ◽  
The Impact

Purpose – The purpose of this paper is to provide a summary of main outcomes of the 10th EAMHID International Congress and a critical overview of some key contributions. Design/methodology/approach – A discussion on the impact of the neurodevelopmental perspective on mental health care achievements and failures in the field of intellectual disability (ID) and autism spectrum disorders (ASD). Findings – The considerable progress in the field of mental health care for people with ID that has been made in the last 30 years and that is reflected through the 350 papers presented in this Congress represents the continuation of the work of great pioneers, such as Frank Menolascino, Felix Platter or William I. Gardner, who have been honoured by the EAMHID in the naming of the congress rooms, and the dedication of the poster award. The neurodevelopmental perspective was confirmed to be the current most valued conceptual framework to explain relations across systems and to support multi-level, transnosographic, life-long, interdisciplinary approaches in the production of aetiological insight and good-quality intervention for mental health problems; on the other hand it might determine a premature abandonment of the traditional nosology and the appearance of very broad spectrum conditions covering the full range of psychopathology. Also psychopharmacology was extensively considered, with the explicit aim to raise the attention of researchers and clinicians on this neglected topic. Unfortunately, adults with ID/ASD are still deprived of the right to receive treatments that are based on strong evidence, as it is for the general population. Originality/value – This editorial outlines the second part of a special issue that offers a comprehensive and varied collection of papers from the contributions to the 10th International Congress of the EAMHID.

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