scholarly journals Multidisciplinary team functioning and decision making within forensic mental health

2018 ◽  
Vol 23 (3) ◽  
pp. 185-196 ◽  
Author(s):  
Alina Haines ◽  
Elizabeth Perkins ◽  
Elizabeth A. Evans ◽  
Rhiannah McCabe
Keyword(s):  
Mental Health ◽  
Multidisciplinary Team ◽  
Analysis Data ◽  
Future Research ◽  
Power Dynamics ◽  
Service Users ◽  
Content Type ◽  
Documentary Analysis ◽  
Video Observations ◽  
Team Functioning

Purpose The purpose of this paper is to investigate the operation of multidisciplinary team (MDT) meetings within a forensic hospital in England, UK. Design/methodology/approach Mixed methods, including qualitative face to face interviews with professionals and service users, video observations of MDT meetings and documentary analysis. Data were collected from 142 staff and 30 service users who consented to take part in the research and analysed using the constant comparison technique of grounded theory and ethnography. Findings Decisions taken within MDT meetings are unequally shaped by the professional and personal values and assumptions of those involved, as well as by the power dynamics linked to the knowledge and responsibility of each member of the team. Service users’ involvement is marginalised. This is linked to a longstanding tradition of psychiatric paternalism in mental health care. Research limitations/implications Future research should explore the nuances of interactions between MDT professionals and service users during the meetings, the language used and the approach taken by professionals to enable/empower service user to be actively involved. Practical implications Clear aims, responsibilities and implementation actions are a pre-requisite to effective MDT working. There is a need to give service users greater responsibility and power regarding their care. Originality/value While direct (video) observations were very difficult to achieve in secure settings, they enabled unmediated access to how people conducted themselves rather than having to rely only on their subjective accounts (from the interviews).

Now they’re listening: involvement in clinical psychology training

2019 ◽  
Vol 23 (1) ◽  
pp. 23-29
Author(s):  
Laura Lea ◽  
Sue Holttum ◽  
Victoria Butters ◽  
Diana Byrne ◽  
Helen Cable ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Clinical Psychology ◽  
Health Professionals ◽  
Service User ◽  
Health Workers ◽  
Psychology Training ◽  
Service Users ◽  
Clinical Psychology Training ◽  
Content Type

PurposeThe 2014/2015 UK requirement for involvement of service users and carers in training mental health professionals has prompted the authors to review the work of involvement in clinical psychology training in the university programme. Have the voices of service users and carers been heard? The paper aims to discuss this issue.Design/methodology/approachThe authors update the paper of 2011 in which the authors described the challenges of inclusion and the specific approaches the authors take to involvement. The authors do this in the context of the recent change to UK standards for service user and carer involvement, and recent developments in relation to partnership working and co-production in mental healthcare. The authors describe the work carried out by the authors – members of a service user involvement group at a UK university – to ensure the voices of people affected by mental health difficulties are included in all aspects of training.FindingsCareful work and the need for dedicated time is required to enable inclusive, effective and comprehensive participation in a mental health training programme. It is apparent that there is a group of service users whose voice is less heard: those who are training to be mental health workers.Social implicationsFor some people, involvement has increased. Trainee mental health professionals’ own experience of distress may need more recognition and valuing.Originality/valueThe authors are in a unique position to review a service-user-led project, which has run for 12 years, whose aim has been to embed involvement in training. The authors can identify both achievements and challenges.

An outcomes study of eTherapy for dual diagnosis using Breaking Free Online

2014 ◽  
Vol 7 (2) ◽  
pp. 52-62 ◽  
Author(s):  
Sarah Elison ◽  
Jonathan Ward ◽  
Glyn Davies ◽  
Nicky Lidbetter ◽  
Daniel Hulme ◽  
...  
Keyword(s):  
Mental Health ◽  
Dual Diagnosis ◽  
Substance Dependence ◽  
Clinical Effectiveness ◽  
Outcome Data ◽  
Post Treatment ◽  
Service Users ◽  
Original Cohort ◽  
Content Type ◽  
Self Help

Purpose – In recent years there has been a proliferation of computer-based psychotherapeutic interventions for common mental health difficulties. Building on this, a small number of such interventions have now been developed to address substance dependence, one of which is Breaking Free Online (BFO). A new “eTherapy” self-help service, which was set up by the UK mental health charity Self-Help Services, has provided access to BFO to service users presenting with comorbid mental health and substance misuse difficulties. The purpose of this paper is to evaluate a range of clinical outcomes in the first cohort of service users accessing this dual diagnosis service. Design/methodology/approach – A number of standardised psychometric assessments were conducted with service users at baseline and post-treatment at discharge from the service. Outcome data were available for 47 service users out of an original cohort of 74. Findings – Statistically significant improvements were found in terms of measures of social functioning, depression, anxiety, alcohol and drug use and social anxiety. Clinically relevant gains were also identified, with fewer service users reaching threshold scores for depression and anxiety at post-treatment compared to baseline. Effect sizes also indicated that the identified improvements across the psychometric measures were robust and significant. Research limitations/implications – These findings provide further support for the clinical effectiveness of BFO, and also provide evidence that an eTherapy self-help service may be appropriate for some individuals presenting with dual diagnosis. Further research is underway with larger and alternative clinical populations to examine the effectiveness of BFO and also this novel eTherapy self-help approach. Originality/value – This paper has provided initial data to support effectiveness of a novel eTherapy service for dual diagnosis.

scholarly journals Multidisciplinary team meetings in community mental health: a systematic review of their functions

2016 ◽  
Vol 21 (2) ◽  
pp. 119-140 ◽  
Author(s):  
Caoimhe Nic a Bháird ◽  
Penny Xanthopoulou ◽  
Georgia Black ◽  
Susan Michie ◽  
Nora Pashayan ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Community Mental Health ◽  
Multidisciplinary Team ◽  
Community Mental Health Services ◽  
Content Type ◽  
Team Members ◽  
Team Meetings ◽  
Unwarranted Variation ◽  
The Uk

Purpose – Previous research has identified a need for greater clarity regarding the functions of multidisciplinary team (MDT) meetings in UK community mental health services. The purpose of this paper is to identify the functions of these meetings by systematically reviewing both primary research and academic discussion papers. Design/methodology/approach – Papers relating to adult community mental health teams (CMHTs) in the UK and published between September 1999 and February 2014 were reviewed and appraised using NICE quality checklists. The search was broad in scope to include both general CMHTs and specialist CMHTs such as early intervention psychosis services and forensic mental health teams. A thematic synthesis of the findings was performed to develop an overarching thematic framework of the reported functions of MDT meetings. Findings – None of the 4,046 studies identified directly investigated the functions of MDT meetings. However, 49 mentioned functions in passing. These functions were categorised into four thematic domains: discussing the care of individual patients, teamwork, team management and learning and development. Several papers reported a lack of clarity about the purpose of MDT meetings and the roles of different team members which hindered effective collaboration. Practical implications – Without clearly agreed objectives for MDT meetings, monitoring their effectiveness is problematic. Unwarranted variation in their functioning may undermine the quality of care. Originality/value – This is the first systematic review to investigate the functions of CMHT MDT meetings in the UK. The findings highlight a need for empirical research to establish how MDT meetings are being used so that their effectiveness can be understood, monitored and evaluated.

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.

Understanding the gendered nature of developing country MSMEs’ access, adoption and use of information and communication technologies for development (ICT4D)

2020 ◽  
Vol 12 (3) ◽  
pp. 273-295
Author(s):  
Elisa Mohanty ◽  
Anindya Jayanta Mishra
Keyword(s):  
Information And Communication Technologies ◽  
Small And Medium Enterprises ◽  
Communication Technologies ◽  
Dark Side ◽  
Future Research ◽  
Power Dynamics ◽  
Content Type ◽  
Time Period ◽  
Information And Communication ◽  
Medium Enterprises

Purpose The widespread use of information and communication technologies (ICTs) has had a significant effect on various groups and communities of people including micro, small and medium enterprises (MSMEs) and their owners/managers. The current study aims to analyze recent literature regarding adoption of ICTs by MSMEs. Further, it tries to locate gender within this broader context of diffusion of ICTs among MSMEs. Design/methodology/approach Using the thematic analysis approach, the research articles pertaining to six leading journals on ICTs, gender and entrepreneurship published during the time period from 2011 to 2019 are reviewed. Findings The literature selected for the study has been discussed under two primary categories, viz. “adoption of information and communication technologies for development (ICT4D) for business purposes” and “insights on gender in ICT4D use by MSMEs.” Research limitations/implications The context-dependent nature of ICT use can enable future entrepreneurs to assess the scope of specific ICTs in given areas of operation. The gendered nature of ICTs helps to evaluate as well as question the empowerment potential of ICTs. The study emphasizes the need to account for historical specificities and transnational linkages in understanding access, adoption and use of ICT4D by women MSME entrepreneurs. Originality/value The study bridges together literature on ICT4D use by MSMEs and the role of gender in ICT-mediated entrepreneurial environments. While unraveling the interplay of power dynamics in such environments, the scope for future research in terms of tapping into the content of information exchanges and exploring the implications of “dark side of internet” for women MSME entrepreneurs is also indicated.

Stress and productivity in workers of textile companies

2019 ◽  
Vol 23 (1) ◽  
pp. 17-29
Author(s):  
Carlos Ramos-Galarza ◽  
Pamela Acosta-Rodas
Keyword(s):  
Mental Health ◽  
Occupational Stress ◽  
Negative Impact ◽  
Psychological Intervention ◽  
Psychological Treatment ◽  
Economic Losses ◽  
Future Research ◽  
Quantitative Methodology ◽  
Textile Production ◽  
Content Type

Purpose The purpose of this paper is to analyze the relationship between two psychological factors which are occupation stress and productivity, that influence workers immerse into textile production labor context. Design/methodology/approach This study has a quantitative methodology, is cross-sectional, nonexperimental and with an explicative scope. Findings The results of this research allow to identify that occupational stress levels cause a negative impact on worker’s productivity in the textile production area. Research limitations/implications There are two limitations in this study, first is the participant’s subjectivity when filling the questionnaires because it was self-reported and the second limitation is that the sample is specifically from a city of a South American country. Practical implications The results of this investigation show as an evidence the need for psychological intervention within companies for occupational stress, because it will impact in a negative way the textile production of a company, which will guide future research making possible to develop and apply psychological treatment programs pro employee’s mental health. Social implications A textile company with low productivity will bring strong economic losses and even bankruptcy, although, thanks to this study it was possible to identify that occupational stress will have a negative impact in productivity, drawing an important based line to future research, looking to improve worker’s performance and hence, companies’ profits contributing to social economic processes. Originality/value In general, companies of textile industry (as many others from capitalist economic system), make substantial investments in technology instruments, specialized workers, machines’ maintenance and reparation, marketing, etc. to improve their production standards, however, there is a low investment on worker’s mental health, as it has been found in this study it generates a strong negative impact on its productivity.

Linking the past and the present: service users’ perspectives of how adverse experiences relate to their admission to forensic mental health services

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jessica Cartwright ◽  
Daniel Lawrence ◽  
Christopher Hartwright
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Service Users ◽  
Forensic Mental Health ◽  
Discussion Section ◽  
Content Type ◽  
The Past ◽  
Secure Care ◽  
Adverse Experiences

Purpose This study aimed to explore how forensic mental health service users make sense of their past adverse experiences. Secondly, it aimed to explore whether service users considered their adverse experiences to be related to their current stay in a forensic mental health setting. Design/methodology/approach Interpretative phenomenological analysis was used to analyse interviews with eight service users in low and medium secure care. Six of the participants were male and two were female. Findings Four super-ordinate themes emerged from the data: “Living amongst adversity”; “Managing adverse experiences”; “Making sense of going into secure care”; and “Coping with the past in the present”. All participants referred to multiple adverse experiences throughout their lives and used harmful coping strategies to manage these. Individual differences in how they related their past experiences to their detention in secure care were evident. Practical implications Author guidelines state that this section is optional. Implications for clinical practice are discussed at length in the discussion section. Originality/value This study offers an insight into the way in which forensic mental health service users make sense of their past traumas in relation to their current admission to secure services. To the best of the authors’ knowledge, no research has previously addressed this from the perspective of service users.

Mental health, social inclusion and the development of vocational services in the NHS – what can be learnt?

2019 ◽  
Vol 24 (2) ◽  
pp. 133-143 ◽  
Author(s):  
Mark Bertram
Keyword(s):  
Mental Health ◽  
Social Inclusion ◽  
Health Impact ◽  
Service Development ◽  
Service Users ◽  
Policy Makers ◽  
Content Type ◽  
Descriptive Case Study ◽  
Personal Bias ◽  
Vocational Goals

Purpose The purpose of this paper is to describe the learning from a historical NHS vocational service development that focused on: mental health, employment and social inclusion – in an inner city area – involving service users, staff and commissioners. Design/methodology/approach It is a descriptive case study. A range of historical documents was content analysed and described through a first-person narrative: service user consultations, service specifications, audit records, outcome frameworks, internal service evaluations and published literature. Findings When vocational NHS service developments are grounded in what service users say helps them (person-centred, networked and co-ordinated approaches) the evidence indicates people can achieve their vocational goals. Research limitations/implications The range of documents described is factual, although the learning insights from some of the service developments are based on personal judgements. The author was the responsible manager – personal bias is high. There is not enough robust evidence to warrant generalisation. Practical implications When employment and social inclusion are prioritised, as core business in NHS, outcomes and health impact can increase. Greater detail is needed from healthcare policy makers – focusing on who exactly should undertake this work and what the key commissioning social inclusion performance indicators are. Originality/value The bulk of literature on employment support focuses on promoting evidence from one model: individual placement and support. Evidence here indicates a broader range of activity (education, training and volunteering) can have value and health impact.

Research watch: what really helps recovery in relation to severe mental health difficulties?

2020 ◽  
Vol 24 (1) ◽  
pp. 6-12
Author(s):  
Sue Holttum
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Design Methodology ◽  
Support Service ◽  
Health Condition ◽  
Service Users ◽  
Content Type ◽  
Inpatient Settings ◽  
Mental Health Difficulties

Purpose The purpose of this paper is to examine three recent papers on mental health services and how they support recovery following a diagnosis of a severe mental health condition. Design/methodology/approach A search was carried out for recent papers on mental health and recovery. The author selected three papers that seemed to advance understanding of not only whether, but also how recovery of a meaningful life may be best supported in mental health services. Findings One paper suggested how staff were able to support service users’ personal goals and focus on recovery in acute inpatient settings, and what got in the way. The author suggests practical ways to address the barriers. A second paper reported the testing of a new model for supporting staff in primary and secondary care to work together so that service users with a diagnosis of bipolar or schizophrenia were better supported to work towards valued goals. A third paper reviewed 40 studies of how people can experience positive change after a first diagnosis of psychosis, and how change happened. Originality/value By studying the issues in detail, all three papers show how improved support for recovery and inclusion can be implemented against the backdrop of many years of service shortcomings.

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