Religion in inpatient mental health: a narrative review

2014 ◽  
Vol 19 (4) ◽  
pp. 221-236 ◽  
Author(s):  
Suzanne Heffernan ◽  
Sandra Neil ◽  
Stephen Weatherhead
Keyword(s):  
Mental Health ◽  
Traditional Healers ◽  
Service Users ◽  
Topic Area ◽  
Policy Makers ◽  
Content Type ◽  
Spiritual Assessment ◽  
Inpatient Mental Health ◽  
Inpatient Services ◽  
Informed Group

Purpose – The purpose of this paper is to explore the extent to which inpatient mental health services attend to the religious needs of service-users. Literature is presented to argue that whilst the importance of religion is highlighted in consumer accounts, research and policy; inpatient services continue to neglect religion and service-users consistently report insufficient attention to religious needs during hospitalisation. Design/methodology/approach – This review adopts a narrative approach to the literature, drawing upon published journal articles, book chapters and policy documentation. Findings – Literature into the topic area is reviewed and discussed within three themes. First, the extent to which religious needs are currently met is explored. Second, potential reasons for neglect of religion are considered. Finally, examples of religiously informed group programmes, individual psychotherapy and the use of traditional healers are detailed. Practical implications – Findings of the review point towards the requirement for inpatient services to more adequately meet religious needs in terms of available facilities. The need for spiritual assessment and collaboration with hospital chaplains is also highlighted, along with the call for increased staff training. Originality/value – It is expected that this review will be of interest to a range of stakeholders including professionals, policy makers and service users. It highlights the void in clinical attention to religious needs and offers practical suggestions for meeting this need.

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.

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.

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.

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
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Negative Impact ◽  
Sleep Hygiene ◽  
Content Type ◽  
Inpatient Mental Health ◽  
The Impact

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.

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.

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.

New ways to get policy into practice

2018 ◽  
Vol 32 (6) ◽  
pp. 809-824 ◽  
Author(s):  
Peter Nugus ◽  
Geetha Ranmuthugala ◽  
Josianne Lamothe ◽  
David Greenfield ◽  
Joanne Travaglia ◽  
...  
Keyword(s):  
Mental Health ◽  
Organizational Context ◽  
Mutual Influence ◽  
Social Needs ◽  
Policy Makers ◽  
Content Type ◽  
Service Effectiveness ◽  
Street Level ◽  
Social Organizational ◽  
Street Level Bureaucracy

Purpose Health service effectiveness continues to be limited by misaligned objectives between policy makers and frontline clinicians. While capturing the discretion workers inevitably exercise, the concept of “street-level bureaucracy” has tended to artificially separate policy makers and workers. The purpose of this paper is to understand the role of social-organizational context in aligning policy with practice. Design/methodology/approach This mixed-method participatory study focuses on a locally developed tool to implement an Australia-wide strategy to engage and respond to mental health services for parents with mental illness. Researchers: completed 69 client file audits; administered 64 staff surveys; conducted 24 interviews and focus groups (64 participants) with staff and a consumer representative; and observed eight staff meetings, in an acute and sub-acute mental health unit. Data were analyzed using content analysis, thematic analysis and descriptive statistics. Findings Based on successes and shortcomings of the implementation (assessment completed for only 30 percent of clients), a model of integration is presented, distinguishing “assimilist” from “externalist” positions. These depend on the degree to which, and how, the work environment affords clinicians the setting to coordinate efforts to take account of clients’ personal and social needs. This was particularly so for allied health clinicians and nurses undertaking sub-acute rehabilitative-transitional work. Originality/value A new conceptualization of street-level bureaucracy is offered. Rather than as disconnected, it is a process of mutual influence among interdependent actors. This positioning can serve as a framework to evaluate how and under what circumstances discretion is appropriate, and to be supported by managers and policy makers to optimize client-defined needs.

Job creation through income generation: an evaluation of Re-Cover, a decorating project developed with forensic mental health service users

2018 ◽  
Vol 13 (3) ◽  
pp. 148-156
Author(s):  
Sarah McDonald ◽  
Mark Bertram
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Job Creation ◽  
Operating Costs ◽  
Service Users ◽  
Income Generation ◽  
Forensic Mental Health ◽  
Commercial Activity ◽  
Content Type

Purpose The purpose of this paper is to explore and describe the effectiveness, achievements and challenges of a job creation project that was developed with people in contact with forensic mental health services. Design/methodology/approach This evaluation (case study) used a mixed methods approach: a range of quantitative and qualitative data were gathered, analysed and interpreted. Findings There were economic and health benefits. The income generation was sufficient to fund a large chunk of the projects operating costs. Service users reported improvements in mental health, wellbeing, confidence, skill development and earning capacity. Research limitations/implications The sample size was too small to be generalised and no validated measures were used. Further research is required into the long-term benefits of job creation in mental health services and providing a continuum of employment support. Practical implications A range of commercial activity can form the basis for job creation and work training projects in mental health services. Substantial operating costs can be generated, to re-invest in job creation/enterprises. Social implications Social value can be enhanced within NHS public sector procurement procedures. Agreement between a range of internal NHS departments is necessary: finance, commercial, estates and facilities, and procurement. Originality/value Public sector procurement has the potential to act as a catalyst to support the inclusion agenda by funding commercial activity that job creation projects can undertake.

The experience of learning from mental health service users and carers

2019 ◽  
Vol 14 (2) ◽  
pp. 119-130
Author(s):  
Charlotte Wilson
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Online Survey ◽  
User Involvement ◽  
Emotional Arousal ◽  
Student Experiences ◽  
Service Users ◽  
Content Type ◽  
Cognitive Experience

Purpose The purpose of this paper is to explore student experiences of learning from mental health service users and carers. Design/methodology/approach In total, 30 clinical psychology trainees and ex-trainees took part in an online survey (n=21) or focus group (n=9). Responses were analysed using interpretative thematic analysis. Findings A number of themes were identified. There were two pre-conditions of learning: valuing the teaching and emotional arousal. Participants’ learning experiences were characterised by cognitive and meta-cognitive processes: active learning, reflection, increased attention and vivid memories. Furthermore, participants might have a meta-cognitive experience of having learned something, but being unsure what that something was. Participants reported learning about the lives of service users, about themselves and about the wider societal context for people with mental health difficulties. Practical implications In order to facilitate learning students should value the input of service users. This allows them to contain and use the emotional arousal the teaching produces. Furthermore, leaving students with a feeling that something has been learned but not being exactly sure what that has been may facilitate students seeking out further opportunities for service user involvement. Originality/value Few studies have explored the process of learning from mental health service users and carers. In the current study, the emotion aroused in participants was primary. Furthermore, a new meta-cognitive experience, namely, the experience of having learned something, but not being sure what has been learned, has been identified.

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