The recovery-orientation of three mental health units

2014 ◽  
Vol 19 (3) ◽  
pp. 163-175 ◽  
Author(s):  
Hollie Bass ◽  
Anna Tickle ◽  
Nicholas Lewis
Keyword(s):  
Mental Health ◽  
Service User ◽  
Service Development ◽  
Service Improvement ◽  
Service Users ◽  
Cross Sectional ◽  
Content Type ◽  
Staff Members ◽  
Recovery Orientation ◽  
Cross Sectional Design

Purpose – The purpose of this paper is to measure service user and staff views of the recovery orientation of three mental health rehabilitation units; two “open” and one “locked”. It identified elements of recovery that were important to service users. It measured the units’ performance on domains of recovery, attending to differences between staff members’ and service users’ perceptions and between the locked and open units. Design/methodology/approach – A cross-sectional design was used. Staff and service users completed the “Developing Recovery Enhancing Environment Measure (DREEM)”. Findings – Findings revealed some differences between staff and service user views. Service users in the locked unit reported the organisational climate to be more recovery oriented on some domains than those in the open units. Service users’ responses highlighted potential areas for service improvement. Research limitations/implications – The sample was small but reflected the applied setting. Some service users were not invited to participate because of significant communication or cognitive difficulties and it is recognised that they may have had alternative views that remain unrepresented. Practical implications – The DREEM provided valuable information about current practice and potential for service development. Both locked and open units can provide recovery-oriented environments. Services should be aware of discrepant views between staff and service users. Originality/value – To the knowledge, this is the first study to use the DREEM to evaluate the recovery orientation of a locked recovery unit and to compare locked and unlocked units.

Overcoming challenges in service user involvement in an older people’s mental health service

2020 ◽  
Vol 24 (3) ◽  
pp. 151-155
Author(s):  
Sophie Smith ◽  
Maria Abbas ◽  
Ariane Zegarra
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Service User ◽  
User Involvement ◽  
Service Improvement ◽  
Service Users ◽  
Service User Involvement ◽  
Content Type ◽  
Group Members

Purpose The purpose of this paper is to describe how an older people’s mental health service involves service users in research and service improvement projects, the value of this work and the ways in which barriers to user-led research have been approached and handled. Design/methodology/approach The authors conducted a reflective review of their experiences of running “ResearchNet”, a group aimed at putting service users’ perspectives at the heart of service improvement projects, which benefits from and develops its members’ related skills. The authors explore overcoming barriers to service user involvement in research. Findings This paper identified the following key elements that enabled ResearchNet to overcome barriers which might be found in service user–led research: recruitment processes; identifying research projects; building confidence, sustaining motivation and overcoming setbacks; developing service user’s research skills; keeping multiple views in mind; involving people with dementia; being responsive to group members’ needs; and keeping the group safe. Practical implications Oxleas National Health Service is currently looking at integrating with the quality improvement team to provide further structure and training to group members. Originality/value This paper explores an under-represented area of research – service user inclusion in older adult mental health research and service improvement. It provides much needed clinical implications for clinicians seeking to increase clients’ involvement in research and service development projects.

Appreciating collaborative service improvement – a case study on using appreciative inquiry methodology in co-production in mental health

2019 ◽  
Vol 23 (3) ◽  
pp. 105-111
Author(s):  
Nicholas Dent
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Appreciative Inquiry ◽  
Service Development ◽  
Service Improvement ◽  
Health Staff ◽  
Service Users ◽  
Content Type ◽  
Health Service Improvement

Purpose The purpose of this paper is to examine the value of appreciative inquiry (AI) methodology in enabling co-productive work within mental health service development. Design/methodology/approach The methodology of AI is described and observations on its use in mental health service improvement are considered. Findings AI is a really helpful tool in supporting service improvement and is particularly applicable in mental health discussions involving service users and carers. Many service users and carers engaging with service development discussions have had adverse past experiences which can inhibit their successful contribution to planning discussions. AI allows a more positive reflection on how services can be improved which can help achieve positive results. Research limitations/implications AI methodology is a really useful tool in supporting improvement discussions across health, and other public, services, and is particularly valuable in engaging mental health service users and carers in such activity. Practical implications The method is useful across service development needs and could be developed to support mental health service improvement locally, regionally and nationally. Developing the use of this method could make a real contribution to improving relations between service users, carers and health staff and support meaningful and positive change in the delivery of mental health services. Social implications Helping to overcome dissonance between service users and carers, and health staff and commissioners; and developing the use of appreciative enquiry could enhance the value of co-production as a key driver for service improvement. Originality/value The author is aware of little discussion of the value of appreciative enquiry in the growing literature around co-production in mental health.

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.

Exploring Norwegian prison frontline workers’ perceptions of inter professional collaboration – a pilot study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Bjørn Kjetil Larsen ◽  
Sarah Hean ◽  
Atle Ødegård
Keyword(s):  
Mental Health ◽  
Factor Analysis ◽  
Interprofessional Collaboration ◽  
Psychosocial Needs ◽  
Theoretical Frameworks ◽  
Cross Sectional ◽  
Frontline Staff ◽  
Content Type ◽  
Frontline Workers ◽  
Cross Sectional Design

Purpose Interprofessional collaboration is necessary for handling the complex psychosocial needs of prisoners. This collaboration must be addressed to avoid high recidivism rates and the human and societal costs linked to them. Challenges are exacerbated by a linear approach to handling prisoners’ problems, silo working between welfare agencies and professional boundaries between frontline workers. There are few adequate theoretical frameworks and tools to address these challenges in the prison context. The purpose of this study is to explore the perceptions that frontline staff working in Norwegian prison facilities have regarding interprofessional collaboration in providing mental health services for prisoners. Design/methodology/approach This study had a non-experimental, cross-sectional design to explore perceptions of interprofessional collaboration in a prison context. Descriptive and multifactorial analyses (exploratory factor analysis and confirmatory factor analysis) were used to explore the data. Findings The analysis showed that three factors, communication, organizational culture and domain, explained 95% of the variance. Results are discussed using relational coordination, as well as the conceptual PINCOM model, as a theoretical framework. Originality/value Few studies explicitly explore collaboration between professionals in mental health and prison services despite its being a prerequisite to achieving sufficient services for prisoners. To our knowledge, this current study is one of the first in Norway to explore collaboration in a prison context by analysing quantitative data and focusing on frontline workers perception of the phenomenon.

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.

From the service user association's perspective

2020 ◽  
Vol 28 (2) ◽  
pp. 53-63
Author(s):  
Charlotte Klinga ◽  
Johan Hansson ◽  
Henna Hasson ◽  
Magna Andreen Sachs ◽  
Carolina Wannheden
Keyword(s):  
Mental Health ◽  
Service User ◽  
Social Care ◽  
Service Users ◽  
Content Type ◽  
Care Services ◽  
Care And Support ◽  
Health And Social Care ◽  
The Individual ◽  
Integrated Mental Health

PurposeThe aim of this study was to identify key components of integrated mental health and social care services that contribute to value for service users in Sweden.Design/methodology/approachAn explorative research study design was used, based on data from four group interviews conducted in June and August 2017 with service user representatives.FindingsThe analysis resulted in eight subcategories reflecting components that were reported to contribute to value for service users. These subcategories were grouped into three main categories: (1) professionals who see and support the whole person, (2) organizational commitment to holistic care and (3) support for equal opportunities and active participation in society.Research limitations/implicationsThe findings are primarily transferable to integrated mental health and social care services, as they emphasize key components that contribute to value for service users in these specific settings.Practical implicationsThe complexity of integrated mental health and social care services requires coordination across the individual and organizational levels as well as ongoing dialogue and partnerships between service users, service user associations and health and social care organizations. In this integration, it is important that service users and service user associations not only are invited but also keen to participate in the design of care and support efforts.Originality/valueService User Associations (SUAs) can act as a bridge between county and municipal services through their participation in the development of local activities; at the regional and national levels, SUAs can help achieve more equitable integrated services. It is important that SUAs are not only invited but encouraged to actively participate in the design of such care and support efforts.

scholarly journals Foregrounding the perspectives of mental health services users during the COVID-19 pandemic

2020 ◽  
Vol 24 (3) ◽  
pp. 131-133
Author(s):  
Hannah Zeilig ◽  
Brioney Gee ◽  
Bonnie Teague ◽  
Jonathan Wilson ◽  
Corinna Hackmann
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Design Methodology ◽  
Lead Author ◽  
Service Development ◽  
Service Users ◽  
Service Strategy ◽  
Content Type ◽  
Strategy Design

Purpose This paper aims to highlight the critical importance of the perspectives of mental health service-users during the COVID-19 pandemic. Design/methodology/approach This viewpoint is based on a review of recent research and literature and draws on consultations with experts by experience, including the lead author. Findings The authors argue that expertise-by-experience is critical to policy, service development and research; but there is a risk it will be neglected at a time of rapid and reactive clinical development. Research limitations/implications Understanding and responding to the nuances of individual need can only be achieved through coproducing service strategy design, delivery and research with mental health service users. The consultation outlined in this viewpoint gives some indication of the type of valuable insights that can be gained through seeking and listening to the perspectives of experts by experience. Originality/value The discussions revealed that experience of managing severe and complex mental health conditions can actually be advantageous when facing a crisis such as COVID-19.

When policy fails try something different integrated practice improve outcomes for dual diagnosis co-occurring service users accessing mental health services

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lois Dugmore ◽  
Saskia Bauweraerts
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Dual Diagnosis ◽  
Service User ◽  
Substance Misuse ◽  
Service Users ◽  
User Group ◽  
Access To Services ◽  
Content Type ◽  
Drug And Alcohol

Purpose This paper aims to discuss an initiative developed between, Leicestershire Partnership National Health Service Trust and Turning Point, which is the locally commissioned drug and alcohol service in Leicester, Leicestershire and Rutland. The aim was to improve outcomes for clients with dual diagnosis (co-occurring mental health and substance misuse) issues. The purpose of the change in working practice was to engage with local substance misuse agencies more effectively to improve clinical outcomes within this service user group. This was achieved through four interrelated approaches. This comprising providing an integrated service. It included building relationships with substance misuse services, providing specialist dual diagnosis clinics and the introduction of substance misuse workers onto mental health wards and group work specific to substance misuse. The outcomes included easier access to services for service users and greater uptake of service users who were moving onto substance misuse services. This led to a reduction in risk related to prescribing and fewer incidents related to prescribing changes and greater engagement in services. When service users were moving between services better communication led to prescriptions being transferred with no delay and to reduced dropout rates in service. There was improved access to substance misuse services, more referrals and take up of service taking place. There was a greater understanding by staff of co-occurring substance misuse and how to work with this client group. Closer working relationship with substance misuse services and shared skills led to greater confidence in managing this service user group. This demonstrates a cost effective service that can be replicated within similar settings. Design/methodology/approach In clinical practice, shared treatment has proved challenging in light of different service models (Laker, 2006). Substance misuse works on the premise of change comes from the individual, where recovery models in mental health offer a formalised approach. One of the challenges faced by services has been the inability for mental health services to recruit and services become overstretched (Rimmer, 2018); this gave an opportunity for a new method of working to be considered. This led to the development of a new service model. These changes were: • Improving the interface with substance misuse services to improve access to community substance misuse services for mental health clients. • To provide specialist staff within the dual diagnosis field to provide a clinic jointly with local drug and alcohol services. • Introduction of substance misuse workers as team members on acute mental health and rehab wards. • Group Substance Misuse programmes. Findings Working within an integrated model, yet maintaining separate organisations, by offering joint training and clinics has led to a greater understanding of each organisation’s work and increased engagement within the service user group.The introduction of substance misuse workers to acute and rehab mental health inpatient services encouraged service users to engage at the point of admission and to be referred into locally commissioned substance misuse services prior to the point of discharge. Engagement with staff has demonstrated better engagement with substance service by service users following discharge.For clients able to take leave assessment could take place prior to discharge. This led to an increased uptake in services. Due to no opiate substitution given on discharge decreased risk of prescribed medication overdose at point of discharge and led to increase in returning straight to substance misuse services. This meant that service users received medication quicker and the right dose and on discharge ensured reduced risk. The prescribing of Naloxone at discharge is yet to be assessed, but the risk of an overdose within seven days is well-documented and Naloxone is key in reversing this trend. This change in practice can be replicated in any mental health setting and has increased access to services for those using substances. Originality/value Is original no other services have substance workers or joint clinics across the UK. First inpatient unit to welcome patients back post-discharge to attend groups.

Service users’ experiences of participation in clinical psychology training

2017 ◽  
Vol 12 (6) ◽  
pp. 337-349 ◽  
Author(s):  
Meadhbh Campbell ◽  
Charlotte Wilson
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Clinical Psychology ◽  
Service User ◽  
Psychology Training ◽  
Service Users ◽  
Clinical Psychology Training ◽  
Content Type ◽  
Psychology Course

Purpose The purpose of this paper is to explore mental health service users’ experiences of involvement in a clinical psychology course. Design/methodology/approach Five participants were recruited from a service user and carer group aligned to a university professional clinical psychology course. Data were collected using semi-structured interviews and data were analysed using an interpretative phenomenological analysis (IPA). Findings Four superordinate themes, group processes, advocating, transforming and power, were drawn from the data, with ten subthemes emerging capturing experiences on the personal, professional and group levels. Research limitations/implications The study is not generalisable and has a small number of participants. However, many of the themes have resonance with existing literature. Practical implications Service user initiatives need to consider the personal and contextual issues that service users may have experienced prior to their involvement. The needs of service user initiatives may change over time. Such initiatives must evolve in conjunction with the personal and political journeys of participants. Originality/value Few studies have explored the experiences of mental health service users in clinical psychology training using a robust methodology. The current study suggests that eliciting these experiences highlights factors that facilitate involvement as well as the barriers.

An exemplar of GP commissioning and child and adolescent mental health service partnership

2016 ◽  
Vol 24 (1) ◽  
pp. 26-37 ◽  
Author(s):  
Ayla Humphrey ◽  
Lynne Eastwood ◽  
Helen Atkins ◽  
Maris Vainre ◽  
Caroline Lea-Cox
Keyword(s):  
Mental Health ◽  
Capacity Planning ◽  
Service User ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Evidence Based ◽  
Service Users ◽  
Content Type ◽  
Health Report ◽  
Shared Goals

Purpose – The purpose of this paper is to draw attention to commissioning and service structures enabling implementation of evidence-based cost-effective care as illustrated by the “1419” young people’s service treating mild to moderate severity mental health difficulties in teenagers old 14 to 19 years. The authors describe relevant local contextual factors: “relational commissioning”, demand capacity planning and a receptive and safe clinical context. Design/methodology/approach – The authors used a participant observer qualitative research design to describe commissioning and service design. Treatment outcomes were analysed using a quantitative design and found significant improvement in service user mental health and daily function. These results will be reported elsewhere. Findings – The dynamics and structures described here enabled clear shared goals between service user, service purchaser, service provider and service partners. The goals and design of the service were not static and were subject to ongoing development using routine outcome measures and conversations between referrers, commissioners, service users and within the team about what was and was not working. Research limitations/implications – The methods are limited by the lack of a prospective systematic evaluation of the implementation process and by the time limitations of the service. Practical implications – Implementation of whole system change such as that envisioned by Children and Young People’s Improving Access to Psychological Therapies requires consideration of local context and process of implementation. The authors suggest key factors: consideration of “relational commissioning” with purchasers, providers and service users designing services together; case-level collaboration between services and partner agencies; smaller child and adolescent mental health teams eliminating competing task demands, permitting speed of action, providing psychological safety for staff, promoting shared goals and innovation; rigorous demand/capacity planning to inform funding. Social implications – The failings of child and adolescent mental health services (CAMHS) are detailed in the Department of Health report “Future in mind: promoting, protecting and improving our children and young people’s mental health and wellbeing” (2015). The aims of the report are contingent on the ability of local health providers to implement its recommendations. The authors provide a theoretical approach to enable this implementation. Originality/value – To date there are no published papers addressing the key characteristics enabling implementation of evidence-based practice within CAMHS. The unique experience in forming the“1419” service has important implications nationally and brings together evidence of an effective service within a theoretical underpinned context.

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