Professionals harnessing experiential knowledge in Dutch mental health settings

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Simona Karbouniaris ◽  
Alie Weerman ◽  
Bea Dunnewind ◽  
Jean Pierre Wilken ◽  
Tineke A. Abma

Purpose This study aims to explore the perspectives of mental health professionals who are in a process of integrating their own experiential knowledge in their professional role. This study considers implications for identity, dilemmas and challenges within the broader organization, when bringing experiential knowledge to practice. Design/methodology/approach As part of a participatory action research approach, qualitative methods have been used, such as in-depth interviews, discussions and observations during training and project team. Findings The actual use of experiential knowledge by mental health care professionals in their work affected four levels: their personal–professional development; the relation with service users; the relation with colleagues; and their position in the organization. Research limitations/implications Because of its limited context, this study may lack generalisability and further research with regard to psychologists and psychiatrists, as well as perceptions from users, is desirable. Social implications According to this study, social change starts from a bottom-up movement and synchronously should be facilitated by top-down policy. A dialogue with academic mental health professionals seems crucial to integrate this source of knowledge. Active collaboration with peer workers and supervisors is desired as well. Originality/value Professionals with lived experiences play an important role in working recovery-oriented, demonstrating bravery and resilience. Having dealt with mental health distress, they risked stigma and rejections when introducing this as a type of knowledge in current mental health service culture. Next to trainings to facilitate the personal–professional process, investments in the entire organization are needed to transform governance, policy and ethics.

Author(s):  
Aukje Leemeijer ◽  
Mirko Noordegraaf

In many Western countries mental health care institutions employ ‘peer support workers’ in professional teams. They are clients or former clients in mental health care who are trained and educated to transform their personal experience as a client into ‘experiential knowledge’ helping other clients. This is supposed to improve ‘client centeredness’ in mental health care. However, the rise and roles of peer support workers are not undisputed; mental health professionals – psychiatrists, psychologists, nurses and therapists – have ambivalent responses. Peer support workers may challenge the status and dominance of traditional expert knowledge when they bring experiential knowledge into decision making processes. This challenge is strengthened by the development of peer support workers as a new group who may ultimately themselves professionalise. This chapter, focused on The Netherlands, explores from a neo-Weberian standpoint the relationship between mental health professionals and peer support workers. This is related to professional identities and positions, and also institutional surroundings, including how peer support workers and service organisations deal with risks and accountability. On the basis of empirical observational research, organisational conditions are shown to count more than occupational conditions. This underscores that the interweaving of new forms of knowledge in service processes must be organised.


2018 ◽  
Vol 11 (1) ◽  
pp. 30-39 ◽  
Author(s):  
Elizabeth Hughes ◽  
Dan Bressington ◽  
Kathryn Sharratt ◽  
Richard Gray

Purpose There is evidence that novel psychoactive substances (NPS) are commonly used by people with severe mental illness. The purpose of this paper is to undertake a scoping survey to explore the inpatient mental health workers’ perceptions of NPS use by consumers. Design/methodology/approach A cross-sectional online survey of mental health professionals is used in the study. The participants were opportunistically recruited through social media and professional networks. Findings A total of 98 participants (of 175 who started the survey) were included in the analysis. All reported that some patients had used NPS prior to admission. Over 90 per cent of participants reported observing at least one adverse event relating to NPS use in the previous month. The majority of participants reported that patients had used NPS during their inpatient admission. Three quarters were not clear if their workplace had a policy about NPS. Most wanted access to specific NPS information and training. The participants reported that they lacked the necessary knowledge and skills to manage NPS use in the patients they worked with. Research limitations/implications Whilst the authors are cautious about the generalisability (due to methodological limitations), the findings provide useful insight into the perceptions of inpatient staff regarding the extent and impact of NPS use including concerns regarding the impact on mental and physical health, as well as ease of availability and a need for specific training and guidance. Practical implications Mental health professionals require access to reliable and up-to-date information on changing trends in substance use. Local policies need to include guidance on the safe clinical management of substance use and ensure that NPS information is included. Originality/value To the best of the authors’ knowledge, this is the first survey of the perceptions of mental health staff working in inpatient mental health settings regarding NPS. The findings suggest that NPS is a common phenomenon in inpatient mental health settings, and there is a need for more research on the impact of NPS on people with mental health problems.


2020 ◽  
Vol 25 (3) ◽  
pp. 269-280
Author(s):  
Chloe Finamore ◽  
Fiammetta Rocca ◽  
Jennie Parker ◽  
Julia Blazdell ◽  
Oliver Dale

Purpose Mental health professionals working with patients with personality disorder are at risk of burnout. Burnout can adversely affect workforce retention and the delivery of high-quality care. The purpose of this paper is to investigate the impact of the three-day Knowledge and Understanding Framework (KUF) awareness-level personality disorder training on burnout, knowledge and attitudes in staff working in mental health settings. Design/methodology/approach A total of 253 mental health professionals attended the KUF training, delivered through a co-production model (i.e. co-delivered by a mental health professional and service user consultant with lived experience). Questionnaires were administered at pre- and post-training to assess changes in burnout symptoms and understanding, perceived capabilities and emotional reactions concerning personality disorder. Findings There were improvements in two burnout domains: decreases in emotional exhaustion (p = 0.009) and increases in personal accomplishment (p < 0.001) between pre-and post-training. Significant improvements were found in understanding, perceived capabilities and emotional reactions (p < 0.001). Research limitations/implications This evaluation is limited by a lack of a control group and long-term follow-up. Further research is required to investigate the sustainability of reductions in burnout for mental health professionals attending training and supervision structures. Originality/value KUF training may contribute to reductions in the high levels of burnout often experienced amongst staff working in mental health settings and could form a part of a broader strategy focussing on continued supervision and opportunities to integrate learning into practice.


2019 ◽  
Vol 23 (1) ◽  
pp. 23-29
Author(s):  
Laura Lea ◽  
Sue Holttum ◽  
Victoria Butters ◽  
Diana Byrne ◽  
Helen Cable ◽  
...  

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.


2018 ◽  
Vol 23 (1) ◽  
pp. 12-24 ◽  
Author(s):  
Juliette van der Kamp

Purpose The purpose of this paper is to describe the barriers and facilitators to an effective transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It also presents a new entry into considering how the transition can be improved. Design/methodology/approach Insights into the transition from CAMHS to AMHS were gathered through eight semi-structured interviews with mental health professionals. Two methods of data analysis were employed to explore the emerging themes in the data and the observed deficit approach to organisational development. Findings The findings identified a vast volume of barriers in comparison to facilitators to the transition. Adolescents who transition from CAMHS to AMHS initially experience difficulty adapting to the differences in the services due to the short duration of the transition period. However, despite the established barriers to the transition, adolescents tend to adapt to the differences between the services. Findings also showed a negative framing towards the transition amongst the mental health professionals which resembles a deficit approach to organisational development. Originality/value This paper explores mental health professionals’ perspectives regarding the transition in Dumfries and Galloway, Scotland. The transition is increasingly recognised as an area in health care that requires improvement. This research provides a new way to consider the transition by exploring the perceived deficit approach to organisational development in the services.


2021 ◽  
Author(s):  
◽  
Gloria Fraser

<p>While we know that rainbow people in Aotearoa New Zealand (that is, people of diverse sexualities, genders, and sex characteristics) experience high rates of adverse mental health outcomes, we know much less about the extent to which Aotearoa’s rainbow community members are receiving the mental health support they need. To address this gap I used mixed methods and a reflexive community-based approach to extend current understandings of rainbow mental health support experiences, and to explore how the provision of mental health care can be improved for rainbow people in New Zealand.  I first conducted interviews with 34 rainbow community young adults about their experiences of accessing mental health support. My thematic analysis showed that rainbow people across New Zealand faced significant structural barriers to accessing mental health support. Participants understood mental health settings as embedded within a heteronormative and cisnormative societal context, rather than as a safe place outside this context. This, together with a widespread silence from mental health professionals around rainbow identity, meant that participants actively negotiated coming out in mental health settings. Participants shared a variety of perspectives as to whether it should be standard practice for mental health professionals to ask about rainbow identities, but agreed on a number of subtle acts that could communicate a professional or service is rainbow-friendly. Knowledge about sexuality, gender, and sex characteristic diversity, together with clinical skills of empathy, validation, and affirmation, were described as key components for the provision of effective mental health support.  I conducted a second thematic analysis of data from a subset of the initial interviews, in which 13 participants discussed their experiences of accessing gender-affirming healthcare. Participants reported a lack of funding for gender-affirming healthcare in New Zealand, and described its provision a “postcode lottery”; the care available was largely dependent on the region participants were living in. Mental health assessments for accessing gender-affirming care were often described as tests of whether participants were “really” transgender, and participants discussed the need to express their gender in a particular way in order to access the healthcare they needed.  Thematic analyses of interview data informed the development of an online survey about rainbow peoples’ experiences of accessing mental health support and gender-affirming healthcare in New Zealand (n = 1575). Survey results closely reflected interview findings, indicating that rainbow people have mixed experiences in New Zealand’s mental health settings, and that accessing gender-affirming healthcare is a lengthy and convoluted process.   Finally, interview and survey data were used to develop a resource for mental health professionals, to guide their work with rainbow clients. I sought and incorporated feedback from key stakeholders (n = 108) during resource development. I then distributed the resource to mental health professionals around New Zealand, both in print and online.  Overall, my research shows that widespread knowledge gaps compromise the ability of New Zealand’s mental health professionals to provide culturally competent support to rainbow clients. Knowledge from this thesis can be used to increase awareness of rainbow community members’ mental health support needs, and to inform mental health professionals’ training and self-reflection around sexuality, gender, and sex characteristic diversity.</p>


2018 ◽  
Vol 13 (3) ◽  
pp. 173-186 ◽  
Author(s):  
Catherine Cosgrave ◽  
Myfanwy Maple ◽  
Rafat Hussain

Purpose Some of Australia’s most severe and protracted workforce shortages are in public sector community mental health (CMH) services. Research identifying the factors affecting staff turnover of this workforce has been limited. The purpose of this paper is to identify work factors negatively affecting the job satisfaction of early career health professionals working in rural Australia’s public sector CMH services. Design/methodology/approach In total, 25 health professionals working in rural and remote CMH services in New South Wales (NSW), Australia, for NSW Health participated in in-depth, semi-structured interviews. Findings The study identified five work-related challenges negatively affecting job satisfaction: developing a profession-specific identity; providing quality multidisciplinary care; working in a resource-constrained service environment; working with a demanding client group; and managing personal and professional boundaries. Practical implications These findings highlight the need to provide time-critical supports to address the challenges facing rural-based CMH professionals in their early career years in order to maximise job satisfaction and reduce avoidable turnover. Originality/value Overall, the study found that the factors negatively affecting the job satisfaction of early career rural-based CMH professionals affects all professionals working in rural CMH, and these negative effects increase with service remoteness. For those in early career, having to simultaneously deal with significant rural health and sector-specific constraints and professional challenges has a negative multiplier effect on their job satisfaction. It is this phenomenon that likely explains the high levels of job dissatisfaction and turnover found among Australia’s rural-based early career CMH professionals. By understanding these multiple and simultaneous pressures on rural-based early career CMH professionals, public health services and governments involved in addressing rural mental health workforce issues will be better able to identify and implement time-critical supports for this cohort of workers. These findings and proposed strategies potentially have relevance beyond Australia’s rural CMH workforce to Australia’s broader early career nursing and allied health rural workforce as well as internationally for other countries that have a similar physical geography and health system.


2019 ◽  
Vol 14 (3) ◽  
pp. 164-173 ◽  
Author(s):  
Andrian Liem

Purpose As part of a nationwide research about knowledge, attitude, experiences and educational needs towards complementary and alternative medicine (CAM) among Indonesian clinical psychologists (CPs), the purpose of this paper is to explore CPs’ perceptions of CAM research and their interest in learning CAM. Design/methodology/approach A link to an online survey was e-mailed to all 1,045 CPs across Indonesia. At the end of the survey, two open-ended questions were asked: “What do you think about CAM research in Indonesia?” and “Why are you interested in learning about CAM?”, which were responded to by 127 participants (87 per cent of females; Mage=36.67, SD=9.02). Participants’ responses were analysed using inductive qualitative content analysis. Findings It was found that two global themes for CPs’ perceptions of CAM were to improve participants’ professionalism and as part of continuing education and development for mental health professionals. The favourable responses in this study may reflect participants’ willingness to be involved in collaborative CAM research and education. Moreover, CAM was perceived as part of Indonesian culture and participants viewed CAM research and knowledge as a chance to promote Indonesian local wisdom to complement conventional psychotherapy. Research limitations/implications These findings might call for stakeholders to integrate CAM knowledge into psychology education, facilitate CAM research in psychology settings and encourage collaborative CAM research. However, self-selection bias may limit the findings of this study. Originality/value This study explored perceptions of CAM research and interest in learning CAM that have rarely been investigated among mental health professionals and particularly, until now, have not been investigated in Indonesia.


2019 ◽  
Vol 11 (2) ◽  
pp. 78-87 ◽  
Author(s):  
Gianni Pirelli ◽  
Liza Gold

Purpose Firearm-involved violence and suicide in the USA, often collectively referred to as “gun violence,” has been labeled a public health problem and an epidemic, and even an endemic by some. Many lawmakers, community groups, mainstream media outlets and professional organizations regularly address gun-related issues and frequently associate firearm violence with mental health. As a result, these groups often set forth positions, engage in discussions and promote policies that are at least partially based on the widely held but incorrect assumption that medical and mental health professionals are either inherently equipped or professionally trained to intervene with their patients and reduce gun deaths. The paper aims to discuss this issue. Design/methodology/approach Furthermore, notable proportions of medical and mental health professionals self-report a level of comfort engaging in firearm-specific interventions that is often disproportionate to their actual education and training in the area. This type of overconfidence bias has been referred to as the Lake Wobegon Effect, illusory superiority, the above average effect, the better-than average effect or the false uniqueness bias. While medical and mental health professionals need to serve on the front line of firearm-involved violence and suicide prevention initiatives, the vast majority have not actually received systematic, formal training on firearm-specific issues. Findings Therefore, many lack the professional and cultural competence to meet current and potential future in regard to addressing gun violence. In this paper, the authors discuss empirical studies that illustrate this reality and a novel model (i.e. the Know, Ask, Do framework) that medical and mental health professionals can use when firearm-related issues arise. In addition, the authors set forth considerations for clinicians to develop and maintain their professional and cultural competence related to firearms and firearm-related subcultures. Originality/value This paper provides empirical and conceptual support for medical and mental health programs to develop formal education and training related to guns, gun safety and gun culture. A framework is provided that can also assist medical and mental health professionals to develop and maintain their own professional and cultural competence.


2020 ◽  
Vol 26 (3) ◽  
pp. 2011-2029 ◽  
Author(s):  
Julia Ivanova ◽  
Adela Grando ◽  
Anita Murcko ◽  
Michael Saks ◽  
Mary Jo Whitfield ◽  
...  

Integrated mental and physical care environments require data sharing, but little is known about health professionals’ perceptions of patient-controlled health data sharing. We describe mental health professionals’ views on patient-controlled data sharing using semi-structured interviews and a mixed-method analysis with thematic coding. Health information rights, specifically those of patients and health care professionals, emerged as a key theme. Behavioral health professionals identified patient motivations for non-sharing sensitive mental health records relating to substance use, emergency treatment, and serious mental illness (94%). We explore conflicts between professional need for timely access to health information and patient desire to withhold some data categories. Health professionals’ views on data sharing are integral to the redesign of health data sharing and informed consent. As well, they seek clarity about the impact of patient-controlled sharing on health professionals’ roles and scope of practice.


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