scholarly journals Producing a new website for a paediatric liaison mental health team with our service users

2020 ◽  
Vol 9 (4) ◽  
pp. e001128
Author(s):  
Alexander Adams ◽  
Virginia Davies ◽  
Bethany Stubbs
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Patient Experience ◽  
Service Users ◽  
Health Issues ◽  
Web Page ◽  
Mental Health Team ◽  
Children And Young People ◽  
Specific Feedback ◽  
Source Of Information

IntroductionOnline resources are an important source of information about mental health issues and services for children and young people. Our service’s website had an out-of-date appearance and was aimed at professionals. More importantly, comments in our routinely collected patient experience data indicated that service users did not know what to expect when coming to our service.MethodsWe followed the model for improvement by testing out changes in plan, do, study and act cycles that included a review of recently updated child and adolescent mental health services’ and youth charities’ websites, designing a new web page for our service and then testing out the website in focus groups. We used routinely collected patient experience data to assess impact on wider patient satisfaction.ResultsFocus groups involving patients, parents and professionals judged the new website to be clearer, more attractive and easier to understand. Routine patient experience data did not reveal any website-specific feedback.ConclusionThis study demonstrates that it is easy and possible to create an attractive and accessible website for a mental health service using quality improvement methodology. In order to capture and integrate ongoing feedback about a service’s website from service users, routinely collected patient experience measures would need to ask specific questions related to this area. In this study, preproject and postproject patient experience data did not generate any specific comments.

scholarly journals To improve the communication between a community mental health team and its service users, their families and carers

2020 ◽  
Vol 9 (4) ◽  
pp. e000914
Author(s):  
Priyalakshmi Chowdhury ◽  
Amir Tari ◽  
Ola Hill ◽  
Amar Shah
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
User Satisfaction ◽  
Service User ◽  
Service Users ◽  
Not Given ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Specialist Registrar ◽  
Health Team

This article describes the application of quality improvement (QI) to solve a long-standing, ongoing problem where service users or their carers felt they were not given enough information regarding diagnosis and medication during clinic assessments in a community mental health setting. Service users and carers had shared feedback that some of the information documented on clinic letters was not accurate and the service users were not given the opportunity to discuss these letters with the clinician. The aim of this QI project was to improve the communication between the community mental health team (CMHT) and service users and their carers. Wardown CMHT volunteered to take on this project. The stakeholders involved were the team manager and deputy manager, the team consultant, the team specialist registrar, team administrative manager, two carers and one service user. The project had access to QI learning and support through East London NHS Foundation Trust’s QI programme. The team organised weekly meetings to brainstorm ideas, plan tests of change to review progress and to agree on the next course of action. The outcome was an increase in service user satisfaction from 59.9% to 78% over a period of 6 months, and a reduction in complaints to zero.

scholarly journals Increasing staff confidence about domestic abuse identification, disclosure and safeguarding in a community mental health team

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S146-S147
Author(s):  
Beth McCausland ◽  
Nicola Minicozzi ◽  
Siobhan O'Halloran ◽  
Avril Ward ◽  
Kerry Elliott
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Trust Management ◽  
Domestic Abuse ◽  
Pilot Project ◽  
Baseline Survey ◽  
Service Users ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

AimsTo increase staff confidence about identifying Domestic Abuse (DA), particularly regarding ‘how to ask’ to encourage disclosure and the pathways available for appropriately safeguarding survivors; in a Community Mental Health Team (CMHT) setting.BackgroundDA is bi-directionally associated with mental health (MH) disorders; 1:4 women in contact with MH services are currently experiencing DA. MH professionals (MHPs) are in a privileged position to identify DA and support survivors. However, this is dependent on MHPs receiving adequate training about DA. For this, we collaborated with Pathfinder, a national pilot project run by a consortium of five expert partners that aims to establish comprehensive health practice in relation to DA and Violence Against Women & Girls in Acute Hospital Trusts, MH Trusts and Primary Care. In Southampton, Pathfinder has funded two domestic and sexual abuse (DSA) advocates to both train MH staff and take a small caseload of MH service users who are experiencing abuse.MethodWe conducted a baseline survey of staff confidence across the following domains:Knowing the legal definition of DA,The process used to escalate a DA concern,How to make a referral,How to complete DASH forms,How and when to refer to Pathfinder,What the following acronyms mean: PIPPA, MAPPA, MARAC, IDVA, DASH,What HRDA and MASH mean,How to ask about DA,Who to signpost service users to if they make a disclosure, and when to involve the police.We presented the survey results at the regional Pathfinder strategic group, with Trust management representatives present. This project fits within the strategic group's sustainability aims to increase DA awareness and safeguarding processes across the Trust.The Pathfinder funded DSA Advisors delivered a four-hour training package targeting the surveyed questions and wider information on DA. We then re-surveyed to see if staff confidence had increased. We are currently analyzing the number of referrals to the Pathfinder service pre- and post-training.ResultStaff confidence increased across all domains following the training (% mean increase): Qs1 (35%), Qs2 (9%), Qs3 (45%), Qs4 (81%), Qs5 (25%), Qs6 (49%), Qs7 (89%), Qs8 (62%) and Qs9 (48%).We have now arranged a bi-monthly drop-in at the CMHT by the DSA advisor who provided the training, to embed the link between the services and maintain staff confidence. We will circulate these results to advocate that this training is provided across the Trust.

The challenge of change fatigue on workplace mental health

2020 ◽  
Vol 19 (5) ◽  
pp. 199-203
Author(s):  
Jan Bruce ◽  
Lucy English
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Behavioral Health ◽  
Health Issues ◽  
Workplace Issues ◽  
Content Type ◽  
Extreme Stress ◽  
Workplace Mental Health ◽  
Mental Health Issues ◽  
The Impact

Purpose Change and “change fatigue” were contributing to a spectrum of workplace issues – from extreme stress and burnout – to rising mental health issues even before the impact of COVID-19. This paper aims to examine why identifying mental and behavioral health issues had become a top priority for some employers and explore the negative impacts mental health issues present to organizations. Design/methodology/approach To gain this additional insight and data, meQuilibrium partnered with Employer Health Innovation Roundtable (EHIR) to hold a series of four workshops and focus groups, in the Fall of 2019 with 37 participating EHIR members representing large employers. The authors also gathered data through a short survey instrument. The discussions and the survey focused on the current mental and behavioral health challenges being faced by their organizations and what innovations are being put in place or will need to be put in place as part of a future integrated workforce strategy. Findings A key, and foundational, finding was that among these human resource (HR) leaders there was a view shared by 97% of survey respondents that the workplace was facing a greater mental health challenge than previously. Hundred per cent of participants agreed that the success of a workplace mental health solution will now require highly personalized, whole-person care across the full range of problems from mild to severe and will need to include not just the employee but also their spouse/partner and children. Originality/value While identifying mental and behavioral health issues had become a top priority for some employers even before the pandemic, meQuilibrium believed there was a need for more clarity as to how the HR professionals were viewing the urgency of the situation. This study examines key stakeholders in their organizations, the effectiveness of their current solutions and what new approaches to employee mental health they were considering. This paper includes original data compiled through workshops and focus groups.

CHAOS: A Co-Creation

2020 ◽  
Vol 7 (1) ◽  
pp. 205-223
Author(s):  
Hannah Waldron ◽  
Steve Braund
Keyword(s):  
Mental Health ◽  
Social Services ◽  
Creative Process ◽  
Life Story ◽  
Mental Healthcare ◽  
Self Esteem ◽  
Service Users ◽  
Health Issues ◽  
Critical Account ◽  
Collective Empowerment

This is a critical account of a year-long collaboration between MA Authorial Illustration students and service users of a social services organization and mental healthcare provider, The CHAOS Group (Community Helping All Of Society), with the aim of communicating the journey of those experiencing mental health issues and the efficacy of authorial illustration in promoting wellbeing. Central to the project was the production of the book CHAOS: A Co-Creation, and this article describes the book’s development and the experience of working in the co-creation mode. Drawing upon research methods in narrative and authorial illustration, the article explores the potential of authorial illustration to serve as a tool for benefitting mental health: could an illustrational mindset ‐ one rooted within personal authorship ‐ bring out those personal voices, rekindling a sense of worth and self-esteem? At the heart of the project was the concept of shared creative process, a ‘thinking-through-making’ in which weekly creative sessions allowed each of the participants’ individual voices to emerge and feel empowered through a gradual encouragement to author personal stories. Alongside the fostering of individual authorial voices through illustration, the article describes how, through a non-hierarchical co-creation process, we witnessed a collective empowerment. The article draws upon the recent research-based publication Co-Creation (in France) and draws on the notion from social psychology that there seems to be a sense in which narrative, rather than referring to ‘reality’, may in fact create or constitute it, as when ‘fiction’ creates a ‘world’ of its own: empowering each individual to author their own life-story (Jerome Bruner 1991: 1‐21).

scholarly journals Training to enhance user and carer involvement in mental health-care planning: the EQUIP research programme including a cluster RCT

2019 ◽  
Vol 7 (9) ◽  
pp. 1-140 ◽  
Author(s):  
Karina Lovell ◽  
Penny Bee ◽  
Peter Bower ◽  
Helen Brooks ◽  
Patrick Cahoon ◽  
...  
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Service User ◽  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Training Intervention ◽  
Service Users ◽  
Care Planning ◽  
Audit Tool ◽  
Patient Reported

Background Service users and carers using mental health services want more involvement in their care and the aim of this research programme was to enhance service user and carer involvement in care planning in mental health services. Objectives Co-develop and co-deliver a training intervention for health professionals in community mental health teams, which aimed to enhance service user and carer involvement in care planning. Develop a patient-reported outcome measure of service user involvement in care planning, design an audit tool and assess individual preferences for key aspects of care planning involvement. Evaluate the clinical effectiveness and the cost-effectiveness of the training. Understand the barriers to and facilitators of implementing service user- and carer-involved care planning. Disseminate resources to stakeholders. Methods A systematic review, focus groups and interviews with service users/carers/health professionals informed the training and determined the priorities underpinning involvement in care planning. Data from focus groups and interviews were combined and analysed using framework analysis. The results of the systematic review, focus groups/interviews and a review of the training interventions were synthesised to develop the final training intervention. To develop and validate the patient-reported outcome measure, items were generated from focus groups and interviews, and a psychometric analysis was conducted. Patient-reported outcome measure items and a three-round consensus exercise were used to develop an audit tool, and a stated preference survey was undertaken to assess individual preferences for key aspects of care planning. The clinical effectiveness and cost-effectiveness of the training were evaluated using a pragmatic cluster trial with cohort and cross-sectional samples. A nested longitudinal qualitative process evaluation using multiple methods, including semistructured interviews with key informants involved locally and nationally in mental health policy, practice and research, was undertaken. A mapping exercise was used to determine current practice, and semistructured interviews were undertaken with service users and mental health professionals from both the usual-care and the intervention arms of the trial at three time points (i.e. baseline and 6 months and 12 months post intervention). Results The results from focus groups (n = 56) and interviews (n = 74) highlighted a need to deliver training to increase the quality of care planning and a training intervention was developed. We recruited 402 participants to develop the final 14-item patient-reported outcome measure and a six-item audit tool. We recruited 232 participants for the stated preference survey and found that preferences were strongest for the attribute ‘my preferences for care are included in the care plan’. The training was delivered to 304 care co-ordinators working in community mental health teams across 10 NHS trusts. The cluster trial and cross-sectional survey recruited 1286 service users and 90 carers, and the primary outcome was the Health Care Climate Questionnaire. Training was positively evaluated. The results showed no statistically significant difference on the primary outcome (the Health Care Climate Questionnaire) (adjusted mean difference –0.064, 95% confidence interval –0.343 to 0.215; p = 0.654) or secondary outcomes at the 6-month follow-up. Overall, the training intervention was associated with a net saving of –£54.00 (95% confidence interval –£193.00 to £84.00), with a net quality-adjusted life-year loss of –0.014 (95% confidence interval –0.034 to 0.005). The longitudinal process evaluation recruited 54 service users, professionals and carers, finding a failure of training to become embedded in routine care. Limitations Our pragmatic study was designed to improve service user and care involvement in care planning among routine community mental health services. We intervened in 18 sites with > 300 care co-ordinators. However, our volunteer sites may not be fully representative of the wider population, and we lacked data with which to compare our participants with the eligible population. Conclusions We co-developed and co-delivered a training intervention and developed a unidimensional measure of service user and carer involvement in care planning and an audit tool. Despite a high level of satisfaction with the training, no significant effect was found; therefore, the intervention was ineffective. There was a failure of training to become embedded and normalised because of a lack of organisational readiness to accept change. Working with NHS trusts in our ‘Willing Adopters’ programme with enhanced organisational buy-in yielded some promising results. Future work Research should focus on developing and evaluating new organisational initiatives in addition to training health-care professionals to address contextual barriers to service and carer involvement in care planning, and explore co-designing and delivering new ways of enhancing service users’ and carers’ capabilities to engage in care planning. Trial registration Current Controlled Trials ISRCTN16488358. Funding This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 7, No. 9. See the NIHR Journals Library website for further project information.

scholarly journals Cross cultural and global uses of a digital mental health app: results of focus groups with clinicians, patients and family members in India and the United States

2021 ◽  
Vol 8 ◽  
Author(s):  
Elena Rodriguez-Villa ◽  
Abhijit R. Rozatkar ◽  
Mohit Kumar ◽  
Vikram Patel ◽  
Ameya Bondre ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Focus Groups ◽  
Digital Health ◽  
Phase 1 ◽  
Family Members ◽  
The United States ◽  
Mental Illnesses ◽  
Human Interaction ◽  
Specific Feedback

Abstract Background Despite significant advancements in healthcare technology, digital health solutions – especially those for serious mental illnesses – continue to fall short of their potential across both clinical practice and efficacy. The utility and impact of medicine, including digital medicine, hinges on relationships, trust, and engagement, particularly in the field of mental health. This paper details results from Phase 1 of a two-part study that seeks to engage people with schizophrenia, their family members, and clinicians in co-designing a digital mental health platform for use across different cultures and contexts in the United States and India. Methods Each site interviewed a mix of clinicians, patients, and their family members in focus groups (n = 20) of two to six participants. Open-ended questions and discussions inquired about their own smartphone use and, after a demonstration of the mindLAMP platform, specific feedback on the app's utility, design, and functionality. Results Our results based on thematic analysis indicate three common themes: increased use and interest in technology during coronavirus disease 2019 (COVID-19), concerns over how data are used and shared, and a desire for concurrent human interaction to support app engagement. Conclusion People with schizophrenia, their family members, and clinicians are open to integrating technology into treatment to better understand their condition and help inform treatment. However, app engagement is dependent on technology that is complementary – not substitutive – of therapeutic care from a clinician.

scholarly journals Perceptions of the social worker role in adult community mental health teams in England

2020 ◽  
pp. 147332502092408
Author(s):  
Michele Abendstern ◽  
Jane Hughes ◽  
Mark Wilberforce ◽  
Karen Davies ◽  
Rosa Pitts ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Work ◽  
Community Mental Health ◽  
Social Workers ◽  
Social Model ◽  
Service Users ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
The Social

There is a growing recognition of the importance of the social work contribution within community mental health services. However, although many texts describe what the mental health social work contribution should be, little empirical evidence exists about their role in practice and the difference it might make to service users. This qualitative study sought to articulate this contribution through the voices of social workers and their multidisciplinary colleagues via focus group discussions across four English Mental Health Trusts. These considered the impact of the social worker on the service user. Thematic analysis resulted in the identification of three over-arching themes: social workers own perceptions of their contribution situated within the social model; the high value their colleagues placed on social work support and leadership in a range of situations and the concerns for service users if social workers were withdrawn from teams. Key findings were that social workers are the only professional group to lead on the social model; that this model enhances the whole teams’ practice and is required if service users are to be offered support that promotes long-term recovery and that without social workers, the community mental health team offer would be more transactional, less timely, with the potential for the loss of the service users’ voice. If social work is to make a full contribution to community mental health team practice, it must be clearly understood and provided with the support to enable social workers to operate to their full potential.

Recognising mental health issues – Episode 5 ‘Autism, a parents guide’ with Dr. Ann Ozsivadjian

2020 ◽  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Health Issues ◽  
Autistic Children ◽  
Children And Young People ◽  
Mental Health Issues

Ann discusses anxiety in autistic children and young people, why mental health issues often go untreated and if depression presents differently in autism. Includes transcription, and links.

Dignity and respect

2018 ◽  
pp. 83-100
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Professional Identity ◽  
Communication Skills ◽  
Service Users ◽  
Clinical Team ◽  
Shared Decision ◽  
Health Issues ◽  
Individualized Care ◽  
Mental Health Issues

More than any other concept, ‘dignity’ captures the philosophical and professional essence of nursing. This chapter looks at how language and communication can play a pivotal role in the provision of dignified, respectful, and compassionate care. It is suggested that the promotion of dignity is a product of the professional identity of nurses and the healthcare culture within which care is enacted, acknowledging that core values need to be shared by the clinical team. Emphasis is given to practical ways nurses can utilize communication skills and take account of the physical environment, to sustain the emotional and humanistic components of caring about people, as well as for them. An important part of this process is valuing each person and working with them to develop individualized care based on shared decision-making. For certain groups of service users, there are additional challenges, and attention is given to communicating with older people, those who live with dementia, people with a learning disability, and individuals who have mental health issues or experience psychological distress.

Trust and psychosis services: Bridging the gap between managing risk and meeting need

2011 ◽  
Vol 26 (S2) ◽  
pp. 754-754
Author(s):  
P. Brown ◽  
M. Calnan
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Users ◽  
Healthcare Outcomes ◽  
Structured Interviews ◽  
Mental Health Team ◽  
Quality Healthcare ◽  
Potential Benefits ◽  
Managing Risk

IntroductionResearch suggests that trust is vital for quality healthcare and effective outcomes. Trust becomes necessary in conditions of vulnerability and uncertainty. These conditions may be especially relevant to the experience and treatment of mental illness - not least psychosis. There currently exists a paucity of research into trust and mental health services.Aims and objectivesTo develop an understanding of trust as it relates to psychosis services and their users. To identify practical contexts where trust may be particularly relevant and where research may inform policy, service organization and individual practice.MethodSemi-structured interviews were carried out with 21 stakeholders - service-users, professionals, managers, carers - across 3 different types of service working with people experiencing psychosis: early intervention; assertive outreach; and a more standard community mental health team.FindingsTrust appears to be salient and yet problematic for mental health services, not least in terms of approachability, disclosure and cooperation with treatment programmes. Organizing services around understandings of trust, rather than risk, may be more effective both at meeting need and managing risk.ConclusionsThrough an improved understanding of trust and its effect on the engagement of service-users, there are clear potential benefits for mental health services through an enhanced ability to facilitate access and develop effective cooperation towards healthcare outcomes.

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