scholarly journals A qualitative comparison of experiences of specialist mother and baby units versus general psychiatric wards

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jessica Griffiths ◽  
Billie Lever Taylor ◽  
Nicola Morant ◽  
Debra Bick ◽  
Louise M. Howard ◽  
...  

Abstract Background Mother and baby units (MBUs) are an inpatient mental health service where women experiencing acute severe postpartum psychiatric difficulties can be admitted with their babies. They are currently viewed as best practice in the UK and elsewhere. However, as service provision is fragmented, some women residing in areas without MBUs are admitted to acute general psychiatric wards without their infants. This study aimed to compare qualitatively experiences of these two service types from the perspectives of women and clinicians. Methods Semi-structured interviews were conducted with fifteen women who received treatment for perinatal mental health problems on a general psychiatric ward and/or MBU in England. Two focus groups were also conducted, one with MBU staff (n = 11) and one with acute ward staff (n = 6). Data were analysed thematically. Results Women generally preferred being co-admitted with their baby to an MBU over lone admission to a general psychiatric ward. Women and clinicians felt that MBUs provided more perinatally-focused, family-centred care, and were better-equipped to meet women’s needs. General wards were reported by women and staff to lack the necessary facilities and expertise to support perinatal women adequately, while separation of mothers and babies was often experienced by women as traumatic and detrimental to recovery. However, some areas for improvement were also identified across both service types, particularly relating to difficulties transitioning home post-discharge, inadequate support for family members, staffing issues and access problems (with MBUs). Conclusions Findings suggest that specialist perinatal inpatient care is considered preferable to generic care in the perinatal period from both service user and staff perspectives. Increased collaboration between perinatal and non-perinatal services could help improve perinatal expertise on general psychiatric wards, while further expansion of perinatal services (e.g. to cater for women currently considered too high risk for MBUs and for those discharged from inpatient settings) could tackle other shortfalls in care.

Author(s):  
Tinne Nuyts ◽  
Sarah Van Haeken ◽  
Neeltje Crombag ◽  
Binu Singh ◽  
Susan Ayers ◽  
...  

Challenges during the perinatal period can lead to maternal distress, negatively affecting mother-infant interaction. This study aims to retrospectively explore the experiences and needs regarding professional support of mothers with difficulties in mother-infant interaction prior to their admission to an infant mental health day clinic. In-depth semi-structured interviews were conducted with 13 mothers who had accessed an infant mental health day clinic because of persistent severe infant regulatory problems impairing the wellbeing of the infant and the family. Data were transcribed and analyzed using the Qualitative Analysis Guide of Leuven (QUAGOL). Three themes were identified: ‘experience of pregnancy, birth, and parenthood’; ‘difficult care paths’; and ‘needs and their fulfillment’. The first theme consisted of three subthemes: (1) ‘reality does not meet expectations’, (2) ‘resilience under pressure’, and (3) ‘despair’. Mothers experienced negative feelings that were in contradiction to the expected positive emotions associated with childbirth and motherhood. Resilience-related problems affected the mother-child relationship, and infants’ regulatory capacities. Determined to find solutions, different healthcare providers were consulted. Mothers’ search for help was complex and communication between healthcare providers was limited because of a fragmented care provision. This hindered the continuity of care and appropriate referrals. Another pitfall was the lack of a broader approach, with the emphasis on the medical aspects without attention to the mother-child dyad. An integrated care pathway focusing on the early detection of resilience-related problems and sufficient social support can be crucial in the prevention and early detection of perinatal and infant mental health problems.


Author(s):  
Anja Čuš ◽  
Julian Edbrooke-Childs ◽  
Susanne Ohmann ◽  
Paul L. Plener ◽  
Türkan Akkaya-Kalayci

Nonsuicidal self-injury (NSSI) is a major mental health problem associated with negative psychosocial outcomes and it most often starts in early adolescence. Despite this, adolescents are rarely involved in informing the development of interventions designed to address their mental health problems. This study aimed to (1) assess adolescents’ needs and preferences about future interventions that are delivered through smartphones and (2) develop a framework with implications for designing engaging digital mental health interventions. Fifteen adolescent girls, aged 12–18 years, who met diagnostic criteria for a current NSSI disorder and were in contact with mental health services, participated in semi-structured interviews. Following a reflexive thematic analysis approach, this study identified two main themes: (1) Experiences of NSSI (depicts the needs of young people related to their everyday experiences of managing NSSI) and (2) App in Context (portrays preferences of young people about smartphone interventions and reflects adolescents’ views on how technology itself can improve or hinder engaging with these interventions). Adolescent patients expressed interest in using smartphone mental health interventions if they recognize them as helpful, relevant for their life situation and easy to use. The developed framework suggests that digital mental health interventions are embedded in three contexts (i.e., person using the intervention, mental health condition, and technology-related factors) which together need to inform the development of engaging digital resources. To achieve this, the cooperation among people with lived experience, mental health experts, and human computer interaction professionals is vital.


2021 ◽  
Author(s):  
Claire M Ghetti ◽  
Bente Johanne Vederhus ◽  
Tora Söderström Gaden ◽  
Annette K Brenner ◽  
Łucja Bieleninik ◽  
...  

Abstract Premature infants and their parents experience significant stress during the perinatal period. Music therapy (MT) may support maternal–infant bonding during this critical period, but studies measuring impact across the infant’s first year are lacking. This nonrandomized feasibility study used quantitative and qualitative methods within a critical realist perspective to evaluate the feasibility, acceptability, and suitability of the treatment arm of the Longitudinal Study of music Therapy’s Effectiveness for Premature infants and their caregivers (LongSTEP) (NCT03564184) trial with a Norwegian cohort (N = 3). Families were offered MT emphasizing parent-led infant-directed singing during neonatal intensive care unit (NICU) hospitalization and across 3 months post-discharge. We used inductive thematic analysis of semi-structured interviews with parents at discharge from NICU and at 3 months and analyzed quantitative variables descriptively. Findings indicate that: (1) parents of premature infants are willing to participate in MT research where parental voice is a main means of musical interaction; (2) parents are generally willing to engage in MT in NICU and post-discharge phases, finding it particularly interesting to note infant responsiveness and interaction over time; (3) parents seek information about the aims and specific processes involved in MT; (4) the selected self-reports are reasonable to complete; and (5) the Postpartum Bonding Questionnaire appears to be a suitable measure of impaired maternal–infant bonding. Parents reported that they were able to transfer resources honed during MT to parent–infant interactions outside MT and recognized parental voice as a central means of building relation with their infants. Results inform the implementation of a subsequent multinational trial that will address an important gap in knowledge.


2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Ousman Bajinka

Following childbirth, with a psychosis and associated mood disturbance, Postpartum Psychosis (PPP) is studied to be a severe mental health condition. PPP affects 1 to 2 per 1000 women among the psychiatric emergency. To curb this severe disorder, acute clinical intervention is warranted. Maternal mental health problems with a focus on depression as the condition with the biggest public health impact should be the way forward. This review is set to look into the risk factors, prevention and management of PPP. Both the acute onset and recurrence of psychiatric illness are common during the perinatal period as women are more vulnerable during this period. Timely detection and effective management of perinatal psychiatric disorders are critical for managing PPP. Part of the management strategies for women who experience PPP is to seek guidance on further pregnancies and risk of illness. Since PPP is a disturbing complication of childbirth that carries high risks for both mother and child, if one is at high risk of developing puerperal psychosis, there is the need for a specialist care during pregnancy and be seen by a psychiatrist.


2016 ◽  
Vol 15 (1) ◽  
pp. 25-36 ◽  
Author(s):  
Christopher Harkins ◽  
Lisa Garnham ◽  
Aileen Campbell ◽  
Carol Tannahill

Purpose – Previous research emphasises the need for preventative interventions to reduce mental health problems among disadvantaged children and adolescents. There is however little consensus concerning the delivery and impacts of such interventions particularly non-clinical, arts-based models delivered within community settings. The purpose of this paper is to begin to address this deficit through a qualitative assessment of the short- to medium-term impacts to participants’ mental and emotional wellbeing within Sistema Scotland’s Big Noise orchestral programme. Design/methodology/approach – Semi-structured interviews, observation, participant drawing exercise, participatory filmmaking, focus group and analysis of programme engagement were undertaken to examine the mental and emotional wellbeing impacts of the programme which are observable at this early stage of programme delivery and participants’ lives. Findings – The qualitative findings indicate that participation in the Big Noise programme enhances participant mental and emotional wellbeing in three ways; first, the happiness and enjoyment of taking part in the programme and orchestra, particularly from music making; second, the security, belonging and relationships fostered through participation; the quality of musician/participant relationship is important here as is programme design which enables support, routine and structure; and third, increased pride, confidence and self-esteem, as a result of acquiring difficult musical skills, receiving regular praise and having frequent opportunities to demonstrate these acquired skills through regular orchestral performances. Originality/value – There is little evidence or understanding of community-based, preventative, arts interventions like Big Noise: their delivery, their life-course impacts and their potential contribution to mental health and to addressing social and health inequalities. The causal pathways in the field are under-theorised. These early findings are important as they serve as an important basis from which to consider the programme’s wider and longer term impacts, which will be assessed through an on-going longitudinal, mixed method summative evaluation.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Johanna Frerichs ◽  
Jo Billings ◽  
Nick Barber ◽  
Anjie Chhapia ◽  
Beverley Chipp ◽  
...  

Abstract Background Loneliness is associated with negative outcomes, including increased mortality and is common among people with mental health problems. This qualitative study, which was carried out as part of a feasibility trial, aimed to understand what enables and hinders people with severe depression and/or anxiety under the care of secondary mental health services in the United Kingdom to participate in the Community Navigator programme, and make progress with feelings of depression, anxiety and loneliness. The programme consisted of up to ten meetings with a Community Navigator and three optional group sessions. Methods Semi-structured interviews were carried out with participants (n = 19) shortly after programme completion. A co-produced two-stage qualitative approach, involving narrative and reflexive thematic analysis, was undertaken by members of the study’s working group, which included experts by experience, clinicians and researchers. Results The narrative analysis showed that individuals have varied goals, hold mixed feelings about meeting other people and define progress differently. From the thematic analysis, six themes were identified that explained facilitators and challenges to participating in the programme: desire to connect with others; individual social confidence; finding something meaningful to do; the accessibility of resources locally; the timing of the programme; and the participant’s relationship with the Community Navigator. Conclusions We found that people with severe depression and/or anxiety supported by secondary mental health services may want to address feelings of loneliness but find it emotionally effortful to do so and a major personal challenge. This emotional effort, which manifests in individuals differently, can make it hard for participants to engage with a loneliness programme, though it was through facing personal challenges that a significant sense of achievement was felt. Factors at the individual, interpersonal and structural level, that enable or hinder an individual’s participation should be identified early, so that people are able to make the best use out of the Community Navigator or other similar programmes.


2018 ◽  
Vol 8 (2) ◽  
pp. 41 ◽  
Author(s):  
Marie Pier Rivest ◽  
Mélissa Roy ◽  
Nicolas Moreau ◽  
Aude Martel ◽  
Lilian Negura ◽  
...  

Previous research in sociology has shown that what is considered as sanity or mental health is described according to a social ideal. Mental health problems have been theorized as a deviance from such norms. Depression, in particular, has been the object of sociological contemplation due to its divergence from a Western social normativity focused on functionality, adaptation and productivity. This research adds to this body of work on depression as a deviation from social norms. It seeks to address a gap within the literature, by exploring the ways in which the “post-depressive” state may be defined in accordance with social norms. As such, it analyzes the links between “post-depression” and normality, from the perspective of individuals having lived with depression. 46 semi-structured interviews were conducted with Canadians individuals who have experienced depression. Results from our content analysis show that the absence of depression was often synonymous with normality and characterized by the following dimensions: a positive attitude; the potential to take action; functionality and performance; self-management; a positive relationship with others; and the notion of meaningful projects. Our results show that participants do not define the absence of depression following psychiatric or clinical indicators, as recorded in the DSM, and that they do not consider it to be a return to an anterior, pre-depression, state. Rather, post-depression is idealized, perceived as a state of unfailing conformity to social expectations and norms.


2020 ◽  
Author(s):  
Azizeh Alizadeh1 ◽  
Behnaz Dowran ◽  
maryam azizi ◽  
Seyed -Hossein Salimi

Abstract Background: Military personnel are likely to encounter mental health problems due to High-risk occupations associated with significant levels of psychological distress. The aim of the present study was to explore psychological distress experienced by Iranian military personnel. Methods: The present qualitative study was conducted on 15 Iranian military personnel. Purposeful sampling was used to select the participants and continued until data saturation was reached. Data were collected using semi-structured interviews and then the qualitative data were analyzed through direct content analysis. Results: By analyzing show 395 primary codes, 2 main categories, including demands and resources were extracted from the experiences of military members. The categories included several sub-categories, which were classified according to their significant characteristics. Findings of this study ascertain that different factors affect the military member’s psychological distress.Conclusions: Military organization and leaders should consider the factors of psychological distress that raised by specialists, and assign policies to improve their mental health. According to the present results, it is recommended that the process of psychological distress in military members be investigated further.


2020 ◽  
pp. 002076402095425 ◽  
Author(s):  
Maria Sundvall ◽  
David Titelman ◽  
Valerie DeMarinis ◽  
Liubov Borisova ◽  
Önver Çetrez

Background: Problems with social networks and social support are known to be associated with mental ill-health in refugees. Social support after migration promotes resilience. Aim: To study how Iraqi refugees who arrived in Sweden after the year 2000 perceived their social networks and social support, and to relate the observed network characteristics and changes to the refugees’ mental health and well-being. Method: Semi-structured interviews with 31 refugees, including questions on background and migration experiences, a biographical network map, and three health assessment scales. The findings were analysed with descriptive statistics and content thematic analysis. Results: The respondents’ networks were diminished. Social support was continued to be provided mainly by family members and supplemented by support from authorities. The main themes of the refugee experience of post-migration challenges were weakened social networks, barriers to integration and challenges to cultural and religious belonging. Failed reunion and worrying about relatives was described as particularly painful. Negative contacts with authority persons were often seen as humiliating or discriminating. Acquiring a new cultural belonging was described as challenging. At the same time, changing family and gender roles made it more difficult to preserve and develop the culture of origin. Traumatic experiences and mental health problems were common in this group. Family issues were more often than integration difficulties associated with mental health problems. Conclusion: In order to strengthen post-migration well-being and adaptation, authorities should support the refugees’ social networks. Clinicians need to address post-migration problems and challenges, including the meaning and function of social networks.


2019 ◽  
Vol 8 (3) ◽  
pp. 229-236 ◽  
Author(s):  
Stewart A. Vella

Mental health is one of the most prominent global burdens of disease among young people, while organized youth sport is one of the most popular activities for children and adolescents worldwide. Organized sport can be an engaging vehicle for the promotion of mental health, but participation also brings several meaningful risks and detriments for young people’s mental health. This paper contains a review of the evidence underpinning the relationships between sport participation and mental health during childhood and adolescence and also outlines the key areas of risk for mental health problems. Relevant theoretical frameworks are discussed, as are the key concepts underpinning 2 exemplar sport-based interventions to promote mental health and reduce the risk of mental health problems. Recommendations for best practice in organized youth sport are not available. However, relevant frameworks are outlined, from which administrators, coaches, and athletes can base the design and delivery of sport programs to be consistent with relevant theoretical and philosophical approaches such as the athlete-centered approach to youth sports.


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