scholarly journals Mental healthcare clinician engagement with point of care testing; a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joseph Butler ◽  
Simone de Cassan ◽  
Phil Turner ◽  
Belinda Lennox ◽  
Gail Hayward ◽  
...  

Abstract Background Point of Care Testing (POCT) is being increasingly used to augment the delivery of physical health care in a variety of settings, but their use in mental health has been limited. Research into understanding the barriers faced for successful implementation of POCT in these settings is lacking. We aimed to identify factors affecting engagement and implementation of POCT within mental health teams by exploring the attitudes to POCT, and the perceived impact POCT has on the practice of mental healthcare clinicians. Methods Alongside a study evaluating the impact of a point of care device in Community Mental Health Teams (CMHTs), qualitative interviews were carried out with CMHT clinicians using POCT as part of annual physical checks for patients with severe and enduring mental illness. Data were collected using semi-structured interviews and analysed using thematic analysis. Results Fifteen clinicians were interviewed across a range of professional backgrounds. Clinicians identified usability of the technology, positive impact on their patient’s experience and improved self-efficacy as drivers for successful implementation of POCT into their clinical practice. Issues with device functioning and the potential for a negative effect on the therapeutic relationship with their patients were identified as barriers. Level of physical heath training was not found to be a barrier by mental health professionals to using POCT. Conclusions Understanding barriers and drivers for engagement is important to allow co-production of POCT and guidelines to facilitate introduction of POCT into routine clinical practice.

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.


2021 ◽  
Author(s):  
Cristina Mendes-Santos ◽  
Francisco Nunes ◽  
Elisabete Weiderpass ◽  
Rui Santana ◽  
Gerhard Andersson

BACKGROUND Despite Digital Mental Health’s potential to provide cost-effective mental healthcare, its adoption in clinical settings is limited and little is known about the perspectives and practices of mental health professionals regarding its implementation or the factors influencing such perspectives and practices. OBJECTIVE The current study aimed at characterizing in-depth the perspectives and practices of mental health professionals regarding the implementation of Digital Mental Health and exploring the factors impacting such perspectives and practices. METHODS A qualitative study using in-depth semi-structured interviews with Portuguese mental health professionals (N=13) - psychologists and psychiatrists – was conducted. Transcribed interviews were thematically analysed. RESULTS Mental health professionals deemed important or engaged in the following practices during the implementation of Digital Mental Health: i) Indication evaluation; ii) Therapeutic contract negotiation; iii) Digital psychological assessment; iv) Technology setup and management; and v) Intervention delivery and follow-up. Low threshold accessibility and professionals' perceived duty to provide support to their clients facilitated the implementation of Digital Mental Health. Conversely, the lack of structured intervention frameworks; the unavailability of usable, validated, and affordable technology; and the absence of structured training programmes, inhibited Digital Mental Health’s implementation by mental health professionals. CONCLUSIONS The publication of practice frameworks, the development of evidence-based technology, and the delivery of structured training seem key to expedite implementation and encourage the sustained adoption of Digital Mental Health by mental health professionals.


2015 ◽  
Vol 20 (4) ◽  
pp. 232-241 ◽  
Author(s):  
Eleanor Bradley

Purpose – The purpose of this paper is to provide a brief overview of the literature to date which has focused on co-production within mental healthcare in the UK, including service user and carer involvement and collaboration. Design/methodology/approach – The paper presents key outcomes from studies which have explicitly attempted to introduce co-produced care in addition to specific tools designed to encourage co-production within mental health services. The paper debates the cultural and ideological shift required for staff, service users and family members to undertake co-produced care and outlines challenges ahead with respect to service redesign and new roles in practice. Findings – Informal carers (family and friends) are recognised as a fundamental resource for mental health service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited by mental health professionals or taken into account during decision making. This issue is considered alongside new policy recommendations which advocate the development of co-produced services and care. Research limitations/implications – Despite the launch of a number of initiatives designed to build on peer experience and support, there has been a lack of attention on the differing dynamic which remains evident between healthcare professionals and people using mental health services. Co-production sheds a light on the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer recovery workers across England, there has been little research or service development designed to focus explicitly on this particular dynamic. Practical implications – Despite these challenges, coproduction in mental healthcare represents a real opportunity for the skills and experience of family members to be taken into account and could provide a mechanism to achieve the “triangle of care” with input, recognition and respect given to all (service users, carers, professionals) whose lives are touched by mental distress. However, lack of attention in relation to carer perspectives, expertise and potential involvement could undermine the potential for coproduction to act as a vehicle to encourage person-centred care which accounts for social in addition to clinical factors. Social implications – The families of people with severe and enduring mental illness assume a major responsibility for the provision of care and support to their relatives over extended time periods (Rose et al., 2004). Involving carers in discussions about care planning could help to provide a wider picture about the impact of mental health difficulties, beyond symptom reduction. The “co-production of care” reflects a desire to work meaningfully and fully with service users and carers. However, to date, little work has been undertaken in order to coproduce services through the “triangle of care” with carers bringing their own skills, resources and expertise. Originality/value – This paper debates the current involvement of carers across mental healthcare and debates whether co-production could be a vehicle to utilise carer expertise, enhance quality and satisfaction with mental healthcare. The critique of current work highlights the danger of increasing expectations on service providers to undertake work aligned to key initiatives (shared decision-making, person-centred care, co-production), that have common underpinning principles but, in the absence of practical guidance, could be addressed in isolation rather than as an integrated approach within a “triangle of care”.


2016 ◽  
Vol 76 (2) ◽  
pp. 244-256 ◽  
Author(s):  
Louise Doyle ◽  
Jan de Vries ◽  
Agnes Higgins ◽  
Brian Keogh ◽  
Padraig McBennett ◽  
...  

Objectives: This study evaluated the impact of a one-day mental health Wellness Workshop on participants’ mental health and attitudes towards mental health. Design: Convergent, longitudinal mixed-methods approach. Setting: The study evaluated Wellness Workshops which took place throughout the Republic of Ireland. Method: Questionnaires measuring hope, mental health self-efficacy, attitudes towards mental health and perceived impact on wellbeing were administered to participants before the workshop ( n = 415), 1 week after ( n = 221) and 3 months after ( n = 110). Semi-structured interviews were carried out with 24 participants to generate a more in-depth understanding of the impact of the workshop. Results: Quantitative findings relating to hope, mental health self-efficacy and attitudes towards mental health did not identify statistically significant changes; however, participants’ perceptions of the effect of the workshop on wellbeing suggested a positive impact which was maintained over time. Qualitative findings, however, suggested that hope and self-efficacy were improved and the simplicity and utility of the wellness strategies disseminated in the workshop, in addition to the warmth and openness of the narrative approach used by the facilitators, were central to the perceived positive impact. Conclusion: This evaluation demonstrates the potential for wellness interventions to have a subjective improvement in wellbeing in members of the general public.


2021 ◽  
Vol Volume 5 (1) ◽  
pp. 76-85
Author(s):  
Raazia Israr ◽  
Dr. Mamoona Ismail Loona ◽  
DR. Mazhar Iqbal Bhatti

The present research examined the impact of frustration intolerance on Burnout among Mental Health Professionals. A total of 200 mental health professionals (n=100 males and n=100 females) from different hospitals, clinics and NGOs of Rawalpindi, Islamabad and Lahore, participated in this study. Mental health professionals that participated in present study were psychologists (n=50), psychiatrists (n=50), counsellors (n=50), and occupational therapists (n=50). Maslach burnout inventory was used to measure burnout scores. Frustration discomfort scale was used to measure frustration intolerance. Simple linear regression was used to check the impact of frustration intolerance on burnout. Results indicated that frustration intolerance has a positive impact on burnout. Present research further studied gender differences in burnout and frustration intolerance. Females’ scores were higher on burnout and frustration intolerance measures as compared to males.


Author(s):  
Howard N. Garb

How do clinicians arrive at diagnostic decisions? In most cases the decision is not made following formal criteria, but by intuition. In addition, routine interviews are often narrow and the feedback gleaned from patients is inadequate. Yet it is not clear if screening helps or hinders clinical judgment. It might be that only clinicians who have low confidence and interviewing and diagnostic skills are open to the use of and actually helped by diagnostic tools. To provide a theoretical framework for understanding why it is difficult for physicians to detect depression in primary care settings, a broad array of research in the mental health fields can be described. For example, more than 1,000 studies have been conducted on clinical judgment in the area of mental health practice, and the results from these studies can be used to illuminate the challenges physicians face in judging whether a patient is clinically depressed and can benefit from treatment. In this chapter, results on clinical judgment will be described. A second topic will also be briefly discussed. Results from research on clinical judgment would seem to indicate that screening should be of value. Yet, as noted in Chapter 7, stand-alone screening programs have added little or nothing to outcomes. Reasons for this unexpected result will be explored. Three topics will be discussed: (1) narrowness of interviews, (2) nature of patient feedback, and (3) the cognitive processes of clinicians. Depression goes undetected because in many cases physicians do not ask patients if they have symptoms of a depressive mood disorder.3 To place this in context, it can be noted that mental health professionals also often do not ask patients about important symptoms and behaviors. Failure to inquire about depression in primary care settings can be viewed in the broader context of failure to inquire about important symptoms and events in mental health settings. Research on clinical judgment has demonstrated that lack of comprehensiveness is often a problem for interviews made in clinical practice. For example, in one study,4 mental health professionals saw patients in routine clinical practice, and afterwards research investigators conducted semi-structured interviews with the patients. Remarkably, the mental health professionals had evaluated only about 50% of the symptoms that were recorded using the semi-structured interviews.


2018 ◽  
Vol 26 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Barbara Murphy ◽  
Chris Gibbs ◽  
Kate Hoppe ◽  
Deepika Ratnaike ◽  
Harry Lovelock

Purpose The Mental Health Professionals Network (MHPN) was established to support and enhance collaborative care among health professionals working in primary mental healthcare. The MHPN has two primary arms: face-to-face network meetings and online webinars. The purpose of this paper is to investigate attitudinal and practice changes amongst health professionals after participation in MHPN’s network meetings. Design/methodology/approach In April 2016, an online survey was e-mailed to health professionals who had attended at least one network meeting during 2015. The survey asked about practice changes across seven key areas relating to increased awareness of and interaction with professionals from other disciplines. Interdisciplinary differences were investigated using the χ2 statistic (p<0.05). Findings A total of 1,375 health professionals participated in the survey. For each of the seven practice changes investigated, between 74 and 92 per cent of respondents had made the change. Those who attended more network meetings were significantly more likely to have made changes. General practitioners were significantly more likely than other professionals to have made changes. Research limitations/implications Attendance at MHPN network meetings has a positive impact on health professionals’ attitudes and practices towards a more collaborative approach to mental healthcare. Originality/value MHPN is a unique, national platform successfully delivering opportunities for interdisciplinary professional development in the primary mental health sector. The model is unique, cost-effective, practitioner driven and transferable to other settings.


2016 ◽  
Vol 33 (S1) ◽  
pp. S176-S176 ◽  
Author(s):  
M. Pinto da Costa ◽  
E. Biskup ◽  
A. Giurgiuca ◽  
J. Kaaja ◽  
Ö. Kilic ◽  
...  

IntroductionWorkforce migration of mental health professionals seems to have a significant impact on mental health services, both in the donor and host countries. Nevertheless, information on migration in junior doctors within Europe is very limited. Therefore, the European Federation of Psychiatric Trainees (EFPT) has conducted the Brain Drain Survey.ObjectivesTo identify, in junior doctors training in psychiatry, the impact of international short-term mobility experiences, towards a future workforce migration across countries, exploring its patterns and reasons.MethodsIn this cross-sectional international study, data were collected from 2281 psychiatric trainees in 33 countries. All participants answered to the EFPT Brain Drain Survey reporting their attitudes and experiences on mobility and migration.ResultsOnly one-third of the trainees had a short-mobility experience in their lifetime, being education the main purpose for these experiences. Interestingly, the main predictors for future migratory tendency were not only the having a income and being dissatisfied with this income, but having a short-mobility experience. In fact, people that had short-mobility experiences were two times more likely to express a migratory tendency. Trainees that went abroad were predominantly satisfied with their experiences, reporting that these influenced their attitudes towards migration, positively.ConclusionsThese findings show that short-term mobility has a positive impact into future long-term migration, increasing its probability.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2021 ◽  
Vol 12 ◽  
Author(s):  
Joschka Haltaufderheide ◽  
Jakov Gather ◽  
Georg Juckel ◽  
Jan Schildmann ◽  
Jochen Vollmann

Background: Ethics consultation has been advocated as a valuable tool in ethically challenging clinical situations in healthcare. It is paramount for the development and implementation of clinical ethics support services (CESS) in psychiatry that interventions can address the moral needs of mental health professionals adequately and communicate the nature of the services clearly. This study explores types of ethical problems and concepts of ethical expertise as core elements of CESS in mental healthcare with the aim of contributing to the further development of ethical support in psychiatry.Methods: We conducted 13 semi-structured interviews with mental health professionals and CESS members and triangulated them with four non-participant observations of ethical case consultations in psychiatry. Data were analyzed according to principles of grounded theory and are discussed from a normative perspective.Results: The analysis of the empirical data reveals a typology of three different ethical problems professionals want to refer to CESS: (1) Dyadic problems based on the relationship between patients and professionals, (2) triangular problems, where a third party is involved and affected as a side effect, and (3) problems on a systemic level. However, CESS members focus largely on types (1) and (2), while the third remains unrecognized or members do not feel responsible for these problems. Furthermore, they reflect a strong inner tension connected to their role as ethical experts which can be depicted as a dilemma. On the one hand, as ethically trained people, they reject the idea that their judgments have expert status. On the other hand, they feel that mental health professionals reach out for them to obtain guidance and that it is their responsibility to offer it.Conclusion: CESS members and professionals in mental healthcare have different ideas of the scope of responsibility of CESS. This contains the risk of misunderstandings and misconceptions and may affect the quality of consultations. It is necessary to adapt concepts of problem solving to practitioners' needs to overcome these problems. Secondly, CESS members struggle with their role as ethical experts. CESS members in psychiatry need to develop a stable professional identity. Theoretical clarification and practical training are needed.


PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0256077
Author(s):  
Camila Perera ◽  
Kelly A. McBride ◽  
Áine Travers ◽  
Pia Tingsted Blum ◽  
Nana Wiedemann ◽  
...  

Background Despite recent advances in the development and provision of mental health and psychosocial support (MHPSS) in humanitarian settings, inadequate supervision remains a significant barrier to successful implementation. The present study sought to incorporate broad stakeholder engagement as part of the first phase of development of a new Integrated Model for Supervision (IMS) for use within MHPSS and protection services in humanitarian emergencies. Methods Semi-structured interviews were conducted with 26 global mental health professionals. Data was analysed thematically, using a combination of inductive and deductive methods. Codes and themes were validated through co-author cross-checks and through a webinar with an expert advisory group. Results Results reinforce the importance of effective supervision to enhance the quality of interventions and to protect supervisees’ wellbeing. Participants generally agreed that regular, supportive supervision on a one-to-one basis and as a separate system from line management, is the ideal format. The interviews highlight a need for guidance in specific areas, such as monitoring and evaluation, and navigating power imbalances in the supervisory relationship. Several approaches to supervision were described, including some solutions for use in low-resource situations, such as group, peer-to-peer or remote supervision. Conclusion An integrated model for supervision (IMS) should offer a unified framework encompassing a definition of supervision, consolidation of best practice, and goals and guidance for the supervisory process.


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