scholarly journals A paradigm shift: relationships in trauma-informed mental health services

2018 ◽  
Vol 24 (5) ◽  
pp. 319-333 ◽  
Author(s):  
Angela Sweeney ◽  
Beth Filson ◽  
Angela Kennedy ◽  
Lucie Collinson ◽  
Steve Gillard
Keyword(s):  
Mental Health ◽  
Service Providers ◽  
Mental Healthcare ◽  
Organisational Change ◽  
Public Health Issue ◽  
List Type ◽  
Service Users ◽  
Department Of Health ◽  
Trauma Informed ◽  
Highly Correlated

SUMMARYTrauma-informed approaches emerged partly in response to research demonstrating that trauma is widespread across society, that it is highly correlated with mental health and that this is a costly public health issue. The fundamental shift in providing support using a trauma-informed approach is to move from thinking ‘What is wrong with you?’ to considering ‘What happened to you?’. This article, authored by trauma survivors and service providers, describes trauma-informed approaches to mental healthcare, why they are needed and how barriers can be overcome so that they can be implemented as an organisational change process. It also describes how past trauma can be understood as the cause of mental distress for many service users, how service users can be retraumatised by ‘trauma-uninformed’ staff and how staff can experience vicariously the service user's trauma and can themselves be traumatised by practices such as restraint and seclusion. Trauma-informed mental healthcare offers opportunities to improve service users' experiences, improve working environments for staff, increase job satisfaction and reduce stress levels by improving the relationships between staff and patients through greater understanding, respect and trust.LEARNING OBJECTIVES•Appreciate broad-based definitions of trauma•Gain an understanding of what trauma-informed approaches are and why they have emerged, including the potential for (re)traumatisation in the mental health system•Consider how to practise trauma-informed approaches, including in ‘trauma-uninformed’ organisations, and the potential barriers to and opportunities from doing soDECLARATION OF INTERESTA. S. is funded by a National Institute for Health Research (NIHR) Post-Doctoral Fellowship. This article presents independent research partially funded by the NIHR. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health.

scholarly journals Reproductive and sexual health of women service users: what's the fuss?

2010 ◽  
Vol 16 (4) ◽  
pp. 279-280 ◽  
Author(s):  
Kathryn Abel ◽  
Sian Rees
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Sexual Health ◽  
Mental Healthcare ◽  
Health Needs ◽  
Service Users ◽  
Strategic Development ◽  
Department Of Health ◽  
Reproductive And Sexual Health ◽  
Women's Lives

SummaryNearly a decade ago, the Department of Health published its strategic development plan for mental healthcare for women. It focused on the ways in which mental health services for women should be configured to take account of the context of women's lives and the complexity of their health needs. This commentary argues that attention to the reproductive and sexual health of women in mental healthcare is at the centre of a gender-sensitive and modern mental health service.

scholarly journals Remote care for mental health: qualitative study with service users, carers and staff during the COVID-19 pandemic

2021 ◽  
Author(s):  
Elisa Liberati ◽  
Natalie Richards ◽  
Jennie Parker ◽  
Janet Willars ◽  
David Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Healthcare ◽  
List Type ◽  
Service Users ◽  
Diverse Range ◽  
Qualitative Interview Study ◽  
Mental Health Difficulties ◽  
Remote Care

ABSTRACTObjectivesTo explore the experiences of service users, carers and staff seeking or providing secondary mental health services during the COVID-19 pandemic.DesignQualitative interview study, co-designed with mental health service users and carers.MethodsWe conducted semi-structured, telephone or online interviews with a purposively constructed sample; a peer researcher with lived experience conducted and analysed interviews with service users. Analysis was based on the constant comparison method.SettingNHS secondary mental health services in England between June and August 2020.ParticipantsOf 65 participants, 20 had either accessed or needed to access English secondary mental healthcare during the pandemic; 10 were carers of people with mental health difficulties; 35 were members of staff working in NHS secondary mental health services during the pandemic.ResultsExperiences of remote care were mixed. Some service users valued the convenience of remote methods in the context of maintaining contact with familiar clinicians. Most participants commented that a lack of non-verbal cues and the loss of a therapeutic ‘safe space’ challenged therapeutic relationship building, assessments, and identification of deteriorating mental wellbeing. Some carers felt excluded from remote meetings and concerned that assessments were incomplete without their input. Like service users, remote methods posed challenges for clinicians who reported uncertainty about technical options and a lack of training. All groups expressed concern about intersectionality exacerbating inequalities and the exclusion of some service user groups if alternatives to remote care are lost.ConclusionsWhilst remote mental healthcare is likely to become increasingly widespread in secondary mental health services, our findings highlight the continued importance of a tailored, personal approach to decisions about remote mental healthcare. Further research should focus on which types of consultations best suit face-to-face interaction, and for whom and why, and which can be provided remotely and by which medium.ARTICLE SUMMARYStrengths and limitations of this studyStrengths include its qualitative approach in speaking to a large sample of participants with varied mental health difficulties, carers, and a diverse range of mental healthcare staff.Its novelty lies in a deep exploration of the views and experiences of remote mental healthcare during a pandemic.The methods are strengthened by the involvement of experts-by-experience and the use of peer research methods.We did not adopt a narrative method; the interviews were one-off conversations so we could not explore change as the pandemic progressed and people may have become accustomed to remote care.The study used remote methods to comply with UK lockdown regulations; this will have excluded some groups without the ability to engage remotely.

scholarly journals Remote care for mental health: qualitative study with service users, carers and staff during the COVID-19 pandemic

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e049210
Author(s):  
Elisa Liberati ◽  
Natalie Richards ◽  
Jennie Parker ◽  
Janet Willars ◽  
David Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Mental Healthcare ◽  
Well Being ◽  
Comparison Method ◽  
Service Users ◽  
Qualitative Interview Study ◽  
Remote Care

ObjectivesTo explore the experiences of service users, carers and staff seeking or providing secondary mental health services during the COVID-19 pandemic.DesignQualitative interview study, codesigned with mental health service users and carers.MethodsWe conducted semistructured, telephone or online interviews with a purposively constructed sample; a lived experience researcher conducted and analysed interviews with service users. Analysis was based on the constant comparison method.SettingNational Health Service (NHS) secondary mental health services in England between June and August 2020.ParticipantsOf 65 participants, 20 had either accessed or needed to access English secondary mental healthcare during the pandemic; 10 were carers of people with mental health difficulties; 35 were members of staff working in NHS secondary mental health services during the pandemic.ResultsExperiences of remote care were mixed. Some service users valued the convenience of remote methods in the context of maintaining contact with familiar clinicians. Most participants commented that a lack of non-verbal cues and the loss of a therapeutic ‘safe space’ challenged therapeutic relationship building, assessments and identification of deteriorating mental well-being. Some carers felt excluded from remote meetings and concerned that assessments were incomplete without their input. Like service users, remote methods posed challenges for clinicians who reported uncertainty about technical options and a lack of training. All groups expressed concern about intersectionality exacerbating inequalities and the exclusion of some service user groups if alternatives to remote care are lost.ConclusionsThough remote mental healthcare is likely to become increasingly widespread in secondary mental health services, our findings highlight the continued importance of a tailored, personal approach to decision making in this area. Further research should focus on which types of consultations best suit face-to-face interaction, and for whom and why, and which can be provided remotely and by which medium.

scholarly journals Delivering race equality in mental health services

2008 ◽  
Vol 14 (5) ◽  
pp. 326-329 ◽  
Author(s):  
Annie Lau
Keyword(s):  
Mental Health ◽  
Care Pathway ◽  
Action Plan ◽  
Good Practice ◽  
Mental Healthcare ◽  
Policy Initiatives ◽  
Pilot Survey ◽  
The Past ◽  
Department Of Health ◽  
Clinical Engagement

‘Delivering race equality’ is a 5-year action plan for tackling race inequalities in mental healthcare in England and Wales, based on the main themes of improved services, better community engagement and better information. The perception is that clinical teams have not been sufficiently engaged with the plan and progress is slow. This article shares insights from the author's work across government departments over the past 2 years and explores the potential for linking up different initiatives across the patient care pathway in support of the plan's delivery. A summary of conclusions from a pilot survey of consultant psychiatrists, commissioned by the Department of Health in June 2007, addresses the main controversial areas in the action plan, with suggestions for improvement. Areas for clinical engagement are identified that exploit new funding, investment and policy initiatives. Examples of good practice are offered.

Monitoring the physical health of individuals with serious mental illness

2008 ◽  
Vol 25 (3) ◽  
pp. 108-115
Author(s):  
Majella Cahill ◽  
Anne Jackson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Service ◽  
Physical Health ◽  
Serious Mental Illness ◽  
Health Monitoring ◽  
Service Providers ◽  
Psychiatric Service ◽  
Service Users ◽  
Effective Models

AbstractDeveloping effective models of identifying and managing physical ill health amongst mental health service users has become an increasing concern for psychiatric service providers. This article sets out the general professional and Irish statutory obligations to provide physical health monitoring services for individuals with serious mental illness. Review and summary statements are provided in relation to the currently available guidelines on physical health monitoring.

Neuro-reciprocity and vicarious trauma in psychiatrists

2018 ◽  
Vol 26 (4) ◽  
pp. 388-390 ◽  
Author(s):  
Sophie Isobel ◽  
Gavin Angus-Leppan
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
High Risk ◽  
Health Service ◽  
Vicarious Trauma ◽  
Vicarious Traumatization ◽  
Organizational Level ◽  
Service Users ◽  
Trauma Informed ◽  
The Brain

Objectives: This paper aims to briefly overview the processes of neuro-reciprocity relevant to vicarious traumatization of psychiatrists through their clinical roles. Conclusions: High rates of trauma in mental health service users, understanding of the effects of trauma on the brain and mechanisms of neuro-reciprocity in empathic attunement suggest that psychiatrists are at high risk of vicarious trauma. Preventing vicarious trauma at an organizational level through trauma-informed approaches is of paramount importance.

Health in a connected world

2020 ◽  
pp. 573-580
Author(s):  
Philippe Delespaul ◽  
Catherine van Zelst
Keyword(s):  
Mental Health ◽  
Virtual Reality ◽  
Lived Experience ◽  
Therapeutic Relationship ◽  
Social Relationships ◽  
Daily Life ◽  
Mental Healthcare ◽  
Well Being ◽  
Service Users ◽  
Changing World

This chapter is about a redesign of mental healthcare, as it evolves in a changing world. It focuses on digital transformations and their impact on social relationships, networks, and communities. It intends to demonstrate better responses to the needs of service users in society. It first defines terminologies to access the changing world and focus on how to understand health, recovery, and well-being in people with lived experience of psychosis. These central elements can be accessed or maintained using eHealth, including mHealth, virtual reality, and eCommunities. It also discuss strengths, challenges, and pitfalls in developing and applying innovative interventions in the context of daily life. It reviews these trends and how these relate to the therapeutic relationship in general, and the mental health practitioner’s role in particular.

scholarly journals Clinical practice guidelines: the priorities

1996 ◽  
Vol 20 (1) ◽  
pp. 40-42 ◽  
Author(s):  
Claire Palmer
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Royal College ◽  
Guideline Development ◽  
Service Users ◽  
Department Of Health ◽  
Health Community ◽  
Self Harm

The Clinical Practice Guidelines (CPG) Steering Group commissioned a survey to find out which areas of clinical practice the mental health community view as priority for the development of clinical practice guidelines (CPGs). Fifty per cent of all professionals and service users surveyed considered the assessment of risk and management of deliberate self-harm and dangerousness' a priority area for guideline development. These findings provided the basis for a successful bid to the Department of Health for the development of The Royal College of Psychiatrists' first CPG.

Should Programs Designed to Help IPV Survivors Screen for Mental Health–Related Problems

2016 ◽  
Vol 23 (5) ◽  
pp. 603-622 ◽  
Author(s):  
Catherine A. Simmons ◽  
Matthew J. Delaney ◽  
Leslie Lindsey ◽  
Anna Whalley ◽  
Olliette Murry-Drobot ◽  
...  
Keyword(s):  
Mental Health ◽  
Intimate Partner Violence ◽  
Data Analysis ◽  
Concept Mapping ◽  
Partner Violence ◽  
Service Providers ◽  
Intimate Partner ◽  
Health Related ◽  
Trauma Informed ◽  
Qualitative Responses

Qualitative responses that 187 service providers gave to a question assessing whether agencies designed to help intimate partner violence (IPV) survivors should screen for mental health-related problems were analyzed using a version of the concept mapping approach. Nine central clusters emerged from the data analysis, which can be linked to three underlying themes: how the identification of mental health-related problems (i.e., labeling) could be misused when working with IPV survivors, ways screening can be appropriately used to help IPV survivors, and barriers that prevent screening. Findings highlight the importance of trauma-informed approaches across all aspects of service delivery.

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).

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