Service users’ experiences of the impact of mental health crisis on social identity and social relations

2014 ◽  
Vol 1 ◽  
Author(s):  
Monika K. Gullslett ◽  
◽  
Hesook Suzie Kim ◽  
Marit Borg ◽  
◽  
...  
Keyword(s):  
Mental Health ◽  
Social Identity ◽  
Social Relations ◽  
Service Users ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
The Impact

scholarly journals Contribution of the voluntary sector to mental health crisis care in England: protocol for a multimethod study

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e019238 ◽  
Author(s):  
Karen Newbigging ◽  
John Mohan ◽  
James Rees ◽  
Jenny Harlock ◽  
Alex Davis
Keyword(s):  
Mental Health ◽  
National Survey ◽  
Local Authority ◽  
Voluntary Sector ◽  
Ethical Review ◽  
Service Users ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Crisis Care ◽  
The Impact

IntroductionTimely access to the right kind of support for people experiencing a mental health crisis can be problematic. The voluntary sector (VS) plays a key role in providing support and enabling access, but there is a knowledge gap concerning its contribution and interface with public services in mental health crisis care. This study aims to address this.Methods and analysisThe study has three empirical elements: (1) a national survey of voluntary sector organisations (VSOs) in England and national stakeholder interviews to develop a typology of organisations and interventions provided by VSOs; (2) detailed mapping of VS services in two regions through interviews and extending the national survey; (3) four case studies, identified from the regional mapping, of VS mental health crisis services and their interface with National Health Service (NHS) and local authority services, at both a system and individual level. Data collection will involve interviews with commissioners; VSO and NHS or local authority providers; and focus groups with people who have experience of VSO crisis support, both service users and carers; and mapping the crisis trajectory of 10 service users in each study site through narrative interviews with service users and informal carers to understand the experience of VSO crisis care and its impact.Ethics and disseminationThe University of Birmingham Humanities and Social Sciences Ethical Review Committee granted ethical approval (reference ERN_16–1183) for the national and regional elements of the study. Ethical review by the Health Research Authority will be required for the case study research once the sites have been identified from the first two elements of the study. A range of methods including a policy seminar, publication in academic journals and a tool kit for commissioners and practitioners will be produced to maximise the impact of the findings on policy and practice.

scholarly journals Typology of psychiatric emergency services in the United Kingdom: a narrative literature review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Opeyemi Odejimi ◽  
Dhruba Bagchi ◽  
George Tadros
Keyword(s):  
Mental Health ◽  
Emergency Service ◽  
Psychiatric Emergency ◽  
Service Users ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
The United Kingdom ◽  
Narrative Literature ◽  
Narrative Literature Review ◽  
The Uk

Abstract Background Mental health crisis requiring emergency access to psychiatric service can occur at any time. Psychiatric Emergency Service (PES) is described as one that provides an immediate response to an individual in crisis within the first 24 h. Presently, several types of PESs are available in the United Kingdom (UK) with the aim of providing prompt and effective assessment and management of patients. Therefore, this study aims to provide a detailed narrative literature review of the various types of Psychiatric Emergency Service (PES) currently available in the UK. Method Electronic search of five key databases (MEDLINE, PsychINFO, EMBASE, AMED and PUBMED) was conducted. Studies were included if it described a mental health service in the UK that provides immediate response in mental health crisis within the first 24 h. Excluded studies did not describe a PES, non-English, and were not conducted in UK. Results Nine types of PESs were found. Amongst the 9 services, more papers described crisis resolution home treatment. Majority of the papers reported services within England than other countries within the UK. Conclusion All types of PESs were described as beneficial, particularly to mental health service users, but not without some shortcomings. There is a need to continue carrying out methodological research that evaluate impact, cost-effectiveness as well as identify methods of optimising the beneficial outcomes of the various types of PESs. This may help inform researchers, policy makers and commissioners, service users and carers, service providers and many more on how to ensure current and future PESs meet the needs as well as aid recovery during crisis.

scholarly journals Acute Day Units for mental health crises: A qualitative study of service user and staff views and experiences

2020 ◽  
Author(s):  
Nicola Morant ◽  
Michael Davidson ◽  
Jane Wackett ◽  
Danielle Lamb ◽  
Vanessa Pinfold ◽  
...  
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Acute Care ◽  
User Satisfaction ◽  
Service Users ◽  
Mental Health Crisis ◽  
Structured Interviews ◽  
Short Term Treatment ◽  
Health Crisis ◽  
Care Systems

AbstractBackgroundAcute Day Units (ADUs) provide intensive, non-residential, short-term treatment for adults in mental health crisis. They currently exist in approximately 30% of health localities in England, but there is little research into their functioning or effectiveness, and how this form of crisis care is experienced by service users. This qualitative study explores the views and experiences of stakeholders who use and work in ADUs.MethodsWe conducted 36 semi-structured interviews with service users, staff and carers at four ADUs in England. Data were analysed using thematic analysis.ResultsBoth service users and staff provided generally positive accounts of using or working in ADUs. Valued features were structured programmes that provide routine, meaningful group activities, and opportunities for peer contact and emotional, practical and peer support, within a ‘safe’ environment. Aspects of ADU care were often described as enabling personal and social connections that contribute to shifting from crisis to recovery. ADUs were compared favourably to other forms of home- and hospital-based acute care, particularly in providing more therapeutic input and social contact. Some service users and staff thought ADU lengths of stay should be extended slightly, and staff described some ADUs being under-utilised or poorly-understood by referrers in local acute care systems.ConclusionsMulti-site qualitative data suggests that ADUs provide a distinctive and valued contribution to acute care systems, and can avoid known problems associated with other forms of acute care, such as low user satisfaction, stressful ward environments, and little therapeutic input or positive peer contact. Findings suggest there may be grounds for recommending further development and more widespread implementation of ADUs to increase choice within local acute care systems.

scholarly journals Fear as a mental health crisis in the context of global risks and changes

2021 ◽  
Vol 10 (1) ◽  
pp. 17-26
Author(s):  
M.I. Rozenova ◽  
V.I. Ekimova ◽  
A.S. Ognev ◽  
E.V. Likhacheva
Keyword(s):  
Mental Health ◽  
Theoretical Model ◽  
The State ◽  
Point Of View ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Structural Concept ◽  
Emergency Events ◽  
The Impact

The paper presents the analysis of the results of international and national research in the field of studying the impact of global crises and pandemic situations (including COVID-19) on the state of mental health of people. Traditionally, the fear that accompanies emergency events and situations is considered as a source of mental and psychological traumatology of various kinds, however, the authors consider fear in a period of global risks and changes, from the point of view of not the cause, but an indicator of a decrease in the integrity of a person's mental health. The initial theoretical model that allows us to differentiate and diagnose different qualities of fear was the "I-structural" concept of G. Amon, which allows us to describe and understand the specific phenomenology of fears in the pandemic period. The qualities of fear, manifested in its constructive, destructive and deficient form, according to the authors, reflect the resource reserve of a person's mental health and the level of his psychological stability.

scholarly journals Acute day units in non-residential settings for people in mental health crisis: the AD-CARE mixed-methods study

2021 ◽  
Vol 9 (18) ◽  
pp. 1-122
Author(s):  
David Osborn ◽  
Danielle Lamb ◽  
Alastair Canaway ◽  
Michael Davidson ◽  
Graziella Favarato ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Well Being ◽  
Service Users ◽  
Mental Health Crisis ◽  
Work Package ◽  
Crisis Resolution ◽  
Data Set ◽  
Health Crisis ◽  
Crisis Resolution Teams

Background For people in mental health crisis, acute day units provide daily structured sessions and peer support in non-residential settings as an alternative to crisis resolution teams. Objectives To investigate the provision, effectiveness, intervention acceptability and re-admission rates of acute day units. Design Work package 1 – mapping and national questionnaire survey of acute day units. Work package 2.1 – cohort study comparing outcomes during a 6-month period between acute day unit and crisis resolution team participants. Work package 2.2 – qualitative interviews with staff and service users of acute day units. Work package 3 – a cohort study within the Mental Health Minimum Data Set exploring re-admissions to acute care over 6 months. A patient and public involvement group supported the study throughout. Setting and participants Work package 1 – all non-residential acute day units (NHS and voluntary sector) in England. Work packages 2.1 and 2.2 – four NHS trusts with staff, service users and carers in acute day units and crisis resolution teams. Work package 3 – all individuals using mental health NHS trusts in England. Results Work package 1 – we identified 27 acute day units in 17 out of 58 trusts. Acute day units are typically available on weekdays from 10 a.m. to 4 p.m., providing a wide range of interventions and a multidisciplinary team, including clinicians, and having an average attendance of 5 weeks. Work package 2.1 – we recruited 744 participants (acute day units, n = 431; crisis resolution teams, n = 312). In the primary analysis, 21% of acute day unit participants (vs. 23% of crisis resolution team participants) were re-admitted to acute mental health services over 6 months. There was no statistically significant difference in the fully adjusted model (acute day unit hazard ratio 0.78, 95% confidence interval 0.54 to 1.14; p = 0.20), with highly heterogeneous results between trusts. Acute day unit participants had higher satisfaction and well-being scores and lower depression scores than crisis resolution team participants. The health economics analysis found no difference in resource use or cost between the acute day unit and crisis resolution team groups in the fully adjusted analysis. Work package 2.2 – 36 people were interviewed (acute day unit staff, n = 12; service users, n = 21; carers, n = 3). There was an overwhelming consensus that acute day units are highly valued. Service users found the high amount of contact time and staff continuity, peer support and structure provided by acute day units particularly beneficial. Staff also valued providing continuity, building strong therapeutic relationships and providing a variety of flexible, personalised support. Work package 3 – of 231,998 individuals discharged from acute care (crisis resolution team, acute day unit or inpatient ward), 21.4% were re-admitted for acute treatment within 6 months, with women, single people, people of mixed or black ethnicity, those living in more deprived areas and those in the severe psychosis care cluster being more likely to be re-admitted. Little variation in re-admissions was explained at the trust level, or between trusts with and trusts without acute day units (adjusted odds ratio 0.96, 95% confidence interval 0.80 to 1.15). Limitations In work package 1, some of the information is likely to be incomplete as a result of trusts’ self-reporting. There may have been recruitment bias in work packages 2.1 and 2.2. Part of the health economics analysis relied on clinical Health of the Nations Outcome Scale ratings. The Mental Health Minimum Data Set did not contain a variable identifying acute day units, and some covariates had a considerable number of missing data. Conclusions Acute day units are not provided routinely in the NHS but are highly valued by staff and service users, giving better outcomes in terms of satisfaction, well-being and depression than, and no significant differences in risk of re-admission or increased costs from, crisis resolution teams. Future work should investigate wider health and care system structures and the place of acute day units within them; the development of a model of best practice for acute day units; and staff turnover and well-being (including the impacts of these on care). Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 18. See the NIHR Journals Library website for further project information.

scholarly journals What service users with psychotic disorders want in a mental health crisis or relapse: thematic analysis of joint crisis plans

2014 ◽  
Vol 49 (10) ◽  
pp. 1609-1617 ◽  
Author(s):  
Simone Farrelly ◽  
Gill Brown ◽  
Diana Rose ◽  
Elizabeth Doherty ◽  
R. Claire Henderson ◽  
...  
Keyword(s):  
Mental Health ◽  
Thematic Analysis ◽  
Psychotic Disorders ◽  
Service Users ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Crisis Plans

Breaking down the barriers to mental health crisis care: Evaluation of a training package for emergency department clinicians

2017 ◽  
Vol 41 (S1) ◽  
pp. s895-s895
Author(s):  
M. Fernando ◽  
M. Bhat
Keyword(s):  
Mental Health ◽  
Care Quality ◽  
Psychotic Symptoms ◽  
Mental Health Training ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Before And After ◽  
Crisis Care ◽  
The Uk ◽  
The Impact

IntroductionAbout one in 20 attendances at emergency departments (EDs) in the UK relate to mental health, yet recent work has shown that a majority of people presenting with mental health crises do not report positive experiences (Care Quality Commission, 2015). Although there are many reasons for this, one may be a lack of mental health training for staff working in EDs. In response to this, a new training module for multi-professional ED staff was developed.Objectives and methodsWe aimed to assess the impact of this new module on clinicians’ confidence in managing mental health presentations. Thirty-eight ED doctors and nurses across two centers were asked to complete surveys before and after receiving training.ResultsFollowing training, we found improvements in confidence in each of five domains explored: assessing self-harm; managing someone with personality difficulties; assessing psychotic symptoms; distinguishing between physical and psychotic symptoms; and, managing psychotic symptoms. These improvements were seen for clinicians across both centers.ConclusionsThe results show that training can help to improve confidence around mental health. This is particularly important given that before the training was developed a survey of local ED doctors had shown that 31% felt under-confident in managing mental health conditions. Since developing the training, it has been further enhanced at the request of local EDs to include video-based scenarios. We continue to assess its impact in improving the confidence of ED clinicians (as well as their knowledge, skills and attitudes towards mental health), and ultimately the benefit to patients experiencing mental health crises.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Predictors of Mental Health during the Covid-19 Pandemic in the US: role of economic concerns, health worries and social distancing

2020 ◽  
Author(s):  
Fabrice Kämpfen ◽  
Iliana V. Kohler ◽  
Alberto Ciancio ◽  
Wändi Bruine de Bruin ◽  
Jürgen Maurer ◽  
...  
Keyword(s):  
Mental Health ◽  
Online Survey ◽  
Adult Population ◽  
Anxiety Symptoms ◽  
Mental Health Crisis ◽  
Public Health Response ◽  
Health Crisis ◽  
Social Distancing ◽  
The Us ◽  
The Impact

ObjectiveTo assess mental health in the US adult population in the Covid-19 pandemic and explore the roles of economic concerns, health worries and social distancing in shaping mental health outcomes.MethodsWe analyze online survey data from the “Understanding America Study” (UAS) that is representative of the US adult population and covers the period of March 10-31st 2020 (sample size: 6436).ResultsAbout 29% (CI:27.4-.30.4%) of the US adult population reported some depression/anxiety symptoms osver the study period, with symptoms deteriorating over the month of March. Worsening mental health was most strongly associated with concerns about the economic consequences of the pandemic, while concerns about the potential impact of the virus on respondents’ own health and the practice of social distancing also predicted the presence of depression and anxiety symptoms, albeit less strongly.ConclusionsOur findings point towards a major mental health crisis unfolding simultaneously with the pandemic in the US. They also highlight the importance of economic countermeasures and social policy for mitigating the impact of Covid-19 on adult mental health in the US over and above an effective public health response.

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