scholarly journals Supporting mental health service users to stop smoking: findings from a mixed method evaluation of the implementation of nicotine management policies into two mental health trusts

2020 ◽  
Author(s):  
Susan E Jones ◽  
A. Billett ◽  
S. Mulrine ◽  
H. Clements ◽  
S. Hamilton
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Health Services ◽  
Smoking Prevalence ◽  
Routine Data ◽  
Data Capture ◽  
Service Users ◽  
Stop Smoking ◽  
Management Policies

Abstract Background Life expectancy is 10-20 years lower among people with a severe mental health disorder. Most of these early deaths are due to chronic conditions, including cardiovascular and respiratory diseases. Smoking is a major risk factor for these conditions and introducing nicotine management policies has been recommended to mental health service providers. This paper reports an evaluation of introducing these policy recommendations. Aim To reflect on the process and effectiveness outcomes when introducing nicotine management policies, including smokefree sites, in National Health Service (NHS) Trusts providing mental health services in an English region. Method Process data were collected through semi-structured interviews with staff (n=51), members of partnering organisations (n=5), service users (n=7) and carers (n=2) between November 2016–April 2017. Normalization Process Theory (NPT) was used to design the data collection tools and analyse the data. A framework approach was taken with the analysis using the four concepts of NPT: coherence, cognitive participation, collective action and reflexive monitoring. Aggregate routine quantitative data indicating the smoking status of service users were collected by querying patient administration systems every other quarter between 2013 and 2017. The data were analysed to investigate quality and completeness and to monitor smoking prevalence among service users over time. Results The policy made sense to some staff (coherence) who ‘bought-into’ the idea (cognitive participation) but other staff disagreed. Although nicotine management interventions were operationalised (collective action), sometimes they were opposed. Progress was made, especially in some units, but continued to be resisted in others. Informal appraisal of progress (reflexive monitoring) presented a varied picture. Routinely collected numerical data were of limited quality due to the high proportion of missing values; although there was some evidence of reducing smoking prevalence in both Trusts. Conclusion Some progress has been made in terms of changing entrenched, smoking cultures into one that is smokefree on Trust sites across the region. Systems for accurate, routine data capture of continued smoking and stop smoking journeys need to be established. Perseverance and resourcing over the long-term is required to establish routine data capture and a non-smoking culture in on-site provision of mental health services.

scholarly journals Ethical Concerns or Medical Dominance? Ethical Responsibility Conflicts Between Mental Health Authorities and Social Researchers

2017 ◽  
Vol 13 (10) ◽  
pp. 226
Author(s):  
Dilrukshi Abeysinghe
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Health Services ◽  
Social Research ◽  
Ethical Responsibility ◽  
Service Users ◽  
Research Projects ◽  
Health Authorities ◽  
Health Institutions

The objective of this paper is to examine the ethical responsibility conflicts between mental health authorities and social researchers. This issue is examined with reference to the social research protocols imposed by the authorities of mental health institutions based on ethical grounds. It also explores how such ethical conflicts affect social research, which provides convincing evidence for the enhancement of mental health services. This paper analyzes ethical reasoning conflicts between social researchers and mental health authorities in terms of the psychiatric and social approaches to mental health and distress. The study is based on eight research projects to be conducted at mental health institutions in Sri Lanka during the period 2014–2016 that were designed by two academic staff members, two postgraduates, and four undergraduates in the Department of Sociology at the University of Colombo. Data was collected from the eight researchers who designed the research projects and from four administrative officers, one officer from each of the concerned institutions where the projects were to be conducted. A structured interview method was used to collect the data. According to the findings, the protocols recommended by mental health authorities based on ethical grounds divest social researchers of their ethical responsibility to conduct research that could advance mental health services and assist mental health service users. The study reveals that such protocols deprive mental health service users of their right and autonomy to make decisions about divulging information, expressing views, and accessing meaningful social relationships and activities.

The perspectives of people who use mental health services engaging with arts and cultural activities

2016 ◽  
Vol 20 (3) ◽  
pp. 180-186 ◽  
Author(s):  
Anita Jensen ◽  
Theodore Stickley ◽  
Alison Edgley
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Central Component ◽  
Service Users ◽  
Structured Interviews ◽  
Content Type ◽  
Museum Educator

Purpose – The purpose of this paper is to present a study of arts engagement for mental health service users in Denmark. Design/methodology/approach – The study was completed at Hans Knudsen Instituttet, Denmark. It involved analysis of emerging themes from semi-structured interviews with six participants who had participated in a structured visit to the National Gallery (Statens Museum for Kunst) in Denmark. Findings – Multiple benefits for people who use mental health services engaging in arts activities are reported. Arts activities are described as a central component of everyday life; a way of life and a significant factor in getting through the day. Barriers are identified in the interdisciplinary working between the museum educator and participants. Social implications – This study identifies that the participants benefited from taking part in the arts/cultural activity. Findings also suggest that if museums are offering activities to people who use mental health services they should equip staff with training designed to support appropriate ways of working with this group. This interdisciplinary activity offers a relatively untapped potential arena of support. Originality/value – The paper will be of relevance and value to those working with mental health and arts. The study demonstrates the importance for mental health service users to engage in creative activity and for museum staff to have appropriate skills for inclusion to be successful.

scholarly journals Co-production as an approach to developing stakeholder partnerships to reduce mental health inequalities: an evaluation of a pilot service

2016 ◽  
Vol 18 (01) ◽  
pp. 14-23 ◽  
Author(s):  
Saumu Lwembe ◽  
Stuart A. Green ◽  
Jennifer Chigwende ◽  
Tom Ojwang ◽  
Ruth Dennis
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Small Scale ◽  
Community Mental Health Service ◽  
Service Users ◽  
Ethnic Communities ◽  
Minority Ethnic

Aim This study aimed to evaluate a pilot cross-sector initiative – bringing together public health, a community group, primary mental health teams and patients – in using co-production approaches to deliver a mental health service to meet the needs of the black and minority ethnic communities. Background Black and minority ethnic communities continue to face inequalities in mental health service access and provision. They are under-represented in low-level interventions as they are less likely to be referred, and more likely to disengage from mainstream mental health services. Effective models that lead to improved access and better outcomes are yet to be established. It has long been recognised that to be effective, services need to be more culturally competent, which may be achieved through a co-production approach. Methods This study aimed to evaluate the role of co-production in the development of a novel community mental health service for black and minority ethnic service users. Qualitative research methods, including semi-structured interviews and focus groups, were used to collect data to examine the use of co-production methods in designing and delivering an improved mental health service. Findings Twenty-five patients enrolled into the study; of these, 10 were signposted for more intensive psychological support. A 75% retention rate was recorded (higher than is generally the case for black and minority ethnic service users). Early indications are that the project has helped overcome barriers to accessing mental health services. Although small scale, this study highlights an alternative model that, if explored and developed further, could lead to delivery of patient-centred services to improve access and patient experience within mental health services, particularly for black and minority ethnic communities.

scholarly journals Recognition as a valued human being: Perspectives of mental health service users

2012 ◽  
Vol 19 (3) ◽  
pp. 357-368 ◽  
Author(s):  
Kristin Ådnøy Eriksen ◽  
Bengt Sundfør ◽  
Bengt Karlsson ◽  
Maj-Britt Råholm ◽  
Maria Arman
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Research Process ◽  
Service Users ◽  
Process Data ◽  
Starting Point ◽  
The Individual

The acknowledgement of basic human vulnerability in relationships between mental health service users and professionals working in community-based mental health services (in Norway) was a starting point. The purpose was to explore how users of these services describe and make sense of their meetings with other people. The research is collaborative, with researcher and person with experienced-based knowledge cooperating through the research process. Data is derived from 19 interviews with 11 people who depend on mental health services for assistance at least three times a week. Data is analysed according to the Interpretative Phenomenological Analysis (IPA). Results confirm that reciprocity is fundamental for relationships, and that recognizing the individual entails personal involvement. The participants describe a struggle, and recognizing this struggle may help the professional to achieve a deeper understanding of the individual.

scholarly journals Health system influences on potentially avoidable hospital admissions by secondary mental health service use: A national ecological study

2021 ◽  
pp. 135581962110367
Author(s):  
Charlotte Woodhead ◽  
Peter Martin ◽  
David Osborn ◽  
Helen Barratt ◽  
Rosalind Raine
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Health System ◽  
Hospital Admissions ◽  
Service Users ◽  
Physical Conditions ◽  
Health Diagnosis

Objectives Potentially avoidable hospital admissions (PAAs) are costly to health services and potentially harmful for patients. This study aimed to compare area-level PAA rates among people using and not using secondary mental health services in England and to identify health system features that may influence between-area PAA variation. Methods National ecological study using linked English hospital admissions and secondary mental health services data (2016–2018). We calculated two-year average age-sex standardised area-level PAA rates according to primary admission diagnoses for 12 physical conditions, among, first, secondary mental health service users with any non-organic diagnosis, and, second, people not in contact with secondary mental health services. We used penalised regression analyses to identify predictors of area-level variation in PAA rates. Results Area-level PAA rates were over four times greater in the mental health group, at 7,594 per 100,000 population compared to 1,819 per 100,000 in the comparator group. Common predictors of variation were greater density of older age groups (lower PAA rates), higher underlying population morbidity of chronic obstructive pulmonary disease and, to a lesser extent, urbanity (higher PAA rates). For both groups, health system factors such as the number of general practitioners per capita or ambulance despatch rates were significant but weak predictors of variation. Mental health diagnosis data were available for half of secondary mental health care records only and sensitivity analyses found that urbanity remained the sole significant predictor for PAAs in this group. Conclusions Findings support the need for improved management of physical conditions for secondary mental health service users. Understanding and predicting variation in PAAs among mental health service users is constrained by availability of data on mental health diagnosis, physical health care and needs.

scholarly journals Barriers and facilitators of disclosures of domestic violence by mental health service users: qualitative study

2011 ◽  
Vol 198 (3) ◽  
pp. 189-194 ◽  
Author(s):  
Diana Rose ◽  
Kylee Trevillion ◽  
Anna Woodall ◽  
Craig Morgan ◽  
Gene Feder ◽  
...  
Keyword(s):  
Mental Health ◽  
Domestic Violence ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Qualitative Study ◽  
Health Services ◽  
Mental Health Professionals ◽  
Community Mental Health Service ◽  
Service Users

BackgroundMental health service users are at high risk of domestic violence but this is often not detected by mental health services.AimsTo explore the facilitators and barriers to disclosure of domestic violence from a service user and professional perspective.MethodA qualitative study in a socioeconomically deprived south London borough, UK, with 18 mental health service users and 20 mental health professionals. Purposive sampling of community mental health service users and mental healthcare professionals was used to recruit participants for individual interviews. Thematic analysis was used to determine dominant and subthemes. These were transformed into conceptual maps with accompanying illustrative quotations.ResultsService users described barriers to disclosure of domestic violence to professionals including: fear of the consequences, including fear of Social Services involvement and consequent child protection proceedings, fear that disclosure would not be believed, and fear that disclosure would lead to further violence; the hidden nature of the violence; actions of the perpetrator; and feelings of shame. The main themes for professionals concerned role boundaries, competency and confidence. Service users and professionals reported that the medical diagnostic and treatment model with its emphasis on symptoms could act as a barrier to enquiry and disclosure. Both groups reported that enquiry and disclosure were facilitated by a supportive and trusting relationship between the individual and professional.ConclusionsMental health services are not currently conducive to the disclosure of domestic violence. Training of professionals in how to address domestic violence to increase their confidence and expertise is recommended.

scholarly journals Mental health service users' and professionals' relationship with games and gaming

2018 ◽  
Vol 4 ◽  
pp. 205520761877971
Author(s):  
Hanna Hopia ◽  
Marko Siitonen ◽  
Katja Raitio
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Mental Health Professionals ◽  
Qualitative Content Analysis ◽  
Mental Healthcare ◽  
Digital Games ◽  
Service Users

Background Games and elements of gamification can be utilized in mental healthcare to provide customized interventions for the service users. However, very little evidence exists as to what kind of experiences service users and professionals have towards games and gaming, and what their perceptions of the phenomenon are. This sort of information is needed to help professionals put game-based interventions actively into practice in mental health services. Research objectives The objective is to describe the experiences and perceptions of digital games and gaming from the perspectives of mental health service users and mental health professionals. Methods In this qualitative study, data consisted of interviews of 23 mental health service users and professionals working in the mental health field. We conducted altogether 39 interviews. Sixteen of the participants were interviewed twice. Main categories and subcategories were identified using qualitative content analysis. Results The analysis revealed four distinct orientations towards games and gaming: (a) compulsive gaming; (b) closet gaming; (c) gaming as a hobby; and (d) late bloomers. Each group was characterized by different personal histories, experiences, conceptions and attitudes regarding gaming and digital games. Conclusion When attempting to implement a game-based intervention in mental health services, it is essential to recognize the different attitudes that both service users and staff exhibit concerning games and gaming. The attitudes of service users and professionals described in this study can be utilized in the implementation of game-based methods as part of care and rehabilitation in mental health services.

scholarly journals Speaking Truth to Power: Mental Health Service Users’ Experiences of Participation in their Diagnosis and Treatment

2020 ◽  
Vol 22 (1) ◽  
pp. 137-156
Author(s):  
Gloria Kirwan
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service User ◽  
Help Seeking ◽  
Service Providers ◽  
Diagnosis And Treatment ◽  
Service Users

In a qualitative study, long-term mental health service users shared their views on the concept of ‘participation’ as shaped by their personal histories of contact with mental health services in Ireland. Adopting a narrative methodology, the study participants were asked to draw on their experiences with mental health services to illustrate their general views on participation by service users in mental health care contexts.In this study, the research participants recounted positive experiences of participation in which their expressed views regarding their symptoms and treatment needs were incorporated into the service responses they received. The data revealed that service users perceived open and inclusive communication by service providers as an important factor in optimising their ability to participate in help-seeking, diagnosis and treatment plans. However, the study also illuminated the chilling effect on participation when service users’ views were not heeded or acknowledged by service providers. The findings highlight how the failure to include service users’ insights can negatively encroach on service user participation. The service user narratives collected in this study exposed the often uneasy juxtaposition of the service user’s personally held ‘truth’ regarding their lived experience of mental distress versus the powerful system of expert diagnosis and treatment. This article focuses on reporting selective findings from the study regarding participation in the contexts of help-seeking, diagnosis and treatment decisions.

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