Exploring Therapeutic Risk in the Recovery Process of Adolescents at Risk of Self-harm: A Thematic Analysis of Support Staff Perceptions.

2020 ◽  
Vol 10 ◽  
Author(s):  
Tomos Redmond
Keyword(s):  
Mental Health ◽  
Emotional Regulation ◽  
Recovery Process ◽  
Individual Risk ◽  
Service Users ◽  
Structured Interviews ◽  
High Prevalence ◽  
Risk Approach ◽  
Mental Health Support ◽  
Self Harm

Background and Objective: The high prevalence of adolescent self-harm within mental health services presents considerable management concerns, exacerbated by a lack of clear evidence regarding therapeutically effective approaches. This shortfall perpetuates traditional risk-adverse practice, despite likely inadequacies in mitigating self-harm through failing to address underlying psychological mechanisms. Therapeutic risk, defined as an approach whereby clinicians support individual risk-taking, may be an alternative that yields improved recovery outcomes. However, related research is adult-focussed and provides limited detail on its features, practical delivery and impact on recovery. Consequently, the current study explored the experiences of professionals delivering a therapeutic risk ethos, including their conceptualisation of it and its impact on young people. Methods: Semi-structured interviews were conducted with seven mental health support workers employed by a residential healthcare provider that promotes a therapeutic risk approach. The provider supported service users aged 15 - 20 experiencing complex psychopathology who, following inpatient discharge, presented high risk of self-harm and suicidality. Interview data was thematically analysed. Discussion and Conclusion: Staff participants provided their understanding of a therapeutic risk approach; suggesting risk is viewed as positive and beneficial to recovery, alongside the promotion of service user freedom and flexible therapeutic risk management. They perceived therapeutic risk incorporates both permission and support, which facilitates the exploration of underlying feelings and alternative actions. Additionally, therapeutic risk promotes positive recovery outcomes due to empowered service users having increased control over their lives. They argued this can reduce psychological distress, encouraging the development of emotional regulation and adaptive coping strategies.

Religion, spirituality and personal recovery among forensic patients

2019 ◽  
Vol 21 (3) ◽  
pp. 190-200
Author(s):  
Emily Glorney ◽  
Sophie Raymont ◽  
Amy Lawson ◽  
Jessica Allen
Keyword(s):  
Mental Health ◽  
Interpretative Phenomenological Analysis ◽  
Recovery Process ◽  
Personal Meaning ◽  
Service Users ◽  
Religion And Spirituality ◽  
Personal Recovery ◽  
Structured Interviews ◽  
Hospital Data ◽  
Content Type

Purpose Religion and spirituality are well-researched concepts within the field of psychology and mental health yet they have rarely been researched in high-secure services within the UK. Research in mental health and prison contexts suggests benefits of religion/spirituality to coping, social support, self-worth, symptoms of depression and anxiety and behavioural infractions. The purpose of this paper is to investigate the role of religion/spirituality in high-secure service users’ personal recovery. Design/methodology/approach Semi-structured interviews were carried out with 13 male patients in a high-secure hospital, with primary diagnoses of mental illness (n=11) or personality disorder (n=2). Participants were from a range of religious/spiritual backgrounds and were asked about how their beliefs impact their recovery and care pathways within the hospital. Data were analysed using interpretative phenomenological analysis. Findings Three superordinate themes were identified: “religion and spirituality as providing a framework for recovery”; “religion and spirituality as offering key ingredients in the recovery process”; and “barriers to recovery through religion/spirituality”. The first two themes highlight some of the positive aspects that aid participants’ recovery. The third theme reported hindrances in participants’ religious/spiritual practices and beliefs. Each theme is discussed with reference to sub-themes and illustrative excerpts. Practical implications Religion/spirituality might support therapeutic engagement for some service users and staff could be more active in their enquiry of the value that patients place on the personal meaning of this for their life. Originality/value For the participants in this study, religion/spirituality supported the principles of recovery, in having an identity separate from illness or offender, promoting hope, agency and personal meaning.

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.

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 High Prevalence of Depression, Anxiety and Stress Among Secondary School Students During COVID-19 Lockdown and Social Distancing and Its Associated Factors: An Online Cross-Sectional Survey

2020 ◽  
Author(s):  
Gunn Pungpapong ◽  
Rasmon Kalayasiri
Keyword(s):  
Mental Health ◽  
Secondary School ◽  
Secondary School Students ◽  
Mental Health Problems ◽  
Cross Sectional Survey ◽  
School Students ◽  
Cross Sectional ◽  
Social Distancing ◽  
High Prevalence ◽  
Mental Health Support

Abstract Background: Stressors introduced to adolescents by COVID-19 social distancing measures may cause mental health problems to (re)surface. We studied depression, anxiety and stress among adolescents experiencing lockdown. Methods: From May-June 2020, secondary school students were enrolled in an online cross-sectional survey through social media. We assessed presence and severity of depression (PHQ-9), anxiety (GAD-7) and stress (PSS-10) in the last month, demographics, degree of social distancing, and other associated issues.Results: Of 392 respondents (56.4% male, 43.1% female), mostly from Thailand (59.2%) and UK (26.5%). We identified depressive symptoms in 58.7%, anxiety in 40.3% and high levels of stress in 9.7%. We found, by multivariate analysis, significant associations between being female and depression and anxiety, being in late secondary school years and depression, and changes in patterns of substance use and anxiety and stress.Conclusions: We propose that girl-centred mental health support platforms should be readily available and tailored to fit specific countries’ contexts. Schools must closely monitor and act upon any concerns which arise from their students and must also monitor mental health wellbeing as changes in academic routine due to COVID-19 could be drastic for some. Harm reduction services must adapt and utilise innovative telemedicine interventions, tailored towards adolescent users.

scholarly journals The crucible of co-production: Case study interviews with Recovery College practitioner trainers

2019 ◽  
Vol 78 (8) ◽  
pp. 977-987
Author(s):  
Mark Dalgarno ◽  
Jennifer Oates
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Healthcare Professionals ◽  
Mental Healthcare ◽  
Single Site ◽  
Future Research ◽  
Service Users ◽  
Structured Interviews

Objectives: This study explored healthcare professionals’ accounts of being practitioner trainers in a mental health Recovery College, where they worked with peer trainers, who were people with lived experience of mental illness, to co-produce workshops for mental health service users and staff. The aim of this study was to understand the process of co-production in the Recovery College from the perspective of practitioner trainers. Design: Single-site case study. Setting: A Recovery College in the South of England, open to staff and service users from one mental health care provider organisation. Methods: Semi-structured interviews with eight mental healthcare professionals. Transcripts were thematically analysed. Results: A central image of ‘the workshop as crucible’ emerged from the three themes derived from the analysis. Co-facilitating the workshop was a ‘structured’ encounter, within which health professionals experienced ‘dynamism’ and change. For them, this involved experiences of ‘challenge and discomfort’. Conclusion: Findings from this study contribute to the evidence base for the evaluation of Recovery Colleges by focusing on the training impact on staff. Findings suggest that taking on a trainer role in Recovery College co-production is beneficial for healthcare professionals as well as mental health service users, especially if healthcare professionals are open to the dynamism and possible discomfort of these workshop encounters. Future research, however, should expand beyond single-site case studies to test the extent to which this metaphor and themes are appropriate to describing the ‘transformative’ element of co-production.

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.

Trust and psychosis services: Bridging the gap between managing risk and meeting need

2011 ◽  
Vol 26 (S2) ◽  
pp. 754-754
Author(s):  
P. Brown ◽  
M. Calnan
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Users ◽  
Healthcare Outcomes ◽  
Structured Interviews ◽  
Mental Health Team ◽  
Quality Healthcare ◽  
Potential Benefits ◽  
Managing Risk

IntroductionResearch suggests that trust is vital for quality healthcare and effective outcomes. Trust becomes necessary in conditions of vulnerability and uncertainty. These conditions may be especially relevant to the experience and treatment of mental illness - not least psychosis. There currently exists a paucity of research into trust and mental health services.Aims and objectivesTo develop an understanding of trust as it relates to psychosis services and their users. To identify practical contexts where trust may be particularly relevant and where research may inform policy, service organization and individual practice.MethodSemi-structured interviews were carried out with 21 stakeholders - service-users, professionals, managers, carers - across 3 different types of service working with people experiencing psychosis: early intervention; assertive outreach; and a more standard community mental health team.FindingsTrust appears to be salient and yet problematic for mental health services, not least in terms of approachability, disclosure and cooperation with treatment programmes. Organizing services around understandings of trust, rather than risk, may be more effective both at meeting need and managing risk.ConclusionsThrough an improved understanding of trust and its effect on the engagement of service-users, there are clear potential benefits for mental health services through an enhanced ability to facilitate access and develop effective cooperation towards healthcare outcomes.

scholarly journals The PARALLEL Study (imPAct of expeRiencing Another’s seLf harm and suicidaL bEhaviour in hospitaL)

2017 ◽  
Vol 19 (4) ◽  
pp. 258-268
Author(s):  
Rebecca Hargate ◽  
Sharon Howden ◽  
Emma Tarpey ◽  
Tammi Walker
Keyword(s):  
Mental Health ◽  
Suicidal Behaviour ◽  
Interpretative Phenomenological Analysis ◽  
Health Unit ◽  
Structured Interviews ◽  
Content Type ◽  
The North ◽  
Self Harm ◽  
The Impact ◽  
Mental Health Unit

Purpose The purpose of this paper is to explore the experiences of both staff and patients in a medium-secure mental health unit of the self-harm and/or suicidal behaviour of others. Suicide and self-harm is highly prevalent in forensic settings and evidence suggests that experiencing other people’s self-harm and suicidal behaviour can lead to negative outcomes, both for staff and patients. This is particularly important in hospitals where patients are highly dependent on staff for support. Design/methodology/approach Semi-structured interviews were conducted with five staff members and six patients in a medium-secure male mental health unit in the North of England. Data were analysed following interpretative phenomenological analysis guidelines. Findings Three dominant themes were identified during analysis: the impact of suicide and self-harm; the role of others; and the importance of understanding and experience. Various impacts were discussed including desensitization, negative emotions and the desire to help. Other people played an important role in protecting against negative impacts, with shared experiences and peer support reported as the biggest benefits. Experiences of self-harm and suicide were found to increase understanding resulting in more positive attitudes. Additionally, the importance of training and education was highlighted. Originality/value This paper provides an insight into the experiences of staff and patients in medium-secure male mental health unit, which has benefits to practitioners when considering support mechanisms.

scholarly journals A qualitative exploration of 14 to 17-year old adolescents’ views of early and preventative mental health support in schools

2020 ◽  
Author(s):  
Liam Spencer ◽  
Ruth McGovern ◽  
Eileen Kaner
Keyword(s):  
Mental Health ◽  
Health Literacy ◽  
Young People ◽  
Mental Health Literacy ◽  
Health Interventions ◽  
Structured Interviews ◽  
North East ◽  
School Based ◽  
Mental Health Support ◽  
Mental Health Interventions

Abstract Background Preventative interventions may be effective in reducing and preventing symptoms of mental ill health in children and young people. However, there is a paucity of research in this area that explores the views of young people. This paper reports on a qualitative study to inform the future development of attractive and appropriate early and preventative school-based mental health interventions. Methods Semi-structured interviews were conducted with a purposive sample of 12 young people aged 14–17 in North East England. Interviews were audio-recorded, transcribed, anonymised and analysed following a thematic approach. Results Four key themes were identified, relevant to those providing, designing and commissioning early and preventative mental health interventions in schools: ‘mental health literacy’, ‘risk factors for wellbeing decline’, ‘experience of school-based support’ and ‘recommendations for future support’. Conclusions Young people have varying levels of mental health literacy, but are able to identify academic stress, bullying and the transition from primary to secondary school as leading causes of worry. Young people want more regular and in-depth mental health education, tailored levels of support in school and improved training for teachers.

Exploring the acceptability of a digital mental health platform incorporating a virtual coach: The good, the bad, and the opportunities

2021 ◽  
Vol 27 (1) ◽  
pp. 146045822199487
Author(s):  
Anthony Venning ◽  
Madeleine CE Herd ◽  
Tassia K Oswald ◽  
Sabran Razmi ◽  
Fiona Glover ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
User Engagement ◽  
Behaviour Therapy ◽  
Structured Interviews ◽  
Negative Experiences ◽  
The People ◽  
Cognitive Behaviour ◽  
Mental Health Support ◽  
Health Support

Digital Mental Health Platforms offer feasible options to increase access to mental health support. This study aimed to examine the acceptability of a Low Intensity Cognitive Behaviour Therapy Digital Mental Health Platform, containing a Virtual Coach, with University Students ( n = 16) and Mental Health Professionals ( n = 5). Semi-structured interviews, exploratory focus groups, and inductive thematic analysis were conducted. Four overarching themes were identified, with potential users and professionals highlighting positive aspects, elements to be improved, and ambivalent feelings towards the platform overall. However, participants predominately expressed negative experiences indicating that the Virtual Coach was unrelatable and hard to engage with. While Virtual Coaches and similar Digital Mental Health Platforms have the potential to overcome barriers for those attempting to access mental health services, their effectiveness may be limited if the people who need them are not drawn to and then consistently engaged with them. Based on the feedback attained for this specific Digital Mental Health Platform, recommendations are provided for future developers aiming to create similar platforms, to assist in their uptake and ensure ongoing user engagement.

Sign in / Sign up

Export Citation Format

Share Document