Online Stepped Care Mental Health System (TourHeart): A Qualitative Evaluation from Multiple Stakeholders’ Perspectives (Preprint)

2021 ◽  
Author(s):  
Emily W.S. Tsoi ◽  
Winnie W.S. Mak ◽  
Connie Y.Y. Ho ◽  
Gladys T.Y. Yeung
Keyword(s):  
Mental Health ◽  
User Experience ◽  
Service Providers ◽  
Qualitative Evaluation ◽  
Well Being ◽  
Stepped Care ◽  
Service Users ◽  
Personal Recovery ◽  
Structured Interviews ◽  
Online Platform

BACKGROUND Online stepped care mental health platform is a one-stop solution that integrates psychoeducation and other well-being promotional tools for mental health promotion and illness prevention and evidence-based low-intensity psychological interventions for treatment of people with anxiety and depressive symptoms. Rather than being strictly symptom-based, feedback from stakeholders is necessary for services to be person-centered and recovery-oriented. Thus, understanding from the perspectives of users and service providers is needed to fine-tune both the design and content of the services for enhanced service personalization and personal recovery. OBJECTIVE This is a qualitative study that evaluates the Jockey Club “TourHeart” stepped care mental health platform with both online and offline services targeting adults along the mental health spectrum based on the two-continua model of mental health and mental illness. This study incorporates perspectives from both service users and providers who administered the platform and provided coaching services. Offline services, design of the online platform, user experience, and views about the contents were explored using semi-structured interviews. METHODS The interview questions were designed based on the RE-AIM framework. A total of 37 service users and 22 service providers took part in the study. Analysis followed a hybrid thematic analysis to identify salient aspects of users and providers’ experience and views of the platform. RESULTS Three broad themes (namely, quality of the platform, drivers for platform usage, and coaching services) emerged from the interview data to illustrate the users’ views and experiences with the online platform. The platform’s general aesthetics, operations, and contents were all found to be critical features as well as drivers for continued usage. Coaching services were indispensable while participants preferred the autonomy and anonymity associated with online mental health services. CONCLUSIONS This study confirms existing design standards and recommendations and suggested that more rigorous user experience research and robust evaluation to be carried out in future adaptation of online stepped care services so that services can be more personalized and better promote personal recovery.

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 Readiness of Allied Professionals to Join the Mental Health Workforce: A Qualitative Evaluation of Trained Lay Trauma Counsellors’ Experiences When Refugee Youth Disclose Suicidal Ideation

2021 ◽  
Vol 18 (4) ◽  
pp. 1486 ◽  
Author(s):  
Sandra Löfving Gupta ◽  
Katarina Wijk ◽  
Georgina Warner ◽  
Anna Sarkadi
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Health Workforce ◽  
Qualitative Evaluation ◽  
Behavioural Therapy ◽  
Stepped Care ◽  
Trauma Symptoms ◽  
Structured Interviews ◽  
Refugee Youth ◽  
Mental Health Workforce

The recent refugee crisis presented a huge challenge for the Swedish mental health workforce. Hence, innovative mental health workforce solutions were needed. Unaccompanied refugee minors (URM) are a particularly vulnerable refugee group. Teaching Recovery Techniques (TRT) was introduced as a community-based intervention utilising trained lay counsellors in a stepped model of care for refugee youth experiencing trauma symptoms. Professionals (e.g., teachers, social workers) can deliver the Cognitive Behavioural Therapy-based intervention after a brief training. A point of debate in this workforce solution is the readiness of trained lay counsellors to deal with potentially demanding situations like disclosure of suicidal ideation. This study aimed to explore the TRT trained lay counsellors’ experiences of procedures upon URM’s disclosure of suicidal ideation. Individual semi-structured interviews with TRT trained lay counsellors were conducted, then analysed using systemic text condensation. The analysis revealed four themes: “Importance of safety structures”, “Collaboration is key”, “Let sleeping dogs lie” and “Going the extra mile”. Dealing with suicidal ideation is challenging and feelings of helplessness occur. Adding adequate supervision and specific training on suicidal ideation using role play is recommended. Collaboration between agencies and key stakeholders is essential when targeting refugee mental health in a stepped care model.

A qualitative evaluation of an ACT-based substance misuse treatment programme for service users within a secure mental health setting

2019 ◽  
Vol 12 (3) ◽  
pp. 117-131
Author(s):  
Lacey M. Johnson ◽  
Kelly J. Elsegood ◽  
Charlotte Lennox
Keyword(s):  
Mental Health ◽  
Substance Misuse ◽  
Qualitative Evaluation ◽  
Structured Interview ◽  
Service Users ◽  
Treatment Programme ◽  
Mental Health Setting ◽  
Structured Interviews ◽  
Content Type ◽  
The Impact

Purpose The purpose of this paper is to understand service users’ experience of a new acceptance and commitment therapy (ACT)-based substance misuse programme. The programme is designed for people in secure mental health services, presenting with complex mental health difficulties and co-occurring substance misuse problems. Design/methodology/approach A qualitative approach informed an exploratory pilot of this novel intervention. Service users completing a 16-week ACT programme were invited to participate in the current study. Out of the nine individuals enroled on the programme, six opted to take part in the exploratory pilot and completed semi-structured interviews following part 1 of the programme (eight weeks). Four of these participants proceeded into part 2 of the programme (eight weeks) and completed a further semi-structured interview. Findings The thematic analysis identified five main themes: “Increased awareness of personal values and the impact of substance use on values”, “Taking committed action towards values”, “Coping skills and the application of skills to manage difficult thoughts and feelings”, “Personal development” and “Use of metaphors/analogies”. Research limitations/implications A quantitative evaluation of clinical outcomes is recommended to gauge further programme effectiveness. Practical implications The findings provide preliminary support for the use of an ACT-based substance misuse programme in a secure mental health setting. Originality/value This study evaluates the use of a novel ACT-based substance misuse intervention with people in secure mental health care with co-occurring mental health and substance misuse difficulties. This paper provides an in-depth understanding of service users’ experience of participating in this new treatment programme.

scholarly journals Accessing and Utilizing One’s City Space: The Role of Specialized Community Mental Health Teams in Brazil and Canada

2020 ◽  
Vol 39 (1) ◽  
pp. 85-100
Author(s):  
Emmanuelle Khoury ◽  
Isabelle Ruelland
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Mental Health Professionals ◽  
Service Providers ◽  
Service Users ◽  
Structured Interviews ◽  
City Space ◽  
Mental Health Programs ◽  
The City

Community mental health programs have garnered significant attention during the last decade. In this paper we ask to what extent these programs impact the capacity of service users to move around in the city space. Drawing on case studies from ethnographic research conducted in Campinas (Brazil) and Montréal (Canada), which included semi-structured interviews with a total of 16 service users and 49 mental health professionals, we explore the significance of urban mobility as part of service users’ mental health recovery and service providers’ practice. Findings suggest that service providers play a key role in facilitating meaningful mobility in the city space.

scholarly journals Recovery priorities of people with psychosis in acute mental health in-patient settings: a Q-methodology study

2021 ◽  
pp. 1-14
Author(s):  
Catherine Douglas ◽  
Lisa Wood ◽  
Danny Taggart
Keyword(s):  
Mental Health ◽  
Q Methodology ◽  
Final Analysis ◽  
Well Being ◽  
Symptom Reduction ◽  
Personal Recovery ◽  
Mental Health Support ◽  
Health Support ◽  
Mental Health Hospital ◽  
Health Hospital

Abstract Background: Personal recovery from psychosis has been explored extensively in community samples but there has been little exploration with people currently receiving care from an acute mental health in-patient setting. Aims: The aim of this study was to explore the personal recovery priorities of people experiencing psychosis who are currently receiving care from an acute mental health in-patient ward. Method: A Q-methodology mixed-methods approach was adopted. Thirty-eight participants were recruited from an outer London acute mental health hospital. They were required to sort 54 statements regarding personal recovery from most important to least important to reflect their recovery priorities. Thirty-six were included in the final analysis. Results: Analysis revealed four distinct viewpoints relating to factors that promote recovery in the acute mental health in-patient setting. These were: stability, independence and ‘keeping a roof over your head’; hope, optimism and enhancing well-being; personal change, self-management and social support; and symptom reduction through mental health support. Conclusions: Acute mental health in-patient wards need to ensure that they are considering the personal recovery needs of in-patients. Symptom reduction was valued by some, but broad psychosocial factors were also of priority.

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 Classification of Mental Health among Korean Vietnam War Veterans: A Latent Profile Analysis

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 637-637
Author(s):  
Hyunyup Lee ◽  
Carolyn Aldwin ◽  
Sungrok Kang ◽  
Xyle Ku
Keyword(s):  
Mental Health ◽  
Vietnam War ◽  
Military Service ◽  
Latent Profile Analysis ◽  
Service Providers ◽  
Profile Analysis ◽  
Well Being ◽  
War Veterans ◽  
Vietnam War Veterans ◽  
Latent Profile

Abstract We investigated the dimensional structure of mental health among aging Korean Veterans using latent profile analysis (LPA) on posttraumatic stress disorder symptoms (PTSD), late onset stress symptomology (LOSS), and psychosocial well-being (PWB). The Korean Vietnam War Veterans Study consists of 367 men (Mage=72, SD=2.66). LPA identified five classes of mental health as best fitting the data. Most men were in the normal (38%) and moderate distress (31%) groups, while smaller proportions were in the low affect (13%) and severe distress (7%) groups. The resilient group (12%) had low PTSD, medium LOSS, and high PWB, and were highest on optimism, positive appraisals of military service, and social support. Negative and positive aspects of mental health outcomes were on separate dimensions rather than on a single bipolar dimension. Service providers should attempt to both reduce Veterans’ negative psychological symptoms and increase psychosocial well-being. Part of a symposium sponsored by the Aging Veterans: Effects of Military Service across the Life Course Interest Group.

scholarly journals Exploring the role of an emotional support and counselling service for people with visual impairments

2013 ◽  
Vol 31 (1) ◽  
pp. 5-19 ◽  
Author(s):  
Suzanne Hodge ◽  
Wally Barr ◽  
Louise Bowen ◽  
Martina Leeven ◽  
Paul Knox
Keyword(s):  
Emotional Support ◽  
Service Providers ◽  
Low Vision ◽  
Visual Impairments ◽  
Well Being ◽  
Service Users ◽  
Social Changes ◽  
Psychological Well Being ◽  
Mixed Methods Evaluation

There is growing evidence of the need for services to address the emotional support needs of people with visual impairments. This article presents findings from a mixed methods evaluation of an emotional support and counselling (ESaC) service delivered within an integrated low vision service, focusing primarily on the qualitative findings. Data collected using a standardised measure of psychological well-being (Clinical Outcomes in Routine Evaluation–Outcome Measure; CORE-OM) show an improvement in the psychological well-being of clients of the service between baseline and follow-up assessment. Qualitative findings from interviews with service users and service providers help to illustrate and explain the experiences underlying the quantitative findings. The ESaC services are shown to be helpful to service users in two particular ways: helping them to normalise their experiences by talking to an impartial listener and helping them to accept and adapt to the physical, emotional and social changes in their lives resulting from their visual impairment.

Recovery colleges: long-term impact and mechanisms of change

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Holly Thompson ◽  
Laura Simonds ◽  
Sylvie Barr ◽  
Sara Meddings
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Positive Impact ◽  
Evidence Base ◽  
College Attendance ◽  
Personal Recovery ◽  
Structured Interviews ◽  
Content Type ◽  
Educational Paradigm ◽  
Long Term Impact

Purpose Recovery Colleges are an innovative approach which adopt an educational paradigm and use clinician and lived experience to support students with their personal recovery. They demonstrate recovery-orientated practice and their transformative role has been evidenced within mental health services. The purpose of this study is to explore how past students understand the influence of the Recovery College on their on-going recovery journey. Design/methodology/approach An exploratory, qualitative design was used and semi-structured interviews took place with 15 participants. Data was analysed using the “framework method” and inductive processes. Findings All participants discussed gains made following Recovery College attendance that were sustained at one year follow-up. Three themes emerged from the data: Ethos of recovery and equality; Springboard to opportunities; and Intrapersonal changes. Originality/value This research explores students’ experiences a year after attendance. This contrasts to most research which is completed immediately post course. This study contributes to the emergent evidence base highlighting the longitudinal positive impact of Recovery Colleges. This study is of value to those interested in recovery-oriented models within mental health. Recovery Colleges are gaining traction nationally and internationally and this research highlights processes underlying this intervention which is of importance to those developing new Recovery Colleges.

Modeling variables associated with personal recovery among service users with mental disorders using community-based services

2019 ◽  
Vol 65 (2) ◽  
pp. 123-135 ◽  
Author(s):  
Marie-Josée Fleury ◽  
Judith Sabetti ◽  
Jean-Marie Bamvita ◽  
Guy Grenier
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Health Service ◽  
Mood Disorders ◽  
Basic Needs ◽  
Equation Modeling ◽  
Service Users ◽  
Personal Recovery ◽  
Local Health Service ◽  
Comprehensive Service

Background: Mental health research is evolving toward the identification of conceptual models and associated variables, which may provide a better understanding of personal recovery, given its importance for individuals affected by mental disorders (MDs). Aims: This article evaluated personal recovery in a sample of adults with MDs using an adapted conceptual framework based on the Andersen behavioral model, which evaluates predisposing, enabling and needs factors in service use. Methods: The study design was cross-sectional and included 327 mental health service users recruited across four local health service networks in Quebec (Canada). Data were collected using seven standardized instruments and participant medical records. Structural equation modeling was performed. Results: Quality of life (QOL), an enabling factor, was most strongly associated with personal recovery. Health behavior variables associated with recovery included the following: use of alcohol services, having a family physician, consulting a psychologist, use of food banks, consulting fewer professionals and not using drug services. Regarding needs factors, higher numbers of needs, lower severity of unmet health, social and basic needs and absence of mood disorders were also associated with personal recovery. No predisposing factors emerged as significant in the model. Conclusion: Findings suggest that QOL, needs variables and comprehensive service delivery are important in personal recovery. Services should be individualized to the health, social and basic needs of service users, particularly those with mood disorders or co-occurring mental health/substance use disorders.

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