scholarly journals Types of Ethical Problems and Expertise in Clinical Ethics Consultation in Psychiatry – Insights From a Qualitative Empirical Ethics Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Joschka Haltaufderheide ◽  
Jakov Gather ◽  
Georg Juckel ◽  
Jan Schildmann ◽  
Jochen Vollmann
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Clinical Ethics ◽  
Mental Healthcare ◽  
Ethics Consultation ◽  
Third Party ◽  
Practical Training ◽  
Structured Interviews ◽  
Ethical Problems

Background: Ethics consultation has been advocated as a valuable tool in ethically challenging clinical situations in healthcare. It is paramount for the development and implementation of clinical ethics support services (CESS) in psychiatry that interventions can address the moral needs of mental health professionals adequately and communicate the nature of the services clearly. This study explores types of ethical problems and concepts of ethical expertise as core elements of CESS in mental healthcare with the aim of contributing to the further development of ethical support in psychiatry.Methods: We conducted 13 semi-structured interviews with mental health professionals and CESS members and triangulated them with four non-participant observations of ethical case consultations in psychiatry. Data were analyzed according to principles of grounded theory and are discussed from a normative perspective.Results: The analysis of the empirical data reveals a typology of three different ethical problems professionals want to refer to CESS: (1) Dyadic problems based on the relationship between patients and professionals, (2) triangular problems, where a third party is involved and affected as a side effect, and (3) problems on a systemic level. However, CESS members focus largely on types (1) and (2), while the third remains unrecognized or members do not feel responsible for these problems. Furthermore, they reflect a strong inner tension connected to their role as ethical experts which can be depicted as a dilemma. On the one hand, as ethically trained people, they reject the idea that their judgments have expert status. On the other hand, they feel that mental health professionals reach out for them to obtain guidance and that it is their responsibility to offer it.Conclusion: CESS members and professionals in mental healthcare have different ideas of the scope of responsibility of CESS. This contains the risk of misunderstandings and misconceptions and may affect the quality of consultations. It is necessary to adapt concepts of problem solving to practitioners' needs to overcome these problems. Secondly, CESS members struggle with their role as ethical experts. CESS members in psychiatry need to develop a stable professional identity. Theoretical clarification and practical training are needed.

Mapping mental health professionals’ perspectives and practices regarding the implementation of Digital Mental Health: a qualitative study (Preprint)

2021 ◽  
Author(s):  
Cristina Mendes-Santos ◽  
Francisco Nunes ◽  
Elisabete Weiderpass ◽  
Rui Santana ◽  
Gerhard Andersson
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Mental Healthcare ◽  
Cost Effective ◽  
Clinical Settings ◽  
Structured Interviews ◽  
Intervention Delivery ◽  
Training Programmes

BACKGROUND Despite Digital Mental Health’s potential to provide cost-effective mental healthcare, its adoption in clinical settings is limited and little is known about the perspectives and practices of mental health professionals regarding its implementation or the factors influencing such perspectives and practices. OBJECTIVE The current study aimed at characterizing in-depth the perspectives and practices of mental health professionals regarding the implementation of Digital Mental Health and exploring the factors impacting such perspectives and practices. METHODS A qualitative study using in-depth semi-structured interviews with Portuguese mental health professionals (N=13) - psychologists and psychiatrists – was conducted. Transcribed interviews were thematically analysed. RESULTS Mental health professionals deemed important or engaged in the following practices during the implementation of Digital Mental Health: i) Indication evaluation; ii) Therapeutic contract negotiation; iii) Digital psychological assessment; iv) Technology setup and management; and v) Intervention delivery and follow-up. Low threshold accessibility and professionals' perceived duty to provide support to their clients facilitated the implementation of Digital Mental Health. Conversely, the lack of structured intervention frameworks; the unavailability of usable, validated, and affordable technology; and the absence of structured training programmes, inhibited Digital Mental Health’s implementation by mental health professionals. CONCLUSIONS The publication of practice frameworks, the development of evidence-based technology, and the delivery of structured training seem key to expedite implementation and encourage the sustained adoption of Digital Mental Health by mental health professionals.

Asking the Hard Questions: Psychologists’ Discomfort With Inquiring About Sexual Abuse Histories

2021 ◽  
pp. 107780122110145
Author(s):  
Belinda Nixon ◽  
Elly Quinlan
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Mental Health Professionals ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Early Career ◽  
Evidence Based ◽  
Structured Interviews ◽  
Early Career Psychologists ◽  
University Training

The literature on sexual abuse indicates low rates of inquiry by mental health professionals. This study explores early career psychologists’ experiences of inquiry into their clients’ sexual abuse histories. Twelve Australian psychologists participated in semi-structured interviews with transcripts analyzed using thematic analysis. The vast majority of participants reported that they did not routinely inquire about sexual abuse with barriers including not knowing what to do, discomfort, stigma, and fear of negative outcomes. Participants asserted that their university training in sexual abuse inquiry was inadequate. Findings emphasize the need for the development of an evidence-based framework for sexual abuse training.

The transition between mental health services in Scotland

2018 ◽  
Vol 23 (1) ◽  
pp. 12-24 ◽  
Author(s):  
Juliette van der Kamp
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Transition Period ◽  
Organisational Development ◽  
Structured Interviews ◽  
Content Type ◽  
Experience Difficulty

Purpose The purpose of this paper is to describe the barriers and facilitators to an effective transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It also presents a new entry into considering how the transition can be improved. Design/methodology/approach Insights into the transition from CAMHS to AMHS were gathered through eight semi-structured interviews with mental health professionals. Two methods of data analysis were employed to explore the emerging themes in the data and the observed deficit approach to organisational development. Findings The findings identified a vast volume of barriers in comparison to facilitators to the transition. Adolescents who transition from CAMHS to AMHS initially experience difficulty adapting to the differences in the services due to the short duration of the transition period. However, despite the established barriers to the transition, adolescents tend to adapt to the differences between the services. Findings also showed a negative framing towards the transition amongst the mental health professionals which resembles a deficit approach to organisational development. Originality/value This paper explores mental health professionals’ perspectives regarding the transition in Dumfries and Galloway, Scotland. The transition is increasingly recognised as an area in health care that requires improvement. This research provides a new way to consider the transition by exploring the perceived deficit approach to organisational development in the services.

scholarly journals The Psychological Impact of Covid-19 on University Students: Their Expectations of Mental Health Professionals

2021 ◽  
Vol 8 (4) ◽  
pp. 1-20
Author(s):  
M.Siyabend KAYA ◽  
Yavuz KOŞAN
Keyword(s):  
Mental Health ◽  
University Students ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Psychosocial Support ◽  
Qualitative Content Analysis ◽  
Psychological Impact ◽  
Depression And Anxiety ◽  
Structured Interviews ◽  
Main Effects

The current study focused on exploring the psychological impact of the COVID -19 outbreak on university students and participants' expectations of mental health professionals. Semi-structured interviews were conducted with 80 university students aged 18 to 33 years from 19 cities in Turkey. Qualitative content analysis was used to identify important aspects of the students' experiences. According to the results, the main effects of the epidemic COVID -19 on the participants were depression and anxiety. We found that participants used various ways to cope with COVID -19 such as reading books and paying attention to hygiene. Participants also indicated that they perceived some positive situations, such as the value of nature and humanity, the importance of family, and various negative situations, such as mental exhaustion. Finally, participants stressed that they had different expectations regarding psychosocial support and the planning of individual activities by mental health professionals

scholarly journals Mental health professionals’ perceptions on patients control of data sharing

2020 ◽  
Vol 26 (3) ◽  
pp. 2011-2029 ◽  
Author(s):  
Julia Ivanova ◽  
Adela Grando ◽  
Anita Murcko ◽  
Michael Saks ◽  
Mary Jo Whitfield ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Information ◽  
Data Sharing ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Health Data ◽  
Structured Interviews ◽  
Timely Access ◽  
The Impact

Integrated mental and physical care environments require data sharing, but little is known about health professionals’ perceptions of patient-controlled health data sharing. We describe mental health professionals’ views on patient-controlled data sharing using semi-structured interviews and a mixed-method analysis with thematic coding. Health information rights, specifically those of patients and health care professionals, emerged as a key theme. Behavioral health professionals identified patient motivations for non-sharing sensitive mental health records relating to substance use, emergency treatment, and serious mental illness (94%). We explore conflicts between professional need for timely access to health information and patient desire to withhold some data categories. Health professionals’ views on data sharing are integral to the redesign of health data sharing and informed consent. As well, they seek clarity about the impact of patient-controlled sharing on health professionals’ roles and scope of practice.

scholarly journals Approved mental health professionals: A jack of all trades? Hybrid professional roles within a mental health occupation

2019 ◽  
Vol 19 (5-6) ◽  
pp. 987-1006 ◽  
Author(s):  
Caroline Leah
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Structured Interviews ◽  
Mental Health Nursing ◽  
Hybrid Identities ◽  
Study Approach ◽  
Health Occupation ◽  
Mixed Origin ◽  
Health Nursing

This article presents findings from the Hybrid Identities Project that investigated the professional role and identities of ten multi-professional Approved Mental Health Professionals (AMHPs) from social work, mental health nursing and occupational therapy backgrounds as hybrid professionals. Hybrid professionals are professionals of a mixed origin who work across several roles and areas of expertise within public services. AMHPs have a legal role within the Mental Health Act 1983 (2007) in England and Wales to plan the assessment of individuals who require care and treatment for a mental disorder. An intrinsic case study approach was undertaken with data generated through semi-structured interviews that examined professional hybridisation, illustrated through AMHPs’ enactment of eight hybrid roles. The article contributes to empirical understandings of AMHP professional practice through advancing ideas about role hybridisation within a previously under-researched mental health occupation.

scholarly journals Mental health professionals’ experiences with shared decision-making for patients with psychotic disorders: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Espen W. Haugom ◽  
Bjørn Stensrud ◽  
Gro Beston ◽  
Torleif Ruud ◽  
Anne S. Landheim
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Shared Decision Making ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Psychotic Disorders ◽  
Successful Implementation ◽  
Practical Training ◽  
Shared Decision ◽  
Antipsychotic Medications

Abstract Background Shared decision-making (SDM) is a process whereby clinicians and patients work together to select treatments based on both the patient’s preferences and clinical evidence. Although patients with psychotic disorders want to participate more in decisions regarding their care, they have limited opportunities to do so because of various barriers. Knowing about health professionals’ experiences with SDM is important toward achieving successful implementation. The study aim was to describe and explore health professionals’ SDM experiences with patients with psychotic disorders. Methods Three focus group interviews were conducted, with a total of 18 health professionals who work at one of three Norwegian community mental health centres where patients with psychotic disorders are treated. We applied a descriptive and exploratory approach using qualitative content analysis. Results Health professionals primarily understand the SDM concept to mean giving patients information and presenting them with a choice between different antipsychotic medications. Among the barriers to SDM, they emphasized that patients with psychosis have a limited understanding of their health situation and that time is needed to build trust and alliances. Health professionals mainly understand patients with psychotic disorders as a group with limited abilities to make their own decisions. They also described the concept of SDM with little consideration of presenting different treatment options. Psychological or social interventions were often presented as complementary to antipsychotic medications, rather than as an alternative to them. Conclusion Health professionals’ understanding of SDM is inconsistent with the definition commonly used in the literature. They consider patients with psychotic disorders to have limited abilities to participate in decisions regarding their own treatment. These findings suggest that health professionals need more theoretical and practical training in SDM.

scholarly journals On the Question of Integrating Spirituality with Counselling in India

2016 ◽  
Vol 15 (1) ◽  
pp. 35
Author(s):  
Thomas Joseph Parayil ◽  
Tony Sam George
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Qualitative Data ◽  
Treatment Process ◽  
Years Of Experience ◽  
Structured Interviews

This paper explores the therapists’ views and experience on spiritual components in counselling. Qualitative data were collected through semi-structured interviews, and thematic analysis used. The participants were nine mental health professionals from different backgrounds with 15 to 30 years of experience in the field. The four main themes that emerged are faith in God, the power of prayer, forgiveness and wholesome treatment process  

Mental health professionals discussing spiritual care for psychiatric outpatients: a qualitative study of multidisciplinary meetings

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Bart Cusveller ◽  
Maarten van Garderen ◽  
Joan Roozemond-Kroon
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Spiritual Care ◽  
Health Professionals ◽  
Mental Healthcare ◽  
Multidisciplinary Care ◽  
Psychiatric Outpatients ◽  
Insurance Reimbursement ◽  
Multidisciplinary Meetings ◽  
Group Interviews

Abstract Aim: To explore how mental health professionals address spiritual care for outpatients in weekly multidisciplinary care meetings (MDM), and to explore the barriers and facilitators in the ways health professionals address spiritual care in those meetings. Method: Two teams of mental health professionals providing care for psychiatric outpatients are included. Qualitative data were collected from audio recordings of multidisciplinary meetings and from focus-group interviews afterwards. Data were analysed using ‘open coding’. Results: Spiritual care was not frequently addressed mostly due to the requirements of the health insurance reimbursement system. Aspects of spirituality addressed in these meetings pertained mainly to meaningful daily activities. Addressing spiritual care was facilitated, on the other hand, by a holistic focus on health and recovery-oriented care. Conclusion: In ambulatory mental healthcare spirituality is sparsely addressed and, when addressed, few aspects of spirituality come into view. Facilitating healthcare professionals’ awareness of their clinical perspective is an essential step to improve spiritual care for psychiatric outpatients.

scholarly journals Services for ethnic minorities: a question of trust

2008 ◽  
Vol 32 (11) ◽  
pp. 401-402 ◽  
Author(s):  
Louis Appleby
Keyword(s):  
Mental Health ◽  
Ethnic Minorities ◽  
Mental Health Professionals ◽  
Government Policy ◽  
Health Professionals ◽  
Mental Healthcare ◽  
Minority Communities ◽  
Fair Treatment ◽  
Positive Message ◽  
Policy Priority

SummaryMental healthcare for ethnic minorities is a government policy priority. However, debate about how services should develop has been overshadowed by public criticism over high rates of admission and sectioning in some ethnic groups, the implication being that racism is rife in mental healthcare. These criticisms are headline-seeking, scientifically crude and unfair to mental health professionals. However, it is true that some minority communities are mistrustful of the services available. We need to overcome this mistrust with a positive message – and a promise of fair treatment.

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