scholarly journals Implementation of Therapeutic Virtual Reality Into Psychiatric Care: Clinicians' and Service Managers' Perspectives

2022 ◽  
Vol 12 ◽  
Author(s):  
Olivia S. Chung ◽  
Tracy Robinson ◽  
Alisha M. Johnson ◽  
Nathan L. Dowling ◽  
Chee H. Ng ◽  
...  
Keyword(s):  
Mental Health ◽  
Successful Implementation ◽  
Staff Attitudes ◽  
Clinical Factors ◽  
Implementation Barriers ◽  
Enabling Factors ◽  
Ethical Concerns ◽  
Attitudes Towards Technology ◽  
Organisational Factors ◽  
Service Managers

Objectives: Virtual reality (VR) has emerged as a highly promising tool for assessing and treating a range of mental illnesses. However, little is known about the perspectives of key stakeholders in mental healthcare, whose support will be critical for its successful implementation into routine clinical practise. This study aimed to explore the perspectives of staff working in the private mental health sector around the use of therapeutic VR, including potential implementation barriers and facilitators.Methods: Semi-structured qualitative interviews were conducted with cross-disciplinary clinicians (n = 14) and service managers (n = 5), aged 28–70 years working in a major private mental health hospital in Victoria, Australia. Transcripts were analysed using general inductive coding to allow themes to naturally emerge.Results: Three major themes were identified: clinical factors (four subthemes), organisational factors (five subthemes), and professional factors (three subthemes). The themes encompassed enabling factors and potential barriers that need to be addressed for successful implementation of VR. Clinical factors highlighted the influence of knowledge or perceptions about appropriate clinical applications, therapeutic efficacy, safety and ethical concerns, and patient engagement. Organisational factors emphasised the importance of service contexts, including having a strong business case, stakeholder planning, recruitment of local opinion leaders to champion change, and an understanding of resourcing challenges. Professional factors highlighted the need for education and training for staff, and the influence of staff attitudes towards technology and perceived usability of VR.Conclusions: In addition to enabling factors, potential implementation barriers of therapeutic VR were identified, including resourcing constraints, safety and ethical concerns, negative staff attitudes towards technology and VR system limitations. Future dissemination should focus on addressing knowledge and skills gaps and attitudinal barriers through development of clinical guidelines, training programs, and implementation resources (e.g., adoption decision tools, consultation opportunities).

scholarly journals Predicting Inpatient Aggression in Forensic Services Using Remote Monitoring Technology: Qualitative Study of Staff Perspectives (Preprint)

2019 ◽  
Author(s):  
Ben Greer ◽  
Katie Newbery ◽  
Matteo Cella ◽  
Til Wykes
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Remote Monitoring ◽  
Negative Impact ◽  
Well Being ◽  
Staff Attitudes ◽  
Forensic Mental Health ◽  
Implementation Barriers ◽  
Monitoring Technology ◽  
Potential Benefits

BACKGROUND Monitoring risk of imminent aggression in inpatient forensic mental health services could be supported by passive remote monitoring technology, but staff attitudes toward the relevance and likelihood of engagement with this technology are unknown. OBJECTIVE This study aimed to explore staff views, specifically potential benefits and implementation barriers, on using this technology for monitoring risk of inpatient aggression. METHODS We conducted semistructured focus groups with nurses in an inpatient forensic mental health service. We used thematic analysis with two independent raters to identify themes and subthemes related to staff attitudes toward passive remote monitoring. We subsequently checked with members to ensure the validity of the themes identified by the raters. RESULTS From January to March 2019, a total of 25 nurses took part in five focus groups. We identified five main themes, one of which concerned the potential benefits that passive remote monitoring could provide for monitoring risk of aggression. Staff suggested it could provide an early warning of impending aggression and enable support to be provided earlier. The remaining themes concerned implementation barriers, including risks to the users’ physical and mental well-being; data security concerns and potential access by third parties; the negative impact of a constant stream of real-time data on staff workload; and design characteristics and user awareness of the benefits of passive remote monitoring. CONCLUSIONS Passive remote monitoring technology could support existing methods of monitoring inpatient aggression risk, but multiple barriers to implementation exist. Empirical research is required to investigate whether these potential benefits can be realized, and to identify ways of addressing these barriers to ensure acceptability and user engagement.

scholarly journals Predicting Inpatient Aggression in Forensic Services Using Remote Monitoring Technology: Qualitative Study of Staff Perspectives

10.2196/15620 ◽  
2019 ◽  
Vol 21 (9) ◽  
pp. e15620
Author(s):  
Ben Greer ◽  
Katie Newbery ◽  
Matteo Cella ◽  
Til Wykes
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Remote Monitoring ◽  
Negative Impact ◽  
Well Being ◽  
Staff Attitudes ◽  
Forensic Mental Health ◽  
Implementation Barriers ◽  
Monitoring Technology ◽  
Potential Benefits

Background Monitoring risk of imminent aggression in inpatient forensic mental health services could be supported by passive remote monitoring technology, but staff attitudes toward the relevance and likelihood of engagement with this technology are unknown. Objective This study aimed to explore staff views, specifically potential benefits and implementation barriers, on using this technology for monitoring risk of inpatient aggression. Methods We conducted semistructured focus groups with nurses in an inpatient forensic mental health service. We used thematic analysis with two independent raters to identify themes and subthemes related to staff attitudes toward passive remote monitoring. We subsequently checked with members to ensure the validity of the themes identified by the raters. Results From January to March 2019, a total of 25 nurses took part in five focus groups. We identified five main themes, one of which concerned the potential benefits that passive remote monitoring could provide for monitoring risk of aggression. Staff suggested it could provide an early warning of impending aggression and enable support to be provided earlier. The remaining themes concerned implementation barriers, including risks to the users’ physical and mental well-being; data security concerns and potential access by third parties; the negative impact of a constant stream of real-time data on staff workload; and design characteristics and user awareness of the benefits of passive remote monitoring. Conclusions Passive remote monitoring technology could support existing methods of monitoring inpatient aggression risk, but multiple barriers to implementation exist. Empirical research is required to investigate whether these potential benefits can be realized, and to identify ways of addressing these barriers to ensure acceptability and user engagement.

Clinical dilemmas of routine outcome monitoring and clinical feedback: a qualitative study of patient experiences

2020 ◽  
Author(s):  
Stig Magne Solstad ◽  
Gøril Kleiven Solberg ◽  
Louis George Castonguay ◽  
Christian Moltu
Keyword(s):  
Mental Health ◽  
Clinical Skill ◽  
Routine Outcome Monitoring ◽  
Future Research ◽  
Successful Implementation ◽  
Basic Training ◽  
Feedback Systems ◽  
Clinical Encounters ◽  
Outcome Monitoring ◽  
Clinical Feedback

Purpose: Routine outcome monitoring (ROM) and clinical feedback systems (CFS) are becoming prevalent in mental health services. The field faces several challenges to successful implementation. The purpose of this study is to gain a better understanding of these challenges by exploring the patient perspective. Method: We report the findings from a qualitative, video assisted interview study of 12 patients from a Norwegian mental health outpatient clinic using ROM/CFS. Results: Our analysis resulted in three pairs of opposing experiences with using ROM/CFS: 1) Explicit vs. implicit use of CFS information, 2) CFS directing focus towards- vs. directing focus away from therapeutic topics and 3) Giving vs. receiving feedback. None of these were intrinsically helpful or hindering. Participants had vastly differing preferences for how to use ROM/CFS in clinical encounters, but all needed the information to be used in a meaningful way by their therapists. If not, ROM/CFS was at risk of becoming meaningless and hindering for therapy. Conclusion: These findings confirm and provide further nuance to previous research. We propose to consider ROM/CFS a clinical skill that should be a part of basic training for therapists. How to use and implement ROM/CFS skillfully should also be the focus of future research.

scholarly journals Evidence for implementation of interventions to promote mental health in the workplace: a systematic scoping review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Charlotte Paterson ◽  
Caleb Leduc ◽  
Margaret Maxwell ◽  
Birgit Aust ◽  
Benedikt L. Amann ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
Scoping Review ◽  
Mental Health Problems ◽  
Evaluation Studies ◽  
Grey Literature ◽  
Mental Health Promotion ◽  
Successful Implementation ◽  
Health Promotion Interventions ◽  
Promote Mental Health

Abstract Background Mental health problems are common in the working population and represent a growing concern internationally, with potential impacts on workers, organisations, workplace health and compensation authorities, labour markets and social policies. Workplace interventions that create workplaces supportive of mental health, promote mental health awareness, destigmatise mental illness and support those with mental disorders are likely to improve health and economical outcomes for employees and organisations. Identifying factors associated with successful implementation of these interventions can improve intervention quality and evaluation, and facilitate the uptake and expansion. Therefore, we aim to review research reporting on the implementation of mental health promotion interventions delivered in workplace settings, in order to increase understanding of factors influencing successful delivery. Methods and analysis A scoping review will be conducted incorporating a stepwise methodology to identify relevant literature reviews, primary research and grey literature. This review is registered with Research Registry (reviewregistry897). One reviewer will conduct the search to identify English language studies in the following electronic databases from 2008 through to July 1, 2020: Scopus, PROSPERO, Health Technology Assessments, PubMed, Campbell Collaboration, Joanna Briggs Library, PsycINFO, Web of Science Core Collection, CINAHL and Institute of Occupational Safety and Health (IOSH). Reference searching, Google Scholar, Grey Matters, IOSH and expert contacts will be used to identify grey literature. Two reviewers will screen title and abstracts, aiming for 95% agreement, and then independently screen full texts for inclusion. Two reviewers will assess methodological quality of included studies using the Mixed Methods Appraisal Tool and extract and synthesize data in line with the RE-AIM framework, Nielson and Randall’s model of organisational-level interventions and Moore’s sustainability criteria, if the data allows. We will recruit and consult with international experts in the field to ensure engagement, reach and relevance of the main findings. Discussion This will be the first systematic scoping review to identify and synthesise evidence of barriers and facilitators to implementing mental health promotion interventions in workplace settings. Our results will inform future evaluation studies and randomised controlled trials and highlight gaps in the evidence base. Systematic review registration Research Registry (reviewregistry897)

scholarly journals Protocol for a hybrid type 2 cluster randomized trial of trauma-focused cognitive behavioral therapy and a pragmatic individual-level implementation strategy

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Aaron R. Lyon ◽  
Michael D. Pullmann ◽  
Shannon Dorsey ◽  
Carol Levin ◽  
Larissa M. Gaias ◽  
...  
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Behavior Change ◽  
Implementation Strategy ◽  
Youth Mental Health ◽  
Successful Implementation ◽  
Individual Level ◽  
Implementation Outcomes ◽  
Cluster Randomized

Abstract Background More than two-thirds of youth experience trauma during childhood, and up to 1 in 5 of these youth develops posttraumatic stress symptoms that significantly impair their functioning. Although trauma-focused cognitive behavior therapy (TF-CBT) has a strong evidence base, it is rarely adopted, delivered with adequate fidelity, or evaluated in the most common setting where youth access mental health services—schools. Given that individual behavior change is ultimately required for successful implementation, even when organizational factors are firmly in place, focusing on individual-level processes represents a potentially parsimonious approach. Beliefs and Attitudes for Successful Implementation in Schools (BASIS) is a pragmatic, motivationally focused multifaceted strategy that augments training and consultation and is designed to target precise mechanisms of behavior change to produce enhanced implementation and youth clinical outcomes. This study protocol describes a hybrid type 2 effectiveness-implementation trial designed to concurrently evaluate the main effects, mediators, and moderators of both the BASIS implementation strategy on implementation outcomes and TF-CBT on youth mental health outcomes. Methods Using a cluster randomized controlled design, this trial will assign school-based mental health (SMH) clinicians and schools to one of three study arms: (a) enhanced treatment-as-usual (TAU), (b) attention control plus TF-CBT, or (c) BASIS+TF-CBT. With a proposed sample of 120 SMH clinicians who will each recruit 4–6 youth with a history of trauma (480 children), this project will gather data across 12 different time points to address two project aims. Aim 1 will evaluate, relative to an enhanced TAU condition, the effects of TF-CBT on identified mechanisms of change, youth mental health outcomes, and intervention costs and cost-effectiveness. Aim 2 will compare the effects of BASIS against an attention control plus TF-CBT condition on theoretical mechanisms of clinician behavior change and implementation outcomes, as well as examine costs and cost-effectiveness. Discussion This study will generate critical knowledge about the effectiveness and cost-effectiveness of BASIS—a pragmatic, theory-driven, and generalizable implementation strategy designed to enhance motivation—to increase the yield of evidence-based practice training and consultation, as well as the effectiveness of TF-CBT in a novel service setting. Trial registration ClinicalTrials.gov registration number NCT04451161. Registered on June 30, 2020.

scholarly journals An evidence-based approach to routine outcome assessment

2012 ◽  
Vol 18 (3) ◽  
pp. 180-182 ◽  
Author(s):  
Mike Slade
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Decision Making ◽  
Academic Discipline ◽  
Community Mental Health Services ◽  
Clinical Decision ◽  
Successful Implementation ◽  
Frontline Workers ◽  
Routine Outcome Assessment

SummaryRoutine use of Health of the Nation Outcome Scales (HoNOS) has not produced the anticipated benefits for people using mental health services. Four HoNOS-specific reasons for this are: low relevance to clinical decision-making; not reflecting service user priorities; being staff-rated; and having a focus on deficits. More generally, the imposition of a centrally chosen measure on the mental health system leads to a clash of cultures, since frontline workers do not need a standardised measure to treat individuals. A better approach might be to use research from the emerging academic discipline of implementation science to inform the routine use of a standardised measure that is chosen by the people who will use it and hence is more concordant with existing clinical processes. This is illustrated using a case study of successful implementation of the Camberwell Assessment of Need (CAN) in community mental health services across Ontario, Canada.

ISM-MICMAC approach for analysis of project-based learning barriers

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Syed Khalid Perwez ◽  
Goutam Kumar Kundu
Keyword(s):  
Structural Model ◽  
Educational Institution ◽  
Project Based Learning ◽  
Educational Institutions ◽  
Successful Implementation ◽  
Implementation Barriers ◽  
Higher Educational Institutions ◽  
Content Type ◽  
Barriers To Implementation ◽  
Higher Educational

Purpose This paper aims to identify and model the key barriers to implementation of project-based learning (PjBL) in higher educational institution. Design/methodology/approach Using the interpretive structural modelling (ISM) technique, the study has developed a hierarchical-based model, depicting the mutual relationships amongst the key barriers to implementation of PjBL. Additionally, the paper has performed Matrice d’ Impacts Croises Multiplication Appliqué an Classement (MICMAC) analysis to categorize the barriers in terms of their driving and dependence power. Findings The study has identified the key barriers to implementation of PjBL and presented an integrated model using ISM. Higher educational institutions need to pay attention to diagnose and overcome these hindrances for effective implementation of PjBL in their programmes. Research limitations/implications The study adopts a systematic way to model the relevant barriers to implementation of PjBL. The ISM-based model would help higher education institutions to prioritize the issues as the barriers are hierarchically structured. As the input to model development is based on the experts’ opinions, it may be biased, influencing the final output of the structural model. Originality/value The presentation of PjBL implementation barriers in the form of an ISM-based model is a new effort. The model would be useful to understand the barriers and overcome these for the successful implementation of PjBL in higher educational institutions.

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