scholarly journals Understanding the Experience of Service Users in an Integrated Care Programme for Obesity and Mental Health: A Qualitative Investigation of Total Wellbeing Luton

2022 ◽  
Vol 19 (2) ◽  
pp. 817
Author(s):  
Fani Liapi ◽  
Angel Marie Chater ◽  
Julia Vera Pescheny ◽  
Gurch Randhawa ◽  
Yannis Pappas
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Integrated Care ◽  
Behaviour Change ◽  
Positive Impact ◽  
Self Regulation ◽  
Public Health Issue ◽  
Service Users ◽  
Structured Interviews ◽  
Care Programme

Obesity is a complex public health issue with multiple contributing factors. The emphasis on joined care has led to the development and implementation of a number of integrated care interventions targeting obesity and mental health. The purpose of this study was to examine user experience in an integrated care programme for obesity and mental health in Luton, UK. Semi-structured interviews were conducted with a purposeful sample of service users (N = 14). Interview transcripts were analysed using thematic analysis. Analysis of the interviews identified six main themes for understanding service users’ experiences of integrated care: (1) ‘A user-centered system’, (2) ‘Supports behaviour change’, (3) ‘Valued social support’, (4) ‘Communication is key’, (5) ‘Flexible referral process’, and (6) ‘Positive impact on life’. These themes describe how the service is operated, evidence perceived value service users place on social support in behavior change intervention, and address which service areas work well and which require improvement. The findings of these interviews have offered a significant contribution to understanding what service users value the most in an integrated healthcare setting. Service users value ongoing support and being listened to by healthcare professionals, as well as the camaraderie and knowledge acquisition to support their own behaviour change and promote self-regulation following their participation in the programme.

scholarly journals The social support, mental health, psychiatric symptoms, and functioning of persons with schizophrenia participating in peer co-delivered vocational rehabilitation: a pilot study in Taiwan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kan-Yuan Cheng ◽  
Chia-Feng Yen
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Vocational Rehabilitation ◽  
Psychiatric Symptoms ◽  
Skills Training ◽  
Service Users ◽  
Pilot Program ◽  
The Social ◽  
Functional Scores ◽  
Persons With Schizophrenia

Abstract Background Vocational peer support (VPS) services are recovery-oriented interventions in modern psychiatric care for persons with schizophrenia. However, few VPS services are found in Taiwan. Hence, a pilot program of peer co-delivered vocational rehabilitation to support persons with schizophrenia in Taiwan was proposed and evaluated. Methods Six peers were trained and were willing to co-lead and assist workplace problem-solving groups and care skills training in an extended vocational rehabilitation program from August 2017 to December 2018. The social support, mental health, psychiatric symptoms, and functioning of service users were assessed before and after peer co-delivered services, and the assessments were based on the following: Social Support Scale (SSS), Chinese Health Questionnaire-12 (CHQ-12), Brief Psychiatric Rating Scale (BPRS), Global Assessment of Function (GAF), and the Chinese version of the Social Functioning Scale (C-SFS). Results The recruited 46 service users were mostly middle-aged (49.1 ± 9.8), with 27 being male (58.7%). After interventions, 42 service users who completed the program had a significantly increased SSS score (149.1 ± 31.8 vs. 161.2 ± 35.0, df = 41, t = 2.70, p = 0.01) and subscale of friend-peer dimension (44.4 ± 12.0 vs. 53.2 ± 13.2, df = 41, t = 4.72, p < 0.001). The objective (GAF: 69.8 ± 9.8 vs. 72.6 ± 8.8, df = 41, t = 3.50, p = 0.001) and subjective social functional scores (C-SFS: 75.2 ± 8.8 vs. 78.1 ± 9.5, df = 41, t = 2.59, p = 0.01) both significantly increased. The weekly wage elevated significantly (37.5 ± 35.5 vs. 43.6 ± 38.0, df = 41, t = 2.57, p = 0.01) and the BPRS-18 score decreased significantly, too (31.2 ± 6.7 vs. 29.3 ± 5.0, df = 41, t = − 2.83, p = 0.007). Conclusions Peer co-delivered vocational rehabilitation services may enhance the social support received by persons with schizophrenia and improve their occupational outcomes. The pilot program proposed can thus be a model for non-Western countries with limited resources allocated by governments to support persons with schizophrenia. Trial registration: ClinicalTrials NCT04767204, retrospectively registered on Feb 23, 2021.

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.

scholarly journals Integrated care to address the physical health needs of people with severe mental illness: a rapid review

2016 ◽  
Vol 4 (13) ◽  
pp. 1-130 ◽  
Author(s):  
Mark Rodgers ◽  
Jane Dalton ◽  
Melissa Harden ◽  
Andrew Street ◽  
Gillian Parker ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Physical Health ◽  
Integrated Care ◽  
Health Needs ◽  
Rapid Review ◽  
Advisory Group ◽  
Service Users ◽  
Physical Health Care ◽  
Facilitators And Barriers

BackgroundPeople with mental health conditions have a lower life expectancy and poorer physical health outcomes than the general population. Evidence suggests that this discrepancy is driven by a combination of clinical risk factors, socioeconomic factors and health system factors.Objective(s)To explore current service provision and map the recent evidence on models of integrated care addressing the physical health needs of people with severe mental illness (SMI) primarily within the mental health service setting. The research was designed as a rapid review of published evidence from 2013–15, including an update of a comprehensive 2013 review, together with further grey literature and insights from an expert advisory group.SynthesisWe conducted a narrative synthesis, using a guiding framework based on nine previously identified factors considered to be facilitators of good integrated care for people with mental health problems, supplemented by additional issues emerging from the evidence. Descriptive data were used to identify existing models, perceived facilitators and barriers to their implementation, and any areas for further research.Findings and discussionThe synthesis incorporated 45 publications describing 36 separate approaches to integrated care, along with further information from the advisory group. Most service models were multicomponent programmes incorporating two or more of the nine factors: (1) information sharing systems; (2) shared protocols; (3) joint funding/commissioning; (4) colocated services; (5) multidisciplinary teams; (6) liaison services; (7) navigators; (8) research; and (9) reduction of stigma. Few of the identified examples were described in detail and fewer still were evaluated, raising questions about the replicability and generalisability of much of the existing evidence. However, some common themes did emerge from the evidence. Efforts to improve the physical health care of people with SMI should empower people (staff and service users) and help remove everyday barriers to delivering and accessing integrated care. In particular, there is a need for improved communication between professionals and better information technology to support them, greater clarity about who is responsible and accountable for physical health care, and awareness of the effects of stigmatisation on the wider culture and environment in which services are delivered.Limitations and future workThe literature identified in the rapid review was limited in volume and often lacked the depth of description necessary to acquire new insights. All members of our advisory group were based in England, so this report has limited information on the NHS contexts specific to Scotland, Wales and Northern Ireland. A conventional systematic review of this topic would not appear to be appropriate in the immediate future, although a more interpretivist approach to exploring this literature might be feasible. Wherever possible, future evaluations should involve service users and be clear about which outcomes, facilitators and barriers are likely to be context-specific and which might be generalisable.FundingThe research reported here was commissioned and funded by the Health Services and Delivery Research programme as part of a series of evidence syntheses under project number 13/05/11. For more information visitwww.nets.nihr.ac.uk/projects/hsdr/130511.

Safe but isolated – an interview study with Iraqi refugees in Sweden about social networks, social support, and mental health

2020 ◽  
pp. 002076402095425 ◽  
Author(s):  
Maria Sundvall ◽  
David Titelman ◽  
Valerie DeMarinis ◽  
Liubov Borisova ◽  
Önver Çetrez
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Social Networks ◽  
Mental Health Problems ◽  
Health Assessment ◽  
Well Being ◽  
Health Problems ◽  
Traumatic Experiences ◽  
Iraqi Refugees ◽  
Structured Interviews

Background: Problems with social networks and social support are known to be associated with mental ill-health in refugees. Social support after migration promotes resilience. Aim: To study how Iraqi refugees who arrived in Sweden after the year 2000 perceived their social networks and social support, and to relate the observed network characteristics and changes to the refugees’ mental health and well-being. Method: Semi-structured interviews with 31 refugees, including questions on background and migration experiences, a biographical network map, and three health assessment scales. The findings were analysed with descriptive statistics and content thematic analysis. Results: The respondents’ networks were diminished. Social support was continued to be provided mainly by family members and supplemented by support from authorities. The main themes of the refugee experience of post-migration challenges were weakened social networks, barriers to integration and challenges to cultural and religious belonging. Failed reunion and worrying about relatives was described as particularly painful. Negative contacts with authority persons were often seen as humiliating or discriminating. Acquiring a new cultural belonging was described as challenging. At the same time, changing family and gender roles made it more difficult to preserve and develop the culture of origin. Traumatic experiences and mental health problems were common in this group. Family issues were more often than integration difficulties associated with mental health problems. Conclusion: In order to strengthen post-migration well-being and adaptation, authorities should support the refugees’ social networks. Clinicians need to address post-migration problems and challenges, including the meaning and function of social networks.

Controlled trial of discharge planning by video-link in a UK urban mental health service: Responses of staff and service users

2002 ◽  
Vol 8 (3_suppl) ◽  
pp. 44-46 ◽  
Author(s):  
Paul Mclaren ◽  
Sab Jegan ◽  
Johanna Ahlbom ◽  
Fidel Gallo ◽  
Fiona Gaughran ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Discharge Planning ◽  
Controlled Trial ◽  
Service Users ◽  
Care Programme ◽  
Baseline Phase ◽  
Urban Mental Health ◽  
Video Link

summary We examined the use of videoconferencing in a UK urban mental health service for discharge planning within the framework of the Care Programme Approach (CPA). The study was an AB design. Baseline data were collected over three months, before the introduction of the CPA by videoconferencing. Twenty-seven CPA meetings were held in the baseline phase of the study and 23 during the video-link phase. Service users and professional participants were asked to complete the Guy's Communication Questionnaire (GCQ) at the end of the meeting. A total of 204 GCQs were completed (88% of those issued). Responses were compared between the face-to-face and video-link conditions. No significant differences were found in satisfaction measures between the two conditions. These data suggest that the video-link medium is acceptable to service users and professionals alike for discharge planning.

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 Understanding University Students’ Experiences, Perceptions, and Attitudes Toward Peers Displaying Mental Health-related Problems on Social Network Sites (Preprint)

2020 ◽  
Author(s):  
Taewan Kim ◽  
Hwajung Hong
Keyword(s):  
Mental Health ◽  
Social Support ◽  
College Students ◽  
At Risk ◽  
Mental Health Problems ◽  
Health Problems ◽  
Structured Interviews ◽  
Design Guideline ◽  
Perceptions And Attitudes ◽  
Health Related

BACKGROUND College students are at a vulnerable age; among those with serious mental health problems, this period is frequently when the first episodes appear. As a result, college students are increasingly disclosing their vulnerable, stigmatized experiences on social networking sites (SNSs). Understanding students’ perceptions and attitudes toward their peers who are dealing with mental health problems is vital to the efforts to eliminate peer exclusion and foster social support. OBJECTIVE This work aims to provide a better understanding of how college perceive and react to their fellow students’ mental health related activities on SNSs. We investigate how students recognize, perceive, and react to peers who display mental health related challenges on SNSs. METHODS Survey with 226 students, and semi structured interviews with 20 students were conducted at six universities in South Korea. RESULTS We revealed that a considerable number of college students did not proactively provide support even when they identified at-risk peers because of stigmatized content, unusual online activities, or a gap between online and offline identities. We found that the students’ lack of knowledge, confidence, and expectations as well as their desire to maintain distance from at-risk peers hindered social support. CONCLUSIONS On the basis of this study’s finding, we discuss SNS design guideline that would help these platforms facilitate support exchanges among peers while minimizing potential risks.

Is Everything in the Garden Rosy? An Integrated Care Pathway for Acute Inpatient Mental Health Care, from Development to Evaluation: Part 2

2005 ◽  
Vol 9 (3) ◽  
pp. 101-105
Author(s):  
Robert Grant ◽  
Julie Hall ◽  
Roger Pritlove
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Integrated Care ◽  
Care Pathway ◽  
Service Users ◽  
Inpatient Mental Health ◽  
Integrated Care Pathway ◽  
Health Care Records ◽  
The Impact

This is the second paper of two, which considers the development, use and evaluation of an integrated care pathway (ICP) for acute inpatient mental health care. This paper reports an evaluation that was carried out to measure the impact of an ICP (described in Part 1) on the interventions it was designed to guide. The methodology used was pre- and post-ICP comparison of activities/care recorded in health-care records using delineating measures. Data were gathered from the notes of 23 service-users who had two inpatient stays within a year, one pre-ICP and one post-ICP. The findings suggested an overall improved provision of interventions, although as the ICP progressed the likelihood of receiving interventions fell. Three specific aspects were not affected by the ICP, these were giving information about observation levels to service-users, care planning and medical interventions. These issues are discussed and the conclusion raise implications for further ICP development and implementation.

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.

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.

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