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Emerald Group Publishing Limited
Article Type: News item From: Advances in Dual Diagnosis, Volume 6, Issue 3.
19th International Network for Psychiatric Research conference: the personal and political of mental health nursing research
The NPNR conference is an annual event which aims to showcase the best in mental health nursing research as well as provide a supportive forum for new researchers to present their work. For the first time in its history it has moved from Oxford to the University of Warwick. It is also an inclusive conference with a significant presence from service users and carers, and clinical staff.
The central theme this year was around the personal and political nature of mental health nursing which seemed timely given the radical changes to public sector services and welfare occurring in the UK and elsewhere in the world. The keynote speakers reflected this theme and certainly threw down the gauntlet to the mental health profession to consider what are we doing “personally” about challenging the changes (which are directly affecting the services we work in, and the welfare that the service and users and carers receive), and what we can collectively do politically to influence and modify these changes.
Amongst the keynote speakers were Professor Kate Pickett (University of York, UK) who highlighted that mental distress is higher in more financially unequal societies (where the gap between the wealth of richest and poorest people is greater), Charles Walker (MP for Broxbourne and Chair of the All Party Parliamentary Group for Mental Health, UK) who spoke about his role as an MP around mental health and was met with challenges from the audience about the cuts facing mental health services and users of the services. On Friday the gauntlet was clearly laid down by Simon Duffy (Centre for Welfare Reform, UK) in a keynote on welfare reform and challenged us in our roles as citizens, professionals and users of services to work collectively to instigate change. Professor Len Bower (Kings College London) presented the findings of a NIHR Programme Grant “Safe Wards” which was a large multi-site trial of evidence based interventions to reduce conflict and containment in inpatient psychiatric wards. Finally, Dr Fiona Nolan (UCL and Camden and Islington NHS Trust, London) presented the findings of a study that compared wards that had established “protected engagement time” (PET) or worked as usual, and found there was no difference in outcomes between the two modes of operating in terms of patient satisfaction, conflict, ward atmosphere and other related outcomes. Dr Nolan notes that there is minimal guidance as to what is PET in terms of what should nurses be doing in the protected time and that further work needs to be done to develop the specific intervention and test again.
Over the parallel sessions, there were only four papers specifically related to dual diagnosis. Dr Duncan Stewart (Kings College, London) presented some findings from a large study on conflict and containment in inpatient settings in the UK, and noted that contrary to expectations, incidents of physical violence on wards were not correlated with drug and alcohol use. A further study is underway to examine routinely collected data within the hospitals to further examine the relationship between violence and substance misuse in people admitted to acute psychiatric wards. Dr Liz Hughes and Rose Pringle (University of York) discussed the issue of developing staff competence in working with dual diagnosis on inpatient wards with an overview of previous projects, highlighting the drivers for this type of training including some high-profile deaths that could have been prevented had the staff demonstrated more awareness of the risks to life from extreme intoxication. She also discussed the challenges of undertaking robust research evaluations of the impact of training on service user outcomes, and the planned qualitative evaluation of a pilot training project in Manchester with dual diagnosis link workers (in collaboration with Mark Holland).
Hannah Oakenfold from South London and Maudsley Trust presented a survey of opinion about drug dogs being routinely used to detect illicit substances in inpatient wards in their service. The aim was obtain the perspectives from the service users, the staff and the carers. The preliminary findings were that there was a range of opinion, generally in favour of the use of the drug dogs. Some service users raised concerns about specific issues about infringement of privacy and dignity and some inconsistencies in how the searches were conducted, and not all had felt they had been given relevant information beforehand. The conclusion was that contrary to expectation, generally service users, staff and carers thought that drug dogs were acceptable, and some useful recommendations about the sensitive use of the dogs were made.
Finally, Charlotte Kirton (Middlesex University) presented her Masters project into whether people with dual diagnosis reported more physical health problems when compared with serious mental health problems alone. This involved interviewing people identified as having a dual diagnosis whilst admitted to an acute inpatient ward and obtaining self-reported data on their health issues. She found that there wasn’t an increased incidence of health problems in this group, which was contrary to her original hypothesis that people with dual diagnosis would have more health issues (on account of the physical toll of using drugs and alcohol).
Further information see – NPNR: www.rcn.org.uk/development/communities/rcn_forum_communities/mental_health/npnr
Organised by the Royal Collage of Nursing and Mental Health Nurse Academics UK.