Editorial

Citation

Bailey, D. (2015), "Editorial", The Journal of Mental Health Training, Education and Practice, Vol. 10 No. 4. https://doi.org/10.1108/JMHTEP-08-2015-0038

Editorial

Article Type: Editorial From: The Journal of Mental Health Training, Education and Practice, Volume 10, Issue 4.

Di Bailey

This edition of the journal is dedicated to mental health training education and practice in relation to the area that I refer to as "complex mental health needs". Staff working with people with complex mental health needs are often working in secure hospitals and prisons as well as in community settings. People who present to our services with complex mental health needs include those with self-harm, suicide and personality disorders and whilst often these types of mental health issues do present together it is important to understand how they can also present differently as this has implications for the ways in which we intervene with individuals, work together within and across services and how we train and develop staff.

For example we know that suicide can be associated with self-harm (Hawton et al., 2015) but that suicidal behaviour can be an attempt to end consciousness completely rather than to alter consciousness to cope with distress (Walsh, 2012). We also know that in general the majority of people who self-harm do so as a coping response, either to relieve too much emotion (usually of a negative and distressing nature) (Walsh, 2012; Ward and Bailey, 2013) or to relieve too little emotion or states of dissociation.

Whilst borderline personality disorder is the most common diagnosis in those who self-harm we also need to understand the link between trauma, self-harm and the label of personality disorder, which is recognised by many including key policy makers as an unhelpful and pejorative label (Tantum and Hubband, 2009). We need a better understanding of how individuals come to acquire the label often as a result of non-conforming behaviour associated with biological and social characteristics such as gender, poverty and social disadvantage (Bailey, 2012).

Three papers in this edition are dedicated to increasing our understanding of suicide behaviour and the associated needs of staff for training in this important area of preventative work. Magruder et al. compare outcomes of training for staff, when the training is delivered either in-person or through an e-learning modality. Gulfi et al. consider how best to support staff who are encountering suicide in the service users they work with and Slade and Oakes-Rogers consider pathways to completed suicide for women prisoners to obtain a better understanding of the relationship between self-harm, suicide and trauma.

In relation to personality disorder, Watt et al. focus on mental health nurses’ perceptions of attachment style when working with service users who present with the label of personality disorder in a secure hospital setting and Cooke et al. consider the impact of service users co-creating a knowledge and understanding framework for increasing professionals’ awareness of the issues associated with the diagnosis and related types of interventions.

Finally, Foster et al. report their evaluation of a service development project conducted in the northwest of England that attempts to improve outcomes for young people who self-harm. One upshot of the project is the development of a practitioner resource that can be used to assist those working in this area.

The papers in this edition testify to the fact that new ways to educate and train the mental health workforce to work more effectively and sensitively with people with complex needs are emerging. We need to understand the heterogeneity of the service user group who present with these complex issues that often have become entangled over time and as a result of the way that services have become involved and/or labelled them, if we are to find more responsive and effective ways to intervene in the future.

References

Bailey, D. (2012), Interdisciplinary Working in Mental Health, Palgrave Macmillan, Basingstoke

Hawton, K., Bergen, H., Cooper, J., Turnbull, P., Waters, K., Ness, J. and Kapur, N. (2015), "Suicide following self-harm: findings from the multicentre study of self-harm in England, 2000-2012", Journal of Affective Disorders, Vol. 175, pp. 147-51

Tantum, D. and Hubband, N. (2009), Understanding Repeated Self-injury: A Multidisciplinary Approach, Palgrave Macmillan, Basingstoke

Walsh, B.W. (2012), Treating Self-Injury: A Practical Guide, 2nd ed., Guilford Press, New York, NY

Ward, J. and Bailey, D. (2013), "Improving outcomes for women who self-injure using an action research approach in a women’s prison", Journal of Mental Health, Vol. 22 No. 4, pp. 306-16