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Can models be set in place to prevent neglect and abuse in inpatient settings from becoming systemic? This article suggests that they can, and describes how the establishment of…
Abstract
Can models be set in place to prevent neglect and abuse in inpatient settings from becoming systemic? This article suggests that they can, and describes how the establishment of multi‐agency forums within care teams can help foster working practices that are open, accountable and respectful.
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Deborah Wildgoose, Peter Flanagan and Melanie Crewe
Lack of therapeutic activities, or simply ‘something to do’ has been widely criticised as a major shortcoming of acute inpatient psychiatric units. Deborah Wildgoose and…
Abstract
Lack of therapeutic activities, or simply ‘something to do’ has been widely criticised as a major shortcoming of acute inpatient psychiatric units. Deborah Wildgoose and colleagues describe how one trust introduced a flexible, innovative programme of evening and weekend activities run by sessional workers from outside the mental health services. The programme was devised in consultation with service users and was reported by patients and staff to have reduced the stress of hospital admission and improved the whole ward atmosphere.
Elizabeth Hughes, Neil Robertson, Cheryl Kipping and Claire Lynch
Dual diagnosis poses particular challenges for inpatient mental health services. Workers have low levels of training, clinical experience and support to deliver integrated care…
Abstract
Dual diagnosis poses particular challenges for inpatient mental health services. Workers have low levels of training, clinical experience and support to deliver integrated care that combines mental health and substance use interventions. In addition, inpatient workers have to balance being therapeutic with ensuring that illicit substance use does not occur on the wards. This often leads to confrontation and poor engagement.In order to improve the capabilities of the workers to deliver more effective interventions for this group of service users, dual diagnosis training should be a high priority for acute inpatient services. However, there are a number of challenges in the implementation of this including lack of resources to fund training and specialist roles, lack of time to attend training (and supervision), and lack of time to implement learning in routine care.This paper will describe the policy drivers for the improvement of dual diagnosis care in acute psychiatric inpatient services, and how two initiatives in London are overcoming some of the obstacles and showing some promising initial outcomes. This paper will make recommendations for future research and developments.
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Nicola Vick and Cheryl Kipping
Addressing the needs of people with a dual diagnosis is a core component of acute inpatient mental healthcare. In 2006/2007, the Healthcare Commission conducted a national review…
Abstract
Addressing the needs of people with a dual diagnosis is a core component of acute inpatient mental healthcare. In 2006/2007, the Healthcare Commission conducted a national review of NHS acute inpatient wards in England. The review included five indicators of particular relevance to working with people with a dual diagnosis. This paper provides an overview of the review process, reports the dual diagnosis findings and considers their implications for improving the care and treatment of people with a dual diagnosis in the inpatient setting.
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Paul Greenwood, Tony Ryan, John Keaveny and Ripu Deo
This article describes the processes undertaken to implement change in East Lancashire adult mental health services through New Ways of Working. The views of users, carers and…
Abstract
This article describes the processes undertaken to implement change in East Lancashire adult mental health services through New Ways of Working. The views of users, carers and staff of the services at the start of the project are described, and an overview offered of the development work that took place to support the change. Barriers to change are also described.
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Suzanne Heffernan, Sandra Neil and Stephen Weatherhead
The purpose of this paper is to explore the extent to which inpatient mental health services attend to the religious needs of service-users. Literature is presented to argue that…
Abstract
Purpose
The purpose of this paper is to explore the extent to which inpatient mental health services attend to the religious needs of service-users. Literature is presented to argue that whilst the importance of religion is highlighted in consumer accounts, research and policy; inpatient services continue to neglect religion and service-users consistently report insufficient attention to religious needs during hospitalisation.
Design/methodology/approach
This review adopts a narrative approach to the literature, drawing upon published journal articles, book chapters and policy documentation.
Findings
Literature into the topic area is reviewed and discussed within three themes. First, the extent to which religious needs are currently met is explored. Second, potential reasons for neglect of religion are considered. Finally, examples of religiously informed group programmes, individual psychotherapy and the use of traditional healers are detailed.
Practical implications
Findings of the review point towards the requirement for inpatient services to more adequately meet religious needs in terms of available facilities. The need for spiritual assessment and collaboration with hospital chaplains is also highlighted, along with the call for increased staff training.
Originality/value
It is expected that this review will be of interest to a range of stakeholders including professionals, policy makers and service users. It highlights the void in clinical attention to religious needs and offers practical suggestions for meeting this need.
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