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Several decades of mental health research in the UK repeatedly report that people of African-Caribbean origin are more likely than other ethnic minorities, including the White majority, to be diagnosed with schizophrenia and related psychoses. Race-based inequalities in mental healthcare persist despite numerous initiatives such as the UK’s ‘Delivering Race Equality’ policy, which sought to reduce the fear of mainstream services and promote more timely access to care. Community-level engagement with members of African-Caribbean communities highlighted the need to develop culturally relevant psychosocial treatments. Family Intervention (FI) is a ‘talking treatment’ with a strong evidence-base for clinical-effectiveness in the management of psychoses. Benefits of FI include improved self-care, problem-solving and coping for both service users and carers, reducing the risk of relapse and re-hospitalisation. Working collaboratively with African-Caribbeans as ‘experts-by-experience’ enabled co-production, implementation and evaluation of Culturally adapted Family Intervention (CaFI). Our findings suggests that a community frequently labelled ‘hard-to-reach’ can be highly motivated to engage in solutions-focussed research to improve engagement, experiences and outcomes in mental health. This underscores the UK’s Mental Health Task Force’s message that ‘new ways of working’ are required to reduce the inequalities faced by African-Caribbeans and other marginalised groups in accessing mental healthcare. Although conducted in the UK (a high-income multi-cultural country), co-production of more culturally appropriate psychosocial interventions may have wider implications in the global health context. Interventions like CaFI could, for example, contribute to reducing the 75% ‘mental health gap’ between High and Low-and-Middle-Income counties reported by the World Health Organization.

Current national policies present a challenge to the existing mental health workforce as most staff have not been trained to work with people within the context of their social support network. This paper presents two complementary training initiatives designed to enable mental health staff to meet the range of needs of families: (1) an in‐house accredited (one‐year) course that has enabled the successful creation of specialist family intervention in psychosis teams; and (2) a whole‐team trust‐wide training programme (three‐day course) to promote partnership working with families by both community and inpatient teams. Issues that have enabled the successful translation of training to practice are considered.

Despite the efficacy, political will and numbers of mental health practitioners trained in psychosocial interventions, they remain scarcely available in routine clinical practice. External factors such as the inability of mental health organisations to develop strategies to support the use of psychosocial interventions have been implicated. This study compares data from two groups, one that had completed psychosocial intervention training (n=104) and one that had not received psychosocial intervention training (n=102). Both groups completed measures of self‐efficacy, locus of control and an application of psychosocial interventions to practice. Results showed that psychosocial intervention training significantly increased the level of self‐efficacy for using psychosocial interventions in practice. The group that had received psychosocial interventions training had lower internal locus of control orientation. Self‐efficacy was significantly related to using psychosocial interventions in practice. There is a discussion of the implications of these findings.

Systems of care and evidence-based practice possess distinct histories. Though each developed out of attempts to improve services to youth with emotional and behavioral disorders, they did so from perspectives so different as to appear diametrically opposed. Service systems exist at multiple levels, including the practice, program, and system levels (Rosenblatt, 1988, 2005; Rosenblatt & Woodbridge, 2003). Research on health and mental health service systems similarly varies, often by level of the service system, with the research methods, independent and dependent variables, populations of interest, and ultimately the consumers of the research product interacting differentially in the creation and understanding of what constitutes a knowledge base for service delivery. Systems of care and, with limited exceptions, evidence-based practices exist at different levels of the service delivery structure, require and derive from different research approaches, and speak to overlapping but historically different audiences.

This case report highlights the importance of the role of the family in supporting a young person with a developmental disability. The young person discussed has a complex neurodevelopmental disorder with co‐morbid physical health problems. Her family have coped with a number of events in CR's life, ensuring that she has always had their support and understanding. At the time of transition there is a risk of failure to understand the complexities of the role of the family in CR's life. The implications will be discussed.

The purpose of this paper is to describe the development of an eating disorder care pathway for adults with eating disorders, in a northern borough town. It arose out of a need to reduce and address inconsistent access to services and treatment pathways.

The development involved a mapping exercise of current service delivery, a review of the literature on eating disorder care pathways, consultation workshops, the engagement of service users and carers, and the development of draft pathways for patients and carers.

Significant emphasis was on raising awareness, prevention, identification and assessment, treatment and recovery. Two pathways were proposed, one for service users focusing on awareness raising/prevention, identification and assessment, treatment, stabilisation and relapse prevention and one for carers/families focusing on carers being identifiable in their own right to receive support for caring for someone with an eating disorder.

A limitation of the care pathway under development was the difficulty obtaining an accurate figure of the true number of cases of eating disorders in the local area. This, together with the lack of any form of systematic review or meta-analysis of care pathways made identifying the number of people suffering from eating disorders and developing an effective model difficult.

The proposed pathway places significant emphasis on increasing knowledge, incorporating the patient perspective, and enhancing the recognition and understanding of eating disorders in the community. A model was created that could be implemented successfully and identify patients suffering from eating disorders, when the true incidence of eating disorders remains hidden.

There has been a recent initiative in England to establish a wider provision of psychotherapy. Studying the models of psychological treatment and experiences in other countries may enable policy makers in England to learn lessons and avoid pitfalls. This paper assesses and compares the provision of psychotherapy for adults in a selected number of European and non‐European countries. A structured list of psychotherapy features was used to collect information from each country on the number of psychotherapists, professional qualifications, the settings and models of psychotherapy, the referral procedures, funding arrangements, quality management and outcome assessments. These data were then compared in a non‐systematic way. Comparison of levels of provision was the most difficult to establish, but the findings suggest that psychotherapy that is broadly free at the point of entry is more widely available in other EU countries than in England. They also show that the plans currently being discussed for a psychotherapy service in England differ from those provided in most of the other countries in this study. The differences include the lack of statutory accreditation rules and lower qualification thresholds for psychotherapists, the concept of treatment centres, the low number of sessions, and the regular assessment of outcome data. Therefore, based on this comparison, the necessity of these features, their priority and possible alternatives may need to be considered.

The purpose of this paper is to identify barriers for people with psychotic spectrum disorders accessing CBTp in NHS Lothian. Despite national guidelines recommending CBT for the treatment of schizophrenia (National Institute for Health and Care Excellence Guidelines 2014) and (Scottish Intercollegiate Guidelines Network Guidelines 2013), levels of access to CBTp remain low. The overall goal of the study is to uncover emergent themes regarding barriers to access to CBT for patients with psychosis. In addition, the influence of psychosocial skills intervention (PSI) training for psychosis (Brooker and Brabban, 2006) will be explored and if completion of this training effects referral behaviours and attitudes to CBTp.

This study is a quantitative service evaluation project which uses a questionnaire design to explore the factors that influence a clinician’s decision to refer a patient for CBTp. Three qualitative questions are included for thematic analysis to allow the respondents to elaborate on their views on potential barriers. All appropriate Community Mental Health Team (CMHT) staff in adult mental health in NHS Lothian were invited to participate in the study.

CMHT staff in NHS Lothian hold favourable views of CBTp and would support an increase in access for patients with psychosis. Key barriers to access for CBTp identified in this study comprise of, little or no access to CBTp, lack of integration of services and unclear referral pathways. Further themes emerging from the study also included, improving multi-disciplinary communication and increasing CMHT staff knowledge and confidence in CBTp. PSI training was shown to have a significant effect on referral rates. Further research would be warranted to explore the influence of PSI training on CMHT staff confidence and knowledge in CBTp.

This is the first paper of its kind to investigate the potential barriers to access to CBTp in Scotland. The paper has highlighted some key barriers and potential strategies to overcome the barriers identified will be discussed.