Search results

The COVID-19 pandemic has brought about disruption in the way health-care professionals carry out their day-to-day practices across communities. The purpose of this research paper is to explore the professional experiences of occupational therapists working in community and rehabilitation mental health settings during a period of the COVID-19 pandemic and to help gain an understanding of how their day-to-day work practices have been affected.

A qualitative phenomenological research study explored the lived experiences of ten occupational therapists working within Health Service Executive community and rehabilitation mental health services during the COVID-19 pandemic. Participants included eight community mental health occupational therapists and two rehabilitative mental health occupational therapists. Data was collected through semi-structured interviews and analysed using reflexive thematic analysis.

Three themes were identified: holding on to what we do; technology: friend and foe; and COVID as a catalyst to clarify the occupational therapy role. These themes capture the community changes, challenges and frustrations experienced by the occupational therapists while striving to provide quality mental health occupational therapy services during the pandemic.

The findings demonstrate the adaptive nature of the profession, the importance of traditional observation methods of community-based care, the experiences with telehealth approaches and an opportunity to clarify misconceptions of aspects of the profession’s role in relation to employment-related issues and occupational therapy group work within such mental health settings.

To improve outcomes for people with co-occurring mental health and substance use disorders, the Eastern Health Mental Health Service implemented an integrated treatment model known as the dual diagnosis clinician shared care model. This study aims to provide evidence for a relatively unexplored model in clinical mental health services within the state of Victoria, Australia.

Dual diagnosis clinicians were placed into community mental health clinics in a shared-care, modified case management role, to provide primary and secondary consultations to select consumers and/or their carers, as well as to provide capacity-building training to the mental health staff facing real world clinical challenges in dual diagnosis service delivery.

Since the commencement of this service, more than 800 consumers of the adult mental health service have been supported to concurrently address their harmful substance use, while receiving recovery-focused community mental health care. Preliminary findings include previously unknown figures on the prevalence for co-occurring substance use at the point of referral and a demonstrated preference by consumers for treatment of both disorders at the same time by the same service (in-house treatment).

The establishment of a dedicated, integrated dual diagnosis team has significantly increased the capacity of a community-based clinical mental health service to engage with and treat consumers with dual diagnosis disorders. This model is beginning to produce evidence challenging traditional siloed approaches to mental health and alcohol and drug treatment.

Physical health inequalities and mortality rates are higher amongst individuals with severe mental illness (SMI), including among forensic populations, than the general population. This paper aims to explore the experiences of individuals accessing primary health care following discharge from secure services, and the practitioners who support them.

Face-to-face qualitative interviews were conducted with service users (n = 4) and mental health practitioners (n = 4) within a forensic community mental health team in one NHS Trust in England in 2019. Data were analysed using the Interpretative Phenomenological Analysis.

Four super-ordinate themes emerged: perceived importance of physical health, agency, responsibility and relationships. Service users mostly saw themselves as passive recipients of health care and prioritised their mental health over their physical health. Close working relationships meant that mental health practitioners were often the first contact for service users with any health issue and thus felt a sense of responsibility for their physical health care. Service users who did access primary care reported that consistency of professional, feeling understood and listened to without judgement or stigma were important.

Interventions for service users that include practicalities and strategies to facilitate independence in physical health care, and collaborative working between primary care and forensic mental health services, are encouraged.

This study highlights some of the unique challenges in forensics around improving physical health outcomes for individuals with SMI.

The purpose of this paper is to evaluate the impact on recovery and personal goal attainment of a transition intervention service for return to the community following exit from an alternative to psychiatric inpatient admission – a residential recovery house. The services seek to facilitate community reintegration, promote recovery and prevent future mental health crisis. The service was funded by the Stone Family Foundation.

This evaluation employed a within groups design: a single case evaluation follow-up. Analysis of Recovery Star and personal goal achievement data collected at service entry and exit points during routine practice (n=181), at four sites in England. The adults had mental illness diagnoses including depression, schizophrenia, bipolar disorder, personality disorder, and anxiety disorder.

There was a significant increase in overall Recovery Star scores with a large effect size, and significant increases in eight of the ten Recovery Star life domains. There were significant increases in the goal scores linked to “Managing mental health”, “Self-care” and “Living skills”.

A transitional intervention service provided by the third sector for return to community following mental health crisis may contribute to recovery and personal goal achievement. A randomised control trial of this transition intervention service is recommended.

This is first outcome evaluation of an alternative to psychiatric inpatient admission transition intervention service and findings indicate the potential positive effect of having this service incorporated into the design of alternative to admission provision.

The Author Reviews fourteen papers from localities throughout England outlining developments in collaborative approaches to mental health services. She considers how effective they are likely to be, in the light of evaluation and research.

The purpose of this paper is to argue that recent attention has been focused on inpatient services at the expense of community mental health teams and that it is time to redress the balance.

This is a personal viewpoint.

In writing this piece it has enabled us to focus on just how widespread the issues are regarding the lack of focus on community services, and that the view and paradigm needs to change on all levels/structures. Services need to recognise the wide scope of community services and the part they inevitably play in someone’s recovery journey. It also throws the spotlight on services working too often in silos deeply affecting people in receipt of the services.

To stimulate debate about the role of community mental health teams.

An enormous amount of change has occurred in the last six years for the mental health system in England and the workforce within it. We have seen the 10‐year National Service Framework for Mental Health (Department of Health, 1999) gradually make its impact felt in the form, in particular, of new community mental health teams and structures for delivering care in the community. We have also, most recently, experienced the passing of the Mental Health Act 2007 (HM Government, 2007), after many turbulent years of controversy and argument, extending to nurses and non‐medical practitioners who have been given statutory powers to act as approved mental health practitioners and approved clinicians.Alongside these important developments has been a gradual revolution in traditional ways of working, in the form of the New Ways of Working initiative. This article considers the impact of New Ways of Working on mental health nursing ‐ the single largest professional group within the mental health workforce ‐ and the continuing implications for the profession. The development of nurse prescribing is used as an illustration of the challenges and opportunities that have commonly arisen when new roles and skill sets have been introduced in mental health settings.

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.

The provision and effectiveness of community‐based treatment packages for people with alcohol misuse problems, has been recognised and highlighted in government policy, most recently by The National Assembly for Wales (2000). Responding to ‘problem drinkers’ within the primary health care setting, is a cost‐effective treatment option. The Specialist Community Alcohol CPN Service, within The North West Wales NHS Trust, is part of the Mental Health & Learning Disabilities Directorate. It is also at the forefront of clinical governance measures and the service strives towards clinical excellence through evidence‐based practice. In a recent survey, it was found that 72% of referrals came from general practitioners (Sims et al., 2002). This integrated care pathway, for the ‘problem drinker in the community’ is designed in an attempt to smooth the referral process. Moreover, it is intended as a way of giving information to referrers, regarding the range of clinical interventions available and raising awareness regarding ‘options for change’ with the service user.