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There is evidence that novel psychoactive substances (NPS) are commonly used by people with severe mental illness. The purpose of this paper is to undertake a scoping…
There is evidence that novel psychoactive substances (NPS) are commonly used by people with severe mental illness. The purpose of this paper is to undertake a scoping survey to explore the inpatient mental health workers’ perceptions of NPS use by consumers.
A cross-sectional online survey of mental health professionals is used in the study. The participants were opportunistically recruited through social media and professional networks.
A total of 98 participants (of 175 who started the survey) were included in the analysis. All reported that some patients had used NPS prior to admission. Over 90 per cent of participants reported observing at least one adverse event relating to NPS use in the previous month. The majority of participants reported that patients had used NPS during their inpatient admission. Three quarters were not clear if their workplace had a policy about NPS. Most wanted access to specific NPS information and training. The participants reported that they lacked the necessary knowledge and skills to manage NPS use in the patients they worked with.
Whilst the authors are cautious about the generalisability (due to methodological limitations), the findings provide useful insight into the perceptions of inpatient staff regarding the extent and impact of NPS use including concerns regarding the impact on mental and physical health, as well as ease of availability and a need for specific training and guidance.
Mental health professionals require access to reliable and up-to-date information on changing trends in substance use. Local policies need to include guidance on the safe clinical management of substance use and ensure that NPS information is included.
To the best of the authors’ knowledge, this is the first survey of the perceptions of mental health staff working in inpatient mental health settings regarding NPS. The findings suggest that NPS is a common phenomenon in inpatient mental health settings, and there is a need for more research on the impact of NPS on people with mental health problems.
Dual diagnosis poses particular challenges for inpatient mental health services. Workers have low levels of training, clinical experience and support to deliver integrated…
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.
People with dual diagnosis have complex needs and vulnerabilities that may lead to incarceration in prisons. Mental health and substance use services in prisons should…
People with dual diagnosis have complex needs and vulnerabilities that may lead to incarceration in prisons. Mental health and substance use services in prisons should have the capabilities to address their needs while incarcerated and facilitate the transfer of care to community services on release. In order to develop these capabilities, a training programme is required.A pilot training programme for dual diagnosis was developed and piloted in five London prisons. The training was based on a training needs assessment of prison staff and consultation with service users. It was delivered in two forms: a five‐day classroom based course, and a ‘blended learning’ method that comprised a manual and three sessions of supervision. The course was evaluated by a brief questionnaire that included items on attitudes, self‐efficacy and knowledge about working with dual diagnosis.The evaluation of the training revealed that all workers, no matter what method of training they received increased their perception of their skills (self‐efficacy) and increased their attitudes. Knowledge remained the same (although the scores pre‐training were high). There was no difference between the two types of training when mean scores were compared at post‐training. There was also no difference between the mental health and substance workers regarding their mean scores at follow‐up, apart from knowledge.The conclusion is that the training pilot was evaluated positively and did indicate that it has some effect on attitudes and self‐efficacy. More rigorous evaluation of the impact of the training is required, using a robust methodology and assessing the impact on clinical skills and service user outcomes.
The focus of this paper is to consider the findings of a survey, which aims to identify the types of training that acute mental health staff could access, in relation to…
The focus of this paper is to consider the findings of a survey, which aims to identify the types of training that acute mental health staff could access, in relation to workforce development and substance misuse issues in acute mental health care.
An electronic survey was developed and distributed using work email lists to all clinicians who worked in acute mental health services across a region in England. Not all NHS organisations agreed to participate.
A total of 89 clinicians responded to the survey, some failed to indicate their consent, therefore the results of the 77 that did are presented. The main finding was that most acute care staff had only accessed mandatory training such as risk assessment. Many staff had not been trained in the use of psychosocial approaches. Drug and alcohol specific activities were performed on the whole only “sometimes”.
It was not possible to determine the total number of potentially eligible staff who were sent the survey, therefore, response rates cannot be calculated. It is possible that the findings may not be generalisable to other services. There may be bias in those who choose to respond to an electronic email, in terms of those who had access to a computer or who were more IT literate. In addition, the survey did not specifically set out to examine substance misuse issues as its main focus.
Acute care staff work with service users with increasingly complex needs. Creative and cost effective ways of facilitating access to training and support must be found as a priority to ensure that staff have the competencies to identify and manage substance users effectively in acute mental health settings.
The findings reinforce previous studies highlighting the deficit in access to psychosocial interventions training for acute care staff.