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This chapter qualitatively explored the impact of including parent liaisons (i.e., parents with lived experience caring for a child with complex needs, who support other caregivers in navigating child and family needs) in a case conferencing model for children with complex medical/social needs. Case conferences are used to address fragmented care, shared decision-making, and set patient-centered goals. Seventeen semi-structured interviews were conducted with clinicians and parent liaisons to assess the involvement of parent liaisons in case conferencing. Two main themes included benefits of parent liaison involvement (10 subthemes) and challenges to parent liaison involvement (5 subthemes). Clinicians reported that liaison participation and support of patients reduced stress for clinicians as well as family members. Challenges to liaison involvement included clinical team/parent liaison communication delays, which were further exacerbated by the COVID-19 pandemic. Parent liaison involvement in case conferences is perceived to be beneficial to children with complex needs, their families, and the clinical team. Integration of liaisons ensures the familial perspective is included in clinical goal setting.

Families of children with disabilities experience many challenges, which Sparkle’s Family Liaison Service (FLS) aims to alleviate. The purpose of this study was to evaluate the impact of the service.

Qualitative interviews with ten families who had accessed the FLS and 14 professionals working with children with disabilities were conducted in 2020. Interview transcripts were analysed using inductive and deductive thematic analysis.

Families valued an accessible service and a neutral individual who could empathise with them. Professionals highlighted the FLS relieving pressure they felt to provide informal support for families they work with, resulting in considerable time saving.

To the best of the authors’ knowledge, this is the first evaluation of the novel FLS meeting the unmet needs of families of children with disabilities. The service equips and empowers caregivers to enhance their own lives and the lives of their children and family.

The purpose of this paper is to consider the key themes highlighted by Collins et al., in light of the wider research evidence base on informal sources of support for families of children with intellectual and developmental disabilities.

This commentary reflects on the provision of informal support services for families of children with intellectual and developmental disabilities.

The wider literature highlights the key role of family support in shifting negative narratives concerning parenting a child with intellectual and developmental disabilities, the impact of austerity and COVID-19 on support provision and the importance of services working effectively in collaboration to promote self-determination for families and individuals with intellectual and developmental disabilities.

Continued efforts to explore how services and informal social supports might work together in an effective manner are key to improving the quality of life of parents caring for children with intellectual and developmental disabilities.

As part of a larger grant-funded project, a professional development (PD) series was conducted within the framework of a school–university partnership to improve teachers’ capacity to meaningfully include fathers and father figures in the school environment, with a particular focus on fathers of children with disabilities. The authors sought to understand the extent to which a school-wide PD framed through the lens of a father of a child with a disability might inform practice with sustainable implementation. Due to the pandemic, the original format of the PD was redesigned for virtual delivery.

A three-phase data collection and analysis approach included a pre-PD survey, a post-PD survey and a one-year follow-up survey. All surveys included both quantitative and qualitative self-report data components.

Results suggest school personnel found the virtual PD valuable, gleaning several useful strategies for reflecting on their own practices, working to improve communication with families of children with disabilities and more meaningfully including fathers and father figures in future school-related activities and programing.

First, the sample size of the present study was small, and participation was variable across PD sessions. In addition, participants self-selected into the series, and therefore, they may be more likely to value father-figure involvement with or without participation in the PD series. The small sample size may minimize the generalizability of these results across other replicable settings and participants. Second, the results of the pre-PD survey could be positively skewed since the university partner’s initial delivery of PD related to this topic began in 2018. In the pre-PD survey, the majority of respondents indicated, as an example, that they believed father involvement was correlated with higher academic achievement. It is not clear if respondents held these beliefs independently at the inception of the partnership or if they perhaps learned of these connections during an earlier PD offered by the authors.

The current study offers a small glimpse into the world of a school–university partnership and its ability to actualize meaningful reflection on family engagement practices. Results also indicate a greater awareness of significant male figures/fathers and their needs. Content delivered during each PD supports capacity building in terms of teachers’ ability to see fathers and father figures as meaningful contributors within the context of the school environment. Participants mentioned that the PD taught them ways to recognize and remediate some of the insidious communication barriers that exist.

Participants stated that they grew in their understanding of intentional connections with significant male figures, noting a concerted effort to ensure communication of information pertaining to school events, conferences and, in some cases, individualized educational programs (IEPs). Staff members also felt as though the pandemic fostered greater connections with fathers who were working at home and who were simultaneously helping their children access online learning platforms. However, it is noteworthy that the latter benefit was likely a positive side effect of mandatory home-based learning as opposed to a direct result of the present study. Socially, the authors all find ourselves embarking on a bit of social uncertainty, where perhaps it is no longer appropriate or significant to mention one's gender. Nonetheless, the research highlights the unique contributions that fathers and father figures can make to children's positive trajectory, and the authors espouse that the current study suggests that virtual PD sessions can help train school personnel to recognize and foster such relationships.

The past few decades have ushered in an awareness of significant male involvement and its importance in the development of young children. Despite this surge of interest, the research on father/significant male involvement in the school context remains limited. Additionally, the implementation of virtual PD and its potential positive impacts remain largely unexplored, especially when the intersection with father engagement practices is considered. As such, the authors espouse that the present study reflects a unique combination of content and pedagogy.

Research ethics and integrity stipulates that research must be conducted with responsibility towards the research community and should benefit the intended population. This chapter will share insights from an ongoing research programme to reduce family conflict in the context of dementia care while discussing the accompanying ethical considerations. Research into dementia care has primarily focused on improving outcomes for the care dyad, leaving the influence and input of the wider family unit under investigated. Family conflict can detrimentally impact the quality of care provided and leave caregivers vulnerable to psychosocial difficulties. Family conflict occurs in the context of dementia care but there is little research on how to reduce, or prevent, such conflict occurring. In this research programme, a systematic review investigated the effectiveness of interventions that include the wider family unit to reduce family conflict; only one study was included which evidenced the lack of interventions in this area. A qualitative scoping review was then conducted to explore the lived experiences of caregiving families with experience of family conflict and reported solutions. It was found that conflict occurred due to factors including care decisions and role transitions which impacted relationships and affected care provision. Solutions to conflict were less often reported, indicating an important gap in the literature. Interviews with Alzheimer's Society staff and volunteers revealed that stigma and denial surrounding dementia were prevalent, and families were often reluctant to seek external help. This research programme is currently establishing public patient involvement (PPI) to develop the research methodology and interview questions for people with dementia (PWD) and their family caregivers to explore their lived experiences and potential solutions to family conflict. To conclude, this research programme will propose a family-focused intervention aimed at systemic family conflict for those caring for someone with dementia.

The need to develop effective approaches for responding to healthcare incidents for the purpose of learning and improving patient safety has been recognised in current national policy. However, research into this topic is limited. This study aims to explore the perspectives of professionals in mental health trusts in England about what works well and what could be done better when implementing serious incident management systems.

This was a qualitative study using semi-structured interviews. In total, 15 participants were recruited, comprising patient safety managers, serious incident investigators and executive directors, from five mental health trusts in England. The interview data were analysed using a qualitative-descriptive approach to develop meaningful themes. Quotes were selected and presented based on their representation of the data.

Participants were dissatisfied with current systems to manage serious incidents, including the root cause analysis approach, which they felt were not adequate for assisting learning and improvement. They described concerns about the capability of serious incident investigators, which was felt to impact on the quality of investigations. Processes to support people adversely affected by serious incidents were felt to be an important part of incident management systems to maximise the learning impact of investigations.

Findings of this study provide translatable implications for mental health trusts and policymakers, informed by insights into how current approaches for learning from healthcare incidents can be transformed. Further research will build a more comprehensive understanding of mechanisms for responding to healthcare incidents.

This study addresses a gap in evidence on small employer experiences of managing mental health problems in the workplace. The authors gathered first-hand experiences of small business managers to empirically investigate how the small business context affects the management and support of mental health problems in the workplace, and the practice implications that arise.

Qualitative interviews, combining semi-structured and narrative approaches, with 21 small business managers with experience of managing employees with mental health difficulties. The 21 managers recounted a total of 45 employee cases, which were analysed thematically, using a case-based matrix. Study participants were drawn from small businesses within England and Scotland (UK). Interviews were conducted between November 2019 and February 2020.

Support aligned with current understanding of effective practice, yet was often informal, instinctive and flexible. Accommodating employees with mental health problems impacted the workload of managers and co-workers, and business operation and growth. Challenges and tensions reflected the difficult balancing act faced by managers in organisations of all sizes. However, the intensity and immediacy of cross-pressures was enhanced for small businesses, due to their smaller workforce and lack of dedicated Human Resource Management and occupational health expertise.

Guidance should address the navigation of day-to-day management and support for employees with mental health difficulties, including approaches to balancing the needs of the wider workforce and business operation. Access to HR and occupational health expertise is valuable. Financial subsidies may be of lesser concern to small businesses.

This study offers originality in focusing exclusively on small business managers with first-hand experience of supporting employees with mental health problems. Findings challenge the perception that small firms have unique experiences, whilst highlighting contextual features that exacerbate intensity and immediacy of impacts.

There is a proportion of psychiatric service users whose needs are not met by existing models of care. This can lead to a reliance on acute and crisis services. These service users may be considered high intensity users (HIUs). The purpose of this research is to evaluate the Crisis Plus model, an intervention designed to better support HIUs in the community and reduce dependency on acute and crisis services.

Forty-seven HIUs were involved in Crisis Plus. The core intervention of Crisis Plus was an Anticipatory Management Plan (AMP), produced in collaboration with service users, their families and their care coordinators. AMPs were shared with relevant services and attached to electronic patient notes to ensure a uniform, psychologically informed approach to care.

HIU service use was compared pre and post-AMP. On average, number of inpatient admissions, number of days spent on the ward, accepted psychiatric liaison referrals and accepted home treatment team (HTT) referrals decreased significantly.

Crisis Plus has taken a collaborative, proactive approach to engage HIUs, their families and the services that care for them. Crisis interventions that emphasise collaborative working and service user agency are key.

The provision of dedicated psychological support to HIUs and their professional and personal network is crucial to reduce reliance on acute and crisis care. Crisis Plus is unique in that it instigates co-production and active consultation with HIUs and services to improve clinical outcomes, in addition to reducing NHS expenditure.

Readmission to hospital can be distressing, costly for the National Health Service (NHS) and legally it should be a last resort as it entails restriction of liberty. This study aims to develop an understanding of factors leading to readmission for a cohort of service users under the care of a community forensic mental health team (CFMHT) in England to consider how support could be improved to reduce incidence of future readmissions.

Thematic analysis was used to examine case recording relating to 13 service users who were readmitted to hospital within a specified time period. The same service users were invited to complete questionnaires regarding their views of what contributed to the readmission to cross-reference with themes identified.

The analysis of case notes produced eight sub-themes. These were sorted into three overarching themes, illustrating the challenges that service users face upon discharge from hospital, the sense they make of these challenges and the impact upon relational patterns, in particular with the CFMHT. Researchers highlight that the multiple challenges can increase service users’ sense of being under threat which can lead to distrust of professionals.

Practical suggestions arising from the study were fed back to the subject team and are listed at the end of the paper.

Findings from this study parallel those previously reported. This study contributes an inter-relational aspect of the factors and the central role of meaning-making in the path of recovery and building a life in the community.

India is a diverse country in which the development of services for children with disabilities presents many challenges. There is evidence that progress towards the provision of educational and therapeutic services has been considerable in the metropolitan cities, with reports of many examples of good and innovative practice. Rural communities are often less well served, and families living in some areas continue to face challenges when attempting to gain support for their children with disabilities. This chapter interrogates the situation for families in districts in southern and central India. The authors draw upon recent research to consider how the challenges of providing a multi-disciplinary support mechanism can be delivered to those living in these areas. Issues related to co-ordination of services, recruitment and retention of professionals and allocation of resources are considered through an examination of the socio-economic conditions confronted by families and professionals. Case study evidence from projects aimed at providing effective services are presented and discussed.