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1 – 10 of 363Stephen Linacre, Jessica Green and Vishal Sharma
Carers of people with eating disorders (EDs) experience high levels of burden which can lead to clinical levels of depression and anxiety, high levels of expressed emotion and can…
Abstract
Purpose
Carers of people with eating disorders (EDs) experience high levels of burden which can lead to clinical levels of depression and anxiety, high levels of expressed emotion and can lead to a non-conducive environment to support recovery. The Maudsley Method skills-based workshops can empower carers to support people with ED to move towards recovery, reduce carer burden and high levels of distress. The paper aims to discuss these issues.
Design/methodology/approach
Adaptations have been made to the Maudsley Method skills based workshops to include evidence based approaches from cognitive remediation therapy; mindfulness and acceptance commitment therapy. The adapted workshops were assessed via a pilot study with ten carers of people with ED using a mixed method design. The Experience of Caregiving Inventory and SF-36 were used to assess aspects of caregiving and carer wellbeing, respectively pre and post intervention. Thematic analysis was used to evaluate carers’ views on the intervention.
Findings
Results indicated that carers reduced their level of burden particularly in their experience of stigma, dependency and loss. Furthermore, positive aspects of the relationship with the person with the ED improved. Thematic analysis was used to obtain feedback from carers of the workshops. Qualitative data identified that carers improved their self-awareness, understanding of ED and the techniques they could use, and increased their social support.
Research limitations/implications
Further research is required to compare the original workshops with this adapted intervention.
Originality/value
Although this is a pilot study, the results suggest that further evidence based interventions could be added to the Maudsley Method approach to support carers.
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Marta Ortega Vega, Chris Attoe, Hannah Iannelli, Aleks Saunders and Sean Cross
Public mental health training can effectively support well-being at a population level. The application of this type of training is increasingly prevalent, however, training…
Abstract
Purpose
Public mental health training can effectively support well-being at a population level. The application of this type of training is increasingly prevalent, however, training evaluation is currently limited and inconsistent. This paper aims to summarise the characteristics of public mental health training available in England, presents key quality criteria for this training and identifies gaps in training provision.
Design/methodology/approach
This paper uses a pragmatic mixed-methods approach including database and Google Searches, focus groups and survey methods. The data analysis included a structured data extraction template for the training availability scoping and thematic analysis of the survey and focus groups.
Findings
This paper identifies a total of 74 training courses targeting workplace employees, young people and the general population. Most courses were delivered face-to-face (54), followed by e-learning (16) and blended modalities (4). This paper derives four core quality principles, focussing on the training approach, key features of training, trainer attributes and evaluation. There were no significant gaps in training provision, although areas for future development included consistency in public mental health terminology, systems and populations requiring additional training and the logistics of training delivery, etc.
Originality/value
The results contribute to the evidence base of interventions that are currently available, supporting the efforts to evaluate the impact of training provision in this area. This paper provides a novel approach to assessing training quality and discuss areas for development and innovation in this field.
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Archana Waller, Chiara Paganini, Katrina Andrews and Vicki Hutton
The aim of the study is to explore the experience of eating disorder support group participants. The research question is “What is the experience of adults recovering from an…
Abstract
Purpose
The aim of the study is to explore the experience of eating disorder support group participants. The research question is “What is the experience of adults recovering from an eating disorder in a professionally-led monthly support group?”
Design/methodology/approach
This qualitative study explored the experience of adults recovering from an eating disorder in a professionally-led monthly support group. Participants were 18 adults recovering from an eating disorder who attended a monthly support group. The data were collected using an online anonymous survey and then analysed using a thematic analysis.
Findings
The main themes that emerged were: (1) sharing the pain and promise, (2) cautions and concerns and (3) facilitators have influence. The findings indicate that the support group provided a safe space to share their lived experience, that it reduced stigma and isolation, and improved participants' motivation and engagement. Moreover, the results revealed some challenges to the functioning of the group. These included management of discussions and dominant members, need for psycho-educational information and managing intense feelings, relating to body-related comparison and other mental disorder comorbidities.
Originality/value
This is the first study highlighting the valuable role of the facilitator in balancing content with compassion, in ensuring safety in the group, and potentially fulfilling a valuable education function in supporting participants in their eating disorder recovery journey.
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Tasnim Uddin, Amina Saadi, Megan Fisher, Sean Cross and Chris Attoe
Emergency services face increasing frontline pressure to support those experiencing mental health crises. Calls have been made for police and ambulance staff to receive training…
Abstract
Purpose
Emergency services face increasing frontline pressure to support those experiencing mental health crises. Calls have been made for police and ambulance staff to receive training on mental health interventions, prevention of risk and inter-professional collaboration. Mental health simulation training, a powerful educational technique that replicates clinical crises for immersive and reflective training, can be used to develop competencies in emergency staff. This study aims to evaluate the effectiveness of mental health simulation training for police and ambulance staff.
Design/methodology/approach
In total, 199 participants from the London Metropolitan Police Service and London Ambulance Service attended a one-day simulation training course designed to promote effective and professional responses to mental health crises. Participants took part in one of six simulated scenarios involving mental health crisis before completing structured debriefs with expert facilitators. Participants’ self-efficacy and attitudes towards mental illness were measured quantitatively using pre- and post-course questionnaires while participants’ perceived influence on clinical practice was measured qualitatively using post-course open-text surveys.
Findings
Statistically significant improvements in self-efficacy and attitudes towards mental illness were found. Thematic analyses of open-text surveys found key themes including improved procedural knowledge, self-efficacy, person-centred care and inter-professional collaboration.
Originality/value
This study demonstrates that mental health simulation is an effective training technique that improves self-efficacy, attitudes and inter-professional collaboration in police and ambulance staff working with people with mental health needs. This technique has potential to improve community-based responses to mental health crises.
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Grégoire Billon, Chris Attoe, Karina Marshall-Tate, Samantha Riches, James Wheildon and Sean Cross
The purpose of this paper is to discuss the role of education and training in addressing health inequalities in intellectual disabilities, before examining innovative approaches…
Abstract
Purpose
The purpose of this paper is to discuss the role of education and training in addressing health inequalities in intellectual disabilities, before examining innovative approaches to healthcare education. Preliminary findings of a simulation training course to support healthcare professionals to work with people with intellectual disability are then presented.
Design/methodology/approach
This study employed a mixed methods design to assess the impact of the simulation course. Quantitative data were collected using the Healthcare Skills Questionnaire and a self-report confidence measure; qualitative data were collected using post-course survey with free text responses to open questions.
Findings
Healthcare skills and confidence showed statistical improvements from pre- to post-course. Qualitative analyses demonstrated that participants perceived improvements to: attitudes, communication skills, reasonable adjustments, interprofessional and multi-disciplinary working, knowledge of key issues in working with people with intellectual disabilities.
Practical implications
Encouraging findings imply that simulation training to address health inequalities in intellectual disabilities is a valuable resource that merits further development. This training should be rolled out more widely, along with ongoing longitudinal evaluation via robust methods to gauge the impact on participants, their workplaces, and people with intellectual disabilities.
Originality/value
The authors believe this paper to be the first to assess an interprofessional, high-fidelity simulation course, using actors as simulated patients to address the mental and physical health needs of people with intellectual disabilities. The rigorous use of co-production and co-delivery, alongside promising findings for this training method, represent a useful contribution to the literature.
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Hannah Iannelli, Camilla Tooley, Grégoire Billon, Sean Cross, James Pathan and Chris Attoe
Individuals health with intellectual disabilities (ID) experience comorbid physical and mental health needs and have poorer outcomes resulting in early mortality. Currently, many…
Abstract
Purpose
Individuals health with intellectual disabilities (ID) experience comorbid physical and mental health needs and have poorer outcomes resulting in early mortality. Currently, many training provisions based on ID exist; however, limited research supports their effectiveness. High-fidelity simulation is an innovative training mechanism with promising preliminary results. This study aims to evaluate the longitudinal impact of simulation training on clinical practice in ID.
Design/methodology/approach
A mixed-method approach was used in this study. A one-day simulation course using actors who had ID was delivered to 39 health-care professionals from across London hospitals. Nine semi-structured interviews were conducted 12–18 months post training.
Findings
High-fidelity simulation training is an effective training modality, which has a sustainable impact on participants, their clinical practice and patients. Core features of the training including debriefing, the use and type of actors, scenario design and the facilitators are crucial learning mechanisms which impacts learning outcomes and changes to behaviour in clinical practice and settings.
Originality/value
To the best of the authors’ knowledge, this study is the first to longitudinally evaluate high-fidelity simulation training designed to improve the physical and mental health needs of those with ID. The research begins to bridge an important gap in the current literature, with a need for more research.
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Raul Szekely, Syrgena Mazreku, Anita Bignell, Camilla Fadel, Hannah Iannelli, Marta Ortega Vega, Owen P. O'Sullivan, Claire Tiley and Chris Attoe
Many health-care professionals leave clinical practice temporarily or permanently. Interventions designed to facilitate the return of health-care professionals fail to consider…
Abstract
Purpose
Many health-care professionals leave clinical practice temporarily or permanently. Interventions designed to facilitate the return of health-care professionals fail to consider returners’ psychosocial needs despite their importance for patient care. This study aims to evaluate the efficacy of a psychoeducational intervention in improving personal skills and well-being among UK-based health-care professionals returning to clinical practice.
Design/methodology/approach
In total, 20 health-care professionals took part in the one-day intervention and completed measures of demographics, self-efficacy, positive attitudes towards work and perceived job resources before and after the intervention. A baseline comparison group of 18 health-care professionals was also recruited.
Findings
Significant associations were detected between return-to-work stage and study group. Following the intervention, participants reported improvements in self-efficacy and, generally, perceived more job resources, whereas positive attitudes towards work decreased. While none of these changes were significant, the intervention was deemed acceptable by participants. This study provides modest but promising evidence for the role of psychoeducation as a tool in supporting the psychosocial needs of returning health-care professionals.
Research limitations/implications
Additional research is needed to clarify the reliability of intervention effects, its effectiveness compared to alternative interventions, and the impact across different subgroups of returning health-care professionals.
Practical implications
Return-to-practice interventions should address the psychosocial needs of health-care professionals in terms of their personal skills and well-being. Psychoeducation can increase self-efficacy and perceptions of job resources among returning health-care professionals.
Originality/value
This study sheds light on a relatively understudied, but fundamental area – the psychosocial challenges of health-care professionals returning to clinical practice – and further justifies the need for tailored interventions.
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Claire McDonald, Fiona Seaman-Thornton, Che Ling Michelle Mok, Hanne Jakobsen and Simon Riches
Negative attitudes towards “personality disorder” are common among mental health professionals. This study aims to design a psychoeducational training targeting attitudes to…
Abstract
Purpose
Negative attitudes towards “personality disorder” are common among mental health professionals. This study aims to design a psychoeducational training targeting attitudes to “personality disorder” for staff working in a London psychiatric hospital. Its impact on staff attitudes was evaluated.
Design/methodology/approach
Mental health clinicians were recruited from five acute psychiatric wards. Feasibility of implementing the training was measured. A free-association exercise explored baseline attitudes to “personality disorder” and visual analogue scales assessed staff attitudes pre- and post-training. Content analysis of staff feedback was carried out.
Findings
Psychoeducational training was found to be feasible, well-attended and highly valued by ward staff (N = 47). Baseline results revealed negative perceptions of “personality disorder”. Post-training, significant improvements in understanding, levels of compassion and attitudes to working with service users with a diagnosis of a “personality disorder” were observed. Staff feedback highlighted desire for further training and support.
Research limitations/implications
The sample size was relatively small and there was no control group, so findings should be interpreted with caution.
Practical implications
The findings highlight the need for support for staff working with service users with diagnoses of “personality disorder” on acute psychiatric wards. Providing regular training with interactive components may promote training as a resource for staff well-being. Planning to ensure service users’ and carers’ views are incorporated into the design of future training will be important.
Originality/value
This study is innovative in that it investigates the impact of a brief psychoeducational training on “personality disorder” designed for mental health staff on acute psychiatric wards.
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Geraldine Lines, Jodie Allen and Caryl Jane Marshall
People with intellectual disability (ID) experience significant health and social inequality compared to their non-disabled peers. Individuals with ID who access mental health…
Abstract
Purpose
People with intellectual disability (ID) experience significant health and social inequality compared to their non-disabled peers. Individuals with ID who access mental health services can have complex comorbidities and presentations. In the UK, a significant proportion of individuals with ID are supported within general adult mental health services not by specialist ID teams. The purpose of this study is to explore whether psychiatry trainees in the Maudsley Training Programme (MTP) feel adequately skilled to support individuals with ID.
Design/methodology/approach
An online survey of trainee psychiatrists in the MTP was completed to evaluate self-perceived skills and knowledge in the care of individuals with ID in mental health services. Statistical analysis of the results was completed.
Findings
Experience of working in specialist ID teams is positively associated with greater confidence and skills among trainees in the care of people with ID; this is beyond what would be expected based on seniority alone.
Research limitations/implications
The response rate was 16.7 per cent; a larger sample size would add strength to the study. Like all online surveys, there exists the risk of selection bias.
Practical implications
UK Policy states that people with ID should be supported to access mainstream services where possible, including psychiatric care. Practical experience for all psychiatry trainees involving specialist ID services and people with ID could improve the care given to that particularly disadvantaged group.
Originality/value
This is the only paper known to the authors that has focused specifically on the skills and knowledge of psychiatry trainees in the UK with regards to ID.
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Georgina L. Barnes, Alexandra Eleanor Wretham, Rosemary Sedgwick, Georgina Boon, Katie Cheesman and Omer Moghraby
Clinicians working in UK child mental health services are faced with several challenges in providing accurate assessment and diagnosis of attention deficit hyperactivity disorder…
Abstract
Purpose
Clinicians working in UK child mental health services are faced with several challenges in providing accurate assessment and diagnosis of attention deficit hyperactivity disorder (ADHD). Within the South London & Maudsley (SLaM) NHS Trust, community Child & Adolescent Mental Health Services (CAMHS) are developing structured pathways for assessing and diagnosing ADHD in young people. To date, these pathways have not been formally evaluated. The main aims of this evaluation are to evaluate all ADHD referrals made to the service in an 18-month period, including the number of completed assessments and proportion of children diagnosed with ADHD; and investigate adherence to the National Institute for Clinical Excellence (NICE) guideline for diagnosing ADHD in children and young people.
Design/methodology/approach
Retrospective data analysis was performed using service databases and electronic patient records. Adherence to the clinical guideline was measured using the NICE data collection tool for diagnosing ADHD in children and young people. All completed ADHD assessments were compared to four key recommendation points in the guideline.
Findings
Within the time frame, 146 children aged 4-17 years were referred and accepted for an ADHD assessment. Of these, 92 families opted in and were seen for an initial appointment. In total, 36 ADHD assessments were completed, of which 19 children received a diagnosis of ADHD and 17 did not. Aside from structured recording of ADHD symptoms based on ICD-10 criteria (69%) and reporting of functional impairment (75%), adherence to all guidance points was above 90%. The study also found that although a greater proportion of children referred to the service were male and identified as White, these differences narrowed upon receipt of ADHD diagnosis.
Research limitations/implications
Relationship to the existing literature is discussed in relation to the assessment process, demographic characteristics and rates of co-occurrence.
Practical implications
The findings demonstrate that in child mental health services, gold standard practice for diagnosing ADHD should be the adoption of clear, protocol-driven pathways to support appropriate access and treatment for young people and their families.
Originality/value
This article is unique in that it is, to the best of the authors’ knowledge, the first to describe and report clinician-adherence to a structured pathway for diagnosing ADHD in young people within a community CAMHS service in South London.
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