The Journal of Mental Health Training, Education and Practice

Melanie Jordan

2012 The Journal of Mental Health Training, Education and Practice

doi: 10.1108/17556221211287244

Purpose – This paper aims to explore qualitative semi‐structured interviews – conducted with NHS mental healthcare patients/prisoners located in one HM Prison Service (HMPS) establishment. The methodological reflections, whilst not directly related to the content of the interviews, seek to offer a debate about interview data in relation to the processes of their creation. Design/methodology/approach – The dialogue is designed primarily for those who conduct, or have an interest in, mental health‐orientated research, particularly those who undertake studies in secure settings with mental health service users as participants. Findings – Regarding interview method as a tool for data collection/creation, methodological foci for discussion include the structure of interview questions, participant unfamiliarity with the process, body language and non‐verbal communication, plus discussions concerning conversational turn‐taking and interviewee agency. Originality/value – This article stems from a small‐scale empirical fieldwork study in one prison setting and offers a debate about interview data in secure settings with mental health service users.

Claire de Motte; Di Bailey; James Ward

2012 The Journal of Mental Health Training, Education and Practice

doi: 10.1108/17556221211287235

Purpose – The aims of this paper are to determine the state of visiting for women in the English prison system and to explore the relationship between women's mental health and visits in prison. Design/methodology/approach – For the purpose of this paper the authors conducted a review of the literature. All literature published from 1983 onwards was included to coincide with the introduction of Pat Carlen's (1983) campaigning group Women in Prison (WIP). The review focused on all literature from England and Wales to reflect the National Criminal Justice System and used an inclusion criteria to achieve this. Findings – The review revealed key themes including visit rejection, the importance of visits for maintaining identity and the contradicting emotions that women in prison experience when visited. Originality/value – Social relationships and family ties are protective factors for prisoners' mental wellbeing, yet the number and frequency of visits to offenders in custody has declined. The potential role for prison visiting schemes to improve the mental wellbeing of women in custody is explored, including the implications for the education and training of staff and visitors involved in the visiting process.

Graham Lowings; Beth Wicks

2012 The Journal of Mental Health Training, Education and Practice

doi: 10.1108/17556221211287190

Purpose – Many people within secure forensic settings are expected to take part in psycho‐educational programmes as part of their treatment and rehabilitation. Many are hampered in their progress due to cognitive difficulties. This paper aims to outline the scale of the problem and to offer potential solutions. Design/methodology/approach – The numbers of people who are placed in secure settings with known neuropsychological difficulties and the range of their cognitive problems are explored. It is proposed that individual education plans based on neuropsychological profiles together with guidance on the preparation and delivery of educational materials could improve the efficacy of psycho‐educational programmes. Findings – Many people within the secure forensic estate have neuropsychological deficits. Many have suffered traumatic or other acquired brain injury or have deficits associated with substance misuse or even childhood emotional trauma. Others have cognitive difficulties specific to their mental health and occasionally their prescribed medication. A significant number will have intellectual disability (IQ<70) or be within the borderline range (IQ between 70 and 79). Originality/value – Understanding neuropsychological difficulties would mean that best use is made of the psycho‐educational materials presented, thus speeding up and improving the efficacy of the rehabilitation process and potentially reducing the risk that the person poses to themselves and others. There are resources, which offer guidance to teachers of children with neuropsychological difficulties but not for the adolescent and adult forensic population. This paper addresses this gap.

Ruth Bagshaw; Rhiannon Lewis; Andrew Watt

2012 The Journal of Mental Health Training, Education and Practice

doi: 10.1108/17556221211287208

Purpose – The aim is to determine whether staff ratings of service user attachment style are associated with service user misconduct during inpatient treatment in a medium secure mental health unit; also, to gauge whether staff can evaluate attachment style reliably. Design/methodology/approach – Retrospective case note analysis on 55 inpatient treatment episodes were supplemented with staff ratings of service user attachment style. Records of untoward incidents were centrally retrieved. Kappa statistics were used to analyse levels of staff agreement regarding service user attachment style. Findings – Attachment style was associated with hostile episodes, treatment non‐compliance and service user aggression. Post hoc analysis on a subset of data yielded poor overall agreement in ratings of attachment style (Kappa=0.2). Further analysis revealed a sex‐based asymmetry with high consistency in ratings of female service users (Kappa=0.79) and very low inter‐rater reliability for male service users (Kappa=−0.05). It is important to note that the staff included in the interrater reliability analysis were female. Research limitations/implications – The sample was small, the observation period was short and staff conducting the ratings had no special training in the rating tool. Practical implications – Attachment style per se played a significant part in the success and/or failure of service user treatment (when measured by misconduct). However, the validity of staffs' ratings of attachment style may interact systematically with the sex of staff and service users. These findings have important implications for the application of the concept of attachment in clinical settings. Social implications – Mental health professionals place central importance on the establishment of therapeutic relationships between clinicians and service users. Service user attachment style is assumed to play a role in mediating the success, or failure, of relationships with clinicians. Originality/value – This study makes a novel contribution to the application of attachment theory to secure mental health care, it also demonstrates that gender is an important factor in staff appraisals of service users' approach to treatment.

Andy Mott; James Walton; Lee Harries; Penny Highfield; Anthony Bleetman; Paul Dobson

2012 The Journal of Mental Health Training, Education and Practice

doi: 10.1108/17556221211287217

Purpose – This paper aims to examine the nature and prevalence of violence in a medium secure unit and to evaluate a personal defence training programme for staff working with mentally disordered offenders. Design/methodology/approach – The paper identifies an existing training gap associated with traditional breakaway techniques and describes a process of piloting a new educational module known as the spontaneous protection enabling accelerated response (SPEAR) system. Structured questionnaires were used to collect demographic data and analyse staff confidence and perceptions of the training module. Clinician confidence in coping with patient aggression was measured before, immediately after and at three months following participation in the new programme. Findings – A significant change in staff confidence was observed at two time scales after the training had been administered when compared with the pre‐test baseline total scores. Over 90 per cent of staff either agreed or strongly agreed that training in the new personal defence module provided a credible defence against sudden episodes of high‐risk violence. Originality/value – The paper describes a proposed module of training that may provide a credible tertiary strategy for those frontline clinicians currently exposed to the risk of sudden, spontaneous episodes of close proximity violence where traditional breakaway techniques are likely to be ineffective. This paper would interest managers, trainers and specialist practitioners that are involved in the preparation and delivery of violence reduction initiatives aimed at promoting safer and therapeutic services.