The Journal of Mental Health Training Education and Practice

Sullivan, Patrick Joseph

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/jmhtep-05-2018-0031

The purpose of this paper is to consider some of the legal implications of adopting a harm minimisation approach in supporting people who self-injure within inpatient mental health units. It is argued that a focus on risk and the increasing influence of the law and legal styles of thinking often associated with the allocation of blame have produced a more risk adverse clinical environment. As a result health professionals are more likely to err on the side of caution rather than engage in practices that although potentially therapeutic are not without their risks.Design/methodology/approachThe analysis draws on the clinical, philosophical and legal literature to help understand how harm minimisation may support people who self-injure. It considers some of the complex medico-legal issues that arise in a clinical environment dominated by risk.FindingsA focus on risk and accountability has produced an environment where the law and legal styles of thinking have come to influence practice. This is often associated with blame in the minds of the health professional. Given the legal obligation to prevent suicide, health professionals may take a conservative approach when working with people who self-injure. This makes the adoption of harm minimisation difficult.Originality/valueThis paper provides a legally informed analysis of some of the challenges associated with using harm minimisation techniques with people who self-injure. It adds to the literature regarding this area of clinical practice.

Page, Ruairi; Hynes, Fiona; Reed, James

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/jmhtep-10-2016-0052

The purpose of this paper is to describe the use of videoconferencing to deliver a post-graduate education programme in forensic mental services by video-conference across three sites in a large urban centre and develop a forensic community of practice.Design/methodology/approachThis paper describes the setting up of the programme, equipment used, the challenges and evaluation of a teaching programme delivered using technology-enhanced education.FindingsThis forward thinking mechanism of delivery of education has propelled multi-disciplinary and multi-site discussion with the formation of a community of practice.Research limitations/implicationsAdditional skills are demanded of clinicians including familiarisation with the equipment and an awareness of the restrictions in communication using videoconferencing.Practical implicationsThe use of technology has facilitated delivery of a learning programme within our services. Practical benefits are readily evident with increased accessibility, cost and travel savings.Social implicationsThe greatest benefit has been the development of a virtual community allowing peer support, an extended peer review and network development.Originality/valueThe paper describes use of technology to support delivery of a post-graduate forensic mental health training programme.

Czamanski-Cohen, Johanna; Sarid, Orly; Cwikel, Julie; Levitas, Eliahu; Har-Vardi, Iris

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/jmhtep-04-2018-0022

Coping and communication strategies affect how one perceives potentially stressful life events, such as infertility. Cognitive behavioral interventions (CBI) can reduce the distress related to undergoing in vitro fertilization (IVF). The purpose of this paper is to examine the effect of CBI on the coping and communication skills as well as perceived stress and depressive symptoms of women undergoing IVF treatment. The authors also explored the relationship between coping strategies and pregnancy rates.Design/methodology/approachThe authors conducted a randomized controlled trial of CBI in 50 women undergoing IVF (NCT00685282).FindingsThe authors found that CBI was associated with reductions in active-confrontive coping among over 50 percent of participants, which was also found to be positively related to depressive symptoms. Furthermore, high meaning-based coping at baseline and high-avoidant coping at the end of IVF treatment were associated with increased pregnancy rates.Research limitations/implicationsCBI can be helpful in reducing the perceived stress of women undergoing IVF; however, the adaptiveness of individual coping skills and communication skills vary. Since different coping strategies seem to be of benefit at different time points, further studies might benefit from the examination of engaging in context-dependent coping strategies.Practical implicationsIntegrating mental health care on infertility units may assist in reducing the stress and thus quality of care in women undergoing IVF. Mental health care can be tailored to meet the individual needs of infertility patients based on their preferred coping strategies and communication style. Further research is needed to examine the cost benefit of reducing perceived stress in fertility patients.Social implicationsInfertility is a social and medical problem that has vast implications on the mental health of individuals. Providing support along with practical tools for stress reduction and improved coping and communication can result in reduced stress and improved coping.Originality/valueThis paper examined the effect of a cognitive behavioral intervention on the coping strategies and communication skills of women undergoing IVF and can contribute to our understanding of the value of integrating mental health and medical care.

Fontein-Kuipers, Yvonne; Jomeen, Julie

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/jmhtep-06-2018-0034

The purpose of this paper is to investigate the validity and accuracy of the Whooley questions for routine screening of maternal distress in Dutch antenatal care.Design/methodology/approachIn this cohort design, the authors evaluated self-reported responses to the Whooley questions against the Edinburgh Depression Scale screening for antenatal depression, State-Trait Anxiety Inventory for general anxiety and the pregnancy-related anxiety questionnaire-revised screening for pregnancy-related anxiety, among Dutch pregnant women during the first and third trimester of pregnancy. The authors used standard diagnostic performance measures for the two case-finding items.FindingsThe Whooley items in this study showed a higher specificity than sensitivity. The Whooley results showed good evidence to identify women who are depressed or (trait)anxious in both trimesters of pregnancy, but the results showed weak to moderate evidence to identify pregnancy-related anxiety. The Whooley items had a low to moderate predictive ability for depression, trait-anxiety and pregnancy-related anxiety and a good ability for negative case-finding. The Whooley items proved to be more able to report how effective the case-finding questions are in identifying women without depression, trait-anxiety and pregnancy-related anxiety (ruling out) rather than how effective these are in identifying women with depression, trait-anxiety and pregnancy-related anxiety (ruling in). The Whooley items were accurate in identifying depression and trait-anxiety in both trimesters but were not very accurate to identify pregnancy-related anxiety.Research limitations/implicationsAssessment of pregnancy-related anxiety using a case-finding tool requires further attention.Practical implicationsThe two-item Whooley case-finding tool has shown good utility as a screening instrument for maternal distress. The continuous assessment of maternal emotional health during the childbearing period or, at least, revisiting the topic, would both support the woman and the midwife in regarding perinatal emotional wellbeing as an important remit of midwifery care.Originality/valueA novel aspect of this paper is the proposition of applying the Whooley questions at later stages of pregnancy or presenting the Whooley questions in a written or digital form.

Attoe, Chris; Lavelle, Mary; Sherwali, Susan; Rimes, Katharine; Jabur, Zaina

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/jmhtep-06-2018-0037

Mental health simulation is the educational practice of recreating clinical situations in safe environments using actors, followed by structured debriefing, to foster professional development and improve care. Although evidence outlines the benefits of simulation, few studies have examined the impact of interprofessional mental health simulation on healthcare trainees, which is more reflective of clinical care. The purpose of this paper is to evaluate the impact of mental health simulation training on students’ confidence, attitudes, knowledge and perceived professional development and anticipated clinical practice.Design/methodology/approachParticipants (n=56) were medical (41 per cent) and mental health nursing students (41 per cent), and clinical psychology trainees (18 per cent). Six simulated scenarios, involving one to three trainees, were followed by structured debriefs with trained facilitators. Scenarios, using actors, reflected patient journeys through emergency, medical and psychiatric settings. Participants’ confidence, knowledge and attitudes were measured quantitatively using pre- and post-course self-report questionnaires. Perceptions of impact on professional development and clinical practice were assessed using thematic analysis of post-course questionnaire responses.FindingsKnowledge, confidence and attitudes scores showed statistically significant increases, with large effect sizes. Thematic analyses highlighted themes of: interprofessionalism, communication skills, reflective practice, personal resilience, clinical skills and confidence.Research limitations/implicationsFurther research should clarify the impact of interprofessional simulation training on mental health practice in the context of other training received.Practical implicationsSimulation training may begin to influence participants’ professional development and future clinical practice and subsequently care delivered, supporting its increased use in mental health.Originality/valueThis study adds to nascent understandings of the use and potential of interprofessional mental health simulation, outlining innovative training, its positive outcomes and implications.

Foster, Celeste

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/jmhtep-04-2018-0023

The purpose of this paper is to investigate professional quality of life of mental health nursing staff working within an adolescent psychiatric intensive care unit (PICU) setting. Professional quality of life is important, as there is a correlation between staff wellbeing and the quality of healthcare services delivered, particularly within mental health settings. Mental health nursing staff in adolescent PICU services deal with a wide range of physically and emotionally demanding challenges when providing care, yet the potential impact of this demanding work upon staff in this context has not been explored.Design/methodology/approachThe study used a longitudinal non-experimental design with a purposive sample. Quantitative data were collected from a total of 17 registered mental health nurses and healthcare assistants (HCAs) working in an adolescent PICU in the North of England. Repeated measures were administered at three consecutive intervals, three months apart, using a validated self-report measure, the Professional Quality of Life Scale V (ProQOL V, Stamm, 2010). Data were analysed using descriptive and inferential statistical analysis using benchmark data from the ProQOL V instrument for comparison.FindingsAnalysis of results compared to ProQOL V benchmark data showed significantly higher than expected levels of compassion satisfaction, and lower than expected levels of burnout and secondary traumatic stress for adolescent PICU nursing staff within the study. There were no significant differences between qualified nurses and HCAs. Potential explanations and practice implications of these findings are discussed.Originality/valueThis is the first published study to investigate professional quality of life within the mental health nursing population working in adolescent PICU, providing empirical insights into a previously unexplored mental health context.