The Journal of Mental Health Training Education and Practice

Drill, Rebecca; Malone, Johanna; Flouton-Barnes, Meredith; Cotton, Laura; Keyes, Sarah; Wasserman, Rachel; Wilson, Kelly; Young, Monica; Laws, Holly; Beinashowitz, Jack

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/JMHTEP-02-2018-0009

PurposeThe purpose of this paper is to address the barrier to care experienced by LGBTQIA+ populations by binary language for gender, sexual orientation and relationship status.Design/methodology/approachThe authors review the research that shows linguistic barriers are a significant obstacle to healthcare for LGBTQIA+ communities. The authors describe both a process and revisions for addressing language bias in psychiatric intake/research research materials as well as quantify its impact in an adult psychotherapy clinic in a public hospital.FindingsPatients self-identified their gender, sexual orientation and relationship status in a variety of ways when not presented with binaries and/or pre-established response choices. In addition, the non-response rate to questions decreased and the authors received positive qualitative feedback. The authors also present the revisions to the intake/research materials.Practical implicationsOther healthcare settings/clinicians can revise language in order to remove significant barriers to treatment and in doing so, be welcoming, non-pathologizing and empowering for LGBTQIA+ consumers of mental health services (as well as for non-LGBTQIA+ consumers who are in non-traditional relationships).Social implicationsThis work is one step in improving healthcare and the healthcare experience for LGBTQIA+ communities and for those in non-traditional relationships.Originality/valueThis work is set in a public safety-net hospital providing care for underserved and diverse populations. This paper describes the process of revising psychiatric materials to be more inclusive of the range of self-identity are: gender, sexual orientation and relationship status.

Snowden, Robert J.; Holt, Jordan; Simkiss, Nicola; Smith, Aimee; Webb, Daniel; Gray, Nicola S.

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/jmhtep-03-2019-0016

Wales Applied Risk Research Network (WARRN) is a formulation-based technique for the assessment and management of serious risk (e.g. violence to others, suicide, etc.) for users of mental health services. It has been gradually adopted as the risk evaluation and safety-planning technique for all seven health boards in Wales. The purpose of this paper is to examine the opinions of WARRN as used within these health boards.Design/methodology/approachAn online survey was disseminated to NHS clinicians in secondary mental health services to evaluate their perceptions of the use and effectiveness of WARRN. Data from 486 clinicians were analysed with both quantitative and qualitative methods.FindingsResults indicated that the overall impact of WARRN on secondary mental health care was very positive, with clinicians reporting increased skills in the domains of clinical risk formulation, safety-planning and communication, as well as increased confidence in their skills and abilities in these areas. Clinicians also reported that the “common-language” created by having all NHS health boards in Wales using the same risk assessment process facilitated the communication of safety-planning. Crucially, NHS staff believed that the safety of service users and of the general public had increased due to the adoption of WARRN in their health board and many believed that lives had been saved as a result.Originality/valueWARRN is perceived to have improved clinical skills in risk assessment and safety-planning across Wales and saved lives.

Best, Stephanie; Koski, Arja; Walsh, Lynne; Vuokila-Oikkonen, Päivi

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/JMHTEP-10-2018-0063

PurposeThe purpose of this paper is to investigate the use of innovative teaching methods and share a four-step model, to promote the use of co-production in mental health practice.Design/methodology/approachThe case study approach highlights three real-life examples of day to day experiences in mental health nurse education with innovative approaches to sharing and developing co-production skills and attitudes in mental health student nurses.FindingsThe case studies highlight three settings where undergraduate mental health nurses experience co-production through a world café event and dialogical community development. Common themes include setting the environment, developing a common aim and relationship building.Research limitations/implicationsA limitation of this paper is that only three case studies are provided, further examples would provide a greater pool of exemplars for others to draw on. However, by focusing upon student nurse education in learning environment, these examples are transferable to other settings.Practical implicationsThe practical applications are summarised in a four-step model that can help develop co-productive teaching methods; enable educators to set the climate and generate an understanding of co-production that empowers students and service users.Social implicationsThe emphasis and relevance of promoting co-productive working habits early on in nurses’ mental health nursing careers will enable them to raise awareness of future social implications for a range of client groups.Originality/valueThis paper focuses upon mental health student nurses whilst providing an innovative model to facilitate co-production experiences applicable in a range of settings.

Moulton-Perkins, Alesia; Wressle, Alexandra; Grey, Nick; Sired, Rebecca

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/jmhtep-04-2019-0025

Applications for clinical psychology training far outstrip places and relevant work experience is key. Paid opportunities are limited and therefore many choose volunteering, with well-connected graduates faring best. To promote equal opportunities a coordinated psychology graduate voluntary internship programme was established in a National Health Service Trust in the South of England. The purpose of this paper is to evaluate intern and supervisor outcomes, equality of access and adherence to governance standards.Design/methodology/approachThree cohorts of interns, unappointed applicants and supervisors were surveyed. Between 2013 and 2016, 270 psychology graduates applied, 119 were recruited and 151 either refused a place or were unsuccessful. In total, 91 supervisors provided service-level feedback.FindingsInterns and applicants were predominantly young, able-bodied white British heterosexual females. Demographic profiles were similar and broadly representative of psychology graduates nationally. While fewer were from Black and Ethnic Minority backgrounds, proportions were greater than the local population. Participants were more socioeconomically privileged than undergraduates nationally. The scheme was popular and well governed according to interns and supervisors. Post-internship employment prospects were improved, with most interns gaining paid mental health roles like assistant psychologist. Most supervisors commented on the positive contribution made by interns to service outcomes.Originality/valueThis study makes a significant contribution to the literature on voluntary psychology graduate posts, an area under-researched until now. Our results suggest that a coordinated, transparent approach can benefit both interns and services by minimising exploitation and maximising developmental opportunities for the new graduate. The programme makes an important contribution to addressing inequalities experienced by psychology graduates attempting to enter mental health careers.

Lane-Martin, Athene

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/JMHTEP-04-2019-0023

PurposeThe benefits of a student-led mental health promotion intervention on World Mental Health day result in tangible learning benefits for those students. The event occurs within the students’ own university. The paper aims to discuss this issue.Design/methodology/approachThis case study evaluates students’ experience on a mental health promotion intervention. This intervention was to enable students to experience running a health promotion intervention and develop their health promotion skills outside of their lectures. Students were recruited who had just completed a module on health promotion. Students had to plan and organise the intervention, which included involving other organisations and facilities both external and internal to the university. The experience was evaluated through the case study using as data collection a semi-structured interview.FindingsResults indicated that students found the experience to be beneficial in deepening their understanding of health promotion, mental health awareness and in increasing their self-esteem. Limitations of this case study are in the argument for reproducibility of results, which is affected by the small number of students who took part.Research limitations/implicationsThere are opportunities to develop this idea further and to broaden the availability of the initiative, enabling more students from diverse backgrounds to experience putting theory into practice.Originality/valueTo the best knowledge of the author, this study, although with limitations, provided a good understanding on how to develop health promotion skills within a university setting. The outcomes of this study are mainly applicable to a health studies course, educators of mental health promotion, university mental health support services and research related to this topic, especially on promoting mental health awareness and education.

Kuipers, Yvonne; Jomeen, Julie; Dilles, Tinne; Van Rompaey, Bart

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/jmhtep-05-2019-0028

The purpose of this paper is to measure reliability, validity and accuracy of the 12-item General Health Questionnaire (GHQ-12) as a measure of emotional wellbeing in pregnant women; utility and threshold in particular.Design/methodology/approachThe authors measured self-reported emotional wellbeing responses of 164 low-risk pregnant Dutch women with the GHQ-12 and a dichotomous case-finding item (Gold standard). The authors established internal consistency of the 12 GHQ-items (Cronbach’s coefficient α); construct validity: factor analysis using Oblimin rotation; convergent validity (Pearson’s correlation) and discriminatory ability (area under the receiver operating characteristics curve and index of union); and external validity of the dichotomous criterion standard against the GHQ-12 responses (sensitivity, specificity, likelihood ratios and predictive values), applying a cut-off value of ⩾ 12 and ⩾ 17, respectively.FindingsA coefficient of 0.85 showed construct reliability. The GHQ-12 items in the pattern matrix showed a three-dimensional factorial model: factor 1, anxiety and depression; factor 2, coping; and factor 3, significance/effect on life, with a total variance of 59 per cent. The GHQ-12 showed good accuracy (0.84; p=<0.001) and external validity (r=0.57; p=<0.001) when the cut-off value was set at the ⩾ 17 value. Using a cut-off value of ⩾ 17 demonstrated higher sensitivity (72.32 vs 41.07 per cent) but lower specificity (32.69 vs 55.77 per cent) compared to the commonly used cut-off value of ⩾ 12.Research limitations/implicationsFindings generally support the reliability, validity and accuracy of the Dutch version of the GHQ-12. Further evaluation of the measure, at more than one timepoint during pregnancy, is recommended.Practical implicationsThe GHQ-12 holds the potential to measure antenatal emotional wellbeing and women’s emotional responses and coping mechanisms with reduced antenatal emotional wellbeing.Social implicationsAdapting the GHQ-12 cut-off value enables effective identification of reduced emotional wellbeing to provide adequate care and allows potential reduction of anxiety among healthy pregnant women who are incorrectly screened as positive.Originality/valueA novel aspect is adapting the threshold of the GHQ-12 to ⩾ 17 in antenatal care.

Narusson, Dagmar; Wilken, Jean Pierre

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/jmhtep-02-2018-0011

The purpose of this paper is to focus on individuals who experience mental health difficulties with the services they receive from “support workers” as part of a personal recovery model, this study will obtain individuals reflections, experiences and opinions on how support helps them stay well and facilitates their personal recovery process. Recovery is seen through the lens of the CHIME framework (Connectedness–Hope–Identity–Meaning–Empowerment).Design/methodology/approachThe sample size included 13 people who experience mental health difficulties and are receiving support from mental health care services. The structured interview was designed based on the INSPIRE measurement and the CHIME framework structure. The qualitative content analyses, discursive framing approach and CHIME as a framework made it possible to examine the key activities of recovery-oriented support work revealed in the data.FindingsParticipants valued the enhancement of hope provided by support workers and also expressed it was important as they were non-judgemental. Identity and meaning in recovery could be enhanced by sharing powerful stories about the individuals’ own life and health experiences, and those of support workers or others. Inclusive behaviour in public spaces and trying out new interest-based activities together were considered as empowering.Originality/valueThis research helps to understand the value of personal recovery support activities given the societal changes (tension between survival vs self-expression values) and highlights the need for value-based recovery-oriented education and practice.

Stubbings, Daniel Robert; Hughes, Kyle; Limbert, Caroline

2019 The Journal of Mental Health Training Education and Practice

doi: 10.1108/jmhtep-10-2018-0059

The purpose of this paper is to explore the perceptions of staff towards psychotropic Pro Re Nata (PRN) medication in a residential care setting.Design/methodology/approachThree male and seven female participants were interviewed using a semi-structured interview. Transcripts were analysed using thematic analysis.FindingsFour themes pertaining to PRN medication emerged from the data: behaviour change, calming effect, importance of timing and perceived uniqueness.Research limitations/implicationsThe participant group was not homogenous and findings may have been different in a more qualified cohort. This care setting may not be representative of other environments where PRN medication is administered. The findings do, however, highlight some of the challenges facing the administration of PRN medication in mental health and care settings.Practical implicationsThe awareness of these themes is significant for improving staff knowledge, training practices and policies towards the use and administration of psychotropic PRN medication.Originality/valueThis is the first study to engage in a thematic analysis of staff views towards the administration of PRN medication.

Gheduzzi, Eleonora; Masella, Cristina; Segato, Federica

2019 The Journal of Mental Health Training, Education and Practice

doi: 10.1108/jmhtep-01-2019-0008

The purpose of this paper is to study four cases of the adoption of co-production and compare them according to the type of user involvement, contextual factors and the organizational structure.Design/methodology/approachIn total, 30 interviews were conducted in four mental health organizations which are implementing co-production in the North of Italy. Interviews were conducted with clinicians, nurses, patients and family members. The data collected was triangulated with further sources and official documents of organizations. The results have been compared by means of a validated international framework (IAP2) regarding the contextual factors and the level of co-production adopted.FindingsThe adoption of co-production in the four cases differs by the activities implemented and how organizations involve informal actors. It seems to be influenced by the contextual factors specific to each organization: power, professionals’ opinions and leadership. Organizations whose practitioners and leaders are willing to distribute their power and value informal actors’ opinions seem to facilitate the systematic involvement of users. Overall, the results highlight the importance of considering contextual factors when evaluating and describing co-production activities.Originality/valueThis paper contributes to describing how mental health organizations are implementing co-production. It examines the influence of contextual factors on the type of co-production adopted.