The Journal of Mental Health Training, Education and Practice

Wakelin, Rachel; Oakes, Peter

2020 The Journal of Mental Health Training, Education and Practice

doi: 10.1108/jmhtep-08-2018-0045

Research indicates that the diagnostic label of Bipolar Disorder is being both over and under-used in mental health services. Disagreement between clinicians in how the diagnosis of Bipolar Disorder is perceived and how the label is used can make it difficult to establish and uphold consistent care. This may lead to the experience of negative emotions for service users and poor engagement with intervention. Therefore, the purpose of this paper is to explore whether clinicians do hold different perceptions of the diagnosis of Bipolar Disorder, with the view of providing insight into how this may impact service provision.Design/methodology/approachQ-methodology was used to investigate the subjective viewpoints of 19 clinicians from mental health community teams supporting individuals with a diagnosis of Bipolar Disorder. The completed Q-sorts were subject to analysis using Q-methodology analysis software.FindingsThree main factors representing the viewpoints of participants were identified: seeing the person and their experience, promoting quality through standardised processes and understanding the function of diagnostic labels. All three factors agreed that more than one assessment appointment should be required before a diagnosis of Bipolar Disorder was given and that the focus should be on the difficulties experienced rather than the diagnostic label.Originality/valueThese three viewpoints provide different perspectives of the diagnosis of Bipolar Disorder, which are likely to impact on service provision. Services may benefit from a better integration of the viewpoints, noting the important functions of each viewpoint and being guided by individuals’ needs.

Wasser, Tobias; Chandra, Saksham; Michaelsen, Katherine

2020 The Journal of Mental Health Training, Education and Practice

doi: 10.1108/jmhtep-04-2019-0021

The purpose of this paper is to review the impact of a new, brief forensic rotation for general psychiatry residents on the variety of residents’ forensic exposures.Design/methodology/approachThe authors surveyed residents who trained before and after the implementation of the new rotation to assess the impact of the rotation on the residents’ forensic experiences during training across a variety of domains.FindingsEven in a highly clinical forensic setting, residents participating in the required rotation reported significantly greater variety of forensic experiences than those who had not completed the required rotation, including types of settings and assessments, Rotation completers reported greater exposure to various types of settings and assessments, and courtroom-related experiences, as well as the overall number of forensic exposures. The two groups did not differ in their forensic exposures in general psychiatry settings, civil-forensic evaluations or diverse forensic populations. Secondary analyses showed that increased exposure to court-based experiences and multiple forensic settings was associated with forensic fellowship interest.Originality/valueThis study demonstrates that a brief, mandatory forensic clinical rotation may increase residents’ exposure to forensic settings, assessments and courtroom-related experiences and that increased exposure to courtroom-based experiences in particular may increase interest in forensic fellowship. While not surprising, the results demonstrate that residents were not otherwise having these forensic experiences and that even time-limited forensic rotations can enhance the breadth of residents’ forensic exposures. Further, the rotation achieved these outcomes without using typical forensic sites but instead highly clinical sites, which may be particularly encouraging to residency programs without ready access to classic forensic rotation sites. This study contributes to the small but expanding body of the literature describing the value of increasing psychiatry residents’ training in clinical forensic psychiatry.

Stacey, Gemma; Pearson, Mark

2020 The Journal of Mental Health Training, Education and Practice

doi: 10.1108/jmhtep-06-2019-0029

In the assessment of student nurses, there is limited research exploring why the contributions of people with lived experience (LE) have an impact on learning. The purpose of this paper is to compare the nature of feedback provided to students by people who have both worked in and used mental health services.Design/methodology/approachTo explore the nature of qualitative student feedback generated from an assessment involving people who have experience of using and working in mental health services. Therefore, an inductive content analysis conducted on the formative written feedback provided to students following a simulated assessment.FindingsThe results demonstrate significant similarities in the feedback provided by those with LE of using and working within mental health services, suggesting a shared conceptualisation of professionalism.Research limitations/implicationsThe research indicates the potential socialisation of professionals and service users to not only the assessment process but also the professional expectations of mental health nurses. These findings resonate with Barker et al.’s (1999) description of the “pseudo ordinary me” and emphasise the principles and importance of person-centred care.Originality/valueThe paper highlights that assessment approaches which incorporate feedback from people with LE offer a vehicle to demonstrate and explore how attributes, subjectively associated with professionalism, can be recognised and developed by student mental health nurses.