People of BAMME (Black, Asian, Minority, and Migrant ethnic) heritage in the UK experience variou... more People of BAMME (Black, Asian, Minority, and Migrant ethnic) heritage in the UK experience various anomalies when engaging with mental health services. Typically concentrated at secondary and secure levels of care, these discrepant experiences interact with a reticence to uptake mental health support at the primary care level. Official, national anti-stigma campaigns often reproduce messages that do not connect with BAMME communities, raising questions about how best to challenge stigma in this context. This research paper describes a case study of an alternative means to address stigma, drawing from a dramatic comedy performance, Plant Fetish, written and performed by an artist who carries a diagnosis of complex post-traumatic stress disorder (Complex PTSD). The study comprised of an individual interview with the artist, audience feedback, and a group discussion conducted after the show. Data were subject to interpretative phenomenological analysis. Findings are discussed in relati...
OBJECTIVES This integrative review provides a collective understanding of the experiences of stud... more OBJECTIVES This integrative review provides a collective understanding of the experiences of student mental health nurses and service users carrying a diagnosis of personality disorder and the time they share together. DESIGN Published studies about the time service users and students share together were systematically selected in order to integrate their findings in a thematic analysis. DATA SOURCES Various databases were searched from 1984 until 2020. Specific search terms were used. REVIEW METHODS 37 studies were included in the integrative review. The studies were from peer reviewed nursing, student, psychology and health related journals. A quality appraisal was completed using Walsh and Downe (2006) framework. FINDINGS Four themes emerged from a thematic analysis of the integrative review. These were; With 'Impact of time' as an overarching theme. CONCLUSION A positive environment which considers time and focuses on seeing the person, as an individual can lead to the development of therapeutic relationships; a core element of the Nursing and Midwifery Council standards for nursing registration in the UK (Nursing and Midwifery Council, 2018). Students attempting to build such relationships need to be mindful of service users' and their own attachment experiences and the impact these can have on experiences of transference and countertransference, particularly for service users carrying a personality disorder diagnosis. It is important for students to be aware of the supportive impact of positive environments and how doing 'everyday stuff' can make a person feel human despite residing in potentially dehumanizing places.
Iodine deficiency is still prevalent in parts of Pakistan, despite the introduction of a national... more Iodine deficiency is still prevalent in parts of Pakistan, despite the introduction of a national Iodine Deficiency Disorder Control Programme in 1994. The purpose of this study was to gain an understanding of the knowledge, attitudes and practice regarding the use of iodised salt in a brick kiln community, and to use this information to design an intervention to increase its consumption. A cross-sectional survey was used to assess the use of iodised salt and focus group discussions explored the attitudes and barriers to its use. Thematically analysed transcripts informed the design of a 4-month intervention. Iodised salt sales and urine iodine concentration (UIC) were monitored to assess the effectiveness of the intervention. At baseline, 2.6% of households reported use of iodised salt and barriers included its higher cost and belief about a negative impact on reproduction. During the intervention, sales of salt labelled as iodised increased by 45%, however this was not reflected i...
ConTEnTS Acknowledgements vii List of abbreviations xi Potential conflicts of interest xii A note... more ConTEnTS Acknowledgements vii List of abbreviations xi Potential conflicts of interest xii A note on terminology xiii Executive summary xv Research Review 1 Introducton 1.1 Terms of reference for the revew 1.2 Research objectves 1.3 Objectves for the knowledge revew 1.4 Involvement of stakeholders 6 Summary and conclusons 6.1 Gaps n knowledge 6.2 Development of mental health advocacy for Afrcan and Carbbean men 6.3 Implcatons for future studes 6.4 Concluson Practice Survey 7 Ams 8 Methodology 8.1 Stakeholder nvolvement 8.2 Sources of nformaton 8.3 Confdentalty and ethcal ssues 8.4 Data analyss v Contents 9 Provson of mental health advocacy: dfferent types of groups, dfferent forms of advocacy 9.1 Provson of mental health advocacy 87 9.2 Advocacy actvty 9.3 Access to mental health advocacy by Afrcan 93 and Carbbean men What does advocacy mean? 93 10.1 The meanng of advocacy 10.2 The need for advocacy 10.3 Men, masculnty and mental health 11 Respect and trust: the advocacy relatonshp 11.1 An advocate lke me 11.2 Relatonshps 12 Results: the outcomes of advocacy 13 Optmum confguraton and organsaton of servces 13.1 Characterstcs of a qualty advocacy servce for Afrcan and Carbbean men 13.2 Developng a whole system of advocacy 108 provson 13.3 Fundng nsecurtes: placng the results at rsk 13.4 Commssonng: plannng and purchasng for advocacy 14 Transformng mental health servces for Afrcan 113 and Carbbean men 15 Summary and conclusons 15.1 Lmtatons of the Practce Survey 15.2 Current professonal consensus 15.3 Custom and practce 15.4 Emergng new practce ADULTS' SERVICES v 16 Synthess 16.1 Needs and experences of Afrcan and Carbbean men 16.2 Provson of advocacy 16.3 Organsatonal arrangements 17 Concluson References Appendix 1: Partner organisations Appendix 2: Key reports and policy initiatives Appendix 3: overview of search results Appendix 4: Typology of mental health advocacy provision for African and Caribbean men
This chapter develops thinking about participation in different but connected initiatives concern... more This chapter develops thinking about participation in different but connected initiatives concerned with mental health, the arts and humanities. These are located in a university community engagement context developed with participatory action research methods. Particular themes at play include: the filmic depiction of madness and its relationship to wider social representations; the motivating zeal of service user participants and the potential for this to be understood as part of a wider movement for change; and the extent to which these can touch or move an audience of learners. We will draw on participant accounts arising from the course of the action research project and a number of purposeful focus groups and interviews relevant to the experience of (i) developing and managing a mental health film festival and (ii) participating in a mini-project to produce video/re-usable learning objects, in effect service users making their own films to support practitioner education. These...
This paper attempts a critical discussion of the possibilities for mental health nurses to claim ... more This paper attempts a critical discussion of the possibilities for mental health nurses to claim a particular right of conscientious objection to their involvement in enforced pharmaceutical interventions. We nest this within a more general critique of perceived shortcomings of psychiatric services, and injustices therein. Our intention is to consider the philosophical and practical complexities of making demands for this conscientious objection before arriving at a speculative appraisal of the potential this may hold for broader aspirations for a transformed or alternative mental health care system, more grounded in consent than coercion. We consider a range of ethical and practical dimensions of how to realize this right to conscientious objection. We also rely upon an abolition democracy lens to move beyond individual ethical frameworks to consider a broader politics for framing these arguments.
Purpose The label “Personality Disorder” continues to divide opinion. Challenges to the terminolo... more Purpose The label “Personality Disorder” continues to divide opinion. Challenges to the terminology of personality disorder led by people with lived experience and supported by critical practitioners and academics are tempered by acknowledgement of certain positive social consequences of obtaining a diagnosis. This study aims to engage service users and staff in a process of inquiry to better understand the complexities of views on the terminology of Personality Disorder. Design/methodology/approach This study set out to qualitatively explore the views of a range of people with lived, occupational and dual lived experience/occupational expertise, relating to the diagnostic label of Personality Disorder, via participatory and critical group debate. The World Café approach is an innovative methodology for participatory inquiry into subjective views suited to exploring the contested subject matter. Findings This study identified contrasting opinions towards the label of Personality Dis...
This editorial highlights some of the public health hazards implicit within the government's ... more This editorial highlights some of the public health hazards implicit within the government's treatment of migrants and locates these within a wider frame of mental health. In the midst of a pandemic threatening countless lives and a belated lockdown inducing widespread mental stress, the Government continues to pursue a Hostile Environment policy. This involves various legislative and administrative measures aimed at making it as difficult as possible for people without full rights to remain in the UK to actually stay in the country.
This study explores the experiences of the black children and young men that attended a Youth Off... more This study explores the experiences of the black children and young men that attended a Youth Offending Team (YOT) in Liverpool, a city in the North of England, UK. It focuses on the perspectives of both the YOT practitioners and the black children/young men as they develop working relationships with each other. Through this two-way prism the back children/young men reflect on what is important to them before and after they enter the criminal justice system. Likewise, the YOT practitioners provide their understanding of the key issues in the young people’s lives—in particular, how the black children/young men made sense of their lives in Liverpool with a particular identity with place, space, class and race. A genealogy of race/class prism, along with an intersectional and appreciative inquiry methodology, was employed that encouraged the youth justice workers and young black men to explore the strengths and realities of their lives. Focus groups were undertaken with seven YOT pract...
Coercive practices, such as physical restraint, are used globally to respond to violent, aggressi... more Coercive practices, such as physical restraint, are used globally to respond to violent, aggressive and other behaviours displayed by mental health service users.1 A number of approaches have been designed to aid staff working within services to minimise the use of restraint and other restrictive practices. One such approach, the 'REsTRAIN Yourself' (RYS) initiative, has been evaluated in the UK. Rapid ethnography was used to explore the aspects of organisational culture and staff behaviour exhibited by teams of staff working within 14 acute admission mental health wards in the North West region of the English NHS. Findings comprise four core themes of space and place; legitimation; meaningful activity; and, therapeutic engagement that represent characteristics of daily life on the wards before and after implementation of the RYS intervention. Tensions between staff commitments to therapeutic relations and constraining factors were revealed in demarcations of ward space and limitations on availability of meaningful activities. The physical, relational and discursive means by which ward spaces are segregated prompts attention to the observed materialities of routine care. Legitimation was identified as a crucial discursive practice in the context of staff reliance upon coercion. Trauma-informed care represents a potentially alternative legitimacy.
CLoK Central Lancashire online Knowledge www.clok.uclan.ac.uk 'Catching your tail and firefightin... more CLoK Central Lancashire online Knowledge www.clok.uclan.ac.uk 'Catching your tail and firefighting': the impact of staffing levels on restraint minimisation efforts.
Minimising the use of physical restraint in acute mental health services: The outcome of a restra... more Minimising the use of physical restraint in acute mental health services: The outcome of a restraint reduction programme ('REsTRAIN YOURSELF)
Different aspects of the neighborhood social environment have been linked with mental ill health;... more Different aspects of the neighborhood social environment have been linked with mental ill health; however, the mechanisms underlying these associations remain poorly understood because of the number and complexity of the components involved. We used a novel statistical approach, network analysis, to explore the complex associations between neighborhood social cohesion, social disorder, and mental-health symptoms in a sample of 3,670 adults from an economically deprived region of the United Kingdom (mean age = 49.34 years, SD = 18.87; 57% female). Elasso regularized networks were estimated, and network comparisons were conducted by level of deprivation. Mental-health symptoms and neighborhood components formed relatively distinct clusters of items. These domains were linked primarily by paranoia, although only in the most deprived group. Drunken/rowdy behavior was particularly influential within the neighborhood cluster; therefore, policies aimed at reducing such disruptive behavior ...
International journal of mental health nursing, 2018
In Western society, policy and legislation seeks to minimize restrictive interventions, including... more In Western society, policy and legislation seeks to minimize restrictive interventions, including physical restraint; yet research suggests the use of such practices continues to raise concerns. Whilst international agreement has sought to define physical restraint, diversity in the way in which countries use restraint remains disparate. Research to date has reported on statistics regarding restraint, how and why it is used, and staff and service user perspectives about its use. However, there is limited evidence directly exploring the physical and psychological harm restraint may cause to people being cared for within mental health inpatient settings. This study reports on an integrative review of the literature exploring available evidence regarding the physical and psychological impact of restraint. The review included both experimental and nonexperimental research papers, using Cooper's (1998) five-stage approach to synthesize the findings. Eight themes emerged: Trauma/retra...
The relative burden of mental health disorders is increasing globally, in terms of prevalence and... more The relative burden of mental health disorders is increasing globally, in terms of prevalence and disability. There is limited data available to guide treatment choices for clinicians in low resourced settings, with mHealth technologies being a potentially beneficial avenue to bridging the large mental health treatment gap globally. The aim of the review was to search the literature systematically for studies of mHealth interventions for psychosis globally, and to examine whether mHealth for psychosis has been investigated. A systematic literature search was completed in Embase, Medline, PsychINFO and Evidence Based Medicine Reviews databases from inception to May 2016. Only studies with a randomised controlled trial design that investigated an mHealth intervention for psychosis were included. A total of 5690 records were identified with 7 studies meeting the inclusion criteria. The majority of included studies, were conducted across Europe and the United Sates with one being conducted in China. The 7 included studies examined different parameters, such as Experiential Sampling Methodology (ESM), medication adherence, cognitive impairment, social functioning and suicidal ideation in veterans with schizophrenia. Considering the increasing access to mobile devices globally, mHealth may potentially increase access to appropriate mental health care. The results of this review show promise in bridging the global mental health treatment gap, by enabling individuals to receive treatment via their mobile phones, particularly for those individuals who live in remote or rural areas, areas of high deprivation and for those from low resourced settings.
Amidst the burgeoning number of texts which celebrate progress in health and social care, or manu... more Amidst the burgeoning number of texts which celebrate progress in health and social care, or manuals that offer DIY guides to excellence, this book is a timely pause for reflection. In an era that proclaims enlightened policy, champions community care, and lauds the centrality of the consumer, these authors offer a much needed alternative to rhetoric. This edited volume is rigorously researched, extremely accessible, and informed by a trenchant political critique of service provision and professional practice. It needs to be read, and deserves to become an essential part of the recommended literature for any education or training courses in this field. Utilising a 'life-course' perspective, contributors focus upon the domains of child care, learning disability, mental health and the experience of older people. Of equal importance, though, to these discrete areas of working is a spirit of critical inquiry that warrants a much wider audience. The concepts of 'institution' and 'abuse' are themselves problematised and deconstructed so that the body, rather than concrete structures, is identified as the site of oppressive practice and integral to any meaningful change strategies. Beyond headline scandals and high profile inquiry reports, we are reminded of the complex set of power relations that construct policy and practice. From this position, inequality mediated by the divisions of age, gender, sexuality, race, and disability is contrasted starkly with paternalistic ideology and commodification of the client. These impressive theoretical advances are superbly balanced and enriched by the narrative accounts of those who both receive and deliver care. Important themes are bullying, workplace harassment, therapeutic abuse, managerial complacency, and the cost of 'whistle-blowing'. It is difficult to offer a brief review of a book so brave and broad ranging in its concerns. Most importantly, though, it challenges the naive blame-culture of 'bad apples' and bad staff. In so doing it calls for a systematic monitoring of services, and signals a positive understanding of empowerment where users are the socially valued signatories to a contract of care.
People of BAMME (Black, Asian, Minority, and Migrant ethnic) heritage in the UK experience variou... more People of BAMME (Black, Asian, Minority, and Migrant ethnic) heritage in the UK experience various anomalies when engaging with mental health services. Typically concentrated at secondary and secure levels of care, these discrepant experiences interact with a reticence to uptake mental health support at the primary care level. Official, national anti-stigma campaigns often reproduce messages that do not connect with BAMME communities, raising questions about how best to challenge stigma in this context. This research paper describes a case study of an alternative means to address stigma, drawing from a dramatic comedy performance, Plant Fetish, written and performed by an artist who carries a diagnosis of complex post-traumatic stress disorder (Complex PTSD). The study comprised of an individual interview with the artist, audience feedback, and a group discussion conducted after the show. Data were subject to interpretative phenomenological analysis. Findings are discussed in relati...
OBJECTIVES This integrative review provides a collective understanding of the experiences of stud... more OBJECTIVES This integrative review provides a collective understanding of the experiences of student mental health nurses and service users carrying a diagnosis of personality disorder and the time they share together. DESIGN Published studies about the time service users and students share together were systematically selected in order to integrate their findings in a thematic analysis. DATA SOURCES Various databases were searched from 1984 until 2020. Specific search terms were used. REVIEW METHODS 37 studies were included in the integrative review. The studies were from peer reviewed nursing, student, psychology and health related journals. A quality appraisal was completed using Walsh and Downe (2006) framework. FINDINGS Four themes emerged from a thematic analysis of the integrative review. These were; With 'Impact of time' as an overarching theme. CONCLUSION A positive environment which considers time and focuses on seeing the person, as an individual can lead to the development of therapeutic relationships; a core element of the Nursing and Midwifery Council standards for nursing registration in the UK (Nursing and Midwifery Council, 2018). Students attempting to build such relationships need to be mindful of service users' and their own attachment experiences and the impact these can have on experiences of transference and countertransference, particularly for service users carrying a personality disorder diagnosis. It is important for students to be aware of the supportive impact of positive environments and how doing 'everyday stuff' can make a person feel human despite residing in potentially dehumanizing places.
Iodine deficiency is still prevalent in parts of Pakistan, despite the introduction of a national... more Iodine deficiency is still prevalent in parts of Pakistan, despite the introduction of a national Iodine Deficiency Disorder Control Programme in 1994. The purpose of this study was to gain an understanding of the knowledge, attitudes and practice regarding the use of iodised salt in a brick kiln community, and to use this information to design an intervention to increase its consumption. A cross-sectional survey was used to assess the use of iodised salt and focus group discussions explored the attitudes and barriers to its use. Thematically analysed transcripts informed the design of a 4-month intervention. Iodised salt sales and urine iodine concentration (UIC) were monitored to assess the effectiveness of the intervention. At baseline, 2.6% of households reported use of iodised salt and barriers included its higher cost and belief about a negative impact on reproduction. During the intervention, sales of salt labelled as iodised increased by 45%, however this was not reflected i...
ConTEnTS Acknowledgements vii List of abbreviations xi Potential conflicts of interest xii A note... more ConTEnTS Acknowledgements vii List of abbreviations xi Potential conflicts of interest xii A note on terminology xiii Executive summary xv Research Review 1 Introducton 1.1 Terms of reference for the revew 1.2 Research objectves 1.3 Objectves for the knowledge revew 1.4 Involvement of stakeholders 6 Summary and conclusons 6.1 Gaps n knowledge 6.2 Development of mental health advocacy for Afrcan and Carbbean men 6.3 Implcatons for future studes 6.4 Concluson Practice Survey 7 Ams 8 Methodology 8.1 Stakeholder nvolvement 8.2 Sources of nformaton 8.3 Confdentalty and ethcal ssues 8.4 Data analyss v Contents 9 Provson of mental health advocacy: dfferent types of groups, dfferent forms of advocacy 9.1 Provson of mental health advocacy 87 9.2 Advocacy actvty 9.3 Access to mental health advocacy by Afrcan 93 and Carbbean men What does advocacy mean? 93 10.1 The meanng of advocacy 10.2 The need for advocacy 10.3 Men, masculnty and mental health 11 Respect and trust: the advocacy relatonshp 11.1 An advocate lke me 11.2 Relatonshps 12 Results: the outcomes of advocacy 13 Optmum confguraton and organsaton of servces 13.1 Characterstcs of a qualty advocacy servce for Afrcan and Carbbean men 13.2 Developng a whole system of advocacy 108 provson 13.3 Fundng nsecurtes: placng the results at rsk 13.4 Commssonng: plannng and purchasng for advocacy 14 Transformng mental health servces for Afrcan 113 and Carbbean men 15 Summary and conclusons 15.1 Lmtatons of the Practce Survey 15.2 Current professonal consensus 15.3 Custom and practce 15.4 Emergng new practce ADULTS' SERVICES v 16 Synthess 16.1 Needs and experences of Afrcan and Carbbean men 16.2 Provson of advocacy 16.3 Organsatonal arrangements 17 Concluson References Appendix 1: Partner organisations Appendix 2: Key reports and policy initiatives Appendix 3: overview of search results Appendix 4: Typology of mental health advocacy provision for African and Caribbean men
This chapter develops thinking about participation in different but connected initiatives concern... more This chapter develops thinking about participation in different but connected initiatives concerned with mental health, the arts and humanities. These are located in a university community engagement context developed with participatory action research methods. Particular themes at play include: the filmic depiction of madness and its relationship to wider social representations; the motivating zeal of service user participants and the potential for this to be understood as part of a wider movement for change; and the extent to which these can touch or move an audience of learners. We will draw on participant accounts arising from the course of the action research project and a number of purposeful focus groups and interviews relevant to the experience of (i) developing and managing a mental health film festival and (ii) participating in a mini-project to produce video/re-usable learning objects, in effect service users making their own films to support practitioner education. These...
This paper attempts a critical discussion of the possibilities for mental health nurses to claim ... more This paper attempts a critical discussion of the possibilities for mental health nurses to claim a particular right of conscientious objection to their involvement in enforced pharmaceutical interventions. We nest this within a more general critique of perceived shortcomings of psychiatric services, and injustices therein. Our intention is to consider the philosophical and practical complexities of making demands for this conscientious objection before arriving at a speculative appraisal of the potential this may hold for broader aspirations for a transformed or alternative mental health care system, more grounded in consent than coercion. We consider a range of ethical and practical dimensions of how to realize this right to conscientious objection. We also rely upon an abolition democracy lens to move beyond individual ethical frameworks to consider a broader politics for framing these arguments.
Purpose The label “Personality Disorder” continues to divide opinion. Challenges to the terminolo... more Purpose The label “Personality Disorder” continues to divide opinion. Challenges to the terminology of personality disorder led by people with lived experience and supported by critical practitioners and academics are tempered by acknowledgement of certain positive social consequences of obtaining a diagnosis. This study aims to engage service users and staff in a process of inquiry to better understand the complexities of views on the terminology of Personality Disorder. Design/methodology/approach This study set out to qualitatively explore the views of a range of people with lived, occupational and dual lived experience/occupational expertise, relating to the diagnostic label of Personality Disorder, via participatory and critical group debate. The World Café approach is an innovative methodology for participatory inquiry into subjective views suited to exploring the contested subject matter. Findings This study identified contrasting opinions towards the label of Personality Dis...
This editorial highlights some of the public health hazards implicit within the government's ... more This editorial highlights some of the public health hazards implicit within the government's treatment of migrants and locates these within a wider frame of mental health. In the midst of a pandemic threatening countless lives and a belated lockdown inducing widespread mental stress, the Government continues to pursue a Hostile Environment policy. This involves various legislative and administrative measures aimed at making it as difficult as possible for people without full rights to remain in the UK to actually stay in the country.
This study explores the experiences of the black children and young men that attended a Youth Off... more This study explores the experiences of the black children and young men that attended a Youth Offending Team (YOT) in Liverpool, a city in the North of England, UK. It focuses on the perspectives of both the YOT practitioners and the black children/young men as they develop working relationships with each other. Through this two-way prism the back children/young men reflect on what is important to them before and after they enter the criminal justice system. Likewise, the YOT practitioners provide their understanding of the key issues in the young people’s lives—in particular, how the black children/young men made sense of their lives in Liverpool with a particular identity with place, space, class and race. A genealogy of race/class prism, along with an intersectional and appreciative inquiry methodology, was employed that encouraged the youth justice workers and young black men to explore the strengths and realities of their lives. Focus groups were undertaken with seven YOT pract...
Coercive practices, such as physical restraint, are used globally to respond to violent, aggressi... more Coercive practices, such as physical restraint, are used globally to respond to violent, aggressive and other behaviours displayed by mental health service users.1 A number of approaches have been designed to aid staff working within services to minimise the use of restraint and other restrictive practices. One such approach, the 'REsTRAIN Yourself' (RYS) initiative, has been evaluated in the UK. Rapid ethnography was used to explore the aspects of organisational culture and staff behaviour exhibited by teams of staff working within 14 acute admission mental health wards in the North West region of the English NHS. Findings comprise four core themes of space and place; legitimation; meaningful activity; and, therapeutic engagement that represent characteristics of daily life on the wards before and after implementation of the RYS intervention. Tensions between staff commitments to therapeutic relations and constraining factors were revealed in demarcations of ward space and limitations on availability of meaningful activities. The physical, relational and discursive means by which ward spaces are segregated prompts attention to the observed materialities of routine care. Legitimation was identified as a crucial discursive practice in the context of staff reliance upon coercion. Trauma-informed care represents a potentially alternative legitimacy.
CLoK Central Lancashire online Knowledge www.clok.uclan.ac.uk 'Catching your tail and firefightin... more CLoK Central Lancashire online Knowledge www.clok.uclan.ac.uk 'Catching your tail and firefighting': the impact of staffing levels on restraint minimisation efforts.
Minimising the use of physical restraint in acute mental health services: The outcome of a restra... more Minimising the use of physical restraint in acute mental health services: The outcome of a restraint reduction programme ('REsTRAIN YOURSELF)
Different aspects of the neighborhood social environment have been linked with mental ill health;... more Different aspects of the neighborhood social environment have been linked with mental ill health; however, the mechanisms underlying these associations remain poorly understood because of the number and complexity of the components involved. We used a novel statistical approach, network analysis, to explore the complex associations between neighborhood social cohesion, social disorder, and mental-health symptoms in a sample of 3,670 adults from an economically deprived region of the United Kingdom (mean age = 49.34 years, SD = 18.87; 57% female). Elasso regularized networks were estimated, and network comparisons were conducted by level of deprivation. Mental-health symptoms and neighborhood components formed relatively distinct clusters of items. These domains were linked primarily by paranoia, although only in the most deprived group. Drunken/rowdy behavior was particularly influential within the neighborhood cluster; therefore, policies aimed at reducing such disruptive behavior ...
International journal of mental health nursing, 2018
In Western society, policy and legislation seeks to minimize restrictive interventions, including... more In Western society, policy and legislation seeks to minimize restrictive interventions, including physical restraint; yet research suggests the use of such practices continues to raise concerns. Whilst international agreement has sought to define physical restraint, diversity in the way in which countries use restraint remains disparate. Research to date has reported on statistics regarding restraint, how and why it is used, and staff and service user perspectives about its use. However, there is limited evidence directly exploring the physical and psychological harm restraint may cause to people being cared for within mental health inpatient settings. This study reports on an integrative review of the literature exploring available evidence regarding the physical and psychological impact of restraint. The review included both experimental and nonexperimental research papers, using Cooper's (1998) five-stage approach to synthesize the findings. Eight themes emerged: Trauma/retra...
The relative burden of mental health disorders is increasing globally, in terms of prevalence and... more The relative burden of mental health disorders is increasing globally, in terms of prevalence and disability. There is limited data available to guide treatment choices for clinicians in low resourced settings, with mHealth technologies being a potentially beneficial avenue to bridging the large mental health treatment gap globally. The aim of the review was to search the literature systematically for studies of mHealth interventions for psychosis globally, and to examine whether mHealth for psychosis has been investigated. A systematic literature search was completed in Embase, Medline, PsychINFO and Evidence Based Medicine Reviews databases from inception to May 2016. Only studies with a randomised controlled trial design that investigated an mHealth intervention for psychosis were included. A total of 5690 records were identified with 7 studies meeting the inclusion criteria. The majority of included studies, were conducted across Europe and the United Sates with one being conducted in China. The 7 included studies examined different parameters, such as Experiential Sampling Methodology (ESM), medication adherence, cognitive impairment, social functioning and suicidal ideation in veterans with schizophrenia. Considering the increasing access to mobile devices globally, mHealth may potentially increase access to appropriate mental health care. The results of this review show promise in bridging the global mental health treatment gap, by enabling individuals to receive treatment via their mobile phones, particularly for those individuals who live in remote or rural areas, areas of high deprivation and for those from low resourced settings.
Amidst the burgeoning number of texts which celebrate progress in health and social care, or manu... more Amidst the burgeoning number of texts which celebrate progress in health and social care, or manuals that offer DIY guides to excellence, this book is a timely pause for reflection. In an era that proclaims enlightened policy, champions community care, and lauds the centrality of the consumer, these authors offer a much needed alternative to rhetoric. This edited volume is rigorously researched, extremely accessible, and informed by a trenchant political critique of service provision and professional practice. It needs to be read, and deserves to become an essential part of the recommended literature for any education or training courses in this field. Utilising a 'life-course' perspective, contributors focus upon the domains of child care, learning disability, mental health and the experience of older people. Of equal importance, though, to these discrete areas of working is a spirit of critical inquiry that warrants a much wider audience. The concepts of 'institution' and 'abuse' are themselves problematised and deconstructed so that the body, rather than concrete structures, is identified as the site of oppressive practice and integral to any meaningful change strategies. Beyond headline scandals and high profile inquiry reports, we are reminded of the complex set of power relations that construct policy and practice. From this position, inequality mediated by the divisions of age, gender, sexuality, race, and disability is contrasted starkly with paternalistic ideology and commodification of the client. These impressive theoretical advances are superbly balanced and enriched by the narrative accounts of those who both receive and deliver care. Important themes are bullying, workplace harassment, therapeutic abuse, managerial complacency, and the cost of 'whistle-blowing'. It is difficult to offer a brief review of a book so brave and broad ranging in its concerns. Most importantly, though, it challenges the naive blame-culture of 'bad apples' and bad staff. In so doing it calls for a systematic monitoring of services, and signals a positive understanding of empowerment where users are the socially valued signatories to a contract of care.
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Papers by Mick McKeown