Patient and Service User Care
http://hdl.handle.net/20.500.12904/4964
2024-03-29T07:50:38Z
2024-03-29T07:50:38Z
The impact of reduced routine community mental healthcare on people from minority ethnic groups during the COVID-19 pandemic: Qualitative study of stakeholder perspectives
Franklin, Donna
http://hdl.handle.net/20.500.12904/18333
2024-03-12T01:57:56Z
2024-01-01T00:00:00Z
The impact of reduced routine community mental healthcare on people from minority ethnic groups during the COVID-19 pandemic: Qualitative study of stakeholder perspectives
Franklin, Donna
BACKGROUND: Enduring ethnic inequalities exist in mental healthcare. The COVID-19 pandemic has widened these. AIMS: To explore stakeholder perspectives on how the COVID-19 pandemic has increased ethnic inequalities in mental healthcare. METHOD: A qualitative interview study of four areas in England with 34 patients, 15 carers and 39 mental health professionals from National Health Service (NHS) and community organisations (July 2021 to July 2022). Framework analysis was used to develop a logic model of inter-relationships between pre-pandemic barriers and COVID-19 impacts. RESULTS: Impacts were largely similar across sites, with some small variations (e.g. positive service impacts of higher ethnic diversity in area 2). Pre-pandemic barriers at individual level included mistrust and thus avoidance of services and at a service level included the dominance of a monocultural model, leading to poor communication, disengagement and alienation. During the pandemic remote service delivery, closure of community organisations and media scapegoating exacerbated existing barriers by worsening alienation and communication barriers, fuelling prejudice and division, and increasing mistrust in services. Some minority ethnic patients reported positive developments, experiencing empowerment through self-determination and creative activities. CONCLUSIONS: During the COVID-19 pandemic some patients showed resilience and developed adaptations that could be nurtured by services. However, there has been a reduction in the availability of group-specific NHS and third-sector services in the community, exacerbating pre-existing barriers. As these developments are likely to have long-term consequences for minority ethnic groups' engagement with mental healthcare, they need to be addressed as a priority by the NHS and its partners.
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of Royal College of Psychiatrists. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
2024-01-01T00:00:00Z
Healthcare professionals' experiences of recovery-oriented collaboration between mental health centres and municipalities: A qualitative study
Watson, Emma
http://hdl.handle.net/20.500.12904/18194
2024-02-01T09:52:18Z
2024-01-01T00:00:00Z
Healthcare professionals' experiences of recovery-oriented collaboration between mental health centres and municipalities: A qualitative study
Watson, Emma
Collaboration within mental health centres and with municipalities in Western European healthcare has presented challenges due to structural and cultural disparities. The Danish healthcare system faces obstacles that impact mental healthcare services, particularly in cross-sectorial cooperation. Our aim was to investigate healthcare professionals' experiences of recovery-oriented collaboration within a mental healthcare setting across hospitals and municipalities to gather a deeper understanding of this issue. Twenty-four employees were purposively sampled from mental health centres in Copenhagen and focus group interviews were conducted to explore their perceptions of working together. Inductive content analysis was used to analyse the data and identify themes and categories. The participants emphasised challenges in communication and coordination to improve collaboration within across the two sectors. This study can contribute to a greater understanding of collaboration between mental health centres and municipalities. It aims to inspire improvements in communication, coordination, and the optimisation of mental health service delivery across sectors.
2024-01-01T00:00:00Z
The last chance to get it right: the experience of health professionals delivering end-of-life care in an in-patient mental health setting. A modified critical review of literature
Furby, Robert
http://hdl.handle.net/20.500.12904/15777
2022-09-09T14:55:51Z
2022-01-01T00:00:00Z
The last chance to get it right: the experience of health professionals delivering end-of-life care in an in-patient mental health setting. A modified critical review of literature
Furby, Robert
The purpose of this modified critical review of literature is to draw upon the contemporary evidence base to explore the lived experiences of healthcare professionals delivering end-of-life care to patients cared for in mental healthcare settings. People of severe and persistent mental illness are a very vulnerable cohort of patients. They often live with higher-than-average co-morbidities, low than average life expectancy and high mortality rates. Little is known about the experience of mental health professionals delivering end-of-life care to those patients whose care needs can only be met in an in-patient facility. This review aims to provide a window into this experience and draw out the barriers and enablers to good care. For this review, 64 unique titles and abstracts were identified through the search of six databases. The appraisal of these papers resulted in six meeting the inclusion and quality criteria and subsequent syntheses of the findings were presented into three themes:1) There was a recurrent lack of preparedness of both services and staff to assess and meet the needs of patients at the end-of-life in mental healthcare settings.2) There was a clear need for collaborative work between mental and physical healthcare professionals; however, this was often difficult to achieve.3) Patients at the end-of-life with Severe Mental Illness poses specifically challenges which professional caring for them need to be aware of.The findings of the review were in keeping with other work in the area and provides four main recommendations for practice:1) Services must have a clearly defined collaborative approach to working relationships between palliative care and mental healthcare professionals.2) Specific training and education for mental healthcare professionals in end-of-life care and visa verse for physical healthcare professionals when caring for a patient with a comorbid serious mental illness.3) Thought should be put into the environment of an in-patient mental healthcare ward. While it is recognised the need to maintain safety of patients in these environments, considerations such as the availability to the correct equipment, décor and access to meaningful activity is invaluable for both care giver and patient.4) Services should consider that their policies and procedures reflect that end-of-life care could be a need of any patient in a services care. The ability to refer to policy and procedure was found to be a comfort and a supportive measure for staff caring for patients at the end-of-life.
2022-01-01T00:00:00Z
Quality improvement project for out-of-hours clinical handover
Krishnan, Deepa B.
Nixon, Neil L.
http://hdl.handle.net/20.500.12904/15693
2023-10-06T08:44:50Z
2022-01-01T00:00:00Z
Quality improvement project for out-of-hours clinical handover
Krishnan, Deepa B.; Nixon, Neil L.
Aim Nottinghamshire Healthcare NHS Foundation Trust (NHFT) provides a variety of mental health services across Nottinghamshire. During out-of-hours work, junior doctors cover each of these three main hospital sites.The Health Education East Midlands (HEE) Quality Management visit concluded the handover system in NHFT was not fit for purpose, posing significant risks to both patients and junior doctors.The aim of our quality improvement project was to assess these concerns using a mixed methodology, including local surveys and audit; and secondly to make any necessary quality improvements to the handover process and guidance. The pre-implementation evaluation of the handover system in use consisted of a survey and an audit.Methods The quality improvement strategy involved a two-pronged approach, which included the development of a new IT-based handover recording tool and improving education and training in its use.We used Plan-Do-Study-Act (PDSA) cycles between August 2015 and August 2016 to implement changes.Phase 2 of the project involved audit, education and training to consolidate and reinforce the change to make it sustainable through creation of a white board animation video for junior doctors.Results Percentage of recorded handovers was the main outcome measure. Quality outcomes improved after the phase 1 and were sustained during the phase 2 of the project due to introduction of mandatory recording fields.Conclusion We learnt that the active engagement of end users in the designing and implementation of the new IT handover system was a key factor in optimal development. We learnt that continuous induction, training and monitoring are important to sustain high usage of the system. Also, use of project management tools from the start will improve efficiency and time management. This project demonstrates how existing resources within a NHS Trust can be collaboratively and iteratively deployed to improve patient care.
2022-01-01T00:00:00Z