Hybrid journal * Containing 2 Open Access article(s) in this issue * ISSN (Print) 1361-9322 - ISSN (Online) 2042-8758 Published by Emerald[362 journals]
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Authors:Cathy Street, Ellen Ni Chinseallaigh, Ingrid Holme, Rebecca Appleton, Priya Tah, Helena Tuomainen, Sophie Leijesdorff, Larissa van Bodegom, Therese van Amelsvoort, Tomislav Franic, Helena Tomljenovic, Fiona McNicholas Abstract: This study aims to explore how young people in child and adolescent mental health services (CAMHS) in the UK, Ireland, The Netherlands and Croatia, experienced leaving CAMHS and identified a range of factors impeding optimal discharge or transition to adult mental health services (AMHS). Interviews about discharge or transition planning, including what information was provided about their ongoing mental health needs, undertaken with 34 young people aged 17–24, all previous or current attendees of CAMHS. Some interviews included accounts by parents or carers. Data were thematically analysed. A number of previously well-documented barriers to a well-delivered discharge or transition were noted. Two issues less frequently reported on were identified and further discussed; they are the provision of an adequately explained, timely and appropriately used diagnosis and post-CAMHS medication management. Overall, planning processes for discharging or transitioning young people from CAMHS are often sub-optimal. Practice with regard to how and when young people are given a diagnosis and arrangements for the continuation of prescribed medication appear to be areas requiring improvement. Study participants came from a large cohort involving a wide range of different services and health systems in the first pan-European study exploring the CAMHS to adult service interface. Two novel and infrequently discussed issues in the literature about young people’s mental health transitions, diagnosis and medication management were identified in this cohort and worthy of further study. Citation: Mental Health Review Journal PubDate: 2023-08-29 DOI: 10.1108/MHRJ-10-2022-0066 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:Victoria Olubola Adeyele, Veronica Ibitola Makinde Abstract: Domestic violence is a universal social concern, and its implication on children’s mental health is a global health predicament. Although the aftereffect of domestic violence on the mental health of women is well researched, mental health disorders of children in terms of attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), oppositional defiant disorder (ODD), general anxiety disorder (GAD), separation anxiety disorder (AD) and mood disorder (MD) on account of domestic violence is rarely investigated. Hence, the purpose of the study is to investigate the impact of exposure to domestic violence on children’s mental health. To examine the correlation between domestic violence and mental health among children, in a survey of public primary schools in Ekiti State, Nigeria, the authors employed 664 pupils with simple random techniques. The Multidimensional Domestic Violence Scale assessed the participants’ exposure to domestic violence. The Child & Youth Mental Health General Screening Questionnaire was used to examine respondents’ mental health. The results revealed a high incidence of domestic violence among children. It also showed a substantial correlation between domestic violence and the mental health of primary school pupils. Children living with domestic violence experience significantly increased rates of ADHD, ODD, AD, GAD and MD as forms of mental health disorders. Given the unpleasantness of this social issue affecting the well-being of children globally, it is imperative to engage in intervention and prevention packages that will assist the victims, perpetrators, parents, teachers, schools and other stakeholders. Introducing counselling services into the primary school curriculum will assist victims and those at risk develop self-confidence that will enable them to report their violators. Although counselors do not diagnose, early detection of victims would assist in early intervention where counselors can use different techniques and approaches to help such victims to resolve all forms of cognitive distortions that can lead to mental health disorders. Counselling services can help in providing referral opportunities to victims or “at risk children,” rehabilitation and follow-up services for victims of domestic violence. Government organizations should also reintroduce health-care services where clinical psychologists will be available in primary schools to provide psychological services to meet the needs of the victims. Conclusively, the study presents evidence that children who witness domestic violence face a significant risk of developing mental health disorders. The findings highlight the potential harm that domestic violence can inflict on children’s mental well-being. Mental health conditions such as ADHD, CD, ODD, GAD, AD and MD are commonly observed in these children. It recommends establishing early intervention programs for children witnessing domestic violence in schools and communities and programs to detect and address mental health issues promptly. Citation: Mental Health Review Journal PubDate: 2023-08-24 DOI: 10.1108/MHRJ-11-2022-0072 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:Emma Elizabeth Curry, Panoraia Andriopoulou Abstract: The aim of this study is to explore the dual-experiences of AN recovered service providers. Prognoses for anorexia nervosa (AN) and anorexia nervosa-like (AN-like) presenting patients remain poor, and notably, no current treatment approach is reliably successful. Past research into AN has focused on singular experiences, those of either AN patients or those of practitioners providing treatment, but has yet to explore the experiences of recovered AN service users now working as AN service providers. In this study, four UK-based female participants shared their dual experiences of treatment for AN or AN-like presentations through individual semi-structured interviews. Data collection and analysis were conducted in accordance with an Interpretative Phenomenological Analysis methodology. Analysis revealed four primary themes, including barriers to accessing services; the impact of treating professionals’ approaches; displacement of responsibility for treating AN; and the value of dual-experience of AN. This study focuses on AN and AN-like presentations and does not address the other eating disorders. Additionally, only female-identifying individuals volunteered their participation. As such, this study is notably lacking the voices of individuals of other genders. Participant narratives suggest that improvements in the treatment of AN lie in improving professionals’ understanding of – and compassion towards – this patient group to optimise the power of the therapeutic relationship across all AN-treating professions. Participants revealed a pervasive misunderstanding of AN among treating professionals that is hindering patients’ treatment and suggested that lived experience can be an asset in a professional context. Individuals with dual experiences of AN can provide a unique and reflective insight into experiences of treatment through their combined personal and professional expertise and elucidate the experiences that both helped and hindered their own recovery. Citation: Mental Health Review Journal PubDate: 2023-08-21 DOI: 10.1108/MHRJ-02-2022-0010 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:John Mills, Lee Cumbers, Samuel Williams, Henry Titley-Wall Abstract: Adolescence and young adulthood are recognised as critical time for developing mental health literacy (MHL). The purpose of this study is to analyse the effectiveness of current MHL interventions to guide the future development of MHL intervention strategies. A meta-analysis adopting the PRISMA framework for systematically reviewing the literature was adopted. Three authors independently reviewed studies and extrapolated key data for analysis. A robust random-effects model with adjustments for small study biases was conducted to establish the effect sizes of all included MHL interventions. Moderator analysis was conducted to examine the effects of intervention length in MHL. A total of 11 intervention studies were identified and analysed, resulting in a medium to large pooled effect size of 0.62 (95% CI: 0.28; 0.96). Moderator analysis found that short interventions had an estimated standard mean difference (SMD) effect size of 0.9220 (95% CI: −1.1555; 2.9995). This was greater than the medium length interventions, with an estimated SMD effect size of 0.4967 (95% CI: 0.0452; 0.9483), and long interventions, with an estimated SMD effect size of 0.5628 (95% CI: −0.2726; 1.3983). As a result, MHL interventions are proficient in improving young adults’ MHL, with shorter interventions (45–50 min) having the largest effect size. This study highlights several inconsistencies in methodological rigour and reporting from studies in this area, which future research should look to address. To date, MHL review studies have often focused their attention on a specific domain, most notably education and school-based setting. To the best of the authors’ knowledge, no reviews have conducted a meta-analysis across contexts and domains with a specific focus on MHL intervention strategies for young adults. Citation: Mental Health Review Journal PubDate: 2023-08-11 DOI: 10.1108/MHRJ-07-2022-0052 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:Antaine Stíobhairt, Nicole Cassidy, Niamh Clarke, Suzanne Guerin Abstract: This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented practice and related professional practice issues. A qualitative hermeneutic phenomenological study was conducted from a social constructivist perspective. Semi-structured interviews with 17 psychologists were analysed using reflexive thematic analysis. Twenty-four themes were identified, which were clustered into four overarching themes. Participants viewed themselves and psychology in Ireland more broadly as peripheral to seclusion. They believed that seclusion possessed no inherent therapeutic value but viewed it as an uncomfortable and multi-faceted reality. Participants regarded seclusion and recovery as largely inconsistent and difficult to reconcile, and they perceived systemic factors, which had a pervasive negative impact on seclusion and recovery in practice. The findings highlight the perceived complexity of seclusion and its interface with recovery, and the need to conscientiously balance conflicting priorities that cannot be easily reconciled to ensure ethical practice. The findings suggest psychologists are well-suited to participate in local and national discussions on using seclusion in recovery-oriented practice. This study offers a unique insight into psychologists’ perceptions of seclusion and considers the implications of these views. Participants’ nuanced views suggest that psychologists can make valuable contributions to local and national discussions on these topics. Citation: Mental Health Review Journal PubDate: 2023-07-25 DOI: 10.1108/MHRJ-08-2022-0058 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:Peta Temple Abstract: The purpose of this paper is to explore the historic policy context and social implications of the diagnosis of personality disorder and also consider formulation-based and trauma-informed understandings of distress. Ongoing changes to (and splits between) medical understandings of what is being labelled as personality disorder have eroded the label’s cultural capital, adding weight to lived-experience-led calls to Drop the Disorder (Watson, 2019). This paper explores the impact and implications of the historic policy and practice context through a lived experience lens. Such diversity of views in the lived experience and medical communities on personality disorder has allowed alternatives to diagnostically informed understandings of distress (such as formulation-based and trauma-informed approaches) to gain traction with practitioners (Bloom and Farragher, 2013; Johnstone and Boyle, 2020). The broader assimilation of these alternative perspectives into dominant medical ideology is evidenced by the fact that the Royal College of Psychiatrists (RCP) is now also exploring alternatives to diagnosis (2023). This suggests even more change ahead for how we understand people and their relationships with trauma and distress. This paper discusses UK policy and does not include broader global policies. This paper would be helpful for any student interested in where the ideas that underpin personality disorder diagnosis stemmed from and why so many lived experience practitioners and experts by profession question the diagnosis' legitimacy. As the RCP is now considering alternatives to diagnosis, it is even more critical that practitioners are aware of the competing narratives surrounding this contested diagnosis – as the author believes this will promote more compassionate, trauma-informed working practices. This is the author’s own work and includes not only the RCP position change but also directly quotes Professor Tyrer (who wrote the International Classification of Diseases 11), giving his views on the changed RCP position, as he recently presented at a conference here in Cornwall. The author is a part of Lighthouse peer support group and wrote this paper as preparation for a Participatory Action Research project they are planning, where they will evaluate the Sanctuary Approach with their membership to create a lived experience-designed trauma-informed charter. Before starting that work, the author wanted to better understand the historic policy context and created this paper to fill that need. Citation: Mental Health Review Journal PubDate: 2023-07-20 DOI: 10.1108/MHRJ-03-2023-0014 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:Ketan Ramesh Sonigra, Lucy McIvor, James Payne-Gill, Tim Smith, Alison Beck Abstract: There is a proportion of psychiatric service users whose needs are not met by existing models of care. This can lead to a reliance on acute and crisis services. These service users may be considered high intensity users (HIUs). The purpose of this research is to evaluate the Crisis Plus model, an intervention designed to better support HIUs in the community and reduce dependency on acute and crisis services. Forty-seven HIUs were involved in Crisis Plus. The core intervention of Crisis Plus was an Anticipatory Management Plan (AMP), produced in collaboration with service users, their families and their care coordinators. AMPs were shared with relevant services and attached to electronic patient notes to ensure a uniform, psychologically informed approach to care. HIU service use was compared pre and post-AMP. On average, number of inpatient admissions, number of days spent on the ward, accepted psychiatric liaison referrals and accepted home treatment team (HTT) referrals decreased significantly. Crisis Plus has taken a collaborative, proactive approach to engage HIUs, their families and the services that care for them. Crisis interventions that emphasise collaborative working and service user agency are key. The provision of dedicated psychological support to HIUs and their professional and personal network is crucial to reduce reliance on acute and crisis care. Crisis Plus is unique in that it instigates co-production and active consultation with HIUs and services to improve clinical outcomes, in addition to reducing NHS expenditure. Citation: Mental Health Review Journal PubDate: 2023-06-16 DOI: 10.1108/MHRJ-05-2022-0031 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:Jenny Meggs, Susan Young, Annette Mckeown Abstract: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition with community prevalence globally of 2%–7% (M = 5%; Sayal, Prasad, Daley, Ford, and Coghill; 2018). Clinicians are routinely encouraged to explain to children and young people the benefits of a healthy lifestyle, including exercise (NICE NG87, 2018). Exercise has been proposed as a safe and low-cost adjunctive approach for ADHD and is reported to be accompanied by positive effects on several aspects of executive functioning (EF). The purpose of this narrative review was to synthesise the contemporary randomised control trial (RCT) studies that examine the effect of sport, physical activity and movement on EF in children and adolescents with ADHD. A narrative review approach with a systematic literature search using PRISMA guidelines for screening and selecting relevant systematic reviews was used. The final review included four peer-review systematic reviews (>2019). The results identified three RCT meta-analyses and findings showed that children and adolescents with lower baseline cognitive performance demonstrated greater improvements in functioning after physical activity interventions, particularly for tasks with higher executive function demands, where baseline performance reaches an optimal level. Findings suggest that 10–20 min of acute moderate-high-intensity exercise interventions (cycling/running) appeared to have positive effects on indices of inhibitory control. Preliminary evidence suggests that as little as 5 min of jumping exercises improved inhibitory control. And 60–80 min of moderately intense, repeated (chronic) exercise appeared to demonstrate the greatest beneficial impact on selection attention. To the best of the authors’ knowledge, this review is the first to present the extant literature on the effect of physical activity and sport on symptoms of young people with ADHD. It presents evidence to suggest that exercise with progressively increasing cognitive demands may have positive effects for children with ADHD, specifically in terms of improving cognitive flexibility. Further large-scale clinical trials are needed to confirm the positive effects of physical exercise on cognitive functioning in children with ADHD. Citation: Mental Health Review Journal PubDate: 2023-06-06 DOI: 10.1108/MHRJ-07-2022-0045 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:Chris Griffiths, Ksenija da Silva, Harmony Jiang, Kate Walker, David Smart, Azhar Zafar, Sarah Deeks, Sinead Galvin, Taz Shah Abstract: This study aims to evaluate the effect of Alpha-Stim Anxiety, Insomnia and Depression (AID) cranial electrotherapy stimulation (CES) on anxiety, depression and health-related quality of life for primary care social prescribing service patients with anxiety symptoms. Open-label patient cohort design with no control group. A total of 33 adult patients (average age 42 years) completed six weeks of Alpha-Stim AID use. Pre- and post-intervention assessment with participant self-report measures: Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder (GAD-7) and European Quality of Life Five Dimension (EQ-5D-5L). Reliable improvement and remission rates, respectively, were 53.39% and 33.3% for GAD-7; 46.7% and 29.5% for PHQ-9. There was a significant improvement in GAD-7 and PHQ-9 with large effect sizes. EQ-5D-5L results showed significant improvements in health-related quality of life. Perceived quality of life increased by 0.17 on the health index score, with the intervention adding 1.68 quality-adjusted life years (QALYs). Alpha-Stim AID can be delivered through a primary health-care social prescribing service and most patients will use as prescribed and complete treatment course. Alpha-Stim AID CES may be an effective anxiety and depression treatment for people with anxiety symptoms. The widespread roll-out of Alpha-Stim AID in health-care systems should be considered. To the best of the authors’ knowledge, this is the first study to respond to the UK’s National Institute for Health and Care (NICE) request for the collection of real-world data to understand better Alpha-Stim AID in relation to people’s treatment uptake, response rates and treatment completion rates (NICE, 2021). Citation: Mental Health Review Journal PubDate: 2023-05-25 DOI: 10.1108/MHRJ-11-2022-0068 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:John Goodwin, Laura Behan Abstract: People who experience mental illness often demonstrate limited help-seeking behaviours. There is evidence to suggest that media content can influence negative attitudes towards mental illness; less is known about how media impacts help-seeking behaviours. The purpose of this study is to identify if media plays a role in people’s decisions to seek help for their mental health. The databases Academic Search Complete, CINAHL Plus with Full Text, MEDLINE, APA PsycArticles, APA PsycInfo, Social Sciences Full Text [H.W. Wilson] and Soc Index were systemically searched for papers in the English language that investigated the link between media and help-seeking for mental illness. Sixteen studies met eligibility criteria. There was some evidence to suggest that various forms of media – including video and online resources – can positively influence help-seeking for mental health. Print media had some limited effect on help-seeking behaviours but was weaker in comparison to other forms of media. There was no evidence to suggest that media discourages people from seeking help. This review identified that, given the heterogeneity of the included papers, and the limited evidence available, there is a need for more focused research to determine how media impacts mental health-related help-seeking behaviours. Citation: Mental Health Review Journal PubDate: 2023-05-16 DOI: 10.1108/MHRJ-06-2022-0038 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:Fiammetta Rocca, Thomas Schröder, Stephen Regel Abstract: Lengthy and complex routes to specialist care may negatively affect clinical profiles of trauma survivors accessing mental health services. The purpose of this study was to describe the characteristics and referral pathways of a cohort of clients accepted by a specialist trauma service in England; and investigate the associations between referral pathways and clients’ clinical profiles, namely, pre-treatment levels of post-traumatic stress, depression, anxiety, stress and post-traumatic growth. Data on 117 consecutive, accepted referrals were extracted from clients’ clinical records. Information on demographics, trauma histories, clinical presentations and referral pathways was synthesised through summary statistics. Correlational analyses were conducted to test associations with pre-treatment scores. Clients accessing the service were highly complex and mostly experienced prolonged, interpersonal trauma. Pathways to the service varied, but 50% of the sample had at least four “steps” in their referral histories and seven previous clinical contacts. The average time between trauma and specialist referral was 16.34 years. The number of referral steps positively, significatively and moderately correlated with anxiety and stress at pre-treatment. Limitations include issues around collecting past referral information, the small sample size for clients with available pre-treatment data and the lack of post-treatment scores. This evaluation provides an informative overview of the characteristics and referral pathways of clients accessing a specialist trauma service. It also offers preliminary insights on the relationship between clients’ routes into the service and their clinical profiles. Practice, commissioning and research implications are discussed. Citation: Mental Health Review Journal PubDate: 2023-05-16 DOI: 10.1108/MHRJ-08-2022-0055 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:Kelly Fenton, Katherine Kidd, Alex Lord Abstract: The purpose of this study is to assess if the new community-enhanced rehabilitation team reduced anxiety and readmissions in service users discharged from an inpatient rehabilitation setting. The study used both qualitative and quantitative methodology. Service user’s anxiety level was measured before being discharged and at the end of the Community Enhanced Rehabilitation Team (CERT) transition intervention. Six service users were interviewed to gain further understanding of their experiences of anxiety. Findings showed the anxiety score was significantly lower (M = 1.5, 95% CI [0.051,2.99], t(20) = 2.159, p = 0.043) following the CERT intervention (M = 8.6, SD = 6.4) compared to before (M = 10.1, SD = 7.0). No service user receiving the CERT intervention was readmitted to hospital within 12 weeks of discharge from the inpatient setting, compared to three service users (15% of those discharged) who were discharged to other community services. Community rehabilitation pathways would benefit from having interventions to aid patient transitions from inpatient to the community. The National Health Service (NHS) trusts develop community rehabilitation teams as recommended by the National Institute for Health and Care Excellence (NICE), and they should consider including transitional support as part of their model. It is recommended that as NHS trusts design and implement community mental health teams, they should consider including transition support as part of their model. People with severe and enduring mental health difficulties who have been in an inpatient rehabilitation setting would benefit from community transitional support. This study suggests that such support helps reduce anxiety and readmission. Community rehabilitation teams are currently being developed across the NHS as part of the NHS long-term plan. These teams are new, and as such, there is a dearth of information regarding their effectiveness. To the best of the authors’ knowledge, this is one of the first studies to evaluate outcomes in these new teams. Citation: Mental Health Review Journal PubDate: 2023-05-08 DOI: 10.1108/MHRJ-09-2022-0059 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:Hala Bucheeri, Afsana Faheem Abstract: This study aims to explore whether the cultural competency training in Improving Access to Psychological Therapies (IAPT) services is sufficient to equip Psychological Wellbeing Practitioners (PWP) to support Black, Asian and Minority Ethnic (BAME) service users. A qualitative design was adopted using semi-structured interviews with six PWP participants. Reflexive thematic analysis using Braun and Clarke’s (2006) six-step process was used in data analysis. Three themes revealed evaluations of PWP training, factors supporting PWPs’ cultural competency and points of improvement for PWP training. The training briefly and superficially covered cultural competency content; however, it encouraged PWPs to explore potential personal and cultural biases in therapy. PWP training can also be improved by providing more culturally relevant resources and involving BAME service users. A small sample size (N = 6) was used, impacting the findings’ generalizability. PWP training does not sufficiently equip PWPs to support BAME service users. PWPs’ reflection of their own ethnic identity and personal experiences, when combined with training, can improve cultural competency. IAPT training should focus on cultural awareness, knowledge and skills to enhance therapeutic experience. Moreover, PWPs should reflect on their identity, personal biases and experiences when working with diverse communities. This is one of the few qualitative studies evaluating the cultural competencies of PWPs in IAPT. Citation: Mental Health Review Journal PubDate: 2023-04-25 DOI: 10.1108/MHRJ-01-2023-0004 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:Gilbert Azuela, Daniel Sutton, Kirsten van Kessel Abstract: Sensory modulation is an emerging approach that aims to reduce distress and agitation in mental health service users and potentially avoid the necessity for coercive practices such as seclusion and restraint. Despite the growing use of this intervention, there has been limited research exploring the implementation of sensory modulation at an organisational level, both internationally and within the New Zealand context. The purpose of this study is to investigate the implementation of a sensory modulation programme in two New Zealand inpatient mental health services using an exploratory organisational case study design. Organisational case study design methodology was used to explore the implementation of a sensory modulation programme in two New Zealand acute adult inpatient mental health services. This study explored how key organisational and staff factors (including policies and practices related to de-escalation and seclusion reduction) influence sensory modulation implementation. Cases were described and examined the pattern of findings. Strategies found to support implementation were identified at environmental, organisational, group and individual staff levels. Aspects highlighted as being particularly important included taking an inter-professional approach in leadership and training, rostering flexibility and leeway in staffing levels to support training attendance and responsiveness to crises. The facilitators and strategies highlighted in this study may be used to support the design and implementation of future sensory modulation programmes in New Zealand and internationally. The complexity of factors that influenced the implementation of the sensory modulation approach within an inpatient setting made determining the effectiveness of the approach challenging. However, the general principles and strategies identified in this study offer useful insights for the design and implementation of future sensory modulation programmes. Citation: Mental Health Review Journal PubDate: 2023-04-18 DOI: 10.1108/MHRJ-06-2022-0035 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
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Authors:Ollie Pentz, Jennifer Cooke, Harriet Sharp Abstract: This study aims to describe the experiences and barriers to care for women with autistic spectrum condition (ASC) under the care of the Brighton and Hove Specialist Perinatal Mental Health Service (BHSPMHS) and provide recommendations to improve the service. Patients with an ASC diagnosis or suspected diagnosis and awaiting assessment under the care of BHSPMHS were offered to take part in the study. Five patients were interviewed to explore their experiences. Participants had a mix of positive and negative experiences of services. Positives included the continuous support and allowing flexibility around appointments. Dialectical behavioural therapy groups running online instead of in-person was highlighted as a universal negative as well as delays in diagnosing ASC. Those likely to meet the criteria for ASC but are awaiting formal diagnosis should be treated with appropriate adjustments to service provision as those who have received a diagnosis. Recommendations for service improvements include the provision of smaller, in-person therapy groups. Adjustments to treatments may include flexibility around appointment times and location. There is little research into the experiences of people with ASC under the care of perinatal mental health teams. As specialist perinatal services expand, it is important to understand the experiences of women with ASC being cared for by these services, to ensure they are accessible and inclusive. The results of this study will be used to guide service development and act as a model for other services, with the intention of improving care for this patient group. Citation: Mental Health Review Journal PubDate: 2023-04-07 DOI: 10.1108/MHRJ-08-2022-0056 Issue No:Vol. ahead-of-print, No. ahead-of-print (2023)
Hybrid journal * Containing 2 
Open Access article(s) in this issue *
