Many mental health nurse academics have strong clinical backgrounds and will have worked for periods in a variety of mental health care settings. Mental health care itself has a chequered history in relation to restrictive practices and while many of us are less than enamoured with this part of the work we recognise that preventing people from harming themselves or others can require us to take steps that would be considered extraordinary in everyday settings. As the CQC annual report on the use of the Mental Health Act in England this week has highlighted the finding that some practices have become ordinary and every day in many health care settings is a worrying development. For instance it noted:
“We continue to see widespread use of blanket rules including access to the internet, outside areas, room access, and rigid visiting times. Some type of blanket rule was in place in more than three quarters of the wards we visited. Such practices have no basis in law or national guidance on good practice and are unacceptable. We continue to hear accounts of patients’ experiences of being restrained.”
It is not all doom and gloom however as they also found that there was cause for optimism:
“In this report we promote examples of good practice where providers of inpatient mental health services have taken positive steps to reduce the use of restraint.”
Here we catch a glimpse of the excellent work of mental health nurses making a real difference to the positive experiences of mental health care. Our colleague Professor Len Bowers and his team have also shown via their Safewards project that is it possible to make improvements to mental health care delivery in our inpatient settings. Len and colleagues have published the basis of their model in open access format here
There is a significant amount of work going on in this area and Mental Health Nurse Academics UK is involved or asked to respond to a number of these developments. So for instance, the Royal College of Nursing is currently conducting some work for the Department of Health to develop guidance on the use of restrictive practices in health and social care settings including special schools. You can find details on their web pages here
We are now consulting with MHNAUK members to formulate a response to the RCN consultation in which we will be concerned to highlight needs for education and research to inform best practice in this fraught area. Ultimately I would like to see a strong principle based approach to mental health nursing care that embeds notions of doing no harm, close involvement of the person in decisions about their care and an approach to practice that critically engages with the evidence base. It is now over to our members to tell me what they would like to see us say in our response to the consultation.
Chair of MHNAUK
Mental Health Nurse Academics UK is interested in hearing about research priorities for mental health nursing from members. Previously on this blog Alan Simpson has posted a list from an exercise at City University http://mhnauk.com/2013/10/14/research-priorities and Ben Hannigan and Nicola Evans replied with lists from Cardiff. Professor Len Bowers is collating these lists for discussion at a future MHNAUK meeting. If you have suggestions then you can reply here or directly to Len.
A recent request at Swansea for mental health nursing research priorities resulted in this short list,
1. What are the key skills and knowledge mental health nurses need to make a positive impact on the physical health of mental health service users? (thinking about post reg courses here to an extent)
2. The effectiveness of mental health nurses v peer supporters
3. What selection procedures for mental health nursing are likely to encourage the most emotionally literate candidates?
4. Mental health nurses – how effective are we in improving service users’ mental health?
5. Does location or place influence outcome of mental health nursing intervention?
6. Timely access to services: what is the role of the mental health nurse (thinking of new developments in criminal justice and police triage services but also more common access via primary care etc.)
7. Care co-ordination across the service systems interface: what help works and by whom?
8. How can assistance with identity-work aid recovery and integration?
some similarities with the lists of others can clearly be seen but also the thorny question of what a mental health nursing research priority is raises its head? Is it something distinct from other professions, related solely to the work of mental health nurses or more widely to the fields in which mental health nurses operate? I think here there is some work for us to do in defining what it is we mean and its great that we are making a start.
Busy year ahead it seems!
From time to time the pressures of managing multiple roles can tell and perhaps this story illustrates that inescapable fact or possibly that my own organising and filing skills are less than optimum.
The photo above for posterity is of a piece of paper I recently found wedged into the bottom of my workbag. I had no recollection of it but quickly linked the venue with a meeting of MHNAUK in the summer and then vaguely recalled that it might have something to do with our plan to have a quick response group for the purposes of producing press statements or replies to consultations. Embarrassingly I had to admit all of this when I emailed everyone on the list and had this confirmed by respondents. One of these, Andy Mercer I think, said he would be pleased to be part of the “CrumpledList group” and hence a name was born. If we have cause to respond to anything then you can be sure the CrumpledList group will have been involved!
Mental Health Nurse Doctoral Students’ Network
We are interested in your suggestions and tips, whatever stage of the doctorate you are at.
I’m approaching data analysis, feeling a slight sense of nervousness, and that I need to be equipping myself in terms of preparation.
Emma’s Blog this month has useful information about qualitative data analysis, and how she got into ‘data display’ – http://emmaburnettx.wordpress.com/ There are lots of PhD blogs out there, this is a good one in my opinion.
Also was alerted to a new edition today from Sage, and have ordered:
Green, J., Thorogood, N. (2013) Qualitative methods for health research, 3rd edition. London: Sage This link will take you to the Sage site, and inspection copies are available for academic staff:
What are your top tips as students approach data analysis?
bw, Julia Terry
Our colleague Grahame Smith from Liverpool John Moore’s University has kindly agreed to draft a MHNAUK statement on dementia care which I post below. Take a look and let us know what you think MHNAUK should be saying in relation to mental health nursing education, research and practice innovation.
Mental Health Nurse Academics UK – Position Statement on Dementia
Living with dementia can be overwhelming and can significantly impact upon the quality of life of the individual, their families and carers. There are approximately 700,000 people aged over 65 years diagnosed with dementia in the UK, though some studies argue that this is an underestimation of the true figure. As people live longer it is predicted that the incidence of people living with dementia will increase. The societal challenge will be to ensure health and social care delivery is responsive to this potential increase in demand and in a way that ‘quality’ is not compromised.
To ensure that care delivery meets this challenge within a present and future context it is essential that there is a continual drive to promote excellence in research, care, education and training. Taking this into consideration the Mental Health Nurse Academics UK is committed to ‘influence and promote education, research and values-based mental health nursing practice for the benefit of people living with dementia’
It is important to acknowledge that this aspiration is a work in progress. Historically Government and charitable spending on dementia research has been significantly lower than in other long term conditions such as cancer and heart disease. This picture is now starting to change as there is an increasing focus on dementia research, one such initiative which Mental Health Nurse Academics UK members are aligned to, is the Dementia Nursing Research Taskforce initiative which aims to:
- Identify key nursing research questions to support improvements in patient care in all settings
- Establish writing groups to develop priority research proposals
- Develop a plan for building the nurse researcher capacity in dementia
In relation to care standards, the nursing strategy, ‘making a difference in dementia’ provides a clear vision which is both underpinned by a care model for dementia and maps to the Curriculum for Dementia Education (CfDE). These approaches are committed to improving care for people with dementia through policy, practice and education. The Curriculum for Dementia Education has been developed by the Higher Education for Dementia Network (HEDN) and supported by members of the Mental Health Nurse Academics UK forum. This initiative provides a content guide for health and social care professionals that are looking to develop higher education programmes which have a dementia focus.
City university kick off a MHNAUK exercise writes Alan Simpson
MHN Research Priorities: A starter for 26
Inspired by last week’s MHNAUK meeting, today staff at our mental health research team meeting were asked to identify their research priorities for mental health nursing research. The meeting consists of various academic research staff and clinical academics discussing on-going and forthcoming research studies and various research-related issues. Today, I simply asked each person to write a short list of priorities, which we then shared and discussed. Here’s our Top 30 in no particular order with repeats removed. Most frequent repeat was physical healthcare. Second was recovery. Third – racism and culture. What’s your Top 10?
1. Generic vs Specialist MHN training
2. Measures of Compassion
3. Effects of selection procedures for MHN students and staff
4. Nursing and PTSD
5. Tool development
6. Risk assessment and MHN
7. The 6 Cs and MHN
8. Mental capacity and issues of consent
9. Racism and stigma in MHN
10. Values and beliefs and how they impact on practice
11. Mental health and the performing arts
12. MHN training and learning disabilities
13. MHN views on developments that may threaten MHN, e.g. peer support, self-care.
14. Physical healthcare in secondary mental health care settings
15. Philosophy and MHN: The Art of Living
16. Identity and body image in people with MI
17. Community and third sector organisations and how they link with mental health teams/services
18. Communication, especially information giving and the first contact.
19. Culture and ‘cultural safety’ as a useful model
20. Fear – underpinning MHN and service user behaviours
21. Brokerage roles, self-care and MHN
22. Workforce planning and nurse education/training and physical/mental health divide
23. Evaluation of education/training and preparation of MHNs for the job
24. Recovery and MHN interventions
25. MHN interventions to maximise engagement
26. Liaison mental health care
City University London