Mental Health Review JournalTable of Contents for Mental Health Review Journal. List of articles from the current issue, including Just Accepted (EarlyCite)https://www.emerald.com/insight/publication/issn/1361-9322/vol/29/iss/1?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestMental Health Review JournalEmerald Publishing LimitedMental Health Review JournalMental Health Review Journalhttps://www.emerald.com/insight/proxy/containerImg?link=/resource/publication/journal/f3f22c80ac06f3f29a9faac583eae921/urn:emeraldgroup.com:asset:id:binary:mhrj.cover.jpghttps://www.emerald.com/insight/publication/issn/1361-9322/vol/29/iss/1?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestSeclusion in the context of recovery-oriented practice: the perspectives and experiences of psychologists in Irelandhttps://www.emerald.com/insight/content/doi/10.1108/MHRJ-08-2022-0058/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestThis 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.Seclusion in the context of recovery-oriented practice: the perspectives and experiences of psychologists in Ireland
Antaine Stíobhairt, Nicole Cassidy, Niamh Clarke, Suzanne Guerin
Mental Health Review Journal, Vol. 29, No. 1, pp.1-18

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.

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Seclusion in the context of recovery-oriented practice: the perspectives and experiences of psychologists in Ireland10.1108/MHRJ-08-2022-0058Mental Health Review Journal2023-07-25© 2023 Antaine Stíobhairt, Nicole Cassidy, Niamh Clarke and Suzanne Guerin.Antaine StíobhairtNicole CassidyNiamh ClarkeSuzanne GuerinMental Health Review Journal2912023-07-2510.1108/MHRJ-08-2022-0058https://www.emerald.com/insight/content/doi/10.1108/MHRJ-08-2022-0058/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Antaine Stíobhairt, Nicole Cassidy, Niamh Clarke and Suzanne Guerin.http://creativecommons.org/licences/by/4.0/legalcode
The art of the possible? Supporting a patient safety culture in mental healthcare to maximise safetyhttps://www.emerald.com/insight/content/doi/10.1108/MHRJ-05-2023-0026/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestThe current national patient safety strategy for the National Health Service (NHS) in England states that actions need to be taken to support the development of a patient safety culture. This includes that local systems should seek to understand staff perceptions of the fairness and effectiveness of serious incident management. This study aims to explore the perspectives of patient safety professionals about what works well and what could be done better to support a patient safety culture at the level of Trust strategy and serious incident governance. A total of 15 professionals with a role in serious incident management, from five mental health trusts in England, were interviewed using a semi-structured interview guide. Thematic analysis and qualitative description were used to analyse the data. Participants felt that actions to support a patient safety culture were challenging and required long-term and clinical commitment. Broadening the scope of serious incident investigations was felt to be one way to better understand patient safety culture issues. Organisational influences during the serious incident management process were highlighted, informing approaches to maximise the fairness and objectivity of investigation findings. The findings of this study offer original insights that the NHS safety system can use to facilitate progression of the patient safety culture agenda. In particular, local mental health trusts could consider the findings in the context of their current strategic objectives related to patient safety culture and operational delivery of serious incident management frameworks.The art of the possible? Supporting a patient safety culture in mental healthcare to maximise safety
David P. Wood, Rajan Nathan, Catherine A. Robinson, Rebecca McPhillips
Mental Health Review Journal, Vol. 29, No. 1, pp.19-33

The current national patient safety strategy for the National Health Service (NHS) in England states that actions need to be taken to support the development of a patient safety culture. This includes that local systems should seek to understand staff perceptions of the fairness and effectiveness of serious incident management. This study aims to explore the perspectives of patient safety professionals about what works well and what could be done better to support a patient safety culture at the level of Trust strategy and serious incident governance.

A total of 15 professionals with a role in serious incident management, from five mental health trusts in England, were interviewed using a semi-structured interview guide. Thematic analysis and qualitative description were used to analyse the data.

Participants felt that actions to support a patient safety culture were challenging and required long-term and clinical commitment. Broadening the scope of serious incident investigations was felt to be one way to better understand patient safety culture issues. Organisational influences during the serious incident management process were highlighted, informing approaches to maximise the fairness and objectivity of investigation findings.

The findings of this study offer original insights that the NHS safety system can use to facilitate progression of the patient safety culture agenda. In particular, local mental health trusts could consider the findings in the context of their current strategic objectives related to patient safety culture and operational delivery of serious incident management frameworks.

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The art of the possible? Supporting a patient safety culture in mental healthcare to maximise safety10.1108/MHRJ-05-2023-0026Mental Health Review Journal2023-12-12© 2023 Emerald Publishing LimitedDavid P. WoodRajan NathanCatherine A. RobinsonRebecca McPhillipsMental Health Review Journal2912023-12-1210.1108/MHRJ-05-2023-0026https://www.emerald.com/insight/content/doi/10.1108/MHRJ-05-2023-0026/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
One size doesn’t always fit all: professional perspectives of serious incident management systems in mental healthcarehttps://www.emerald.com/insight/content/doi/10.1108/MHRJ-04-2023-0018/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestThe need to develop effective approaches for responding to healthcare incidents for the purpose of learning and improving patient safety has been recognised in current national policy. However, research into this topic is limited. This study aims to explore the perspectives of professionals in mental health trusts in England about what works well and what could be done better when implementing serious incident management systems. This was a qualitative study using semi-structured interviews. In total, 15 participants were recruited, comprising patient safety managers, serious incident investigators and executive directors, from five mental health trusts in England. The interview data were analysed using a qualitative-descriptive approach to develop meaningful themes. Quotes were selected and presented based on their representation of the data. Participants were dissatisfied with current systems to manage serious incidents, including the root cause analysis approach, which they felt were not adequate for assisting learning and improvement. They described concerns about the capability of serious incident investigators, which was felt to impact on the quality of investigations. Processes to support people adversely affected by serious incidents were felt to be an important part of incident management systems to maximise the learning impact of investigations. Findings of this study provide translatable implications for mental health trusts and policymakers, informed by insights into how current approaches for learning from healthcare incidents can be transformed. Further research will build a more comprehensive understanding of mechanisms for responding to healthcare incidents.One size doesn’t always fit all: professional perspectives of serious incident management systems in mental healthcare
David Phillip Wood, Catherine A. Robinson, Rajan Nathan, Rebecca McPhillips
Mental Health Review Journal, Vol. 29, No. 1, pp.34-47

The need to develop effective approaches for responding to healthcare incidents for the purpose of learning and improving patient safety has been recognised in current national policy. However, research into this topic is limited. This study aims to explore the perspectives of professionals in mental health trusts in England about what works well and what could be done better when implementing serious incident management systems.

This was a qualitative study using semi-structured interviews. In total, 15 participants were recruited, comprising patient safety managers, serious incident investigators and executive directors, from five mental health trusts in England. The interview data were analysed using a qualitative-descriptive approach to develop meaningful themes. Quotes were selected and presented based on their representation of the data.

Participants were dissatisfied with current systems to manage serious incidents, including the root cause analysis approach, which they felt were not adequate for assisting learning and improvement. They described concerns about the capability of serious incident investigators, which was felt to impact on the quality of investigations. Processes to support people adversely affected by serious incidents were felt to be an important part of incident management systems to maximise the learning impact of investigations.

Findings of this study provide translatable implications for mental health trusts and policymakers, informed by insights into how current approaches for learning from healthcare incidents can be transformed. Further research will build a more comprehensive understanding of mechanisms for responding to healthcare incidents.

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One size doesn’t always fit all: professional perspectives of serious incident management systems in mental healthcare10.1108/MHRJ-04-2023-0018Mental Health Review Journal2023-12-06© 2023 Emerald Publishing LimitedDavid Phillip WoodCatherine A. RobinsonRajan NathanRebecca McPhillipsMental Health Review Journal2912023-12-0610.1108/MHRJ-04-2023-0018https://www.emerald.com/insight/content/doi/10.1108/MHRJ-04-2023-0018/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
A film-based intervention (Intinn) to enhance adolescent mental health literacy and well-being: multi-methods evaluation studyhttps://www.emerald.com/insight/content/doi/10.1108/MHRJ-05-2023-0027/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestAdolescent mental health is a global concern. There is an urgent need for creative, multimedia interventions reflecting adolescent culture to promote mental health literacy and well-being. This study aims to assess the impact of a film-based intervention on adolescent mental health literacy, well-being and resilience. A pretest-posttest intervention with a multi-methods evaluation was used. A convenience sample of ten schools facilitated students aged 15–17 years to engage in an online intervention (film, post-film discussion, well-being Webinar). Participants completed surveys on well-being, resilience, stigma, mental health knowledge and help-seeking. Five teachers who facilitated the intervention participated in post-implementation interviews or provided a written submission. Analysis included paired-t-test and effect size calculation and thematic analysis. Matched pretest-posttest data were available on 101 participants. There were significant increases in well-being, personal resilience and help-seeking attitudes for personal/emotional problems, and suicidal ideation. Participants’ free-text comments suggested the intervention was well-received, encouraging them to speak more openly about mental health. Teachers similarly endorsed the intervention, especially the focus on resilience. Intinn shows promise in improving adolescents’ mental health literacy and well-being. Film-based interventions may encourage adolescents to seek professional help for their mental health, thus facilitating early intervention.A film-based intervention (Intinn) to enhance adolescent mental health literacy and well-being: multi-methods evaluation study
John Goodwin, Laura Behan, Mohamad M. Saab, Niamh O’Brien, Aine O’Donovan, Andrew Hawkins, Lloyd F. Philpott, Alicia Connolly, Ryan Goulding, Fiona Clark, Deirdre O’Reilly, Corina Naughton
Mental Health Review Journal, Vol. 29, No. 1, pp.48-63

Adolescent mental health is a global concern. There is an urgent need for creative, multimedia interventions reflecting adolescent culture to promote mental health literacy and well-being. This study aims to assess the impact of a film-based intervention on adolescent mental health literacy, well-being and resilience.

A pretest-posttest intervention with a multi-methods evaluation was used. A convenience sample of ten schools facilitated students aged 15–17 years to engage in an online intervention (film, post-film discussion, well-being Webinar). Participants completed surveys on well-being, resilience, stigma, mental health knowledge and help-seeking. Five teachers who facilitated the intervention participated in post-implementation interviews or provided a written submission. Analysis included paired-t-test and effect size calculation and thematic analysis.

Matched pretest-posttest data were available on 101 participants. There were significant increases in well-being, personal resilience and help-seeking attitudes for personal/emotional problems, and suicidal ideation. Participants’ free-text comments suggested the intervention was well-received, encouraging them to speak more openly about mental health. Teachers similarly endorsed the intervention, especially the focus on resilience.

Intinn shows promise in improving adolescents’ mental health literacy and well-being. Film-based interventions may encourage adolescents to seek professional help for their mental health, thus facilitating early intervention.

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A film-based intervention (Intinn) to enhance adolescent mental health literacy and well-being: multi-methods evaluation study10.1108/MHRJ-05-2023-0027Mental Health Review Journal2023-12-04© 2023 John Goodwin, Laura Behan, Mohamad M. Saab, Niamh O’Brien, Aine O’Donovan, Andrew Hawkins, Lloyd F. Philpott, Alicia Connolly, Ryan Goulding, Fiona Clark, Deirdre O’Reilly and Corina Naughton.John GoodwinLaura BehanMohamad M. SaabNiamh O’BrienAine O’DonovanAndrew HawkinsLloyd F. PhilpottAlicia ConnollyRyan GouldingFiona ClarkDeirdre O’ReillyCorina NaughtonMental Health Review Journal2912023-12-0410.1108/MHRJ-05-2023-0027https://www.emerald.com/insight/content/doi/10.1108/MHRJ-05-2023-0027/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 John Goodwin, Laura Behan, Mohamad M. Saab, Niamh O’Brien, Aine O’Donovan, Andrew Hawkins, Lloyd F. Philpott, Alicia Connolly, Ryan Goulding, Fiona Clark, Deirdre O’Reilly and Corina Naughton.
Illicit drug use among medical students and its association with gender, psychological distress sleep quality and exposure to psychiatry: a nationwide studyhttps://www.emerald.com/insight/content/doi/10.1108/MHRJ-01-2023-0005/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestIllicit drug use is a well-known global problem that has been noticed to be increased significantly among medical students. This study aims to assess the prevalence and consequences of illicit drug use among medical students in the country of Jordan using the validated Drug Abuse Screening Test-10 (DAST-10). The authors used a cross-sectional, descriptive design to conduct this study. A total of 2,104 participants from six medical schools were included. A structured online-based English self-administered questionnaire was used for data collection. Out of 2,104 included participants, 242 (11.5%) reported using illicit drugs in the past year. More than three-quarters (77%) of the drug users suffer from various degrees of problems related to drug use, ranging from risky (41%) to severe risk (6%). Drug use was found to be associated with gender, planned specialty and exposure to psychiatry training. The cross-sectional design prevents from drawing cause-and-effect relationships and confirming how the tendency toward substance use is affected by the psychological state, sleep quality and exposure to psychiatry. Also, although it is important to measure the subjective observation of distress and sleep, objective estimates of psychological distress and sleep including actigraphy and sleep diary could be helpful to strengthen the findings. Also using an online survey with convenience sampling are some inevitable limitations with the present COVID-19 restrictions. Also, the nature of DAST-10 closed-ended questions precluded from accurately exploring the consequences of substance abuse. Appropriate screening to identify medical students at risk for substance abuse and provide them with treatment referrals are strongly recommended in this study. In addition, medical schools should provide a comfortable environment that encourages a healthy lifestyle with a responsible attitude toward using drugs. There is a dearth of information about illicit drug use among medical students, especially in the country of Jordan. The nature of their studies, the different stresses they experience and the impact imposed by other factors such as sociocultural all are likely to make medical students more susceptible to drug abuse. To the best of the authors’ knowledge, this is the first cross-national study of its kind in Jordan with a representative sample of 2,104 participants. We assessed the prevalence and consequences of self-reported illicit drug use and the sleep quality of medical students from all schools of medicine in Jordan.Illicit drug use among medical students and its association with gender, psychological distress sleep quality and exposure to psychiatry: a nationwide study
Rayan M. Joudeh, Raba’a F. Jarrar, Adnan Raed Alnaser, Abdelkader Battah, Mazen Hindi, Arwa A. Battah, Eslam M. Wadi, Osama A. Zitoun
Mental Health Review Journal, Vol. 29, No. 1, pp.64-78

Illicit drug use is a well-known global problem that has been noticed to be increased significantly among medical students. This study aims to assess the prevalence and consequences of illicit drug use among medical students in the country of Jordan using the validated Drug Abuse Screening Test-10 (DAST-10).

The authors used a cross-sectional, descriptive design to conduct this study. A total of 2,104 participants from six medical schools were included. A structured online-based English self-administered questionnaire was used for data collection.

Out of 2,104 included participants, 242 (11.5%) reported using illicit drugs in the past year. More than three-quarters (77%) of the drug users suffer from various degrees of problems related to drug use, ranging from risky (41%) to severe risk (6%). Drug use was found to be associated with gender, planned specialty and exposure to psychiatry training.

The cross-sectional design prevents from drawing cause-and-effect relationships and confirming how the tendency toward substance use is affected by the psychological state, sleep quality and exposure to psychiatry. Also, although it is important to measure the subjective observation of distress and sleep, objective estimates of psychological distress and sleep including actigraphy and sleep diary could be helpful to strengthen the findings. Also using an online survey with convenience sampling are some inevitable limitations with the present COVID-19 restrictions. Also, the nature of DAST-10 closed-ended questions precluded from accurately exploring the consequences of substance abuse.

Appropriate screening to identify medical students at risk for substance abuse and provide them with treatment referrals are strongly recommended in this study. In addition, medical schools should provide a comfortable environment that encourages a healthy lifestyle with a responsible attitude toward using drugs.

There is a dearth of information about illicit drug use among medical students, especially in the country of Jordan. The nature of their studies, the different stresses they experience and the impact imposed by other factors such as sociocultural all are likely to make medical students more susceptible to drug abuse. To the best of the authors’ knowledge, this is the first cross-national study of its kind in Jordan with a representative sample of 2,104 participants. We assessed the prevalence and consequences of self-reported illicit drug use and the sleep quality of medical students from all schools of medicine in Jordan.

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Illicit drug use among medical students and its association with gender, psychological distress sleep quality and exposure to psychiatry: a nationwide study10.1108/MHRJ-01-2023-0005Mental Health Review Journal2023-11-27© 2023 Emerald Publishing LimitedRayan M. JoudehRaba’a F. JarrarAdnan Raed AlnaserAbdelkader BattahMazen HindiArwa A. BattahEslam M. WadiOsama A. ZitounMental Health Review Journal2912023-11-2710.1108/MHRJ-01-2023-0005https://www.emerald.com/insight/content/doi/10.1108/MHRJ-01-2023-0005/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
Acceptability of home-based transcranial direct current stimulation (tDCS) in major depression: a qualitative analysis of individual experienceshttps://www.emerald.com/insight/content/doi/10.1108/MHRJ-07-2022-0050/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestThe purpose of this paper was to gain a qualitative view of the participant experience of using home-based transcranial direct current stimulation (tDCS). Acceptability impacts patient preference, treatment adherence and outcomes. However, acceptability is usually assessed by rates of attrition, while multifaceted constructs are not reflected or given meaningful interpretations. tDCS is a novel non-invasive brain stimulation that is a potential treatment for major depressive disorder (MDD). Most studies have provided tDCS in a research centre. As tDCS is portable, the authors developed a home-based treatment protocol that was associated with clinical improvements that were maintained in the long term. The authors examined the acceptability of home-based tDCS treatment in MDD through questionnaires and individual interviews at three timepoints: baseline, at a six-week course of treatment, and at six-month follow-up. Twenty-six participants (19 women) with MDD in a current depressive episode of at least moderate severity were enrolled. tDCS was provided in a bifrontal montage with real-time remote supervision by video conference at each session. A thematic analysis was conducted of the individual interviews. Thematic analysis revealed four main themes: effectiveness, side effects, time commitment and support, feeling held and contained. The themes reflected the high acceptability of tDCS treatment, whereas the theme of feeling contained might be specific to this protocol. Qualitative analysis methods and individual interviews generated novel insights into the acceptability of tDCS as a potential treatment for MDD. Feelings of containment might be specific to the present protocol, which consisted of real-time supervision at each session. Meaningful interpretation can provide context to a complex construct, which will aid in understanding and clinical applications.Acceptability of home-based transcranial direct current stimulation (tDCS) in major depression: a qualitative analysis of individual experiences
Rachael M. Rimmer, Rachel D. Woodham, Sharon Cahill, Cynthia H.Y. Fu
Mental Health Review Journal, Vol. 29, No. 1, pp.79-91

The purpose of this paper was to gain a qualitative view of the participant experience of using home-based transcranial direct current stimulation (tDCS). Acceptability impacts patient preference, treatment adherence and outcomes. However, acceptability is usually assessed by rates of attrition, while multifaceted constructs are not reflected or given meaningful interpretations. tDCS is a novel non-invasive brain stimulation that is a potential treatment for major depressive disorder (MDD). Most studies have provided tDCS in a research centre. As tDCS is portable, the authors developed a home-based treatment protocol that was associated with clinical improvements that were maintained in the long term.

The authors examined the acceptability of home-based tDCS treatment in MDD through questionnaires and individual interviews at three timepoints: baseline, at a six-week course of treatment, and at six-month follow-up. Twenty-six participants (19 women) with MDD in a current depressive episode of at least moderate severity were enrolled. tDCS was provided in a bifrontal montage with real-time remote supervision by video conference at each session. A thematic analysis was conducted of the individual interviews.

Thematic analysis revealed four main themes: effectiveness, side effects, time commitment and support, feeling held and contained. The themes reflected the high acceptability of tDCS treatment, whereas the theme of feeling contained might be specific to this protocol.

Qualitative analysis methods and individual interviews generated novel insights into the acceptability of tDCS as a potential treatment for MDD. Feelings of containment might be specific to the present protocol, which consisted of real-time supervision at each session. Meaningful interpretation can provide context to a complex construct, which will aid in understanding and clinical applications.

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Acceptability of home-based transcranial direct current stimulation (tDCS) in major depression: a qualitative analysis of individual experiences10.1108/MHRJ-07-2022-0050Mental Health Review Journal2024-01-23© 2024 Emerald Publishing LimitedRachael M. RimmerRachel D. WoodhamSharon CahillCynthia H.Y. FuMental Health Review Journal2912024-01-2310.1108/MHRJ-07-2022-0050https://www.emerald.com/insight/content/doi/10.1108/MHRJ-07-2022-0050/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2024 Emerald Publishing Limited
Leave for informally admitted patients: a review of written guidance produced by mental health services in England and Waleshttps://www.emerald.com/insight/content/doi/10.1108/MHRJ-03-2023-0013/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestThe purpose of this paper is to report on the use and content of written guidance produced by mental health services in England and Wales describing hospital leave for informally admitted patients. Guidance on leave was requested from National Health Service (NHS) mental health trusts in England and health boards in Wales (n = 61) using a Freedom of Information submission. Data were analysed using content analysis. In total, 32 organisations had a leave policy for informal patients. Policies varied considerably in content and quality. The content of policies was not supported by research evidence. Organisations appeared to have developed their policies by either adapting or copying the guidance on section 17 leave outlined in the Mental Health Act Codes of Practice for England and Wales (Department of Health, 2016; Welsh Government, 2016). Definitions of important terms, for example, leave and hospital premises, were either absent or poorly defined. Finally, some organisations appeared to be operating pseudo-legal coercive contracts to prevent informal patients from leaving hospital wards. Research should be undertaken to explore the impact of local policies on the informal patient’s right to life and liberty. All NHS organisations need to develop an evidence-based policy to facilitate the informal patient’s right to take leave. A set of national standards that organisations are required to comply with would help to standardise the content of leave policies. To the best of the author’s knowledge, this is the first study to examine the use and content of local policies describing how informal patients can take leave from hospital.Leave for informally admitted patients: a review of written guidance produced by mental health services in England and Wales
Russell Ashmore
Mental Health Review Journal, Vol. 29, No. 1, pp.92-109

The purpose of this paper is to report on the use and content of written guidance produced by mental health services in England and Wales describing hospital leave for informally admitted patients.

Guidance on leave was requested from National Health Service (NHS) mental health trusts in England and health boards in Wales (n = 61) using a Freedom of Information submission. Data were analysed using content analysis.

In total, 32 organisations had a leave policy for informal patients. Policies varied considerably in content and quality. The content of policies was not supported by research evidence. Organisations appeared to have developed their policies by either adapting or copying the guidance on section 17 leave outlined in the Mental Health Act Codes of Practice for England and Wales (Department of Health, 2016; Welsh Government, 2016). Definitions of important terms, for example, leave and hospital premises, were either absent or poorly defined. Finally, some organisations appeared to be operating pseudo-legal coercive contracts to prevent informal patients from leaving hospital wards.

Research should be undertaken to explore the impact of local policies on the informal patient’s right to life and liberty.

All NHS organisations need to develop an evidence-based policy to facilitate the informal patient’s right to take leave. A set of national standards that organisations are required to comply with would help to standardise the content of leave policies.

To the best of the author’s knowledge, this is the first study to examine the use and content of local policies describing how informal patients can take leave from hospital.

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Leave for informally admitted patients: a review of written guidance produced by mental health services in England and Wales10.1108/MHRJ-03-2023-0013Mental Health Review Journal2023-12-25© 2023 Emerald Publishing LimitedRussell AshmoreMental Health Review Journal2912023-12-2510.1108/MHRJ-03-2023-0013https://www.emerald.com/insight/content/doi/10.1108/MHRJ-03-2023-0013/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
“Finding light in the darkness”: exploring comedy as an intervention for eating disorder recoveryhttps://www.emerald.com/insight/content/doi/10.1108/MHRJ-08-2023-0045/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestEating disorders (EDs) remain a major health concern, and their incidence has further increased since the COVID-19 pandemic. Given the equally increasing demands on treatments and service provision and the high levels of relapse post-treatment, it is important that research explore novel and innovative interventions that can further support recovery for individuals with EDs. There is growing evidence that arts interventions are beneficial for recovery from EDs. This study aims to evaluate the feasibility of conducting a stand-up comedy course to support ED recovery. The study used a qualitative interview study design to evaluate the recovery benefits of participating in stand-up comedy workshops for a pilot group of people in recovery from EDs (n = 10). The comedy intervention was well-attended and had high acceptability and feasibility. For most individuals, participating in the course had a positive impact, including promoting personal recovery (PR) outcomes across all five elements of the CHIME framework. Unique assets of the course included providing participants with an opportunity to distance themselves from everyday worries of living with an ED; the opportunity to cognitively reframe situations by making them the object of humour; and providing a safe space to (re-)build a positive sense of self. This is the first study, to the best of the authors’ knowledge, that evaluates stand-up comedy workshops for ED recovery and further demonstrates the potential of arts interventions and the relevance of PR frameworks in this field.“Finding light in the darkness”: exploring comedy as an intervention for eating disorder recovery
Dieter Declercq, Eshika Kafle, Jade Peters, Sam Raby, Dave Chawner, James Blease, Una Foye
Mental Health Review Journal, Vol. 29, No. 1, pp.110-126

Eating disorders (EDs) remain a major health concern, and their incidence has further increased since the COVID-19 pandemic. Given the equally increasing demands on treatments and service provision and the high levels of relapse post-treatment, it is important that research explore novel and innovative interventions that can further support recovery for individuals with EDs. There is growing evidence that arts interventions are beneficial for recovery from EDs. This study aims to evaluate the feasibility of conducting a stand-up comedy course to support ED recovery.

The study used a qualitative interview study design to evaluate the recovery benefits of participating in stand-up comedy workshops for a pilot group of people in recovery from EDs (n = 10).

The comedy intervention was well-attended and had high acceptability and feasibility. For most individuals, participating in the course had a positive impact, including promoting personal recovery (PR) outcomes across all five elements of the CHIME framework. Unique assets of the course included providing participants with an opportunity to distance themselves from everyday worries of living with an ED; the opportunity to cognitively reframe situations by making them the object of humour; and providing a safe space to (re-)build a positive sense of self.

This is the first study, to the best of the authors’ knowledge, that evaluates stand-up comedy workshops for ED recovery and further demonstrates the potential of arts interventions and the relevance of PR frameworks in this field.

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“Finding light in the darkness”: exploring comedy as an intervention for eating disorder recovery10.1108/MHRJ-08-2023-0045Mental Health Review Journal2024-01-09© 2023 Emerald Publishing LimitedDieter DeclercqEshika KafleJade PetersSam RabyDave ChawnerJames BleaseUna FoyeMental Health Review Journal2912024-01-0910.1108/MHRJ-08-2023-0045https://www.emerald.com/insight/content/doi/10.1108/MHRJ-08-2023-0045/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
Assessing the use of the transtheoretical model to manage referrals in mental health serviceshttps://www.emerald.com/insight/content/doi/10.1108/MHRJ-04-2023-0019/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestThe transtheoretical model (TTM) has been applied to varying areas of physical health, e.g. diabetes. However, research into its applicability to psychotherapy is mixed. The TTM is applied through the University of Rhode Island Change Assessment (URICA). Investigating the utility of the URICA is needed to improve patient care and outcomes. This study aims to assess whether the URICA scores relate to patient outcomes; patient attendance; practitioner ratings of patient readiness, appropriateness, insight, motivation and potential for improvement; and to explore practitioner’s perspectives on the URICA. Correlational methods were used to assess the relationship between the URICA and therapeutic outcome, attendance and practitioner-rated areas. Content analysis was used to analyse practitioner qualitative data. The URICA did not correlate with either therapeutic outcome or attendance. A significant negative correlation was found between the URICA and practitioner-rated appropriateness of the referral. This means practitioners perceived individuals with lower URICA scores to be a more appropriate referral, despite the score indicating a reduced readiness to change. Qualitative categories included positive views, negative views, ambivalence and changes to measure and process. To conclude, the URICA does not explain a patient’s outcome or attendance. The URICA may not be appropriate to use in its current format in mental health services; therefore, assessing the TTM verbally may be more helpful. This study provides research into suitability of using the URICA to assess the TTM and its applicability to attendance and outcome in psychological therapies.Assessing the use of the transtheoretical model to manage referrals in mental health services
Jackson Lord, Rachel Sabin-Farrell
Mental Health Review Journal, Vol. ahead-of-print, No. ahead-of-print, pp.-

The transtheoretical model (TTM) has been applied to varying areas of physical health, e.g. diabetes. However, research into its applicability to psychotherapy is mixed. The TTM is applied through the University of Rhode Island Change Assessment (URICA). Investigating the utility of the URICA is needed to improve patient care and outcomes. This study aims to assess whether the URICA scores relate to patient outcomes; patient attendance; practitioner ratings of patient readiness, appropriateness, insight, motivation and potential for improvement; and to explore practitioner’s perspectives on the URICA.

Correlational methods were used to assess the relationship between the URICA and therapeutic outcome, attendance and practitioner-rated areas. Content analysis was used to analyse practitioner qualitative data.

The URICA did not correlate with either therapeutic outcome or attendance. A significant negative correlation was found between the URICA and practitioner-rated appropriateness of the referral. This means practitioners perceived individuals with lower URICA scores to be a more appropriate referral, despite the score indicating a reduced readiness to change. Qualitative categories included positive views, negative views, ambivalence and changes to measure and process. To conclude, the URICA does not explain a patient’s outcome or attendance. The URICA may not be appropriate to use in its current format in mental health services; therefore, assessing the TTM verbally may be more helpful.

This study provides research into suitability of using the URICA to assess the TTM and its applicability to attendance and outcome in psychological therapies.

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Assessing the use of the transtheoretical model to manage referrals in mental health services10.1108/MHRJ-04-2023-0019Mental Health Review Journal2024-02-09© 2024 Emerald Publishing LimitedJackson LordRachel Sabin-FarrellMental Health Review Journalahead-of-printahead-of-print2024-02-0910.1108/MHRJ-04-2023-0019https://www.emerald.com/insight/content/doi/10.1108/MHRJ-04-2023-0019/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2024 Emerald Publishing Limited
Evaluating the effectiveness of trauma-informed care training delivered to staff in community Older Adult Mental Health Serviceshttps://www.emerald.com/insight/content/doi/10.1108/MHRJ-07-2023-0037/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestBy older adulthood, the majority of individuals will have experienced at least one traumatic event. Trauma-informed care (TIC) is proposed to improve effectivity of health-care provision and to reduce likelihood of services causing retraumatisation. This study aims to assess the effectiveness of staff training in TIC in older adult services. TIC training was delivered across eight Older Adult Community Mental Health Teams in the same UK organisation. Questionnaires were administered before and after training: a psychometrically robust measure, the Attitudes Related to Trauma-Informed Care, was used to assess TIC-related attitudes, and a service-developed scale was used to measure changes in TIC competence. Data was analysed using linear mixed effects modelling (LMM). Qualitative data regarding the impact of training was gathered one month after training through a free-text questionnaire. There were 45 participants, all of whom were white British. LMM on pre- and post-data revealed that staff training significantly increased competencies across all measured TIC domains. Overall, staff attitudes were also significantly more trauma-informed after training. Qualitatively, staff identified time as the only additional resource required to deliver the skills and knowledge gained from training. Training was found to be effective in increasing TIC-related skills and attitudes. Organisations aiming to become trauma-informed should consider staff training as one aspect of a wider development plan. To the best of the authors’ knowledge, this paper is the first to examine TIC training for staff working in Older Adults Mental Health Services. Recommendations for services aiming to develop a trauma-informed culture have been provided.Evaluating the effectiveness of trauma-informed care training delivered to staff in community Older Adult Mental Health Services
Katie Russell, Nima Moghaddam, Anna Tickle, Gina Campion, Christine Cobley, Stephanie Page, Paul Langthorne
Mental Health Review Journal, Vol. ahead-of-print, No. ahead-of-print, pp.-

By older adulthood, the majority of individuals will have experienced at least one traumatic event. Trauma-informed care (TIC) is proposed to improve effectivity of health-care provision and to reduce likelihood of services causing retraumatisation. This study aims to assess the effectiveness of staff training in TIC in older adult services.

TIC training was delivered across eight Older Adult Community Mental Health Teams in the same UK organisation. Questionnaires were administered before and after training: a psychometrically robust measure, the Attitudes Related to Trauma-Informed Care, was used to assess TIC-related attitudes, and a service-developed scale was used to measure changes in TIC competence. Data was analysed using linear mixed effects modelling (LMM). Qualitative data regarding the impact of training was gathered one month after training through a free-text questionnaire.

There were 45 participants, all of whom were white British. LMM on pre- and post-data revealed that staff training significantly increased competencies across all measured TIC domains. Overall, staff attitudes were also significantly more trauma-informed after training. Qualitatively, staff identified time as the only additional resource required to deliver the skills and knowledge gained from training.

Training was found to be effective in increasing TIC-related skills and attitudes. Organisations aiming to become trauma-informed should consider staff training as one aspect of a wider development plan.

To the best of the authors’ knowledge, this paper is the first to examine TIC training for staff working in Older Adults Mental Health Services. Recommendations for services aiming to develop a trauma-informed culture have been provided.

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Evaluating the effectiveness of trauma-informed care training delivered to staff in community Older Adult Mental Health Services10.1108/MHRJ-07-2023-0037Mental Health Review Journal2024-03-01© 2024 Emerald Publishing LimitedKatie RussellNima MoghaddamAnna TickleGina CampionChristine CobleyStephanie PagePaul LangthorneMental Health Review Journalahead-of-printahead-of-print2024-03-0110.1108/MHRJ-07-2023-0037https://www.emerald.com/insight/content/doi/10.1108/MHRJ-07-2023-0037/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2024 Emerald Publishing Limited
Serious games for mental health promotion in adolescents with chronic diseases: a scoping reviewhttps://www.emerald.com/insight/content/doi/10.1108/MHRJ-07-2023-0038/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestThis study aims to synthesize the existing serious games designed to promote mental health in adolescents with chronic illnesses. This study conducted a review following the guidelines of Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in databases PubMed, Scopus, Web of Science, Cochrane Library, cumulative index to nursing and allied health literature, PsycINFO, China national knowledge infrastructure Wanfang, VIP Database for Chinese Technical Periodicals and SinoMed from inception to February 12, 2023. A total of 14 studies (describing 14 serious games) for improving the mental health of adolescents with chronic diseases were included. Of all the included games, 12 were not described as adopting any theoretical framework or model. The main diseases applicable to serious games are cancer, type 1 diabetes and autism spectrum disorder. For interventional studies, more than half of the study types were feasibility or pilot trials. Furthermore, the dosage of serious games also differs in each experiment. For the game elements, most game elements were in the category “reward and punishment features” (n = 50) and last was “social features” (n = 4). Adolescence is a critical period in a person’s physical and mental development throughout life. Diagnosed with chronic diseases during this period will cause great trauma to the adolescents and their families. Serious game interventions have been developed and applied to promote the psychological health field of healthy adolescents. To the best of the authors’ knowledge, this study is the first to scope review the serious game of promoting mental health in the population of adolescents with chronically ill. At the same time, the current study also extracted and qualitatively analyzed the elements of the serious game.Serious games for mental health promotion in adolescents with chronic diseases: a scoping review
Yi Wu, Tianxue Long, Jing Huang, Yiyun Zhang, Qi Zhang, Jiaxin Zhang, Mingzi Li
Mental Health Review Journal, Vol. ahead-of-print, No. ahead-of-print, pp.-

This study aims to synthesize the existing serious games designed to promote mental health in adolescents with chronic illnesses.

This study conducted a review following the guidelines of Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in databases PubMed, Scopus, Web of Science, Cochrane Library, cumulative index to nursing and allied health literature, PsycINFO, China national knowledge infrastructure Wanfang, VIP Database for Chinese Technical Periodicals and SinoMed from inception to February 12, 2023.

A total of 14 studies (describing 14 serious games) for improving the mental health of adolescents with chronic diseases were included. Of all the included games, 12 were not described as adopting any theoretical framework or model. The main diseases applicable to serious games are cancer, type 1 diabetes and autism spectrum disorder. For interventional studies, more than half of the study types were feasibility or pilot trials. Furthermore, the dosage of serious games also differs in each experiment. For the game elements, most game elements were in the category “reward and punishment features” (n = 50) and last was “social features” (n = 4).

Adolescence is a critical period in a person’s physical and mental development throughout life. Diagnosed with chronic diseases during this period will cause great trauma to the adolescents and their families. Serious game interventions have been developed and applied to promote the psychological health field of healthy adolescents. To the best of the authors’ knowledge, this study is the first to scope review the serious game of promoting mental health in the population of adolescents with chronically ill. At the same time, the current study also extracted and qualitatively analyzed the elements of the serious game.

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Serious games for mental health promotion in adolescents with chronic diseases: a scoping review10.1108/MHRJ-07-2023-0038Mental Health Review Journal2024-03-25© 2024 Emerald Publishing LimitedYi WuTianxue LongJing HuangYiyun ZhangQi ZhangJiaxin ZhangMingzi LiMental Health Review Journalahead-of-printahead-of-print2024-03-2510.1108/MHRJ-07-2023-0038https://www.emerald.com/insight/content/doi/10.1108/MHRJ-07-2023-0038/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2024 Emerald Publishing Limited