An evaluation of education and implementation of psychosocial interventions within one UK mental healthcare trust

Abstract

Psychosocial interventions (PSI), though recommended in the NICE guidelines for schizophrenia and bipolar affective disorder, are not routinely available to people with a serious mental illness in the UK. Education and training initiatives to equip mental health professionals with skills in PSI have grown over the last decade; yet the literature indicates serious problems in implementation of PSI in routine service provision. This paper examines on a local level the factors which support and limit the education and practice of PSI in one UK mental healthcare trust. It reports on a survey of trainees and their managers which aims to evaluate the impact of a PSI training programme and practice development strategy on staff, managers and service provision. The key findings are: a high rate of implementation of PSI by PSI-trained staff in the Trust; a strong association between PSI training and career progression for staff; and the support mechanisms which are most effective in the education and implementation of PSI. The paper concludes that certain measures and support mechanisms have facilitated the successful implementation of PSI with positive outcomes for staff and service provision. Further recommendations are made identifying measures which facilitate the implementation of PSI through an integrated education and practice development strategy owned by all stakeholders.

Getting psychosocial interventions into mental health nursing practice: a survey of skill use and perceived benefits to service users

“…Although several reports have sought to increase implementation of these skills through enhanced supervision (Robinson et al 2012) and organizational support (Sin & Scully 2008), perhaps the real challenge is to effect cognitive persuasion that these therapies are not seen as optional but required. The low implementation rate may also reflect role preferences for more informal clinical work, which can act as a barrier to new ways of working post PSI training (Kuipers 2011).…”

“…These have been attributed to large case load size, lack of managerial support (Brooker et al 2003), time factors (Sin & Scully 2008) and whether service user and families value such therapies (Mairs & Bradshaw 2005). There are very low implementation rates of some structured PSIs, specifically, FI and CBTp.…”

“…These included a review of the literature, adaptation of items used in previous surveys that evaluated the use of psychosocial interventions (Brooker et al 2003, Gauntlett 2005, Sin & Scully 2008, the inclusion of skills taught ( Figure 1) and items relevant to the programmes learning outcomes and objectives of the study. Several measures were taken to ensure face and content validity.…”

Referral to a new psychological therapy service is associated with reduced utilisation of healthcare and sickness absence by people with common mental health problems: a before and after comparison

“…To date, reviews have focused on evaluation of the service22 23 or on comparing psychological therapy with usual practice,24 rather than its impact at the population level. There are no published studies that link clinical data in primary and secondary healthcare services to evaluate the system impact of the IAPT programme.…”

Practice What You Preach: Developing Person-Centred Culture in Inpatient Mental Health Settings through Strengths-Based, Transformational Leadership

“…These principles have been further reinforced through the evolution of the recovery movement and increased understanding of the iatrogenic effects of health care institutions and practices (Shepherd, Boardman, & Slade, 2008). Despite this, acute inpatient mental health services continue to be criticised for their failure to implement even basic, individualised evidence-based practices (Mullen, 2009;Sin & Scully, 2008)-and nurses make up the largest proportion of this workforce. Studies that have sought to introduce practice improvement activities in these clinical environments have reported limited success in engaging nurses and achieving sustained improvements (Carradice & Round, 2004;Hall, 2006;McCann & Bowers, 2005;Melvin, Hall, & Bienek, 2005).…”