Improving serious mental illness through interprofessional education

Abstract

Current health policies emphasize partnership between professional groups, between agencies and with users, to ensure more integrated health and social care services. However, a number of reasons have been consistently identified as inhibiting interprofessional working. Among the many factors identified are poor communication, conflicting power relations and role confusion, and these present immense challenges to those who wish to offer interprofessional education and training opportunities. East Gloucestershire NHS Trust worked in partnership with the University of Gloucestershire (formerly the Cheltenham and Gloucester College of Higher Education) to overcome these problems and deliver an important postqualifying interprofessional training for those working with people with serious mental illness - the Thorn-based 'Diploma in Integrated Approaches to Serious Mental Illness'. This collaborative initiative represents a good model by which practitioners of all disciplines can be trained to a high standard and meet the requirements of the National Service Framework for Mental Health. This paper describes the initiative and identifies the extent to which the course has, by mirroring the practice it is seeking to generate, 'pulled together' to ensure interprofessional, intersectoral and professional/user collaboration. The key challenges associated with interprofessional working (with people with serious mental illness and with others) and with course implementation and how these were met are discussed and further opportunities are identified.

The Effects of Interprofessional Education in Mental Health Practice: Findings from a Systematic Review

“…Benefits to patients • Improved social functioning and life satisfaction [17] [17]; six studies demonstrated adequate alignment between the objectives of the study and the reported outcomes, although their research designs were less rigorously described [1,7,13,14,25,27]. Despite this heterogeneity, we found evidence that students of mental health responded well to IPE, especially in terms of more positive attitudes toward the contribution of other professions [1,7,13,14,17,25] and increased knowledge of and skills in collaboration [1,7,13,14,17,26]. However, we found no substantial evidence of changes in behavior or organizational practices, which possibly reflects the complexity of IPE interventions and attitudinal differences toward IPE stemming from differences in work culture, as has also been found by other review studies [3,[28][29][30].…”

“…Eight studies reported attitudes toward other professions (level 2a in Kirkpatrick's models of evaluation). Six studies reported change in knowledge and skills [1,7,13,14,17,26]; three studies reported behavior changes that enhanced collaboration [17,25,27]. Changes in organizational practice [1,17,27] were reported in three studies, while only two reported outcomes related to patients' benefit [17,27].…”

“…Caution should thus be taken with Rolls et al's [26] findings, as their study was judged to be at critical risk of bias.…”

“…The duration of the IPE interventions varied from 1 day to training sessions conducted over a month. The least extensive element lasted 6 h over 2 days [26], while the most extensive program appeared to be 40 days [27]. A variety of small group learning activities were reported, including group discussions [27], workshops [7,13,26], standardized patients [13], problem-based learning to enhance collaboration [1,13,14], and reflection [7].…”

“…The study by Rolls et al [26] was considered to be of "poor quality," primarily due to its unclear reporting of sample size and incomplete description of evaluation methods and outcomes. Its weak design was indicated by the absence of baseline data collection, which precludes a convincing account of change relating to the IPE interventions.…”