Psychologists’ perspectives on the contribution of psychology to acute adult mental health inpatient, crisis response home treatment and mental health liaison services

Ebrahim, Selma

doi:10.1080/09638237.2021.1875410

Cited by 10 publications

(15 citation statements)

References 10 publications

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“…Similar to previous reports, 31 , 32 we found variable access to psychologists. Although clinical psychologists are part of acute care pathways, some staff felt that they were elusive, expensive and hard to access in liaison psychiatry owing to lack of funding and complex commissioning arrangements.…”

Section: Discussionsupporting

confidence: 91%

“…Although clinical psychologists are part of acute care pathways, some staff felt that they were elusive, expensive and hard to access in liaison psychiatry owing to lack of funding and complex commissioning arrangements. However, consistent with findings reported by Ebrahim, 32 most staff felt that psychologists played integral roles in multidisciplinary team meetings, clinical formulation, staff training and support. Further studies are needed to explore the role of psychologists in liaison psychiatry.…”

Section: Discussionsupporting

confidence: 88%

“…Clinical psychologists, owing to their expertise and roles across acute and community services, and multidisciplinary teams have significant potential to facilitate greater integration and care continuity for patients who have self-harmed. 32 Closer integration and working relationships between liaison psychiatry and primary care psychological services may also help to develop optimal care pathways and enhanced joint working.…”

Section: Discussionmentioning

confidence: 99%

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Liaison psychiatry practitioners’ views on accessing aftercare and psychological therapies for patients who present to hospital following self-harm: multi-site interview study

et al. 2023

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Background Timely provision of aftercare following self-harm may reduce risks of repetition and premature death, but existing services are frequently reported as being inadequate. Aims To explore barriers and facilitators to accessing aftercare and psychological therapies for patients presenting to hospital following self-harm, from the perspective of liaison psychiatry practitioners. Method Between March 2019 and December 2020, we interviewed 51 staff members across 32 liaison psychiatry services in England. We used thematic analyses to interpret the interview data. Results Barriers to accessing services may heighten risk of further self-harm for patients and burnout for staff. Barriers included: perceived risk, exclusionary thresholds, long waiting times, siloed working and bureaucracy. Strategies to increase access to aftercare included: (a) improving assessments and care plans via input from skilled staff working in multidisciplinary teams (e.g. including social workers and clinical psychologists); (b) supporting staff to focus on assessments as therapeutic intervention; (c) probing boundaries and involving senior staff to negotiate risk and advocate for patients; and (d) building relationships and integration across services. Conclusions Our findings highlight practitioners’ views on barriers to accessing aftercare and strategies to circumvent some of these impediments. Provision of aftercare and psychological therapies as part of the liaison psychiatry service were deemed as an essential mechanism for optimising patient safety and experience and staff well-being. To close treatment gaps and reduce inequalities, it is important to work closely with staff and patients, learn from experiences of good practice and implement change more widely across services.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Liaison psychiatry practitioners’ views on accessing aftercare and psychological therapies for patients who present to hospital following self-harm: multi-site interview study

et al. 2023

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“…An alternative may be to consider how psychologists might support S136 teams with formulations and care plans, shown to be of benefit in liaison psychiatry. 33 Since the COVID-19 pandemic, cases of both domestic abuse 34 and mental health crises 35 have risen in the United Kingdom and seeking help has become increasingly challenging. It has never been more crucial to recognise and support repeat attenders to the S136 suite, for whom these issues appear particularly pertinent Table 3.…”

Section: Discussionmentioning

confidence: 99%

“…An alternative may be to consider how psychologists might support S136 teams with formulations and care plans, shown to be of benefit in liaison psychiatry. 33…”

Section: Discussionmentioning

confidence: 99%

A retrospective cohort study describing characteristics of those repeatedly detained under Section 136 of the Mental Health Act over a 5-year period and the association with past abuse

et al. 2021

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Individuals repeatedly detained under Section 136 (S136) of the Mental Health Act account for a significant proportion of all detentions. This study provides a detailed analysis of those repeatedly detained (‘repeat attenders’) to a London Mental Health Trust, identifying key demographic profiles when compared to non-repeat attenders, describing core clinical characteristics and determining to what degree a past history of abuse might be associated with these. All detentions to the S136 suite at South West London and St George's Mental Health NHS Trust over a 5-year period (2015–2020) were examined. Data were collected retrospectively from electronic records. A total of 1767 patients had been detained, with 81 patients identified as being a ‘repeat attenders’ (having had > = 3 detentions to the S136 suite during the study period). Repeat attenders accounted for 400 detentions, 17.7% of all detentions. Repeat attenders included a higher proportion of females (49.4%, p = 0.0001), compared to non-repeat attenders, and a higher proportion of them were of white ethnicity (85.2%, p = 0.001). 52 (64%) patients reported being a victim of past abuse or trauma. Of repeat attenders who reported past abuse or trauma, a high proportion had diagnoses of personality disorders, with deliberate self-harm as the most common reason for detention. They were more commonly discharged home with community support, rather than considered for hospital admission. In light of these findings, this paper discusses support potential strategies for those most vulnerable to repeated S136 detention, thereby minimising the ever-growing number of S136 detentions in the UK.

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Patient perspectives on psychological interventions provided in adult psychiatric inpatient wards: A thematic synthesis

Carr,

Awenat,

Ray

et al. 2024

Clin Psychology and Psychoth

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ObjectivesPsychological intervention is an important part of psychiatric inpatient treatment for people experiencing severe problems affecting their mental health. Unfortunately, many service users accessing acute inpatient services are not being offered psychological interventions. Recent research has focussed on effectiveness, facilitators and barriers to providing psychological interventions in this setting. This review aimed to provide a qualitative synthesis of service user perspectives regarding psychological interventions provided on inpatient wards, to understand what is helpful and unhelpful about current provision.MethodA systematic literature search of four databases was conducted to identify published qualitative literature regarding service user perspectives of NICE‐recommended psychological interventions provided on adult acute mental health inpatient wards. Study quality was assessed using the Critical Appraisal Skills Programme tool. Data was analysed and synthesised using thematic analysis.ResultsThe search was completed in May 2023. Seventeen studies were included in the review and encapsulated feedback from at least 192 service users. All studies were rated as high or moderate on the quality appraisal tool. Three superordinate themes were identified: ‘Connecting with Others’, ‘Psychological Processes’ and ‘Engaging with the Intervention’. Participants valued supportive relationships with peers and therapists and felt empowered to achieve change through expression, focussing on difficulties and gaining new perspectives. Participants wanted more support to maintain benefits and sometimes struggled to engage with group therapy due to difficult peer dynamics.ConclusionsThe results give a detailed synthesis of some of the important factors, from service users' perspectives, for accessing psychological interventions. Recommendations for clinical practice and future research are provided.

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Psychologists’ perspectives on the contribution of psychology to acute adult mental health inpatient, crisis response home treatment and mental health liaison services

Cited by 10 publications

References 10 publications

Liaison psychiatry practitioners’ views on accessing aftercare and psychological therapies for patients who present to hospital following self-harm: multi-site interview study

Liaison psychiatry practitioners’ views on accessing aftercare and psychological therapies for patients who present to hospital following self-harm: multi-site interview study

A retrospective cohort study describing characteristics of those repeatedly detained under Section 136 of the Mental Health Act over a 5-year period and the association with past abuse

Patient perspectives on psychological interventions provided in adult psychiatric inpatient wards: A thematic synthesis

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