The perceived challenges of working with patients who use new psychoactive substances: a qualitative study in a medium secure unit

Abstract

Purpose New psychoactive substances (NPS) are increasingly being used in secure mental health settings. Within these settings, NPS use presents a range of challenges and staff currently lack adequate training to manage these challenges. The purpose of this paper is to explore nursing staffs’ perception of the challenges of working with patients who use NPS and to explore nursing staffs’ perception of their training needs in relation to NPS. Design/methodology/approach A cross-sectional qualitative design was employed. Semi-structured interviews were conducted with eight nursing staff from a medium secure unit (MSU). Findings A thematic analysis identified three overarching themes: “There Will Always Be Something”, “We Are Doing Our Best” and “If We Know More, We Can Do More”. The findings describe how nursing staff manage NPS use at present, and their perceptions of how training could improve their management of NPS use in the future. Practical implications The findings suggest that MSUs require a local policy for managing NPS use. The research implies that staff training programmes should recognise the existing methods staff use to manage NPS use. The findings also suggest that NPS interventions should target the whole peer group and not just the individual using NPS. Originality/value This paper contributes to the limited literature on NPS. The findings demonstrate the importance of developing evidence-based mechanisms for managing NPS use. Changes to practice are suggested, with the view of developing ways in which staff currently manage NPS use by complementing this with specific training on NPS.

Forensic patients’ experiences of Synthetic Cannabinoid Receptor Agonists (SCRAs) within custodial settings

“…However, while there has been a recent increase in research examining NPS and SCRAs use among offending populations (Corazza et al, 2020), research has not focused on the experiences of SCRA use in patients detained within low or medium secure forensic services. However, secure forensic services, which assess and treat people detained under the Mental Health Act (1983), have also seen a rise in SCRA use (Public Health England, 2017;McKenzie & Harvey, 2019); with a survey of UK secure services reporting that 12.07% (n = 218) of patients were known to have been using SCRAs at the time of admission (Public Health England, 2017). This increase in SCRA use has been associated with an increase in the severity and number of violent incidents (Stevenson & Tuddenham, 2014), adverse patient mental health outcomes (Gray et al, 2016), and reduced staff wellbeing (Hughes et al, 2018;McKenzie & Harvey, 2019); highlighting the significant impact SCRA use has for secure forensic services.…”