Tag Archives: mental health

Understanding patient views of online discussion forums to help improve patient safety

16 Nov

close up businesswoman hand holding smartphone touch screen on display for checking work with virtual reality interface for future technology concept

by Sally Giles

A new study exploring patient views on using online discussion forums, to find information relating to side effects from medication, will begin shortly. It is hoped the findings will lead to new ways of improving patient safety.  We know many people with long-term conditions use online discussion forums to share experiences and support. The free-text information from online discussions could provide a valuable source of information about side effects from medication.  However, the experiences of those using online forums varies considerably depending on which long-term condition(s) they may suffer from.

In light of this, it is important to understand the views of different groups of patients in relation to sharing information about medication side effects from online discussion forums.  The plan is to conduct 5 focus groups with patients from 5 of the online communities in Health Unlocked, including patients with lung conditions, thyroid disorders, fibromyalgia, mental health issues and rheumatoid arthritis.  We also have a patient and public involvement (PPI) advisory group. This group consists of 6 members of the public who are part of the five online communities. Their role will be to contribute to the design of the study and its materials, as well as involvement in focus group facilitation and analysis. The PPI group will also play a key part in the dissemination of the findings and development of any future work.

If you would like more information about this study, please contact Sally Giles.

European Conference on Mental Health: discussing care transitions

16 Nov


by Natasha Tyler

NIHR Greater Manchester PSTRC Research Associate, Natasha Tyler recently presented her work entitled ‘Care Transitions: Patient Distress and Knowledge Sharing’ at the European Conference on Mental Health in Split, Croatia. The conference focused on discussions and collaboration between professionals, researchers and service users in the field of mental health. Natasha was presenting a paper that she is writing alongside Professor Justin Waring and Dr Nicola Wright regarding the distress experienced by those on acute inpatient mental wards during care transitions (when patients are moved from one place to another, or from one healthcare provider to another).

Care transitions are a vulnerable and high-risk stage of most care processes. The recent Healthwatch report found that patients often leave hospital too early or without appropriate levels of ongoing support. The quality and safety of care transitions depends on the involvement and coordination of multiple professionals working within and across multiple care settings. Research consistently shows that patients are often unprepared for the self-management role that occurs in the succeeding care setting, they receive inconsistent advice concerning illness management, and are frequently unable to contact the relevant healthcare professional with access to their care plan.

For people with acute mental health problems, the transition into and out of the hospital can be especially complicated, whereby issues of psychological distress or anxiety require particular consideration. The paper presented used data from focus groups that included 52 participants of different professions (doctors, ward nurses, community healthcare professionals) and service users. It found that service users felt particularly distressed regarding unplanned or unsupported discharge. Professionals also experienced stress as they felt unable to pay appropriate attention to preparing service users for care transitions, because they are overstretched and felt it outside their comfort zone. This was characterised by one poignant quote that was tweeted by interested academics attending the presentation ‘we have had a couple of incidents when we’ve had to discharge people to the pavement’.

Whilst at the conference, Natasha networked with a number of academics, she was particularly interested in research conducted in Finland using Assertive Community Treatment, an intensive and highly integrated approach for community mental health service delivery. The presentation was entitled ‘No more revolving door’; which is of particular relevance to mental health care transitions, whereby the metaphor ‘revolving door’ is used to describe an endless cycle of admission and discharge from inpatient acute services. The Finnish research reported a slight improvement in patient outcomes as a result of the service. This was relevant as Natasha is currently conducting a review of discharge interventions in acute metal health services in order to identify the most important outcomes to measure. When she asked the presenter how he chose the outcomes, he explained these were just the outcomes he felt most relevant. This supports the rationale for the necessity to develop a standardised set of core outcomes, which would reduce inconsistency in outcome reporting; which is the next phase of Natasha’s research.

ReVerse: creative conversations between mental health service users and staff

6 Jun

Words_ReVerse illustration_cropped

by Bella Starling

Mental health service users, carers and staff have much in common these days coping with stress and distress, especially at a time of huge pressure on services.

ReVerse workshops aim to equalise the space between mental health service users and staff, to creatively nurture insight, dialogue and healing relationships about patient safety in mental health services and research.

We think a good way to do this is through poetry and spoken word. Creative formats can provide a different angle and unique insight into ourselves, others and our collective wellbeing, and provide those who often feel they are not heard with an opportunity to express their voices. Exploring metaphor and meaning can offer new dimensions to personal and professional health and research relationships.

The workshops are open to mental health service users, carers and staff (including clinical, research, managerial, administrative and support staff). We aim to have an equal mix of staff and service users. ReVerse workshops will include:

  • Examples and readings of poetry and/or spoken word, drawing from different experiences of mental health 
  • Discussions and reflections
  • Having a go: producing your own poetry or prose.

The ReVerse initiative is a collaboration between David Gilbert (poet, Patient Director and mental health service user) and Bella Starling (Wellcome Trust Engagement Fellow, Director of Public Programmes Team, Manchester University NHS Trust) and the NIHR Greater Manchester PSTRC.

For more information behind the workshops, see David’s recent blog post.

Our first workshop takes place in Ziferblat Media City on Tuesday 3 July, register your interest on our Eventbrite page. Registration is free, but requires a commitment to attend.

These workshops are pilots as part of an exciting new initiative. Those involved will help to shape the future development of this ReVerse Programme.

Improving patient safety: linking PSTRC research and expertise to policy and practice

14 Mar

Nav Kapur

Linking up with policy-makers and clinical services is an important part of the work of the NIHR Greater Manchester PSTRC.  Nav Kapur, who is a Professor at the University of Manchester and one of the Research Leads for the Centre, really values the wider engagement he has had with NICE (he chaired the NICE self-harm and depression guidelines), the Department of Health and Social Care,  and Health Education England amongst others.  

Nav says: “We are proud to be a leading centre for research into self-harm and suicide and it’s been a privilege to inform policy and practice.  As an academic, being involved in guideline development allows you to get a wider view of the worldwide literature and its impact on patients.  As a clinician, I like the fact that being involved in guidelines and policies allows you to improve the care of all patients, not just the patient in front of you.”

He continues: “As part of my role as a member of the National Suicide Prevention Strategy Advisory Group for England I contributed to the new suicide prevention strategy, particularly its emphasis on self-harm, as well as contributing to initiatives on confidentiality and responding to new methods of suicide.  My work with Health Education England aims to develop competencies for all NHS staff in the assessment of patients who present with suicidal thoughts or self-harm.” 

Nav also values his role contributing to the induction of new chairs for NICE Guidelines. He explains: “In some ways I find it quite strange that I am now one of the most experienced guideline chairs!  But I really enjoy sharing my experiences of chairing groups and guideline development with people just embarking on the process and I hope they find it helpful too.” 

Nav and colleagues including Roger Webb and Caroline Sanders who lead the Safety in Marginalised Groups theme are looking forward to contributing further to guidelines and policy and practice.  In particular the planned work on the management of self-harm, the safety of mental health services, and improving care for marginalised groups could have a major impact on patient safety and patient care.