scholarly journals Magical thinking and moral injury: exclusion culture in psychiatry

2021 ◽  
pp. 1-4
Author(s):  
Chloe Beale
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Mental Health Service ◽  
Health Service ◽  
National Health ◽  
Moral Injury ◽  
Risk Averse ◽  
Magical Thinking ◽  
Culture Of Fear ◽  
Iatrogenic Harm

Summary This is an article about exclusion. We might not like to admit it – even fail to realise it – but National Health Service (NHS) mental health service structures have become increasingly focused on how to deny people care instead of help them to access it. Clinicians learn the art of self-delusion, convincing ourselves we are not letting patients down but, instead, doing the clinically appropriate thing. Well-meant initiatives become misappropriated to justify neglect. Are we trying to protect ourselves against the knowledge that we're failing our patients, or is collusion simply the easiest option? Problematic language endemic in psychiatry reveals a deeper issue: a culture of fear and falsehood, leading to iatrogenic harm. An excessively risk-averse and under-resourced system may drain its clinicians of compassion, losing sight of the human being behind each ‘protected’ bed and rejected referral.

scholarly journals Investigating Mental Health Service User Opinions on Clinical Data Sharing: Qualitative Focus Group Study

10.2196/30596 ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. e30596
Author(s):  
Abimbola Adanijo ◽  
Caoimhe McWilliams ◽  
Til Wykes ◽  
Sagar Jilka
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Mental Health Service ◽  
Health Service ◽  
Data Sharing ◽  
National Health ◽  
Service User ◽  
User Involvement ◽  
Service Users ◽  
Service User Involvement

Background Sharing patient data can help drive scientific advances and improve patient care, but service users are concerned about how their data are used. When the National Health Service proposes to scrape general practitioner records, it is very important that we understand these concerns in some depth. Objective This study aims to investigate views of mental health service users on acceptable data sharing to provide clear recommendations for future data sharing systems. Methods A total of 4 focus groups with 4 member-checking groups were conducted via the internet between October 2020 and March 2021, with a total of 22 service users in the United Kingdom. Thematic analysis was used to identify the themes. Results Six main themes, with several subthemes were identified, such as the purpose of data sharing—for profit, public good, and continuation of care; discrimination through the misattribution of physical symptoms to mental health conditions (ie, diagnostic overshadowing) alongside the discrimination of individuals or groups within society (ie, institutional discrimination); safeguarding data by preserving anonymity and confidentiality, strengthening security measures, and holding organizations accountable; data accuracy and informed consent—increasing transparency about data use and choice; and incorporating service user involvement in system governance to provide insight and increase security. Conclusions This study extends the limited research on the views and concerns of mental health service users regarding acceptable data sharing. If adopted, the recommendations should improve the confidence of service users in sharing their data. The five recommendations include screening to ensure that data sharing benefits the public, providing service users with information about how their data are shared and what for, highlighting the existing safeguarding procedures, incorporating service user involvement, and developing tailored training for health care professionals to address issues of diagnostic overshadowing and inaccurate health records. Adopting such systems would aid in data sharing for legitimate interests that will benefit patients and the National Health Service.

scholarly journals Investigating Mental Health Service User Opinions on Clinical Data Sharing: Qualitative Focus Group Study (Preprint)

2021 ◽  
Author(s):  
Abimbola Adanijo ◽  
Caoimhe McWilliams ◽  
Til Wykes ◽  
Sagar Jilka
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Mental Health Service ◽  
Health Service ◽  
Data Sharing ◽  
National Health ◽  
Service User ◽  
User Involvement ◽  
Service Users ◽  
Service User Involvement

BACKGROUND Sharing patient data can help drive scientific advances and improve patient care, but service users are concerned about how their data are used. When the National Health Service proposes to <i>scrape</i> general practitioner records, it is very important that we understand these concerns in some depth. OBJECTIVE This study aims to investigate views of mental health service users on acceptable data sharing to provide clear recommendations for future data sharing systems. METHODS A total of 4 focus groups with 4 member-checking groups were conducted via the internet between October 2020 and March 2021, with a total of 22 service users in the United Kingdom. Thematic analysis was used to identify the themes. RESULTS Six main themes, with several subthemes were identified, such as the <i>purpose</i> of data sharing—for profit, public good, and continuation of care; <i>discrimination</i> through the misattribution of physical symptoms to mental health conditions (ie, diagnostic overshadowing) alongside the discrimination of individuals or groups within society (ie, institutional discrimination); <i>safeguarding</i> data by preserving anonymity and confidentiality, strengthening security measures, and holding organizations accountable; data <i>accuracy</i> and <i>informed consent</i>—increasing transparency about data use and choice; and incorporating <i>service user involvement</i> in system governance to provide insight and increase security. CONCLUSIONS This study extends the limited research on the views and concerns of mental health service users regarding acceptable data sharing. If adopted, the recommendations should improve the confidence of service users in sharing their data. The five recommendations include screening to ensure that data sharing benefits the public, providing service users with information about how their data are shared and what for, highlighting the existing safeguarding procedures, incorporating service user involvement, and developing tailored training for health care professionals to address issues of diagnostic overshadowing and inaccurate health records. Adopting such systems would aid in data sharing for legitimate interests that will benefit patients and the National Health Service. CLINICALTRIAL

scholarly journals Research productivity of staff in NHS mental health trusts: comparison using the Leiden method

2014 ◽  
Vol 38 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Alex J. Mitchell ◽  
John Gill
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Research ◽  
Research Productivity ◽  
Social Care ◽  
Clinical Implications ◽  
Clinical Services ◽  
Health And Social Care

Aims and methodTo examine research productivity of staff working across 57 National Health Service (NHS) mental health trusts in England. We examined research productivity between 2010 and 2012, including funded portfolio studies and all research (funded and unfunded).ResultsAcross 57 trusts there were 1297 National Institute for Health Research (NIHR) studies in 2011/2012, involving 46140 participants and in the same year staff in these trusts published 1334 articles (an average of only 23.4 per trust per annum). After correcting for trust size and budget, the South London and Maudsley NHS Foundation Trust was the most productive. In terms of funded portfolio studies, Manchester Mental Health and Social Care Trust as well as South London and Maudsley NHS Foundation Trust, Oxford Health NHS Foundation Trust and Cambridgeshire and Peterborough NHS Foundation Trust had the strongest performance in 2011/2012.Clinical implicationsTrusts should aim to capitalise on valuable staff resources and expertise and better support and encourage research in the NHS to help improve clinical services.

scholarly journals Specialist personality disorder services in England: a case for managed clinical networks?

2005 ◽  
Vol 29 (10) ◽  
pp. 365-368 ◽  
Author(s):  
Kingsley Norton ◽  
Julian Lousada ◽  
Kevin Healy
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Personality Disorder ◽  
Health Service ◽  
Personality Disorders ◽  
National Health ◽  
Clinical Networks ◽  
Department Of Health ◽  
Specialist Services

Following the publication by the National Institute for Mental Health in England (NIMHE) of Personality Disorder: No Longer A Diagnosis of Exclusion (National Institute for Mental Health in England, 2003), it is perhaps surprising that so soon after there have been threats to the survival of some of the small number of existing specialist personality disorder services to which it refers. Indeed, one of the few in-patient units specialising in such disorders (Webb House in Crewe) closed in July 2004. Such closures or threats argue for closer collaboration in planning between the relevant secondary and tertiary services and also between the Department of Health, the NIMHE and local National Health Service commissioners. Not safeguarding existing tertiary specialist services, at a time of increasing awareness of the needs of patients with personality disorders, may be short-sighted.

scholarly journals Homebirthing in the United Kingdom during COVID-19

2020 ◽  
Vol 20 (3) ◽  
pp. 183-200
Author(s):  
Elizabeth Chloe Romanis ◽  
Anna Nelson
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
United Kingdom ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Place Of Birth ◽  
Physical And Mental Health ◽  
The United Kingdom ◽  
Failure To Protect

COVID-19 has significantly impacted all aspects of maternity services in the United Kingdom, exacerbating the fact that choice is insufficiently centred within the maternity regime. In this article, we focus on the restrictions placed on homebirthing services by some National Health Service Trusts in response to the virus. In March 2020, around a third of Trusts implemented blanket policies suspending their entire homebirth service. We argue that the failure to protect choice about place of birth during the pandemic may not only be harmful to birthing people’s physical and mental health, but also that it is legally problematic as it may, in some instances, breach human rights obligations. We also voice concerns about the possibility that in the absence of available homebirthing services people might choose to freebirth. While freebirthing (birthing absent any medical or midwifery support) is not innately problematic, it is concerning that people may feel forced to opt for this.

Psychiatric In-Patients and Out-Patients: A Reply to Mezey and Evans

1972 ◽  
Vol 120 (557) ◽  
pp. 433-436 ◽  
Author(s):  
D. G. Morgan ◽  
R. M. Compton
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
Social Security ◽  
Patient Care ◽  
National Health ◽  
Recent Article ◽  
Psychiatric Services ◽  
Outpatient Services ◽  
Department Of Health

Department of Health and Social Security statistics show a steady rise in the use of outpatient services from the inception of the National Health Service; since the Mental Health Act of 1959, the numbers of new outpatient and clinic attendances have increased by one-third and one-fifth respectively (D.H.S.S., 1971). However, as our knowledge of the actual functions of out-patient services and their relationship to in-patient care is at best only rudimentary, the recent article by Mezey and Evans (Journal, June 1971, 118, p. 609) is a much needed contribution towards evaluating these different facilities of the psychiatric services.

Preparing for group analytic psychotherapy: meeting the new patient

2018 ◽  
Vol 51 (2) ◽  
pp. 159-174 ◽  
Author(s):  
Kristian Valbak
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Health Services ◽  
National Health ◽  
Waiting List ◽  
Health Services Use ◽  
Outpatient Practice ◽  
First Contact

Preparing for group analytic psychotherapy—the patient and yourself as a therapist—is apparently done in many ways and still invested with much controversy and ambivalence. Some say, they do no selection or assessment at all. The patients or clients are taken from the waiting list in alphabetic order. Other therapists—mainly those working in National Health Services—use several assessment interviews before including patients into short- or long-term groups. Either way, this article revives some research results about assessment and hopes to inspire therapists in their first contact with the patient by presenting some examples from a clinical outpatient practice in a mental health service.

scholarly journals Tilting the balance: the first long-term medium secure unit in the NHS in England and Wales

2006 ◽  
Vol 30 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Niamh Power ◽  
Dawn Harwood ◽  
Akintunde Akinkunmi
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
The West ◽  
England And Wales ◽  
Future Developments ◽  
Secure Unit

Rollo May Ward, a long-term medium secure facility integrated within the West London Mental Health National Health Service (NHS) Trust, is the first dedicated long-term NHS medium secure unit to have opened in England. It caters for a group of men with complex clinical needs and risk assessment issues who had previously been inappropriately detained within high secure services owing to a lack of suitable, less secure placement facilities. We describe the background to the development of the long-term medium secure service, the referral and assessment processes, the structure of the ward and the therapeutic programmes available to patients. We also outline the characteristics of the first 21 patients to be admitted to the ward and offer advice for similar future developments.

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