Category: Research

December catch-up

Competing priorities have kept me away from this site in recent weeks. There’s been work to do on COCAPP, which is close to the finish line, and doctoral students’ drafts to read and comment on (before imminent thesis submission, in one case). I’ve also been reading a thesis ahead of a PhD examination I’m involved in at the end of the coming week. So if this catch-up post feels a little bitty, then that’s because it is: there’s been lots happening that I want to comment on.

First up is the RiSC study, which I’ve mentioned here plenty of times before. In the last ten or so days the NIHR has published a first look summary of our aims, methods and findings. This is a precursor to the publication of our whole report, which is now post-peer review. Sometime in the new year we’ll be reconvening as a research team to plan our next project.

In October I made the short trip to the University of South Wales to hear Professor Linda Aiken from the University of Pennsylvania deliver this year’s RCN Winifred Raphael Lecture. Professor Aiken spoke on Quality nursing care: what makes a difference?, drawing on findings from the RN4Cast study and more. As promised, the RCN Research Society has now uploaded its video of the event for the world to see. It’s well worth watching.

News on the Mental Health Nurse Academics UK front includes an election, which we are now midway through, for the group’s next Vice Chair and Chair Elect. I’m overseeing this process (as I’ve done twice before), and will be in a position to announce the successful nominee on December 15th. One of the things that MHNAUK does is to work with the RCN to run the annual NPNR conference, and I’m very pleased to have had the chance to join the NPNR scientific and organising committee for a three year stint. More to follow on that front in the future, including details of next year’s event as they emerge.

Elsewhere I read that the Shape of Caring review, chaired by Lord Willis, is looking at the UK practice of preparing new nurses, at the point of registration, for work in one of four fields (mental health, adult, child and learning disability). This is something to keep a close eye on, with reports from last month’s Chief Nursing Officer Summit in England suggesting that the fields may be on their way out. For a useful, balanced, review in this area I refer the reader to the 2008 King’s College London Policy+ paper Educating students for mental health nursing practice: has the UK got it right? and, for a longer read, to Approaches to specialist training at pre-registration level: an international comparison.

Turning back the clock?

Here’s a post to draw attention to the RCN‘s newly published Report on Mental Health Services in the UK. This looks to be the latest document from Frontline First, a campaign revealing the effects of funding cuts on NHS care and nursing.

Working with the charity Rethink Mental Illness, and drawing on publicly available data, the RCN shows how (since 2010) the number of staffed mental health hospital beds across all four countries of the UK has reduced. The number of nurses working in NHS mental health services has also fallen, those remaining being revealed as an ageing group. Year on year, an increasing proportion is shown to be over the age of 50.

Here’s a chart showing reductions in the mental health nursing workforce, which I’ve extracted from page 16 of the report:

And, right at the front of the document, I see a clear case for investment contained in these recommendations which I reproduce word-for-word:

1) Governments must ensure there is equal
access to mental health services and that
the right treatment is available for people
when they need it.

2) Governments and NHS providers must
ensure that the commitment to parity of
esteem is directly reflected in the funding,
commissioning of services, workforce
planning, and patient outcomes.

3) Local commissioners and health boards
must make available enough local beds
to meet demand.

4) The principle of least restriction must
be embedded across all mental health
services. Detention under mental health
legislation should always be based on
clinical opinion and never be a result
of local failures to provide appropriate
care. Due to the significant increase in
detentions under the Mental Health Act
there should be a national objective set
to reduce detention rates in England.

5) There must be a consistent shift across
the UK from inpatient acute care to
community-based services which
recognises that prevention and early
intervention results in better outcomes,
reduces the pressure on acute services,
and reduces the overall cost to the NHS
in the long term.

6) Urgent action must be taken to address
the workforce shortages. Resources must
be committed to training and recruiting
enough mental health nurses who are able
to deliver specialist care in the changing
health and social care landscape.

7) NHS providers must invest in the current
mental health nursing workforce.
Band 6, 7 and 8 mental health nurses
should be developed to become advance
practitioners to deliver effective
recovery-led care in mental health
services.

8) There must be a sustainable and
long-term workforce planning strategy
which acknowledges the current
challenges facing the mental health
nursing workforce.

Horatio Festival of Psychiatric Nursing

Horatio is the European Association for Psychiatric Nurses. On the group’s website it says:

The aims of the Association are twofold: to advocate for the interest of the members by providing input into the decision-making processes on issues relevant to psychiatric and mental health nursing in Europe and to promote the development of psychiatric and mental health nursing practice, education, management and research.

I’m just back from Horatio’s latest gathering: the Third European Festival of Psychiatric Nursing, with its theme of ‘Creativity in Care’. This took place between November 6th-9th in Malta, which (unfortunately for those of us aiming to sightsee on our single free afternoon) happened to be experiencing some unseasonably miserable weather.

As an event, this was a large and properly international one. Whilst there I delivered two presentations: one from the RiSC study, and one a knitting-together of ideas, methods and findings from a series of interconnected and now-completed studies into changing mental health systems and nursing work. My themes in this second presentation will be familiar to readers of this blog, but if it’s worth saying once it’s worth saying again. Here are my slides, for anyone interested:

 

Research in mental health nursing

At 8pm on Monday October 27th I’ll be hosting a #WeMHNs tweet chat on Research in mental health nursing:

Here’s the pre-chat post from the @WeMHNurses blog, which as you’ll see links this chat to a second scheduled for December which will be hosted by André Tomlin (who runs the excellent Mental Elf website):

Research in mental health nursing
Research is about creating new knowledge. In practitioner fields like nursing, research findings can aid decisions on the provision of care or treatments, and on ways of organising services. Research uncovering the views and experiences of people using, or working in, services can be used to inform improvements.

This is the first of two linked chat s about research, and is about involvement and engagement . The second, on keeping up to date with the evidence, will be facilitated by André Tomlin (who runs The Mental Elf website at www.thementalelf.net/ and who tweets at @Mental_Elf) on Thursday December 11th between 8:30 and 9:30pm. A ll are welcome to both chats : practitioners, students, service users, carers, managers, policymakers, researchers. No particular knowledge of research methods, or direct experience of involvement in research, is needed.

In this first chat we’re interested in hearing (and talking about):

•  What (if any) are people’s experiences of research, along a continuum of doing research, to taking part in research to using (or being otherwise affected by) the research findings produced by others?

•  How has research made a difference to people working in mental health services?

•  How has research made a difference to people using mental health services?

•  What are the opportunities for embedding research into mental health nursing policy, services and practice?

•  What are the challenges facing efforts to embed research into mental health nursing policy, services and practice?

•  What research is currently happening, how is it being done, and by whom?

•  What are the research priorities for mental health nursing?

People wanting to know more about research in mental health nursing ahead of this chat may wish to follow links to individuals and organisations accessible from the website of Mental Health Nurse Academics UK (@MHNAUK), which is at http://mhnauk.swan.ac.uk/main.htm . MHNAUK is a group existing to influence and promote education, research and values-based mental health nursing practice for the benefit of people using services and their families.

People wanting to know more about recent and ongoing research projects led by mental health nurses may be interested to follow some of these links:

•  Safewards, led by Professor Len Bowers: http://www.safewards.net/

•  Cross-national comparative study of recovery-focused mental health care planning and coordination (COCAPP), led by Professor Alan Simpson: http://www.nets.nihr.ac.uk/projects/hsdr/11200412

•  Cross-national comparative study of recovery-focused mental health care planning in acute inpatient mental health settings (COCAPP-A), led by Professor Alan Simpson: http://www.nets.nihr.ac.uk/projects/hsdr/131075

•  An evidence synthesis of risk identification, assessment and management for young people using tier 4 inpatient child and adolescent mental health services (RiSC), led by Dr Ben Hannigan: http://www.nets.nihr.ac.uk/projects/hsdr/11102408

•  Plan4Recovery, led by Dr Michael Coffey: http://plan4recovery.org.uk

•  Enhancing the quality of user involved care planning in mental health services (EQUIP), led by Professor Karina Lovell: http://www.nursing.manchester.ac.uk/equip

So, there it is: please spread the word!

Research away day and MHNAUK meet-up

Lots of interesting things to report from a packed week. Monday took me to a meet-up with research-minded nurses from Cardiff and Vale UHB, the first of a series of events organised by Professor Lesley Lowes aimed at supporting research capacity and engagement amongst practitioners. Here’s the flyer:

Lesley's event

In her presentation, Bridie Evans made use of a segment from a NISCHR CRC video introducing the work of Involving People. This has been uploaded to the NISCHR CRC YouTube channel, where the part Bridie used begins at around the 1:53 mark:

Yesterday was the first Mental Health Nurse Academics UK meeting of the 2014-15 academic year. We convened in Manchester, with public involvement and engagement in mental health research and education the theme for the pre-business part of the day. Lauren Walker and Lindsey Cree led with an excellent presentation drawing on their service user and carer researcher experiences working on the Enhancing the Quality of User Involved Care Planning in Mental Health Services (EQUIP) study. Steven Pryjmachuk and I talked about our experiences of involving young people in research, drawing on Steven’s self-care project and our shared RiSC study. John Baker closed this part of the day with an impressive University of Manchester case study of how public and patient involvement in research and education can be embedded at institutional level.

Elsewhere in yesterday’s MHNAUK meeting there was a lively discussion around the promotion of physical health and well-being in people using mental health services, and a review of this year’s NPNR conference. Plans are also being laid for next year’s event, with opportunities about to be notified for people interested in becoming more involved via membership of the conference organising committee.

Voting for mental health

In this post I underestimated the number of charities which specifically fund mental health research. Last week Hugh McKenna sent a message to members of Mental Health Nurse Academics UK alerting us to the Alliance of Mental Health Research Funders, and particularly to this group’s Prioritising Mental Health Research manifesto produced ahead of next year’s general election.

I count 13 members of the Alliance, and read this from the about section of the organisation’s website:

We are a group of charities and foundations that support mental health research. We meet regularly to share progress and generate new ideas for improving mental health research in the UK. We believe that more and better research is urgently needed to find ways of promoting good mental health, treating mental health problems, and supporting the wellbeing of individuals, families and communities. Research can help people with mental health problems, and those around them such as family members or friends, practitioners and leaders of organisations, to find solutions so individuals can enjoy better health and longer, more fulfilling lives.

In its 2015 manifesto the AMHRF says:

We all know someone with a mental health problem and can see how lives would be improved with better treatments and support and less stigma. Mental health research saves lives, relieves significant distress
and improves quality of life. It also benefits the whole of our society by generating social and economic benefits that contribute to thriving communities built upon resilience, reduced levels of mental ill-health and less stigma and discrimination.

Yet mental health research is underfunded and under-prioritised by government. We are missing opportunities to achieve breakthroughs seen in other areas of healthcare that could transform people’s lives and enhance wellbeing.

The 2015 General Election is a landmark opportunity for political parties to build on growing public awareness of mental health and the value of all health and social care research.

The Alliance is right about a growing public awareness of mental health issues, and its message on underfunding is an important one which deserves to be heeded. The LibDems have promised to include a commitment to increasing mental health research in their 2015 manifesto, and other parties (including those with a chance of forming a government) might consider following suit. Personally I would like to see this wrapped up in a more overarching promise to invest properly in mental health across the board, including in services. Elsewhere this week announcements have been made of extra funds to reduce waiting times for mental health care in England. This is a good thing, but needs to be seen in the context of persistent cuts to the mental health system over the lifetime of this government which have  had serious implications for people left in need.

NPNR 2014 reflections

For those not at the 20th International Network for Psychiatric Research Conference, which took place yesterday and the day before at Warwick University, here are links to the conference brochure and the book of abstracts. Following this link takes you to Laura Benfield’s aggregation of #NPNR2014-tagged tweets. Laura, I hear, is moving on from the RCN Events team: many thanks to her for all the behind-the-scenes work at this, and previous, conferences.

This was another high-quality NPNR gathering. Brendan McCormack gave an impassioned keynote on person-centred care, emphasising the absolute importance of values and culture, and Julie Repper spoke eloquently on co-production and the vital work that mental health nurses can do to promote this. Debbie Hicks talked of the work of The Reading Agency in using books to promote mental health and wellbeing. In his Friday morning keynote Swaran Singh gave a presentation which had, at its heart, the idea that higher recorded rates of mental illness in migrant groups are better explained by experiences of social adversity than they are by institutionalised racism. Kevin Ann Huckshorn delivered a final keynote centring on leadership and the implementation of recovery and coercion-reducing approaches.

I also sat in on, and chaired, some excellent concurrent sessions. From speaking with fellow delegates I know that I missed plenty of others of equal quality. From Fiona Nolan and colleagues I learned of the latest in the development and evaluation of protected engagement time initiatives, and from Hilary Ford of the use of a lifecourse approach in pre-registration mental health nurse education. I always appreciate what Mick McKeown has to say, and this year heard Fiona Jones and him talking about the opportunities (and challenges) of introducing recovery ideas in a secure hospital. I heard Brenda Happell deliver two papers: on the relationships between clinical experiences in mental health settings and nursing students’ attitudes to mental health as a field of practice, and on the introduction and evaluation of a service user-led module. Iain Hepworth and Peter Martin both gave talks touching on the work of liaison mental health nurses, and Alan Finnegan presented findings from a grounded theory study of military mental health nurses. Hilary Wareing shared experiences in introducing smoke-free mental health services, Hannah Walsh and colleagues talked of education and training for clinical support workers, and last (but certainly not least) Len Bowers shared his thoughts on (and experiences of) online suicide prevention education for mental health nurses.

I was also mightily pleased to have had the chance to be involved in four papers, each arising from funded research ongoing or recently completed and drawing on the talents and experiences of the fine people variously associated with COCAPP, Plan4Recovery and RiSC. We were there in force in Warwick: Alan Simpson, Michael Coffey, Sally Barlow, Jitka Všetečková, Bethan Edwards, Alan Meudell, Julian Hunt, Nicola Evans and Steven Pryjmachuk. Many thanks to those who came along to listen to, and discuss, our project experiences and our findings.

The NPNR conference is also the place where the following year’s JPMHN Lifetime Achievement Award winner and Skellern lecturer are announced. Very big congratulations to Ian Norman (who, as it happens, was one of my PhD examiners) and to Marion Janner, both of whom will be delivering their addresses at Nottingham University on June 11th 2015.

It’s worth mentioning, too, that the annual NPNR conference has a deserved reputation for informal collegiality and friendliness, and this year was no exception. I enjoyed meeting up with friends old and new.

Looking ahead, I see that an early call for suggested themes for NPNR 2015 has already gone out:

I, for one, plan to be there.

NPNR 2014

I’m off to Warwick University tomorrow, leaving on a too-early train, for this year’s International Network for Psychiatric Nursing Research Conference. This is the NPNR’s 20th edition, and here (lifted shamelessly from the event website, accessible by following the link directly above) is a taster of what’s on offer:

Themes for 2014

Contemporary practice in mental health nursing research

Involving people – where has it got us?

Reflections and reminders

Building new knowledge for effective partnerships

Methodologies, methods and magic

Innovation in teaching, learning and practice

Keynote speakers

Thursday 18 September

Person-Centre Care: Collaborative practice and research

Professor Brendan McCormack, Head of Nursing at Queen Margaret University, Edinburgh

Co-production and the future role of Mental Health Nursing  

Dr  Julie Repper, Recovery LeadNottingham Healthcare Trust, Nottingham, UK

Mental health and Wellbeing: Books on Prescription

Debbie Hicks, Director of Research, The Reading Agency

Friday 19 September

Understanding Pathways to Care in Early  Psychosis                         

Professor Swaran P Singh, Head of Division, Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK

The Role of Leaders in Designing Recovery Oriented Systems of Care: Upsetting the Historical Applecart

Dr Kevin Ann Huckshorn, State Division, Director for the Division of Substance Abuse and Mental Health, Delaware, USA

I’ll aim to tweet from Warwick whilst I’m there. To join in the conference-wide discussion, here’s some info from the @MHNAUK Twitter feed:

Building research capacity

Last night I enjoyed an evening event in Cardiff with other past, and present, members of the RCBC (Research Capacity Building Collaboration) Wales Community of Scholars. This is a collaborative venture supported by higher education institutions, with funds now coming from NISCHR. Since coming into being in 2006 the RCBC programme has sought to develop research capacity across nursing, midwifery and the allied health professions. I’ve written about the scheme on this blog before (see here and here), and am personally grateful for the support I received as an RCBC Post-Doctoral Fellow which enabled me to complete my study into the work and system impact of crisis resolution and home treatment teams. For more on what I found in that project, check out these green open access articles saved in Cardiff University’s ORCA repository:

Hannigan B. and Coffey M. (2011) Where the wicked problems are: the case of mental health. Health Policy 101 (3) 220-227

Hannigan B. (2014) ‘There’s a lot of tasks that can be done by any’: findings from an ethnographic study into work and organisation in UK community crisis resolution and home treatment services. Health: an Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 18 (4) 406-421

Hannigan B. and Evans N. (2013) Critical junctures in health and social care: service user experiences, work and system connections. Social Theory & Health 11 (4) 428-444

Hannigan B. (2013) Connections and consequences in complex systems: insights from a case study of the emergence and local impact of crisis resolution and home treatment services. Social Science & Medicine 93 212-219

Last night began with a talk from Tina Donnelly, Director of RCN Wales and Commanding Officer of the 203 Welsh Field Hospital. In introducing Tina, RCBC Grant Holder Professor Donna Mead (from the University of South Wales) shared the news that the RCBC scheme has received confirmation from NISCHR of continued funding. That’s good, and means we can look forward to more doctoral (and hopefully, post-doctoral) opportunities in the coming months and years.

 

New academic year post

University departments for the health professions, like Cardiff University’s School of Healthcare Sciences, have long academic years. We welcome intakes of new pre-registration undergraduate nurses every September, which is a time when students of many other disciplines are still enjoying the tail end of their summer holidays. In September we also welcome back existing students, and this afternoon – assuming I can navigate across Cardiff and its NATO summit-encircling ring of steel – I’m off to the School’s University Hospital of Wales (UHW) campus to meet a group of third year undergraduates to talk about the ethical aspects of nursing and healthcare research.

More generally, I start the 2014-15 academic year as incoming Co-Director of Postgraduate Research in the School, sharing this work with my esteemed colleague Dr Tina Gambling. Currently in the School of Healthcare Sciences we have almost 80 students studying for either the degree of PhD or the Professional Doctorate in Advanced Healthcare Practice (DAHP). The student group is a rich and varied one, and includes many who have made significant commitments to leave their homes (and often, their families) in other parts of the world to live and study in Cardiff. An example is Mohammad Marie, who I have written about on this site before.

In the case of new, or intending, postgraduate research students in the School some helpful advice is: keep an eye on the School’s website. We’re in the process of launching a new research strategy with distinct themes, and our aim is to recruit new PhD and Professional Doctorate students whose interests are clearly aligned with these. Research theme groups will, we’re all hoping, become communities of scholars drawing in researchers with all levels of experience: including those just starting out, and those who are internationally regarded.