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Abstract
Background
Psychological therapy is core component of mental health care. However, many people with severe mental illnesses do not receive therapy, particularly in acute mental health settings.
Aims
This study identifies barriers to delivering and accessing psychological therapies in acute mental health settings and is the first to recommend how services can increase access from the perspectives of different stakeholders (staff, patients and carers).
Method
Sixty participants with experiences of acute mental health wards (26 staff, 22 patients and 12 carers) were interviewed about barriers to accessing therapy in inpatient settings and how therapies should be delivered to maximise access.
Results
Four themes were identified: (i) ‘Models of care’ including the function of inpatient wards, beliefs about the causes of mental health problems and the importance of strong leadership to support psychosocial interventions ; (ii) ‘Integrated care’ including the importance of psychologists being ward-based, as well as having strong links with community teams; (iii) Acute levels of distress, including factors which aggravate or ameliorate the impact of this on engagement in therapy; (iv) ‘Enhancing staff capability and motivation’ which is influenced by contextual issues.
Conclusions
It is possible to improve access to therapy through strong leadership (which is supportive of talking treatments), flexible delivery of therapy (which considers short admissions) and a whole-systems approach which promotes ward staff understanding of the psychosocial causes of mental illness and staff wellbeing. It is essential to ensure continuity between inpatient and community therapy services and for wards to have physical space to carryout therapy.
Keywords:
Acute, psychiatric, patient, psychology, service model, implementation, therapy
Psychological therapy is core component of mental health care. However, many people with severe mental illnesses do not receive therapy, particularly in acute mental health settings.
Aims
This study identifies barriers to delivering and accessing psychological therapies in acute mental health settings and is the first to recommend how services can increase access from the perspectives of different stakeholders (staff, patients and carers).
Method
Sixty participants with experiences of acute mental health wards (26 staff, 22 patients and 12 carers) were interviewed about barriers to accessing therapy in inpatient settings and how therapies should be delivered to maximise access.
Results
Four themes were identified: (i) ‘Models of care’ including the function of inpatient wards, beliefs about the causes of mental health problems and the importance of strong leadership to support psychosocial interventions ; (ii) ‘Integrated care’ including the importance of psychologists being ward-based, as well as having strong links with community teams; (iii) Acute levels of distress, including factors which aggravate or ameliorate the impact of this on engagement in therapy; (iv) ‘Enhancing staff capability and motivation’ which is influenced by contextual issues.
Conclusions
It is possible to improve access to therapy through strong leadership (which is supportive of talking treatments), flexible delivery of therapy (which considers short admissions) and a whole-systems approach which promotes ward staff understanding of the psychosocial causes of mental illness and staff wellbeing. It is essential to ensure continuity between inpatient and community therapy services and for wards to have physical space to carryout therapy.
Keywords:
Acute, psychiatric, patient, psychology, service model, implementation, therapy
| Original language | English |
|---|---|
| Journal | BJ Psych Open |
| Publication status | Accepted/In press - 30 Jun 2022 |
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(MCHP) : Manchester Centre for Health Psychology
Peters, S., Ulph, F., Arden Armitage, C., Borrelli, B., Bowen, A., Byrne-Davis, L., Edge, D., French, D., Hart, J., Todd, C., Skevington, S., Wearden, A., Cotterill, S., Brooks, J., Brown, L., Bull, E., Cordingley, L., Epton, T., Smith, D., Speer, S., Powell, R., Bartlett, K., Coupe, N., Shepherd, S., Dienes, K., Ghio, D., Hood, A., Lavallee, J., Rowland, C., Benton, J., Goldthorpe, J., McWilliams, L., Keyworth, C., Goulding, R., Loughran, M., Hawkes, R., Kapadi, A., Hurley, R., Leather, J., Musa, C., Angelakis, I., Reid, C., Alshammari, D., Mountain, D., Hooper, E., Gates, E., Johnson, F., Lomas, F., Kaplan, G., Cross, H., Foote, H., Long, H., Reid, H., Hamer, J., Sibasa, K., Hozhabrafkan, K., Al Abri, K., Lucas, L., Millard, L., Hulme, L., Dhanwani, M., Sonola-Jones, O., Sfakianaki, R., Broadbent, R., Crone, R., Husni, R. R., Mank, S., Booth, S., Hindmarch, S., Plant, S., Mace, S., Sidhu, T., Macintyre, V., Vidayanti, V., Peterson, J., Woof, V., El-Khani, A., Devereux-Fitzgerald, A., Chisholm, A., Sawyer, C., Hope, H., Wilkes, J., Birtwell, K., Bakur, K., Stringer, G., Mohd Faudzi, F. N. B., Checketts, M., Tang, M. Y., Coupe, N., Crook, R., Hamnett, C., Lyons, S., Longley, V., Hulme, L., Mountain, D., Talbot, H., Lucas, L., Ecob, C., Huggett, C., Hozhabrafkan, K., Hyder, S. S. & Lee, R.
1/09/10 → …
Project: Research