2Nd Scottish Mental Health Nursing Research Conference 3 May 2013 Welcome

2nd Scottish Mental Health Nursing Research Conference 3 May 2013 Welcome

From Mary Addo, Chairwoman for the 2nd Mental Health Research Nursing Conference 2013

Dear Colleagues,

It is with great pleasure and honour that we warmly welcome you to the 2nd Scottish Mental Health Nursing Research Conference. We look forward to your engagement in the discussions and debates that arise during the conference.

The theme for today’s conference is “Promoting mental health and wellbeing for all – evidencing mental health practice.” No human being is immune from the ‘tentacles’ of mental illness. We are all too aware of the suffering that goes not only for the individual, but also their families, friends and colleagues, including practitioners who work in mental health services.

However, with the right intervention at the right time and for the right reasons, individuals and their families can take charge of their situation, achieve, and lead a meaningful life. This requires appropriate help based on a multiplicity of sound evidence of what works in a given context.

In the Mental Health Strategy for Scotland: 2012 -20151 improving mental health and treating mental illness are two major challenges to address. To achieve this, seven key themes were identified as targets for improving the mental health and wellbeing of everyone. One of these seeks to -“Develop the outcomes approach to include personal, social and clinical outcomes,” and this conference is evidence of the progress the profession is making towards this goal.

It is hoped that the contents of today’s conference will help us to make appropriate decisions regarding relevant services and interventions, to support and empower individuals experiencing mental ill health, not forgetting the needs of practitioners. Throughout the day we will be reminded that “mental wellbeing is a dynamic state in which the individual is able to develop their potential, work productively and creatively, build strong and positive relationships with others and contribute to their community. It is enhanced when an individual is able to fulfil their personal and social goals and achieve a sense of purpose in society.” 2

The 2nd Scottish Mental Health Nursing Research Conference provides a fantastic opportunity for like minded people engaged in mental health practice to share and learn from each other. We are confident that your attendance at today’s

1 The Scottish Government (2012) Mental Health Strategy for Scotland: 2012-2015: The Scottish Government: Edinburgh.

2 Foresight Mental Capital and Wellbeing (2008) Final Project Report - Executive Summary. The Government Office for Science: London.

conference will provide you with a thought provoking, stimulating, inspiring, and energising learning experience. This will help you to support and enhance the quality of life of others, in promoting human flourishing in the services you provide.

We are proud to say that the conference is funded by the Scottish Government and supported by the School of Nursing and Midwifery and the Institute for Health and Welfare Research (IHWR) at Robert Gordon University. We worked in collaboration with partners in the NHS and several Scottish universities to ensure the conference has wide relevance to clinical practice and education.

Again, a big thank you on behalf of the conference committee for making the effort to join us today, to share and celebrate mental health nursing research in Scotland.

Dr Mary Addo, PhD, MEd, MA (Soc.Sci), DMS, PgCert TLT, RMN, EN (G) Lecturer in Mental Health Nursing

Keynote Speakers

Susan Blishen, Project Manager, Right Here

Susan Blishen of the Paul Hamlyn Foundation is the Manager of Right Here. She helped to develop and now oversees the delivery and evaluation of this programme. Project initiation and management has been central to Susan’s roles at the Paul Hamlyn Foundation and to her previous roles. Susan helped to set up, and then manage, the Paul Hamlyn Foundation’s Fund for Young Refugees and Asylum Seekers and the Reading and Libraries Challenge Fund. She also contributed to the development of the Foundation’s newest grants programme, the Social Justice Programme. Susan’s publications include “Supporting Young People’s Mental Health: Eight Points for Action”, Mental Health Foundation Policy Briefing, 2007 (with Moira Fraser) and “Access to Books and Reading for Young People in Public Care”, the Network, 2007 (with John Vincent). She has a Masters Degree in English Literature.

As our first keynote speaker for the conference Susan will present a talk entitled:

Re-scripting young people’s experiences of health and support services

Right Here is a unique, five-year collaboration between Paul Hamlyn Foundation and the Mental Health Foundation to develop effective new approaches to improving the mental health and well-being of 16 – 25 year olds. Since 2009 the initiative has been working with four partnerships in Brighton and Hove, Fermanagh, NI, Newham, and Sheffield, where young people and adults have worked together to design, deliver, commission and evaluate a range of health promoting, therapeutic and resilience- building activities. In 2011, Right Here, with Comic Relief and Nominet Trust also began developing a range of new digital products to support young people’s mental health, as part of the Innovation Labs initiative.

Susan will speak about the benefits and challenges of the co-production process (young people/adults; youth workers/mental health professionals), which informs all of these projects. Drawing on the independent evaluations of Right Here from the Tavistock Institute and the Institute for Voluntary Action Research (IVAR), and the views of the young people who have been involved, she will also propose some key design features for future youth mental health and well-being services, including on-line, and digital services.

Professor Brian J. Webster

Brian Webster is a Professor of Nursing and Assistant Dean of the Faculty of Health, Life and Social Sciences, at Edinburgh Napier University. Brian is both a mental health nurse and an adult nurse and has been a nurse since leaving School at 17. He quickly found his area of professional interest in alcohol misuse and has built his career in both mental health and adult nursing settings around this interest. Brian worked in Scotland as a Charge Nurse before moving to the South of England where he held several clinical positions in forensic mental health, substance misuse, emergency medicine, gastroenterology and haematology. He joined the University of Portsmouth as a Lecturer/Practitioner, before moving to the University of Southampton where he became the Director of Education at the Faculty of Health Sciences. Brian has degrees in politics, education, and advanced practice and his research focuses on alcohol misuse, particularly amongst University students. In 2009, Brian moved back to Scotland as the head of the School of Nursing and Midwifery at the Robert Gordon University. He is Chair of the Scottish Heads of Academic Nursing and Allied Health Professions (SHANAHP) as well as being an Executive Member of the Council of Deans of Health UK. His book, “Achieving the NMC Competencies – A Handbook for Student Nurses” is due for release in October 2013.

Professor Webster will present the second keynote address at the conference.

Alcohol Use in Scotland – The challenge to us as practitioners

Scotland has a long standing problematic relationship with alcohol. Whilst the total consumption of alcohol per head is falling, the problematic use of alcohol continues to rise. This keynote speech will look at the current challenges that many people have with alcohol in Scotland. As practitioners, I would suggest that we need to do more in assessing, supporting, referring and educating the populations that we come in contact with. In order to do that we need to address this from a multi-factorial level and this speech will look at the areas of;

• The education of nurses – have we got this right? • Our role as nurses - the skills we need • Our own use of alcohol – as part of our nation • What the future holds

It is my belief that significant change is required for Scotland to change its relationship with alcohol, that the health of our nation is of major concern to us as mental health practitioners and that we do have a role to play in addressing this. Professor Susan Klein

Professor Susan Klein, as Director of the Aberdeen Centre for Trauma Research and Principal Member and Theme Leader for Neurological & Mental Health, Institute for Health & Welfare Research, is recognised as a national and international expert in the field of trauma-related research. She has contributed to the development of evidence-informed guidance for the psychosocial response to major incidents commissioned by the Department of Health/NATO and, more recently, psychosocial mental healthcare provision for emergency preparedness and response in collaboration with the Resilience Advisory Board for Scotland (RABS) and for implementation as part of the Care for People affected by Emergencies.

Professor Klein presents the third of our keynote addresses.

Title: Mitigating the Impact of Trauma in the Workplace: Lessons Learned

Abstract: Traumatic workplace incidents are not rare. In the United Kingdom, some 85% of workplaces have recorded verbal abuse or staff harassment, and 65% have reported actual physical assault on staff. Within the health service evidence suggests, for example, that nurses are at “high risk” of being exposed to violent or aggressive patients. Dealing with such patients on a regular basis has been reported to be a common occupational hazard and may conduce to the development of post-traumatic symptoms and occupational burnout. Trauma in the workplace, however, may not just refer to adverse events experienced by an unsuspecting employee. Some workers have a responsibility to deal with the traumatic events endured by others, for example, those employed in the rescue and emergency services, healthcare services, and the military. To mitigate the impact of trauma in the workplace requires a good understanding of the exacting demands of this type of work, and to identify facilitative factors in meeting the requirements of fulfilling such a role. This keynote address will present the findings from empirical studies conducted by the Aberdeen Centre for Trauma Research on evaluating the impact of trauma in the workplace and the lessons learned therefrom.

Mr Hugh Masters

Associate Chief Nursing Officer (Interim) and Health Professional Policy Lead for Older People, Learning Disabilities and Mental Health

Scottish Government

After training as a mental health nurse, Hugh worked in a variety of practice settings, before moving to Edinburgh Napier University as a senior lecturer. In 2009, he took up a post in the Scottish Government as Nursing Officer for Mental Health and Learning Disabilities and in March 2012 moved to his present post in the Scottish Government. He is currently focused on assuring the care of older people in hospitals and the implementation of the Standards of Care for Dementia in hospital settings.

Hugh Masters will bring the conference to a close by drawing out and discussing the key themes of the day and finally to offer some challenges to the research community alongside national policy drivers such as health and care integration, person centred care and the increasing influence of improvement science methodologies.

Our visiting poet

Jo McFarlane

Jo is a poet and service user in recovery. She lives in Edinburgh but performs her poems at conferences and events across the country. Recently she performed at the Scottish Parliament. She has written several collections and is currently working on a memoir which will include her experiences of psychiatric care. The purpose of sharing her story is to generate awareness, to thank the people who have helped her, and above all to inspire hope in others that recovery is possible.

You can find Jo on Facebook: www.edinburghjo.co.uk

Today Jo will be sharing poems on the themes of recovery, positive nurse/patient relationships and user and carer involvement. There may even be a few rib ticklers, including one about a psychiatrist she locked in the loo and another with a very naughty word that will make you want to reach for your prescription pad. But don't worry, it's all done in the best possible taste!

Conference Committee

Mary Addo, PhD, MEd, MA (Soc.Sci), DMS, PgCert TLT, RMN, EN(G) is a lecturer with 30 years mental health nursing experience, the last 11 years relates to teaching in the School of Nursing and Midwifery and she is a member of the Institute for Health and Welfare Research, at Robert Gordon University. She has contributed to publicly funded research, and supervises PhD and Masters research students. Her research interests include bipolar disorder, clinical supervision, experience of service users and informal carers, forensic nursing, and observation of acutely ill patients.

Audrey Stephen, PhD, is a research fellow in the School of Nursing and Midwifery and a member of the Institute of Health and Welfare Research at Robert Gordon University. Her main research interest is in bereavement and bereavement care. She has a background in adult nursing in acute care settings.

Andrew McKie, PhD, is a lecturer in the School of Nursing and Midwifery at Robert Gordon University. He has teaching, scholarship and research interests in the areas of mental health nursing, ethics and in the use of the arts and humanities in professional health care education.

Debbie Banks has a background in mental health nursing and many years experience as a nurse educator. She is currently programme leader, curriculum development and delivery, for pre-registration nursing at RGU. RGU awarded Debbie Teaching Fellow status in 2012. She has influenced mental health nursing education through membership of both local and national groups and committees.

Jane Ross has worked in the field of mental health for longer than she cares to admit. She is an Accredited Cognitive Behavioural Therapist and Independent Prescriber working in community mental health. She is also a Doctoral student at the University of Aberdeen.

Colin Macduff is Reader in Nursing at Robert Gordon University. A mental health nurse by background, he has extensive experience of evaluating policy to practice developments in healthcare.

Steve Smith is a Lecturer in Mental Health and an Enterprise Fellow of Robert Gordon University. His background is in Mental Health Nursing and he has over twenty-five years clinical experience gained in a variety of settings. Since 2006 he has developed and led the Solution Focused Brief Therapy courses at RGU, and has delivered these to Health Boards across the country.

Inga Heyman is a lecturer in mental health nursing at Robert Gordon University. Prior to joining the University Inga worked as Adult Protection Co- ordinator with Grampian Police. Her clinical practice in Australia and Scotland has shaped her research interest in police and nursing collaborations, suicide intervention and substance use in the energy sector.

Lee Boag MA Psychology, Cert COSCA has worked in both community and residential settings in the role of mental health support worker and has experience in counselling work. He has been a research assistant at the University of Aberdeen, Aberdeen Royal Infirmary and the Royal Aberdeen Children's Hospital. He is currently studying for his PhD through the Institute of Health & Welfare Research and is working on developing and piloting a self-care intervention for the informal caregivers of a relative with bipolar disorder.

Susan Cumming is the Administration Manager for the School of Nursing and Midwifery. She has worked in administration roles for over 35 years in a variety of sectors including the oil industry and banking. For the last 20 years she has been employed within RGU, firstly in the Estates Department before joining the School of Nursing and Midwifery in 1999. She has assisted the conference group with some aspects of the event organisation which is an area of interest to her.

Billy Ridler is a Stage 3 Bachelor in Nursing (Mental Health) nursing student at Robert Gordon University. He has a keen interest in research, particularly in relation to patient safety and the use of clinical observations.

Margaret Conlon MSc; BSc; CPN dip; RMN; RSCN is a Lecturer and Teaching Fellow in the School of Nursing and Midwifery at Edinburgh Napier University. Her twenty years’ experience as a mental health nurse provides an excellent backdrop for scholarly activity that includes all aspects of mental health education, in particular teaching and learning of interpersonal skills and values based practice. For the last five years, research activity has been focusing on practice learning in programme development.

Val Howatson is a lecturer in mental health nursing and pathway lead for the undergraduate programme at Glasgow Caledonian University. She is a qualified CBT therapist and has extensive clinical and teaching expertise in psychosocial interventions for serious mental health problems.

Sandy McComish RMN, RNT, DMS PGCert, MSc, MA (Social Policy) is Senior Teaching Fellow and Professional lead for mental Health at School of Nursing and Midwifery at University of Stirling. Research interests are wide and varied including violence and aggression, forensic mental health, service user and carer involvement in nurse education, learning experiences in virtual environment. He is Deputy Chair of the School Research Ethics Committee and mental health research interest group at University of Stirling.

Austyn Snowden PhD BA (Hons) BSc (Hons) is a Reader in mental health at UWS. His main research interests are medicines management in mental health, distress in cancer, and concordance in general.

Brodie Paterson is a Senior Lecturer, University of Stirling. Degrees in psychology, sociology, social policy and education. Chair European Network for Training in the Management of Aggression, Fellow European Academy of Nursing Scientists. Experienced researcher with record of more than published 100 articles, chapters and texts with a particular focus on violence and suicide. Current interests include gender and violence and the implications for staff training and practice, trauma informed education and practice, mindfulness based approaches to stress management.

Billy Mathers EdD RMN is lecturer in mental health at the University of the West of Scotland. His research interests include promoting therapeutic involvement in acute mental health wards.

Conference Programme 08.30 Programme Agenda - Registration 09.30 (Room H230) Introduction (Lecture Theatre H223) Conference Chair: Dr Mary Addo – Lecturer in Mental Health Nursing, School of Nursing and Midwifery, RGU Health and Safety: Mrs Susan Cumming – Administrator, School of Nursing and Midwifery, RGU 09.30 Welcome to RGU: Professor Cherry Wainwright - Director, Institute for Health and Welfare Research, RGU - Keynote Address 1: Susan Blishen, Project Manager - RIGHT - HERE PROJECT - PAUL HAMLYN FOUNDATION 10.30 (Lecture Theatre H223) Keynote Address 2: Professor Brian Webster, Assistant Dean - Edinburgh Napier University Jo McFarlane (Poet) Edinburgh (1st Set) (Lecture Theatre H223) 10.30 Coffee Break - (Room H230) 10.50

st 1 ORAL PRESENTATIONS Session 1 Session 2 Session 3 Session 4 Session 5

Presenters: Presenters: Presenters: Presenters: Presenters: Emma Lamont Dr Andrew McKie & Susan Dr Brodie Paterson & Prof. Brian Webster, Tara Robinson, Project Lead- Nurse Lecturer, Naysmith Mr Ivor Smith, Edinburgh Napier Assertive Outreach Service, V University of Abertay Robert Gordon University University of University, Inga Heyman, Cardiff and Vale University I What is the concept of Exploring critical Stirling/Forth Valley Rosemary Shaw, Local Health Board recovery and its journey perspectives in mental NHS Lecturers, Robert Gordon Improving the Gateway for E to orientate care in health nursing education Decisions around the University Homeless Services Users 10.50 W Scotland so far? use of observation in Blow out Preventer: through Direct Access to acute psychiatric in- Problematic substance use mental Health Care. - I patient care. A social in the offshore oil and gas 11.20 N judgement analysis. community

G Room H405 Room H407 Room H408 Room H409 Room H410 2nd ORAL PRESENTATIONS

Session 6 Session 7 Session 8 Session 9 Session 10 P O Presenters: Presenter: Presenters: Presenter: Presenters: Robin Ion, Lecturer Kirsty Blair Dr Brodie Paterson & Jane Ross, PhD Student, Liz Brodie & S Scott Hardie, Senior 3rd Year Mental Health Kevin McKenna, University of Aberdeen, Fiona Carver T Lecturer, Bridey Nursing Student. Robert University of Stirling CPN/Independent Nurse Edinburgh Napier University Monger, PhD student, Gordon University A European charter for Prescriber. NHS Grampian An alternative approach to a E University of Abertay/ Are healthcare trainers in the Mental health nurse contentious issue: Borderline R Research Officer for professionals doing more management of prescribing: using a personality disorder Penumbra. Nigel harm than good? An violence. Results of a constructive approach to S Henderson, Chief international literature Delphi exercise. investigate the nurse Executive of Penumbra, review patient relationship Jane Cumming, Senior 11.25 Manager, Penumbra - I Recovery, outcome measurement and N 11.55 mental health nursing

Room H405 Room H407 Room H408 Room H409 Room H410

3rd ORAL PRESENTATIONS F Session 11 Session 12 Session 13 Session 14 Session 15 O Y Presenters: Presenters: Presenters: Presenter: Presenter: Lee Boag, PhD Student, Dr Winifred Eboh, Dr Dr Brodie Paterson, Anne Marie Rennie PhD Dr Penny Woolnough, E Dr Mary Addo, Catherine Rolland, Robert University of Stirling Student / Lecturer in Senior Research Officer, R Professor Susan Klein, Gordon University, Why are restraint Midwifery. Robert Gordon Grampian Police Dr John Love, Robert Professor Edwin van trainers men? University Missing an opportunity: Gordon University Teijlingen, Bournemouth Psychological well-being Exploring the importance of A Life Interrupted: University following miscarriage mental health in cases of Hermeneutic Systematic review of the missing persons 12.00 phenomenological study impact on the mental - of the lived experiences health of adolescents with of informal care givers sickle cell disease during 12.30 of a relative with bipolar transition from paediatrics disorder to adult healthcare.

Room H405 Room H407 Room H408 Room H409 Room H410 12.30 Lunch Break - (Room H230) 13.30

Jo McFarlane (Poet) Edinburgh (2nd Set)

13.30 - Keynote Address 3: Professor Susan Klein – Director, Aberdeen Centre for Trauma Research 14.00 Principal Member- Institute for Health and Welfare Research Theme Leader: Neurological and Mental Health / (Lecture Theatre H223) WORKSHOPS

Workshop 1 Workshop 2 Workshop 3 Workshop 4 Workshop 5

V Presenters: Presenters: Presenters: Presenters: Presenters: Dr Mary Addo, Dr Dr Colin Macduff, Shuai Inga Heyman, Lecturer, Melanie D’ardis, Karen Gwenne McIntosh, I Audrey Stephen, Ziying, PhD Research Robert Gordon Shanahan, Suzanne Edinburgh Napier E Pamela Kirkpatrick student. Robert Gordon University, Professor Barclay University, Robert Gordon University Brian Webster, Buckinghamshire New M. McCraig & L. McNay, W University Edinburgh Napier University, Middlesex. University of the West of I Values base and recovery University, Gavin Innes, Scotland & V. Howatson Acute mental health focused practice in E- Learning Advisor. Forum Theatre to resolve Glasgow Caledonian N 14.05 nurses’ experiences of Scottish mental health Robert Gordon conflict between nursing University G clinical supervision in nursing: where are we University students and their – promoting their now? mentors. The HEI-R: a potential tool

14.40 wellbeing in their Joining forces – for developing Recovery workplace: a systematic Collaborative police and Focussed Practice in HEI’s? review nurse practice and P education to support O those with mental health needs. S Room H410 T Room H407 Room H408 Room H409

E Room H405 R 4th ORAL PRESENTATIONS S Session 16 Session 17 Session 18 Session 19 Session 20

Presenters: Presenters: Presenters: Presenters: Presenters: Dr Fiona MacDonald, Dr Brodie Paterson, James Taylor Dr Billy Mathers, John Karen Newbigging, Principal I Independent, Dr Susan University of Stirling, Ms PhD research Green, Christine Lecturer/ Senior Research , N Pollock, NHS Lothian Jenny Young, student/Teaching Robertson, Bob Porter. School of Nursing, Training and Assistant. University of University of the West of University of Central Psychotherapist, Forth Development, Trevor Stirling Scotland Lancashire & Dr Julie Ridley, 14.45 Jones, Senior Charge Valley NHS Senior Research Fellow ,

– Nurse Royal Edinburgh Military veterans who Service users’ involvement School of Social Work F Hospital An evaluation of fast track offend: do their mental in mental health nurse 15.15 access to novel O health, drugs or alcohol teaching and recruitment The Right to be Heard! A FIRST FOR THE psychological therapies for problems differ from Review of the quality of adult survivors of Y ORCHARD CLINIC! other offenders? A mental health advocacy in Developing peer childhood sexual abuse summary of the findings E England education in a secure from a wider systematic R setting review Room H410 Room H408 Room H409 Room H405 Room H407 Summary 15.15 Prize Giving - Closing Address: Mr Hugh Masters – Associate Chief Nursing Officer (Interim) Scottish Government 15.35 (Lecture Theatre H223) Jo McFarlane (Poet), 3rd Set Conference Evaluation Forms 15.35 Conference Closed - 15.45 Thank you and wishing you a safe journey home…

15.45 - Optional Coffee Break for Networking & Discussion 16.15 (Room H230)

ABSTRACTS (Contents printed as submitted but with editorial amendments)

Oral presentations Sessions 1-20

Session 1

What is the concept of recovery and its journey to orientate care in Scotland so far?

Emma Lamont, University of Abertay

Introduction

Since devolution in Scotland and the establishment of Scottish Parliament in 1999, Scottish health policy has focused on improving the health of the nation. Mental health has become a key priority with the emergence of agendas such as the review of mental health nursing; Rights, Relationships and Recovery (SGHD, 2006). The review introduced recovery as a concept to orientate mental health care for the future. But where is the concept of recovery today and what has been its journey in Scotland so far?

Aims and objectives

The purpose of this paper is to review the relevant literature regarding how recovery is conceptualised as a philosophy or concept by service users, mental health workers, families, professionals, policy makers and scholars within Scotland.

Methods

Databases were searched to identify peer reviewed literature published from Scotland over the past four years. Six studies were selected and key themes emerged by identifying common recurring elements. An integrative review of literature was undertaken, exploring a number of perspectives from a variety of voices.

Results / Discussion

Six studies were selected. Three broad themes identified were; interpersonal and intrapersonal constructs of experience, political and social movement and orientation and guidance for mental healthcare. The discussion gives a modern perspective of the concept of recovery which reaffirms what is already known and adds to knowledge by focusing on Scottish literature. Leamy et al (in press) recognised the need for further research into how micro processes of recovery operate such as; how hope is re-awakened and sustained.

Conclusion

Further research is recommended and will be undertaken with more diverse samples to understand how recovery is conceptualised by people from marginalised groups such as nurses and other professions recognised to be stressful, linking with mental illness, different ethnic, cultural backgrounds and at different stages of mental health difficulties.

References:

Leamy M, Bird V, Le Boutillier C, Williams J, Slade M (in press) A conceptual framework for personal recovery in mental health: systematic review and narrative synthesis, British Journal of Psychiatry. Scottish Government health Department (2006) the rights, relationships and recovery: review of mental health nursing. Available at: http://www.scotland.gov.uk/Resource/Doc/924/0097678.pdf

Learning outcomes

Constant critical of the concept of recovery is important and relevant within particular areas such as Scotland to ascertain peculiarities between regions and countries

Biography

Emma was born in Dundee a while ago…, trained to be a mental health nurse in 1990 in an old house up Glasgow Road in Perth (called the college) where I met my husband. Worked for NHS Tayside for 23 years in hospital and community, sponsored to undertake a master’s degree 3 years ago because I had an idea that I could make a difference! Left the NHS last year to work as lecturer in mental health nursing at University of Abertay, Dundee as I had another idea I could make a difference in education. I am on the verge of completing an MSc in advanced practice in mental health. My research project is about the concept of recovery from the perspective of mental health nurses who have lived experience of mental illness. The best writer I have discovered over the last year is R.D Laing who said; ‘Children do not give up their innate imagination, curiosity, dreaminess easily. You have to love them to get them to do that.’ Finally and most importantly I have 3 children and 2 dogs.

Session 2

Exploring critical perspectives in mental health nursing education

Dr Andrew McKie and Ms Susan Naysmith, Robert Gordon University

This paper discusses the promotion of critical perspectives in undergraduate students within mental health nursing degree programmes. Reflecting the diverse conceptual base of mental health nursing practice, the paper presents student nurse narratives which demonstrate the importance of fostering critical thinking in pre-registration mental health nursing education programmes.

Narratives are drawn from the first author's narrative research of student nurses exploring the relationship between reading literature and poetry and their ethical practice. Other narratives are drawn from the second author's engagement with selected texts of literary fiction within a third-year degree module entitled 'Critical Perspectives in Mental Health Nursing'.

These narratives demonstrate the importance of encouraging critical thinking in students of mental health nursing. By undertaking a liberal education, student nurses can link their own personal narratives to professional narratives as they progress through the curriculum.

This paper demonstrates the significance of critical thinking in the learning development of students of mental health nursing. By engagement with a variety of knowledge sources, students can be encouraged to adopt critical stances towards the practice of mental health nursing itself. Such approaches are applicable to all the areas outlined in the conference introduction.

References

Hurley, J. et al. 2009. Doomed to fail: the persistent search for a modernist mental health nurse identity. Nursing Philosophy 10 1 53-59

Jones-Davitt, S. & Smith, L. 2007. Critical Thinking in Health and Social Care. Sage: London

Learning objectives

(1) To demonstrate the importance of alternative conceptual bases of mental health nursing in person-centred care and values-based practice

(2) To demonstrate the cultivation of critical thinking in students via their narrative engagement with diverse knowledge bases

Keywords

Critical thinking. Narrative, humanities, sciences

Biographies

Andrew McKie is a lecturer in mental health nursing at Robert Gordon University. He has teaching, scholarship and research interests in the areas of mental health nursing, ethics and the place of the arts and humanities in professional health care education.

Susan Naysmith has a degree in philosophy and graduated with a Bachelor of Nursing degree from Robert Gordon University in 2011.

Session 3

Decisions around the use of observation in acute psychiatric in-patient care. A social judgement analysis

Dr Brodie Paterson and Mr Sandy McComish, University of Stirling

Introduction

The use of observation rests on two premise. A) that practitioners can accurately predict imminent suicide at the level of the individual. B) that practitioners judgements of the probability of suicide are correlated with their decisions regarding observation.

Aims

What importance (weighting) do practitioners attach to the cues they use in assessing the probability of suicide in decisions regarding observation? What are the similarities/differences between decisions made by psychiatrists and mental health nurses, with regard to the use of observation? Method

For each of 13 variables identified via a literature review different ‘levels’ were constructed representing different levels of severity of the variable. All variables were then placed into a computer program that randomly generated case vignettes. A total of 130 vignettes, representing services users with different potential degrees of suicide risk were generated, and validated together with 15 repeat cases. 63 health care professionals from four primary care trusts across Scotland completed the vignette booklets, which required them to make a judgement regarding risk and a decision regarding which level of observation they would place the patient on.

Results

Individual decision policies contained from one to six cues. See Figure 1 below. Mean risk judgement scores, mean adjusted r2 and mean percentages of patients placed on the different levels of observation can be seen in Table 2.

Discussion / Conclusion

Practitioners judgements of risk were strongly correlated with their use of observation but they used a range of variables to inform their decisions.

Learning Points.

1. Observation decisions are strongly influenced by decisions regarding risk.

2. Practitioners should be aware of the variables they use in making decisions. Figure One: Information cues used in observation decision policies

100 90 80 70 60 50 40 Percentage 30 Psychiatrists 20 Nurses 10 0 Insight Gender morbidity - Diagnosis Compliance Co Perceived risk Hopelessness Adverse events Suicidal ideation Suicidal Protective factors Protective Length of admissionLength Clinical improvementClinical Number of admissions Previous suicide attempt

Table 2: Comparison of means Variable Mean scores (SD) Psychiatrists Nurses (n = Sig (2- (n=12) 51) tailed)

Mean risk prediction 54.8 (9.8) 50.4 (11.8) 0.19 Mean adjusted R2 for risk 0.34 (0.09) 0.28 (0.1) policies Percentage on pass 5 (8.6) 4.5 (6) 0.86 Percentage on general 45.3 (18.9) 66.1 (18.9) 0.001* observation Percentage on constant 34.8 (18.3) 26.6 (17.4) 0.14 observation Percentage on special 7.8 (8.7) 2.7 (5.7 ) 0.075 observation Mean adjusted R2 for decision 0.66 (0.1) 0.52 (0.2) policies

Biographies

Dr Brodie Paterson is a Senior Lecturer, University of Stirling. Degrees in psychology, sociology, social policy and education. Chair European Network for Training in the Management of Aggression, Fellow European Academy of Nursing Scientists. Experienced researcher with record of more than published 100 articles, chapters and texts with a particular focus on violence and suicide. Current interests include gender and violence and the implications for staff training and practice, trauma informed education and practice, mindfulness based approaches to stress management.

Sandy McComish RMN, RNT, DMS PGCert, MSc, MA (Social Policy) is Senior Teaching Fellow and Professional lead for mental Health at School of Nursing and Midwifery at University of Sterling. Research interests are wide and varied including violence and aggression, forensic mental health, service user and carer involvement in Nurse education, learning experiences in virtual environment. He is Deputy Chair of School Research Ethics Committee and Mental health research interest Group at University of Stirling. Session 4

Blow out Preventer: Problematic substance use in the offshore oil and gas community

Brian Webster, Inga Heyman, Rosemary Shaw

Background

Evidence suggests that substance use is prevalent in the oil and gas workforce across the globe. Embracing a zero tolerance policy in a safety critical environment such as an offshore installation is an acceptable option to ensure a safe working environment (Nolan 2008). There is little focus on employee’s use of substances whilst on shore leave, which can also compromise offshore health and safety.

Aims

This paper will discuss the impact of drug and alcohol use by employees during shore leave, the impact of this on the offshore environment, employee health and explore the remote health care practitioner’s role in these challenges.

Method

A group consisting of academic staff, medical staff and remote health care practitioners developed, designed and implemented education and training aimed at remote health care practitioners/ rig medics across the globe (Webster et al 2012 a). In partnership, experienced academic staff from relevant backgrounds in substance misuse and occupational health proposed new evidence based recommendations for screening and brief interventions (Webster et al 2012b).

Findings

Energy sector strong cultural and social bonds significantly impact on shore leave drinking and drug use patterns. Many do not identify their use as problematic which impacts on health and safety on returning to the offshore platform. This combined with a lack of knowledge or recognition within industry employers brings a new element of risk.

Conclusion

Offshore medics and occupation health nurses are ideally positioned to deliver alcohol and substance use brief interventions to screen and reduce harm to this group. There is an urgent need for change to the education, practice and scope of these roles.

References

Nolan, S. (2008).’Drug- free workplace programmes: New Zealand perspective. Forensic science international, 174 (2), pp.125-132

Webster ,B.J., Kirkpatrick, P. & Martindale, S. (2012).”Advancing Continuous Professional Development for Remote Health Care Practitioners”. Journal for the Institute of Remote Health Care 3 (1), pp.3-9 Webster,B.J., Heyman, I. & Shaw, R. (2012).” Substance and alcohol misuse in the offshore community – reviewing the evidence”. Journal for the Institute of Remote Health Care 3 (1), pp.15-20

Biographies

Inga Heyman is a lecturer in mental health nursing at Robert Gordon University, Aberdeen. Prior to joining the University Inga worked as Adult Protection Co- ordinator with Grampian Police. Her clinical practice in Australia and Scotland has shaped her research interest in police and nursing collaborations, suicide intervention and substance use in the energy sector.

Rosemary Shaw is the Course Leader for Occupational Health Practice and close to the completion of her Master's in Education from Robert Gordon University. She also serves as an external examiner at Leeds Metropolitan University for SCPHN courses. In addition to these roles, Rosemary is the Vice Chairperson for the National Occupational Health course leaders’ group by reviewing and contributing to national Occupational Health publications.

Session 5

Improving the Gateway for Homeless Services Users through Direct Access to Mental Health Care.

Tara Robinson, Cardiff and Vale University Local Health Board

It is widely recognised that people who experience homelessness have a significantly higher rate of mental illness (Caffel 2012), with the likelihood of psychosis increasing by as much as 4 -15 times compared to the average UK population. This increases to a staggering 50- 100 times more likely for those who are street homeless experiencing a psychotic disorder (Rees 2009).

Serious mental illness is often accompanied by drug or alcohol addiction amongst the homeless population. The majority of studies suggest that the rate of those who would fulfil dual diagnosis criteria within the homeless population varies between 10 and 20% (Rees 2009).

Attendance at appointments with Secondary Mental Health Services is thought to be low for people who are considered to be homeless, with a national study highlighting that as little as 34% attending Follow up Care (Dobscha 1999).

Partner agencies from Housing and Voluntary services reported concerns that service users who experience mental illness face an inequity in receiving appropriate care, and that the pathway to refer service users for secondary mental health via the GP faces a number of barriers:-

•The low value homeless service users place on their health

•No GP, or failure to attend GP appointments

•No postal address for appointments to be sent to

•Inflexible appointment systems

•Lack of available domiciliary ally visits

•Lack of clarity between services about the clinical responsibility for the service user, often falling between Mental Health and Drug and Alcohol services

•Challenging behaviours that may exclude service users from accessing services

This concern was presented to the Cardiff and Vale Mental Health Services by Housing providers and it was agreed that the Assertive Outreach Service would develop a care pathway with our partner agencies for our marginalised communities including Sex Workers and Homeless

Learning objectives

1. Developing a flexible and responsive mental health service for homeless people.

2. Developing networks with partner agencies to engage people who are considered "hard to engage.” Keywords

Mental Health, Homeless population, Assertive Outreach, Cardiff

Biography

Tara Robinson qualified with an Honours Nursing Degree in Cardiff during 2001. Since then her carer has focused on community mental health nursing. In 2010 Tara project led the development of an Assertive Outreach Service for Cardiff; this included the formation of care pathways for marginalised populations including sex workers and homeless people.

Session 6

Recovery, outcome measurement and mental health nursing

Robin Ion, Scott Hardie, Bridey Monger, Nigel Henderson and Jane Cumming

Background

Recovery and routine outcome measurement are key issues for mental health nurses. While the former has arguably become the most influential concept in mental health nursing in the last two decades, the latter is rapidly gaining centre stage as a way of tracking both service user progress and organization performance and effectiveness. As mental health nurses we have a commitment to recovery and a vested interest in understanding the concept as an outcome of our work.

Method

In this paper we describe a 12-item outcome measure that was designed by the Scottish charity, Penumbra, in order to measure recovery in mental health. We explain how the tool was developed and outline the steps taken to assess its reliability, validity and usability.

Results

We also present preliminary results, which indicate that the tool is an effective measure of recovery in mental health, and that it is easy to use for both clients and mental health workers. In addition we provide an explanation of the next steps in the process of assessing the full psychometric properties of the tool.

Discussion/Conclusion

We conclude by discussing some the challenges and benefits associated with embedding routine outcome measurement at an organisational level.

Learning objectives

1. Describe the concept of routine outcome measurement 2. Describe a tool designed to measure recovery 3. Describe the psychometric properties of the tool 4. Outline some of the organisational challenges and benefits associated with embedding routine outcome measurement.

Keywords

Recovery, routine outcome measurement, mental health

Biographies

Robin Ion is a lecturer in mental health nursing at the University of Abertay.

Scott Hardie is a senior lecturer in psychology at the University of Abertay.

Bridey Monger is a PhD student at the University of Abertay and research officer for Penumbra.

Nigel Henderson is Chief Executive of Penumbra

Jane Cumming is a senior manager with Penumbra. Session 7

Are healthcare professionals doing more harm than good? An international literature review

Kirsty Blair, Robert Gordon University

Background

The prevalence of self-harm is 20-40% higher in the psychiatric population than the general population. Self-harm in secure settings is significantly higher than the general population. Given that people in secure settings tend to have mental health problems; they have a high vulnerability towards self-harm. However, workers in secure environments often display negative attitudes towards self- harm.

Aim

This paper presents key findings from an international literature review, examining the attitudes of staff in secure settings towards self-harm.

Method

A literature search of published research and evidence was undertaken from the timescale of 1990-2013. Key terms used were forensic, self-harm, self-injurious behaviour, secure settings, attitudes, prison and custody. Articles were critically and systemically reviewed using appropriate inclusion and exclusion criteria. Key themes from chosen articles were then extracted.

Findings

Generally education on self-harm improves attitudes, profoundly impacting upon those who self-harm in secure settings. Good therapeutic relationships where healthcare professionals and clients can communicate support a positive role in prevention and reduction of self-harm. Alternatively, breakdowns in communication and labelling of clients can have detrimental effects, often exacerbating problem negative behaviours. Despite this some prisoners didn’t want a relationship with healthcare professionals, displaying an ‘us and them attitude’ whereby collaboration was not wanted or feasible.

Conclusion

Generally clients prefer responses like understanding, respect and caring. Evidence suggests that further education, for staff working with clients who self- harm, would increase positive responses. It seems that more research should be carried out in order to further determine attitudes towards self-harm in secure settings.

Learning objectives

1. Evaluate reasons behind clients self-harming in secure settings 2. Review why many healthcare professionals hold negative attitudes towards self-harm and how this can be improved.

Keywords

Forensic, self-harm, self-injurious behaviour, secure settings, attitudes, prison and custody

Biography

Kirsty has spent the last three years studying mental health nursing at the Robert Gordon University. During this time she has developed an interest in forensic mental health through placements in such areas. She also has a particular interest in challenging the stigma and labelling attached to self-harm.

Session 8

A European charter for trainers in the management of violence. Results of a Delphi exercise.

Dr Brodie Paterson1, Mr Kevin McKenna2 and Mr Vaughan Bowie3 1University of Stirling, 2Dundalk Institute of Technology, 3University of Western Sydney

Introduction

Despite European guidance regarding the content of training in the prevention and management of violence in services for people mental disorder (Council of Europe,(CoE) 2004) training practice continues to vary both across Europe and within individual states.

Aims

To establish a European consensus on best practice

Method

A Delphi technique was used. The sample were those attending a workshop at the ENTMA conference in Amsterdam in 2010. Sample size n=54. 66% male, 35% female.

Results

Table 1. below illustrates the responses to a series of statements which participants were asked to rate their agreement with using a Visual Analogue Scale. The lower the rating the higher the level of agreement. Qualitative data was also collected.

Discussion

The consensus established reflects best practice but also indicates areas of disagreement that require further exploration within and outside Europe.

Learning Points

1 Practice must reflect an awareness of the international dimension. 2 Incorporating training into a broader organisational agenda appears challenging for trainers

References

CoE, Committee of Ministers (2004), Recommendation (2004)10, CoE Strasbourg.

Table 1.

Section Mean rating

Section 1: The role of the trainer as professional

Trainers should only provide training within their scope of competence 9.2

Trainers should demonstrate their commitment to continuing professional 9.5 development

Trainers should act in a professional and ethical manner 4.09

Section 2: Training Content

Training should be located in the context of a professional relationship 13.05

Training provided should be safe, evidence based and best practice 6.3

Training provided should be needs assessed service specific and fit for 9.8 purpose

Training should be conducive with prevailing legal and ethical guidance 6.0

Training should emphasise the primacy of prevention at all levels 8.2

Section 3: The provision of training

Trainers should strive to integrate training into a broader organisational 12.7 agenda

Training should be conducted with due care to the safety of participants 5.4

Training should be conducted in a manner that recognises diversity 7.4 in all its forms

Training should be conducted in a manner that respects the dignity 5.3 of participants

Biography

Dr Brodie Paterson is a Senior Lecturer University of Stirling, Degrees in psychology, sociology, social policy and education. Chair European Network for Training in the Management of Aggression, Fellow European Academy of Nursing Scientists. Experienced researcher with record of more than published 100 articles, chapters and texts with a particular focus on violence and suicide. Current interests include gender and violence and the implications for staff training and practice, trauma informed education and practice, mindfulness based approaches to stress management.

Session 9

Mental health nurse prescribing: using a constructivist approach to investigate the nurse patient relationship.

Jane Ross, NHS Grampian/University of Aberdeen

Background The interpersonal relationship between nurses and clients is seen as the central element or core activity of mental health nursing. Concern has been expressed that nurse prescribing could have a negative impact on the nurse patient relationship and result in the nurse sacrificing nursing skills for the prescribing role.

Aim The aim of this study was to explore the nurse patient relationship in the mental health setting when the nurse is a prescriber. In order to do this a comprehensive literature review was undertaken and views of clients, nurse prescribers, pharmacist prescribers, nurse managers and doctors were explored and relationships described.

Methodology and methods

Nurse prescribers within one location were sent questionnaires to gather demographic data and basic qualitative data. Focus groups and interviews were undertaken with fifty seven participants employing a constructivist approach. A discussion guide and an iterative approach were used to clarify findings. Data analysis was guided by a Framework approach using an evolving theoretical Framework to interrogate the data.

Findings The findings revealed that the majority of participants in this study preferred to have their nurse prescribe for them and believed that nurse prescribing improved the nurse patient relationship. Trust was highly valued within the pre- established relationship and clients found nurses easier to talk to about their medication than doctors. The venue where nurse prescribers could see clients was seen as important, with many believing seeing the client in his or her own home gave added insight into other aspects of their lives. Nurse prescribers placed high importance on being able to reduce and discontinue medication. Nurse prescribers were uncomfortable with the concept of power, preferring to use the term ‘empowerment’. All groups of participants were unanimous that nurse prescribers continued to provide care and that they had not moved from a traditional ‘caring’ role to a ‘medical’ curing role.

Conclusion Rather than detracting from the nurse patient relationship, results from this study suggest that nurse prescribing enables the mental health nurse prescriber to provide more holistic care than previously.

Learning objectives

Nurse prescribing does not change the emphasis from 'care' to 'cure'. Nurse prescribing enables the provision of more holistic care.

Keywords

Mental health nurse prescribing, nurse patient relationship

Biography

Jane has worked in the field of mental health for over 30 years. Her main interests are cognitive behavioural therapy and nurse prescribing. She is an Honorary Lecturer at the University of Aberdeen and is currently a doctoral student there.

Session 10

An alternative approach to a contentious topic: Borderline personality disorder

Liz Brodie and Fiona Carver

Introduction

People who have a diagnosis of borderline personality disorder (BPD) are amongst the most marginalised and stigmatised of those who experience mental health problems. Sadly this experience can be replicated within mental health services (Westwood & Baker, 2010). A theory module for senior mental health nursing students was developed in 2012 as part of the mental health nursing programme at Edinburgh Napier University.

Aims

1) To demonstrate that educational experiences can positively influence how nurses work with people with BPD

2) To demonstrate that promoting positive mental health facilitates hope and optimism in working with this group

3) To illustrate how service users can effectively contribute to and enhance curriculum development, design and delivery

Method

The module team enlisted the involvement of service users who had produced a training resource for BPD (CAPS, 2011) in the module design and development Module content was devised and delivered collaboratively between the module teaching team and the service users

Results

The creation of a module which enshrined positive mental health promotion and recovery in working with people with a diagnosis of BPD

Discussion/ Conclusion

Students, lecturers and service users alike found this to be a refreshing and challenging way of working. There were some issues in synthesising what felt like three distinct but related elements of teaching (BPD, health promotion, clinical skills development) This module is ground breaking in its capacity to fully utilise and embrace the service user experience in a way that enables nurses to enhance and develop their values, skills and attitudes toward mental health and well being

Learning outcomes

1) Discuss the impact of the collaborative engagement of module teaching staff and service users in module design, development and delivery

2) Evaluate the impact of positive health promoting approaches to working with service users with a diagnosis of borderline personality disorder Two things you will learn

How to meaningfully involve service users at the forefront of module development and delivery

How to develop a more service user centred way of working with people who have the diagnosis of borderline personality disorder. (350 words)

References

CAPS Independent Advocacy (2011) Much more than a label: A resource about personality disorder by people by the lived experience. Edinburgh: NHS Lothian

Westwood, L. & Baker, J ( 2010) Attitudes and perceptions of mental health nurses towards borderline personality disorder clients in acute mental health settings: a review of the literature Journal of Psychiatric and Mental Health Nursing, 2010, 17, pp657–662

Biographies

Liz Brodie works in the mental health teaching team at Napier University. She has extensive experience of acute mental health and working with those with severe and enduring mental health problems. Later work in a substance misuse team has stimulated an interest in the interface between mental health and primary care workers. She is specifically interested in substance misuse in pregnancy, perinatal mental health and developing substance misuse education for student nurses across all fields of practice and practitioners in all health and social care settings.

Fiona Carver trained initially as an adult nurse and then as a mental health nurse before working in mental health in various roles for several years. She was seconded to Edinburgh Napier University in 2005 and subsequently got a permanent job there. She recently achieved an MSc in brief intervention Psychological Therapies. Her interests are psychological interventions; primary care mental health; student mental health and wellbeing.

Session 11

A Life Interrupted: Hermeneutic phenomenological study of the lived experiences of informal caregivers of a relative with bipolar disorder. Mr Lee Boag, Dr Mary Addo, Professor Susan Klein and Dr John Love, Robert Gordon University

Approximately 14% of the UK population provide regular care for a family member or friend. Despite the crucial role they play as part of an “invisible” healthcare system, informal caregivers have become a forgotten and potentially vulnerable group within their own right. Informal caregivers experience increased risk of physical and psychological difficulties; financial and occupational disruption reduced quality of life and increased rates of suicide. Due to the chronic and dynamic nature of Bipolar Disorder (BD), caregivers for this condition are at a further increased risk of these consequences. Little focus to date has investigated the informal care-giving role in regards to BD and those that do delineate the hardships but have scarcely suggested how to improve the health and wellbeing of those in the role. There is a highlighted need for a targeted intervention for informal caregivers of persons with BD and it has been recognised that a prerequisite for this requires exploration of the lived experiences of this population. This paper presents a completed first phase of a PhD study which is part of an on-going project to develop an intervention for the informal caregivers of BD. Phenomenological interviews were conducted with six people who cared for a relative with BD and the transcripts were analysed using Gadamerian hermeneutics. The results provide in-depth and previously unreported lived experiences that could provide a basis for targeted interventions and evidence based practice in regards to caregivers for BD.

Learning objectives

1) The consequences of the informal care giving role for a relative with Bipolar Disorder.

2) The importance of understanding lived experiences in intervention development with regards to a whole state approach.

3) The benefits and utility of hermeneutic phenomenology in mental health research to uncover these experiences.

Keywords

Informal care, bipolar disorder, hermeneutic, phenomenology

Biography

Lee Boag has a background in psychology, has worked in both community and residential settings in the role of mental health support worker and has experience in counselling work. He has been a research assistant at the University of Aberdeen, Aberdeen Royal Infirmary and the Royal Aberdeen Children's Hospital. He is currently studying for his PhD through the Institute of Health & Welfare and is working on developing and piloting a self-care intervention for the informal caregivers of a relative with bipolar disorder.

Session 12

Systematic review of the impact on the mental health of adolescents with sickle cell disease during transition from paediatrics to adult healthcare

Dr Winifred Eboh, Dr Catherine Rolland, Professor Edwin van Teijlingen

Background

Sickle cell disease (SCD) is a clinically complex disorder which can have a profound effect on physical and mental wellbeing at every stage of life. From as early as the first year of life, children with sickle cell disorders can experience painful vaso-occlusive crises (obstruction of blood vessels by sickle cells preventing free circulation of oxygenated blood) often requiring repeated hospitalisation for analgesia. Children are at risk of life threatening sickling (a process whereby red blood cells change into a sickle shape becoming rigid and not negotiating finer capillary networks and preventing the free from of oxygenated blood to surrounding tissues) in organs such as the lungs, spleen and cerebral vasculature. Stroke in children is a devastating complication and “silent” infarcts, as evidenced by MRI of ischaemia, are seen in around 20% of children with sickle cell and are associated with poor performance in neuropsychological testing. Research has also shown that these children experience extreme emotional and psychological morbidity, especially at the point of transition from childhood to teenage years.

Aim

This systematic review will examine studies and literature that explore some of these issues with the aim of eliciting a comprehensive dossier of how best to approach this critical time of adolescence to young adulthood in children with SCD.

Method

Scoping of existing literature suggests that mental well-being although widely researched for this client group have not been properly addressed in terms of care provision.

Outcome

It is important to establish to what extent mental illness occurs in this population; how it manifests itself and recognised; what are the existing management options for children with SCD displaying mental health illness and how this is received by affected populations.

Learning objectives

1. To identify the extent of mental health morbidity in children/adolescents with SCD, and understand how it manifests itself and is recognised.

2. To be aware of management options for children with SCD displaying mental health illness and how this is received by affected populations.

Keywords

Sickle cell disease; mental health; children and adolescents; transition

Biographies

Dr Winifred Eboh is a senior lecturer at the School of Nursing and Midwifery at the Robert Gordon University with over 20 years experience in haemoglobinopathy counselling and currently involved in research in this field.

Catherine Rolland is an expert in obesity and its related co-morbidities within RGU’s Institute of Health and Welfare Research. She has carried out a number of dietary intervention studies investigating the effects of weight loss on resting metabolic rate, body composition, glycaemic status and cardiovascular risk. She has currently taken an interest in developing her skills in qualitative research.

Edwin van Teijlingen is a Professor of Reproductive Health Research at Bournemouth University. He is trained as a medical sociologist and has an interest in mixed-methods research, qualitative research and evaluation research. A large share of his academic work has been in the field of either Public Health or the Organisation of Maternity Care and has substantial research experience in conducting large-scale comparative studies, often using mixed- methods approaches. Session 13

Why are all the restraint trainers men?

Dr Brodie Paterson1 and Mr Vaughan Bowie2 University of Stirling1, University of Western Sydney2

Introduction

The mental health nursing workforce in the UK is predominantly female. This should be reflected in the composition of the restraint trainer workforce. The development and dissemination of structured training in restraint in health, care has though historically been characterised by an overwhelming predominance of men.

Aims / questions

Are there barriers to participating in participating in restraint instructor training for women?

Does the dominance of men in the development of training have a negative or positive impact for those women who receive training?

Method

The study (part of larger project) comprised semi structured interviews with 4 women who had experience of physical intervention training and its use. Interviews were recorded and transcribed and analysed thematically using the six phase process identified by Braun and Clarke (2006).

Results

Two of the four women in the sample interviewed disclosed that they had previously experienced violence and aggression from males in a domestic context and one women disclosed she had experienced sexual abuse as a child. Four themes were identified in the analysis.

Theme 1 ‘Men and women think about violence differently’.

Theme 2 ‘Macho and non Macho Training Programs’

Theme 3 ‘Active and Passive Resistance’

Theme 4 ‘Training as a positive experience’

Discussion

Gruber (1998:302) has described normative dominance as a process whereby one gender exerts greater control and influence over the other in a given area. Understanding why this process has occurred may however enable such dominance and its consequences to be addressed more effectively.

Learning Points

1. The implications of gender would appear to have received insufficient attention in the design and delivery of training in restraint. 2. Training in restraint must reflect an awareness of the potentially high prevalence of abuse in training participants.

References

Braun V. and Clarke V. (2006) Using Thematic Analysis in Psychology, Qualitative Research in Psychology, 3, 77-101.

Gruber J. (1998) The Impact of male work environments and organizational policies on women’s experience of sexual harassment, Gender and Society, 12(3), 301-320

Biography

Session 14

Psychological wellbeing following miscarriage

Anne Marie Rennie

Background

Miscarriage is common, affecting 10 to 20 % of all pregnancies (Prenderville, 1997), and 25%-50% of women (Rai & Regan, 2006). The role of promoting wellbeing is becoming a greater responsibility for midwives (Scottish Government, 2011). Greater knowledge is needed in relation to support strategies that develop psychological resilience and greater coping ability, and ultimately to enhanced wellbeing with women who experience miscarriage. There are indications that a high degree of anxiety leads to shifts in the immunological and neuroendocrine balance and that a miscarriage can be triggered by means of this mechanism (Arck et al., 2001). This suggests that women, who have high anxiety in the next pregnancy, may be at risk of suffering another miscarriage (Cumming et al., 2007). Not all women suffer from grief, depression or anxiety following miscarriage therefore, it is important to identify potential moderating and protective factors. One way to examine this is to take a salutogenic perspective, rather than study causes of disease, it focuses on unravelling the mystery of health, and is an attempt to address how people manage life events and stay well (Antonovsky, 1987).

Aim

The aim of this research is to examine how women adjust psychologically following miscarriage, examining the moderating effects of locus of control and social support.

Method

The study uses mixed methodology, starting with a prospective comparative study, to examine protective factors in relation to psychological wellbeing, and see if these protective factors remain consistent over time. Understanding how women enhance wellbeing following miscarriage complements knowledge on risk factors for maladjustment.

Findings/ Impact

Findings from the quantitative study will be further explored in 2013 in a qualitative in-depth study using Framework Analysis and will be of value in informing the development of more tailored support. The research has full ethical approval.

Biography

Anne Marie Rennie is a Midwifery Lecturer at Robert Gordon University and was awarded a PhD studentship in 2010 to examine Psychological Wellbeing Following Miscarriage. She is particularly interested in research related to enhancing the health and wellbeing of women and their families and was attracted to the PhD studentship, which is topical and highly relevant for the midwifery profession. She is an active member on the editorial board for ‘The Practising Midwife’ Journal. Session 15

Missing an opportunity: Exploring the importance of mental health in cases of missing persons

Penny S. Woolnough, Grampian Police

Background

Estimates indicate the UK police receive in the region of 327,000 reported incidents of missing people per year representing approximately 216,000 individuals1. While research suggests those living with a mental illness are one of the groups most at risk of going missing2, what we currently know about missing persons and mental health is extremely limited. Where some studies have looked at patients missing from care, no single study has specifically investigated the relationship between mental health and missing.

Aim

Given the size of the missing person problem nationally, the study described here aims to fill a significant gap in knowledge by examining the nature and prevalence of mental health issues in the missing person population as well as exploring the potential impact of mental health on whether people who are recorded as missing are eventually found and the extent to which providers of mental health services are involved in missing episodes.

Method

In order to achieve this, a content analysis of 2198 closed missing person reports (adults and children) from 22 UK police forces was undertaken.

Results

Findings from this exploratory study suggest that mental health problems are more prevalent in the missing person population than the general population and that there are opportunities for improved understanding and response to this vulnerable group by police, health and social care practitioners in terms of recognising, reporting and preventing people from going missing.

Learning outcome

Delegates will learn key empirical findings from the study, their potential implication for policy and practice and recommendations for further research and development in this area.

References

1NPIA (2011). Missing Persons: Data and analysis 2010/2011, National Policing Improvement Agency.

2James, M., Anderson, J. & Putt, J. (2008). Missing Persons in Australia. Research and Public Policy Series. Canberra, Australian Government.

Biography

Penny Woolnough is Senior Research Officer at Police Scotland, a Registered Forensic Psychologist and a Fellow of the International Academy of Investigative Psychology. One of her main areas of research centres on the behaviour of missing persons and police investigations.

Session 16

A FIRST FOR THE ORCHARD CLINIC! Developing peer education in a secure setting

Dr Fiona Macdonald, Dr Susan Pollock and Mr Trevor Jones, NHS Lothian

Lothian’s groundbreaking ‘S1 to S5’ recovery workshops are now at the Orchard Clinic (OC). The peer education workshops are led by people who have personal experience of recovery from mental health challenges.

To share ideas and tools for recovery in this medium secure setting, facilitators build on developmental work by previous S1 to S5 participants, people who are past and current OC patients and the support of NHS Lothian staff. ‘Use of self’, recovery education, the ability to share personal learning and to make changes responsively are central to each session.

Planning evolves collaboratively in small groups, involving S1 to S5 facilitators, a planning group member who has experience of being an OC in-patient, an occupational therapist and OC nursing staff. Support and supervision for sessions is provided by the Lothian Recovery Network (LRN) training and development worker and is external to the Orchard Clinic.

Our paper describes key aspects of learning from workshop development and content. Creative flexibility and trust are central to overcoming potential barriers and promoting recovery and peer values in this context. The workshops are also an introduction to WRAP (Wellness Recovery Action Planning) and other person centred planning and recovery tools, available at the OC from trained WRAP facilitators.

We aim to bring focus to what each of us learns individually from lived experience, how we contribute and how we can share our learning through peer education. Hope, challenges, strengths and recovery are a bridge to learning within the OC, to connections with peers beyond the OC and to opportunities and resources in the community. Participants are proud of what we have achieved. The workshops are evaluating well, with rich learning insights.

References

Faulkner, A. & Kalathil, J. (2012). The Freedom to be, the Chance to Dream: Preserving User-led Peer Support in Mental Health. London: Together.

Copeland, M. (2002). Wellness Recovery Action Plan. Vermont: Peach Press.

Biographies

Dr Fiona Macdonald is interested in the development of learning about recovery from lived experience. Her experience includes ongoing personal recovery and co-facilitating peer education in small groups, past hospital and community nursing and research.

Trevor Jones is a Senior Charge Nurse in The Orchard Clinic, a “medium secure unit”, in Edinburgh. He has been involved in promoting recovery focused services since 2005. Session 17

An evaluation of fast track access to novel psychological therapies for adult survivors of childhood sexual abuse.

Dr Brodie Paterson1, Mr Sandy McComish1, Ms Therese McGoldrick2, Mrs Janine Rennie3 1University of Stirling, 2Forth Valley Health Board, 3Open Secret

Introduction

Many survivors of childhood sexual abuse find talking therapies very difficult because they cannot verbally recount their experiences or find giving their accounts acutely distressing. NHS FV has been at the forefront of researching and pioneering “non talking” therapies, so was uniquely placed to pilot fast track access to a Survivors Trauma Service in partnership with Open Secret

Aims

To evaluate the effectiveness of fast track access to two novel psychological therapies for adult survivors of childhood sexual abuse

Method

Eye Movement Desensitization and Reprocessing (EMDR) and Emotional Freedom Therapy (EFT) were delivered by three experienced nurse psychotherapists trained to deliver both interventions. Each therapist offered both treatments. Treatment sessions were conducted individually. In order to comply with the NICE (2005) guidelines for the treatment of PTSD, up to eight sessions were offered as part of the project. Each therapy session lasted up to 1 hour. Pre- and post-treatment and follow – up assessments were conducted using 3 self rating measures, PTSD Checklist (PCL-C) the Impact of Events Scale (IOE) and the Hospital Anxiety and Depression Scale (HADS).

Results

A total of total of 26 participants were eligible for the project, consented to participate and started treatment. Of these 9 had EMDR alone, 7 had EFT alone and the remaining 10 had a combination of both therapies. Pre to post all three variables PTSD, IOE & HADS – showed significant positive change.

Discussion

Access to treatment was associated with a significant improvement in symptoms on all measures for the patients who completed treatment. Such findings confirm previous research suggesting that EMDR is a potentially effective treatment for PTSD and other symptoms in adult survivors of childhood sexual abuse However; they also suggest that EFT a newer and more controversial therapy may be as effective as EMDR and perhaps even more effective in treating symptoms of PTSD.

Learning Points:

1. EMDR and EFT may offer effective treatments for adult survivors of childhood sexual abuse. 2. Fast track access to effective treatments can produce significant improvement in psychological symptoms.

Biography

Session 18

Military veterans who offend: do their mental health, drug or alcohol problems differ from other offenders? A summary of the findings from a wider systematic review.

James Taylor, University of Stirling

Introduction

Media reports of recent military conflicts, such as Iraq and Afghanistan, has raised awareness the dangers of serving in the armed forces and the difficulties some military personnel experience after leaving active service. Whilst the majority of military personnel manage the transition back to civilian status some experience difficulties and there is concern that some, in particular those with mental health, drug or alcohol problems, may subsequently come into contact with criminal justice services. But, how different are the rates of mental health problems found in military offenders with that of other offenders, in what other ways do they differ and how has this changed over the years?

Aim

To identify how military veteran offenders who have mental health, drug or alcohol problems differ from other offenders and whether there has been any change over time.

Methods

As part of a wider systematic review, examining military veterans with mental health problems contact with justice systems, international literature, dated between 1939 to 2011, was searched. For details of the full systematic review protocol see Taylor et al (2012). Identified literature was heterogeneous preventing statistical or thematic analysis however a narrative summary was obtained.

References

Taylor, J., Parkes, T., Haw, S. & Jepson, R. (2012) Military veterans with mental health problems: a protocol for a systematic review to identify whether they have an additional risk of contact with criminal justice systems compared with other veterans groups. Systematic Reviews 1:53 doi:10.1186/2046-4053-1-53

Learning outcomes

1. Delegates will be made aware how, as identified in the international literature reviewed, the rates mental health, drug and alcohol problems differ between offenders who have previous military services and those with no military service. 2. Delegates will hear, as identified from the international literature, how personal characteristics; mental health, drug and alcohol; and offending histories differ between military veteran offenders and non-military veteran offenders, and will have a greater understanding on whether mental health problems contribute to military veteran offending.

Biography

James Taylor is a mental health nurse who has had many years’ experience, at local and national levels, working within public and private sector health/ social care arenas. This includes working with people who experience psychological trauma or those who come into contact with the criminal justice system. The former Mental Health and Suicide Risk Management Advisor for the Scottish Prison Service teaches on the School’s undergraduate and postgraduate nursing courses and is currently in his final year of PhD study examining the needs of military veterans with mental health, drug and alcohol problems in the Scottish prison system.

Session 19

Service users’ involvement in mental health nurse teaching and recruitment.

Billy Mathers, John Green, Christine Robertson and Bob Porter

Introduction

Service users have a unique contribution to make in both the recruitment and teaching of undergraduate mental health nurses. The Paisley Association of Service Users and Carers (PACS) have been involved in this process at the University of the West of Scotland (UWS) for the past three years and have made a significant contribution to the success of the undergraduate mental health nursing programme.

Aims

This presentation will give an account of an evaluation of the PACS’ involvement and their feelings about their contribution and how this aided their recovery.

Method

An audio recorded focus group was conducted to illicit PACS’ thoughts and feelings in regard to their involvement in teaching and recruitment at UWS.

Results

The opportunity to be involved in recruitment interviews gave service users a sense of ownership of the student programme. They felt valued by students in the teaching which they undertook and students indicated to them that their teaching added another dimension to programme.

Discussion

Service user involvement is a key component in nurse education (McAndrew and Samocuik 2003, Mental Health Foundation 2003) and this study highlights its importance to service users. In recruitment their intuitive feelings about applicants to new programmes at the interview stage makes them an invaluable part of the recruitment process. In teaching, students benefit from their authentic account of the psychological problems encountered over the course of many years which are often more poignant than the perceived ‘second hand knowledge’ of academic or clinical staff. More significantly, the process has benefitted the service users themselves as they feel valued and appreciated in their continued journey towards recovery.

References

McAndrew, S. & Samocuik, G. A. (2003) Reflecting together: developing a new strategy for continuous user involvement in mental health nurse education. Journal of Psychiatric and Mental Health Nursing, 10, 616–621.

Mental Health Foundation (2003) Surviving User-led Research: Reflections on Supporting User-led Research Projects. London: Mental Health Foundation

Learning objectives

1. Audience could learn what service users give to students and also what they gain from the process in return.

Keywords

Service users, Education, Mental health Biography

Dr Billy Mathers has 26 years of mental health nursing experience including working in forensic units and CMHTs. The last 17 years have been in teaching in higher education. His most recent research has been evaluating psychosocial skills for acute psychiatric wards and service user involvement in nurse education.

Session 20

The Right to be Heard! Review of the quality of mental health advocacy in England

Karen Newbigging and Julie Ridley, University of Central Lancashire

Introduction

Independent advocacy has the potential to enhance personal agency and recovery. Independent Mental Health Advocates (IMHAs) are a specialist type of mental health advocate, granted specific roles and responsibilities under the Mental Health Act, 2007 to safeguard the rights of people detained under the legislation. In 2010, the Department of Health commissioned research into the quality and implementation of IMHA services.

Study Aim To review the extent to which these services were providing accessible, effective, and appropriate support to qualifying patients, and to understand the factors that influence this.

Methods

A multi-method study involving: • Eleven focus groups with IMHA users, IMHA services, mental health professionals and commissioners • Shadow visits to IMHA services • Eight case studies of the access, uptake and experience of IMHA services. Results

Access and uptake of IMHA services varied considerably and is problematic for marginalised groups. The quality and effectiveness of IMHA was, to a large extent, linked to the extent to which mental health services staff appreciated and understood advocacy. Once service users access the service it is highly valued but its impact is limited by IMHA capacity and the organisational culture of mental health services.

Conclusions

The IMHA role was highly valued by service users, although its full potential had not been realised. Mental health services need to develop a more positive predisposition towards advocacy, distinguishing between independent advocacy and ‘best interests’ work. The emancipatory and transformative potential of advocacy depends upon the willingness of mental health services relating constructively to the challenges posed.

Reference

Newbigging, K., Ridley, J., Mckeown, M., et al. (2012) The Right to Be Heard. Review of the Quality of Independent Mental Health Advocate (IMHA) Services in England. Preston: UCLAN.

Learning outcomes

1. Increase participants’ knowledge of the role of independent advocacy and the impact on its quality of the context and relationship with mental health services

2. An awareness of the action that mental health professionals, service users and their families can take to promote the implementation of effective advocacy and move closer to practice that supports self-determination.

Biographies

Karen Newbigging is a Principal Lecturer in the School of Health at UCLAN. She led the first national review of Independent Mental Health Advocacy for the Department of Health in England and has previously undertaken research in relation to mental health advocacy and African and Caribbean men.

Dr Julie Ridley is Senior Research Fellow in the School of Social Work at UCLAN. Julie led on the Scottish Government research on early implementation of the Mental Health (Care & Treatment) (Scotland) Act 2003, and was part of the UCLAN team reviewing IMHA alongside Karen Newbigging.

Workshop presentations 1-5

Workshop 1

Acute mental health nurses’ experiences of clinical supervision (CS) in promoting their wellbeing in their workplace: a systematic review.

Dr Mary Addo, Dr Audrey Stephen and Pamela Kirkpatrick, Robert Gordon University

Introduction

The nature of nursing work is stressful, and the most common reason for long- term sick leave is depression caused by burnout. Particular concerns have been raised in acute mental health care settings. Consequently, there is increased interest in promoting health and well-being in staff. CS is a process of support which fosters professional and personal development.

Review question

What are the experiences of acute mental health nurses of clinical supervision in promoting their wellbeing in their place of work?

Objective

To systematic review and synthesise the best available qualitative evidence on the positive aspects of clinical supervision for acute mental health nurses.

Methods

Identification, data extraction and critical appraisal of qualitative research studies on the topic took place. Joanna Briggs Institute methods and software were used to facilitate the review.

Results

Database searches identified thirteen studies that fitted the review criteria, of which two were assessed as good quality research for inclusion in the review. The studies showed that:

a) CS benefits psychological and physical well being of nurses;

b) Reflection within CS allows nurses to ventilate frustrations and explore feelings;

c) Sharing experiences is affirming and allows nurses to continue in their roles;

d) There are many barriers to participating in CS and these should be managed to enable nurses to benefit.

Discussion/Conclusion

Mental health nurses in acute settings gain positive outcomes from participating in CS, including improved feelings of well being and positivity about their worth as members of the ward team. Opportunities to include CS in ward routines should be explored and staff supported to participate. Ideas for further research will be discussed in the session. Learning outcomes for audience

1. Raised awareness in mental health nurses, particularly those working in acute settings, of how the working environment affects their well being and functioning at work and in their personal lives.

2. For managers in acute mental health care settings to:

a) identify the benefits of offering CS to staff

b) to encourage exploration of opportunities to introduce CS in units

c) reduce deterrents to nurses participation in CS.

References

Currid, T. (2009) Experiences of stress among nurses in acute mental health settings. Nursing Standard, 23, (44):40-46.

The Scottish Government (2009) Health Works: A Review of the Scottish Government’s Healthy Working Lives Strategy. Scottish Government: Edinburgh.

Biographies

Dr Mary Addo is a lecturer with 30 years experience in mental health nursing including working in acute, rehabilitation, care of the elderly and forensic care settings. The last 11 years relates to teaching across pre and post registration courses in the School of Nursing and Midwifery at Robert Gordon University. She is a member of the university’s Institute for Health and Welfare Research, supervises research students, involved in research, and has academic publications on forensic and mental health nursing practice.

Dr Audrey Stephen is a research fellow in the School of Nursing and Midwifery and a member of the Institute for Health and Welfare Research at Robert Gordon University. She has a specialist research interest in bereavement and bereavement care.

Pamela Kirkpatrick is a Lecturer and Course Leader in the School of Nursing & Midwifery teaching across pre and post registration courses. Within her CPD remit she also has a focus on developing education for Remote Healthcare Practitioners. She is also a member of the Institute for Health and Welfare Research where she is the Director of the Scottish Centre for Evidence-Based Multi-Professional Practice, an affiliate centre of the Joanna Briggs Institute, having a focus on training and undertaking Systematic Reviews of healthcare research. Pamela is currently undertaking a PhD study on COPD in working age people from a mental health and well being perspective which considers resilience promoting factors.

Workshop 2

Values based and recovery focused practice in Scottish mental health nursing: where are we now?

Dr Colin Macduff and Shuai Ziying, Robert Gordon University

Background

In 2006 Rights, Relationships and Recovery set out a bold new agenda for Scottish mental health nursing that set values-based and recovery-focused practice as its foundation. While nursing staff were the main focus, in that all were to undertake values-based training, the initiative’s training resources were seen as being open and applicable to all mental health workers. Based on a cascade model, first phase training centred on the 10 Essential Shared Capabilities, while the second phase focused on facilitation of recovery. A national evaluation of the training and its initial impact was undertaken (Macduff et al 2010), but it is unclear to what extent lasting progress has been made. This workshop has two main elements. Firstly, the presenters will offer an analysis and synthesis of the initiative, based on the national evaluation. This will serve to inform conference participants and call to mind issues of relevance to the promotion of mental health. The second part of the presentation will invite interaction from participants by asking them to share their perceptions of the progress of values based and recovery focused practice in, and beyond, mental health nursing since 2010. This will be facilitated by using two typologies of practice that emerged from the evaluation, so that issues of development, legacy and sustainability are explored. In this way it is hoped to enable a session of interest to a wide range of conference participants. In doing so, the workshop will have relevance to all the conference topics, but particularly to the topic of workplace.

References

Macduff, C et al (2010) An Evaluation of the Impact of the Dissemination of Educational Resources to Support Values-Based and Recovery-Focused Mental Health Practice. Report for NHS Education for Scotland. The Robert Gordon University, Aberdeen.

Scottish Executive Health Department (2006) Rights, Relationships and Recovery. The Report of the National Review of Mental Health Nursing in Scotland. Edinburgh: Scottish

Learning objectives

1) Participants will be able to identify main features of the VBT and RF initiative in Scotland from 2006-2010 2) Participants will be able to share critical analyses and reflections on progress since 2012

Keywords

Values based practice; recovery; evaluation; sustainability

Biographies

Colin Macduff is Reader in Nursing at RGU. He has a background in mental health nursing and extensive experience of evaluation research.

Shuai Ziying (Suzy) is currently undertaking a doctoral study of policy to practice initiatives in Scottish NHMAHPs during the past 6 years.

Workshop 3

Joining Forces - Collaborative police and nurse practice and education to support those with mental health needs

Inga Heyman Prof. Brian Webster, Gavin Innes

Background

The number of people coming to police attention with complex mental health and public protection needs has increased dramatically over the past decade. Internationally interdisciplinary police and nurse practice has developed to more effectively support this group driving advancement in new nursing roles working alongside the police. Innovations in interdisciplinary education have helped to broaden understanding of interagency roles and relationships in promoting workforce partnership.

Aims

This workshop explores international and local police and nursing collaborations in the context of Adult Support and Protection in mental health practice. During the workshop participants will get the opportunity to explore a virtual police custody suite to support police and health practitioner education.

Method

There will be three parts to this workshop:

1. Findings of an international systematic literature review of collaborative education and practice will be presented 2. Approaches to local interdisciplinary education will be discussed. 3. Development and application of a virtual police custody suite as an educational tool will be discussed.

Outcomes

Workshop participants will develop their understanding of international integrated police/nursing models of practice and education, to more effectively support police officers, health practitioners and those with public protection needs coming to police attention. Locally driven collaborations between police and Robert Gordon University will be examined and new opportunities investigated. Participants will actively participate in and explore a virtual police custody suite as a learning tool for police and heath education.

Conclusion

Insights will be made into novel approaches to collaborative police and health practitioner education and practice.

Impact on practice

Opportunities to advance collaborative police /nursing practice and education lie in partnership funding, working and training. Interactive activities promote quality and effective learning outcomes. Therefore, Inter-professional education and the use of innovative teaching tools can significantly improve outcomes for those requiring public protection. References

GLEN, S. and MOULE, P., eds., 2006. e-Learning in Nursing. Basingstoke: Palgrave Macmillan.

MACARTHUR FOUNDATION, 2009. Law Enforcement Responses to People with Mental Illness. A Guide to Research-Informed Policy and Practice. Justice Centre. The Council of State Governments.

Biographies

Gavin is an e-Learning Adviser at the School of Nursing & Midwifery. His primary role is to support staff and students using technology in teaching and learning such as CampusMoodle, ePortfolio, and the Personal Response System. In addition, he develops interactive online learning materials, supports the use of audio & video equipment, provides staff development and maintains the school web site.

Workshop 4

Forum Theatre to resolve conflict between nursing students and their mentors

Melanie D’Ardis, Karen Shanahan, and Suzanne Barclay, Buckinghamshire New University, Oxford road, Uxbridge, Middlesex

Background

A common discussion among nursing students involves their relationship with their mentors while on placement. It is not unusual for challenges and difficulties to arise, which, if not properly addressed, can impact on the confidence of the students and mentors alike. Whether these issues are the result of personality clashes or because of the pressures of the environment – usually a hospital ward – they need to be addressed effectively to ensure that the processes of learning and teaching are not detrimentally undermined.

Using Forum Theatre, based on the work of Augusto Boal, our workshop aims to demonstrate how some of these particular concerns can be explored and overcome. To this end, the workshop will begin with an introduction to the theoretical underpinnings of this approach, as well as a brief discussion about how forum theatre has been applied in other contexts, including educational settings, prisons and in therapeutic group work. A demonstration of the technique will follow. A scenario will be performed and the audience will be invited to participate in the resolution of the problem presented.

Before inviting questions and further discussion, a review of methods of evaluating the efficacy of this approach to problem-solving and conflict resolution will be presented.

Learning Outcome

By the end of the workshop, the audience will have an understanding of the origins of Forum theatre, its applications and the opportunities available therein, and an awareness of developments in quantitative research methodologies that underpin much of the evaluation of the work.

References

Boal, Augusto (1992) Games for Actors and Non-actors. London: Routledge

Baillie, L & Gallagher, A (2012) Raising Awareness of Patient Dignity. Nursing Standard. 27. (5)

Biography

Melanie – The thesis of the Masters degree I completed at Manchester University was an evaluation of a drama programme I helped to develop, that focussed on preparing male prisoners for employment after release. I went on to work in substance misuse services for ten years, with a special interest in Criminal Justice issues and mental health in addiction. I am currently on a secondment to complete postgraduate studies in Mental Health Nursing at Buckinghamshire New University. Workshop 5

The HEI-R: a potential tool for developing Recovery Focussed Practice in HEI’s?

G. McIntosh1, M. McCraig2, L. McNay3 and V. Howatson4

1ENU, 2UWS, 3UWS, 4GCU

The aim of this presentation is to highlight the work of the HEI Scottish User and Carer Involvement group. The group have been working in partnership with SRN to develop a tool which could enable Higher Education Institute’s (HEIs) to audit and develop their practices in terms of promoting a recovery based approach to mental health education.

This abstract would be linked to the topic of “Workplace” for this conference as it is proposed that through the development of this tool there would be opportunities to model best practice and be seen as part of the ‘recovery jigsaw’ that includes universities, service providers, service users, carers, students, and the wider public.

This paper sets out to propose that Higher Education Institutions (HEIs) need to audit and further develop their practices in relation to promoting recovery. This recognises that HEIs are part of the ‘recovery jigsaw’ of promoting recovery focused practice/services, given that the preparation of student mental health nurses is a shared responsibility between HEIs and service partners. In practice within Scotland the Scottish Recovery Indicator 2 (sri2) (Scottish Recovery Network (SRN), 2012) is being rolled out across NHS services to promote service development in recovery focused practice as outlined in the Mental Health Strategy for Scotland (Scottish Government, 2012). We are proposing that a similar tool be developed for HEIs. Mental Health lecturers need to further develop/demonstrate what they teach in terms of role-modelling recovery focused practice and they require systems within HEIs to support this endeavour.

It is argued that this tool could promote an effective teaching and learning climate which promotes real opportunities for developing and reinforcing values based practice by effective role modelling.

This presentation will describe the development of the tool so far and promote discussion and debate around the reality of using this to develop a recovery focus to mental health nurse education in Scotland.

References

NHS Education for Scotland (2008) The National Framework for Pre-registration Mental Health Nursing Programmes in Scotland. Edinburgh: NES

NHS Education for Scotland (2012) The National Framework for Pre-registration Mental Health Nursing Field Programmes in Scotland. Edinburgh: NES

Scottish Executive (2006) Rights, Relationships and Recovery: The Report of the National Review of Mental Health Nursing in Scotland. Edinburgh: Scottish Executive Scottish Government (2012) Mental Health Strategy for Scotland: 2012-2015. Edinburgh: Scottish Government

Scottish Recovery Network (2012) SRI 2 available www.sri2.net

Biographies

Gwenne McIntosh, Lecturer, (Mental Health) Edinburgh Napier University.

Marie McCaig, Lecturer, University of the West of Scotland.

Lisa McNay, Lecturer, University of the West of Scotland.

Val Howatson, Lecturer/Pathway Lead (Mental Health) Glasgow Caledonian University.

The presenters are lecturers in Higher Education Institutions (HEIs) who are members of a national group who meet to promote the meaningful involvement of service users and carers in the design and delivery of pre-registration and post-registration mental health nursing programmes. We also aim to Identify and disseminate examples of good practice in service user and carer involvement in education to inform development on a national basis.

Currently the group has been developing a Mental Health Education – Recovery Indicator Tool (MER-RIT) in partnership with John McCormack from SRN as part of their on-going commitment to meaningful partnership.

Poster presentations 1-7

Poster 1

First Aid without the Plasters: The student experience of Applied Suicide Intervention Skills Training (ASIST)

Inga Heyman, Kirsty Blair and Katie Stevenson School of Nursing and Midwifery, Robert Gordon University

Background

Suicide remains a global public health issue and a major governmental concern. The World Health Organisation advises that there must be continued investment in education for frontline professionals and caregivers. Efforts should continue to focus on increasing the uptake of training among key groups such as GPs, A&E staff, mental health nurses and substance misuse workers. This direction is reflected in The Nursing and Midwifery Council Nursing Standards who advise that: Mental health nurses must work proactively and positively with those who are at risk of suicide or self harm and use evidence based models of suicide intervention and prevention and harm reduction to minimise risk

Robert Gordon University introduced the ASIST in the stage two BN (Mental Health) nursing curriculum to support understanding of the complexities of suicide whilst developing skills to intervene with those considering suicide.

Aim

To make explicit through a phenomenographical study the student experience of suicide intervention education in the undergraduate curriculum to support potential expansion across other undergraduate nursing and midwifery fields of practice.

Method

The students experiences were illuminated through two focus groups. Thematic analysis illustrates their understandings which are supported with verbatim accounts will be presented.

Findings

Five dominant themes arose through the students narratives.

1. The emotional impact on students with negative and positive consequences 2. Workshop structure, facilitation and peer bonding supported positive learning experiences 3. The bridging of theory to practice was made allowing students to feel confident to work with those considering suicide 4. The development of class cohesion and trust, positively influencing current and future learning 5. The desire by students to build on suicide intervention skills throughout the curriculum with introduction in stage one, intermediate skills in stage two and advanced learning in stage three

Recommendations

1. To develop ASIST workshops across all stage two Nursing and Midwifery fields of practice 2. Provide a progressive range of suicide intervention skills based programs developed across the curriculum.

References

NURSING AND MIDWIFERY COUNCIL, 2010. Standards for Pre-registration Nurse Education. London: Nursing and Midwifery Council.

THE WORLD HEALTH ORGANISATION, 2012. Public Health Action for the Prevention of Suicide:A Framework. Geneva: The World Health Organisation.

Biographies

Kirsty Blair has spent the last three years studying mental health nursing at the Robert Gordon University. During this time I have developed an interest in forensic mental health through placements in such areas. I also have a particular interest in challenging the stigma and labelling attached to self-harm.

My name is Katie Stevenson and I am a third year Mental Health Nursing Student at Robert Gordon University in Aberdeen. Prior to becoming a Student Nurse at Robert Gordon University I lived in Inverness working as a Support Worker for Learning Disabilities. I have always worked in the care sector since the age of 17.

Poster 2

Exploring the impact of carer involvement in mental health nurse education

Gwenne McIntosh, Edinburgh Napier University

Background

Family carers are often not considered a marginalised group or a group who would be aligned with groups who experience inequalities. The 2010 Equalities Act to some extent changed this by including: protecting carers from discrimination, a “new measure” within the Act (UK Government 2010). Having worked over the past 6 years to establish more meaningful and visible carer involvement in mental health nursing education I recognised the apparent afterthought carers are given both in legislation, policy and research.

Making a difference to carers experience starts with being identified as a family carer – mental health carers are further “hidden” by the often transient nature of their caring role and by distress experienced by service users. The Carers Strategy (Scottish Government 2010) emphasises the role of health care staff in not only identifying carers but also meeting carers information and support needs. Increasing the awareness of the role and experiences of carers in nurse education has the potential to equip nurses of the future to better understand and identify carers earlier.

Aim

To provide an opportunity to explore and discuss the way in which carers are involved in nurse education and its impact on student learning.

Method

A small scale study exploring the views and perceptions of mental health student nurses of service user and carer involvement in teaching and assessment highlighted the significant impact that family carers of people who experience mental health distress can have on. It also indicated the value of both hearing carers’ accounts of interactions with service providers and viewing carers in the role of educator/assessor.

This presentation will explore the findings of this small scale study and its potential impact on practice while generating some discussion about meaningful involvement and its place within higher education. The study also considers the barriers student nurses face when considering increasing the involvement people have in mental health services.

References

Scottish Government (2010) Caring Together: The Carers Strategy for Scotland 2010 – 2015. Edinburgh. Scottish Government.

UK Government (2010) The Equality Act 2010. UK. The Stationery Office.

Biography

Gwenne McIntosh MSc, RMN, PgCert TLA. Coming from a background of community mental health nursing in Scotland Gwenne has had a varied career working in a variety of settings including the voluntary sector, community and primary care. Having concentrated primarily on working with families and carers over a number of years Gwenne is now a Lecturer in Mental Health at Edinburgh Napier University and is currently the Programme Leader for the mental health nursing pre-registration programme.

Poster 3

Clinical Supervision for Mental Health Student Nurses on placement

Liz Adams, Sandra Nicoll and Louise Robertson, NHS Grampian

Introduction

A pilot clinical supervision group was offered to 3rd year nursing students to introduce the concept of clinical supervision early in their careers and to evaluate any benefits to their clinical practice. The students were on final placements to various mental health practice locations

Rationale

There are numerous professional support systems available to student nurses throughout their training, the best known perhaps being that of Mentorship, which can never be underestimated. However, the benefits of Clinical supervision towards the maintenance and improvement of patient care has been well documented in research literature, e.g.. Butterworth et al (1997); Davey et al (2006) and is recognized by the NMC and RCN as a supportive way to facilitate learning from experience.

Method

Within NHS Grampian, a pilot clinical supervision group was offered to 3rd year mental health nursing students to introduce the concept of clinical supervision early in their careers and to evaluate any benefits to their clinical practice. The group was facilitated by 2 senior mental health nurses and ran fortnightly over a 4 month period.

Outcomes

The students learned about the concept of Clinical supervision through taking part in the group and qualitative data identified significant benefits to practice; e.g. increased ability to reflect, less afraid to challenge practice issues and now much it easier to discuss worries and concerns with colleagues and peers.

Feedback suggests an increase in self-awareness, which was evident during some discussions within the group and one student felt that Clinical supervision should be made available to all nursing students as part of their training. The authors have always recognized the richness of peer group learning and this group has confirmed this belief.

Next steps

Future aspirations are underway to create further opportunities for 3rd year nursing students, given the healthy response by participants.

References

Butterworth et al (1997) 'Clinical supervision and Mentorship - it is good to talk'. An evaluation study in England and Scotland; University of Manchester; The School of Nursing, Midwifery and Health Visiting.

Davey et al (2006) 'The practice-policy divide: who has clinical supervision in nursing? Journal of Research in Nursing 11. (3), p237-248

Biographies

Liz Adams qualified as an RMN in 1992 and has almost 20 years experience working in various Mental Health settings. Currently work in Liaison Psychiatry, which provides a comprehensive psychiatric and psychological service to in- patients within a general hospital setting. Successfully completed a B.Sc. (Hons) in Psychology and Critical Practice in Health and Social Care in 2006 and has extensive experience in both acute psychiatry and various specialities, including substance misuse, psychotherapy and psychiatric rehabilitation. Prior to occupying current post Liz was manager at the Community Rehabilitation Unit at Polmuir Road. Liz has always found groups to be a rich medium to work within and completed an experiential training in clinical supervision in 2001 and subsequently facilitated group clinical supervision for 6 nursing colleagues for a period of 5 years. Currently supervision input is a bit more ad hoc and is offered mainly to medical and nursing students.

Sandra Nicoll has worked as a Clinical Nurse Specialist in Child and Family Mental Health for the last 10 years. Prior to this she was Ward Manager at the Lowit Unit, a residential assessment Unit for children with emotional, behavioural and psychological difficulties. Has completed an M.A. (Hons) Psychology in 1992 and being dual trained has completed both RGN and RMN training. Sandra’s interest in groups has persisted throughout her career and she has a firm belief in the usefulness of good supervision. Previous experience in facilitating group supervision includes providing a supervision service for school nurses, teachers and current colleagues.

Louise Robertson is a registered mental nurse. Louise has spent 20 years in a variety of roles within mental health clinical settings and has worked for the last 11 years in a broader development role. Louise is currently employed as Practice Education Facilitator (PEF) within Mental Health Services and provides support, education and developmental activities for both mentors and students undertaking pre and post registration education programmes. A key focus of the PEF role is encouraging the development and maintenance of positive learning environments where both education and lifelong learning are seen as integral to clinical practice and ongoing professional development.

Poster 4

Effectiveness of Solution Focused Brief Therapy as an intervention in real-world clinical practice.

Muriel Constable1 and Steve Smith2 1NHS Grampian, 2Robert Gordon University

Background

The clinical outcomes of forty-two patients referred to a nurse-led Solution Focused Brief Therapy (SFBT) clinic were audited.

Method

Data was subjected to t-test analysis to determine significance of clinical outcomes. Change was measured using the CORE-18 Clinical Outcomes tool.

Results

Results indicate a mean change of 5.4 (p<0.0001) achieved in a mean 4.5 sessions. This suggests that SFBT, delivered as part of a package of treatment, can be effective in bringing about therapeutic change in a range of conditions. The implications are discussed in relation to reducing waiting times for Psychological Services and further targeted research is called for.”

References

Iveson, C. 2002. Solution-focused brief therapy. Advances in Psychiatric Treatment; 8: 149–157.

Trepper, T. et al. 2006. Steve De Shazer and the future of solution-focused therapy. Journal of Marital and Family Therapy; 32 (2): 133-139.

Knekt, P. et al. 2011. Quasi-experimental study on the effectiveness of psychoanalysis, long-term and short-term psychotherapy on psychiatric symptoms, work ability and functional capacity during a 5-year follow-up. Journal of Affective Disorders 132: 37–47.

Biographies

Muriel Constable is an experienced Community Psychiatric Nurse, currently working as part of a Community Mental Health Team in NHS Grampian, Aberdeen. She undertook training in Solution Focused Brief Therapy in 2007, completing further study in 2008. She has been running a nurse-led SFBT clinic for the past three years.

Poster 5

Scottish Dementia Clinical Research Network: Involving Patients and the Public in Dementia Research.

Emma Darling, Justine Hudson, Sarah Gray

Scotland’s National Dementia Strategy (SNDS 2010) highlights the importance of Patient and Public Involvement (PPI) in developing effective dementia healthcare in Scotland. To comply with government priorities, the Scottish Dementia Clinical Research Network (SDCRN) has developed a PPI strategy which further supports the aims of the PPI Strategy for Topic-Specific Research Networks. (Darling & Parra 2013).

The aim of our work is to enable patients, carers and the public to become active partners in research through the implementation of a person-centred approach to identifying research priorities and utilising valuable personal experiences and views to direct future dementia research.

Methods

The SDCRN is proud to have spread a culture of PPI throughout all network activity by implementing various initiatives focusing on collaboration with patients, carers and the public to develop trusting, meaningful partnerships in the research process. Examples of which include: The Research Interest Register, Research Priority Survey, Focus groups, PPI volunteer group, invitation to speak at SDCRN conferences, leaflet development, literature reviews, testimonials, members on our advisory board and conference steering group.

Results

509 responses to the survey provided an invaluable resource to identify public priorities in dementia research (Law et al. 2011). Throughout Scotland we have 133 PPI volunteers keen to participate in varying activities, of which over 90 have participated to date. Testimonials have provided a rich source of feedback as to the benefit of focus groups.

Conclusion

Our results highlight there is a demand for PPI, and is evidenced by the numbers involved. Encouraging patient and public involvement in dementia research throughout Scotland, has allowed people the opportunity to have a ‘Voice’ that can be listened to and acted upon. It has prioritised the needs of those who’s lives are affected by dementia on a daily basis, and highlights the major role they play in the development of dementia healthcare.

Learning objectives

1. To raise awareness among Health Care Professionals of the importance of Patient and Public Involvement in Dementia Research, to direct future services.

2. To inform the public of the vital role they play in the development of dementia health care.

Keywords

Person-centred, partners in research, collaboration.

References

Darling E, Parra M A. Involving Patients and the Public in Research: Harmonisation of the Scottish Dementia Clinical Research Network’s actions with Scotland’s National Dementia Strategy. Nurse Researcher. (In press. Scheduled for July 2013; 20:6).

Law E, Starr J, Connelly P. Dementia Research: What do different public groups want? A survey by the Scottish Dementia Clinical Research Network. Dementia: The International Journal of Social Research and Practice. 2011; 12; 1:23-28.

Biography

Emma Darling is a Registered General Nurse since 1996 and completed a BSc Honours degree in Health Sciences at Aberdeen University in 2006.She has since worked as a research nurse at Aberdeen University, NHS West Suffolk Hospital and NHS Grampian. She has worked for the Scottish Dementia Clinical Research Network for 3 years.

Poster 6

The Impact of Long-Term Psychiatric Medication Use on a Person’s Spirituality: A Qualitative Inquiry

Lynne Esther Vanderpot, Ph.D. candidate in Practical Theology, University of Aberdeen

Introduction

In the United States, the treatment of mental illness with psychiatric medications has increased enormously over the last 25 years. However, to date, there has been a paucity of published research on the potentially troubling effects of psychotropic medications on a person’s spiritual resources (Hagen et al., 2010). Qualitative research may provide practitioners with a way of understanding the experience of long-term medication use in a way that can effectively inform the process of care and help to assess the risk/benefit analysis of this treatment strategy.

Objective

The aim of this study is to explore the impact of long-term psychotropic medication on the spirituality of persons coping with mental illness. It is anticipated that a deeper understanding of the experience will serve to inform accepted treatment practices.

Method

Currently I am working on developing a phenomenological qualitative research study into the long-term effects of psychiatric medication on a person’s spiritual life. Data will be collected in the form of semi-structured, in-depth interviews.

Discussion

Patient preferences are an important component of all evidence-based practices (Gerrish & Lacey, 2010). This study will provide practitioners with new insights into patient’s subjective experiences of using mental health medications.

Learning outcomes

Learning will be focused on why it is critical to consider the impact of treatment from the patient’s perspective, in order to improve current standards of care and maximize health outcomes. In addition, this presentation will consider the small but growing evidence base which suggests that psychiatric medications may have a troubling effect on a persons ability to access personal spiritual resources.

References

Hagen, B., Nixon, B., & Peters, T. (2010). The greater of two evils? How people with transformative psychotic experiences view psychotropic medications. Ethical Human Psychology and Psychiatry, 12(1), 44-59.

Gerrish, K., & Lacey, A. (2010). The research process in nursing. Oxford: Blackwell Publishing. Biography

Lynne E. Vanderpot received her Masters in psychology counselling in 2012 from Goddard College in Vermont, U.S. Currently she is a first year Ph.D. student under the supervision of Professor John Swinton at the University of Aberdeen’s Centre for Spirituality, Health and Disability. Her research is focused on exploring the impact of mental health medications on a person’s spiritual life.

Poster 7

The Recovery Rollercoaster

Elizabeth Burns and Hazel Thompson, University of the West of Scotland

Background

This poster was developed by five 2nd year mental health nursing students studying at Glasgow Caledonian University as part of the learning activities associated with a 6 week module entitled ‘Restoring Mental Health’. The focus of the module was around recovery orientated practice and the knowledge, skills and attributes which underpin this. Service users, carers and experienced practitioners played a key role in helping students develop a deeper insight and awareness into the individual experience of recovery. Students presented their posters at the end of the module. They were viewed and rated by over 120 people, including staff, students, service users and carers and local NHS staff. This poster received the most votes as the one which showed the best depiction of recovery and the greatest degree of insight in to the uniqueness of the recovery journey.

Aim

To visually represent the student’s knowledge, understanding and insight in to recovery in mental health.

Description of the poster:

The foundations of the “Rollercoaster” are depicted as square building blocks. These represent the tools of support and strengths to help promote successes and protect against the lows. They are there to continually build on, adding to the strengths when new ones are discovered.

The sun shines through the words “Recovery” bringing a bright, optimistic feeling when people look at it. We had to say something about “forgiving yourself” if you have had a bad day, for the reason that if we don’t forgive ourselves we will not be in a position to get back on life’s rollercoaster and enjoy the journey ahead.

Life is a journey; it may not be a smooth ride, it does have ups and downs, twists and turns, however it’s still possible to have hopes and dreams, along with having a positive identity and building a meaningful life wherever your home may be.

This poster represents individuality and will hopefully explain how those who need support are central to their own recovery but have support around to guide them through it.

The poster has now been commissioned by NHS GG&C and is being displayed across a number of the acute in-patient wards. It is hoped that this poster will triggers conversations around recovery amongst service users and staff.

Biography

Elizabeth Burns is a third year Mental Health student studying at Glasgow Caledonian University. I always wanted to be a nurse; however I had six children at a young age which kept me busy. Five years ago I knew it was the right time and went to college and completed a HNC in Health Care before starting my degree. I hope to specialise in In-Patient Elderly/ In-Patient Adult when I qualify.

Hazel Thompson is a third year Mental Health Nursing student at Glasgow Caledonian University. I am passionate about recovery in mental health and find working with older adults with dementia a particularly rewarding and challenging and hope to specialise in this area when I qualify.

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