Creating psychologically informed environments on acute psychiatric wards: a lived experience-led study of staff experience

Abstract

Psychologically informed environments aim to transform acute psychiatric settings by providing person-centred, recovery-oriented care. To meet the challenges of implementing these principles, an intensive support programme, derived from the Comprehend, Cope and Connect model, was designed to promote a recovery-focused service. This study aimed to implement the programme in acute wards and explore staff perspectives on its implementation. Qualitative data were gathered from focus groups and semi-structured interviews with ward staff where it was implemented. These were conducted by interviewers with lived experience of acute services. Thematic analysis was used to identify themes from the interviews. Participants were multidisciplinary clinical staff (N = 10) from various professions, including nurses, occupational therapists, and ward managers. Themes were Positive impact on clinical work(n = 9); Importance of programme consistency (n = 7); Significant barriers to implementation (n = 6); Positive impact on patients (n = 6); Positive impact on ward environment (n = 5); Collaboration between professions (n = 5);Increased psychological mindedness of staff (n = 5); Patient barriers to using skills (n = 4); and Increased staff confidence and knowledge (n = 4). Findings indicated acceptability and enthusiasm for the programme. There appear to be clear benefits to staff engaging in psychologically informed programmes, such as increasing their confidence and improving staff unity, in addition to a positive impact on teams, working practice and patients. The findings also highlight barriers to implementation, including staffing levels and patient engagement. Further training and research is required to develop staff awareness of using psychological formulations and to engage patients in these approaches.