Psychiatric Ward Staff Experience of Working with Patients Who Hear Voices and Their Views on Voice Simulation Training: a Qualitative Study

Abstract

Background: Research shows that psychiatric staff lack clinical confidence working with voice hearers. Simulation training is promising but staff input is limited. Aim: The present study aimed to qualitatively investigate ward staff experience of working with voice hearers and their perspectives on simulation training. Method: Multidisciplinary psychiatric ward staff participated in semi-structured interviews on their experience of working with voice hearers and their views and recommendations on simulation training. Participants included seven nurses, five healthcare assistants, and three activities co-ordinators. Results: Following thematic analysis, staff experience themes included Negative impact on therapeutic relationship, Clinical experience improves understanding of voice hearing, Empathy for voice hearers, Challenges of managing risk, Lack of subjective understanding of voice hearing, Limited training for working with voice hearers and Lack of clinical confidence. Views on simulation training themes included Potential to improve subjective understanding, Anxieties about emotional responses, Keenness to participate and Potential to improve clinical confidence. Simulation training recommendation themes included Incorporate practical, skills-based elements, Invite all mental health staff to participate, andUse genuine voice hearer experiences. Conclusion: Lack of subjective understanding and clinical confidence was linked to training limitations, but skills-based simulation training was endorsed as a valuable method to improve staff understanding, confidence, and quality of care.