Mental Health Support Workers Research Articles

Mental Health Support Workers Recovery Perceptions and Positive Risk-Taking Approaches Related to Service-Users with a Dual Diagnosis

ABSTRACT Twenty-nine mental health support workers took part in an online-survey consisting of a vignette and scenarios to elicit information regarding their recovery perceptions and positive-risk taking approaches related to service-users with dual-diagnoses of mental illness and substance use disorder. Reflexive thematic analysis was used to analyze the survey-responses. Although the participants emphasized some aspects aligning with the recommended “recovery-oriented practice” approach, there was an overemphasis on reduced substance-use, aversive and overprotective approaches to positive risk-taking and a lack of emphasis on hope and the service-users’ strengths and abilities. It was concluded that there is a continuing need to implement recovery-oriented practice within mental health services.

'You have to be a certain sort of person': An interpretative phenomenological analysis of mental health support workers' experiences of physical restraint in inpatient settings.

Physical restraint is a controversial practice in psychiatric inpatient settings. Research has clearly demonstrated its physical and psychological risks, but few studies investigate how mental health support workers understand their experiences of restraint use. This study uses interpretative phenomenological analysis to explore support workers' understanding of these experiences. The COREQ checklist was used to ensure explicit reporting of the study. Semi-structured interviews were conducted with three participants and were then analysed using an interpretative phenomenological process. One superordinate theme emerged: 'You have to be a certain sort of person'. Restraints require not only the ability to overcome one's emotions, but also the ability to connect with the person being restrained. The implications of these findings for psychiatric care provision and for further research are discussed.

Gender considerations for supportive supervision in humanitarian contexts: A qualitative study.

Supportive supervision has been shown to improve mental health outcomes and job retention for mental health and psychosocial support (MHPSS) workers in humanitarian contexts. However, the impact of gender on supervision practices has been poorly evaluated and documented in international guidelines to date. To address this gap, qualitative interviews were conducted with 12 MHPSS staff working in diverse humanitarian contexts to identify key gender considerations in supportive supervision. Results show that gender in supervision is influenced by the context of MHPSS work; with culture, religion and gender roles identified as key elements. Participants discuss recruitment mechanisms, highlighting the unequal gender distribution and inequitable opportunities within MHPSS programming. The importance of addressing power dynamics impacted by gender and of ensuring the safety of women within supervision is also highlighted. Finally, participants discuss the gender differences across the various supervisory formats. Altogether, results indicate that gender has the potential to influence supportive supervision within MHPSS, and it is recommended that international guidelines account for nuances of gender in supportive supervision within humanitarian contexts.

Maximising the engagement of older people with mental health needs and dementia with social care.

Older people with mental health needs and dementia often face difficulties with daily living and community participation, requiring the intervention of social care services. However, cognitive and emotional needs often mean that mainstream support is not appropriate. In England, mental health support workers may attempt to address these concerns, to prevent mounting care needs and the potential for institutional care. Yet, their work has not been researched to identify good practices and to understand the mechanisms through which they engage older people. A new qualitative study used semi-structured interviews and focus groups with specialist support workers (n= 22), managers (n= 7), homecare staff (n= 4) and service users and carers (n= 6). The latter group were interviewed by co-authors with lived experiences of dementia and care. Participants were recruited from mental health services, home care organisations and third-sector agencies across the North of England in 2020-2021. The study identified three themes that described support worker activities. First, 'building trusting relationships' identified steps to establish the foundations of later interventions. Paradoxically, these may involve misleading clients if this was necessary to overcome initial reluctance, such as by feigning a previous meeting. Second, 're-framing care' referred to how the provision of care was positioned within a narrative that made support easier to engage with. Care framed as reciprocal, as led by clients, and having a positive, non-threatening description would more likely be accepted. Third, 'building supportive networks' described how older people were enabled to draw upon other community resources and services. This required careful staging of support, joint visits alongside workers in other services, and recognition of social stigma. The study was limited by constrained samples and covid context requiring online data collection. The study recommends that support workers have more opportunity for sharing good practice across team boundaries, and improved access to specialist training.

Experiences of mental health support workers in mental healthcare practice: Three visual arts narratives.

WHAT IS KNOWN ON THE SUBJECT?: Mental health support workers (MHSWs) are frequently employed in mental health services in order to augment and diversify the workforce and to promote recovery centred care Research shows that while MHSWs positively support service user mental health recovery, these roles are often unclear or not well understood by MHSWs and other mental health practitioners WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Through arts-based research methods, three MHSWs communicated their personal vulnerabilities and anxieties in supporting others with mental health issues; these insights are rarely presented in mental health research. MHSW experiences of not having recovery-oriented expertise recognized or valued by healthcare team were powerfully conveyed through arts narrative. These findings promote recognition of the strengths and contributions of MHSWs to mental health practice. Arts-based inquiry is a means of providing additional depth to what is already known and contributes novel insights regarding the occupational experiences and perceptions of MHSWs. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses and healthcare teams need to engage fully with recovery-oriented principles acknowledging the vulnerabilities of all practitioners and establishing adequate supervision and support. There needs to be greater clarity concerning roles/scope of practice for MHSWs to enable productive working partnerships in mental health teams. This can be achieved through open communication, education and planning among the wider mental healthcare team. ABSTRACT: Introduction Mental health support workers (MHSWs) make positive contributions to mental health recovery practice yet their roles and support needs are often unclear. This research explored the occupational lived experiences of three MHSWs working in Irish mental healthcare services. Aim The study examined the experiences and perceptions of MHSWs regarding their mental health recovery work. Method A narrative design was used incorporating participatory art-based inquiry as a collaborative means of engaging participants. This innovative methodology enabled exploration and evocative expression of participants' occupational experiences and stories. Results Participants revealed feelings of vulnerability and anxiety regarding personal mental health and supporting the mental health of others; a finding not commonly explored in previous research. MHSW skills and knowledge were evident; however, this expertise and recovery focus was not valued in mental health services. Discussion The strengths and challenges of MHSW engagement in service provision are discussed. Interdisciplinary team integration is explored in terms of contrasting recovery philosophies, practitioner vulnerability and professional demands and imperatives. Implications for practice Mental health teams need to engage with recovery principles, acknowledging strengths and vulnerabilities of all practitioners and establishing adequate supervision and support. Greater clarity and education is required concerning roles/scope of practice for MHSWs to enable productive interdisciplinary partnerships.

Oral health promotion practices of Australian community mental health professionals: a cross sectional web-based survey

BackgroundThis study explored the oral health promotion practices of Australian community mental health professionals working with people living with severe mental illness (SMI).MethodsAn anonymous cross-sectional web-based survey was distributed to all Community Rehabilitation and Support Workers (CRSWs) working at Neami National (n = 471), an Australian community mental health service. The validated questionnaire assessed participants’ self-rated oral health knowledge and confidence (7 questions); their perceived barriers (9 questions) and attitudes (5 questions) to oral health promotion; and their oral health promotion practices (7 questions). Differences in responses between groups were analysed using Chi-square, Fisher’s exact and Mann–Whitney U tests. Logistic Regression Analysis served to explore the probability of providing oral health support to mental health consumers.ResultsA total of 141 CRSWs were included in this study, achieving a response rate of 30 percent. Roughly two-fifths (39.0%) of participants had oral health training in the previous 12-months. The majority of CRSWs (89.3%) believed (‘Agreed’ or ‘Strongly agreed’) that mental health support workers have a role to play in promoting oral health. However, less than half (44.0%) of CRSWs practiced oral health promotion activities when working with mental health consumers. When asked about barriers to promoting oral health, ‘lack of consumer interest’ was the most prevalent issue. CRSWs who had oral health training were over three-times (OR 3.5, 95% CI 1.25–9.83, p = 0.017) more likely to provide oral health support. Results showed the provision of oral health support was most strongly associated with self-rated knowledge and confidence (OR 4.089, 95% CI 1.629–10.263, p = 0.003) and attitudes to oral health promotion (OR 3.906, 95% CI 1.77–8.65, p = 0.001).ConclusionThe results of this study suggest that mental health support workers who have more positive attitudes to oral health promotion and who have higher self-rated oral health knowledge and confidence are more likely to provide oral health support in their professional role. Training for community mental health professionals is essential to build confidence and skills to promote oral health for mental health consumers.

Exploring Therapeutic Risk in the Recovery Process of Adolescents at Risk of Self-harm: A Thematic Analysis of Support Staff Perceptions

Background and Objective: The high prevalence of adolescent self-harm within mental health services presents considerable management concerns, exacerbated by a lack of clear evidence regarding therapeutically effective approaches. This shortfall perpetuates traditional risk-averse practice, despite likely inadequacies in mitigating self-harm through failing to address underlying psychological mechanisms. Therapeutic risk, defined as an approach whereby clinicians support individual risk-taking, may be an alternative that yields improved recovery outcomes. However, related research is adult-focused and provides limited detail on its features, practical delivery and impact on recovery. Consequently, the current study explored the experiences of professionals delivering a therapeutic risk ethos, including their conceptualisation of it and its impact on young people. Methods: Semi-structured interviews were conducted with seven mental health support workers employed by a residential healthcare provider, which promotes a therapeutic risk approach. The provider supported service users aged 15 - 20 experiencing complex psychopathology who, following inpatient discharge, presented a high risk of self-harm and suicidality. Interview data was thematically analysed. Discussion and Conclusion: Staff participants provided their understanding of a therapeutic risk approach, suggesting risk is viewed as positive and beneficial to recovery, alongside the promotion of service user freedom and flexible therapeutic risk management. The perceived therapeutic risk incorporates both permission and support, which facilitate the exploration of underlying feelings and alternative actions. Additionally, therapeutic risk promotes positive recovery outcomes due to empowered service users having increased control over their lives. They argued this can reduce psychological distress, encouraging the development of emotional regulation and adaptive coping strategies.

A randomised controlled trial of energetic activity for depression in young people (READY): a multi-site feasibility trial protocol

BackgroundPrevalence of depression is increasing in young people, and there is a need to develop and evaluate behavioural interventions which may provide benefits equal to or greater than talking therapies or pharmacological alternatives. Exercise could be beneficial for young people living with depression, but robust, large-scale trials of effectiveness and the impact of exercise intensity are lacking. This study aims to test whether a randomised controlled trial (RCT) of an intervention targeting young people living with depression is feasible by determining whether it is possible to recruit and retain young people, develop and deliver the intervention as planned, and evaluate training and delivery.MethodsThe design is a three-arm cluster randomised controlled feasibility trial with embedded process evaluation. Participants will be help-seeking young people, aged 13–17 years experiencing mild to moderate low mood or depression, referred from three counties in England. The intervention will be delivered by registered exercise professionals, supported by mental health support workers, twice a week for 12 weeks. The three arms will be high-intensity exercise, low-intensity exercise, and a social activity control. All arms will receive a ‘healthy living’ behaviour change session prior to each exercise session and the two exercise groups are energy matched. The outcomes are referral, recruitment, and retention rates; attendance at exercise sessions; adherence to and ability to reach intensity during exercise sessions; proportions of missing data; adverse events, all measured at baseline, 3, and 6 months; resource use; and reach and representativeness.DiscussionUK National Health Service (NHS) policy is to provide young people with advice about using exercise to help depression but there is no evidence-based exercise intervention to either complement or as an alternative to medication or talking therapies. UK National Institute for Health and Care Excellence (NICE) guidelines suggest that exercise can be an effective treatment, but the evidence base is relatively weak. This feasibility trial will provide evidence about whether it is feasible to recruit and retain young people to a full RCT to assess the effectiveness and cost-effectiveness of an exercise intervention for depression.Trial registrationISRCTN, ISRCTN66452702. Registered 9 April 2020.

Despair and Suicide-Related Behaviours in Palorinya Refugee Settlement, Moyo, Uganda

This descriptive study illustrates the multitude of intertwining factors contributing to suicidal ideation and attempts, and deaths by suicide among South Sudanese refugees in Moyo/Obongi Palorinya settlements in northern Uganda. It was conducted from 2019 to 2020 due to escalating rates of suicide attempts and deaths by suicide noted in a rapid assessment by Lutheran World Federation mental health and psychosocial support (MHPSS) workers. This study aimed to better understand factors contributing to suicidal ideation and attempts among refugees, to tailor MHPSS interventions and prevent potential escalation of suicidality across the region, including nearby refugee hosting districts in Adjumani/Lamwo. Data collection techniques included key informant interviews, focus group discussions, case studies and review of the lead author’s therapy recovery notes. The findings highlighted the following factors contributing to escalating suicidality among the refugees: war stressors (experiencing and witnessing violent acts), daily stressors, social fragmentation, normalised violence, social isolation, lack of economic opportunities, loss of assets and loss of confidence and hope, among others. The assessment found that the spiking trend of increased suicidal behaviour is apparently unique to Moyo/Obongi, compared to neighbouring settlements, but emphasises the need for monitoring and preventive interventions in neighbouring districts. The psychosocial as well as economic impact of a reduction in funding for MHPSS programming is underlined, emphasising the need for long-term funding to consolidate programme effects and respond to realities on the ground. Community-based psychosocial support interventions provided by Lutheran World Federation are described that have subsequently helped to mitigate and respond to the escalating trend in suicidality and reflections given to strengthen the ongoing response with lessons learned for other contexts.

Suicide Prevention and Response Among Refugees: Personal Reflections on Self-Care for Frontline Mental Health and Psychosocial Support Workers

No matter how experienced we are as professionals, we need to recognise the emotional and physical toll of the work we do as mental health and psychosocial support (MHPSS) frontline workers. The reflections in this article on the nature of trauma − and of shame − are offered to explore just why working with refugee populations may be such an intense experience for frontline MHPSS workers. Trauma is contagious. Shame and guilt are contagious. Feelings of despair, of anger, of guilt and of confusion are contagious. Suicidality among refugees may be considered a dialogue – often including MHPSS frontline workers. When exposed to such despair, even our physical bodies may carry some of the pain and suffering. When faced with suicidality in our work, an extreme manifestation of this, we cannot help but be affected. We are human.

Family understanding and communication about an adult relative's mental health problem: A systematic narrative review.

WHAT IS KNOWN ON THE SUBJECT?: Adults who support an adult family member with a severe and enduring mental health problem often experience carer burden. Over time, this often negatively affects their mental and physical health and social well-being. Understanding and communicating about mental health problems in families can help to improve resilience and coping among both adults and children. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: We conducted a review of studies looking at how adult relatives understand and communicate about an adult family member's mental health problem. The findings highlight that how relatives make sense of MHP is related to historical family relationships, their mental health literacy and whether they see themselves as a "carer" or not. The findings also show that little research to date has explored how adult relatives talk with children about their parent's difficulties, and how the adults' understanding might affect what children learn about the MHP. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: There is a research gap to be addressed regarding family communication with children about parental mental health problems. This knowledge gap likely impacts family-focused mental health nursing and therapy provision. Mental health nursing, therapeutic and support workers and advocates are ideally positioned to assist relatives with improving their mental health literacy and confidence communicating about mental health, and to promote inclusion of relatives and children in interventions. ABSTRACT: Introduction Relatives are profoundly affected by an adult family member's severe and enduring mental health problem (MHP). The burdens of caring impact on adult relatives' emotional, physical and social well-being. How relatives make meaning and communicate about the MHP is thought to affect family talk about mental health, and this can impact family coping and well-being. Aim No review has yet drawn together research about how adult relatives of people with severe and enduring MHP make meaning and communicate about their relatives' difficulties. We aimed to address this gap. Method We conducted a systematic review of peer-reviewed primary research. SCOPUS, PubMed, Psychnet, SCIE, Cochrane and CINAHL+ databases were searched. Results Nineteen papers qualified for inclusion. Findings are organized under four themes: making meaning about the MHP and affected individual; conceptualizing the self in the presence of the MHP; meaning-making processes underlying relatives' well-being outcomes; and relatives' perspectives on family talk about the MHP. Discussion Historical relationships, caregiver identity and mental health literacy moderate relatives' understanding and talk about the MHP. Implications for practice Psychoeducation and communication support for relatives should be provided by mental health practitioners. Future research should address familial communication about MHP, including with children.

Effects of team-based quality improvement learning on two teams providing dementia care

ObjectiveTo determine the effects of a structured team-based learning approach to quality improvement (QI) on the performance 12 months later of two teams caring for patients with dementia.DesignBefore and after...

Imaging Journeys of Recovery and Learning: A Participatory Arts-Based Inquiry.

The relationship between processes of mental health recovery and lifelong learning is an area of increasing international interest. Experiences of transformation, positive effects on self-esteem, self-insight, and empowerment have been identified regarding both endeavors. Recognition of these benefits has stimulated collaborative development of educational programs in personal development, self-efficacy, and recovery principles. The importance of evaluating this educational provision has been emphasized; however, there has been little detailed exploration of students' experiences and perceptions of recovery and learning in the context of recovery education programs. In this article, we present a participatory arts-based inquiry with 14 women, including mental health service users, who undertook a recovery training program to support their roles as mental health support workers in Ireland. Participatory visual analysis revealed three recurring themes; the interrelatedness of learning and recovery journeys, knowledge as a source of stability and rescue and the need for resilience in learning and recovery.

A Virtual World for Learning Skills of Independent Living: a Formative Evaluation

A web-based virtual world was developed to address negative symptoms in people being assisted by community mental health services. The formative evaluation of this virtual world describes the rationale, stakeholder consultation, behavioral objectives, and design principles. Results are presented for a two-phase evaluation of the acceptability and usability of the prototype with mental health support workers and their adult clients. Phase 1 was the development of an initial prototype virtual world and conduct of a survey of 46 support workers’ responses to a questionnaire on their views about that world. Results indicated moderate levels of acceptability and credibility of the concept and identified several perceived barriers to usability by potential clients. Phase 2 was the development of a second prototype and its evaluation by 20 support workers and 10 clients from a mental health support service following an instruction session using the second prototype. Results showed that most of the support workers and clients found it easy to use the virtual world features when assisted by a trainer, and most support workers indicated that they would use it in the future to assist them both to support some of their clients and for their own learning. Our findings indicate that virtual worlds might be useful to assist acquisition or recovery of skills of independent living. This might apply to a wider group that those with mental illness, for example other clinical groups involving disabilities in functional behaviors, including acquired neurological disorders and developmental disabilities.

Mental health support workers: Profession and professionalization

ABSTRACTThe mental health services in Aotearoa New Zealand, have changed significantly since the late 1990s. Community services have expanded, and the role of the mental health support worker has developed and grown to be a significant presence in the mental health and disability workforce. Despite this, the role is minimally discussed, both in Aotearoa New Zealand, and internationally. In December 2014, Auckland University of Technology (AUT) hosted a panel presentation and discussion at the then Department of Psychotherapy & Counselling Forum. This article coalesces the contributions of the presenters at this panel discussion. Consideration is given to the development of the role and education of support workers, the environment in which they work, and the contemporary mental health support work workforce. Two examples of professionalization, with regard to different forms of registration, contribute to the discussion. A tentative conclusion is made that support workers, their employers, and the people they support would all benefit through some form of professionalization, standardization, and recognition.

Do professional boundaries limit trust?

The present study uses stories of mental health support workers talking about their relationship with clients to wonder about how trust might be limited by the professional boundaries of nursing. The writing arose out of an appreciative inquiry study looking at the role of mental health support workers. Participants talked about how they worked with their clients. As researchers, we were struck by the depth of trust that was built between worker and client. We have brought a phenomenological lens to wonder about the nature of trust, as shown in the data. The original research sought to identify what was working well for mental health support workers. The present study brings a phenomenological interpretive approach to four stories from the discovery phase of the study, with our thinking informed by Heidegger and van Manen. Interviews were conducted with 26 mental health support workers and six stakeholders in 2012-2103. For this paper, we drew from those transcripts stories of three mental health support workers and one stakeholder. Through a process of talking together, writing, and rewriting, we wondered about the meaning within these stories, with a strong focus on how trust was enacted. We saw that mental health support workers in this study, by not carrying the boundaries of being 'professional', seemed free to grow a stronger relationship of trust which was therapeutic. We ask: Is it time to rethink how professional boundaries limit the level of trust achieved with clients to the detriment of impactful care?

Personality characteristics of emigrants and re-emigrants with depressive disorders

Aim. Migration is considered as one of the factors that affect the mental health of the population. The accumulation of psychological and social problems provoke personal transformation reaction and exclusion personality, and considering emigration as a factor that provoke manifestation or exacerbation of endogenous mental diseases. Given the paucity and inconsistency of scientific data on the characteristics of psycho-emotional disorders, and personality characteristics of immigrants, and the almost complete lack of information about re-emigrants, the aim of our work was to study the mechanisms of psychosocial adaptation (de-adaptation) re-emigrants and immigrants, as well as developing programs of social, psychological, psychotherapeutic and mental health support workers. Methods. We used a standardized method of investigating the person (SMIP) for realization of tasks. Result. Results suggest the presence in examined patients of patocharacterological features of hypothymic (disthymic) type. Significant differences were found in terms of fixed scales SMIP test most pronounced in the group of psychogenic depression, the least - organic. In general, immigrants are inherent traits of anxiety and emotional breadth, re-emigrants - schizoidness and apathy. Conclusions. Identified patterns should be considered when developing therapeutic, rehabilitative and preventive measures

Unregistered practitioners showcase best practice

British Journal of Healthcare AssistantsVol. 8, No. 5 Health MattersUnregistered practitioners showcase best practiceLynne SmarttLynne SmarttSearch for more papers by this authorLynne SmarttPublished Online:16 May 2014https://doi.org/10.12968/bjha.2014.8.5.258AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article FiguresReferencesRelatedDetails 2 May 2014Volume 8Issue 5ISSN (print): 1753-1586ISSN (online): 2052-4420 Metrics History Published online 16 May 2014 Published in print 2 May 2014 Information© MA Healthcare LimitedPDF download

Mental health support workers’ attitudes towards hepatitis C and injecting drug use: barriers to recovery?

People with a mental illness may be at increased risk of acquiring blood borne viruses, such as hepatitis C. Hepatitis C is highly stigmatized, largely as a result of its association with injecting drug use. Mental illness is also stigmatized and hence people with a mental illness and hepatitis C may face a type of double stigma. This study explored the impact of hepatitis C-related stigma on care and support for people with a mental illness. Cross-sectional surveys were conducted with 117 mental health support workers from a community managed organisation. Surveys assessed support workers' attitudes towards hepatitis C and people who inject, and whether these attitudes influence support workers' level of comfort with and perceived capability in working with clients who have hepatitis C and a mental illness. Surveys also investigated support workers' feelings about recovery in relation to clients with a mental illness who also have hepatitis C. Data indicate that workers’ attitudes towards people with hep...

Survey of northern informal and formal mental health practitioners

BackgroundThis survey is part of a multi-year research study on informal and formal mental health support in northern Canada involving the use of qualitative and quantitative data collection and analysis methods in an effort to better understand mental health in a northern context.ObjectiveThe main objective of the 3-year study was to document the situation of formal and informal helpers in providing mental health support in isolated northern communities in northern British Columbia, northern Alberta, Yukon, Northwest Territories and Nunavut. The intent of developing a survey was to include more participants in the research and access those working in small communities who would be concerned regarding confidentiality and anonymity due to their high profile within smaller populations.DesignBased on the in-depth interviews from the qualitative phase of the project, the research team developed a survey that reflected the main themes found in the initial qualitative analysis. The on-line survey consisted of 26 questions, looking at basic demographic information and presenting lists of possible challenges, supports and client mental health issues for participants to prioritise.ResultsThirty-two participants identified various challenges, supports and client issues relevant to their mental health support work. A vast majority of the respondents felt prepared for northern practice and had some level of formal education. Supports for longevity included team collaboration, knowledgeable supervisors, managers, leaders and more opportunities for formal education, specific training and continuity of care to support clients.ConclusionFor northern-based research in small communities, the development of a survey allowed more participants to join the larger study in a way that protected their identity and confidentiality. The results from the survey emphasise the need for team collaboration, interdisciplinary practice and working with community strengths as a way to sustain mental health support workers in the North.