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Showing results for tags 'Mental health'.
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News Article
Dublin mental health centre falls short on physical restraint code
Patient Safety Learning posted a news article in News
A Dublin mental health centre has failed to comply with the code of practice on physical restraint for four consecutive years, an inspection report has found. The 39-bed Elm Mount Unit at St Vincent’s University Hospital said the issue was now high risk. Two episodes were recorded by the Mental Health Commission (MHC) where the staff member responsible for leading the physical restraint did not monitor the person’s head or airway, and that this went undocumented. In another case, inspectors noted, the physical restraint was not reviewed by members of the multidisciplinary team and recorded correctly. There was also concern regarding the administration of medicine, specifically deficits in the prescription and administration record “which could potentially lead to medication errors”. Read full story Source: The Irish Times, 17 December 2019 -
News Article
Mental health: North Wales A&E support scheme extended
Patient Safety Learning posted a news article in News
A "life-changing" mental health service at three hospitals in north Wales is to be expanded to GP surgeries. More than 2,500 people have used 'I Can' centres at Glan Clwyd, Gwynedd and Wrexham Maelor hospitals since the trial was launched earlier this year. The centres offer support to patients at A&E departments who may not require medical treatment or a bed. They employ both volunteers and paid staff, many of whom have experienced mental health issues themselves. Betsi Cadwaladr University Health Board said the service allowed people to talk about mental health issues away from wards. It hopes extending the scheme to GP surgeries and community hubs will allow people to get support close to home if they do not need medical treatment. Read full story Source: 9 December 2019 -
News Article
Long waits 'leave mental health patients in limbo'
Patient Safety Learning posted a news article in News
Patients with mental health problems are being left in limbo on "hidden" waiting lists by England's NHS talking therapy service, the BBC can reveal. The service, Improving Access to Psychological Therapies, provides therapy, such as counselling, to adults with conditions like depression, post-traumatic stress disorder and anxiety. It starts seeing nine in 10 patients within the target time of six weeks, but that masks the fact many then face long waits for regular treatment. Half of patients waited over 28 days, and one in six longer than 90 days, between their first and second sessions in the past year. Charities said the headline target was giving a false impression of what was happening, warning that patients were facing "hidden waits" that were putting their health at risk. NHS England acknowledged the pressure on the system was causing delays, but pointed out that despite the delays, half of patients given treatment still recovered. Read full story Source: BBC News, 5 December 2019 -
Content ArticleNHS England commissioned this external review of all Independent Investigations following Mental Health Homicides (IIMHH) and related national governance arrangements. The review considered investigations undertaken between 2013 and 2017. NHS England has accepted the report findings and has developed an action plan which is being implemented and monitored via regional and national governance mechanisms.
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News ArticleHow many people die in California psychiatric facilities has been a difficult question to answer. No single agency keeps tabs on the number of deaths at psychiatric facilities in California, or elsewhere in the nation. In an effort to assess the scope of the problem, The Times submitted more than 100 public record requests to nearly 50 county and state agencies to obtain death certificates, coroner’s reports and hospital inspection records with information about these deaths. The Times review identified nearly 100 preventable deaths over the last decade at California psychiatric facilities. It marks the first public count of deaths at California’s mental health facilities and highlights breakdowns in care at these hospitals as well as the struggles of regulators to reduce the number of deaths. The total includes deaths for which state investigators determined that hospital negligence or malpractice was responsible, as well as all suicides and homicides, which experts say should not occur among patients on a psychiatric ward. It does not include people who died of natural causes or other health problems while admitted for a psychiatric illness. Read full story Source: Los Angeles Times, 1 December 2019
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Content ArticleHealth and well-being boards (HWBs) were established under the Health and Social Care Act 2012 to act as a forum in which key leaders from the local health and care system could work together to improve the health and well-being of their local population. In this report from the Kings Fund, Richard Humphries examines the part HWBs and local government more broadly, have played in the emergence of Integrated Care Systens (ICSs) so far and options for their future. Significantly, this report does not mention patient safety. Neither does it reflect on improvement in safety and quality though the more effective cross organisational collaboration at local system level.
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News Article
Six hospitals plummeted to ‘inadequate’ in wake of Whorlton Hall
Patient Safety Learning posted a news article in News
The Care Quality Commission (CQC) has rated six mental health hospitals “inadequate”, just months after describing them as either “good” or “outstanding”, since the Whorlton Hall scandal was revealed. HSJ analysis shows that of the 13 mental health hospitals admitting people with learning disabilities or autism which have been rated “inadequate” by the CQC since May this year, six of them dropped at least two ratings in a short space of time. The six hospitals which dropped at least two ratings include Whorlton Hall — the County Durham hospital closed following a BBC Panorama report in May showing residents being mistreated — which the CQC rated as “good” in December 2017 before revising this to “inadequate” in May. The BBC investigation prompted the CQC to investigate all similar mental health hospitals run by Cygnet, which took over the running of Whorlton Hall in January 2019. Cygnet Newbus Grange in Darlington — which was rated “outstanding” in a report published in February 2019 – was judged “inadequate” by September, while Cygnet Acer Clinic in Chesterfield fell from “good” in November 2018 to “inadequate’ in a report published 12 months later. The other three hospitals were the Breightmet Centre for Autism in Bolton, Kneesworth House in Hertfordshire and The Woodhouse Independent Hospital in Staffordshire. It comes as the CQC prepares to publish independent reports on its role in relation to the Whorlton Hall scandal. NHS England — one of the commissioners, along with local authorities and clinical commissioning groups, of learning disability inpatient care — also last month initiated a “taskforce” on the issue. The CQC has acknowledged it needed to “strengthen” its assessments of this type of care and said it had begun to do so, and was reviewing them further “from a human rights perspective”. Read full story (paywalled) Source: HSJ, 2 December 2019 -
Content ArticleInternationally, safety of care in child and adolescent mental health has received limited attention. Attempts to understand this area have mainly focused on issues of safety in relation to safeguarding on the one hand, or lack of access to services on the other. There is a call for clinicians, service developers and researchers to consider harm and safety more generally in child and adolescent mental health service (CAMHS). America and other countries have begun to initiate discussions on the possibility of harm caused by psychotherapy, however, the lack of shared definitions as to what constitutes safety and harm present ongoing challenges. To start to rise to these challenges this paper, published in Current Treatment Options in Pediatrics, outlines a possible framework for considering harm in relation to child and adolescent mental health provision.
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Content Article
What is a second victim?
PatientSafetyLearning Team posted an article in Second victim
Second Victim Support looks at the definition of a 'second victim', how they are impacted personally and professionally and what can be done to support them. Second victims are healthcare providers who are involved in an unanticipated adverse patient event, a medical error and/or a patient related injury and become victimised in the sense that the provider is traumatised by the event. Frequently, these individuals feel personally responsible for the patient outcome. Many feel as though they have failed the patient, second guessing their clinical skills and knowledge base. (Scott et al, 2009) -
Content Article
A reflective account of the culture of fear
Anonymous posted an article in Bullying and fear
This is my story of how one bad experience can lead to another. We talk a lot about patients and their safety (quite rightly so) but very rarely do we hear about the healthcare professional who is going through turmoil and their mental health. This is my story.- Posted
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Content ArticleA mental health nurse gives an insight into her working week. Published in the Guardian newspaper.
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Content ArticleWith increasing awareness of the importance of good mental health worldwide, attention has focused on the need to overcome the negative perceptions and stigma historically attached to mental health issues. One group that this difficulty has been particularly visible for is men; it is well-established that significantly fewer men are diagnosed with or treated for mental health disorders compared to women, with suicide rates being three times higher in some countries in men than women. Why this crisis in men’s mental health exists is a question with complex answers. It requires a better understanding of how men interact with those around them, why they do (or don’t) access support, as well as other social and cultural factors that influence their health seeking behaviours. Much research has focused on the concept of “masculinity” and the need to question its impact on capacity for emotional communication, service engagement and help-seeking behaviour. Watch the recording of the World Health Organization (WHO) seminar, which took place in Copenhagen, on this complex topic.
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Content ArticleSurveys show that men with ‘macho’ attitudes are more likely to have mental health problems. Jim Pollard argues that reducing the alarming male suicide rates requires a new language as well as new services.
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Content ArticleThis film features frontline staff from Birmingham and Solihull Mental Health NHS Foundation Trust explaining how they are using technology to improve the quality of the care they provide to their service users.
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Content ArticleThe prison population of England and Wales is around 86,000 prisoners. This report by the NHS Benchmarking Network summarises the results of an audit that has taken place across Health and Justice Commissioning services, Her Majesty’s Prison and Probation Service (HMPPS) and NHS England Specialised Commissioning to quantify the extent of prisoners waiting for assessment and waiting for transfer to mental health facilities (secure and non-secure services).
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Content ArticleJo Wailling is a registered nurse and research associate with the Diana Unwin Chair in Restorative Justice, Victoria University of Wellington. Jo presented on restorative practice at the Commission’s mental health and addiction (MHA) quality improvement programme workshop held in Wellington on 26 June for mental health and addiction leaders. This blog is a continuation of that presentation.
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Content ArticleClinicians who are unable to cope with their emotions after a medical error or adverse event are suffering in silence. These healthcare providers are often told to take care of the next patient without an opportunity to discuss the details of the event or share how this has affected them personally and professionally. While patients and families are the first victims of such events, we refer to the healthcare providers who are involved as the second victims.
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Content ArticleInvolvement in an adverse event or error can have serious effects on health care workers. Spotlighting how operating room culture can deter individuals from seeking help, this commentary emphasises the importance of assisting perioperative nurses immediately after a harmful mistake.
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Content ArticlePublished in BMJ Quality and Safety The term ‘second victim’ refers to the healthcare professional who experiences emotional distress following an adverse event. This distress has been shown to be similar to that of the patient, the ‘first victim’. The aim of this study was to investigate how healthcare professionals are affected by their involvement in adverse events with emphasis on the organisational support they need and how well the organisation meets those needs.
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Community Post
Staff safety in the mental healthcare setting
Patient Safety Learning posted a topic in Mental health
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Interesting blog posted from @Sarahjane Jones on her research findings on staff safety: Do you work in mental health? We'd be interested to hear your own experiences? What challenges do you face? -
Content Article
Staff safety in the mental healthcare setting
Sarahjane Jones posted an article in Staff safety
I lead a team of multidisciplinary researchers who explore the power of routinely collected data for improving our understanding of patient safety. Our hope is that this insight will be translated into improvements in patient care. On this World Mental Health Day, there is an opportunity to reflect on the implications of harm to staff who deliver care to some of the most vulnerable patients in any healthcare system and what we might do to better protect them from harm. We recently published a study that focussed on staff safety in the mental healthcare setting and I'd like to discuss some of the findings in this blog. -
Content Article
Time to Change: Our guide to asking twice
Patient Safety Learning posted an article in Mental health
Time to Change is a growing social movement working to change the way we all think and act about mental health problems. They have five simple steps to encourage people to ask questions and to open up about mental health. They also provide sources of help and support. -
Content ArticleNHS England published an independent report into the deaths of people with a learning disability or mental health problem at Southern Health NHS Foundation Trust and highlighted a system-wide response. The report was commissioned by NHS England (South) following the death of Connor Sparrowhawk in July 2013 in a unit in Oxford run by Southern Health NHS Foundation Trust. Both Southern Health NHS Foundation Trust and the clinical commissioning groups (CCGs) that commission services from them have accepted the recommendations.
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Content ArticleThe preventable death of Connor Sparrowhawk in July 2013 led to a number of investigations and enquiries into practice at Southern Health NHS Foundation Trust in whose care he died. This is a review of all deaths of people in receipt of care from Mental Health and Learning Disability services in the Trust between April 2011 and March 2015. It is not a clinical case review of each service user and we have therefore not tried to identify clinically unavoidable deaths. It does seek to establish the extent of unexpected deaths in Mental Health and Learning Disability services provided by the Trust and to identify any themes, patterns or issues that may need further investigation based on a scope provided by NHS England. We were asked to benchmark this Trust with other similar organisations where this was possible. In the report, we focus on the responsibilities as they impact on the Trust to report deaths and then to secure the right level of review, enquiry or investigation. However, the responsibility for investigating deaths lies with a number of organisations across the area and we refer to these responsibilities where appropriate.
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Content Article
Nursing in the criminal justice system – a short film (April 2013)
Claire Cox posted an article in Prison setting
Nurses can have a remarkable impact in the criminal justice system. In this film, we hear from three men who have had their lives changed by Jo Tomlinson, Lead Anxiety Nurse at HMP Stafford.
