ORCID Profile
0000-0003-3286-9846
Current Organisations
King's College London
,
City University
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Publisher: Wiley
Date: 15-11-2010
DOI: 10.1111/J.1365-2850.2010.01614.X
Abstract: • Locking of psychiatric wards doors is more frequent, but the impact is unknown. • Staff patients and visitors returned a questionnaire about the issue. • Patients did not like the door being locked as much as staff, and being on a locked ward was associated with greater rejection of the practice. • Staff working on locked wards were more positive about it than those who did not. Locking the door of adult acute psychiatric wards has become increasingly common in the UK. There has been little investigation of its efficacy or acceptability in comparison to other containment methods. We surveyed the beliefs and attitudes of patients, staff and visitors to the practice of door locking in acute psychiatry. Wards that previously participated in a previous study were contacted and sent a questionnaire. A total of 1227 responses were obtained, with the highest number coming from staff, and the smallest from visitors. Analysis identified five factors (adverse effects, staff benefits, patient safety benefits, patient comforts and cold milieu). Patients were more negative about door locking than the staff, and more likely to express such negative judgments if they were residing in a locked ward. For staff, being on a locked ward was associated with more positive judgments about the practice. There were significant age, gender and ethnicity effects for staff only. Each group saw the issue of locked doors from their own perspective. Patients registered more anger, irritation and depression as a consequence of locked doors than staff or visitors thought they experienced. These differences were accentuated by the actual experience of the ward being locked.
Publisher: Wiley
Date: 02-03-2015
DOI: 10.1111/NIN.12096
Abstract: This study will be of interest to anyone concerned with a critical appraisal of mental health service users' and carers' participation in research collaboration and with the potential of the postcolonial paradigm of cultural safety to contribute to the service user research (SUR) movement. The history and nature of the mental health field and its relationship to colonial processes provokes a consideration of whether cultural safety could focus attention on ersity, power imbalance, cultural dominance and structural inequality, identified as barriers and tensions in SUR. We consider these issues in the context of state-driven approaches towards SUR in planning and evaluation and the concurrent rise of the SUR movement in the UK and Australia, societies with an intimate involvement in processes of colonisation. We consider the principles and motivations underlying cultural safety and SUR in the context of the policy agenda informing SUR. We conclude that while both cultural safety and SUR are underpinned by social constructionism constituting similarities in principles and intent, cultural safety has additional dimensions. Hence, we call on researchers to use the explicitly political and self-reflective process of cultural safety to think about and address issues of ersity, power and social justice in research collaboration.
Publisher: Wiley
Date: 11-09-2014
DOI: 10.1111/JOCN.12671
Abstract: This paper reports mental health nurses' perspectives of absconding. The aims of the study were to explore nurses' perceptions of risk assessment and management practices regarding absconding from acute inpatient psychiatric settings, and their affective responses when patients absconded. Nurses are directly involved in managing the risk of patients leaving hospital while acutely unwell, as well as dealing with the implications of an absconding event. However, despite their key role, few studies have explored nurses' perceptions of absconding. An interpretive inquiry was undertaken using a systematic thematic approach. Mental health nurses (n = 11) from three acute inpatient mental health units in Australia took part in semi-structured interviews, with a focus on the nurses' experiences of working with patients who had absconded. Data were analysed using systematic thematic coding procedures. Nurses' assessment of a patient's risk of absconding involved the use of clinical judgement, focusing on markers of absconding including the patient's history and clinical presentation. The acuity of the perceived risk determined the type of risk management strategy implemented, which could include support, observation and/or the use of containment procedures. Nurses responded with a myriad of affective reactions when patients absconded depending on their assessment of the patient's risk. Support and debriefing is required for mental health nurses following an absconding event. Additional research is vital to identify alternative absconding assessment and management strategies to ensure the best possible outcome for patients and nurses. Mental health nurses play a central role in risk assessment and management for absconding, with fear of repercussions a significant consequence for them. This research highlights the importance of both clinical judgment and standardised instruments in assessing absconding risk. Further research is needed to identify alternative evidence-based absconding management strategies to support nursing practice.
Publisher: Springer Science and Business Media LLC
Date: 17-08-2020
DOI: 10.1007/S00127-020-01924-7
Abstract: The COVID-19 pandemic has many potential impacts on people with mental health conditions and on mental health care, including direct consequences of infection, effects of infection control measures and subsequent societal changes. We aimed to map early impacts of the pandemic on people with pre-existing mental health conditions and services they use, and to identify in idual and service-level strategies adopted to manage these. We searched for relevant material in the public domain published before 30 April 2020, including papers in scientific and professional journals, published first person accounts, media articles, and publications by governments, charities and professional associations. Search languages were English, French, German, Italian, Spanish, and Mandarin Chinese. Relevant content was retrieved and summarised via a rapid qualitative framework synthesis approach. We found 872 eligible sources from 28 countries. Most documented observations and experiences rather than reporting research data. We found many reports of deteriorations in symptoms, and of impacts of loneliness and social isolation and of lack of access to services and resources, but sometimes also of resilience, effective self-management and peer support. Immediate service challenges related to controlling infection, especially in inpatient and residential settings, and establishing remote working, especially in the community. We summarise reports of swiftly implemented adaptations and innovations, but also of pressing ethical challenges and concerns for the future. Our analysis captures the range of stakeholder perspectives and experiences publicly reported in the early stages of the COVID-19 pandemic in several countries. We identify potential foci for service planning and research.
Publisher: Wiley
Date: 15-11-2010
DOI: 10.1111/J.1365-2648.2010.05499.X
Abstract: In this paper we report on the rates of drug/alcohol use on acute psychiatric wards in relation to levels and intensity of exit security measures. Many inpatient wards have become permanently locked, with staff concerned about the risk of patients leaving the ward and harming themselves or others, and of people bringing illicit substances into the therapeutic environment. In 2004/2005, a cross sectional survey on 136 acute psychiatric wards across three areas of England was undertaken. A comprehensive range of data including door locking and drug/alcohol use were collected over 6 months on each ward. In 2006, supplementary data on door locking and exit security were collected. Door locking, additional exit security measures and substance misuse rates of the 136 wards were analysed and the associations between these were investigated. No consistent relationships were found with exit security features, intensity of drug/alcohol monitoring procedures, or the locking of the ward door. There were indications that use of breath testing for alcohol might reduce usage and that the use of 'sniffer' dogs was associated with greater alcohol use. Greater exit security or locking of the ward door had no influence on rates of use of alcohol or illicit drugs by inpatients and thus cannot form part of any strategy to control substance use by inpatients. There are some grounds to believe that a greater use of screening might help reduce the frequency of alcohol/substance use on wards and may lead to a reduction in verbal abuse.
Publisher: Springer Science and Business Media LLC
Date: 14-08-2023
DOI: 10.1007/S11469-023-01126-7
Abstract: The employment of mental health peer support (PS) is recommended in national and international mental health policy, and widely implemented across many countries. The key components of PS remain to be identified. This study aimed to develop a typology of components involved in one-to-one PS for adults in mental health services. A systematised review was performed to establish a preliminary long list of candidate components, followed by expert consultation ( n = 21) to refine the list. Forty-two publications were full-text reviewed, comprising 26 trial reports, nine training manuals, and seven change model papers. Two hundred forty-two candidate components were identified, which were thematically synthesised to 16 components and eight sub-components, categorised into four themes: recruitment, preparation, practice, and PS worker wellbeing. Our typology can inform reflection and planning of PS practice, and allow more rigorous and synthesised studies, such as component network meta-analyses, to characterise the impact of each component and their interactions.
Publisher: Wiley
Date: 08-12-2021
DOI: 10.1111/INM.12954
Abstract: Body‐Worn‐Cameras (BWCs) are being introduced into Mental Health Inpatient Units. At present, minimal evidence surrounding their use in a mental health environment exists. This review examined research on the uses of BWCs in public sector services including healthcare, public transportation, and law enforcement. All eligible studies included a visible BWC, recording on a continuous loop as the main intervention. The evidence base presented high levels of bias, highly varied camera protocols, and heterogeneity of outcome measurements. This review found there is limited evidence for the efficacy of BWCs to control and manage violence within mental health inpatient wards. The technology has shown to be effective in reducing the number of public complaints in a law enforcement setting, but it is unclear how this is achieved. It appears there may be potential beneficial uses and unintended consequences of BWCs yet to be explored by mental health services.
Publisher: Wiley
Date: 07-05-2021
DOI: 10.1111/INM.12877
Abstract: Community treatment orders (CTOs) require in iduals with a mental illness to accept treatment from mental health services. CTO legislation in South Australia states that treatment and care should be recovery‐focused, although justification for use is predominantly risk‐based, and care often coercive. Although CTOs are contested, in iduals, families, and clinicians frequently engage in care planning within this context. This paper examines how the concepts of risk and risk management impact care planning from the perspectives of in iduals on CTOs, their families, and clinicians. Ethnographic methods of observation and interview provided a detailed account of the perspectives of each group over an 18‐month period from two community mental health teams in South Australia. Findings show that care planning occurred within a culture of practice dominated by risk. Risk, however, was understood differently by each participant group, with the dominant narrative informed by biogenetic understandings of mental illness. This dominance impacted on the positioning of participant groups in care planning, focus of care contacts, and care options available. To improve care experiences and outcomes for in iduals on CTOs, narrow conceptualizations of risk and recovery need to broaden to include an understanding of personal and social adversities in iduals face. A broader understanding should reposition participants in the care planning context and rebalance care discussions, from a focus on clinical recovery to recovering citizenship.
Publisher: Public Library of Science (PLoS)
Date: 23-10-2018
Publisher: Informa UK Limited
Date: 02-2012
Publisher: Wiley
Date: 07-03-2011
DOI: 10.1111/J.1365-2850.2011.01716.X
Abstract: Locking the exit doors of psychiatric wards is believed to reduce the risk of patients absconding. The aims of the study were to investigate both the prevalence of door locking and other exit security measures on UK admission wards, as well as whether door locking appears to be effective in keeping inpatients in. A cross-sectional survey on 136 acute psychiatric wards in the UK was conducted, in which a range of data on patients, staff, and conflict and containment events, including door locking and absconding, were collected from shift to shift during a period of 6 months. About one-third of the participating wards (30%) operated with their ward exit door permanently locked, whereas another third (34%) never locked the ward door. Univariate analyses suggested little association between exit security measures and absconding. A more robust multilevel statistical analysis, however, did indicate a reduction of about 30% of absconding rates when the ward door was locked the entire shift. Although locking the ward door does seem to reduce absconding to a certain extent, it far from completely prevents it. As it may be unrealistic to strive for a 100% absconding-proof ward, alternative measures for door locking to prevent absconding are discussed.
Publisher: Wiley
Date: 09-2009
Publisher: Wiley
Date: 11-07-2011
DOI: 10.1111/J.1447-0349.2011.00758.X
Abstract: There is disagreement among psychiatric professionals about whether the doors of acute psychiatric wards should be kept locked to prevent patients from leaving and harming themselves or others. This study explored patient, staff, and visitor perceptions about the acceptability of locking the ward door on acute psychiatric inpatient wards. Interviews were conducted with 14 registered nurses, 15 patients, and six visitors from three different acute wards. Findings revealed commonalities across all groups, with general agreement that locking the door reduced absconding. Staff expressed feelings of guilt, embarrassment, and fear of being blamed when a patient absconded. Staff also reported that open wards created anxious vigilance to prevent an abscond and increased workload in allocating staff to watch the door, whereas staff on partially-locked doors also perceived an increased workload in letting people in and out of the ward. Patients had mixed feelings about the status of the door, expressing depression, a sense of stigma, and low self-esteem when the door was locked. The issue of balancing safety and security on acute psychiatric wards against the autonomy of patients is not easily resolved, and requires focused research to develop innovative nursing practices.
Publisher: Wiley
Date: 26-05-2018
DOI: 10.1111/INM.12351
Publisher: Springer Science and Business Media LLC
Date: 10-11-2016
Publisher: Wiley
Date: 12-08-2021
DOI: 10.1111/HEX.13329
Abstract: In many jurisdictions worldwide, in iduals with a mental illness may be forced to receive care and treatment in the community. In Australia, legislation states that such care should be driven by a care plan that is recovery‐focussed. Key components in the care planning process include engagement and decision‐making about a person's support needs and care options, with trust being an essential component of care planning relationships. This study examines how these components were enacted during service care contacts for in iduals on community treatment orders. The study was located at two community mental health teams in South Australia. Ethnographic observations of care planning discussions between consumers, their carers and clinicians, and interviews with in iduals from these groups, were conducted over 18 months. Carspecken's critical ethnography provided a rigorous means for examining the data to identify underlying cultural themes that were informing day‐to‐day care interactions. Care planning was not occurring as it was intended, with service culture and structures impeding the development of trusting relationships. Clinicians striving to work collaboratively with consumers had to navigate a service bias and culture that emphasized a hierarchy of ‘knowing’, with consumers assumed to have less knowledge than clinicians. Services and clinicians can challenge prejudicial ethical injustice and counter this through testimonial justice and implementation of tools and approaches that support genuine shared decision‐making. This study included in iduals with lived experience of mental illness, their carers and clinicians as participants and researchers.
Publisher: SLACK, Inc.
Date: 2014
DOI: 10.3928/02793695-20131126-04
Abstract: SUGAR (Service User and Carer Group Advising on Research) is an initiative established to develop collaborative working in mental health nursing research between mental health service users, carers, researchers, and practitioners at City University London, United Kingdom. This article will describe the background of SUGAR how the group operates some of the achievements to date, including researcher reflections and case studies of how this collaboration influences our research. Written reflective narratives of service user and carer experiences of SUGAR were analyzed using constant comparative methods by the members. Common themes are presented with illustrative quotes. The article highlights the benefits and possible limitations identified to date by members of SUGAR, outlines future plans, and considers the findings in relation to literature on involvement and empowerment. This article, written by staff and members of SUGAR, is the first venture into collaborative writing of the group and reflects the shared ethos of collaborative working. [ Journal of Psychosocial Nursing and Mental Health Services, 52 (1), 22–30.]
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Alan Simpson.