Posts Characterization and User Engagement

Many health organizations use Facebook as a platform to engage with users. This has resulted in many research studies conducted on this platform. One popular type of research study is to characterize posts and measure user engagement levels . In this study, 100 post on the Mental Health Foundation of New Zealand Facebook page was analyzed this purpose. A mixed method approach was used. Quantitative descriptive statistics was used to analyze levels of engagement whilst qualitative content analysis was used to characterize posts into themes. Preliminary results indicate most posts fit in the awareness theme followed by the campaign theme. High levels of user engagements was observed for posts related to the awareness and others theme. Results of this study makes the suggestion for the implementation of intervention type awareness posts. A recommendation is also to made that the awareness posts promote mental health education and communication. This research study adds new knowledge to the area of posts characterization and user engagement levels on a mental health Facebook page.

Impact of COVID-19 on telepsychiatry at the service and individual patient level across two UK NHS mental health Trusts

BackgroundThe effects of COVID-19 on the shift to remote consultations remain to be properly investigated.ObjectiveTo quantify the extent, nature and clinical impact of the use of telepsychiatry during the COVID-19 pandemic and compare it with the data in the same period of the 2 years before the outbreak.MethodsWe used deidentified electronic health records routinely collected from two UK mental health Foundation Trusts (Oxford Health (OHFT) and Southern Health (SHFT)) between January and September in 2018, 2019 and 2020. We considered three outcomes: (1) service activity, (2) in-person versus remote modalities of consultation and (3) clinical outcomes using Health of the Nation Outcome Scales (HoNOS) data. HoNOS data were collected from two cohorts of patients (cohort 1: patients with ≥1 HoNOS assessment each year in 2018, 2019 and 2020; cohort 2: patients with ≥1 HoNOS assessment each year in 2019 and 2020), and analysed in clusters using superclasses (namely, psychotic, non-psychotic and organic), which are used to assess overall healthcare complexity in the National Health Service. All statistical analyses were done in Python.FindingsMental health service activity in 2020 increased in all scheduled community appointments (by 15.4% and 5.6% in OHFT and SHFT, respectively). Remote consultations registered a 3.5-fold to 6-fold increase from February to June 2020 (from 4685 to a peak of 26 245 appointments in OHFT and from 7117 to 24 987 appointments in SHFT), with post-lockdown monthly averages of 23 030 and 22 977 remote appointments/month in OHFT and SHFT, respectively. Video consultations comprised up to one-third of total telepsychiatric services per month from April to September 2020. For patients with dementia, non-attendance rates at in-person appointments were higher than remote appointments (17.2% vs 3.9%). The overall HoNOS cluster value increased only in the organic superclass (clusters 18–21, n=174; p<0.001) from 2019 to 2020, suggesting a specific impact of the COVID-19 pandemic on this population of patients.Conclusions and clinical implicationsThe rapid shift to remote service delivery has not reached some groups of patients who may require more tailored management with telepsychiatry.

“Lost between the interface of physical and mental health”: focus groups exploring liaison psychiatry staff's perception about working during the first wave of the COVID-19 pandemic in Birmingham and Solihull Mental Health Foundation Trust

AimsAs the COVID-19 pandemic continues, increasing attention is being drawn to the welfare of healthcare providers who have endured many months of sustained exposure to the virus, disrupted working conditions and psychological stress. This project aimed to explore the subjective experiences of staff working in Liaison Psychiatry (LP) in the Birmingham and Solihull Mental Health Foundation Trust, (BSMHFT) during the first wave of the COVID-19 pandemic. These findings have been used to devise recommendations for subsequent waves.MethodData collection occurred as part of a mixed method service evaluation project. We invited all clinical and non-clinical staff from LP departments across BSMHFT to participate in focus groups conducted via Microsoft Teams. The focus groups were video-recorded and facilitated by a moderator and an observer. Subsequent anonymised transcripts were coded and themes were generated by at least two evaluators, using thematic analysis.ResultThe focus groups, which ranged from 21 to 69 minutes, involved consultants, junior doctors and nurses from four hospitals within BSMHFT. Six major themes emerged including an initial reduction in number yet increase in acuity of patients seen by LP, with some perception that this resulted from reduced face-to-face contact with community mental health services. A feeling that LP was lost at the interface between the physical and mental health trusts emerged as another theme. Uncertainty in adapting to unprecedented working conditions, for example, unclear guidance concerning the use of personal protective equipment, was also described alongside anxiety about contracting and transmitting SARS-Cov-2. Additionally, increased pressure was felt due to staff shortages and inadequate inter-departmental communication. Participants reported differential uptake of remote working, as well as conflicting views regarding the feasibility of remote assessments in LP.ConclusionLiaison psychiatry staff within BSMHFT continued to provide a crucial service during the COVID-19 pandemic. Focus groups with thes staff indicate several recommendations for implementation within the Trust and provoke questions for future research. Due to the unique role that LP plays in providing mental health care within general hospitals, clear guidance for LP staff is key for effective service provision and supporting LP staff. Although used widely across community mental health services, the role of remote working in LP is contentious and requires further exploration. However, there are limitations to the use of focus groups and these findings may not fully represent the experiences of LP staff throughout BSMHFT. Different themes may have emerged through the use of anonymous questionnaires.

Perception of junior doctors about local induction in Birmingham and Solihull Mental Health Foundation Trust - A quality improvement project

AimsA quality improvement project was undertaken to understand the perception of trainees about the quality of the local induction delivered by Birmingham and Solihull Mental Health Foundation Trust (BSMHFT). The primary aim was to evaluate the current local induction programme, following concerns raised by previous trainees in National Training Survey (General Medical Council) and local inspection. Our secondary aim was to devise a revised induction programme based on the trainees’ identified needs.MethodTwo anonymised questionnaire surveys were emailed to all Foundation Year Trainees, Core Psychiatry Trainees and General Practice Speciality Trainees working in BSMHFT, in December 2019 and March 2020, using trust survey monkey.ResultThe overall response to survey was 60 percent. 44.44 percent of the responses came from Core Psychiatry Trainees, with 27.78 percent responses each from Foundation Year Trainees and GP Speciality Trainees. Local induction was defined as induction specific to place of work (47.06%), trust based induction (41.18%) or all of the above options (11.76%) by trainees. 83.33% of all trainees had received local induction, whereas 16.67% did not have any local induction at the start of their post. 11.12% trainees were very satisfied and 44.44% were satisfied with local induction. 72.22 percent of the trainees were informed about of the local induction, prior to starting the post.33.3% trainees had a paper version, 22.22% had an electronic version of local induction pack, whereas 44.44% had no induction pack. 55.55% of those trainees who had an induction pack, 43.75% found it very helpful and 56.25% did not find it helpful.88.89% thought having a local induction would be helpful, whereas 11.11 percent did not feel it would help. 94.44% of the trainees completed a local orientation checklist with their consultants. Some of the trainees experienced difficulty in gaining access to electronic prescribing, electronic patient record system (RIO), and identity badges (ID) at the beginning of their post.Conclusion11.12% trainees were very satisfied, 44.44% were satisfied, 22.22 % were neither satisfied nor dissatisfied and 22 % were dissatisfied, with local induction. 88.89% of the trainees thought having a local induction pack would be helpful. Based on the trainees identified needs we developed a template for local induction pack for each post. Clinical supervisors have agreed to take the lead in preparing the local induction pack specific to their post with trainees.We aim to repeat the survey after implementing the changes identified by trainees based on their training needs.

The effectiveness of community treatment orders (CTOS) across Birmingham and Solihull Mental Health Foundation Trust (BSMHFT)

AimsTo ascertain if CTOs ensure that patients are effectively treated in the community and maintain stability in their mental health.If a patient requires recall(+/- revocation) that this is done in a timely fashion in according to the 1983 Mental Health Act.BackgroundA number of studies have been inconclusive in determining the benefits of CTOs in reducing the re-admissions of “revolving door” patients In Assertive Outreach (AO). It is felt that CTOs have reduced readmission of patients due to the intensive input from community teams, decreased recall and subsequent revocation. Those admitted are thought to require fewer inpatient days. It is clear that many patients who require recall following non-engagement, non-compliance, will accept medication following RC review. However at present in BSMHFT patients can only be recalled if they are allocated a bed. Due to the national bed shortage, this has resulted in delays following decision to recall and thus early and effective treatment for patients. In this aspect it defeats the role of the CTO as per the 2007 MHA.MethodCTO data from 1st April 2018 to 31st March 2019 was obtained from all 6 AOT's in BSMHFT. The following factors were considered; 1.Time between decision to recall by RC and recall to inpatient facility2.Number of recalls converted to revocations3.Number of inpatient bed days if revoked4.Number of admissions on CTO5.Patient/family agreement of CTOResult98 CTO patients were recorded over this period. 19 out of 26 recalls had recall dates documented. 10 recalls were revoked due to relapse of mental illness. Average days from RC recall decision to actual recall or cancellation was 63.89 days. Main reasons for delay were bed unavailability and execution of warrant.Following revocation, average inpatient bed days was 103.71. 41% of families agreed with CTOs, 36% of patients contested their CTO.ConclusionOver a quarter of patients on CTO were recalled to hospital however, less than half of these had their CTO revoked. The remainder accepted treatment following urgent community review whilst on the bed list. Evidently the majority of patients didn't need admission. With the ongoing bed crisis, alternative avenues need to be sought to ensure prompt treatment and prevent relapse.A CTO suite designed for recall could be the solution for the future.

Evaluation of physical health assessments for new admissions to the Oleaster during the first wave of COVID-19

AimsPhysical health of psychiatric inpatients is worse than the general population. Physical health monitoring of these patients can have positive effects on outcomes. Birmingham and Solihull Mental Health Foundation Trust (BSMHFT) states that a physical health assessment (PHA) should be completed within 72 hours of admission. This comprises a physical health form (PHF) and minimum data set (MDS): BP, BMI, TB and BBV status, alcohol and drug screen, smoking status, Hba1c and lipids. In a 2017 audit, compliance was shown to need improvement, with 28.3% of admissions not having a PHF documented.ObjectivesTo assess whether PHAs for new admissions to the Oleaster, Birmingham during the first wave of COVID-19 were completed in line with trust policyTo compare findings with a previous auditTo make recommendations to improve inpatient physical health and compliance with trust policyMethodA retrospective audit was conducted, with PHA details accessed via the electronic medical records system RiO. Admissions from 16/03/2020-30/06/2020 were accessed and 158 admissions (155 patients) were included. 21 admissions were excluded as they were internal transfers; only data from the initial admission were included. Data were collected by 2 medical students and a psychiatry trainee using a data collection tool. Data were recorded and analysed on Excel.ResultOf 158 admissions, 81 had PHFs (51.3%). 59 were completed within 72 hours of admission (34.3%); 39 were completed fully (24.7%). Of incomplete PHFs, 2 explicitly stated incompletion due to COVID-19. 22 PHFs were created but not completed within 72 hours. 15 gave a deferral reason e.g., refusal to consent or agitation. For 77 admissions (47.3%), no assessment was documented, with no reason given.2 admissions (1.3%) recorded the full MDS within 72 hours of admission.2 admissions (1.3%) had fully complete PHAs (PHF and MDS) within 72 hours of admission, fulfilling trust policy.Conclusion51.3% of admissions had a PHF, with 34.3% documented within 72 hours of admission. However, only 1.3% of admissions fulfilled trust policy of both a completed PHF and MDS within 72 hours of admission. There were more admissions without a PHF than in the previous 2017 audit; 47.33% compared to 28.3% previously. Given trust targets that a PHA should be fully completed for 100% of admissions, it was found that the Oleaster did not meet these guidelines during this period and improvements must be made to maintain integrity of patient care.

462 COUNSELLING IN CARE HOMES

Introduction Although many people live well within care homes, it is estimated that 60% of those living in residential care have poor mental health (Age Concern & Mental Health Foundation, 2006) and 40% suffer from depression (The Royal College of General Practitioners, 2014). Antidepressant prescribing has been reported to be nearly four times greater in care homes than for older people living in the community (Harris, Carey, Shah, Dewilde & Cook, 2012). However, antidepressants have been found to be ineffective for people with dementia (Dudas, Malouf, McCleery & Dening, 2018). With two-thirds of care home residents having some form of dementia, there is a need to find alternative interventions. Talking therapies, such as counselling, may be a useful alternative. Method Adopting a qualitative approach using semi-structured interviews and focus groups with counsellors (N = 12) who have experience of working in this context and with care home managers (N = 3) and care teams (N = 6), this study aimed to explore the feasibility of implementing counselling in a care home setting. We explored the views of care home staff towards counselling and identify barriers to service implementation, alongside the experience of counsellors who have delivered counselling in care homes to understand what service delivery models are currently adopted. Data were analysed thematically. Results Findings fell under the following key themes: The funding and referral process for counselling in a care home; skills and competences required; training needs; adaptations to practice; barriers to implementing counselling in a care home. Conclusions It is timely to consider the role of psychological therapy in supporting the mental health of care home residents. There is a need for further research to explore a service delivery model of counselling in care homes.

Mind Support: A Systematic Review of Online Peer Support Platforms

Provision of mental healthcare is currently limited and not accessible to all those who require it. The nature of this gap in mental health support calls for a solution that is more accessible, affordable and personalized to prevent the exacerbation of mild mental health issues and to offer support as an adjunct to state of the art therapeutics. To this effect, the non-profit mental health foundation “Mind Support” has been set up, an online peer support platform. This paper analyses the approach and solutions offered by this platform for the growing gap in mental health support and demonstrates the benefits and limitations of online peer support in general. Online peer support as provided by “Mind Support” has the advantage of being anonymous and is free of charge making it accessible to everybody. At the same time, “Mind Support” reaps the benefits of traditional peer support options, such as having a more trauma-informed approach rather than an illness-focused one, aiding in the reduction of stigma and welcoming dialogue. The aim of this article is to stimulate the use of online tools to bridge the mental health support gap.

TEMPAT RETRET KOTA

This world has created major changes, this is considered as the impact of the current globalization that cannot be stopped anymore. This stream of globalization has caused stress for the millennial generation. Millennials are those that are affected by this current, the largest - with their birth in 1981-2000. They are also people of productive age. Research from the Mental Health Foundation (MHF, 2018) found millennials were more stressed than other older age groups such as generation X. This attracted attention to mental and physical health, especially spiritual issues to overcome this. The purpose of this project is to introduce a new type of place of spirituality in the millennial generation, to open new understandings and thoughts about spirituality in architecture, to produce architectural works that support new changes in the millennial generation, and to increase awareness in the millennial pre-post architectural direction future spirituality. Theoretical study that underlies this design project is taken from Suzan Caroll's book entitled Seven Steps to Soul and the method used is Thematic Narrative Architecture. Thematic Approach Narrative Architecture is a design approach by telling a process that considers the application of themes as elements in a building. This approach is supported by other sub-methods, namely Spatial Gestalts, Experiential Archetypes and Reference. This design project brings users into a spiritual experience that aims to become a place of self-release for all people, especially millennials. Abstrak Dunia ini telah menciptakan perubahan besar, hal ini dianggap sebagai dampak dari arus globalisasi yang sudah tidak dapat dibendung lagi. Arus globalisasi ini mengakibatkan stress bagi generasi milennial. Milennial adalah mereka yang terkena dampak arus ini terbesar -dengan kelahirannya pada tahun 1981-2000. Mereka juga adalah orang-orang dengan usia produktif. Penelitian dari Mental Health Foundation (MHF, 2018) menemukan generasi milenial lebih stres dibandingkan kelompok usia lain yang lebih tua seperti generasi X. Hal ini menarik perhatian akan hal kesehatan mental serta fisik khususnya spiritual untuk menanggulangi ini. Adapun tujuan dari proyek ini yaitu mengenalkan tipe baru tempat spiritualitas pada jaman generasi milennial, membuka pengertian dan pemikiran baru tentang spiritualitas dalam arsitektur, menghasilkan karya arsitektur yang mendukung perubahan baru pada jaman generasi milennial, dan meningkatkan awareness pada generasi sebelum-sesudah millennial akan arahan arsitektur spiritualitas kedepan. Kajian Teori yang mendasari proyek desain ini diambil dari buku Suzan Caroll yang berjudul Seven Steps to Soul dan metode yang digunakan adalah Thematic Narrative Architecture.Pendekatan Thematic Narrative Architecture adalah pendekatan desain dengan menceritakan sebuah proses yang memperhatikan penerapan tema sebagai unsur-unsur pada bangunan. Pendekatan ini didukung oleh sub-metode lainnya yaitu Spatial Gestalts, Experiential Archetypes dan Reference. Proyek rancangan ini membawa pengguna kedalam sebuah pengalaman spiritual yang bertujuan untuk menjadi tempat pelepasan diri bagi semua orang khususnya millennial.