A qualitative study of staff experiences on an adult acute mental health inpatient unit: Implications for the development of psychosocial aspects of the service
thesisposted on 18.11.2011, 11:19 by Shelley Marie Parkin
Despite research demonstrating their effectiveness and recommendations of top-down guidance, little in the way of psychosocial services is being delivered within acute inpatient facilities in the UK. The literature review compiled an up-to-date appraisal of research pertaining to the utility of psychosocial services within adult acute mental health inpatient facilities. Searching databases resulted in eleven studies being critically reviewed. Articles related to inpatients, staff and interventions aimed at the organisational level. Despite similar methodological limitations, psychosocial services positively impacted upon self-cognitions, symptoms, functioning and relapse. Staff training improved clinical practice and promoted feelings of staff empowerment. Organisational research demonstrated the need for stakeholder inclusion and supportive organisational structures, for long-term change. Barriers to change, including staff psychological distress and feeling unsupported were highlighted. Qualitative research is needed that further explores obstructions to change and improvement. The research study explored experiences and priorities of staff working in adult acute mental health inpatient units, regarding the role of psychosocial services. The aim was to consider how this differs to and affects the implementation of national guidelines and scientific recommendations, with a view to making suggestions regarding effective implementation. Eight staff members participated in a semi-structured interview and data was analysed using grounded theory. Data emerged suggesting the ward to be isolated, with a lack of team work and effective leadership. The focus on medication encouraged hopelessness about patient progress and a lack of understanding about patients and their own feelings towards them. Staff felt powerless, unsupported and undervalued. They experienced a lack of professional confidence, performance anxiety and fear of change, resulting in overall ambivalence towards change and improvement. Training and therapeutic services for staff are needed, along with organisational consultancy, to increase effective team work, leadership and staff input into service development. Future research is considered.