Chris Lloyd

An investigation into the effectiveness of sensory modulation in reducing seclusion within an acute mental health unit

Abstract In this paper we report the findings from an evaluation of the introduction of sensory modulation (SM) in an acute mental health inpatient unit. It was expected that SM could be used to help settle patients experiencing high levels of disturbance and that as a result, there would be less need for use of more restrictive seclusion practices. The evaluation took place in a hospital in south-east Queensland, Australia. SM was introduced in one acute unit while the other served as a control. The evaluation comprised two studies. In the first study we aimed to determine whether SM reduced the level of disturbance among patients given the opportunity to use it. In the second study we aimed to find out whether the introduction of SM reduced the frequency and duration of seclusion. In study 1, we found that most patients reported marked reduction in disturbance after using SM and there was a very large effect size for the group as a whole. In study 2, we found that frequency of seclusion dropped dramatically in the unit that introduced SM but rose slightly in the unit that did not have access to SM. The change in seclusion rate was highly significant (χ2 = 49.1, df = 1, p < 0.001). Results are discussed, having reference to the limitations inherent in a naturalistic study.

Forming implementation intentions improves prospective memory in early psychosis

The study examined whether individuals with early psychosis are impaired in prospective memory (PM), that is, remembering to execute a planned intention in the future, and whether implementation intentions can improve their PM performance. Thirty participants with early psychosis and 33 healthy controls were randomly allocated to either an implementation intentions or control condition and completed a computerised event-based PM task. Participants were also administered two standardised tests of PM and an abbreviated IQ test. Results demonstrated that individuals with early psychosis showed PM deficits relative to healthy controls on the computerised PM task and on some standardised measures of PM. The PM performance of the early psychosis group benefited from forming implementation intentions. Implementation intentions was concluded to be an effective strategy for improving PM performance in individuals with early psychosis.

Formal plan for self-disclosure enhances supported employment outcomes among young people with severe mental illness.

Young people with mental illness experience high levels of unemployment, which can be related to stigma and discrimination. This may result from poor choices in disclosing personal information, such as their mental illness diagnosis, in the workplace. The aim of this study was to investigate the predictive validity of a formal plan to manage personal information (PMPI) during the early stages of supported employment. The focal question was: does the use of a brief structured PMPI lead to more employment outcomes for young people with a mental illness?

A review of job tenure under the Job in Jeopardy programme in first episode psychosis

Introduction This paper explores what happens to young people with psychosis who have competitive employment when they first engage in treatment. Method 11 of 39 (28%) of programme participants of an individual placement and support programme who received vocational assistance under the Job in Jeopardy funding were identified. A prospective observational design was used to evaluate programme outcomes over a minimum of 6 months. Results It is of interest that the majority of young people who were at risk of losing their job and were receiving assistance did not manage to sustain employment. At the completion of data collection only two people continued to be engaged in competitive employment. Conclusion Although the sample is very small, there appears to be a clear trend demonstrating that being engaged in competitive employment at the point of experiencing a first episode of psychosis does not protect an individual against losing that job. It is evident that staff involved with this group of clients need to assist those with employment to maintain it. There is the potential for occupational therapists to play a key role in assisting these young people to secure and maintain meaningful occupation.

A focus on recovery: using the Mental Health Recovery Star as an outcome measure

Purpose: The Mental Health Recovery Star was adopted as a routine outcome measure by recovery clinicians in the newly developed Mental Health Recovery Service in Queensland, Australia. Design/approach: All service users referred to the Recovery Service during a three-month period completed the Mental Health Recovery Star. A chart audit was conducted to review the utility of the Mental Health Recovery Star as a clinical outcome measure. Findings: Recovery goals identified by service users through this process and the progress they made are reported. Service users identified that they needed assistance in work, social networks, managing mental health and identity and self-esteem. Conclusion: Overall, it was found that the Mental Health Recovery Star was useful in service mapping and assisting recovery clinicians to identify areas that they needed to focus on when providing treatment and following service users progress. It complemented other outcome measures used by the service.

Drug and alcohol use of the homeless within the Homeless Health Outreach Team: Is there an association between drug of choice and mental health diagnosis?

Abstract Alcohol and drug use is commonly reported in homeless populations. The research aimed to identify drug use patterns of the Homeless Health Outreach Team (HHOT) clients, to look at the period and type of homelessness as well as to investigate wether there were any correlations between diagnosis and drug of choice. A chart audit was conducted of the case managed clients of HHOT. Fifty-four charts were reviewed. It was found that a high percentage of people used alcohol, cannabis, opioids, and amphetamines. However, there were no signifi cant correlations found between drug of choice and diagnosis.

The effectiveness of support groups: a literature review

Support groups are a common feature of the mental health support engaged by carers and consumers. The purpose of this paper is to update and consolidate the knowledge and the evidence for the effectiveness of mental health support groups.,This paper is based on a systematic literature review of relevant databases around support groups for mental health. Support groups are defined as meetings of people with similar experiences, such as those defined as carers of a person living with a mental illness or a person living with a mental illness. These meetings aim to provide support and companionship to one another.,The results show that there is a consistent pattern of evidence, over a long period of time, which confirms the effectiveness of mental health support groups for carers and people living with mental illness. There is strong, scientifically rigorous evidence which shows the effectiveness of professionally facilitated, family-led support groups, psychoeducation carers support groups, and professionally facilitated, program-based support groups for people living with mental illness.,This research implies the use of support groups is an important adjunct to the support of carers and people with mental illness, including severe mental illness.,This research brings together a range of studies indicating the usefulness of support groups as an adjunct to mental health therapy.

Effectiveness of sensory modulation in treating sensory modulation disorders in adults with schizophrenia: a Systematic Literature Review

Sensory modulation, as a treatment for sensory modulation disorders in adults with psychiatric conditions, has been implemented by occupational therapists for more than two decades. The purpose of this systematic literature review was to evaluate published research evidence relating to this intervention. The aim of the study was to determine if there was established evidence for the effectiveness of sensory modulation in treating sensory modulation disorder in adults with schizophrenia and to identify any gaps in knowledge to guide further research. We utilized Australia’s National Health and Medical Research Council (NHMRC)’s levels of evidence and recommendation grading and the Rosalind Franklin Research Appraisal Instrument (RF-QRA) to review selected articles. The results were then summarized and reported utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. A total of 17 studies were included in the study. We concluded that there is preliminary evidence for the existence of sensory modulation disorder in schizophrenia and the effectiveness of sensory modulation interventions for reducing distress. We recommended further studies on the effectiveness of sensory modulation with better rigor and advise that guidelines be developed for use in practice by clinicians.

Mental health occupational therapy and supported employment

Purpose The individual placement and support (IPS) model is an evidence-based approach to employment support for people with severe mental illness that functions by co-locating an employment consultant from the local disability employment service within a community mental health team to assist service users to find work. This paper aims to examine the unintended impacts of implementing IPS on occupational therapy practice and offer some suggestions. Design/methodology/approach The authors performed a narrative literature review on the IPS model, employment and occupational therapy. Authors then analysed and discussed impact on occupational therapy practice and concluded by making suggestions based on current evidence and practice. Findings The authors concluded that implementation of IPS has resulted in some unintended changes of practice in mental health with occupational therapists taking a less active role in enabling employment outcomes than previously. This paper concludes by calling upon occupational therapists to re-establish their role of enabling employment. Originality/value This paper offers an original viewpoint on employment and occupational therapy based on current evidence and authors’ expertise.

Progressing recovery-oriented care in psychiatric inpatient units: Occupational therapy’s role in supporting a stronger peer workforce

Purpose Initiated by the service user movement, recovery-oriented practices are one of the keystones of modern mental health care. Over the past two decades, substantial gains have been made with introducing recovery-oriented practice in many areas of mental health practice, but there remain areas where progress is delayed, notably, the psychiatric inpatient environment. The peer support workforce can play a pivotal role in progressing recovery-oriented practices. The purpose of this paper is to provide a pragmatic consideration of how occupational therapists can influence mental health systems to work proactively with a peer workforce. Design/methodology/approach The authors reviewed current literature and considered practical approaches to building a peer workforce in collaboration with occupational therapists. Findings It is suggested that the peer support workforce should be consciously enhanced in the inpatient setting to support culture change as a matter of priority. Occupational therapists working on inpatient units should play a key role in promoting and supporting the growth in the peer support workforce. Doing so will enrich the Occupational Therapy profession as well as improving service user outcomes. Originality/value This paper seeks to provide a pragmatic consideration of how occupational therapists can influence mental health systems to work proactively with a peer workforce.