Sally Hardy

Mental and physical health comordibity: Political imperatives and practice implications

Insufficient priority is being given to meet the physical health-care needs of people with mental illness. Mental health nurses, as the largest professional group working in mental health care, have a pivotal role in improving the physical health and well-being of people with mental illness. Through health-promotion strategies, alongside recovery-focused support aimed at avoiding deteriorating physical health, mental health nurses can significantly contribute to improving the current rate of premature death experienced by people with enduring mental illness. Drawing from contemporary policy, alongside practical examples taken from the published literature, this paper considers what constitutes recommended best practice in dealing with the physical health-care needs of people with mental illness. The role that UK-based health-care policy plays in shaping care delivery that meets the needs of people with mental illness is explored and placed within the context of global health concerns. Recommendations are made on how mental health nursing can work to provide evidence for a reassertion that nurses are well placed to work across organizational and professional boundaries to deliver person-centred care and a holistic approach to population health and well-being.

Re-Defining Nursing Expertise in the United Kingdom:

There is now international recognition of the importance of practice expertise in modern and effective health services. The Expertise in Practice Project in the United Kingdom began in May 1998 and continued to 2004. It included nurses working in all four countries of the United Kingdom, and it covered clinical specialists from pediatrics to palliative care. The project added to the current understanding of what nursing practice expertise is, through the identification and verification of attributes and factors which enable expert practice. The proposed framework offers a language for sharing what constitutes practice expertise and offers insight into what occurs between the expert practitioner and the people that experience their care. The Expertise in Practice Project demonstrates that nurses affect change and facilitate performance and organizational development.

The INFORM project: a service user-led research endeavor.

Effective engagement with people who experience mental health care services, as research participants and as research leads, is presented. A group of volunteer mental health survivors, called INFORM, worked for 6 years to develop and complete a research project, exploring service user experience of a home treatment and crisis resolution service. Within the article, discussion is given to the significance of service continuity, alongside personal accounts of the impact and consequences of health care staffs interpersonal interactions. Two contrasting messages arise from this study: first, the articulation of what services users want from services, and how that relates to what they actually receive, continues to be a necessary debate and issue for consideration at a time of considerable health care reform. The second message is that such articulation, although necessary, is not sufficient in itself to ensure that services are responsive to service user needs and preferences. Findings from the evaluation are consistent with other service user-led research. However, what is also evident is that more work is required in enabling health care consumers to provide feedback that can then be used to inform practice and service delivery improvement.

Barebacking and sexual position

Bareback sex continues to fuel the HIV epidemic among men who have sex with men but despite the fact that much academic attention has been focused on the sexual behaviour of this population few authors have considered the significance of sexual position. In order to explore this relatively under-examined factor, interviews were conducted with 13 HIV-negative and unknown status gay men who had recently engaged in bareback sex. Using Interpretative Phenomenological Analysis and through the lens of sexual position, the findings were organized across three super-ordinal themes. There were some areas in which there was little difference between the mens experiences of engaging in bareback as tops or bottoms (for instance, how participants connected with barebacking partners). In other areas, however, there were clear differences in mens experiences according to sexual position, particularly in the interpersonal dynamic between tops and bottoms during bareback sex encounters, which, it is argued, were acted out in accordance with a barebacking ‘sexual script’. There were further differences by position in how individuals overcame ‘cognitive dissonance’ by invoking strategies to make their engagement in bareback sex safer and in the meanings men ascribed to bareback sex and semen exchange. These findings provide valuable insights for those working with MSM around HIV prevention.

What does practice development (PD) offer mental health‐care contexts? A comparative case study of PD methods and outcomes

Accessible summary Comparing three bespoke practice development (PD) projects reveals similarities in the principles of person-centred practice and cathartic personal growth, as relevant concepts to mental health. PD offers a collaborative approach to practice-driven quality improvement initiatives suitable to the psychologically informed mental health context. Creating a workplace culture that allows all involved to contribute to service improvement can be achieved through embracing a PD-driven change management strategy that aims to stimulate culturally sensitive care delivery. Abstract Practice development (PD) in mental health nursing has been progressing over the last decade; however, the level and impact of PD activity in the field of mental health remains poorly understood outside localized project impact. More specific reporting and comparative analysis of PD outcomes will improve this situation. In response, this paper presents three case scenarios from work taking place in Australia and New Zealand, as working examples of how PD methodologies have been applied within mental health practice settings. Using a comparative framework that captures the contributing assumptions, practices, processes and conditions imperative to effective PD work within a mental health-care context, three case vignettes are reviewed. The critical question driving this paper is ‘what mental health-care services does PD offer in terms of transformational change approaches and the promotion of effective workplace cultures?’ Conditions considered necessary for successful PD initiatives within mental health contexts are explored such as how PD converges and diverges with mental health-related theories, plus where and how PD activity best integrates with the specific elements associated with mental health-care provision. The findings are further reviewed in line with reports of PD outcomes from other fields of health care.

Mental health nursing and the importance of celebrating the skellern lecture and jpmhn lifetime achievement award 2018

The Skellern Lecture and JPMHN Lifetime Achievement Award is scheduled for 14 June 2018, hosted by University of Greenwich. Each year mental health nurses nominate and vote as peers to identify annual award winners. The Skellern Lecture identifies someone working to showcase the contribution mental health is having on modern society, whilst the Lifetime Achievement is offered in recognition of a dedicated career to mental health and wellbeing agendas. This article is protected by copyright. All rights reserved.

JPMHN report on the 2018 Skellern Lecture and JPHMN Lifetime Achievement Award-held at the University of Greenwich Maritime Campus, June 14th 2018

Eileen Skellerns contribution to the development of the modern profession of psychiatric and mental health nursing in the UK was considerable both in terms of practice and policy development. Skellern organised the first major international mental health nursing conference in the UK in 1980, but sadly she died two months before the conference. In 1982 the Skellern Lecture was established to remember Eileen. Since then, there has been a long list of leading nurses who have delivered the Skellern Lecture. This article is protected by copyright. All rights reserved.

Promoting Care Giving Interventions through the Dance of Caring Persons (After Pross et al.)

Health and social care staff work in complex workplace cultures that expose them to human suffering, distress and ‘dis-ease’. To defend themselves from emotional and physical pain, staffs undertake tasks, rituals, customs and practices to ameliorate discomfort. This serves as psychological and physical protection from their clients; alien to the ethos of person centred compassionate care. The dance of caring persons is a metaphor for the physical and emotional interaction of a caring relationship. Being facilitated through each of the dance steps offers one way to reignite caring professions. We outline a workshop process aimed to re-engage care staff with an intention to care. Self-care is the first step, which at an intentional, meaningful level requires a moment of mindfulness as internal bodily awareness. Noticing one’s emotional state increases self-awareness and an ability to focus on the here and now, from which to relish the breadth and depth of human experience. The second step includes a moment of performance; through intentional use of non-verbal communication to welcome and engage with others. The third step of the dance is active and effective verbal communication used to purposefully enter into a caring relationship. The fourth step is critical creative discussion, following mutual reflection of what has gone before. Step five is resonance; delving deeper into understanding the emotional and body senses, exploring the words exchanged, their intention and ‘true’ meaning. Step six is the creation of a ‘collage of caring’. Fragments of mutual learning, emotive expression and reactions (impact) are captured in the final exchange undertaken by all involved in the caring process. The dance of caring persons aims to identify the dance steps each person contributes to the context of caring. Such a compendium of caring provokes a deeper understanding of self in relation to the other, within the context of health and social care interactions.

Introducing a People’s Academy into Higher Education: A coproduction approach to sustained well-being

Purpose: The introduction of a People’s Academy within the School of Health and Social Care at London South Bank University has created ripples across the pond that is Higher Education. Approach: Working as a coproduction innovation hub, the People’s Academy celebrates inclusion of those with a lived experience of health and social care services into the academic community as valued members of the teaching and learning team. In it’s second year the People’s Academy has gained attention and achieved a ‘highly commended’ status from external regulating bodies. Findings: In this paper we report on aspects arising from an entrepreneurial education approach. First, is the work based learning experience students achieve within the Higher Education Institution setting, preparing them for clinical placements and client encounters. Second are ripples of activity the People’s Academy workstreams have sent throughout the academic staff via critically creative working practices as a process of entrepreneurial education. Conclusions focus on a sustainable approach to recovery and resilience (whether physical or psychological) and overall wellbeing that People’s Academy members recognise as a raised level of compassion for sustainable health and wellbeing for all. Originality: The work and enthusiasm of the People’s Academy as an authentic social engagement process rippling across the ‘University’ experience; whether for students in the classroom or when working alongside academic staff, is identifiable in all aspects of academic activities. Most importantly is a positive gain in terms of knowledge, skills and confidence for the People’s Academy members themselves and their own wellbeing enhancement.

Perspectives: Is health and social care person centred? Hello, my name is not enough

The World Health Organisation (www.who.int) confirms a growing global population that requires access to effective health care, yet the economic burden of delivery raises questions about whether individualised care is realistic or achievable. Person-centred care places people as equal partners in addressing their individual health care needs. Such a ‘personalised’ approach aims to ensure treatment options are the most appropriate for each person’s specific health requirements, thereby increasing the likelihood of a positive and satisfactory outcome. It involves putting patients and their families/carers at the heart of all decisions. In England, the White Paper ‘Equity and Excellence: Liberating the NHS’ (2012) set out the Government’s vision to put patients and the public first; where ‘no decision about me, without me’ is the set standard for care commissioning and delivery. Whilst considered an ambition, the notion of person-centred care delivery is rarely contested, yet major reports into poor care (c.f. Francis, 2013; Kirkup, 2015) suggest that the policy directive has yet to be universally implemented in practice. Health and social care services across the globe are facing a huge rise in demand, as people live longer and as treatment options become more sophisticated. Take, for example, the experiences outlined in health and social care institutions such as Alder Hey Hospital, Mid Staffordshire Hospitals, Morecombe Bay Hospital and Winterbourne View care homes, to name but a few of the public inquiries into neglect that have revealed evidence of depravity and cruelty, which has led to widespread proportioning of blame on those who deliver care. Subsequent pressure on the Care Quality Commission (which monitors quality provision in England) is to publicly expose large National Health Service (NHS) organisations, such as those mentioned, but often these reports neglect to explain the broader context that organisations are battling against increased demand alongside fiscal austerity from a £2.4bn deficit in government