Tawanda Machingura

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.

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.

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.