bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving the Knowledge, Skills and Confidence of Clinicians Towards Mental Health: An Educational Intervention Based on Reflective Practice
Authors: Alinia Meda
Published: July 2023

Aims

Mental illness-related stigma, including that which exists in the healthcare system creates serious barriers to access and quality care. People with lived experience of a mental illness commonly report feeling devalued, dismissed, and dehumanized by many of the health professionals with whom they come into contact. While working in the mental health liaison team in a local general hospital I have experienced first-hand these issues. We decided to organise regular reflective sessions for staff to reflect on what the barriers are to being able to manage patients with mental illness better on the wards, raise mental health awareness, improve staff communication skills, and offer teaching sessions to improve the staff knowledge of psychiatric pathology.

Methods

Before starting, we offered a feedback form to staff to ascertain the value of the project.

To ascertain that the learning has taken place, we have delivered a post-session formative quiz to assess the staff's knowledge of managing patients with mental illness.

To determine the effectiveness of the project, we decided to use Kirkpatrick's evaluation model and assess the first two levels of the programme outcome: (1) learner satisfaction- through staff feedback; (2) measures of learning- knowledge gained showed in the formative post-session quiz.

Results

The sessions were carried out on 2 wards in the general hospital

•

Ward 1: 4 sessions; number of attendees: 12

•

Ward 2: 4 sessions; number of attendees: 5

The student evaluation was done through a quiz offered to the participants at the end of each session.

9 quiz questionnaires were completed on ward 1:

Correct answers: Q1- 67%; Q2- 89%; Q3- 0%; Q4- 100%.

5 quiz questionnaires were completed on ward 2:

Correct answers: Q1- 20%; Q2- 60%; Q3- 0%; Q4- 40%.

The programme evaluation was done through a feedback form offered to the participants at the end of each session.

12 forms were completed on ward 1: 50% strongly agreed that the session was useful to their practice; 70% were quite confident in caring for patients with mental illness following the session.

5 forms were completed on ward 2: 20% strongly agreed that the session was beneficial; 75% were quite confident in caring for patients with mental illness following the session.

Conclusion

Difficult to implement a culture change.

Following a meeting with the stakeholders, we agreed on delivering monthly reflective sessions to the staff in their allocated “team time” where attendance is mandatory and we will also take part in a developmental teaching programme for band 5 nursing staff

We are in the process of extending our project to the Emergency department
Evaluation of the Psychiatry Early Experience Programme: Thematic Analysis of Baseline and One-Year Follow-Up Surveys
Authors: Sanchez Lucia Almazan , Tansley-Ahmed Zena , Morrin Hamilton , Orlando Lia , Crowley Grace , Boardman-Pretty Theo , Rifkin-Zybutz Raphael
Published: July 2023

Aims

The Psychiatry Early Experience Programme (PEEP) is a long-standing scheme, collaboratively run by GKT School of Medical Education and SLaM Trust, which pairs medical students with core psychiatry trainees for clinical shadowing, mentoring and educational talks for the duration of their degree. We aimed to understand the motives of first year students signing up to PEEP and compare these to their feedback after one year.

Methods

Before the 2015 and 2016 academic years we administered an online survey to 159 medical students interested in joining PEEP, asking the free-text questions: “What do you most hope to get out of PEEP?”, and “Why are you interested in the PEEP programme?”. Eighty students were selected for enrollment and of these, sixty who participated in one year of the programme completed a follow-up survey, including the question “What have you taken away from your experience of PEEP so far?”. Authors conducted thematic analysis of the qualitative responses at both timepoints, identifying common themes and seeking feedback from third raters when conflicts emerged.

Results

Themes identified in responses to the baseline survey fell into two categories: psychiatry-related and non-psychiatry-related. The three most common psychiatry-related themes, were: Better understanding of the specialty (n = 67), Role of a psychiatrist (n = 16) and Evaluating interest/suitability to the specialty (n = 7). The four most common non-psychiatry-related themes were: Obtaining clinical experience (n = 70), Insight into the role of a junior doctor (n = 22) and to the Training pathway (n = 10) and Developing clinical and communication skills (n = 14).

Themes identified in responses to the follow-up survey closely reflected those from the baseline survey. Students commonly expressed that they gained a better understanding of what psychiatry is and what working in psychiatry entails (n = 24) and explored their interest in pursuing a career in psychiatry (n = 10). Similarly, they valued the ability to gain early clinical experience (n = 16) and to develop their clinical and communication skills (n = 9).

Conclusion

The results support the value of PEEP in providing opportunities for medical students to better understand what psychiatry is and explore their interest in the specialty. PEEP is also meeting students’ expectations outside of the realm of psychiatry by facilitating early clinical experience and the development of clinical and communication skills which are less available for medical students in their pre-clinical years.

Further collection and analysis of annual quantitative and qualitative data will ensure continuous evaluation and tailoring of the scheme to meet both students’ expectations and its purpose to foster interest in psychiatry.
“Bitesized Teaching”: Promoting Physical Healthcare in Mental Health Settings
Authors: Amjad Mohammad
Published: July 2023

Aims

To assess the effectiveness of a new educational activity for mental health teams, which is intended to empower staff in the early recognition, escalation and management of acute medical problems.

Methods

Health Education England (HEE) has recently developed a teaching resource named ‘Bitesized Teaching’, which spans 24 physical health topics that are commonly encountered in mental health settings. It provides doctors an evidence based framework to deliver a concise 10–15 minute teaching session on each topic at a convenient time and place for everyone. I organised weekly ‘Bitesized Teaching’ sessions for staff at a long term community rehabilitation unit with complex psychiatric conditions. The topics selected for the 8 sessions were based off staff preferences and included; hypotension, deep vein thrombosis, hyperglycaemia and serotonin syndrome. The presentations covered the signs, symptoms, causes and basic ward level management that can be expected from nursing grades. An anonymous feedback form was distributed after the sessions to assess the effectiveness of this new teaching initiative.

Results

Total number of completed feedback forms = 15 (3 HCAs, 9 nurses and 3 student nurses). 11/15 indicated an improvement in their knowledge and understanding of the topics. 10/15 felt confident in managing patients presenting with the conditions. 10/15 felt the teaching material was 'very relevant' to their roles. 11/15 were 'very likely' to recommend these sessions to a colleague. 12/15 described the sessions as 'very useful' and everyone would like the sessions to continue on a regular basis. Open responses shared similar positive sentiments.

Conclusion

The results were reassuring that the ‘Bitesized Teaching’ approach was received well by staff. There is scope to incorporate this into the weekly schedule of mental health teams more long term. It also offers junior doctors a great teaching opportunity and foster greater inter-professional working relationships.
King's College London's Psychiatry Society's Psych for 6th Programme: An Outreach Initiative in South London Sixth Forms
Authors: Binnie Natasha , Pandey Samyak , De Marchi-Taylor Jada , Dahir Tahani
Published: July 2023

Aims

King's College London's (KCL) Psychiatry Society's ‘Psych for 6th’ programme is an outreach initiative for aspiring medical students in year 12 at sixth forms in South London. The aims of the programme are to raise students’ awareness of mental illnesses; for students to gain a better understanding of the style of learning in medicine through the lens of psychiatry; to widen participation in medicine; and to promote a career in psychiatry.

Methods

25 state sixth forms in Southwark and Lambeth were invited to take part in the programme via email. The programme took place at 4 sixth forms for aspiring medical students in year 12 between September to November 2022. The programme involved 2 one hour sessions over 2 consecutive weeks and was run by KCL Psychiatry Society committee members. Session 1 covered the philosophy of health, illness, mental health and mental illness; an overview of the different mental health professionals and how to become a psychiatrist; an introduction to history taking; and an interactive history-taking activity. Session 2 covered the aetiology, pathophysiology, epidemiology, presentation, diagnosis and management of depression; mental health cases; and an interactive psychiatric history-taking activity. Pre- and post-programme questionnaires were sent to the attendees.

Results

The percentage of students considering a career in psychiatry increased by 20% on completion of the programme. The average attendee confidence with talking to patients increased from 2.3 to 4.2 on completion of the programme, with 1 being not confident at all and 5 being very confident. Students gained a better understanding of the different types of mental health conditions psychiatrists manage - “I thought the information about the different [mental health] disorders was very interesting.” In response to “What did you enjoy the most about these workshops?”, 78% of the students commented on the interactive role-play activity where they were given the opportunity to practise taking a history. The programme also gave students a “broader and deeper understanding of what medical school [is like]”.

Conclusion

The sessions were well received by the students with for many of them this programme being their first exposure to psychiatry. KCL Psychiatry Society looks forward to delivering the programme at further South London sixth forms in 2023, working with other university psychiatry societies to run the programme across the UK, and with other mental health multidisciplinary student societies to expand the programme to delve deeper into other mental health careers.
Say NO to Online Mindfullness - a wellBEHing Initiative
Authors: Campling Hannah , Iftikhar Mashal
Published: July 2023

Aims

Trainees in Barnet, Enfield and Haringey (BEH) Mental Health Trust reported feeling isolated and burnt out after COVID-19. Offers of "online mindfulness" or "resilience training", as a substitute for in-person gatherings, felt very inadequate. Well-being initiatives are known to improve staff morale, mental health, patient care, recruitment and retention of trainees. We created and delivered a pilot well-being programme to improve the well-being of trainee psychiatrists working within BEH between September 2022 and January 2023.

Methods

We developed a WellBEHing brand for our trust and a committee of trainees dedicated to improving the well-being of themselves and their colleagues.

We ran a focus group for all trainees to submit ideas for sessions and activities they would enjoy.

We developed a programme of monthly WellBEHing events during protected well-being time, that was funded by medical education and the local division.

We surveyed trainees pre and post WellBEHing autumn/winter programme to record the impact on their sense of well-being. We also collected qualitative data on their experiences of being part of a WellBEHing community.

Results

Prior to the WellBEHing autumn/winter programme we surveyed 40 trainees in BEH and only 12.5% of them rated their well-being as good or great. 35% of trainees felt unvalued or uncared about at work.

At the end of the autumn/winter WellBEHing programme 73% of trainees felt valued at work, with 60% of trainees feeling "happy and cared for".

Some of the qualitative feedback showed the impact well-being events can have on trainees “Seeing everyone in person, and being able to do so during the working day made me feel that BEH values me enough as an employee to prioritise my well-being. The quiz was also excellent and had clearly had a lot of effort put into it.”

Conclusion

Meaningful well-being initiatives take time, effort and funding. They require the support of management and consultants. Our results demonstrate that when well-being is designed and led by trainees, they feel valued and cared for as employees. We are beginning the second phase of project development where we will focus on making the programme sustainable and embedded in trainee life at BEH long-term.
Depicting Perinatal Mental Illness in Hollyoaks – Diane and Liberty's Plotline Analyses
Authors: Charlton Emily , Sule Akeem
Published: July 2023

Aims

The 2018–2020 MBRACE report highlights that 1.5 women per 100,000 die by suicide during pregnancy or up to 6 weeks postpartum in the UK, a threefold increase since the 2017–2019 report. Raising awareness of the variety and severity of perinatal mental illness is vital in order to reduce stigma and ultimately save lives. Hollyoaks is a soap opera with a target audience aged 16–24 years. In 2020 the show aired the storyline of Liberty Savage, a woman whom developed postpartum psychosis. In 2021 the show aired the story of Diane Hutchinson as she develops symptoms of Obsessive Compulsive Disorder (OCD) during her pregnancy. In this article we analyse both storylines for clinical accuracy and consider the impact that this may have.

Methods

EC and AS held structured discussions in order to assess the accuracy of the portrayal of each illness, comparing each presentation to diagnostic criteria. Further discussions were held to establish themes and to consider the impact of the information/misinformation delivered to viewers.

Results

The production team worked with the charity Action on Postpartum Psychosis when producing Liberty's story. The storyline addresses that Liberty hallucinates, although creative licence is used. She is emotionally labile and highly anxious with a fixation on her baby's well-being.

Unfortunately there are many elements of Liberty's storyline that do not accurately portray post-partum psychosis. She has no delusional beliefs, no thought disorder and is fully orientated. Liberty is consistently immaculately presented and while there is mention that she is sleeping poorly this is not explicitly seen. We do not see any interaction with a psychiatrist and Liberty is not admitted to hospital.

Diane's story begins when she falls pregnant during the COVID-19 pandemic. The production team worked with the charity OCD UK.

Diane's presentation is focused around contamination. Her intrusive thoughts are voiced out-loud for the viewer to hear yet are distinguishable from the spoken dialogue. Her intrusive thoughts escalate during labour and in the immediate postpartum period and her distress is palpable throughout these scenes.

Diane's storyline concludes with an evaluation from a supportive psychiatrist who gives a clinically accurate explanation of her presentation and offers reassurance.

Conclusion

The mainstream media can provide a useful tool to raise awareness of perinatal mental illness in the general population and may play a vital role in reducing stigma. However, variations in clinical accuracy are likely to be present, even within the same television programme, limiting potential positive impact.
Surviving Your First On-Call in Psychiatry: A Bootcamp for Junior Doctors
Authors: Cooper Michael , Singh Sukhmeet , Galloway Suzanne , Hegde Rekha
Published: July 2023

Aims

The psychiatry ‘bootcamp’ forms part of the psychiatry induction for junior doctors within NHS Lanarkshire. It was developed to better prepare them for common scenarios on-call and therefore alleviate any anxieties. The session is based upon a weekend on call where a fictional patient is admitted to the psychiatry ward with a psychotic presentation. It introduces the participant to the topics of Mental Health Act utilisation, capacity, acute behavioural disturbance management, and adverse effects of psychotropic medications.

Methods

Focussed teaching regarding fundamental theory for each topic is provided. Following this the facilitators engage the audience through reflective group discussion. Relevant parts of the session involve practical work including individual completion of detention paperwork. Targeted teaching is provided by the facilitators for any knowledge gaps identified.

Pre and post course questionnaires are completed by participants where they provide both written feedback and score various domains between 0 (least confident) and 10 (most confident). Domains are capacity assessment, assessing detention criteria, the process of detaining a patient, and recognition and management of extrapyramidal side-effects.

Results

This course has been run on two separate occasions with a total of 28 participants. All domains assessed on feedback questionnaires have shown an increase in confidence amongst the participants. Following analysis of all pre and post course questionnaires session one showed an average improvement from 4.87/10 to 7.56/10 across all domains. Session two showed an average improvement from 5.34/10 to 8.6/10.

Themes identified on participant feedback included the benefit of having the opportunity to individually practice completing detention paperwork. Another theme identified was that participants found the case used for session delivery relevant to their practice. A final theme identified was the engaging nature of the session which encouraged the participants to ask questions. If a didactic approach was used this could restrict such discussion.

Conclusion

Feedback received suggested that this session was well received by all participants and was felt to be beneficial in both preparing them for and alleviating anxieties ahead of their first shift on-call within psychiatry. Feedback demonstrated that running the session in small groups with a blended approach of direct teaching, reflective discussion, and practical work maximised engagement and was an appropriate approach for session delivery. Feedback suggests that this session has the potential to be an essential part of future junior doctor inductions due to it identifying and meeting the learning needs of the participant.
Improving Confidence and Knowledge in Raising Concerns: A Development Half-Day for Representatives of Postgraduate Doctors in Training
Authors: Thomas Katie , Davies Sian , Ibbett Vicki , Pantall Shay-Anne , Scally Ruth
Published: July 2023

Aims

Raising a concern is an integral duty for a doctor. The General Medical Council guidelines on Good Medical Practice state that a culture should be promoted that allows “all staff to raise concerns openly and safely”. Appointment of Postgraduate Doctors in Training to Representative (Rep) positions can be an effective way to allow trainee voices to be heard. Here we present the results of a Development Half-Day created to empower Reps with the knowledge and confidence to represent peers effectively within a large mental health Trust. The training session was identified as a ”change idea” in a wider Quality Improvement Project (QIP) seeking to improve trainee confidence in raising concerns.

Methods

16 Postgraduate Doctors in Training Reps were invited to attend a Development Half-Day in November 2022. The day included talks on their roles and responsibilities, respectful challenge and maintaining well-being.

Quantitative and qualitative data were gathered using anonymous questionnaires completed before and after the session. The questionnaire contained 4 questions asking them to rate their knowledge of their role as a rep and confidence in raising trainee concerns. This was quantified using a 1-10 scale for each question with 1 being lowest confidence/knowledge and 10 being highest. Mean scores and standard deviations were calculated. A paired one-tailed t-test was used to assess the statistical significance of the difference in pre- and post-session scores.

Results

9 Reps attended the Development Half-Day and completed the pre- and post-session questionnaires.

There was a statistically significant improvement between pre- and post-session scores for all questions (all p values <0.05). Importantly there was a significant increase in the confidence felt by reps in knowing where and who to raise trainee concerns to (p < 0.05).

Qualitative feedback indicated that attendees found the session useful and they appreciated that it was in-person. The only suggestion for improvement was for the session to have been held earlier, closer to when reps were initially appointed; this will be a change that will be implemented in the next “Plan, Do, Study, Act” cycle of the QIP.

Conclusion

Implementation of a Development Half-Day for Trainee Reps was shown to have a significantly positive impact on their confidence in their roles and their ability to respectively challenge seniors. The Reps additionally reported being better equipped at knowing where and who to raise concerns to. This will hopefully aid in their ability to signpost and empower other trainees to do the same.
A Mixed-Methods SWOT Analysis of a Medical Student Balint Group Programme
Authors: McCarron Robyn , FitzGerald James , Swann Peter , Yang Sharon , Wraight Sally , Arends Fraser
Published: July 2023

Aims

Balint groups explore the clinician-patient relationship, with benefits for empathy, resilience, and interpersonal skills. Their use with medical students is increasing, but more research is needed to understand how their benefit, feasibility and accessibility can be optimised. We aimed to explore this over a one-year pilot of a medical student Balint group programme.

Methods

An explanatory sequential mixed methods design was used. Eight medical student Balint groups ran for six weeks during 2022–2023, with 90 students participating. Students completed quantitative and qualitative feedback at the end of each cohort. Themes were identified using qualitative content analysis. Balint group leaders kept reflective session notes and used these alongside student feedback to undertake a strengths, weaknesses, opportunities and threats analysis of the programme.

Results

Students reported a neutral to slightly positive experience of the groups. Strengths were coded as containment, learning, and community identity. Students identified weaknesses due to pace, facilitation, and anxiety. Threats to the future success of the Balint group programme were related to engagement and the group being perceived as inauspicious and intimidating. Potential opportunities to develop the Balint group programme included widening participation and sharpening focus. The strengths, weaknesses, opportunities, and threats identified by the group leaders were in line with those of the students, but also acknowledged the broad range of ethico-legal material discussed by students, timetabling and organisational challenges. A range of opportunities were identified for how the Balint group programme could optimally enrich the clinical curriculum.

Conclusion

Integrating successful Balint groups into the medical school curriculum is challenging on individual and organisational levels. However, students perceive value in these groups, and they provide a unique space to combine learning and emotional support with personal, professional and community development. Ongoing consideration is needed to optimally and sustainably incorporate Balint groups within the undergraduate medical curriculum.
Medical Emergencies in a Mental-Health Setting (MEAMS)
Authors: Fraser Sam , Barrett Megan , McLean Alex , Moulds Yvonne , Lennon Brian , Pettigrew Derek , Ryan Ashley , Toner Alison , Bell Linda
Published: July 2023

Aims

Medical Emergencies in A Mental Health Setting (MEAMS) was a proposed high-fidelity simulation training course specifically designed for the mental health multidisciplinary team (MDT). A team of resus officers, mental health nurses and psychiatric doctors worked to create scenarios reflecting the emergencies encountered in mental health. It aimed to gives staff simulated experience in approaching and managing a verity of complex emergencies, including physical health, as well as communication scenarios. Specifically the aims were: (1) Determine if course was perceived to benefit staff, (2) Determine if course subjectively increased staff knowledge and confidence in mental health emergencies, (3) Review for continued areas of improvement

Methods

The full day sessions were carried out in the Electroconvulsive therapy (ECT) suite, with it being modified into an immersive environment similar to wards or clinics. The faculty of medical resus officers, mental health nurses and psychiatric consultants ran the courses, with participants joining from across the MDT including nursing staff, junior doctors, consultants, students and nursing assistants.

The morning program, run by resus officers, provided education in life support, initial assessment of the unwell patient and intraosseous access. The afternoon contained various scenarios, including for example managing neuroleptic malignant syndrome. Scenarios were observed via video link by faculty, with constructive feedback and debriefs provided.

Quantitative data of knowledge and confidence was obtained pre and post sessions using Likert scales. Qualitative information regarding future proposed scenarios, areas of improvement and areas of notable value was gathered.

Results

36 staff attended the program, run over 4 days. Average knowledge and confidence (scored out of 10) improved from 4.9 pre-session to 8.1 post-session. All 36 staff felt the session was beneficial. Particular positive feedback on scenario realism, MDT working, safe/ supportive teaching and the resus faculty teaching was highlighted.

Areas for improvement highlighted included running sessions more often, widening accessibility to more staff and teaching on resus medications and fluids. A variety of further scenarios were suggested, for example management of withdrawal seizure.

Conclusion

MEAMS was felt to achieve its aims, and demonstrated clear subjective increase in staff knowledge and confidence regarding common emergencies seen in mental health settings. Further sessions and wider accessibility to the mental health MDT is anticipated to continually benefit staff. Taking on qualitative feedback, the faculty aims to continually adapt the program to provide the best possible training and education, adapting and creating new relevant scenarios.
Keeping the Focus on Recruitment and Retention in Psychiatry in Scotland
Authors: Gordon Rosemary , Kader Ihsan
Published: July 2023

Aims

The Scottish psychiatric workforce has remained largely static; in June 2022, there were 1,164.7 whole-time equivalent (WTE) psychiatrists across all grades. RCPsych In Scotland recognise the importance of focussing on, and improving, the recruitment and retention of trainees in Psychiatry in Scotland by undertaking a number of different projects.

Methods

We understand that trainees have differing needs and therefore since 2018 have looked at different ways to attract and retain trainees using different mediums. These included membership benefits, written information, policy work, and events.

With funding from NHS Education for Scotland we focussed on undergraduate students creating bursaries, a new RCPsych In Scotland welcome pack and ran summer schools.

Focussing on existing trainees we had a stand at the virtual international congress, training events including ST4 interview skills webinars, bursaries for trainees to attend conferences and a workforce report to illustrate the likely gaps in future consultant posts as well as barriers to recruitment and retention throughout the work span.

Results

Due to the lengthy duration of psychiatric training it is not possible to evaluate an immediate impact of the campaign on Scotland's workforce however we have seen benefit by looking at other measurable objectives. The work focussing on undergraduates had led to a 333% increase in student associate membership of RCPsych in Scotland.

In 2018 there was a 63.08% fill rate for core psychiatry posts compared to 100% in 2022. As recruitment is now national, it is not possible to get Scotland only data for competition ratios however the 2021 competition ratio for the UK was 2.99 compared to 1.48 in 2018.

We are starting to see a change in higher training fill rates. In 2022 there was a 69% fill rate over all specialties with Psychiatry of Older Adults and Medical Psychotherapy both having a 100% fill rate. This is a slight improvement from 2019 where there was a 61% fill rate.

Conclusion

The work undertaken by RCPscyh in Scotland has increased interest in psychiatry both at an undergraduate and post graduate level although there is still work to be done with regards to retention, both into higher training and also to consultant level posts. The work we are currently undertaking with the workforce report hopes to focus on the reasons that trainees leave training and we aim to use it to advocate for policy change with regards to training numbers and pathways in Scotland.
Psychiatrists’ Experiences of the Transition From Trainee to Consultant: A Qualitative Study
Authors: Greenstone Harriet , Anderson Elizabeth
Published: July 2023

Aims

Population mental health relies on retention of a skilled mental health workforce, including consultant psychiatrists. The purpose of this study was to explore UK psychiatrists’ experiences, expectations, and reflections about the transition from trainee to consultant. By exploring the transition experience, it was hoped that ideas could be generated which might inform ways of supporting psychiatrists during this period.

Methods

A qualitative approach was used to gather rich, detailed data about individuals’ experiences. The sample population was a large NHS mental health trust in the South West of the UK. Stratified purposeful sampling was used, allowing focus on three distinct groups of psychiatrists at different stages of transition. Four trainees, four Specialty Doctors and nine new consultant psychiatrists were interviewed 1-1 by the lead researcher. Qualitative data were analysed using thematic analysis.

Results

Psychiatrists’ experiences of transition centred on three major themes: Facing the Real World, Learning from Others, and Being Myself. These themes were connected by central concepts of belonging and identity. New consultants must survive the challenges associated with transition, and establish professional identity as a consultant; an authentic sense of self-in-role. This relied on the psychiatrist's establishment of a sense of identity, industry and belonging within professional communities.

Conclusion

Transition is unique for each individual but there are common aspects, and study of seventeen individuals’ experiences enriched understanding of the transition period. Clinicians and managers must not underestimate the challenges faced at transition. This matters for the specialty; consultants form a small proportion of the workforce, but their functioning has a major impact. It would be detrimental to care provision if difficulties at consultant transition resulted in attrition of psychiatrists. The main recommendation is development of a trust-level transition programme to provide support to individuals, which could also be of value to the organisation and wider profession.
Racism in Modern Media (The Sopranos) and the Application to Black Mental Health in Modern Day
Authors: Henriques La-Dantai , Sule Akeem
Published: July 2023

Aims

‘The Sopranos’ is a well known television show, following the life of an Italian-American mobster suffering from anxiety and depression. Despite the overarching theme of mental well-being, elements of racism still feature within the show. These elements are ever-present throughout society and can act as an additional stressor for black minorities, who have an increased risk of suffering from mental health problems compared to their counterparts. Racism has also been linked with an increased probability of developing depression. This qualitative study aims to look at the portrayal of black characters in Season One episodes 1 and 2, to identify themes and psychiatric associations with black mental health. It identifies negative portrayals and conceptualises how these impact black mental health in the real world. Finally, it aims to use these results to propose ways of engaging with the media and the self, to improve negative stereotyping and bias.

Methods

This qualitative study was performed using thematic analysis via a deductive approach. This included creating themes, to then apply to depictions and interactions of black characters who featured within episodes 1 and 2 of the first season of The Sopranos.

Themes included: occupation, social network, verbal negative connotations, derogatory language, physical appearance.

Three online databases were used: Google Scholar, PubMed and BMJ Journals to identify literature ranging from 1999–2023. This focused on literature exploring relationships between media, cognition, society and/or racism.

Literature of the most recent mental health data collected within the UK Survey featuring Black Caribbean/British/African was also analysed.

Results

Several depictions of negative stereotypes and behaviours of both black men and women were present in both episodes. These were in the forms of: derogatory language, pacification and code-switching and negative interactions with other characters.

Literature has established that negative presentations within media can result in marginalisation of ethnic groups, which can be extrapolated here.

Conclusion

Negative depictions and stereotypes of black minorities may be having an impact on their mental health and could explain finding of mental health within Black minorities. It could affect the way they interact with the world and apply additional stressors via unconscious bias.

To resolve this, changes within social media and self-awareness should be promoted, so this is less likely to happen.
Implementing and Evaluating Online Revision Sessions for the MRCPsych Paper a Examination
Authors: Hewson Thomas , Patwardhan Swanand , Mountain Emily , Hackett Latha
Published: July 2023

Aims

Preparing for postgraduate examinations is stressful for many doctors, with psychological, financial, and social impacts. Ensuring that doctors feel supported with exam preparation is likely to improve their well-being and performance, whilst also potentially addressing workforce retention and differential attainment. This quality improvement project aimed to improve the confidence and preparedness of trainees taking the MRCPsych Paper A exam in the North West School of Psychiatry.

Methods

Six weekly online revision sessions were held for trainees preparing for the MRCPsych Paper A examination. One session was devoted to each major curriculum topic, whilst two covered neurosciences. The sessions were held over Microsoft Teams for 1 hour and chaired by senior trainees and Consultant Psychiatrists. The sessions incorporated a combination of PowerPoint slides, discussion about relevant theory, and interactive practice questions using Slido. A baseline survey was completed to ascertain trainees current levels of exam preparation and confidence. Questionnaires were administered at the end of each revision session to measure their impact and gather feedback. Trainees indicated the extent to which they felt confident with each curriculum topic and their responses were compared, at group level, before and after the revision sessions (1 = strongly disagree with feeling confident, 5 = strongly agree with feeling confident).

Results

40 trainees completed pre-session feedback and 56 trainees completed post-session feedback. The mean confidence scores of trainees improved by between 25.4% to 51.5% after the revision sessions, with the lowest pre-session mean confidence score being observed for neuroscience and the greatest improvement being observed for psychopharmacology. 77.8% of trainees rated the revision sessions as ‘extremely useful’ and 22.2% perceived them as ‘useful’. All trainees agreed (43.4%) or strongly agreed (56.6%) that their knowledge improved after attending the sessions, and all trainees agreed (23.6%) or strongly agreed (76.4%) that they would recommend them to colleagues. Trainees favourite aspects of the revision sessions included completing multiple choice questions, combining Slido polling with PowerPoint slides, and the speakers explanations of difficult concepts. Suggestions for improvement included offering more frequent and longer revision sessions, concealing group voting choices on Slido until revealing the correct answers, and teaching more relevant theory alongside practice questions.

Conclusion

Online group revision sessions combining interactive polling and didactic teaching are popular and useful amongst trainees preparing for MRCPsych Paper A. These sessions appear to improve trainees' self-reported confidence with exam curricula content, although further evaluation is required to determine whether they improve examination pass rates.
Community Health Workers' Perceptions of Depression and of Barriers and Facilitators in Mental Health Care in Sierra Leone: A Qualitative Study
Authors: Jalloh Abdul , Karadzhov Dimitar
Published: July 2023

Aims

Sierra Leone has a 98% mental health treatment gap. This has been attributed to lack of resources and attitudinal/cultural barriers. Community health workers (CHWs) are the backbone of healthcare delivery in the country, constituting 1,500 of the general health workforce. The government has trained CHWs to improve mental health care. However, evidence have shown that this training is inadequate, leading to poor mental health literacy among CHWs. Sierra Leonean CHWs' perceptions of mental health and experiences of mental healthcare delivery have not been investigated. Therefore, this study aims to assess CHWs' knowledge regarding depression and suicidality, as well as their perceptions of barriers to, and facilitators of, mental health care in Sierra Leone.

Methods

Purposive sampling and snowballing were used in this qualitative descriptive study (N = 10) to recruit CHWs in Kono and Freetown, Sierra Leone. Participants were interviewed remotely using Zoom. A short vignette on depression and suicidality was employed, together with remote semi-structured interviews exploring mental health literacy, perceptions of mental health care, and experiences in providing care during COVID-19. Thematic analysis was utilized.

Results

Five themes and 10 subthemes were derived from the thematic analysis. More than two-thirds of the participants viewed the problem as 'depression', while none mentioned suicidal ideation. Life events were the most commonly identified causes of depression, with no mention of spiritual, supernatural or biological attribution as possible causes. The inductively coded themes include the need for change; barriers to mental health care; accessing care; and COVID-19-related mental health care challenges. All participants agree that seeking counselling or speaking with a mental health expert is preferred. Stigma, prejudice, misconceptions, religious and traditional beliefs and insufficient government support were perceived as key impediments to care. Community health workers' experiences during COVID-19 were mixed. Awareness campaigns, training, establishing mental health policies, and integrating mental health into communities were identified as facilitators of mental health care.

Conclusion

The findings have shown that developing and implementing a comprehensive multi-agency approach is fundamental in dealing with mental health problems in Sierra Leone. In addition, future larger-scale research should be conducted on the underlying cultural principles and traditions regarding mental illness and the status of mental health care provision in Sierra Leone.
Building a Trainee Network of Higher Trainees in Forensic Psychiatry
Authors: Lawrence Christopher , Balakrishnan Vishni , Blott Hector , Al-Juffali Noura
Published: July 2023

Aims

It has long been recognised that psychiatry trainees face challenging and unique stressors within their working and training environment. Many of these stressors were exacerbated by changes to the working environment and training and education programmes during the COVID-19 pandemic. When elected to the role of Higher Trainee Representatives for the Faculty of Forensic Psychiatry one of our key aims was to create a national network of Higher Trainees in Forensic Psychiatry to improve trainee well-being, ensure national views are represented within the Faculty of Forensic Psychiatry and share educational and research opportunities.

Methods

1.

Creation of a National Forensic Trainee mailing list for the dissemination of networking, research and educational opportunities.

2.

Links to the mailing list sign-up form were disseminated through a variety of avenues including local trainee ‘WhatsApp’ groups, by contacting postgraduate administration teams within appropriate NHS Trusts and appropriate social media outlets.

3.

A National Forensic Trainee ‘WhatsApp’ group was established, combining several local groups. Members were encouraged to add their peers.

Results

Prior to May 2022, the previous Higher Trainee Representatives for the Faculty of Forensic Psychiatry only had access to a mailing list of 19 local representatives. This did not cover all deaneries nationally, and several email addresses were inactive following trainee rotations.

Following our campaign, we have established a mailing list of 66 interested parties which includes: 51 Higher Trainees in Forensic Psychiatry, 12 Core Psychiatry Trainees, 1 SAS doctor and 2 medical students.

Conclusion

By establishing new routes of communication, we believe we have met our aim of creating a supportive national network of Forensic Psychiatry Trainees. The Higher Trainee Representatives of the Faculty of Forensic Psychiatry now have an up-to-date mailing list that can be inherited each year by their successors. Subscribers can unsubscribe if they wish and new members can be added via sign-up links, meaning the mailing list will be able to evolve as trainees complete their clinical training and new trainees commence their training in forensic psychiatry. The COVID-19 pandemic has presented a very challenging time to be a doctor in training and initially significantly limited face to face contact with peers. However, it has also opened new avenues, such as the increased familiarity with video conferencing, dismantling barriers that have previously impeded the sharing of opportunities that should be available to all trainees, wherever they are training.
WhatsAppTM for CESR: Experience From a Peer Support Group
Authors: Loo Jiann Lin , Moyal Deepak , Musovic Martina , Bhatia Anshu
Published: July 2023

Aims

Certificate of Eligibility for Specialist Registration (CESR) is an alternative pathway for doctors to join the General Medical Council (GMC) specialist register in the United Kingdom (UK). Despite significant official resources provided online by both the GMC and the Royal College of Psychiatrists (RCPsych), a lot of doctors working toward CESR in psychiatry specialties find the system complex and do not fully understand how to start, especially candidates from abroad. Therefore, a WhatsAppTM group has been set up to provide peer support to any doctors who want to achieve CESR in psychiatry specialties. This article is aimed to share the reflective experience of managing the WhatsAppTM peer support group.

Methods

The WhatsAppTM group entitled “CESR Aspirants” was created on 23 April 2020 by four UK speciality doctors. The number had grown to the size of 218 participants on 19 December 2022. Any doctors could join the group via the common link. All questions and inputs were welcomed as long as the professionalism and values of the group were respected. The discussion was analysed and grouped into different themes to understand the common questions.

Results

The participants in the group come from 12 countries. The main themes of discussion include the following: clarification of the official guidelines, exploration of types of primary evidence for different domains, troubleshooting individual challenges, sharing of experience and resources, questions about resources available, recognition of CESR in the international arena, motivation to each other, and validation of others’ frustration. There is a significant heterogeneous level of support from local employers to CESR candidates, ranging from the absence of support due to prioritisation of service delivery to a structured CESR fellowship. Psychotherapy and electroconvulsive therapy emerged to be commonly discussed issues as not all candidates had access to those services in their practice. More questions were asked by doctors practising in the UK rather than candidates from abroad. There were three candidates who obtained their CESR in the group.

Conclusion

CESR requires significant effort from candidates. The repetitive theme in certain aspects of clinical domains reflects the common challenges faced by candidates as a result of limitations at the workplace. Therefore, support from the employer is essential for candidates to be successful in their CESR journey. Ultimately, a successful CESR candidate will mean extra consultant psychiatrist manpower to the employer. The creation of a local fellowship or mentorship programme will likely be helpful.
Establishing a Memorial Trust Overseas (Kashmir) for the Promotion of Health, Awareness and Education
Authors: Majid Zafrina
Published: July 2023

Aims

To promote physical and mental health in underprivileged communities; (II) to increase awareness on health matters in the community and students.

Methods

May 25th 2011, remains etched in author's mind. Her brother, Dr Syed Arshad Abbas, had a fatal accident while on duty. In 2012 family established a Memorial Trust. Since then, the following are provided:

1.

A free medical health camp twice a year. Patients receive free consultation, free medication and referral to secondary or tertiary services.

2.

An ambulance service available all times.

3.

Two blood donation events, 2012 in collaboration with Red Cross and 2022, in collaboration with an international charity and the hospital of Baramulla.

4.

Sponsorship to students, from primary school to university, with a mentoring scheme for university students.

5.

Mental Health awareness programme every year in different Universities.

Results

1.

To date, 3122 patients were seen at the camps. Medical and psychiatric specialist services are offered face to face or virtual. Depression, Anxiety Disorder and PTSD are the most prevalent disorders. There is an increase in substance use in youth. Polypharmacy is common practice.

2.

Ambulance catered for 2404 patients. The first patient was an 11-year-old boy, with acute abdomen. He was transferred to tertiary hospital and operated within three hours.

3.

Second blood donation event has broken the World Record of number of donations in one day. A database of regional donors was set up. Screening has identified two women with anaemia, highlighted health inequalities which were reported to local government.

4.

Sponsored and mentored university students have completed their degrees and secured placements in tertiary hospitals.

5.

Mental Health awareness programme identified the need for counselling services in universities and need for similar programmes.

Conclusion

This project has given an opportunity to turn loss into positive and a grief into hope. It will help family to move on by providing to the local community. Being a medic trained in UK the author was able to utilize skills into serving her home community, put vision into action and fulfil Hippocratic oath.