bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

AimsSierra 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.MethodsPurposive 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.ResultsFive 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.ConclusionThe 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

AimsIt 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.Methods1.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.ResultsPrior 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.ConclusionBy 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

AimsCertificate 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.MethodsThe 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.ResultsThe 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.ConclusionCESR 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

AimsTo promote physical and mental health in underprivileged communities; (II) to increase awareness on health matters in the community and students.MethodsMay 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.Results1.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.ConclusionThis 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.
The Association of Black Psychiatrists (ABP-UK) and the RCPSYCH Introduction to Mentoring and Coaching: Impact of a Training Program
Authors: Orimoloye Olamide , Oluwaranti Oluwaseun , Ugalahi Theresa , Ugochukwu Uju , Fapohunda Mosun 
Published: July 2023

AimsThe study aimed to check impact (active mentoring and willingness to mentor) following a mentoring and coaching training event facilitated by RCPSYCH and ABP-UK. The program involved watching two pre-recorded videos and a full-day practical session on mentoring and coaching skills.MethodsThe training was targeted at psychiatrists of black heritage, working in the UK. They were recruited through social media adverts and emails sent to members of the organization. A predesigned questionnaire assessing feedback about the program and mentoring activities was sent to the emails of attendees immediately after the program and a year later.ResultsForty-four participants attended the program; 32 completed the feedback immediately after the program, and 20 responded to the one-year follow-up.From the initial survey, majority of respondents (78%) rated the program as excellent, and most (78%) found it relevant to their professional needs. Slightly more than half of the group (53.1%) were involved in mentoring, but only a few (6%) were involved in mentoring activities within a structured organization. Ninety-seven percent felt confident to mentor immediately after the program while 84.4% expressed interest in joining a college division for mentoring.In the follow-up data with 20 respondents, 60% were involved in mentoring and 23% of respondents were new mentors. More respondents were engaged in college-related mentoring (41.7%) than in the previous year and majority (83.3%) expressed that the program had influenced their mentoring.ConclusionResults from the follow-on survey shows that a good number of attendees at the training event had taken up mentoring roles at local, regional levels and at the College. We therefore recommend continued rollout of more targeted mentoring and coaching training programs, with consideration for cultural needs. This will boost the availability of diverse mentors within mentoring schemes available for doctors, ultimately improving quality of care to our diverse patients.
Enhancing Medical Simulation Training by Facilitating Alongside a Communication Skills Coach (CSC)
Authors: Pancha Amit 
Published: July 2023

AimsThe aim was to design and run a communication skills simulation session for psychiatry trainees with the following learning objectives. 1) Exposing trainees to challenging clinical scenarios to increase their confidence in dealing with these. 2) Improving communication skills of trainees in dealing with anxious, psychotic, disinhibited or non-engaging patients. The facilitation of the session would be done by two medical doctors working alongside a communication skills coach (CSC).MethodsTrainees were informed of these optional sessions via email. The majority of those who attended were core trainees, specialty doctors and foundation year doctors.The session was around 3 hours in length. Trainees began by completing a questionnaire which rated their confidence in several domains including when dealing with patients that are anxious, psychotic and disinhibited. This would be repeated at the end of the session to allow for comparison.Trainees were provided with background information for each scenario and were also given a task such as performing a brief risk assessment. The scenarios lasted 10 minutes and involved 1 trainee and 1 professional actor. A 15 minute debrief would then follow. This would cover what went well, what could be improved and feedback from the actor. The CSC would then provide detailed personalised feedback covering both verbal and non-verbal communication. 6 scenarios took place over the session.The session was run 5 times in total. The first 4 sessions were held virtually (Zoom) and a total of 29 trainees attended these. The 5th session was held face to face at the Experiential Learning Centre and 5 trainees attended. 25 of the total 34 attendees completed both questionnaires.ResultsIn all 5 sessions there was noted to be an increase in confidence ratings when comparing pre and post session scores. Trainees had been asked to rate themselves out of 10. Average increases of 1.8 (anxious), 1.6 (psychotic) and 2 (disinhibited) were noted. An average increase of 1.3 was noted when dealing with an angry/upset relative.Trainees had rated the debrief process as 4.6 (scored from 1 to 5) and had given an overall rating of 8.8 (scored from 1 to 10) for the entire session. Oral and written feedback from trainees praised the input from all facilitators, especially the CSC.ConclusionWe feel that the addition of a CSC enhanced our medical simulation training significantly. We hope that others may be inspired to trial something similar in their teaching.
Psych for 6th: A Novel Schools Outreach Programme for Aspiring Medical Students
Authors: Pandey Samyak , Ilola Eveliina , Cai Valerie , Winkler Tabea 
Published: July 2023

AimsThe COVID-19 pandemic had an adverse toll on undergraduate medical education, resulting in less access to work experience opportunities for aspiring medical students, a vital component of the application process. With some studies reporting over 75% of work experience opportunities being cancelled due to COVID-19 restrictions, King's College London Psychiatry Society offered a unique chance for sixth-form students to experience a day in the life of a medical student, providing an authentic insight into the healthcare world. 'Psych for 6th' was a novel outreach programme offered to aspiring medical students in Year 12, helping them to better understand the style of learning in medicine through the lens of psychiatry. This aimed to raise their awareness of mental illnesses, prepare them for medical school applications and promote a career in psychiatry.MethodsIn March 2021, the King's College London Psychiatry Society committee members delivered two interactive sessions online via Microsoft Teams. Session 1 saw students discussing the philosophy of psychiatry and medicine, being taught basic history-taking skills, followed by a chance to practice these as a group with simulated patients.Under the safeguarding of their teachers, the second session involved teaching Major Depressive Disorder to the pupils as if they were medical students, and then having the chance to take a complete psychiatric history in groups from simulated patients.ResultsOut of 16 students who took part, 11 students (69%) reported not being confident at all talking to a patient before the sessions. After participating in the sessions, 14 students (88%) felt confident talking to a patient. 15 (94%) reported considering psychiatry as a career in the future, with all 16 (100%) recommending these workshops to other schools. Qualitative feedback commended the encouragement of active participation, and how their perception of psychiatry has positively changed.Follow-up with the students found that 14 (88%) of students mentioned this programme either in their personal statements or their medical school interviews.ConclusionThe Psych for 6th programme has given a competitive edge to student applications, especially in light of the effects of the COVID-19 pandemic on work experience, and expanded students’ appreciation of mental health diagnoses and treatment.Considering this was a school where over 90% of the pupils were from BAME backgrounds, these workshops have demonstrated that we have been able to put across a positive image of psychiatry, especially in communities where mental health disorders can carry a stigma.
Dealing With Out of Hours Emergencies - A film Project
Authors: Pokharel Prakriti , Jones Claire 
Published: July 2023

AimsThe aim of the project is to support new psychiatric trainees identify common and serious physical health issues on psychiatric wards out of hours; along with the appropriate management and escalation.MethodsThe project began in March 2021, supporting our Medical Education Team with a film project to be shown at induction. Doctors coming to psychiatry jobs come from many different clinical roles. Feedback was received that trainees were unhappy managing medical emergencies in psychiatric hospitals. Most new trainees don't necessarily have knowledge of the capabilities and limitations of care on a psychiatric ward.A survey completed from two trainee rotations regarding the most common physical health issues they encountered and the challenges they faced was used to narrow down to 3 film scenarios, incorporating a comprehensive list of clinical cases that could be encountered on call. We included physical health and mental health emergencies, use of MHA & capacity assessments. We worked with a production company producing scripts and expanded on the scenarios with the help of medical and nursing staff to ensure the scenarios remain relevant, and as realistic as possible to existing trainees. The final stage of the project was November 2021 which involved filming with the production company and professional actors who brought our concept to life. Post-production, we presented them during trust academic program to launch the videos in mid-2022.ResultsThe videos were received positively and quantitative scores completed by a questionnaire before and after showing the videos showed an improvement in confidence in assessing, managing and treating patient with physical health issues and those with physical health complications of their mental health in a psychiatric hospital from 39% to 88% (response rate 62/90).Conclusion/recommendationsWe are proud to report that these videos are now being used during every junior doctor induction and can be referred to if a refresher on that topic is required later.We are excited about this innovative method of training using high-quality videos to ensure trainee engagement. We hope it will form a baseline for further discussions and teaching around the topics derived from the scenarios. The videos were designed to last many years and so we hope will be of benefit to current and future trainees of all levels. This successful project will be expanded further and we are in the process of developing other scenarios that can be used for training.
Is Simulation a Practical and Effective Training Modality in Psychiatry? an Evaluation of What Works and Doesn't From Our Experience in North East
Authors: Rao Prathibha , Owen Bruce , Tippins Val , Mcloughlin Claire , Lamph Richard 
Published: July 2023

AimsSeveral studies on simulation as a method of teaching have identified advantages- on attitudes, skills, knowledge and behaviours, and non-technical skills such as situational awareness, team working, interpersonal interactions with improved confidence. Use of simulation in Psychiatry is growing, but studies are limited. We decided to evaluate our own delivery of simulation in trust and align this to the national strategy to identify gaps and further workMethodsWhat are we offering now?
•Core trainees- Emergencies in Psychiatry- seclusion, suicide risk assessment and fracture neck of femur. Communication skills course, mock CASC, ILS.•Higher trainees- Tribunal preparation and providing evidence, Induction- Out of hours supervising 1st on call, Managing serious incident•In development-Immersive technology- Higher trainee supervising a junior doctor OOHResultsChallenges and solutions
•Participant anxiety-Performing in front of peers can be demanding and reduces take up. ‘What to expect’ pre-session workbook, small group numbers (3), reiterating the focus of session on learning and confidentiality has improved participation.•Resource (scenario development) - Takes time and effort to achieve high quality, piloting and continual adjustments to tailor to the learners' needs. We appointed 3 SIM leads and hold regular meetings.•Resource (trainers)- Hard to resource trained trainers. Developed an in-house training programmes for trainers, but persistent difficulties in maintaining consistency and time commitments with same group of ‘trained trainers’. Included brief training pre-session in morning for facilitators.•Resources (finance)-Expensive to support Simulated patients. We used COVID-19 recovery funds and constructed purpose-built SIM rooms in education centre, which adds to fidelityConclusionFeedback: Excellent feedback received with positive comments about supportive learning, SIM facilities and debriefing.Despite being highly resource intensive, simulation is a powerful, unique, and valuable method of training in Psychiatry. Availability of resource will continue to pose challenges, but use of digital Immersive technology and focussing on relevant areas in line with National vision strategy and with identified groups- Induction, SuppoRTT, new to NHS, Remediation, CASC preparation and enhancing capacity of learning environment where there are gaps may be a good starting point. Use of MDT integrated scenarios can offer more fidelity.Future identified areas will be
•CT1s-Physical health skills (refresher), history taking, MSE, handover. Emergency scenarios- NMS, lithium toxicity, cardiac complications due to clozapine•Higher trainees- Mental health act assessments, supervising doctors in training/members of MDT. Chairing team meeting, handover, breaking bad news, presenting in a coroner's court