bluuebunny/crossref_metadata_2025_split huggingface dataset:
A New Trainee-Run Insomnia Treatment Service for Patients Under Community Mental Health Teams
Authors: Waterman Lauren , Creed Michael 
Published: June 2022

AimsChronic insomnia is a common mental disorder that severely impacts the quality of life of those affected, increases the risk of comorbid mental disorder and physical illness, and makes treatment of other mental disorders less effective. It is particularly common in patients under secondary care mental health services. Once chronic, insomnia rarely resolves spontaneously. Cognitive behavioural therapy for insomnia (CBT-I) is a highly effective treatment that is recommended by the UK's National Institute of Health and Care Excellence as the first-line treatment. Despite this, CBT-I is not universally available or accessible throughout the UK. Therefore, LW obtrained training at a sleep clinic and then initiated, ran and evaluated a new CBT-I service for existing community patients within her NHS trust.MethodsPatients received individual holistic assessments with a psychiatry trainee, a 5-session weekly virtual group intervention run by LW, and an individual 3-month follow-up. LW also trained other psychiatry trainees to run future groups, initially under supervision. Clinical rating scales were employed at initial assessment, following the final workshop and at follow-up.ResultsSeven patients completed all sessions, with five completing a 3-month follow-up review. All had suffered with chronic insomnia for over 5 years. All had moderate-to-severe insomnia on the Insomnia Severity Index (ISI) at assessment (mean 21.3), which had improved by the end of treatment (mean 14.3). All patients seen at follow-up either no longer had insomnia or had sub-threshold insomnia on the ISI (mean 7.2). From assessment to post-treatment to follow-up, mean scores on the Dysfunctional Beliefs and Attitudes About Sleep Scale reduced from 6.6 to 3.7 to 2.5, and mean scores on the Clinical Outcomes in Routine Evaluation–Outcome Measure reduced from 2.18 to 2.01 to 1.27. Mean scores on the Work and Social Adjustment Scale reduced from 23.6 (severe impairment) at assessment to 7.0 (low impairment) at follow-up. Two patients stopped taking sleeping tablets during the treatment, and remained off them at follow-up.ConclusionGroup CBT-I can be a highly effective treatment for insomnia for patients under CMHT services. In this service run by a psychiatry trainee without formal sleep medicine or CBT qualifications, the efficacy of the intervention on insomnia symptoms, as well as on anxiety and depressive symptoms, was similar to the efficacies found in clinical trials and in specialist sleep clinics. CBT-I can be easily learnt by psychiatry trainees and likely other professionals with psychological expertise, which could increase the availability and accessibility of this effective treatment.
An Audit on the Monitoring and Management of Hyperprolactinemia in Inpatient Adults on Regular Antipsychotics in 8 Acute Wards in an NHS Mental Health Trust
Authors: Zhang Peter , Li Zhen Dong 
Published: June 2022

AimsThe aim of the audit is to ascertain how well hyperprolactinemia is being monitored and managed across all acute adult inpatient wards in a mental health NHS Trust, for patients on regular antipsychotic mediation. The objectives of the audit are to: 1) Assess whether prolactin is being monitored according to local guidelines for patients on regular antipsychotic medication, 2) Determine whether hyperprolactinemia is being identified and managed according to appropriate guidelines, 3) Assess the standard of documentation around the decisions made.MethodsData were collected retrospectively from the electronic notes and records for 78 patients, who were discharged from 8 acute wards in February 2021. For checking prolactin test results, the relevant reporting systems were accessed. Two data collection forms were used, which separated patients between those already taking antipsychotics prior to their admission and those who were newly initiated on an antipsychotic.Patients who were prescribed at least one regular antipsychotic were included. Patients with pre-existing medical conditions that cause hyperprolactinaemia, ongoing pregnancy or breastfeeding were excluded. The monitoring for and management of hyperprolactinaemia was assessed against NICE and local guidance.ResultsFrom the reviewed data, 41 patients were prescribed at least one regular antipsychotic drug during their admission. 32 patients were already established on an antipsychotic prior to their admission and 9 individuals were started on their first antipsychotic. Hyperprolactinaemia was identified in 9 patients. 19 patients had no prolactin assay performed during their whole admission.44.4% of antipsychotic naïve patients had a baseline prolactin level taken prior to starting an antipsychotic. 9.1% of patients with hyperprolactinaemia had their symptoms assessed by a clinician. 27.3% of patients with hyperprolactinaemia had actions discussed and undertaken to address this.ConclusionThis audit identified that patients are at risk of suffering from hyperprolactinaemia and are being insufficiently monitored. The symptoms of hyperprolactinaemia are not adequately screened or assessed for. This may increase the side effect burden and decrease medication adherence among patients. There is a need to increase the awareness among clinicians about the importance of regular prolactin monitoring to improve patient outcomes.
A Perinatal Mental Health Education Programme for Maternity, Neonatal and Other Allied Multidisciplinary Teams in NHS Lothian: Why, How, and What's Next
Authors: Argent Vikki , Sherratt Megan , Nelson Marian 
Published: June 2022

AimsThroughout the development of the NHS Lothian Perinatal Mental Health Service, their goals alongside maternity and neonatal teams, family nurse and health visiting services have been to strengthen interdisciplinary working and improve the quality of perinatal mental health care delivered to birthing people. The aims of developing a programme of multidisciplinary education sessions were to develop the knowledge and confidence of non-mental health professionals in caring for birthing people experiencing mental health difficulties, and aid understanding of available services and referral pathways to facilitate appropriate care.MethodsThe programme has been delivered by a Perinatal Psychiatrist and Clinical Midwifery Educators in bimonthly sessions lasting two hours. Sessions have included scenario-based learning, education regarding illnesses and disorders, and promotion of infant mental health and trauma-informed care.Participants have attended virtually via Microsoft Teams or in person. Sessions have been recorded and accessed following teaching. Confidentiality is upheld throughout. A standard operating procedure utilising multi-modal methods has been designed to maximise staff engagement with sessions. Feedback accessed via a QR code has been collated via a Microsoft Forms questionnaire comprising of Likert scale and free-text answer questions. Feedback has guided programme development and topic selection.Initially, sessions were open to inpatient maternity services, but now outpatient maternity services, neonatology, and health visiting and family nursing colleagues are invited to maximise the reach of the staff delivering sessions.ResultsSessions have been well accessed by a variety of professionals, with increasing attendance at each session. Feedback has been obtained from 43% of those attending. Results have been very positive: 100% of respondents strongly agreed or agreed that the format of the session worked well with 92% of respondents strongly agreeing or agreeing that the session content was pitched at the appropriate level. 100% of respondents felt that the content covered was useful in their clinical role which supports the emphasis of the sessions on linking knowledge to clinical application to build confidence. 100% of respondents would recommend these education sessions to a colleague.ConclusionFeedback to date has shown that participants have found the sessions to be accessible and the content appropriately pitched and clinically valuable. Despite launching the programme amidst the challenges of COVID-19, participants have found the delivery of the sessions to be supportive and collaborative.The next phase in the development of the programme will be to understand in more detail what participants are learning and the impact on their practice.
Are Single Doctors More Focussed in Career Progression?
Authors: Metwali Ramy , Chandrika Divya Vikraman , Baiju Siddhartha 
Published: June 2022

AimsIt is commonly assumed that single doctors are more focused on career progression than doctors in a relationship/ or having dependents. In this study, we tried to find out if it's true. We measured this among doctors in Psychiatry (from training – to consultants’ level) across Wales.MethodsWe designed an anonymized online survey and distributed it among Psychiatry doctors.We categorized the relationship status as
a.Singleb.In a relationship – committed, engaged, married, living togetherc.Separated, Divorced, Widowedd.OthersWe measured the career progression on the basis of the following criteria:
1.Why they were interested in Psychiatry2.Number of years taken to complete or intending to complete training.3.Having met the portfolio criteria for their level.4.Undertaking RCPsych Exams5.Having missed any opportunities related to career.We analysed the data from the survey using an online tool.The survey included questions that measured the link between career progression/choices and relationship Status/responsibilities. We used the Likert Scale, yes or no questions, and free text boxes.ResultsWe received 66 responses and we divided them into three groups according to their relationship status which are the single group, relationship group, Divorced/ Separated/ Widowed group, and compared the results between them. We got some interesting results as follows.
◦Single participants seem to be less limited in choosing the specialty, Exam Preparation, and overall career progression.◦A significant proportion of people in relationships felt limited in choosing the Specialty and workplace. Had less time for Exam preparation and have missed career opportunities.◦Females in Relationships were more restricted.◦The divorced / Separated / Widowed group did not feel limited, however, affected their exams, and have missed opportunities.ConclusionSingle doctors seems to have overall better opportunities in career progression compared to people in relationship. However, our sample size was small especially in single group. A bigger study is needed to conclude the impact of relationship in career progression.
Is the Grass Greener on the Other Side? A Qualitative Comparison Study of Psychiatry Trainee Views in England Compared to New Zealand
Authors: Bansal Neha 
Published: June 2022

AimsThe Royal College of Psychiatrists census (2019) highlighted that 10% of all consultant psychiatrist roles remain unfilled. This pattern is replicated elsewhere in the UK with 7.8% in Northern Ireland, 9.6% in Scotland and 12.7% in Wales. This increase in consultant vacant posts is indicative of the recruitment challenges to psychiatry. On the other hand, the 2017 New Zealand Medical Workforce survey report showed recruitment to psychiatry was up by 8.2% in 2018 compared to 2017. I conducted a qualitative comparison study to look at psychiatry trainee views regarding their training in a UK and New Zealand deanery at similar stages of their psychiatric training.MethodsQuestionnaires were distributed to current psychiatry trainees in the Capital and Coast District Health Board (CCDHB) based in Wellington, New Zealand and Birmingham and Solihull Mental Health Foundation Trust (BSMHFT), UK who were between years 1–3 of their psychiatry training. Qualitative information was collated from the questionnaires regarding various aspects of their training. Areas of focus were; pros and cons of psychiatry training, suggestions for improvements, supervision, access to annual leave and study leave, teaching, encouragement to attend courses and involvement in research.ResultsOf the 33 current trainees working in CCDHB, 48% were immigrants from the UK, previously having worked in the NHS.17% of BSMHFT trainees felt valued in their organisation, compared to 64% in New Zealand.27% in New Zealand considered switching to another training programme, whereas none considered switching in the UK. Burn out was quoted as a problem in both New Zealand and the UK. 100% were able to take annual leave with ease in New Zealand, compared to 0% in BSMHFT.ConclusionThis small study gives a closer insight into the views of trainees in New Zealand, a place often thought as being more attractive for doctors to work in. What this study shows is 2 key factors; there are shocking differences in the quality of trainee experiences between New Zealand and the UK, however New Zealand is not free from issues around trainee retention, although the study does show overall trainee satisfaction being greater in New Zealand. Feeling valued, supported and leading a life with better work-life balance appear to be key driving factors for UK graduates leaving the UK and there is more that could be done to make trainees in the UK feel more valued and prevent burn out.
Generating Recommendations for Medical Curricula to Reduce Stigma Towards Psychiatry From Medical Students
Authors: Blake Jack , El-Nimr George 
Published: June 2022

AimsIn 2021, we completed a project entitled: ‘Stigma Towards Psychiatry: Correlating Personal Experience with Existing Literature’ – ‘International Congress Award Winning’. We aim to use the themes generated from this to inform recommendations to medical educators to reduce stigma in their curricula towards psychiatry.MethodsUsing previously identified themes, we generated a set of recommendations aimed at the pre-admission, pre-clinical and clinical phases of learning. Pre-admission themes include: misconceptions of the role of the psychiatrist and disinterested medical applicants. Pre-clinical themes include: dissociation of psychiatry from medicine and clinical role modelling. Our final category, clinical, includes: cross-speciality support for psychiatry, pathophysiology in de-stigmatisation of psychiatric disease, discrimination of the aspiring psychiatrist, psychiatric exposure in training not seeing conversion of students to psychiatrists and the role of unofficial mentors in continuing enthusiasm for the speciality. Division in this way gave us multiple opportunities to look for areas of potential intervention in influencing medical student's views on psychiatry. Further influencing our recommendations was the feedback from a group of consultant psychiatrists this project was presented to.ResultsAddressing the themes driving stigma from the previous project saw us producing a list of recommendations targeted at each phase of medical school. (1) Pre-admission stage: selecting candidates who are more psychologically minded by recognition of A level psychology as a core subject; encouraging people with experience in mental health settings to apply for medical training (Srivastava et al, 2018); highlighting psychiatry as a medical career in the prospectus. (2) Pre-clinical stage: making students aware of their unconscious stigma towards psychiatry; clearer links made to psychiatry in early medical school to relevant biochemistry, anatomy, physiology and pharmacology (Mahli et al, 2003); tutor / doctor led psychiatry based extracurricular groups; highlighting mental health aspects of functional neurological disorders and disorders within rheumatology such as fibromyalgia. (3) Clinical stage: making clinicians aware of their unconscious stigma towards psychiatry; encouraging cross-speciality support for psychiatry; improving contact with psychiatrists on mental health placements (Archdall et al, 2013).ConclusionStigma towards psychiatry extends from medical school and into clinical practice. It feels important that medical school curricula should be altered in order to change students’ experience of psychiatry within medical school. The recommendations target each stage the themes were identified within. Our local medical school has agreed to let us present this at their curriculum meeting which may pave the way for further refinement and implementation of our suggestions.
Providing Mental Health First Aid Training to Hatzola
Authors: Brennan Ailbhe , Hubbett Jack , Buckland Rosalyn , Grant-Peterkin Hugh 
Published: June 2022

AimsHackney is home to the largest Charedi Orthodox Jewish community in Europe. According to the Census 2011, 7% of the population of Hackney are Charedi. Hatzola is a non-profit, volunteer organisation established in 1979 to provide pre-hospital emergency medical response and transportation to acute hospitals at no cost, to those living in and around the North London Charedi community. Given the large Charedi population served by Homerton University Hospital it is a common occurrence for psychiatry liaison staff to work side by side with Hatzola in delivering care to those in mental health crisis. Our aim was to create and nurture a professional relationship between Homerton University Hospital Psychiatry Liaison Service and Hatzola ambulance. We wanted to gain an understanding of the perception of mental illness within the Charedi community, and identify issues faced by members of Hatzola when working with those with mental illness. We wanted to identify the learning needs of Hatzola around psychiatric illness as well as increasing confidence within team members when called to manage mental health crises.MethodsWe scheduled an initial meeting with Hatzola to gain an understanding of their service. We used questionnaires to ascertain their level of knowledge on managing mental health patients. We set out to provide teaching sessions to address Hatzola's learning needs.We designed interactive teaching sessions based on providing mental health first aid, discussing case studies, considering the legal framework around emergency mental health. We ensured coverage of working with both adults and children with mental health difficulties. We delivered these teaching sessions in person over four consecutive weekly meetings, with the sessions being recorded to serve as an educational resource.ResultsWe gathered qualitative evidence reflecting the impact of our intervention. We were able to compare levels of confidence among Hatzola members before and after our teaching programme.ConclusionOur training programme was well received by Hatzola, and it was an excellent opportunity to develop links with members of the community.We have learned that mental health is a taboo subject for members of the Charedi community, and have identified a need for more support to Hatzola in coping with the emotional toll working with mental health patients can take. There may be scope for providing further training on developing reflective practice and more emotional support for Hatzola members in future.
Buddhist Philosophy and Mental Health: Lessons for the 21st Century
Authors: Briggs Patrick 
Published: June 2022

AimsThe aim of this research was to highlight the aspects of Buddhist philosophy which may help to improve mental health. COVID-19 has had a considerable psychological impact on healthcare staff and the general population, emphasizing the importance of treatments and techniques to aid their mental health.MethodsMindfulness, Impermanence and Non-self were discussed as core aspects of Buddhist philosophy and how these relate to mental well-being. Reference was made to peer-reviewed studies that show the positive effects of these concepts.ResultsThis research highlighted the wealth of evidence that Mindfulness, Impermanence and Non-self has in improving mental well-being. However, there were also risks, including depersonalisation and increased anxiety in certain mindfulness practitioners.ConclusionThe findings of this research has generated new ways in which we discuss mental well-being and challenges our current understanding of suffering, providing individuals with further tools to assist with their mental health. This study challenges the idea that philosophy and medicine must be discussed separately and seeks to find further common ground between these two disciplines.
Catch Them Young! Changing Attitudes and Perspectives Towards Psychiatry by Using Patients as Educators Early in Medical Training
Authors: Buck S Caroline , Combs Nicola , Rashid Amina , Ozidu Victoria , Akinola Adeola 
Published: June 2022

AimsThis teaching project aims to improve attitudes and perspectives towards psychiatry by using Patient as Educators (PaE) in a psychiatry teaching program early in medical training.MethodsFollowing the success of a small pilot study in 2020, the project was rolled out to the entire second year medical student body in 2021. Two-hour interactive sessions were delivered online to groups of approximately twelve students. Each session was introduced by a psychiatrist, followed by PaE discussion with questions and answers. The students completed a bespoke online survey at the beginning and the end of the session, looking at attitudes towards psychiatry. Comparative analysis of attitudes pre- and post-intervention was then undertaken. Qualitative data were examined through content analysis and quantitative methods were used to compare pre- and post- attitudes on the Likert scale.ResultsThe pre- and post-intervention questionnaires were completed by 373 and 305 students respectively. Both pre- and post-intervention attitudes were overwhelmingly positive. Post-intervention qualitative results demonstrate the session, especially the PaE, helped students to better understand the complexities of mental illness, the stigma faced and the potential efficacy of good treatment. There was a 25.7% increase in students’ perception of preparedness to see mentally unwell patients. The most significant findings were that the majority of students found having the PaE valuable in improving attitudes regarding the value of psychiatry (72.8% agreed/strongly agreed) and increasing interest in the speciality (84% agreed/strongly agreed).ConclusionEarly experience to clinical placements is an essential component in medical education. In Psychiatry, apart from gentle introduction into the specialty, it is essential that students are orientated into the world of mental health and its various challenges. This project has clearly demonstrated the effectiveness of early exposure of medical students to psychiatry as a specialty. It also demonstrates the effectiveness of using PaE in medical education. Further research would aim to examine whether effect on attitudes persist and correlate the effect on early exposure on recruitment to the speciality.