The therapeutic relationship is not always functional in clinical practice due to various factors, such as lack of time, lack of job motivation, exhaustion and rejection towards the person cared for.
Rates of re-traumatisation among mental ill-health patients have risen significantly over the past decade and clinical guidelines place mental health nurses at the heart of their care. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Advanced planning of care and peer support are two of several approaches advocated by Mental Health Europe as a way to reduce coercive practice in mental health. In this study, Tinland and colleagues have demonstrated that including peer worker support in the development and sharing of advance directives compares favourably to leaving patients to do this on their own.
Reducing admissions is a laudable aim, and the evidence is that, overall, peer support did not achieve this in this high need population, but admissions is not the only important outcome.
Given the positive results from some other high quality RCTs, and importantly from qualitative work about the experiences of those providing and receiving peer support, and the quite specific circumstances in which the results of this study apply, peer support arguably still has much to offer.
Mental Health Act Assessment (MHAA) is not experienced as person-centred. Although not explicitly set as a specific standard of the assessment process (DoH, 2018), the overarching principle is of empowerment, involvement, and increased personalised care (DoH, 2015).
The participants expressed difficulty in understanding the process and their options, lack of voice, and disempowerment.
Thus, this study supports that throughout the MHAA, information be delivered more effectively, repeated discussions on options be had, and emotional support be offered.