Exploring how to improve access to psychological therapies on acute mental health wards from the perspectives of patients, families and mental health staff: qualitative study

[摘要] Background Psychological therapy is core component of mental healthcare. However, many people with severe mental illnesses donot receive therapy, particularly in acute mental healthsettings.AimsThis study identifies barriers to delivering and accessing psychological therapies in acute mental health settings, and is thefirst to recommend how services can increase access from theperspectives of different stakeholders (staff, patients andcarers).MethodSixty participants with experiences of acute mental health wards(26 staff, 22 patients and 12 carers) were interviewed aboutbarriers to accessing therapy in in-patient settings and howtherapies should be delivered to maximise access.ResultsFour themes were identified: (a) ‘Models of care’, including thefunction of in-patient wards, beliefs about the causes of mentalhealth problems and the importance of strong leadership tosupport psychosocial interventions; (b) ‘Integrated care’,including the importance of psychologists being ward-based, aswell as having strong links with community teams; © ‘Acutelevels of distress’, including factors that aggravate or amelioratethe impact of this on engagement in therapy; and (d) ‘Enhancingstaff capability and motivation’, which is influenced by contextual issues.ConclusionsIt is possible to improve access to therapy through strong leadership (that is supportive of talking treatments), flexible deliveryof therapy (that considers short admissions) and a whole-systems approach that promotes ward staff understanding of thepsychosocial causes of mental illness and staff well-being. It isessential to ensure continuity between in-patient and community therapy services, and for wards to have physical space tocarry out therapy.

[学科分类] 计算机科学（综合）

[关键词] Psychosocial interventions;patients;qualitative research;in-patient treatment;cognitive–behavioural therapies