Background and Purpose— Screening tools for depression and psychological distress commonly used in medical settings have not been well validated in stroke populations. We aimed to determine the accuracy of common screening tools for depression or distress in detecting caseness for a major depressive episode compared with a clinician-administered structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition as the gold standard. Methods— Seventy-two participants ≥3 weeks poststroke underwent a diagnostic interview for major depressive episode and completed the Patient Health Questionnaire-2 and -9, Hospital Anxiety and Depression Scale, Beck Depression Inventory-II, Distress Thermometer, and Kessler-10. Internal consistency, sensitivity, specificity, likelihood ratios, and posttest probabilities were calculated. Each measure was validated against the gold standard using receiver operating characteristic curves with comparison of the area under the curve for all measures. Results— Internal consistency ranged from acceptable to excellent for all measures (Cronbach α=0.78–0.94). Areas under the curve (95% CI) for the Patient Health Questionnaire-2, Patient Health Questionnaire-9, Hospital Anxiety and Depression Scale depression and total score, Beck Depression Inventory-II, and Kessler-10 ranged from 0.80 (0.69–0.89) for the Kessler-10 to 0.89 (0.79–0.95) for the Beck Depression Inventory-II with no significant differences between measures. The Distress Thermometer had an area under the curve (95% CI) of 0.73 (0.61–0.83), significantly smaller than the Beck Depression Inventory-II ( P <0.05). Conclusions— Apart from the Distress Thermometer, selected scales performed adequately in a stroke population with no significant difference between measures. The Patient Health Questionnaire-2 would be the most useful single screen given free availability and the shortest number of items.

The DT and PL function as intended, quantifying negative emotional experience (distress) and identifying bio-psychosocial sources of distress. We offer two suggestions to minimise PL response time whilst targeting PL items most related to distress, thereby increasing clinical utility. To identify patients who might require specialised psychological services, we suggest the DT followed by a short, case-finding instrument for patients over threshold on the DT. To identify other important sources of distress, we suggest using a modified PL of 14 key items, with the 15th item 'any other problem' as a simple safety net question. Shorter times for patient completion and clinician response to endorsed PL items will maximise acceptance and clinical utility.

In glis, S c o t t a n d N el s o n, Lo ui s e (2 0 2 0) Ex plo ri n g t h e eff e c t s of cli nic al si m ul a tio n o n n u r si n g s t u d e n t s' le a r ni n g a n d p r a c ti c e. M e n t al H e al t h P r a c tic e. Do w nlo a d e d fro m: h t t p://i n si g h t. c u m b ri a. a c. u k/i d/ e p ri n t/ 5 6 1 3/ U s a g e o f a n y i t e m s f r o m t h e U n i v e r s i t y o f C u m b r i a' s i n s t i t u t i o n a l r e p o s i t o r y 'I n s i g h t' m u s t c o n f o r m t o t h e f o l l o w i n g f a i r u s a g e g u i d e l i n e s. Citation Inglis S, Nelson L (2020) Skill acquisition and assessment through clinical simulation: a small-scale evaluation of the student perspective. Mental Health Practice.

Usage of any items from the University of Cumbria's institutional repository 'Insight' must conform to the following fair usage guidelines.Any item and its associated metadata held in the University of Cumbria's institutional repository Insight (unless stated otherwise on the metadata record) may be copied, displayed or performed, and stored in line with the JISC fair dealing guidelines (available here) for educational and not-for-profit activities provided that• the authors, title and full bibliographic details of the item are cited clearly when any part of the work is referred to verbally or in the written form Accessible summaryWhat is known about the subject? This paper describes Crisis Resolution/Home Treatment (CRHT) teams, which are part of mental health services in the UK. CRHT is expected to assist individuals in building resilience, and work within a recovery approach. What this paper adds to existing knowledge?This paper arises from an interview with one individual, Dale, as part of a larger study exploring service users' experiences of CRHT. It adds to the body of narrative knowledge in CRHT through Dale's co-authorship of this paper, reflecting on his original interview four years later, with co-authors providing critical interpretation of his experience, in turn supported by cognate literature. What are the implications for practice?Implications for practice are considered, themselves mediated through Dale's own descriptions of how CRHT interventions impacted upon him. These impacts are analysed with respect to three themes: Resilience, Recovery and Power.It is centrally contended that clinicians need to more clearly comprehend three core matters.Firstly, what resilience 'is' for service users as well as the complex process through which these individuals move in developing resilience. Secondly, the distinction that service users might make between 'recovery' and 'functionality', and how this in turn can impact on individuals both in personal and socio-economic sense. Finally, the mechanics of power within CRHT contexts, and how these interpersonal dynamics can affect the relationship between service user and clinician in practice.

No abstract