Beyond symptoms: Defining primary care mental health clinical assessment priorities, content and process

Lynch, Johanna; Askew, Deborah; Mitchell, G.; Hegarty, Kelsey

doi:10.1016/j.socscimed.2011.08.043

Cited by 19 publications

(19 citation statements)

References 67 publications

(74 reference statements)

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“…This relates to the development of two levels of knowledge, skills, and professional composition based on different knowledge bases and different organization and management principles – a development that does not contribute to integrated care. Similar to other western countries [47], despite Norway’s efforts to integrate mental health care into primary care, there seems to be a lack of clear theoretical or practical frameworks to guide such a process [4648]. Another aspect is psychiatry’s legitimacy and development within society, expressed as skepticism towards diagnoses and medicine by our participants.…”

Section: Discussionmentioning

confidence: 96%

”You Never Know What Happens Next” – Young Adult Service Users’ Experience with Mental Health Care and Treatment through One Year

Ådnanes

Steihaug

2016

International Journal of Integrated Care

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Fragmented services are a well-known problem in the mental health sector. Mental health service users’ experiences of treatment and care can provide knowledge for developing more user-oriented continuity of care. We followed nine young adults with mental health illnesses and complex needs, conducting four interviews with each informant in the course of a year. The aim was to capture their experiences and views about treatment and care, focusing on (dis)continuities and episodes occurring through that year. The users’ experiences were affected by shifts and transitions between institutions, units and practitioners while their need was predictability and stability. A good and stable patient-provider relationship was considered highly useful but difficult to establish. The participants had a strong desire for explanation, adequate treatment and progress, but very different perceptions of the usefulness of diagnoses. Some felt rejected when they tried to tell the therapist about their trauma. Lack of user-involvement characterized many of the participants’ stories while they desired to become more engaged and included in important decisions concerning treatment and medication.The participants’ experiences stand in contrast to key policy goals of coherent mental health services. The article discusses what may explain the gap between policy and reality, and how continuity of care may be improved.

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Section: Discussionmentioning

confidence: 96%

”You Never Know What Happens Next” – Young Adult Service Users’ Experience with Mental Health Care and Treatment through One Year

Ådnanes

Steihaug

2016

International Journal of Integrated Care

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“…Elements of this suggest that such data are valuable, can inform processes of assessment and can be relied upon in urgent and time‐limited clinical settings (Morrison & Symes, ). However, research also indicates that subjective data are unreliable, too individualistic and reliant on the knowledge and skills of each practitioner (Lynch, Askew, Mitchell, & Hegarty, ). This study reveals opinions that the application of subjective data occurs rapidly and seemingly without much conscious thought.…”

Section: Discussionmentioning

confidence: 99%

Nurse managed patient focused assessment and care: A grounded theory of qualified nurses in acute and critical care settings assessing the mental capacity of adult patients

Jones

Gill

Kenkre

2020

Journal of Clinical Nursing

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Aims To explore processes used by qualified nurses in assessing mental capacity of acutely and critically ill hospitalised adult patients. Background Mental capacity is the ability to understand, reason and make decisions. Acute and critical illness may impact upon the decision‐making abilities of hospitalised adult patients but little is known about how qualified nurses across a range of acute settings assess the capacity of such patients in their care. Design A qualitative grounded theory approach informed by the Corbin and Strauss (Basics of Qualitative Research (Third Edition). London, UK: Sage, 2008) methodological pathway. Methods Data were collected through digitally recorded, semi‐structured interviews to explore assessment of capacity processes used by 13 registered nurses employed in acute and critical care environments in a district general hospital in South Wales, UK. Data were analysed using iterative constant comparative processes leading to a core category and grounded theory. The study is presented in accordance with the COREQ checklist. Results Informal, intuitive, holistic nurse‐led processes were used to assess the mental capacity of patients which combined processes for the assessment of their physiological and mental capacity status, recognising the need to support their rights, dignity and autonomy. The assessment of mental capacity was not a lone process but one that contributed to a cyclical process in which multi‐professional assessment was necessary and ongoing, and in which qualified nurses had a co‐ordinating role. This led to the development of the theory, Nurse Managed Patient Focused Assessment and Care. Conclusion This theory provides a framework to explain processes and strategies used by qualified nurses in assessing mental capacity of, and caring for, adult patients with acute and/or critical illness. Relevance to clinical practice This framework may inform related clinical practice and can serve as a basis of an assessment tool in what has been identified as a fundamental role of the qualified nurse.

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“…In the United Kingdom, it not only fills the gap between generalist and specialist health care, but also includes the management of enduring mental health problems in older adults (4,5) . Primary care constitutes the first point for seeking help for mental health problems (6) . This setting is particularly relevant in the management of mental health problems in later life for two reasons: older adults express more willingness to reveal mental health problems in primary care; secondly, primary care facilitates service provision to marginalised and "difficult-to-reach" groups such as older adults with depression (7,8) .…”

Section: Descriptorsmentioning

confidence: 99%

Mental ill health in the elderly: medical students’ social representations in the United Kingdom

Medeiros

Foster

2014

Rev. esc. enferm. USP

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Objective This study aims to explore medical students’ social representations of mental ill health in older adults. Method It comprises an exploratory and qualitative investigation based on the theory of social representations. Two focus groups with pre-clinical medics (group 1, N=4; group 2, N=4) and 10 individual interviews with clinical medical students were conducted. Thematic analysis at a latent level explored meanings and differences between groups. Results Three overarching themes reflect participants’ representations of mental health problems in later life – mental ill health in old age, polarisation of care, and challenges to care. Primary health care appears as an important strategy to overcome barriers to mental health care in the community. Nevertheless, disqualifying representations, stigma and organization of services constitute the main challenges to quality mental health care in later life. Conclusion This paper highlights the need to address cultural and organizational barriers to promote quality care.

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Beyond symptoms: Defining primary care mental health clinical assessment priorities, content and process

Abstract: The assessment of undifferentiated psychological distress is a daily aspect of primary care practice. Primary care practitioners' underlying values influence the priorities, process and content of assessment. Currently there is a lack of definition of these values in primary care

Cited by 19 publications

References 67 publications

”You Never Know What Happens Next” – Young Adult Service Users’ Experience with Mental Health Care and Treatment through One Year

”You Never Know What Happens Next” – Young Adult Service Users’ Experience with Mental Health Care and Treatment through One Year

Nurse managed patient focused assessment and care: A grounded theory of qualified nurses in acute and critical care settings assessing the mental capacity of adult patients

Mental ill health in the elderly: medical students’ social representations in the United Kingdom

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