Novel psychoactive substance use by mental health service consumers: an online survey of inpatient health professionals’ views and experiences

Abstract

Purpose: There is evidence that novel psychoactive substances (NPS) are commonly used by people with severe mental illness. The aim of the study was to undertake a scoping survey to explore inpatient mental health workers' perceptions of NPS use by consumers.Design/methodology: A cross-sectional online survey of mental health professionals.Participants were opportunistically recruited through social media and professional networks.Findings: A total of 98 participants (of 175 who started the survey) were included in the analysis. All reported that some patients had used NPS prior to admission. Over 90% of participants reported observing at least one adverse event relating to NPS use in the previous month. The majority of participants reported that patients had used NPS during their inpatient admission. Three quarters were not clear if their workplace had a policy about NPS.Most wanted access to specific NPS information and training. Participants reported that they lacked the necessary knowledge and skills to manage NPS use in the patients they worked with.Research Limitations/Implications: Whilst we are cautious about the generalizability (due to methodological limitations), our findings provide useful insight into the perceptions of inpatient staff regarding the extent and impact of NPS use including concerns regarding impact on mental and physical health, as well as ease of availability and a need for specific training and guidance.Practical Implications: Mental health professionals require access to reliable and up to date information on changing trends in substance use. Local policies need to include guidance on the safe clinical management of substance use and ensure that NPS information is included.

Exploring the Baseline Knowledge and Experience of Healthcare Professionals in the United Kingdom on Novel Psychoactive Substances

“…Previously, Schifano et al [53] stressed the need for HCPs to be continuously updated with regards to the constantly changing drug scenarios to identify new, emerging trends that can help with the provision of immediate interventions. Results (Figure 4) suggested improvements where self-reported levels of knowledge on NPS were mostly 'basic' (n = 76; 39.2%) and 'intermediate' (n = 73; 37.6%), which is in contrast to other studies that have reported inadequate HCP knowledge [40][41][42]. Nurses and pharmacists, predominantly working in hospitals and substance misuse services, had the most encounters with NPS use.…”

“…Previous studies have addressed the inadequacy in essential knowledge and skills required by HCPs on NPS to inform various interventions and highlighted the need for education on these novel molecules [38][39][40][41][42][43]. However, several studies only focused on specific professions and geographical locations in the UK [40][41][42][43]. The deficit in general knowledge on NPS may lead to inappropriate medical diagnoses and potentially the provision of inappropriate medical advice or interventions.…”

Patient safety in inpatient mental health settings: a systematic review

“…The only intervention study aiming to reduce these errors found that a new medication dispensing system did not have any significant impact on patient safety 353. Two studies explored staff perceptions of illicit substance use 354 355. One further study described the development of a medication adherence intervention for patients who are prescribed mood-stabilising medication for bipolar disorder 356…”

The rate and impact of substance misuse in psychiatric intensive care units (PICUs) in the UK

“…Despite the Department of Health publishing specific guidance on screening and assessment for inpatient services, this is not common practice (Hughes et al, 2012). This may be in part due to the lack of substance misuse training for staff, and staff consequently lacking the skills and confidence needed (Hughes et al, 2019). There have been numerous calls for training on drug and alcohol use to be provided to staff working in PICUs so comorbid substance misuse can be detected, managed and addressed during treatment (Barnaby, 2003;Place et al, 2017;Hughes et al, 2012).…”