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Purpose The purpose of this paper is to investigate perceptions towards a career in psychiatry among medical students and psychiatrists and identify how recruitment into the specialty may be improved.Design/methodology/approach This study locally compares medical student and psychiatric doctor responses to a structured online survey and structured interviews with key managerial figures in the Humber NHS Foundation Trust.Findings Comparison across two main areas (pre-decision exposure to psychiatry and reasons for considering a psychiatric career) found that both students and doctors were influenced to make a choice about a career in psychiatry during medical school. Medical students found compatibility with family life to be more important when considering psychiatry, whereas doctors cited content-based reasons as significant pull factors. Stigma and fear of being harmed deterred some students from choosing a career in psychiatry. Structured interview responses reiterated the importance of pre-medical school and undergraduate mentorship in bolstering future recruitment to psychiatry.Practical implications Medical students perceive certain career issues differently to their postgraduate counterparts. Widening the content-based appeal of psychiatry and optimising the medical school experience of the specialty via varied and high-quality placements may be a key step towards tackling the national shortfall in qualified psychiatrists.Originality/value This is the first published study comparing medical student and psychiatric doctor perceptions of a career in psychiatry. [ABSTRACT FROM AUTHOR]

Purpose – The aim of this paper is to highlight the challenges in evaluating psychological input into acute wards using more traditional methods; and also to provide an example of how it is possible to evaluate such services capturing outcomes at multiple levels. Design/methodology/approach – Data were gathered from multiple levels including staff, patients and the wider organisation mainly using self report questionnaires. The paper looks at the impact on satisfaction, service utilisation, development of recovery principles, quality of therapeutic environment and alliance with treatment teams following the introduction of a dedicated psychology team. Findings – The results show positive trends in patient experiences of the ward environment, alliance with treating teams and staff recovery principles, along with reduced readmission rates and length of stay in hospital. Qualitative data demonstrate the value of the service to both staff and patients. Research limitations/implications – Much of the data do not meet the criteria for more sophisticated statistical analysis. Originality/value – The paper provides an example of evaluation of a contemporary model of service delivery for which there is currently a limited evidence base and looks to stimulate current thinking on the practice of mental health service delivery. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to investigate the effectiveness of a day treatment programme (DTP) in reducing psychosocial impairment, changing attitudes, restoring body-weight and decreasing binge/vomit symptoms among 52 individuals (aged 16+) with eating disorders. It was hypothesized that day treatment would result in improvements across all variables measured. Design/methodology/approach – In a within-participants design, demographic, physiological and psychological measures were taken on admission to and at discharge from a DTP in the UK. Quantitative outcomes were analysed. Findings – In total, 40 participants were considered to have received an adequate dose of the DTP, having completed at least four weeks on the programme. Analyses supported all hypotheses, with all improvements being statistically significant. Large effect sizes were evident for all outcomes across the whole sample other than shape concern attitudes and weight concern attitudes, which reduced with moderate and moderate-to-large effect sizes, respectively. Originality/value – This study provides new evidence of the effectiveness of day treatment in reducing psychosocial impairment resulting from eating disorder psychopathology. It remains for future research to determine whether these outcomes can be sustained over the longer term. [ABSTRACT FROM AUTHOR]

Purpose – The perspectives of frontline clinical staff working with individuals in later life within an inpatient mental health setting, of their role in recovery, have not yet been explored. The purpose of this paper is to understand what recovery means within an inpatient mental health setting for older adults. The authors address clear implications for clinical practice. Design/methodology/approach – Semi-structured interviews were conducted with 11 multidisciplinary participants across two specialist older adult recovery units at an independent hospital in the UK. Thematic analysis was applied to the transcripts. Findings – Three main themes were identified: participants identified their normative task as the promotion of “moving on” (clinical recovery) and their existential task as personal recovery. The context in which recovery happens was highlighted as the third theme. These represented competing workplace goals of clinical and personal recovery. This highlights the need to give permission to personal recovery as the process that enables mental health recovery in older adults. Originality/value – Staff working in a inpatient mental health service for older adults discussed the meaning of recovery and their role in enabling recovery. This has implications for sustainable clinical practice in this setting. Recovery-orientated practice in this setting is required but the detail is not yet understood. [ABSTRACT FROM AUTHOR]

Purpose – There is growing interest in self-management support for people living with mental health problems. The purpose of this paper is to describe the evaluation of a co-designed and co-delivered self-management programme (SMP) for people living with depression delivered as part of large scale National Health Service quality improvement programme, which was grounded in the principles of co-production. The authors investigated whether participants became more activated, were less psychologically distressed enjoyed better health status, and quality of life, and improved their self-management skills after attending the seven-week SMP. Design/methodology/approach – The authors conducted a longitudinal study of 114 people living with depression who attended the SMP. Participants completed self-reported measures before attending the SMP and at six months follow up. Findings – Patient activation significantly improved six months after the SMP (baseline M=49.6, SD=12.3, follow up M=57.2, SD=15.0, t(113)=4.83, p < 0.001; d=0.61). Participants’ experience of depression symptoms as measured by the Patient Health Questionnaire-9 significantly reduced (baseline M=15.5, SD=6.8, follow up M=10.6, SD=6.9, t(106)=7.22, p < 0.001, d=−0.72). Participants’ anxiety and depression as measured by the Hospital Anxiety Depression Scale also decreased significantly (baseline anxiety: M=13.1, SD=4.2, follow up M=10.2, SD=4.4, t(79)=6.29, p < 0.001, d=−0.69); (baseline depression: M=10.3, SD=4.6, follow up M=7.7, SD=4.5, t(79)=5.32, p < 0.001, d=−0.56). The authors also observed significant improvement in participants’ health status (baseline M=0.5, SD=0.3, follow up M=0.6, SD=0.3, t(97)=−3.86, p < 0.001, d=0.33), and health-related quality of life (baseline M=45.4, SD=20.5, follow up M=60.8, SD=22.8, t(91)=−2.71, p=0.008, d=0.75). About 35 per cent of participant showed substantial improvements of self-management skills. Originality/value – The co-produced depression SMP is innovative in a UK mental health setting. Improvements in activation, depression, anxiety, quality of life and self-management skills suggest that the SMP could make a useful contribution to the recovery services in mental health. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore how staff attend to their well-being when working in an inpatient mental health setting with older adults with dementia and complex mental health needs; how staff understand the link between their well-being and the well-being of patients. Design/methodology/approach – A semi-structured group interview was held with 11 members of two multidisciplinary teams. The discussion was audio-recorded and analysed using thematic analysis. Findings – Staff reported managing their well-being by both connecting with and avoiding the difficult emotions of the work. The team avoided the gravity of the work through humour, a task-focus, an absence of thinking and the displacement of workplace frustrations onto an outgroup. Connecting with emotions was done in tolerable ways: in contained reflective spaces, in the presence of supportive others, through genuine connections with patients as people and when the organisation demonstrated care for the staff. Practical implications – Avoidant strategies appeared to represent short-term ways of maintaining staff well-being, while connecting with the gravity of the work appeared to represent what we hope is a more sustainable approach to managing well-being. A crucial premise for staff well-being is teams embedded within organisations that care for their employees. Originality/value – Poor staff well-being can have serious consequences for an organisation, particularly in the existentially challenging environment of dementia care. This study offers a unique opportunity to explore staff well-being in a UK inpatient mental health setting with older adults with dementia and complex mental health needs. [ABSTRACT FROM AUTHOR]

Purpose - This paper seeks to report upon psychiatric trainees' experience of providing psychodynamic therapy for the first time and their experience of group supervision.Design/methodology/approach - A total of five trainees, undertaking training in psychodynamic therapies, were interviewed on multiple occasions over an 18-month period - before, during, and after undertaking their first case of psychodynamic therapy. A semi-structured, qualitative interview approach was used to explore providing psychodynamic psychotherapy and participating in psychodynamic supervision groups. Interviews were transcribed in full and data analysed following the conventions of thematic analysis.Findings - Trainees' anxieties about working psychodynamically and their concerns for developing new competencies are recognised. Personal and professional challenges associated with this therapeutic approach are identified and the importance of "looking after" trainees is stressed; the role of trainee supervision groups in this is advocated. The potential challenges of integrating psychodynamic thinking into general psychiatric practice are discussed and suggestions to address these difficulties are proposed.Research limitations/implications - The small sample size reflects the total number of trainees participating in training at the time of the study; for future work, a larger sample drawn from multiple training centres would be recommended.Originality/value - Training in psychotherapy is now mandatory for all trainee psychiatrists and this is something which many trainees find daunting; training in psychodynamic techniques is particularly challenging. A fuller awareness and understanding of trainees' experiences is important in nurturing clinicians who are competent in psychodynamic thinking, and who might consequently apply these skills clinically. [ABSTRACT FROM AUTHOR]