The MHIN programme aims to drive national collaborations and changes in mental health practice and the involvement of people with lived experience of mental health services is essential to ensuring the programme’s work reflects the needs of mental health service users.
The event opened with a panel discussion with the MHIN’s Public Patient Involvement (PPI) Advisory Board. The panel members spoke about what motivates them in their work, helping to shape the services that matter to patients, families and communities. They highlighted the importance of PPI in implementation, making interventions relevant to local need.
People with lived experience help to highlight some of the practical challenges of implementation, asking questions that might not have been asked
(Photo: MNIN Patient and Public Advisory Board)
Evaluating and understanding the impact of mental health interventions is also a key strand of the MHIN’s work. The MHIN evaluation team provided an update on their work and a proposal for evaluating the sustainability of interventions with partner sites, explored through a workshop.
The second half of the day discussed progress on three MHIN projects.
The MHIN is evaluating the implementation of community engagement systems for people from ethnic minority communities to improve access to mental health care, with a focus on the Patient and Carer Race Equality Framework (PCREF). The researchers described PCREF as the first ever anti-racist network in the NHS, which aims to address structural racism by transforming systems, policies, practices and attitudes. The MHIN team is assessing PCREF's implementation and evaluating whether it leads to a reduction in restrictive practices, and more culturally appropriate practice and access to care pathways.
This session featured guest speaker, Julian Palfreyman, a community service provider who works with migrant communities in Manchester. He reflected on the impact of the far-right riots and racial violence over the summer on the people that use services and that work in them. Julian also outlined how multiple systems come together to damage refugee communities’ mental health. He said it is vital to take an intersectional approach to understand the varied experiences and identities of people in migrant communities.
There is a long history of inequity in care access, experience, and outcomes for people from ethnic minorities and migrant communities. For example, disproportional use of the Mental Health Act, more coercive care, a lack of access to psychological therapies, and longer in-patient stays. The Patient and Carer Race Equality Framework (PCREF) is designed to address these longstanding inequities and will improve care for everyone
The next session provided an update on the MHIN’s project to implement parent-led CBT to improve access to interventions for child anxiety through mental health support teams on Northwest Coast and primary school support staff in the East of England. While anxiety is one of the most common mental health difficulties in childhood, access to evidence-based treatments is limited with long waiting lists for support.
Therapist-guided parent-led CBT is a brief intervention for children aged 5-12 with anxiety, which has been shown to improve access to anxiety treatments. The team highlighted findings from the Working on Worries project in the East of England, where primary school support staff have been trained to help families access parent-led CBT. Nearly 200 families have now accessed parent-led CBT, the majority choosing the online version, with promising results.
The team evaluated the facilitators and barriers to successful implementation. Facilitators included school staff understanding children’s difficulties, schools having pre-existing relationships with families and convenience for families to attend sessions in school. Barriers included staff not having enough time, ongoing training needed due to staff turnover and the intervention not being accessible to all due to the literacy needed.
Alcohol assertive outreach treatment (AAOT), a community-based treatment for people with alcohol dependence, particularly for those who frequently rely on emergency departments for their care and struggle to engage with traditional alcohol services, has been shown to be an effective treatment. But evidence on how these services can be successfully implemented into clinical practice is limited. The MHIN is addressing this through its project on integrated protocols for substance use, mental and physical health problems.
The MHIN team presented findings from two mixed-methods evaluations of the implementation of AAOT in Hull and Manchester. In Manchester, the researchers found significant reductions in A&E attendances and unplanned ward admissions. Interviews showed that AAOT is an acceptable intervention, especially for service users who face complex needs and struggle to engage with other services. The researchers attributed the success of AAOT to its non-judgmental, persistent and person-centred approach. However, the evaluation identified challenges to long-term sustainability, including short-term funding cycles, high service demand and staff retention.
Similarly, in Hull the researchers found a statistically significant reduction in consumption of alcohol after the AAOT intervention and improved psychological health, but no improvements in physical health.
Yes, it’s alcohol support but not just alcohol support, it’s support for yourself, as in being a person
Bringing the day to a close, Dr Simon Hackett, senior clinical lecturer in applied mental health research, University of Newcastle, and the MHIN programme lead, said: “We have seen the value of researchers, clinicians and people with lived experience coming together, particularly in terms of the questions we ask each other. While challenges remain, our collaborative approach is showing how targeted evidence-based interventions can help to improve mental health care for people across the UK, and I look forward to continuing our work together.”
View the programme and the presentation slides: