Barriers to the sustainability of an intervention designed to improve patient engagement within NHS mental health rehabilitation units: a qualitative study nested within a randomised controlled trial

BMC Psychiatry
Melanie LeanMichael King

Abstract

We undertook a cluster randomised controlled trial to assess the effectiveness of a staff training intervention to improve patient engagement in activities in inpatient mental health rehabilitation units. Concurrently, we undertook a qualitative study to investigate the experiences of staff within the intervention units and the contextual issues that may have influenced the effectiveness of the intervention. We conducted focus groups with staff working in the inpatient units that received the intervention, sampled using a maximum variation strategy. The intervention was accepted by staff. However, the skills gained, and changes to the unit's processes and structures that were agreed with the intervention team were not sustained after they left. The main reasons for this were a) external factors (economic recession, resource limitations); b) organisation level factors (lack of senior staff support; competing priorities); c) limitations of the intervention itself (length of intensive training period; reinforcement of skills). This study illustrates some of the inter-related factors which operate at different levels within and outside of NHS organisations that may impact on the success of complex interventions. These factors need ...Continue Reading

References

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Citations

Apr 12, 2017·Prevention Science : the Official Journal of the Society for Prevention Research·Knowlton JohnsonAbraham Wandersman
Jan 13, 2018·Annual Review of Public Health·Rachel C SheltonShannon Wiltsey Stirman
Oct 7, 2017·The British Journal of Psychiatry : the Journal of Mental Science·Anne LooijmansEva Corpeleijn
May 9, 2019·Journal of Autism and Developmental Disorders·Paige CervantesSarah Horwitz
Jul 25, 2019·Administration and Policy in Mental Health·Francisco José Eiroa-Orosa, Helena García-Mieres
Aug 8, 2018·European Journal of Public Health·Lucie KalisovaHelen Killaspy
Nov 18, 2020·Journal of Autism and Developmental Disorders·Lauren J DonnellySarah M Horwitz
Jul 8, 2021·International Journal of Mental Health Nursing·Tahani HawsawiKatherine Gill

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