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An innovative method of expanding the support for doctors returning to training in psychiatry after a period of extended leave: the Sheffield Mindful Support Programme
- Helen Linnington, Hamid Alhaj
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, p. S145
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- Article
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- Open access
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Aims
To offer regular continuous professional development opportunities covering both clinical and non-clinical skills to trainees and trainers and enhance their experience and skills to increase their wellbeing and resilience.
BackgroundThere are approximately 50,000 doctors undertaking postgraduate training in England. Of these, 10% (5000) are taking approved time out of training at any time. A 2017 HEE survey revealed that doctors returning to work reported numerous concerns. Based on these and with the backdrop of the Bawa-Gaba case HEE's Supported return to Training programme (SuppoRTT) was developed.
We at Sheffield Health and Social Care NHS Foundation Trust devised a unique “Mindful SuppoRTT” initiative and were successful in securing funding from HEE. Part of which was the organisation of a conference aimed at various groups of doctors including those who have previously had time out of training, are currently out of training and those considering time out.
The Sheffield Mindful SuppoRTT Programme not only aimed to provide a structured and systematic process for planning and returning from absence, but also focussed on enhancing performance through promoting the wellbeing of participants and supporting them with important clinical and non-clinical skills.
Method2-day twice yearly conferences, which covered training on speciality specific as well as non-technical skills were organised. The clinical workshops covered interactive sessions of common and emergency clinical scenarios. A wide range of non-technical skills such as an introduction to mindfulness, tai chi, resilience, team-working and leadership, “Thinking Environment” and meditation were introduced and developed using bespoke training. Feedback was collected at the end of each conference day. The attendees were asked to use a 5-point Likert scale (5 being the highest) to rate their satisfaction with the day and to highlight which sessions they found most and least useful.
ResultThe attendee satisfaction rate was high. The first conference had ratings of 56% of attendees scoring 5 (excellent) and the remainder scoring 4 (very good). The second conference achieved even higher satisfaction ratings with 94% of attendees scoring 5 and the remainder scoring 4.
ConclusionThe conference had high attendee satisfaction. The hope is to expand on its success and open it up to delegates from all specialities within HEE South Yorkshire and the Humber. Evaluation of the long-term impact of this programme is also warranted.
Chapter 15 - Attention Deficit Hyperactivity Disorder
- Edited by Rob Butler, Cornelius Katona
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- Book:
- Seminars in Old Age Psychiatry
- Published online:
- 21 June 2019
- Print publication:
- 11 July 2019, pp 165-177
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Summary
Attention deficit hyperactivity disorder (ADHD) is a rarely encountered condition in most services that look after older adults (over 65). Gaining a new diagnosis of ADHD in this age group would be very unusual. However, it is now nearly 50 years since the inclusion of ‘hyperkinetic reaction of childhood’ in DSM-II in 1968, and 20 years since the National Institute for Health and Care Excellence (NICE) guidelines recommended treatment in adults [1], so it is possible that older adults’ services may start to see a few patients, who are presenting for other reasons, with this historical diagnosis. In years to come, old age psychiatrists may be asked to advise on, or be responsible for continuation or cessation of medications for ADHD that have been started years before. As the condition becomes more prominent in the consciousness of the general public, older people, previously undiagnosed may seek a professional opinion to whether ADHD is an explanation for their lifelong difficulties and what should be done about it at this stage.
8 - Accident and emergency psychiatry and self-harm
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- By Helen Linnington, Doncaster and South Humber NHS Foundation Trust, Rotherham, UK, Allan Johnston, Chesterfield Royal Infirmary, Chesterfield, UK, Paul Gill, The Longley Centre, Sheffield, UK, Navneet Kapur, University of Manchester, UK
- Edited by Elspeth Guthrie, Sanjay Rao, Melanie Temple
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- Book:
- Seminars in Liaison Psychiatry
- Published by:
- Royal College of Psychiatrists
- Published online:
- 25 February 2017, pp 101-117
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Summary
The accident and emergency (A&E) department is one of the most accessible elements of health services. Individuals can walk in and request help. It is normally the first port of call for ambulances. Towns and cities have road signs giving directions to the local A&E. Despite the recent drive in the UK to develop alternatives to A&E such as polyclinics and urgent care centres, A&E remains, for many people, the epitome of urgent healthcare. People attend in large numbers and a significant proportion of these will have mental health problems. The first experience of mental health services for many people is the assessment they receive while attending A&E. The importance of first impressions cannot be overstated, particularly as significant numbers of such patients will require ongoing care from mental health services.
The A&E environment can pose challenges to the clinician when conducting a thorough assessment. There may be pressures to conduct an assessment in conditions of disturbance or lack of privacy, or for the assessment to be rushed. It is incumbent on the clinician to ensure that a thorough assessment is conducted in as appropriate an environment as possible.
As A&E allows direct access to the public, the full range of psychiatric conditions can present in this setting. Those which merit special attention, as they are more frequently seen, are discussed in this chapter.
Self-harm
Self-harm imposes a major burden on health services and is a common reason for presentation to A&E (accounting for as many as 200 000 hospital attendances per year in the UK; Hawton et al, 2007). Assessment of individuals who have self-harmed may make up a significant proportion of the workload of liaison psychiatry departments. Patients who self-harm are at increased risk of subsequent suicide, and up to half of those who die by suicide have a history of self-harm. Effective management of self-harm may contribute to suicide prevention.
Terminology
Various terms have been used to describe non-fatal suicidal behaviour (e.g. parasuicide, attempted suicide, overdose, self-injurious behaviour) and none is entirely satisfactory. ‘Deliberate self-harm’ can be defined as an act of intentional self-poisoning or injury irrespective of the apparent purpose of the act (NHS Centre for Reviews and Dissemination, 1998).
8 - Accident and emergency psychiatry and self-harm
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- By Helen Linnington, Consultant in Psychiatry for Older Adults, Rotherham, Doncaster and South Humber NHS Foundation Trust, Rotherham, UK, Allan Johnston, Consultant in General Psychiatry, Hartington Wing, Chesterfield Royal Infirmary, Chesterfield, UK, Paul Gill, Consultant, Department of Liaison Psychiatry, The Longley Centre, Sheffield, UK, Navneet Kapur, Professor, Centre for Suicide Prevention, University of Manchester, UK Renuka Lazarus, Consultant
- Edited by Elspeth Guthrie, Sanjay Rao, Melanie Temple
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- Book:
- Seminars in Liaison Psychiatry
- Published online:
- 02 January 2018
- Print publication:
- 01 March 2012, pp 101-117
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- Chapter
- Export citation
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Summary
The accident and emergency (A'E) department is one of the most accessible elements of health services. Individuals can walk in and request help. It is normally the first port of call for ambulances. Towns and cities have road signs giving directions to the local A'E. Despite the recent drive in the UK to develop alternatives to A'E such as polyclinics and urgent care centres, A'E remains, for many people, the epitome of urgent healthcare. People attend in large numbers and a significant proportion of these will have mental health problems. The first experience of mental health services for many people is the assessment they receive while attending A'E. The importance of first impressions cannot be overstated, particularly as significant numbers of such patients will require ongoing care from mental health services.
The A'E environment can pose challenges to the clinician when conducting a thorough assessment. There may be pressures to conduct an assessment in conditions of disturbance or lack of privacy, or for the assessment to be rushed. It is incumbent on the clinician to ensure that a thorough assessment is conducted in as appropriate an environment as possible.
As A'E allows direct access to the public, the full range of psychiatric conditions can present in this setting. Those which merit special attention, as they are more frequently seen, are discussed in this chapter.
Self-harm
Self-harm imposes a major burden on health services and is a common reason for presentation to A'E (accounting for as many as 200 000 hospital attendances per year in the UK; Hawton et al, 2007). Assessment of individuals who have self-harmed may make up a significant proportion of the workload of liaison psychiatry departments. Patients who self-harm are at increased risk of subsequent suicide, and up to half of those who die by suicide have a history of self-harm. Effective management of self-harm may contribute to suicide prevention.