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WHO AM I? Transcultural Psychiatry in Practice
- Christiana Elisha-Aboh, Wendy Tangen, Nicholos Dodough, Daniel Romeu, Nyakomi Adwok, Sharon Nightingale, Nazish Hashmi
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S88
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- Article
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Aims
Culture refers to the way of life of a group of people and influences their value system. It affects virtually every area of life, unconsciously shaping one's outlook, behaviours and responses. As the world becomes more multicultural, it is essential that mental health professionals possess the much-needed awareness into the constructs of cultural variation and their impact on the expression of psychopathology and treatment. Black, Asian and Minority groups are a diverse group and make up 16% of the population in England & Wales. They are reported to have a less positive experience of mental health systems compared to white people. The common barriers ethnic minority groups face in accessing mental health care include: cultural barriers, stigma, language barriers, lack of cultural sensitivity from professionals, stereotyping, unconscious bias and so on. The aim of this quality improvement project is to improve the delivery of patient care and professional support to ethnically diverse groups.
MethodsA pre-workshop survey was set up to aid planning. The virtual workshop had over 80 people in attendance and included panel discussions, anchored by four professionals and three patients, all with lived experience. It lasted for 1-hour 15minutes, followed by a debrief. Feedback was obtained through survey monkey and the results were analysed with Microsoft Excel.
ResultsThe pre-workshop planning survey identified that 91 % of respondents within the Trust (57 individuals) worry about being misunderstood when working with culturally diverse patients. 93 % feel more education on cultural diversity is needed and only 20 % felt they had sufficient knowledge and resources for day-to-day practice with a diverse patient group.The feedback survey results on the day explored five questions which included: awareness of barriers minority groups experience, awareness of available transcultural resources, awareness of transcultural issues, awareness of local protocols and resources, and likelihood to intervene against discrimination showed an improvement of 41.2%; with average pre-workshop scores of 55% and average post-workshop scores of 96.2%. Using thematic analysis, other areas of interest relating to transcultural psychiatry, at future workshops were considered as; greater awareness, practical approaches, culture/intersectionality, social justice, greater time allocation, spirituality, resources, gender/sexuality and age
ConclusionOverall, majority of the feedback received was positive. Attendees valued the interactive nature of the panel discussions and choice of topics. Suggested areas of improvement were having more time for discussion and including other relevant topics. Recommendations include repeating workshops and raising local/national awareness.
Resilience-culture of support
- Nazish Hashmi, Sunitha Muniyappl
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, p. S139
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Aims
Better-informed trainees will have increased confidence and improved resilience which will have a positive impact on the workforce. To promote and celebrate diversity in psychiatric workforce it is imperative to acknowledge the above and provide adequate support to IMGs across UK.
BackgroundNearly two fifth of licensed doctors in NHS are from black and ethnic minorities. Studies have shown that International Medical Graduates (IMGs) are particularly prone to certain difficulties compared to UK graduates. IMGs are more likely to be subject to investigations by General Medical Council for concerns over clinical skills and knowledge, communication skills, lack of awareness of the laws and code of practice. This has been highlighted by GMC as well as Royal College of Psychiatrists. To promote and celebrate diversity in psychiatric workforce it is imperative to acknowledge this and provide adequate support to IMGs across UK.
MethodAn additional rotation wide induction programme was started for IMGs in August 2018 in West Yorkshire. This has continued on a 6 monthly basis for all new starters and last one was held on 21st of August 2019. Teaching included information about Good Medical Practice, confidentiality issues, principles of consent, information about living skills and practical teaching on phlebotomy and requesting investigations.
ResultThe doctors who attended these sessions found it to be very helpful and some suggested it to be a full day programme. According to the feedback collected there was a definite improvement in understanding noted by IMGs in most areas covered. This induction was also acknowledged in the School of Psychiatry conference in October 2019.
ConclusionConsidering the increasing numbers of International medical graduates it will be beneficial to arrange similar events at local level for easier accessibility. In line with RCPsych and GMC guidelines all trusts should be encouraged to offer IMG induction sessions locally.
Reasonable adjustments for autistic adults
- Nazish Hashmi, Conor Davidson
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, p. S81
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Aims
To embed the use of reasonable adjustments for adults with autism within in mental health services.
ObjectivesThe objectives of the project are as follows:
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To identify how many service users with a diagnosis of autism are under care of local mental health services
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Is there evidence that reasonable adjustments were considered for these service users
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If identified as needing reasonable adjusments is there evidence of such adjustments being made
MethodWe looked at service users with an established diagnosis of autism under care of Leeds and York NHS foundation trust to ascertain if reasonable adjustments have been considered. The audit is based on guidelines provided by Think Autism-department of health statutory guidance 2014. This is based on autism act 2009.
Data were collected for 30 cases in mainstream mental health services undr care of various teams including inpatient and community.
ResultIt was identified that in only 2/30 cases reasonable adjustments were considered and agreed upon. Only 1/30 service users had a disability status updated on electronic patient records. None of the service users had a hospital passport or reasonable adjustment care plan completed.None of the records had “good evidence” of reasonable adjustments.
These findings point to a wider issue for the trust as well as natioanlly as it indicates that autism is not being adequately taken into account for patients accessing our services. Due to the lack of reasonable adjustments adults with autism are potentially at increased risk to disengage leading to deterioration in their mental state and increase in risks.
ConclusionThese findings point to a wider issue for the trust as it indicates that autism is not being adequately taken into account for patients accessing our services. Due to the lack of reasonable adjustments adults with autism are potentially at increased risk to disengage leading to deterioration in their mental state and increase in risks.
We recommend training in autism for all healthcare professionals in the trust to improve their understanding of autism, including making reasonable adjustments.
We also recommend review trust procedure about recording diagnoses and disability status on electronic patient records. We recommend that the reasonable adjustments section on care director is more prominent and easily accessible.
We recommend that an ‘autism flag’ is prominent on patient records to alert staff to the presence of autism
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Chapter 12 - Stress Response to Surgery in the Elderly
- Edited by Shamsuddin Akhtar, Stanley Rosenbaum
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- Book:
- Principles of Geriatric Critical Care
- Published online:
- 13 October 2018
- Print publication:
- 25 October 2018, pp 168-186
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