The journal of mental health training, education, and practice最新文献

{"title":"Translation and adaption of short version of IQCODE into Hausa and its psychometric evaluation among outpatients older adults","authors":"T. Adeniji, A. Oyeyemi","doi":"10.1108/jmhtep-03-2021-0031","DOIUrl":"https://doi.org/10.1108/jmhtep-03-2021-0031","url":null,"abstract":"\u0000Purpose\u0000This study aims at translating and adapting a common and widely used proxy rated cognitive screening tool – Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) into Hausa language and also to evaluate the instrument’s psychometric properties.\u0000\u0000\u0000Design/methodology/approach\u0000IQCODE was translated and adapted using a qualitative process involving experts and the adapted version was then evaluated against a gold standard (Diagnostic and Statistical Manual of Mental Disorder V criteria for neurocognitive disorders) with older adults subjects (N = 100), while its reliability (internal consistency) was also evaluated. Descriptive statistics of mean and frequencies, and inferential statistic of receiver operating curve analysis and Cronbach’s alpha coefficient were used for data analysis at an alpha level set at 0.05.\u0000\u0000\u0000Findings\u0000The Hausa IQCODE has a sensitivity value of 73.3%, specificity value of 71.8% and optimal cut-off values of between 3.2 and 3.3. For his adapted instrument the area under the Curve (AUC) curve is 0.79 (95% CI: 0.663–0.919; std. err: 0.066; P = 0.000), and Cronbach’s alpha value of 0.819 was obtained indicating that the adapted instrument has good internal consistency.\u0000\u0000\u0000Research limitations/implications\u0000The adapted IQCODE is a valid and reliable proxy based cognitive screening tool for the older adult Hausa speakers in Maiduguri. However, clinician and researcher might want to consider different optimal cut-off points when using this tool to screen or to monitor cognitive changes among older adults.\u0000\u0000\u0000Originality/value\u0000This research paper translated and adapted Hausa IQCODE into Hausa language. And it gives information on the validity and reliability of the adapted tool alongside with new optimal cut-off for cognitive screening by proxy among older adult patients in Nigeria.\u0000","PeriodicalId":75090,"journal":{"name":"The journal of mental health training, education, and practice","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83624655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motivation to lead in trainee clinical psychologists: service evaluation of a UK doctorate programme","authors":"C. Hassett, D. M. Gresswell, Sarah Wilde","doi":"10.1108/jmhtep-10-2020-0075","DOIUrl":"https://doi.org/10.1108/jmhtep-10-2020-0075","url":null,"abstract":"\u0000Purpose\u0000This paper aims to explore whether a United Kingdom (UK) clinical psychology training programme (the programme) was effective in producing graduates who are confident in leadership, within the context of the National Health Service and reflecting the British Psychological Society’s views of leadership.\u0000\u0000\u0000Design/methodology/approach\u0000Mixed methods design surveys were administered to prospective-, current- and alumni trainee clinical psychologists on the programme, enquiring about their view of leadership, motivation to lead (MtL) and aspects of the course that are helpful and which need further development. Data collected from 92 individuals were analysed using content and thematic analysis (TA).\u0000\u0000\u0000Findings\u0000From the TA, three themes were identified concerning the meaning of leadership as follows: professional identity, Improving the quality of services (team; organisations and wider context), professional skills. Overall, participants thought leadership was important to the role of a clinical psychologist, with prospective trainees reporting that the desire to develop as leaders influenced their decision to apply to the programme. Moreover, participants felt confident in leadership skills and that the training programme helped develop their leadership skills, with the alumni participants demonstrating a greater MtL. Placements, group study and specific modules were identified as contributing to the development of their leadership skills, but participants felt more teaching on leadership is needed. Recommendations have been suggested to improve the development of leadership skills on the programme.\u0000\u0000\u0000Research limitations/implications\u0000The research was undertaken on a small cohort of trainees based in the UK.\u0000\u0000\u0000Practical implications\u0000Participants were motivated to become clinical leaders but this motivation needed to be nurtured and developed particularly through structured placement and teaching experience.\u0000\u0000\u0000Originality/value\u0000This service evaluation is the only audit of the leadership of the programme and the findings will contribute to the existing body of reviews in this area.\u0000","PeriodicalId":75090,"journal":{"name":"The journal of mental health training, education, and practice","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89300366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is co-production working well in recovery colleges? Emergent themes from a systematic narrative review","authors":"Karen Louise Bester, A. McGlade, E. Darragh","doi":"10.1108/jmhtep-05-2021-0046","DOIUrl":"https://doi.org/10.1108/jmhtep-05-2021-0046","url":null,"abstract":"\u0000Purpose\u0000“Co-production” is a process in health and social care wherein service users and practitioners work in partnership. Recovery colleges (RCs) are educational establishments offering mental health education; a cornerstone feature is that courses are designed and delivered in parity by both mental health practitioners and “peers” – people with lived experience of mental illness. This paper aims to consider, through the identification of key themes, whether co-production within RCs is operating successfully.\u0000\u0000\u0000Design/methodology/approach\u0000The paper is a systematic review of qualitative literature. Relevant concept groups were systematically searched using three bibliographic databases: Medline, Social Care Online and Scopus. Articles were quality appraised and then synthesised through inductive thematic analysis and emergent trends identified.\u0000\u0000\u0000Findings\u0000Synthesis identified three key themes relating to the impact of co-production in RCs: practitioner attitudes, power dynamics between practitioners and service users, and RCs’ relationships with their host organisations. As a result of RC engagement, traditional practitioner/patient hierarchies were found to be eroding. Practitioners felt they were more person-centred. RCs can model good co-productive practices to their host organisations. The review concluded, with some caveats, that RC co-production was of high fidelity.\u0000\u0000\u0000Originality/value\u0000RC research is growing, but the body of evidence remains relatively small. Most of what exists examine the impact of RCs on individuals’ overall recovery and mental health; there is a limited empirical investigation into whether their flagship feature of parity between peers and practitioners is genuine.\u0000","PeriodicalId":75090,"journal":{"name":"The journal of mental health training, education, and practice","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79331367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Service user and carer representatives’ experiences of the personal effects of involvement in clinical psychology training","authors":"D. Boos, Adam K Hill, Anna Tickle","doi":"10.1108/JMHTEP-02-2021-0019","DOIUrl":"https://doi.org/10.1108/JMHTEP-02-2021-0019","url":null,"abstract":"This study explores the experiences and personal effects of service user (SU) involvement in clinical psychology training. A critical realist stance was adopted throughout the research process. \u0000 \u0000Extant literature has predominantly focused on evaluating and optimising SU involvement for the benefit of clinical psychology trainees. Only recently has research started to consider the effects involvement may have on SUs. The research exploring SUs’ experiences in clinical psychology training has derived samples from singular training programmes. Exploring SUs’ experiences from multiple programmes seemed the logical next step. The deductive application of psychological theory allowed further exploration into power, recovery, identity and group development (concepts highlighted as important in the SU involvement literature). \u0000 \u0000Purposive sampling was utilised, with advertisements disseminated via course staff who oversee SU involvement. Fourteen SU representatives, from eight different courses were recruited (with two also identifying as carers). Each participant took part in either a face-to-face or telephone semi-structured interview which was audio recorded and transcribed by the researcher. A deductive thematic analysis was used to analyse the data. \u0000 \u0000Five themes were identified, some with subthemes: Environment determines sense of safety (subthemes: Supportive relationships, Group dynamics); Meeting challenges; Sense of purpose, worth and value (subthemes: Feeling listened to and valued, A positive way to feed back into the system); The person you see now is not the person I was (subthemes: A game changer for personal growth and development, Relating to difficulties in a different way, Reengaging with skills that I thought had gone); and Wanting to break the glass ceiling. Findings are considered and discussed in relation to theories of social identity, power, group development and mental health recovery. \u0000 \u0000Identified benefits for SUs included a positive change in self-perception, including re-engaging with lost skills. Findings suggest involvement can offer an opportunity to further develop recovery. However, there were reported difficulties in joining a new SU group including group dynamics and power imbalances. Findings also suggest that there is a glass ceiling to involvement which SUs have a desire to break. \u0000 \u0000The findings suggest it is important that the environment in clinical psychology training fosters psychological safety for SUs, via positive and supportive relationships with trainees and staff, in which SUs are treated as equal colleagues and financially reimbursed as such. Additionally, the intricacies and nuances of managing and sharing power need to be explored to enable SUs to feel valued and reap benefits from involvement, including developing a positive sense of identity. There are also implications for professionals in mental health services who should look to share theoretical knowledge with SUs who reportedly found that ha","PeriodicalId":75090,"journal":{"name":"The journal of mental health training, education, and practice","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85901756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving outcomes for trauma-experienced individuals through the delivery of trauma awareness training for multi-organisational public sector workers","authors":"Erin Richmond, R. McColm, Marie McCaig, Vikki Binnie","doi":"10.1108/jmhtep-04-2021-0038","DOIUrl":"https://doi.org/10.1108/jmhtep-04-2021-0038","url":null,"abstract":"\u0000Purpose\u0000In support of the national requirement “to ensure that Scotland has a workforce that is fully aware of the impact of trauma, and is equipped to respond appropriately to people who have experienced trauma at any age”, Trauma Awareness Training was delivered to various public sector organisations across Dumfries and Galloway. Research has shown that trauma can significantly impact quality of life (Svanberg, Bonney and McNair, 2011; Bentall et al., 2014). A trauma-informed practice workshop was created and evaluated in response to a need for training within public services for individuals working with clients whom have experienced trauma.\u0000\u0000\u0000Design/methodology/approach\u0000From May 2018 to December 2019, 10 one-day Trauma-Awareness Training courses were delivered, engaging 224 public service workers from Police Scotland, Scottish Fire Service, Relationship Scotland, Shelter Scotland and DandG Council staff working with trauma-experienced individuals. The training was delivered via PowerPoint, short videos, whiteboard explanations/drawings and case examples. The morning workshop concentrated on defining psychological trauma, understanding the psychological process of Post-Traumatic Stress Disorder (PTSD) and the subsequent consequences. The afternoon session focussed primarily on complex PTSD, the role of adverse childhood experiences, attachment and emotional regulation/dysregulation and trauma-focused working with the wider multi-disciplinary workforce. The training concluded with participants developing strategies for coping with trauma. Participants were asked to complete three questionnaires: pre-training questionnaire on perceived knowledge of trauma and delivering trauma practice. Post-training questionnaire on perceived knowledge of trauma and delivering trauma practice to assess change and training evaluation. A third questionnaire was issued seven months after training to establish the impact of training on practice.\u0000\u0000\u0000Findings\u0000Findings evidence a positive impact on person-centred care. In terms of quality improvement, participants felt: The training was relevant across services and raised awareness of the importance of trauma-informed practice. They had a greater awareness of trauma-related issues with individuals. Confident in implementing learned skills to assist those who have experience of trauma. They could build better relationships with their service users, with patients feeling more understood.\u0000\u0000\u0000Originality/value\u0000Project findings identified a need for multi-organisational working and consultancy from psychological services to improve access to services. Ultimately, brief trauma-awareness training for staff can lead to more positive experiences for patients.\u0000","PeriodicalId":75090,"journal":{"name":"The journal of mental health training, education, and practice","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90950838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thematic analysis of mechanisms underpinning email peer support for young people with eating disorders","authors":"Imogen Peebles, Beccy Brown, E. Juster, Fiona Duffy","doi":"10.1108/jmhtep-08-2020-0056","DOIUrl":"https://doi.org/10.1108/jmhtep-08-2020-0056","url":null,"abstract":"\u0000Purpose\u0000Peer support, such as mentorship and befriending, has been found to have a valuable impact on a range of outcomes. There are multiple formats, including face-to-face (individually and group), and in online forums. Advancement in technology has enabled online peer support to increase in popularity; however, little is known about mechanisms underpinning individual one to one online peer interactions. The purpose of this paper is to qualitatively explore the mechanisms underpinning email exchanges in an eating disorder peer support service.\u0000\u0000\u0000Design/methodology/approach\u0000Email transcripts from dyads in a moderated peer-to-peer email support service were analysed using inductive thematic analysis (Braun and Clarke, 2006).\u0000\u0000\u0000Findings\u0000The thematic analysis generated five themes as mechanisms of peer support. Relating and reflecting experience was the central superordinate theme. Subthemes included Positive Encouragement, Checking in and Prompting, Being a Confidante and Defining Recovery.\u0000\u0000\u0000Originality/value\u0000The current findings align with previous research and add new developments. The theme of Defining Recovery added the awareness of the personal perception of recovery, which had not been considered as a mechanism in previous literature and may be specific to this digital platform. This study could assist in the development of training for the provision of further peer support within eating disorder services.\u0000","PeriodicalId":75090,"journal":{"name":"The journal of mental health training, education, and practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77971432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a trauma-informed workforce for the opioid crisis in a rural community in the United States: a case study","authors":"Dalia Chowdhury","doi":"10.1108/jmhtep-06-2021-0070","DOIUrl":"https://doi.org/10.1108/jmhtep-06-2021-0070","url":null,"abstract":"\u0000Purpose\u0000Workforce development in rural communities to address a surge in opioid addiction and overdose related hospitalizations has been an unaddressed issue in the USA. This study aims to present an integrated, trauma-informed, behavioral workforce development initiative in a midwestern rural setting in the USA.\u0000\u0000\u0000Design/methodology/approach\u0000This is a mixed method, two-phased study: the first phase tracked and analyzed two focus group conferences involving experts (n = 6) and professionals (n = 8) to develop a training protocol; the second phase provided a training (n = 101), based on the protocol to future professionals and compared competencies before and after the implementation of the training.\u0000\u0000\u0000Findings\u0000There is a need of a trauma integrated approach in providing interprofessional training connecting health-care workers in rural communities to address the current opioid crisis to bring about cohesion among integrated and interdisciplinary teams. Workforce building will need to implement best practices not only among medical providers but among community mental health practitioners in rural areas.\u0000\u0000\u0000Originality/value\u0000This is a unique trauma-informed workforce development initiative in a rural community. Such studies are extremely limited and almost non-existent. Further initiatives need to be taken in this field to identify unique differences within communities that may hinder implementation.\u0000","PeriodicalId":75090,"journal":{"name":"The journal of mental health training, education, and practice","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78594141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training school teachers in Malawi about substance misuse and trauma: the need for a sustainable strategy","authors":"N. Evans, Rhiannon Lane, Gemma Stacey-Emile, A. Sefasi","doi":"10.1108/jmhtep-07-2020-0049","DOIUrl":"https://doi.org/10.1108/jmhtep-07-2020-0049","url":null,"abstract":"\u0000Purpose\u0000The World Health Organisation found depression to be the fourth leading cause of disability in Malawi (Bowie, 2006) with the prevalence of mental health need in children and young people in Malawi estimated between 10 and 30% (Kutcher et al., 2019). One option to address this was to provide schoolteachers with skills and knowledge related to mental health so they can better support children. There is generally a lack of evidence of the utility or feasibility of school-based mental health literacy programmes in low to medium income countries (LMIC). This paper aims to report on a project to train schoolteachers in Malawi on aspects of mental health.\u0000\u0000\u0000Design/methodology/approach\u0000The aim of this project was to determine the acceptability and feasibility of delivering a training initiative in Malawi to teachers to better enable them to recognise and cope with school children who had been exposed to trauma and substance misuse.\u0000\u0000\u0000Findings\u0000Feedback was generated through the use of a specifically designed pre and post measure, focus groups, interviews and observations of the teaching delivery.\u0000\u0000\u0000Practical implications\u0000Teachers found the training built on their existing knowledge and they requested further opportunities for training and consultation about how to manage difficult presentations. It was evident that teachers did not know how to access mental health care or support for children whose needs could not be met by schoolteachers alone.\u0000\u0000\u0000Originality/value\u0000For a sustainable improvement for children’s mental health care in this context, further training becomes valuable when located as part of a network of joined up health and educational services.\u0000","PeriodicalId":75090,"journal":{"name":"The journal of mental health training, education, and practice","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86792917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting minority groups in schools – reflections on training education mental health practitioners","authors":"H. Woodley","doi":"10.1108/jmhtep-05-2020-0026","DOIUrl":"https://doi.org/10.1108/jmhtep-05-2020-0026","url":null,"abstract":"\u0000Purpose\u0000This study aims to reflect upon the first wave of training of Education Mental Health Practitioners (EMHPs), a new National Health Service role to provide support for Children and Young People (CYP) with low and moderate mental health needs in education settings in England. The study specifically focusses on the training for EMHPs in relation to their support for CYP who identify themselves as Black, Asian or Minority Ethnic (BAME), refugees or from the traveller community.\u0000\u0000\u0000Design/methodology/approach\u0000A brief review of the policy and literature on the role and remit of EMHPs was undertaken, including an exploration of the current status of BAME, refugee and traveller community CYP in schools in England. The review was then related to the specific experience of the author within the context of teaching EMHP trainees in a higher educational setting and evaluated as developing outcomes in low-intensity school-based practice.\u0000\u0000\u0000Findings\u0000There are benefits for trainee EMHPs to have an understanding of the minority groups of CYP attending schools in the area their Mental Health Support Team (MHST) covers. There are benefits for the MHST to form relationships with minority groups at an early stage in the MHST formation. Adapting the EMHP curriculum at a local level to include specific training on the needs of minority groups supports the development of relationships between schools and the communities they engage with locally. Ongoing training should be provided by services focussing on the specific needs of minority groups in their MHST area.\u0000\u0000\u0000Originality/value\u0000Involving minority groups in education in the formation of MHST and the training of EMHPs may improve outcomes in developing therapeutic relationships with CYP. Developing engagement practices in MHSTs with higher education providers, begins the process early in the experience of EMHP trainees, providing a safe environment in which to develop engagement skills.\u0000","PeriodicalId":75090,"journal":{"name":"The journal of mental health training, education, and practice","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83911822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving multiple exclusion homelessness (MEH) services: frontline worker responses to insecure attachment styles","authors":"N. Theodorou, S. Johnsen, B. Watts, Adam Burley","doi":"10.1108/jmhtep-02-2021-0016","DOIUrl":"https://doi.org/10.1108/jmhtep-02-2021-0016","url":null,"abstract":"\u0000Purpose\u0000This study aims to examine the emotional and cognitive responses of frontline homelessness service support staff to the highly insecure attachment styles (AS) exhibited by people experiencing multiple exclusion homelessness (MEH), that is, a combination of homelessness and other forms of deep social exclusion.\u0000\u0000\u0000Design/methodology/approach\u0000Focus groups were conducted with frontline staff (N = 19) in four homelessness support services in Scotland. Hypothetical case vignettes depicting four insecure AS (enmeshed, fearful, withdrawn and angry-dismissive) were used to facilitate discussions. Data is analysed thematically.\u0000\u0000\u0000Findings\u0000Service users with AS characterised by high anxiety (enmeshed or fearful) often evoked feelings of compassion in staff. Their openness to accepting help led to more effective interactions between staff and service users. However, the high ambivalence and at times overdependence associated with these AS placed staff at risk of study-related stress and exhaustion. Avoidant service users (withdrawn or angry-dismissive) evoked feelings of frustration in staff. Their high need for self-reliance and defensive attitudes were experienced as hostile and dismissing. This often led to job dissatisfaction and acted as a barrier to staff engagement, leaving this group more likely to “fall through the net” of support.\u0000\u0000\u0000Originality/value\u0000Existing literature describes challenges that support staff encounter when attempting to engage with people experiencing MEH, but provides little insight into the causes or consequences of “difficult” interactions. This study suggests that an attachment-informed approach to care can promote more constructive engagement between staff and service users in the homelessness sector.\u0000","PeriodicalId":75090,"journal":{"name":"The journal of mental health training, education, and practice","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79513558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}