{"title":"Reimagining psychosis prevention: responding to the accessibility issues of At-Risk Mental State (ARMS) services through a selective public health approach.","authors":"Luke Brown, Siân Lowri Griffiths","doi":"10.1192/bjb.2024.112","DOIUrl":"https://doi.org/10.1192/bjb.2024.112","url":null,"abstract":"<p><p>At-Risk Mental State (ARMS) services aim to prevent the onset of first-episode psychosis (FEP) in those with specific clinical or genetic risk markers. In England, ARMS services are currently expanding, but the accessibility of this preventative approach remains questionable, especially for a subgroup of FEP patients and those from specific ethnic minority communities. This commentary outlines the key debates about why a complimentary approach to psychosis prevention is necessary, and gives details for an innovative public health strategy, drawing on existing research and health prevention theory.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-5"},"PeriodicalIF":2.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982477","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}
Miriam Stanyon, Nagina Khan, Analia Buckley, Naina Patel, Kirit Mistry, Karl Ryan, Subodh Dave
{"title":"Diversity in psychiatry education and patient and public involvement: roundtable analysis.","authors":"Miriam Stanyon, Nagina Khan, Analia Buckley, Naina Patel, Kirit Mistry, Karl Ryan, Subodh Dave","doi":"10.1192/bjb.2024.106","DOIUrl":"https://doi.org/10.1192/bjb.2024.106","url":null,"abstract":"<p><p>Patient involvement in psychiatry education struggles to be representative of the patients that doctors will treat once qualified. The issues of mental health stigma, cultural perspectives of mental health and the unique role of teaching, required exploring to establish the barriers and facilitators to increasing the diversity of patients involved in psychiatry education. To explore the causes of this lack of representation, a roundtable event with 34 delegates composed of people with lived experience of mental health issues, people from underserved communities, academics, mental health professionals and charity representatives met to discuss the barriers to involvement in psychiatry education and possible solutions. Themes were further developed in a context expert focus group. Notes from the roundtable and focus group were analysed and developed into recommendations for medical schools and mental health professional teaching departments.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-7"},"PeriodicalIF":2.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982553","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":"Psychiatric poetics: mental healthcare and Giovanni Stanghellini's 'Logics of Discovery'.","authors":"George Ikkos, Alastair Morgan","doi":"10.1192/bjb.2024.115","DOIUrl":"https://doi.org/10.1192/bjb.2024.115","url":null,"abstract":"<p><p>The importance of art and humanities in mental health is widely recognised, and consumption and creation of poetry, prose, drama and the plastic arts are now considered to be relevant knowledge-generating and therapeutic activities. However, literary and art criticism remain at the margins. By contrast, in his two 'Logics of Discovery' papers, psychiatrist, psychopathologist and psychotherapist Giovanni Stanghellini brings to bear on clinical discovery and the healing alliance cultural historian Aby Warburg's approach to images (specifically, his <i>Atlas of Mnemosyne</i>) and philosopher Giorgio Agamben's analysis of the linguistic phenomenon of parataxis in Friedrich Hölderlin's poetry. Both Warburg and Hölderlin experienced severe mental disorders, and Stanghellini's analysis is notable for its potential to contribute to co-creation in a wide range of clinical settings. We suggest that this work may help to address some key sources of dissatisfaction among mental health patients and thus improve patient experience and clinical outcomes. We also comment on issues regarding implementation of Stanghellini's proposals and conclude with discussion of an example of the severe loosening of associations originally reported by Eugen Bleuler.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943740","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":"Use of the Mental Health Gap Action Programme (mhGAP) by mental health volunteers in the UK: examples from South Asian diaspora charities.","authors":"Leya Luhar, Aditi Arya, Raeesah Rafiq, Nandini Chakraborty","doi":"10.1192/bjb.2024.116","DOIUrl":"https://doi.org/10.1192/bjb.2024.116","url":null,"abstract":"<p><p>The Mental Health Gap Action Programme (mhGAP) was launched by the World Health Organization (WHO) in 2008 to scale up services for mental, neurological and substance use disorders for low- and lower-middle-income countries. Subsequently, an updated mhGAP intervention Guide (mhGAP-IG 2.0) was released in 2016. This study explores the use and effectiveness of mhGAP-IG 2.0 by mental health volunteers of two South Asian charities in the UK. Semi-structured interviews were carried out with eight volunteers. The core themes identified were mental health awareness, mental health education, empathy and care, social perception and bias within the South Asian community, and personal development. The study identified mhGAP as a tool with transformative potential. Although the WHO originally planned the mgGAP-IG as a tool for low- and middle-income countries with limited mental health resources, this study demonstrates its usefulness even in high-income countries, as a foundation to educate volunteers working in mental health.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943742","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":"Promethazine is not a good option to aid sleep quality, especially for people using psychiatric services.","authors":"Jacob D King","doi":"10.1192/bjb.2024.108","DOIUrl":"https://doi.org/10.1192/bjb.2024.108","url":null,"abstract":"<p><p>Promethazine, a sedating antihistamine, is widely and increasingly prescribed for patients reporting problems sleeping. In this Against the Stream article, the case is made that promethazine is not suitable as a sleep aid for people using mental health services, because it has no good evidence base, impedes with psychological and behavioural techniques that do improve sleep in the medium-long term, has underappreciated addictive and recreational-use potential, and an unacceptable side-effect profile. Alternatives to promethazine are described, notably the NICE first-line recommendation, cognitive-behavioural therapy for insomnia.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-3"},"PeriodicalIF":2.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930522","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":"Social contagion, the psychiatric symptom pool and non-suicidal self-injury.","authors":"Joel Paris","doi":"10.1192/bjb.2024.101","DOIUrl":"https://doi.org/10.1192/bjb.2024.101","url":null,"abstract":"<p><p>There is evidence that social contagion plays a role in shaping the clinical presentation of some psychiatric symptoms, particularly affecting features that vary over time and culture. Some symptoms can increase so rapidly in prevalence that they become 'epidemic'. The mechanism involves a spread through peers and/or the media. Within broader domains of psychopathology, this process draws from a 'symptom pool' that can determine which specific symptoms will appear. This article illustrates these mechanisms by focusing on non-suicidal self-injury (NSSI), a syndrome that has been subject to social contagion and whose prevalence may have increased among adolescents.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-3"},"PeriodicalIF":2.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765899","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}
Lucy Goulding, Julie Williams, Alison White, Aileen Jackson, Zoë Lelliott, Stuart Adams, Kia-Chong Chua, Noushig Nahabedian, Juliana Onwumere, James Woollard, Nick Sevdalis, Fiona Gaughran
{"title":"Remote consultations in mental health: collaborative evaluation applying learning health systems thinking.","authors":"Lucy Goulding, Julie Williams, Alison White, Aileen Jackson, Zoë Lelliott, Stuart Adams, Kia-Chong Chua, Noushig Nahabedian, Juliana Onwumere, James Woollard, Nick Sevdalis, Fiona Gaughran","doi":"10.1192/bjb.2024.102","DOIUrl":"https://doi.org/10.1192/bjb.2024.102","url":null,"abstract":"<p><strong>Aims and method: </strong>A collaborative evaluation of remote consultations in mental health services was undertaken by mental health service providers, experts by experience, academic institutions and a Health Innovation Network in south London, UK. 'Learning healthcare systems' thinking was applied. Workstream 1 reviewed international published evidence; workstream 2 synthesised findings from three health provider surveys of the perceptions and experiences of staff, patients and carers; and workstream 3 comprised an electronic survey on local projects.</p><p><strong>Results: </strong>Remote consultations can be acceptable to patients and staff. They improve access for some while restricting access for others, with digital exclusion being a key concern. Providing tailored choice is key.</p><p><strong>Clinical implications: </strong>The collaboration generated learning to inform choices by healthcare providers to embed or adapt remote delivery. A key output was freely downloadable survey questions for assessing the quantity and quality of appointments undertaken by phone or video or face to face.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765898","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":"Whose trauma is it anyway? Creating more equitable mental healthcare in a system that harms.","authors":"James Downs","doi":"10.1192/bjb.2024.103","DOIUrl":"https://doi.org/10.1192/bjb.2024.103","url":null,"abstract":"<p><p>Past experiences of mental healthcare which have been perceived as harmful can present significant barriers to accessing treatment again. This article draws upon research and lived experience to consider the ways in which conceptualisations of 'trauma-informed care' may better incorporate the role of iatrogenic harm, thus providing more acceptable and equitable treatment for those who have previously found treatment to be harmful. A more restorative approach is offered, founded in shared responsibility and compassionate relationships, to help minimise harms and create a more healing system for patients and clinicians alike.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-4"},"PeriodicalIF":2.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738287","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}