QNIC Email Discussion Group
The QNIC email discussion group is a lively
forum with over 200 members that work or have an interest in Tier 4
child and adolescent mental health. The most recent topics will be
detailed below and will be updated depending on new trends and
issues emerging from members.
The recent topics discussed include:
- Email Therapy - The group
are discussing the use and benefits of using e-mail therapy with
individuals, and the evaluation and evidence base for this
approach. Teams have found e-mail therapy helpful as a means of
engaging difficult to engage young people who are able to
communicate about their emotions via the written word but find
face-to-face ‘therapy’ overwhelming.
Articles published around this
type of therapy include:
Roy, H & Gillett, T. E-mail: A
New Technique for Forming a Therapeutic Alliance with High-risk
Young People Failing to Engage with Mental Health Services? A Case
Study. Clin Child Psychol Psychiatry January 2008 vol. 13 no. 1
95-103
- Family Support - Members of
the group are currently considering establishing a family support
element to their inpatient service, giving specific support to
families outside of that given by key workers and other members of
the team. One team has introduced a very comprehensive service to
meet the needs of families, which includes;
- training as part of
the induction process for all staff on family awareness and
communication
- Family Link Worker
role (this is still at early stages) who would
have regular meetings with families to actively involve them
in care planning and offer them regular information and support
- Training for nursing
staff in Behavioural Family Therapy and Psycho-social Interventions
(with supervision from Family Therapists)
- Systemic Family
Therapy
- Uniforms –
There is a push within some inpatient units for staff, in
particular nursing staff, to be required to wear uniforms. In
general the discussion group was opposed to this and QNIC further
supports teams in putting a case forward not to wear uniforms. The
group feel that the use of uniforms may create a barrier between
the young people and staff, and make staff less approachable. It
may also add to the stigma associated with mental health and make
young people feel uncomfortable when escorted off the unit by staff
in uniforms.
- Use of
seclusion – The group have discussed the use of seclusion
on units and what is required in order to safely provide facilities
and manage seclusion in an inpatient setting. Individuals that
added to the discussion felt that instead of introducing seclusion
rooms within units, teams should look at alternatives to
therapeutically manage disruptive or violent behaviour.
- Education for Post
16 year olds – As inpatient units are now admitting young
people up to 18 years old, teaching staff are finding it
increasingly hard to provide educational activities for the post 16
group. The group discussed whilst teaching staff are often not
funded to work with this older age range, that they may help these
young people liaise with local colleges to continue with A levels
or look into local provisions for more vocational subjects. The
upcoming QNIC special interest day on 16th September
will focus on education provision and may be of interest to further
explore this topic.
- Ability to Consent for
16 & 17 year olds – The group has discussed the
differences in age range to consent to treatment across England,
Scotland and Ireland. This discussion also addressed the issue of
parental consent and at what age/situation is the young person able
to make decisions regarding admission and treatment without their
parent’s consent. Further guidance around consent for 16/17 year
olds in England and Wales can be found on the NMHDU website
http://www.nmhdu.org.uk/
The discussion group has also been used to
share examples of therapeutic timetables and rapid tranquilisation
guidelines.
If you would like to join the group please
email 'JOIN' to qnic@cru.rcpsych.ac.uk
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