Barriers to the implementation of psychosocial interventions on acute mental health wards: an ethnographic observational study
BackgroundIt is notoriously challenging to deliver psychosocial interventions on acute mental health wards. This paper presents an ethnographic observational study which captured how ward and staff processes impacted on the delivery of a psychosocial intervention called TULIPS (Talk, Understand and...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1501945/full |
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| author | Katherine Berry Katherine Berry Isobel Johnston Isobel Johnston Paul Wilson Gillian Haddock Gillian Haddock Sandra Bucci Sandra Bucci Karina Lovell Owen Price Adele Beinaraviciute Adele Beinaraviciute Gill Gilworth Sonalia Kaur Helen Morley Helen Morley Georgia Penn Georgia Penn Jessica Raphael Jessica Raphael Mica Samji Richard J. Drake Richard J. Drake Dawn Edge Dawn Edge |
| author_facet | Katherine Berry Katherine Berry Isobel Johnston Isobel Johnston Paul Wilson Gillian Haddock Gillian Haddock Sandra Bucci Sandra Bucci Karina Lovell Owen Price Adele Beinaraviciute Adele Beinaraviciute Gill Gilworth Sonalia Kaur Helen Morley Helen Morley Georgia Penn Georgia Penn Jessica Raphael Jessica Raphael Mica Samji Richard J. Drake Richard J. Drake Dawn Edge Dawn Edge |
| author_sort | Katherine Berry |
| collection | DOAJ |
| description | BackgroundIt is notoriously challenging to deliver psychosocial interventions on acute mental health wards. This paper presents an ethnographic observational study which captured how ward and staff processes impacted on the delivery of a psychosocial intervention called TULIPS (Talk, Understand and Listen for Inpatient Settings). Although the paper is focused on one specific intervention, the findings have implications for the delivery of other psychosocial interventions within acute mental health settings.MethodWe carried out participant observation across 6 case studies wards all participating in the intervention arm of a cluster randomised controlled trial evaluating the TULIPS intervention compared to treatment as usual. Trained researchers observed ward environments, activities and social interactions taking detailed field notes which were later subject to thematic analysis.ResultsFour themes were generated from field notes relating to aspects of the ward culture and staff behaviours which were barriers or facilitators to the delivery of the TULIPS intervention. Theme one highlighted how the person-centred nature of the TULIPS model was at odds with the pre-existing culture of the wards which favoured blanket rules. Theme two highlighted how staff prioritised task-oriented quantifiable activities which clashed with the emphasis the TULIPS model placed on relationship building. The third theme highlighted the presence of conflict between different groups of staff working on the ward and theme four highlighted the stressful nature of the ward environment which drove staff to seek refuge from patient facing activities including TULIPS related activities.ConclusionsIn order to successfully engage with the delivery of psychosocial interventions on acute mental health wards, staff need access to supportive leadership which champions psychological interventions, as well as training, supervision and support systems which value the demanding nature of working on mental health inpatient wards. |
| format | Article |
| id | doaj-art-935af9d4591d4681a5e9b2169f9a8b8d |
| institution | DOAJ |
| issn | 1664-0640 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Psychiatry |
| spelling | doaj-art-935af9d4591d4681a5e9b2169f9a8b8d2025-08-20T03:15:31ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-02-011610.3389/fpsyt.2025.15019451501945Barriers to the implementation of psychosocial interventions on acute mental health wards: an ethnographic observational studyKatherine Berry0Katherine Berry1Isobel Johnston2Isobel Johnston3Paul Wilson4Gillian Haddock5Gillian Haddock6Sandra Bucci7Sandra Bucci8Karina Lovell9Owen Price10Adele Beinaraviciute11Adele Beinaraviciute12Gill Gilworth13Sonalia Kaur14Helen Morley15Helen Morley16Georgia Penn17Georgia Penn18Jessica Raphael19Jessica Raphael20Mica Samji21Richard J. Drake22Richard J. Drake23Dawn Edge24Dawn Edge25School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United KingdomDepartment of Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United KingdomSchool of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United KingdomDepartment of Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United KingdomSchool of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United KingdomSchool of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United KingdomDepartment of Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United KingdomSchool of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United KingdomDepartment of Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United KingdomSchool of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United KingdomSchool of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United KingdomSchool of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United KingdomDepartment of Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United KingdomDepartment of Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United KingdomDepartment of Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United KingdomSchool of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United KingdomDepartment of Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United KingdomSchool of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United KingdomDepartment of Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United KingdomSchool of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United KingdomDepartment of Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United KingdomDepartment of Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United KingdomSchool of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United KingdomDepartment of Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United KingdomSchool of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United KingdomDepartment of Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United KingdomBackgroundIt is notoriously challenging to deliver psychosocial interventions on acute mental health wards. This paper presents an ethnographic observational study which captured how ward and staff processes impacted on the delivery of a psychosocial intervention called TULIPS (Talk, Understand and Listen for Inpatient Settings). Although the paper is focused on one specific intervention, the findings have implications for the delivery of other psychosocial interventions within acute mental health settings.MethodWe carried out participant observation across 6 case studies wards all participating in the intervention arm of a cluster randomised controlled trial evaluating the TULIPS intervention compared to treatment as usual. Trained researchers observed ward environments, activities and social interactions taking detailed field notes which were later subject to thematic analysis.ResultsFour themes were generated from field notes relating to aspects of the ward culture and staff behaviours which were barriers or facilitators to the delivery of the TULIPS intervention. Theme one highlighted how the person-centred nature of the TULIPS model was at odds with the pre-existing culture of the wards which favoured blanket rules. Theme two highlighted how staff prioritised task-oriented quantifiable activities which clashed with the emphasis the TULIPS model placed on relationship building. The third theme highlighted the presence of conflict between different groups of staff working on the ward and theme four highlighted the stressful nature of the ward environment which drove staff to seek refuge from patient facing activities including TULIPS related activities.ConclusionsIn order to successfully engage with the delivery of psychosocial interventions on acute mental health wards, staff need access to supportive leadership which champions psychological interventions, as well as training, supervision and support systems which value the demanding nature of working on mental health inpatient wards.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1501945/fullethnographicinpatientmental healthobservationspsychosocial interventions |
| spellingShingle | Katherine Berry Katherine Berry Isobel Johnston Isobel Johnston Paul Wilson Gillian Haddock Gillian Haddock Sandra Bucci Sandra Bucci Karina Lovell Owen Price Adele Beinaraviciute Adele Beinaraviciute Gill Gilworth Sonalia Kaur Helen Morley Helen Morley Georgia Penn Georgia Penn Jessica Raphael Jessica Raphael Mica Samji Richard J. Drake Richard J. Drake Dawn Edge Dawn Edge Barriers to the implementation of psychosocial interventions on acute mental health wards: an ethnographic observational study Frontiers in Psychiatry ethnographic inpatient mental health observations psychosocial interventions |
| title | Barriers to the implementation of psychosocial interventions on acute mental health wards: an ethnographic observational study |
| title_full | Barriers to the implementation of psychosocial interventions on acute mental health wards: an ethnographic observational study |
| title_fullStr | Barriers to the implementation of psychosocial interventions on acute mental health wards: an ethnographic observational study |
| title_full_unstemmed | Barriers to the implementation of psychosocial interventions on acute mental health wards: an ethnographic observational study |
| title_short | Barriers to the implementation of psychosocial interventions on acute mental health wards: an ethnographic observational study |
| title_sort | barriers to the implementation of psychosocial interventions on acute mental health wards an ethnographic observational study |
| topic | ethnographic inpatient mental health observations psychosocial interventions |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1501945/full |
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