SKELLERN SHORT LIST 2019 – LECTURER SYNOPSES (in alphabetical order).
Professor Paul French - The promise of early access to care for people with emerging psychosis, has it delivered?
Recent years have seen an interest in developing services for people with psychosis that can intervene at the earliest possible opportunity. Early intervention approaches attempt to maximise the life chances of people with an emerging psychosis and minimise long term effects of distressing symptoms. The National Health Service in England introduced the first Access and Waiting Times (AWT) initiative to be employed in mental health services and focussed this on people with an emerging psychosis. The standard is for people to be seen within 2 weeks of a referral to specialist services, and once accepted, to have access to the various aspects of care endorsed through NICE for people with psychosis. Since their inception in 2016, services across England have met and continually exceeded the standard. We are now the only country in the world that can reliably and consistently measure waiting times for people with emerging psychosis in days and weeks.
In this lecture I will highlight the importance of this AWT for people with psychosis and discuss why we must not become complacent, success in delivering the standards to date does not mean “job done”, far from it. Whilst the focus on early interventions is welcomed, people with psychotic related conditions continue to be exposed to high levels of discrimination and are still at risk of premature death due to physical illnesses, there is much more to be done. Throughout the lecture I will emphasise the vital role of mental health nursing in the delivery of these standards and the care of people with psychosis. I will also argue that we need to ensure the unique skills of mental health nurses to engage and sustain complex relationships needs to be valued just as highly as the NICE approved interventions which now drive our service delivery models. Finally I will highlight the frustrations that more nurses are required in senior clinical leadership positions not just senior management to advocate for these developments.
Paul French is Associate Director, Greater Manchester Mental Health NHS Foundation Trust. Clinical Lead for Mental Health Greater Manchester and East Chesire Strategic Clinical Network. Regional Clinical Lead, North West Early Intervention in Psychosis NHSE North. Honorary Professor, Institute of Psychology Health and Society, University of Liverpool.
Professor Mick Mckeown - Making the most of militant and maverick tendencies for mental health nursing
Mental health nursing faces a crisis of legitimacy necessitating critically inspired remedies. I draw upon critical social theory, my own work, activism and anecdotes to suggest alternative futures. In a spirit of persuasion, provocation and poignancy I present workplace democracy, inclusive of workers and service users, as a utopian, yet realisable, means of organising services, capitalising on relational nursing skills; congruent with democratic and dialogic therapy, education and research and aspects of new left populism.
Mental health nurses are susceptible to a deception we always occupy a virtuous occupational role, blinding us to important socio-political actualities. Not least of these is our complicity within an alienating psy-complex of biomedicine and social control operating under an overarching neoliberal polity and risk society. Democratic aspirations complement a call for a new politics of mental health, or a revisiting of some old politics. A case is made for critically engaged academics, practitioners and their trade unions, in alliance with community, service user and survivor activists, to take these ideas forward in practice, education, research and popular protest. Though defending the Welfare State from neoliberal assaults is a priority, it is, on its own, insufficient. We need to build solidarity relations between mental health stakeholders that can get beyond the hurt and harms of psychiatry as we know it. To these ends, a grass-roots process of truth and reconciliation is advocated.
The radical scholar of mental health care, Peter Sedgwick, was happy to adopt the militant, ‘maverick’ identity of his hero, the revolutionary Victor Serge. He offered the persuasive claim that the activist goal of transforming society neatly encompasses the relational transformation required of psychiatry. I contend that we need more mavericks in our ranks and we can imagine and work for a better future.
Mick Mckeown is Professor of Democratic Mental Health. Mick has had a lengthy career as a mental health nurse and researcher. He has a longstanding interest in issues of power and equality within services and wider society. With an emphasis on sociological analyses he takes a critical view of mental health care and the professional practices therein.
When things go wrong - the mental wellbeing of our staff, have we got it right?
Professor Oliver Shanley
This year marks the 70th anniversary of the NHS. We know that we can point to numerous achievements throughout its history that have led to improved health outcomes for all. At the heart of the NHS is its workforce, and at its core, are nurses. We also know that the wellbeing of our staff is linked to better outcomes for those that use our services, so the argument for staff wellbeing should be compelling. In mental health services our staff can be exposed to service user life events that go beyond the realms of other areas of health care, specifically that, at times, they may seek to harm themselves or at worst, take their own lives.
There has been an absence of research on mental health nurses that explore the combined effect of experiencing a patient’s suicide or unexpected death and the subsequent process of professional scrutiny that frequently follows such a death. Mental health nurses provide clinical services within a climate of increasing expectation of patient safety and public confidence. It is suggested that this pressure places undue stress and burden on staff. Elfering et al (2011) affirm that greater attention must be given to occupational stress and its relationship with patient safety. Wu and Steckelberg (2012) also reiterate the potential adverse psychological consequences for staff following patient safety incidents.
My doctoral thesis undertook a qualitative study that explored the experience mental health nurses and their response to a patient suicide. The study considered how the death and the resultant process of professional scrutiny affected the nurses both professionally and, for some, personally. This research was placed within the context of what is known regarding the effects of professional scrutiny, the psychological impact of adverse events, and the broader concepts of responses to adverse events referred to as ‘second victim’ phenomenon. The findings of this study identified several areas that demonstrate the impact of an unexpected death or suicide on the nurses. The participants all experienced varying degrees of psychological distress, which for two were similar to experiences more normally associated with post-traumatic stress disorders. The psychological response to the distress of the death and process of scrutiny was similar to that found in second victim studies. However the nurses in this group did not believe they had made an error, often a factor associated with second victim studies.
The study found that the type of relationship with the service user is an important denominator in determining how the nurse reacts to the death. The process of professional scrutiny further compounds this. Nurses’ report that they are unable to find psychological closure until the scrutiny, particularly the coroners hearing, has concluded. The study identified a number of factors that were likely to aggravate or mitigate the likelihood of experiencing an adverse psychological effect from an unexpected death or suicide. A distinct contribution of this study was the development of a theoretical framework that may aid the understanding of the experiences of the nurse. The study concluded with recommendations for further research regarding how we need to improve how we support staff at a time of enormous emotional turmoil.
Oliver Shanley (OBE) is Regional Chief Nurse, London NHSE and NHSI.
2019 JPMHN Lifetime Achievement Award
Professor Patrick Callaghan RN BSc MSc PhD C.Psychol. PFHEA
Patrick is the Dean of the School of Applied Sciences and Professor of Mental Health Science at London South Bank University. He specialises in psychosocial interventions for mental health and wellbeing. He was previously Dean of Health Sciences at the University of Nottingham and Non-Executive Director of the Nottinghamshire Healthcare Foundation Trust. He chaired the NIHR Funding panel for Integrated Clinical Academic Career Awards for nurses, midwives and allied health professionals 2015-2017 and was the Research Executive Member of the UK Council of Deans for Nursing, Midwifery and Allied Health Professionals 2015-2018.
Patrick was Associate Director (Research Engagement) at the NIHR Clinical Research Network (Mental Health) 2012-2016 and Visiting Professor in Mental Health at Trinity College Dublin, Ireland 2006-2012 and has held Visiting Scholar appointments at the University of Poznan, Poland and Kwazulu-Natal University, South Africa. He was the first elected Chair of Mental Health Nurse Academics UK and sits on the steering committee of Horatio: The European Association of Mental Health Nursing. He is a Professorial Fellow of the Institute of Mental Health, Nottingham.
A Mental Health Nurse and Chartered Health Psychologist, Patrick has worked in mental health for 33 years. In 2010, he was awarded the Eileen Skellern Memorial Lecture for his contribution to Mental Health Nursing and the Winifred Raphael Memorial Lecture by the Royal College of Nursing UK in 2016. He led the education group of the Chief Nursing Officer’s Review of Mental Health Nursing in England in 2005. He is a former non-executive director and Area Commissioner of the Mental Health Act Commission in England. In 2017 Patrick was appointed a Principle Fellow of the UK Higher Education Academy and a National Teaching Fellow in 2018 in recognition of his outstanding teaching and learning in Higher Education. Patrick has published 110 papers, secured around £7m of research grants and edited four books.
Emeritus Professor Chair – Educational Development (Mental Health), London South Bank University.
DHSS Research Fellowship Award (1982) for MSc in the Sociology of Education at The Institute of Education London University. Academic Qualifications achieved at Goldsmith London University, and the Institute of Education London University. PhD Sociology of the Professions Faculty of Economics Institute of Education London University. Professional qualification RMN Warlingham Park Hospital, Dip.N London South Bank University and London University. Trained and worked as Staff Nurse at Warlingham Park Hospital, student experience at Queen Mary’s Hospital Carshalton, and staff Nurse, Charge Nurse and Senior Charge Nurse at The Bethlem Royal and Maudsley Hospitals. Taught and researched, mental health care, interprofessional education and training, research methods, evidence-based practice and conflict management. Has taught at Normanby College Kings College Hospital, West London Institute of Higher Education, City University and London South Bank University. Has worked as Lecturer, Senior Lecturer. Principal Lecturer. Senior Research fellow, Deputy Dean and Professor. Worked at getting Evidence into Practice through working with Research and Development Committees; chaired Evidence Based Practice sub-committees; facilitated Research Journal Clubs and research seminars, engaged in initiatives for practice development; collaborative research with users and carers; supporting staff evaluating their services; supporting staff pursuing higher degrees MSc and M.Phil/Ph.D, working closely with Nursing Directorates. Within London South Bank University contributed to: the Division of Mental Health Studies; the Faculty Research Committee; staff development; the supervision of the concordat for research fellows, and supervised M.Phil/Ph.D students until retirement in 2008. Currently contributes to the supervision and pastoral care of MPhil/PhD and Professional Doctorates students and supports colleagues writing for publication. Functions as internal and external examiner for BA, MSc/MA and MPhil/PhD students nationally and internationally in Mauritius and Ireland. Made three visits to Kobe University in Japan to work with the Faculty of Health Sciences in their development and evaluation of undergraduate interprofessional education and training. Patron of The Nurses Association of Jamaica (UK), The Friends of the Heart Foundation of Jamaica (UK) and Culture and Dementia (UK). Panel member of the Joint Council for Cosmetic Practitioners. Volunteered as a Magistrate on the Bromley Bench and as a Associate Hospital Manager.