Exploring the Use of Body Worn Cameras in Acute Mental Health Wards: a mixed-method evaluation of a pilot intervention

Background: Body worn cameras (BWC) are mobile audio and video capture devices that can be secured to clothing allowing the wearer to record some of what they see and hear. This technology is being introduced in a range of healthcare settings as part of larger violence reduction strategies aimed at reducing incidents of aggression and violence on inpatient wards, however limited evidence exists to understand if this technology achieves such goals.Aim: This study aimed to evaluate the implementation of BWCs on two inpatient mental health wards, including the impact on incidents, the acceptability to staff and patients, the sustainability of the resource use and ability to manage the use of BWCs on these wards. Methods: The study used a mixed-methods design comparing quantitative measures including ward activity and routinely collected incident data at three time-points before during and after the pilot implementation of BWCs on one acute ward and one psychiatric intensive care unit, alongside pre and post pilot qualitative interviews with patients and staff, analysed using a framework based on the Consolidated Framework for Implementation Research. Results: Results showed no clear relationship between the use of BWCs and rates or severity of incidents on either ward, with limited impact of using BWCs on levels of incidents. Qualitative findings noted mixed perceptions about the use of BWCs and highlighted the complexity of implementing such technology as a violence reduction method within a busy healthcare setting Furthermore, the qualitative data collected during this pilot period highlighted the potential systemic and contextual factors such as low staffing that may impact on the incident data presented. Conclusion: This study sheds light on the complexities of using such BWCs as a tool for ‘maximising safety’ on mental health settings. The findings suggest that BWCs have a limited impact on levels of incidents on wards, something that is likely to be largely influenced by the process of implementation as well as a range of contextual factors. As a result, it is likely that while BWCs may see successes in one hospital site this is not guaranteed for another site as such factors will have a considerable impact on efficacy, acceptability, and feasibility. <br/

Cross-cultural comparison of Recovery College implementation between Japan and England: Corpus-based discourse analysis

Recovery Colleges (RCs) are mental health learning communities, operated in 28 countries across cultures. However, the RC operational model is informed by Western countries sharing similar cultural characteristics such as individualism and short-term orientation. How RC operational model needs to be adapted to non-Western culture remains unknown. We investigated how RCs are introduced to the public in two countries with contrasting cultural characteristics: Japan (collectivism, long-term) and England (individualism, short-term). Corpus-based discourse analysis on 22,827 words from promotional texts (13 RCs in Japan, 61 in England) revealed that both countries emphasised mental illness lived experiences. In Japan, the focus was on the relational and long-term aspects of recovery. In England, the focus was on personal learning and skill acquisition. People attending RCs in Japan may anticipate experiencing collectivistic and long-term elements, which are viewed unfavourably in the operational model. Findings suggest refinements to the operational model to include under-represented cultural characteristics

How the pandemic changed Recovery Colleges: A multi-site qualitative study

Background: During the COVID-19 pandemic, mental health problems increased whilst access to clinical mental health services reduced. Recovery Colleges (RCs) are recovery-focussed adult education initiatives delivered by people with professional and lived mental health expertise. Designed to be collaborative and inclusive, RCs were uniquely positioned to support people experiencing mental health problems during the pandemic. There is limited research exploring the lasting impacts of the pandemic on RC operation and delivery to students.Aims: To ascertain how the COVID-19 pandemic changed the operation of RCs in England.Method: A coproduced qualitative interview study of RC managers across the UK. Academics and coresearchers with lived mental health experience collaborated on conducting interviews and analysing data using a collaborative thematic framework analysis.Results: Thirty-one RC managers participated. Five themes were identified: Complex organisational relationships; Changed ways of working; Navigating the rapid transition to digital delivery; Responding to isolation; and Changes to accessibility. Two key pandemic-related changes to RC operation were highlighted: their use as accessible services that relieve pressure on mental health services through hybrid face-to-face and digital course delivery; and the development of digitally delivered courses for individuals with mental health needs.Conclusions: The pandemic either led to or accelerated developments in RC operation, leading to a positioning of RCs as a preventative service with wider accessibility to: people with mental health problems; people under the care of forensic mental health services; and mental healthcare staff. These benefits are strengthened by relationships with partner organisations and autonomy from statutory healthcare infrastructures

Cross-cultural insights from two global mental health studies: self-enhancement and ingroup biases

This Commentary highlights two cross-cultural issues identified from our global mental health (GMH) research, RECOLLECT (Recovery Colleges Characterisation and Testing) 2: Selfenhancement and ingroup biases. Self-enhancement is a tendency to maintain and express unrealistically positive self-views. Ingroup biases are differences in one’s evaluation of others belonging to the same social group. These biases are discussed in the context of GMH research using self-report measures across cultures. GMH, a field evolving since its Lancet series introduction in 2007, aims to advance mental health equity and human rights. Despite a 16.5- fold increase in annual GMH studies from 2007 to 2016, cross-cultural understanding remains underdeveloped. We discuss the impact of individualism versus collectivism on selfenhancement and ingroup biases. GMH research using concepts, outcomes, and methods aligned with individualism, may give advantages to people and services oriented to individualism. GMH research needs to address these biases arising from cross-cultural differences to achieve its aim