The use of positive behaviour support plans in mental health inpatient care: a mixed methods study

An international drive is to minimise restrictive practices in mental healthcare. Positive behaviour support Plans (PBSPs) help staff prevent behaviour which would require restrictive intervention. Originating in learning disability services, data within mental healthcare are limited. To evaluate PBSPs within a mental health‐inpatient service; understand mental health nurses’ and relatives’ attitudes to them and understand the barriers and facilitators for their use in routine mental healthcare. Mixed methods ‐ quality‐ratings and interviews with relatives and nurses. PBSPs were poorly implemented. Relatives and nurses valued the potential of PBSPs to facilitate holistic care, though no relative had contributed to one and not every eligible patient had one. Barriers to their use included confusion around positive behaviour support, including how, when and for whom PBSPs should be used, and difficulties describing the function of a behaviour. The potential of PBSPs to improve mental healthcare is recognised. However, there are barriers to their use which should be addressed to ensure that PBSPs have been properly implemented before their impact on patient care can be assessed. Mental health professionals implementing PBSPs should engage with relatives and patients, gain organizational commitment and ensure that those involved understand fully the positive behaviour support approach

Mental healthcare staff well‐being and burnout: A narrative review of trends, causes, implications, and recommendations for future interventions

Rising levels of burnout and poor well‐being in healthcare staff are an international concern for health systems. The need to improve well‐being and reduce burnout has long been acknowledged, but few interventions target mental healthcare staff, and minimal improvements have been seen in services. This review aimed to examine the problem of burnout and well‐being in mental healthcare staff and to present recommendations for future research and interventions. A discursive review was undertaken examining trends, causes, implications, and interventions in burnout and well‐being in healthcare staff working in mental health services. Data were drawn from national surveys, reports, and peer‐reviewed journal articles. These show that staff in mental healthcare report poorer well‐being than staff in other healthcare sectors. Poorer well‐being and higher burnout are associated with poorer quality and safety of patient care, higher absenteeism, and higher turnover rates. Interventions are effective, but effect sizes are small. The review concludes that grounding interventions in the research literature, emphasizing the positive aspects of interventions to staff, building stronger links between healthcare organizations and universities, and designing interventions targeting burnout and improved patient care together may improve the effectiveness and uptake of interventions by staff