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  Exploring system approaches to enhance the safety of their care experiences for people who self-harm on acute mental health settings


   Faculty of Medicine and Health

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  Prof J Baker, Dr J Johnson  No more applications being accepted  Funded PhD Project (UK Students Only)

About the Project

Self-harm occurs frequently in mental health inpatient units; 10-20% of service-users engage in self-harm and self-harm events comprise 30% of all reported incidents in mental health trusts. It is a frequent trigger to more restrictive practices which exacerbate the physical and psychological harm experienced by service-users, and staff. A small number of studies have investigated the utility of delivering psychological interventions directly to service-users to reduce self-harm in inpatient settings, but these are demanding in resources and often unfeasible to deliver in under-staffed units. This PhD scholarship will explore this issue from an organisational accident perspective, investigating the potential to reduce self-harm via systems-focused changes. A member of our advisory group with lived experience will act as an advisor to this PhD. A scoping review will be undertaken to identify current relevant policies and existing organisational interventions. A mixed-methods approach will then be used to understand the extent to which these interventions are currently adopted. Based on this work we will develop a set of recommendations for each Trust that may include policy changes, environmental redesign, staff training, activity scheduling etc. We will gather feedback from service users, staff and managers on the likely benefits and feasibility of adopting these recommendations.

Research on safety in mental health settings is limited compared to physical healthcare settings. While there is some overlap in pertinent safety outcomes, there are also important differences and transferability cannot be assumed. For example, both the manifestations of some mental illnesses (e.g. self-harm, suicide, violence to others) and the risk management strategies deployed (e.g. restraint, observations, forced treatment, antipsychotic medicines), are inherently risky. Safety research in mental health settings must acknowledge this complexity, the interplay of physical and mental health and the multiple meanings of safety that depend on the perspective adopted: service users, family, healthcare professionals, service managers and regulators. We will be pragmatic in the theoretical frameworks adopted but cognisant that a Safety II approach may offer a lens that allows us to acknowledge this complexity.

Working with Professor John Baker and Dr Judith Johnson at the University of Leeds and colleagues at Bradford Teaching Hospitals Foundation Trust, holders of our prestigious PhD studentships will work within the dynamic research teams at YH PSTRC, which is at the forefront of patient safety research providing nationally and internationally important patient safety research. 

Environment:

The scholarship will be based across the School of Healthcare, University of Leeds, and the Bradford Institute for Health Research. YH PSTRC. PhD students will become NIHR trainees and can benefit from a range of training support and resources to develop your knowledge and health research skills. They will also be embedded within the Yorkshire Quality and Safety Research Group, which is a friendly and dynamic group of researchers conducting high-quality, rigorous and applied research to develop and evaluate innovative solutions to patient safety problems.

YH PSTRC is a collaboration between the Bradford Teaching Hospitals Foundation Trust and the Universities of Leeds and Bradford. Our mission is to deliver research to make healthcare safer. We are one of only three NIHR Patient Safety Translational Research Centres in England. Our work draws on the knowledge and expertise of well-established networks of researchers, patients/carers, clinicians and industry partners to develop ideas that address patient safety problems. 

Our research focusses on four themes that recognise the central role of patients and their carers, the importance of creating workplaces that people want to work in, the safe use of medicines, and the exciting potential for digital technology to improve safety.

Eligibility:

You will be enthusiastic, organised and motivated with experience in, or knowledge of mental health services. You will have a first degree equivalent to a Bachelor Honours degree at 2:1 or above, or a strong postgraduate degree in psychology, social science or a health-related subject. Importantly, you will be committed to fully engaging with patients, carers and staff to conduct high-quality research and keen to develop your research skills.

Applicants whose first language is not English must provide evidence that their English language is sufficient to meet the specific demands of their study. The Faculty of Medicine and Health minimum requirements in IELTS and TOEFL tests are:

• British Council IELTS - score of 6.5 overall, with no element less than 6.0 • TOEFL iBT - overall score of 92 with the listening and reading element no less than 21, writing element no less than 22 and the speaking element no less than 23.

How to apply:

Applicants should complete an online application form and attach the following documentation to support their application. 

  • a full academic CV
  • degree certificate and transcripts of marks
  • Evidence that you meet the University's minimum English language requirements (if applicable).

To help us identify that you are applying for this scholarship project please ensure you provide the following information on your application form;

  • Select PhD in Healthcare as your programme of study
  • Give the full project title and name the supervisors listed in this advert
  • For source of funding please state you are applying for an NIHR YH PSTRC funded scholarship 

As an international research-intensive university, we welcome students from all walks of life and from across the world. We foster an inclusive environment where all can flourish and prosper, and we are proud of our strong commitment to student education. Within the School of Healthcare we are dedicated to diversifying our community and we welcome the unique contributions that individuals can bring, and particularly encourage applications from, but not limited to Black, Asian, people who belong to a minority ethnic community, people who identify as LGBT+; and people with disabilities. Applicants will always be selected based on merit and ability.

For further information about the application process please contact the Faculty Graduate School

e: [Email Address Removed]

If you would like to know more about this studentship or the work of the YH PSTRC, please contact: Professor John Baker

e: [Email Address Removed], t: +44 (0)113 343 1271

You can find out more about the NIHR YH PSTRC at www.yhpstrc.org

Nursing & Health (27) Psychology (31)

Funding Notes

This PhD project is funded by the NIHR Yorkshire & Humber Patient Safety Translational Research Centre (YH PSTRC). The scholarship will attract an annual tax-free stipend of £15,609 for up to 3 years, subject to satisfactory progress and will cover the UK academic fees.

References

1. Zhand, N., Matheson, K., & Courtney, D. (2016). Self-harm in child and adolescent psychiatric inpatients: a retrospective study. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 25(3), 169.
2. Barton, G., Rey, J. M., Simpson, P., & Denshire, E. (2001). Patterns of critical incidents and their effect on outcome in an adolescent inpatient service. Australian & New Zealand Journal of Psychiatry, 35(2), 155-159.
3. NHS England, Data on patient safety incidents reported to the NRLS by each NHS trust in England October 2019 to March 2020 - full workbook. 2020, NHS England: London.
4. Wilstrand, C., Lindgren, B. M., Gilje, F., & Olofsson, B. (2007). Being burdened and balancing boundaries: a qualitative study of nurses' experiences caring for patients who self?harm. Journal of Psychiatric and Mental Health Nursing, 14(1), 72-78.
5. Nawaz, R. F., Reen, G., Bloodworth, N., Maughan, D., & Vincent, C. (2021). Interventions to reduce self-harm on in-patient wards: systematic review. BJPsych open, 7(3).
6. Thibaut B, Dewa LH, Ramtale SC, et al Patient safety in inpatient mental health settings: a systematic review BMJ Open 2019;9:e030230. 

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