MINDS study

The study called MINDS aims to improve the outcomes and experiences of those being discharged from mental health hospitals, it is funded by the NIHR.

What is the problem?

Around 50,000 people leave mental healthcare hospitals every year. Leaving hospital (being discharged) is a critical transition point in the journey to personal recovery. Many find discharge overwhelming and distressing. There is a risk of becoming unwell again and around 13% of people quickly go back into hospital. This has been made worse by COVID-19. A poorly planned discharge can also increase the risk of suicide.

Research shows that identifying people’s needs after they leave hospital can help to support people move safely from hospital to home. Two national surveys have been carried out with a total of 1,341 people (by the charity Mind and our research team). They found that 40% of people leaving mental health hospitals have no plan in place to support them after they leave. National Institute for Health and Care Excellence (NICE) guidelines state that discharge planning should include staff working together with service users (being collaborative). Our survey of 110 people found that over 50% of service users had no or little involvement in planning (see diagram below).

Experiences of Leaving Mental Healthcare Hospital Survey

Working together to improve discharge from hospital

Healthcare systems are complicated and there are lots of reasons that people have bad experiences of leaving hospital. This could include a lack of understanding of how staff, service users and carers/supporters can work together to plan discharge. It can also be a result of the way that staff relate to service users, limited resources, and pressures on staff. We believe that for us to improve discharge planning we need to understand these complicated factors. This diagram below explains where the individual is placed within the complex healthcare system.

Mental healthcare complex system figure

 

 

 

 

 

 

 

 

 

 

 

 

 

 

People with lived experience are at the heart of the MINDS project. This kind of co-produced research – adds an extra dimension. People with lived experience can often raise an issue that others might have missed.

We want to improve the experience of discharge for all. There are guidelines, but so far there is still something that is stopping it from working well – so we need to understand what that is. Our researchers, some with lived-experience, will be spending time on the wards, interviewing and gathering information.

There have been previous attempts to improve discharge, but the surveys show that there is still a problem. This project is the first to combine a research approach called ‘realist research’ with a design process called a ‘systems approach’. The idea is to drill down into each potential problem. Realist research and systems approaches involve understanding all the steps in a process from the point of view of the people involved. Including why discharges are often not well planned, what people need to stay well after leaving hospital and how a coproduced discharge planning approach could address this. This should result in discharge processes that are easier to implement, better address the needs of service users and carers, and are more sustainable than what is currently available.

What will we get from the project?

The MINDS project will work closely with a Lived Experience Advisory Group, carers and healthcare professionals to produce a Systemic Discharge Care Approach together. This will aim to address all the different layers of the complex healthcare system. This will support staff, service users and carers to meaningfully plan for people to leave hospital. This will centre on people’s individual needs, support collaboration, and help people to think about how to maintain good mental health and wellbeing after they leave hospital. 

We will then ask staff and service users to test out the co-produced Systemic Discharge Care Approach. This is to find out whether it helps people feel more prepared to leave hospital, stay well and have a good quality of life after getting home. If we find that the tools and guidance are helpful, we will develop a future study to make sure that the tools and guidance can be used across all NHS adult mental healthcare hospitals.

Co-leads - Dr Jon Wilson and Sarah Rae

Sarah Rae, Co-investigator on MINDS

Sarah Rae, Expert by Experience 

I had a poor experience as a patient in a mental healthcare hospital. My discharge was also not well handled. I have been using this lived experience to make services more patient centred ever since.

My determination to improve the way patients are discharged spurred me on to contact NSFT Research. Jon Wilson, Corinna Hackmann, and I have worked together for over three years to launch the MINDs study. I am very hopeful that this exciting project will lead to changes on the ground for patients, carers, and staff.  

 

 

 

 

 

Dr Jon Wilson, Consultant Psychiatrist

Dr Jon Wilson, Consultant Psychiatrist

I love the opportunity to look at what does or doesn’t work, implement changes and use these to shape services. I can see how MINDS is going to directly improve the experience of service users. 

I have to privilege of being able to do a lot of research trying to improve the lives of people in our communities. I teach communication skills and finals examinations at Norwich medical school. I am also a professor and director of medical education St George's University Grenada and a CASC examiner for the Royal College membership exams.

 

 

Co-investigators on MINDS

Table of Co-investigators

NAME/ TITLE

DEPT/ INSTITUTION

Dr Jon Wilson (Joint CI) Lead Applicant)

Norfolk and Suffolk NHS Foundation Trust

Ms Sarah Rae (Joint CI) Honorary Service User Researcher

Norfolk and Suffolk NHS Foundation Trust

Dr Adam Wagner (CoApplicant) Research Fellow in the Health Economics Group

Norwich Medical School, University of East Anglia

Professor Julia Jones (Co-Applicant) Professor of Public Involvement and Health

Centre for Research in Public Health and Community Care, University of Hertfordshire

Professor Frank Röhricht (Co-Applicant) Consultant Psychiatrist

Centre for Psychiatry, East London NHS Foundation Trust

Dr Zohra Taousi (Co-Applicant) Psychiatrist

PATH Clinical, Hertfordshire Partnership NHS Foundation Trust

Associate Professor Sonia Dalkin (Co-Applicant) Associate Professor of Applied Health Research

Faculty of Health & Life Sciences, Northumbria University

Professor Catherine Haighton (Co-Applicant) Professor of Public Health and Wellbeing

Department of Social Work, Education and Community Wellbeing, Northumbria University

Professor John Clarkson (Co-Applicant) Director, Cambridge Engineering Design Centre

Engineering Design Centre, University of Cambridge

Dr Alexander Komashie (Co-Applicant) Senior Research Associate in Healthcare Systems Design

Engineering Design Centre, University of Cambridge

Professor Alan Simpson (Co-Applicant) Professor of Mental Health Nursing

Institute of Psychiatry, Psychology and Neuroscience, King's College London

Dr Jamie Murdoch (Co-Applicant)

King's College London

Dr Melanie Handley (Co-Applicant) Research Fellow

Centre for Research in Primary and Community Care, University of Hertfordshire

Dr Hannah Zeilig (Co-Applicant)

PPI based in England

Dr Corinna Hackmann (Co-Applicant) Research Clinical Psychologist

Norfolk and Suffolk NHS Foundation Trust

Dr Sophie Bagge (Co-Applicant) Senior Peer Participation Lead

Norfolk and Suffolk NHS Foundation Trust

Dr Joy Bray (Co-Applicant) Research psychiatric nurse

Norfolk and Suffolk NHS Foundation Trust

Dr Emma Kaminskiy (Co-Applicant) Lecturer in Psychology

Faculty of Science and Engineering, Anglia Ruskin University

 

 

Contact Us

If you, or someone you support or care for, has experienced leaving a mental health hospital in the last five years then please email.

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