Welcome to the MINDS study

 

Image of Welcome to the MINDS study

 

What is our project about?

The MINDS research project aims to understand the discharge experiences from viewpoint of everyone involved, people with lived experience, carers and staff.

The first step is to explore everything affecting discharge by drilling down into problem areas, before all coming together to develop solutions. These solutions will then be tried out on a variety of adult wards, where we will consider what works to make a more effective discharge for everyone.

Image of - I was sent home in a taxi at 8 at night. No food, no gas, no medication and no follow up Many patients are discharged in a hurry, perhaps the bed is needed, many have little or no preparation for discharge, or they might be going back to exactly the same situation that caused their admission. For some, coming into hospital was a relief and now they dread going home, or the opposite, for some reason the discharge is delayed  and they spend extra days aimlessley living in the ward desperate to get out. We know  staff do not come to work to do a bad job, but there is something getting in the way of providing the care that they would want to.

We want to improve the experience of discharge for all and reduce the chances of people becoming unwell again. There are guidlines advising staff how to carry out a 'good' discharge, but there are still many factors that are stopping these from being put into practice. For example, not having the time or resources to properly prepare for discharge. Image of - my dad can be very distressed, he doesn't feel he can keep me safe at home. There needs to be more support for carers at discharge....

 

Our researchers work as partners, everyone’s input is valued. We are a group of people with lived experience, carers and different mental health professionals.

This study is funded by the National Institute for Health and Care Research (NIHR) over a period of 3 years. We will be working with three mental health trusts (Norfolk and Suffolk NHS Foundation Trust, East London NHS Foundation Trust, Hertfordshire Partnership University NHS Foundation Trust) serving both rural and inner city and representing diverse communities.

We have spent time on the wards looking at what happens and interviewed people who live and work there so that we understand the whole picture. When we have a better understanding of what is happening, we hope to develop new ways of working together. We will call this ‘a systematic discharge approach’ which will meet everyone’s needs. 

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Study design, how are we going to do this?

 

 The discharge process from a mental health ward can be complex and discharge planning takes place within a multi-layered system.

The MINDS study uses two research approaches 'realist research' and a 'healthcare engineering systems approach' called  Engineering Better Care. Image of What is a system? A set of things working together to do something

Realist approaches focus on what works for whom, under what circumstances and how. It explains the causes but is not a way of solving them. The healthcare engineering approach will follow on from this. This is an ongoing process of identifying a problem, finding out      Image of What is a systemic discharge approach what is actually going wrong and will help us to drill down into each potential problem. We can then consider solutions, put these into practice and look at what other problems need to be focused on. These steps are then repeated until we have developed our solution — 'a systemic discharch approach'.

We hope this will help us to make changes in practice, in a way that allows staff to work in the way that they want to and ensures people with lived experience feel heard and acted upon — so everyone involved benefits.

 

Our plan for the next 3 years involves:

Image of 3 year plan - Year 1: Literature review. Interviews, focus groups and ward observations with staff, service users and carers. Medical notes review & document review. Year 2: 3 deisgn workshops. Co-production with LEAG and study team to design the systemic approach. 3 Feedback workshops. Year 3: Testing out the new process. Ward based observations. Questionnaires. Medical notes review. Cost analysis. Stakeholder focus groups for final evaluation.

Image of a lighbulb Want to know more? Please see below for more detailed information

Co-production within MINDS

People with lived experience are at the heart of the MINDS project and have been meaningfully involved from the start of the research process. Their expertise is essential in order to fully understand the problem and develop solutions.

Sarah Rae (research co-lead) initiated the whole project based on her experience of distressing discharges. We are proud to say that co-production is a way of working that is valued and evident throughout the project at all levels.
Image of - what is co-production? Co-production is an approach to working together in equal partnership and for equal benefit

The MINDS research team also includes a diverse Lived Experience Advisory Group (LEAG) made up of people who have experience of accessing services and carers. 

We are currently working on developing a MINDS mission and vision statement and ways to evaluate our level of co-production within the project.

We are currently working on developing a MINDS mission and vision statement and ways to evaluate our level of co-production within the project.

Explaining the MINDS study through animations

Onwards Planner

The Onwards Planner is owned by service users. The aim of the planner is to facilitate service users and staff working together to support people from admission to moving on from the ward. Both service users and staff might find it helpful to watch the animation below to support them with using the Onwards Planner.

Onwards Supporter Planner

The Onwards Supporter Planner is owned by carers/supporters of service users. This planner aims to include supporters throughout their service user’s time on the ward and beyond. Supporters can watch the animation below to further understand how the Onwards Supporter Planner can be used.

Supportive Practice

Supportive practice is a session for staff to meet and create a space where they can openly talk about their work on the ward, including any difficulties they may be facing. The sessions have a particular focus on discharge. Materials for discussion are provided, and there will also be the chance for staff to bring their own cases. Staff can watch the animation below to find out more about Supportive Practice sessions.  

Mini teams

Mini teams are a way of rearranging ward staff into smaller groups, to make sure that there is always a known member of staff available on the ward for service users to talk to. Mini teams should also help staff with shared decision making. Service users, staff, and supporters can watch the animation below to find out more about mini teams.

Gradual leave

We know that leave can be an important part of the journey towards moving off the ward, and that the way in which leave is used is also important. Watch the animation below to understand more about this.

Onwards Postcards

Onwards postcards are available on the ward for people to send to mark the end of their time in hospital, and recognise the relationships they have formed on the ward. Service users, supporters, and staff can watch the animation below to understand more about these and how they can be used.  

MINDS news, event and publications

(+) Our latest blogpost

 

(+) Listen to our podcast

(+) BBC radio Norfolk interview

Meet the MINDS Team

 Image of Sarah RaeSarah Rae - Co-lead of the MINDS Study

I had a poor experience of care as a mental health inpatient several years ago. Transitioning to the community was especially distressing  after becoming institutionalised during my eight-month ward stay. The prospect of becoming responsible for four children again terrified me, but no one understood this. Since then, I have been involved in research that aims to change service delivery and practice on the ground for the better. If the MINDS study leads to improved discharge planning that benefits everyone, I will feel my job is done. The children have long since fledged the nest, but when I am not beavering away at this project my elderly cat, who needs much tender loving care, is a calming influence and my granddaughter makes life fun.

 


Image of Jon Wilson Jon Wilson
- Co-lead of the MINDS Study 

Dr Jon Wilson is a consultant psychiatrist, consultant medical psychotherapist and Research Director in Norfolk and Suffolk NHS  Foundation Trust. He trained in medicine at St Andrews and Manchester before completing his psychiatry training in far flung places like New Zealand, Edinburgh and Cambridge. He leads a number of National research grants and has particular experience   of service design; especially young people’s mental health services and systems of care. He is particularly interested in research   which is developed by and involves people that use services and makes a tangible difference to their care.

 

 

Image of Corinna Hackmann Corinna Hackmann – Research Clinical Psychologist

Corinna is a Research Clinical Psychologist and leads on Research Development for Adult services at NSFT. I am interested in research that improves mental health services for those who use and work in them – and has coproduction at its heart. I am co—   leading Work Package 2 for the MINDS project.

 

 

 

 Image of Lisa GrunwaldLisa Grunwald – MINDS Study Manager (Currently on maternity leave)

Lisa is the MINDS study manager, and responsible for the day-to-day running of the study. She is about to complete her PhD at  the Division of Psychiatry at UCL. She has been working in NHS services, including inpatient wards, community teams and outpatient psychology departments. Having worked in mental health services, she has developed a keen interest in research, especially service development and improvement.

 

 

 

 Image of Charlotte WheelerCharlotte Wheeler – MINDS Study Manager

I’m the current Study Manager for MINDS. I play a supporting role in recruiting participants for the study, analysing and writing up   our findings, and working with the different study sites to make sure everything runs smoothly. I love that MINDS is such a unique project with coproduction at its heart and an ability to bring together such different people, ideas, and ways of working. Outside of MINDS, I enjoy cooking, reading, and spending time in nature.

 

 


Image of Emma Grindrod Emma Grindrod – Research Assistant Psychologist (ELFT)

I’m a Research Assistant at East London Foundation Trust. I help with the day-to-day activities of MINDS, which includes a lot of   admin, data collection, and data management. I’ve been working in the NHS for eight years, and I’ve seen the negative impact of   poor service design and delivery on everyone. I want to be part of understanding and changing systems, so I am very pleased to support MINDS, and I hope to learn about inclusive systems engineering. In my spare time, I like going to live shows and gigs, spending time in the parks in London, and watching documentaries.

 

 

 Image of Tara Self - Research Assistant Psychologist (HPFT)Tara Self – Research Assistant Psychologist (HPFT)

I’m one of the Research Assistants working on MINDS for the Hertfordshire Partnership University NHS Foundation Trust (HPFT) site. I support with various parts of the research such as recruiting participants to the study, developing materials and data analysis. Outside of the project, I enjoy spending time socialising with friends, exploring new places and watching live sports.

 

 

 

                                                                                                      Work Package 1

 Image of Sonia Dalkin Sonia Dalkin

My interest in the MINDS study stems from my research background in applied health and social care research and my interest in using realist approaches to further understand such services and interventions, allowing for improvement where possible. In my spare time I like to do yoga and enjoy cooking.

 

 

 


Image of Melanie HandleyMelanie Handley

Melanie Handley is a Senior Research Fellow at the University of Hertfordshire. Her recent research focuses on the delivery of health and care services for people living with dementia using realist and co-design methods. Melanie is interested in understanding the factors that influence discharge preparation and planning to help inform how it might work better for people staying and working on the wards.

 

 

 


Image of Emma KaminskiyEmma Kaminskiy

I am an Associate Professor in Psychology at Anglia Ruskin University. I have previous experience of working collaboratively with NHS Trusts on research and service improvement projects. I am dedicated to meaningful public and patient involvement in research, working with people with lived experience and carers to understand what is important and to improve mental health services. Working closely with service users and carers has shown me how valuable service user and carer involvement is in developing and redesigning healthcare services.

 

 

Hannah Zeilig

Hannah Zeilig is a Reader in Arts and Health at the University of the Arts, London. During the ongoing covid-19 pandemic she worked with people living with dementia in care homes and with artists and has researched the arts and dementia in her role as senior research fellow at Wellcome. She lives with bipolar 1 disorder and is motivated to query and challenge accepted norms about mental illness and the treatment of people who live with this range of conditions.

                                                                                                         Work Package 2

 Image of Amanda GreenAmanda Green

As Peer Support Lead I am proud to lead our extraordinary peer support workforce at NSFT using our lived experiences to help   deliver and transform services. An important part of my recovery journey was studying for my Masters in Mental health Recovery   and Social Inclusion, where I fell in love with academia, which is why I now find myself researching Safety Planning: a recovery—   orientated risk management intervention for my PhD at King’s College London. My interest in MINDS project, therefore, is two-fold;   firstly, any excuse to be involved in research should be taken, and secondly, as someone who spent almost a decade in and out of   psychiatric wards, I am keen that people experiences of discharge from wards are facilitative of the next phase of their recovery – whatever that may be. 

 Image of Sam WallerSam Waller

My role is to apply the Improving Improvement toolkit (https://www.iitoolkit.com/) and Engineering Better Care   (https://raeng.org.uk/media/wwko2fs4/final-report-engineering-better-care-version-for-website.pdf) approach within the MINDS   research. I am particular interested in MINDS because the consortium contains a mix of clinicians, researchers, and people with lived experience of the process. My personal interests are kayaking and mountain biking.

 

 

 Image of Timos KipourosTimos Kipouros

I have a Systems Engineering background and I am working with the Aerospace industry for more than 20 years. I have developed   a strong interest on healthcare systems, simply because of the additional complexity of capturing patient and human behaviour   and consider this as input to engineering practices. In the MINDS project, I am excited about the potential solutions we might discover, simply because these will be co-produced directly with service users, carers, and engineers. My role in MINDS is to   coordinate the workshops of co-design and co-production with my colleagues.

 

 

 

                                                                                                            Work Package 3

 Image of Jamie MurdochJamie Murdoch

I am a Senior Lecturer in Social Science and Health in the School of Life Course and Population Sciences, King’s College London. I am co-leading the evaluation of the MINDS discharge care approach, focusing on how it is implemented and experienced within   Mental Health Trusts. In my free time I enjoy spending time with my family and friends, running and when I have the time, trekking   in the mountains.

 

 

 Image of Adam WagnerAdam Wagner

Alongside other members of the team, I co-lead the third part of MINDS, which is looking to understand early evidence around the   acceptability, implementation and cost impact of the intervention (the SDA) being developed in MINDS. As a health economist, my interest is in understanding the resources, associated costs and benefits of different treatment and service alternatives. Therefore, within MINDS, I want to understand the resources and costs of delivering the SDA, and how these impact the wards in which it would be delivered and wider contexts. A good deal of my research focuses on mental health, and having worked Sarah previously   on the PROMISE study, I was interested in being involved in this study. It was also a new opportunity to be involved in the   development of a new intervention, which contrasts to most of my work which focuses on the later stages of evaluating   interventions. Outside of research, Adam can often be found trying to improve his skills on a badminton court or escaping into                              some science fiction.

 Image of Sophie BaggeSophie Bagge

Dr Sophie Bagge is a Senior People Participation Lead at Norfolk and Suffolk NHS Foundation Trust and is motivated to enable all people who use services and their loved ones to be equal partners in the design and development of mental health services. Sophie has previously completed her doctorate at the University of East Anglia.  The title of her doctorate is: A Journey from Science to Art:  Valuing the voices of women in the exploration of traumatic childbirth and perinatal mental health.  Sophie lives with bipolar disorder and is passionate about utilising both her lived and learned knowledge to improve the experiences of people with mental illness.

 

Get in contact

If you want to find out more about the study, or want to be involved, then please email us minds@nsft.nhs.uk .

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