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Below is a list of research projects at the
Royal College of Psychiatrists that have now been completed.
If you would like further information about any of
these projects, please contact Alan Quirk, Senior Research
Fellow, at: aquirk@cru.rcpsych.ac.uk
- Addiction Psychiatry
services
This
study investigated the roles and responsibilities of addiction
psychiatrists in the organisation and provision of addiction
psychiatric services in England.
- Audit of Electroconvulsive
Therapy (ECT) Practice
This audit project examined the practice of
ECT in England and Wales against standards set by The ECT Handbook:
The Second Report of the Royal College of Psychiatrists Special
Committee on ECT.
Results were published in an article, Junior
Doctors Training in the Theory and Practice of Electroconvulsive
Therapy in the Psychiatric
Bulletin Volume 21, p363 -365.
- Audit Pack for the Care Programme
Approach
In 1994, the College Research Unit
was commissioned by the Department of Health to produce a
monitoring tool for auditing local implementation of the Care
Programme Approach (CPA). Work was completed in 1995 and the
resulting Audit Pack was published by the NHS Executive in February
1996.
Key issues for audit included:
- Inter-disciplinary working and the
integration of CPA and Care Management
- Purchaser knowledge based on
needs
- Targeting of the severely mentally
ill
- Involving users and carers
- CPA outcomes
- The CPA Process
- Training for CPA
The pack was widely distributed to all
healthcare purchasers, providers and libraries. The NHS Executive
issued guidelines recommending that every service should audit the
CPA using the pack or an alternative audit product.
- Availability of treatment for addiction in medium
secure wards
This study investigated and
described the availability of treatment for substance misuse
problems to patients in NHS-managed medium secure forensic
psychiatric care in England who have a dual diagnosis.
- Career Intentions in Psychiatric
Trainees and Consultants (CIPTAC)
This project gathered accurate and
meaningful data on the level of 'attrition' at each stage of
psychiatric training, nationally, regionally and locally,
and further investigated why trainees leave at each stage.
- Carer and User Expectations of Services questionnaire
('CUES')
Client and Carer-Focused Outcome
Measures of the Outcomes of Social Care for Adults with Severe
Mental Illness was one of the thirteen projects comprised
of the Outcomes of Social Care for Adults (OSCA) initiative,
commissioned by the Department of Health. The project was a
collaboration between organisations which represent people with
mental health problems, their carers, and the three main
professions involved in mental health care. The project was run
jointly by The National Schizophrenia Fellowship, the Royal College
of Psychiatrists Research Unit, the Royal College of Nursing
Institute and the School of Social Work at the University of East
Anglia. The two-year project developed a set of scales to help
service users and carers to:
- Communicate more effectively with
doctors, nurses and social workers with regard to their own
priorities for treatment, care and support
- Participate in improving services to meet their needs
The dissemination of CUES was managed by the
National Schizophrenia Fellowship.
- Clinical Standards Advisory Group -
Depression
The College Research Unit, in collaboration
with the Royal College of General
Practitioners Effective Clinical Practice Unit and the Health
Advisory Service (HAS 2000) was commissioned to conduct research
into services for people with depression on behalf of the Clinical
Standards Advisory Group.
The programme of work included:
development of standards for NHS services for depression, visits to
eleven UK districts to evaluate services available to people with
depression, a national survey of GPs and the secondary analysis of
national data sets
- Clinical Standards Advisory Group
Schizophrenia
In 1993 the Secretary of State for Health
announced a Ten Point Plan for developing safe and successful
community care in response to public and professional concern about
the care of people with severe mental illness. One of these ten
points called for a review by the Clinical Standards Advisory Group
(CSAG) of the standards of care for people with schizophrenia.
The College Research Unit was asked to
collate existing statements of clinical standards and was then
commissioned to carry out a study to assess standards of NHS mental
health services in eleven UK health authorities. The subsequent
report was published in 1995.
The CSAG report highlighted concerns
about mental health services and was one of the factors that led
the Minister of Health at that time writing to the health
authorities asking for implementation of the Care Programme
Approach. The CSAG service evaluation protocol has been applied by
visiting teams to a number of mental health services since the
completion of the project. It is also being used by the Health
Advisory Service (HAS 2000) as the basis for further development
and refinement in methods for reviewing mental health services.
- Dual Diagnosis Information Project
(DDIP)
This study's aim was to raise awareness
and knowledge levels among substance misuse and mental health
professionals of psychiatric comorbidity (dual diagnosis).
- Living with serious mental
illness
As part of The Living Project, a
researcher immersed himself in the everyday lives of people with
severe mental illness who live in a deprived part of London. This
offered important insight into the real meaning of social exclusion
for this vulnerable group.
Funded from 2003 to 2007 by the Big Lottery
Fund. Publications ongoing.
This research was completed in 2000 and the
final reports from the various research studies in the research
programme were submitted to the Department of Health in early
2000.
A conference summary of the results was held
in March 2000. Findings from the research projects have been
disseminated in papers in various outlets such as academic
journals.
- Mental Health Residential Care Study
This was an NHS R&D funded
project which aimed to assess the characteristics and needs of all
those people with functional mental illness in residential
accommodation in eight districts. The principal question addressed
the extent to which these residents were appropriately placed. The
project involved the assessment of residents in NHS, local
authority and voluntary/private accommodation and the facilities
available to them.
The project was completed in March 1995
and led to the development of a new classification of facilities
which allowed comparisons of provision in different districts. A
methodology to enable a national census of residential
accommodation for people who have mental health problems was also
developed. The College Research Unit and the CEMH have examined
local provision via census days.
Articles relating to the project were
published in the specialist mental health press.
- National Audit of the Care Programme
Approach
In Autumn 1995, the NHS Executive
set a target for full implementation of the Care Programme Approach
(CPA) by the December of that year. Ensuring the full
implementation of the CPA became a priority for health authorities
and trusts providing mental health services.
- National Audit of the Management of
Violence in Mental Health Settings: 1999-2000
Ninety-six psychiatric wards from 42 English
mental health services participated in an audit of the management
of violence in adult in-patient settings.
Key National Findings
Key Recommendations
Discussion
Forty-four psychiatric wards from 27
learning disability services participated in an audit of the
management of violence in services for people with learning
disabilities.
- National Multi-Centre Audit of the
Prescribing of Anti-Psychotic Medication
This audit project was undertaken in
1998/99 and was the second subscription-based multi-centre clinical
audit to be organised by the CRU. The prescribing of anti-psychotic
medication, a key priority area for mental health providers was
chosen for a number of reasons:
- Over prescribing may lead to dangerous or unnecessary side
effects
- Side effects are frequently cited by service users as a reason
for non-compliance with medication and other aspects of care
- Poor practice or inadequate note-keeping on the prescription of
anti-psychotics accounts for a high proportion of negligence claims
against mental health services
- Permanent neurological damage or death caused by anti-psychotic
medication may be dose-related
- The cost of new atypical anti-psychotic drugs may lead to their
use being rationalised
Launched in June 1998, over 50 Trusts
subscribed to this audit which examined the prescribing of
anti-psychotic medication (including the use of high and multiple
doses) based on standards developed by an expert panel convened by
the Royal College of Psychiatrists.
This survey addressed the
important role that psychiatrists play in managing the risk that a
small number of people with mental health problems pose to
others.
The detailed results can be
accessed by College members here
This project was a collaboration between
Project North East, the Hamlet Trust, and the College Research and
Training Unit.
This project focused on the innovative
Business Minds demonstration project in Newcastle. It aimed to
explore whether it was possible for a mainstream ‘high-street’
business advice agency to engage with people with mental health
problems who wanted to become self-employed.
Download the project report here
- Survey of Flexibly trained consultant
psychiatrists
As an off-shoot to the
CIPTAC project, a sub-project examined the experiences of
those psychiatrists that trained flexibly. This
project replicated the study on a national basis to identify
what happened to this particular group of trainees, with the aim of
providing data to allow further workforce planning.
Click here to download a copy of the Psychiatrists'career
development after flexible training final report
The College Research Unit was
successful in gaining support from the Workforce Action Team at the
Department of Health (DoH) to pilot a new method for a systematic
training needs analysis (TNA) in mental health. This was part
funded by the DoH and the Trust in which the TNA was
to be piloted. The TNA aimed to match training the
workforce in mental health and social care to the needs of the
local population.
The skills that
were audited included those for evidence-based
interventions, for delivery of the National Service Framework in
mental health and the NHS Plan, and for the implementation of
clinical governance.
Click here to download the Assessment Schedule
Click here to download the TNA Executive Summary
Click here to download the TNA Manual Brief Guide
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