A feasibility study of the effects of implementing a staff-level recovery-oriented training intervention in older people’s mental health services

Abstract

Objectives: The concept of recovery has exerted considerable traction in mental health services for adults of working age, but less so in older people’s mental health services. The aim of this study was to evaluate the feasibility of a staff-level recovery intervention in older people’s mental health services.

Method: The study used a mixed-method pre-post design. The study took place in NHS older people’s mental health services, UK. Staff participants were multi-disciplinary mental health team members from the same service. The intervention was a manualised staff-level recovery intervention called the Older Adults Recovery Intervention (OARI). Measurement included the Recovery Knowledge Inventory and the Recovery Attitudes Questionnaire (RAQ-7) as well as fidelity data and in-depth qualitative interviews.

Results: OARI was delivered to 204 staff in 15 clinical teams. There was a statistically significant change towards improvement in four of the six recovery attitude and knowledge sub-scales. There were positive findings in change in practice at individual level, but not at team level. A number of context barriers were identified leading to the intervention not being delivered as intended.

Conclusions: Further development of OARI will involve a clearer distinction about the practice implications for service users with dementia versus functional illnesses, a stronger focus on implementation support, more use of evidence in training materials and a tailoring of context to meet professional group training needs. Overall, this study contributes novel data to the evidence base for recovery within older people’s mental health services.

Keywords:

• Recovery
• clinical practice
• older people’s mental health services
• training

Acknowledgements

The authors would like to thank David Newton for his help with the collection of quantitative measures and data entry, and Linda McNab for her help with the development and delivery of the intervention. Thanks also to Joanna Murray for review of the qualitative approach and Dr. Barbara Grey for her help in coding interview transcripts.

Disclosure statement

Professor Banerjee has received grants and personal fees from Abbvie, personal fees and non-financial support from Lilly, personal fees from Eleusis, personal fees from Daval International, personal fees from Boehringer-Ingelheim, personal fees from Axovant, personal fees from Lundbeck, personal fees from Nutricia, he has been employed by the Department of Health for England. The remaining authors report no conflict of interest.

Ethics approval and consent to participate

NHS Research Ethics approval was obtained by NHS Research Ethics Committee (London – Camden and Islington 09/H0722/66). Information about the study was provided to potential participants, and informed written consent was obtained from those taking part in the study.

Consent for publication

Consent for publication agreed. At the point of consent, study participants were made away that study data would be published, on the understanding that their anonymity is preserved.

Availability of data and material

The datasets generated and/or analysed during the current study are not publicly available but are available from the corresponding author on reasonable request.

Author contributions

All authors were involved in the design, conduct, analysis and drafting of this paper. All authors read and approved the final version of the manuscript.

Additional information

Funding

This work was supported equally by the Guy’s and St Thomas’ Charity and the Maudsley Charity.