Psychological consultation in older adult inpatient settings: A qualitative investigation of the impact on staff's daily practice and the mechanisms of change

Abstract

Objectives: Psychological consultation is becoming increasingly common within older adult mental health and dementia services. However, there is very little research that examines the impact or effectiveness of this method of working. This study explored how psychological consultation impacted on the daily practice of staff working on mental health and dementia inpatient units. It also examined the mechanisms that enabled this process.

Method: Given the lack of current literature in this area, an exploratory qualitative design was employed. Ten staff who had received psychological consultation were individually interviewed. Staff comprised qualified and unqualified staff from a range of professions, and worked on older adult mental health or dementia units. Interviews were subject to thematic analysis.

Results: Five themes were identified from the analysis: (1) ‘It makes you understand the reasons why people are like they are’; (2) ‘It depends on the patient or service user’; (3) the importance of visibility and accessibility; (4) impact of psychology consultation on the effectiveness of the team; and (5) impact of psychology consultation on feelings invoked in the workplace.

Conclusions: The findings suggest that psychological consultation impacted on staffs’ daily practice in a variety of ways. Psychological consultation also appeared to increase team efficiency. Less positive findings were identified within the dementia setting. Specific recommendations are drawn from the conclusions to further guide clinical psychologists working within teams. Direction for future research in the area of psychological consultation is also suggested.

Keywords:

• mental health
• dementia
• inpatient care
• psychological consultation

Acknowledgements

Authors would like to thank the service staff who facilitated the research, in particular inpatient unit managers and the participants who took part. Thanks also go to Sarah Dexter-Smith for advice on the consultation model, Stephen Weatherhead for comments on a previous draft and Lancaster University for funding the study.