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Introduction - SH4051 Assessment: Component 001
Research paper 1: Keeping control: Exploring mental health service user perspectives on targeted violence and abuse in the context of adult safeguarding
Main Findings
The study shows a high incidence of violence, abuse, and neglect against mental health service users, especially women in England. Service users expressed that they often felt unsafe in all settings and most of them mentioned that being neglected by mental health staff is a kind of abuse. The problem was compounded by social marginalization, restricted access to decent accommodation, the stigma of diagnosis, and daily contact with high-risk situations, including psychiatric hospitals and deprived communities. Moreover, people had concerns about being disbelieved or punished and some of them mentioned that mental health and social care practitioners are unwilling to admit having failed to address abuse or mistreatment. Interestingly, service users felt that they wanted to be more involved in the safeguarding process to achieve better results that protect their safety and dignity (NHS Digital, 2018).
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Research Approach
This study employed qualitative research design, with service user involvement and guidance and data collected through interviewing and focus group discussions as well as social media-based conversations. About 50% of the members of the research team were service users which ensured that a user perspective was incorporated in the planning of activities as well as the implementation of research. The following methods were employed: a scoping literature review, individual Interviews with 23 self-selecting Mental Health Service Users, and focus group discussions with Mental Health and Safeguarding practitioners. Further, two Twitter conversations were conducted using the @MHChat handle to build more insights. This study used an integrated, cross-sectional, and comparison design to explore the experiences of abuse and neglect among mental health service users and evaluate the perceptions of mental health care providers and safeguarding representatives. This was achieved through the integration of service users within the study to ensure that research is done in a manner that responds to the special concerns of people with mental health issues (Oranga and Matere, 2023).
Key Implications of This Approach
The participatory and qualitative design of the study offers several important implications as regards the understanding of the mental health service users’ experiences and the deficiencies in the safeguarding measures. The study rewrote safeguarding lenses by focusing on service users’ perceptions thus making it a shift from organisational or clinical approach. This is crucial since the research question is “How does this happen?” and this approach provides a description of the day-to-day experience of abuse and neglect among service users in complex and high-risk settings. The use of both Twitter discussions and stakeholder events in the study ensured that the findings were valid and rich due to the provision of multiple viewpoints. Such an approach makes the findings realistic and, in turn, promotes the formulation of policies that are more sensitive to users’ needs (Powell and Clarke, 2006). Also, it raises concerns regarding the system of mental health care, which may prevent or fail to support professionals reporting abuse, indicating the necessity for organizational changes and responsibility. Therefore, the research suggests that vulnerability assessments and prevention measures should be reconsidered in light of the specific requirements of service users, as well as promoting the user-led approach in the field of safeguarding and social care.
Application in Health and Social Care Practice
This research has the potential to impact practice implementation in health and social care, more so in only in adults safeguarding for mental health service users. In this way, the importance of user – focused approaches to intervention in the abuse and neglect of service users is accentuated. Implementation of findings into safeguarding new provisions could help escalate the sensitivity of healthcare and social care professionals to respond to the needs of mental health service users and safeguard them from specific risks. Recommendations For future training of classifiers for healthcare providers, this knowledge should be applied so that service users feel welcome when they report abuse(Greenberg et al., 2020). It is important that service users initiate safety planning and that they are included in their local safeguarding boards – it may promote effective change. This is in contrast with the pre-established and tradition-based service options that are prove d by research to reflect a culture of non-participation of the affected population. He also found existing policy inadequacies in assigning responsibility for the delivery of services and effective interventions, which indicates that new policies supporting the processes of multi-agency working and accountability might enhance the current situation reducing service fragmentation. Increased clarity on how practitioners can act and a clear expectation that practitioners should not expose themselves to litigation risks could help practitioners take appropriate action and report abuse while improving mental health service user safety and quality of care.
Research paper 2: The Impact of Stigma in Healthcare on People Living with Chronic Illnesses
Main Findings
The paper by Earnshaw and Quinn (2011) looks at the impact of stigma on the health care utilization and quality of life of people with chronic diseases. The authors concluded that internalized, experienced, and anticipated stigma greatly reduces healthcare utilization and quality of life. Self-stigma in which people embrace the perceptions others have about them was a direct determinant of limited care and poor quality of life. Perceived (rejection) from the healthcare providers influenced expected rejection by others, which in turn influenced the use of health services. Expected stigma was significantly correlated with limited care utilization, which means that the patients who expected prejudice would receive adequate care had low chances of doing so. Most importantly, care access was found to moderate the relationship between stigma and quality of life implying that stigma does not only affect health but also an individual’s quality of life(Earnshaw and Quinn, 2011).
Research Approach
To test the relationships between the types of stigmas, care access, and quality of life the authors conducted a path analysis with 184 patients with chronic diseases. Path analysis enabled them to model the direct and indirect effects of such variables and they found that internalized stigma had direct effects on quality of life while experienced stigma had indirect effects via anticipated stigma and restricted care seeking. The study also used a structured survey to collect data, from a sample of university students. This approach enabled the assessment of the hypothesized relationships and the assessment of determinants such as stigma and care access using standardized and validated instruments for people with chronic illnesses (Valenzuela and Bachmann, 2017).
Key Implications
Path analysis used in this study gives a step-by-step understanding of how stigma affects care and quality of life. This approach is useful for understanding how various forms of stigma intersect and intertwine, and how they interrelate, with the finding that enacted stigma primarily affects anticipated stigma, which in turn influences healthcare utilization. This more complex concept recognizes the need to decrease internalized as well as experienced stigma to increase the ability to seek and receive care. Further, by considering both direct and indirect effects this approach emphasizes the necessity of interventions that target both intrapersonal (internalized stigma) and interpersonal (experienced stigma) levels to enhance the health of individuals with chronic diseases.
Implications for Health and Social Care Practice
These findings provide important implications for health and social care interventions designed to enhance the quality of life of people with chronic diseases. Strategies that work towards internalized stigma management, such as educational support, positive coping skills, and self-help groups increase self-esteem and thereby increase the quality of life. This paper argues that training healthcare workers to be sensitized on stigma-related conditions can help to alleviate the stigma that patients face and thus eliminate the fear of being stigmatized making the patients comfortable to seek medical care services. In addition, increasing access to care has the potential to bring about numerous benefits given that using conventional healthcare services has been proven to improve the quality of life among people with chronic diseases. The findings also provide evidence for anti-stigma measures in healthcare facilities as leading to improved well-being and quality of life for patients with chronic diseases (Bhattacharya and Ramachandran, 2015).
Application in Health and Social Care Practice
The impact of stigma specifically on the utilization and nature of the healthcare experience of people with chronic diseases is described in this study. In health and social care, it highlights the importance of addressing stigma through practice changes including, for example, educating the staff to eliminate prejudice, and creating an environment that is accepting. In care, more trust in patients and greater satisfaction can be achieved through user-led planning which taps into patients’ decisions. Moreover, including mental health interventions along with chronic disease, and self-management can help to reduce internalized stigma for clients, which will result in better health and well-being for clients, making it possible to use evidence-based practice to enhance the quality and availability of care services.
Research Paper 3: The sound of silence: evidence of the continuing under reporting of abuse in care homes
Main Findings
The study incorporates attributes that have become recurrent in care homes regarding reporting and hiding abuse in the private sector in England as enumerated by Moore in 2020. surveyed 116 staff from 11 new care homes to establish that a good number of the staff had observed abuse, but cases were not reported because the staff feared that they would be punished hence dismissal, and job insecurity. Specifically, 42.54% of respondents claimed that they heard of cases when abuse was purposefully camouflaged, while management tried to forbid subordinates from disclosing this information using threats. A meagre 58% of the respondents said that external agencies were involved in the investigations of the abuses, which puts into perspective the many hurdles towards accountability in the care homes. The results point toward current shortcomings of practice and protection that are in place for identifying and responding to abuse of vulnerable adults in care institutions (Moore, 2020).
Research Approach
The author adapted a qualitative and quantitative data collection technique since the questionnaire was anonymously filled. Administered to 50 newly recruited carers working in 11 care homes, the survey sought to obtain data regarding the exploration of experiences of exposure to abuse as well as their reporting avenues within the before-used care institutions. One advantage of using a self-administered questionnaire is that social desirability bias was minimized since most respondents felt free to provide sensitive information since they were not being interviewed by a researcher. The surveyed subjects were able to add details about what specific kind of abuse they had seen or experienced, what behaviours or actions were most common, and how the organizations of which they were a member addressed these issues. By using this approach which prioritized the narratives from the personnel, a rich understanding of the culture, and the systematic barriers to reporting abuse were captured. Analysis of longitudinal data for the years 2015-2019 added robustness to the study as it allowed the identification of continuous issues in multiple sites (Bansal and Corley, 2011).
Key Implications of This Approach
The approach employed in this research is important in how underreporting occurs as opposed to merely counting the cases of abuse. The author chose anonymous surveys to obtain objective opinions that expose cultural and organizational factors that hinder the reporting of abuse. They postulated that abuse continues to prevail especially in care homes because staff feel threatened to report abuse lenses due to threats of retributive actions. This is a discovery that holds much significance for enactors of the policies at both the state and federal levels since it underscores the importance of passing laws that require people in positions of authority to report abuse and laws that shield and encourage people to report abuse. When these are lacking, the natural altruism of care staff to do the right thing for the patients often gets easily trumped by self-preserving anxieties about sustaining one’s employment (Elo and Kyngäs, 2008).
Application in Health and Social Care Practice
Consequently, Moore’s work is most relevant to health and social care practice by highlighting the need to promulgate work-based strategies for improving an openness and accountability culture. This research may inform practical intervention efforts to create effective whistleblowing frameworks to provide more support from employers, and frequent staff training for abuse recognition and reporting. For example, care homes could set up secure, third-party whistleblowing procedures so that workers do not feel endangered when they come forward to report maltreatment. Furthermore, bringing aspects of abuse awareness and reporting into staff training will help make sure that workers are knowledgeable about their rights as well as their responsibilities. From an EBP perspective, this research contributes to tenable rules of reporting and documentation processes regarding the escalation of abuse cases to other agencies. This is in line with the EBP approach of relying on research findings to inform the changes to be made in practice to improve the healthcare provision, thus safeguarding, will be informed by research. Putting into practice such strategies can help protect vulnerable adults and assist staff as they will know how to handle abuse cases (Dewi, 2022).
References
- Bansal, P. and Corley, K. (2011) 'The Coming of Age for Qualitative Research: Embracing the Diversity of Qualitative Methods,' Academy of Management Journal, 54(2), pp. 233–237. https://doi.org/10.5465/amj.2011.60262792.
- Bhattacharya, I. and Ramachandran, A. (2015) 'A path analysis study of retention of healthcare professionals in urban India using health information technology,' Human Resources for Health, 13(1). https://doi.org/10.1186/s12960-015-0055-x.
- Dewi, I.G.A.A.O. (2022) 'Understanding Data Collection Methods in Qualitative Research: The Perspective Of Interpretive Accounting Research,' Journal of Tourism Economics and Policy, 1(1), pp. 23–34. https://doi.org/10.38142/jtep.v1i1.105.
- Earnshaw, V.A. and Quinn, D.M. (2011) 'The Impact of Stigma in Healthcare on People Living with Chronic Illnesses,' Journal of Health Psychology, 17(2), pp. 157–168. https://doi.org/10.1177/1359105311414952.
- Elo, S. and Kyngäs, H. (2008) 'The qualitative content analysis process,' Journal of Advanced Nursing, 62(1), pp. 107–115. https://doi.org/10.1111/j.1365-2648.2007.04569.x.
- Greenberg, N. et al. (2020) 'Mental health of staff working in intensive care during Covid-19,' Occupational Medicine, 71(2), pp. 62–67. https://doi.org/10.1093/occmed/kqaa220.
- Moore, S. (2019) 'The sound of silence: evidence of the continuing under reporting of abuse in care homes,' The Journal of Adult Protection, 22(1), pp. 35–48. https://doi.org/10.1108/jap-08-2019-0027.
- NHS Digital. (2018). Safeguarding adults collection, England 2017-18 experimental statistics. NHS Digital. Retrieved from https://digital.nhs.uk/data-and-information/publications/statistical/safeguarding-adults
- Oranga, J. and Matere, A. (2023) 'Qualitative Research: Essence, types and Advantages,' OALib, 10(12), pp. 1–9. https://doi.org/10.4236/oalib.1111001.
- Powell, J. and Clarke, A. (2006) 'Information in mental health: qualitative study of mental health service users,' Health Expectations, 9(4), pp. 359–365. https://doi.org/10.1111/j.1369-7625.2006.00403.x.
- Valenzuela, S. and Bachmann, I. (2017) 'Path Analysis,' The International Encyclopedia of Communication Research Methods, pp. 1–9. https://doi.org/10.1002/9781118901731.iecrm0181.
Author Bio
I am Andrew Carter and graduated with distinction, earning a Master of Science degree in management from Cranfield University. I am very well aware of the problems students face as I was a student once. I want to take them out of such a situation and for that I have been helping them for 10 years. I have completed more than 500 management papers for students in provided time.
