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Patient Involvement in Improving the Evidence Base on Inpatient Care (PERCEIVE)

PERCEIVE is a research programme which looks at the therapeutic environment on inpatient psychiatric wards. This programme emphasises service user views and also takes feedback from staff. PERCEIVE creates new questionnaires so the ward environment can be assessed. PERCEIVE also compares ward admission systems and enables staff teams to perform therapeutic interventions on the wards.

Psychiatric wards are unique, complex and challenging environments.  Service users and staff have long called for improvements to wards – including a more therapeutic atmosphere and more support through effective interventions.

PERCEIVE is taking place in 16 acute mental health wards in the South London boroughs of Lambeth, Lewisham, Southwark and Croydon. The research programme has attracted £2m of research funding from the National Institute for Health Research (NIHR) over five years from 2007 until 2012. However, the research in the PERCEIVE study is independent and is carried out by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London.

The service directors of SLaM (the largest combined mental health trust in the UK) are grant holders of the research, in addition to a combined team of more than 25 researchers led by Chief Investigator Professor Til Wykes at the IoPPN. More than 1000 service users and 1000 acute ward staff members will have taken part in the programme by the time it is complete. 

Background

It is clear that the quantity and quality of research evidence in mental health has improved, but that some areas of practice have large evidence gaps. This is particularly apparent for inpatient care where mental health budgets are most highly invested. Most policy and practice take place largely in an evidential vacuum despite the wide consensus that such care is required for the effective management of some emergencies.

The transfer of care from hospital to the community has had clear effects on inpatient care, including increases in the levels of severity of symptoms and behavioural problems, increased numbers of detained patients and difficulty in staff recruitment and retention, leading to a service that can sometimes appear more custodial than therapeutic. Inpatient mental health care has been specifically targeted because these problems have been identified not only in surveys and policy documents but also in reports from service users. Additionally, these reports have highlighted solutions to such issues including increasing therapeutic activities, supporting staff skill development and increasing access to psychological support on wards.

Researcher Caroline Laker discusses nursing research and the benefits of the PERCEIVE project for psychiatric services:

Aims

To evaluate innovative hospital-based mental health care interventions:

  1. Develop measures of staff and patient satisfaction
  2. Measure key indicators of costs in inpatient services
  3. Assess two admissions models: ‘triage’ and ‘mainstream’
  4. Integrate a menu of ward-led therapies and assess them by randomised control trial

Members

Diana Rose

Diana Rose

Professor of User-Led Research

Til Wykes

Til Wykes

Vice Dean (Psychology & Systems Sciences)

Academic papers

Ennis, L., Rose, D., Callard, F., Denis, M., & Wykes, T. (2011). Rapid progress or lengthy process? Electronic personal health records in mental health. BRC Psychiatry, 11:117.

Evans, J, Rose, D, Flach, C, Csipke, E, Glossop, H, & Wykes, T. (in press) VOICE: Developing a New Measure of Service Users’ Perceptions of Inpatient Care, using a Participatory Methodology. Journal of Mental Health.

Laker, C., Callard, F., Sayer, J., Flach, C., & Wykes, T. (Submitted). VOCALISE: measuring staff perceptions of barriers to change in acute ward settings.

Laker, C; *Rose, D; Flach, C; Csipke, E, McCrone, P; Craig, T; Kelland, H; Wykes, T (Submitted). Views of the Therapeutic Environment (VOTE): Stakeholder Involvement in measuring staff perceptions of acute in-patient care. *Joint first author

Rose, D., Evans, J., Laker, C., & Wykes, T. (Submitted). Living and working in acute mental health settings.

Rose, D., Evans, J., Sweeny, A., & Wykes, T. (2011). A model for developing outcome measures from the perspective of mental health service users. International Review of Psychiatry, 23(1), 41-46.

Sabes-Figuera, R., McCrone, P., Sharac, J., Csipke, E., Wood A & Wykes, T. (2012) Developing an instrument for collecting and costing activity data on psychiatric inpatient wards Epidemiology and Psychiatric Sciences, 21, 393-399

Sharac J, McCrone P, Sabes-Figuera R, Csipke E, Wood A, Wykes T. (2010). Nurse and patient activities and interaction on psychiatric inpatients wards: A literature review. International Journal of Nursing Studies, 47, 909-917.

Csipke, E., Flach, C., McCrone, P., Rose, D., Tilley, J., Wykes, T & Craig, T. Inpatient care 50 years after the process of deinstitutionalisation (2013). Social Psychiatry and Psychiatric Epidemiology. DOI: 10.1007/s00127-013-0788-6

Taylor, R., Cella, M Csipke, E, Herriot-Maitland, C, Gibbs C, Wykes, T, (2015) Promoting recovery: Social cognition and interaction training (SCIT) for forensic inpatients. Behavioural and Cognitive Psychotherapy 

Papoulias, C, Csipke, E, Rose, D, McKellar, S, & Wykes, T. (2014). The psychiatric ward as a therapeutic space: a systematic review British Journal of Psychiatry, 205 (3), 171-176. DOI: 10.1192/bjp.bp.114.144873

Williams, P, Csipke, E, Rose, D, Koeser, L, McCrone, P, Tulloch,A D, Salaminios, G, Wykes, T. Craig, T. (2014). Efficacy of a triage system to reduce length of hospital stay. British Journal of Psychiatry, 204 (6) 480-485; DOI: 10.1192/bjp.bp.113.141051

McCrone, P, Sabes-Figuera, R, Csipke, E. Sharma,B, Rose, D, Wykes, T, Jamieson-Craig, Thomas (2015).Predicting Psychiatric Inpatient Costs. Social Psychiatry and Psychiatric Epidemiology (in press).

Papoulia, K, Csipke, E, Vitoratou, S, Rose, D , Wykes, T (2015). Design in Mind: eliciting service user and frontline staff perspectives on psychiatric ward design through participatory methods. Journal of Mental Health. (in press).

Wykes, T, Csipke, E, Williams, P, Rose, D, Koeser, L, McCrone, P, Jaimeson-Craig, T (2015). Following the Francis Report: Investigating patient experience of mental health inpatient care. British Journal of Psychiatry (in press).

Csipke, E, Papoulia, K, Vitoratou, S, Rose, D , Wykes, T (2015). Design in Mind: eliciting service user and frontline staff perspectives on psychiatric ward design through participatory methods. Journal of Mental Health. (accepted).

Conferences and presentations

VOICE Presentation: Patient involvement in improving the evidence base on inpatient care - Feb '08, Service User Involvement & Empowerment in Mental Health Conference

VOICE Presentation: Patient involvement in improving the evidence base on inpatient care - Apr '08, Ladywell Unit Research Forum, Lewisham Hospital

VOICE Presentation: An evaluation of inpatient care: developing a measure from the service user's perspective - Jun '08, MHRN Showcase Conference, London

LIAISE Workshop: Developing a new measure of service user perceptions of inpatient care, using participatory research methods - Nov '08, User-Reported Outcomes & User-Valued Outcomes Conference

VOICE Presentation:  VOICE: Service users' view of inpatient care - Mar '09, 1st Year D. Clin. Psych. at The University of Surrey

VOICE Presentation: An evaluation of inpatient care: developing a measure from the service user's perspective - Mar '09, Service Users in Research Launch, London

LIAISE Poster: Lasting Improvements to Acute Inpatient Settings: LIAISE - part 1 of the PERCEIVE project - May '09, MHRN Scientific Conference, Nottingham

LIAISE Presentation: Lasting Improvements to Acute Inpatient Settings: LIAISE - part 1 of the PERCEIVE project - May '09, Lambeth wards participating

VOICE Presentation: Developing a new measure of service user perceptions of inpatient care, using participatory research methods - Jun '09, International Colloquium of Schizophrenia, Oporto, Portugal

LIAISE Workshop: Developing measures of staff and service user perceptions of acute in-patient settings, using a participatory methodology - Sep '09, 15th International Network for Psychiatric Nursing Research Conference (RCN)

VOCALISE Poster: Barriers to Change - Sep '09, 15th International Network for Psychiatric Nursing Research Conference (RCN)

LIAISE Presentation: An evaluation of inpatient care: developing a measure from the service user's perspective - Feb '10, MHRN Scientific Conference, London

CITRINE Presentation: Developing an instrument for collecting activity data on psychiatric inpatient wards: the Client Services Receipt Inventory-Inpatient (CITRINE) - Mar '10, 2nd RCN Mental Health Nursing Conference and Exhibition

LIAISE Workshop Staff and service user's perceptions of acute care: a thematic analysis - Mar '10, RCN Mental Health Nursing Forum Conference & Exhibition, Liverpool

DOORWAYS Presentation: Doorways: Psychological groupwork with acute patients - Mar '10, Psychological Groupwork Conference

VOCALISE Poster: Barriers to Change - Apr '10, Working Conference - HSR Europe - 'Where Policy & Research Meet' - The Hague

LIAISE Presentation: Staff and service user views of acute inpatient settings - Aug '10, Qualitative Research on Mental Health Conference

LIAISE Presentation: VOICE: Developing a new measure of service users' perceptions of inpatient care - Sep '10, User Involvement in Research Conference, Norway

LIAISE Presentation: Patient and nurse generated outcome measures in mental health - Nov '10, INVOLVE Conference 2010: Public Involvement in Research - Innovation and Impact. Nottingham

LIAISE Presentation: Lasting Improvements to Acute Inpatient Settings: LIAISE - part 1 of the PERCEIVE project - Nov '10, Surrey & Borders Partnership R&D Conference, Leatherhead

LIAISE Presentation: Developing a new measure of service user perceptions of inpatient care, using participatory research methods - Jun '11, HSRN/SDO Network Conference, Liverpool

VOICE Presentation: Improving access to psychological interventions in inpatient acute settings - Jul '11, British Association of Behavioural and Cognitive Psychotherapies

DOORWAYS Presentation: Improving the provision of psychological therapies in inpatient care; the DOORWAYS project - preliminary findings Sep '11 European Association for Behavioural and Cognitive Therapies Congress, Iceland
Conference A comparison of a traditional acute inpatient admission system and a novel triage admission - 2013, European Network for Mental Health Service Evaluation – Italy

Conference: Promoting recovery: social cognition and interaction training (SCIT) for forensic inpatients - 2013, European Network for Mental Health Service Evaluation – Italy

Conference: Increasing therapeutic activities on acute psychiatric wards - 2014, Schizophrenia International Research Society Conference – Italy

Conference: Social cognition training for people with schizophrenia: a randomised study, 2014 - Schizophrenia International Research Society Conference – Italy

Conference: Improving inpatient care: Design in Mind, the physical environment of inpatient wards, 2015 - MHRN – United Kingdom

Contact us

Professor Til Wykes - Chief Investigator

+44 (0) 20 7848 0596