Trust and Connection

On the 28^th of November 8-9pm we are hosting a #WeMHNs chat looking at blended therapy (face-to-face problem-solving therapy with a mobile app) for men who self-harm.

As with all our chats, everyone is welcome to join the conversation. Whether you are a mental health nurse, service user, carer, other health care professional, student, academic or citizen with an interest in the subject, we would like to hear your thoughts!

Make sure you use #EBP for evidence based practice tweets with links to projects or articles as well as #WeMHNs

Background

Developing a personal connection with patients and building their trust is a key skill-set for any mental health nurse, but how is the therapeutic relationship affected by the introduction of digital technology?

This tweet chat will feature researchers from the team at the University of Ottawa who have recently developed a treatment manual to deliver a blended therapy (combining face-to-face problem solving and a smartphone app) for men who present to hospital with intentional self-harm.

More than 804,000 people die by suicide globally each year (WHO, 2014) and the majority of these individuals are men; indeed in Great Britain, three quarters of those who died by suicide in 2016 were men (ONS, 2017). The most recent figures released by UK suicide prevention charity, Samaritans, showed that the highest suicide rate in the UK was among men aged 40-44 (Samaritans, 2017).

Recent years have seen much-needed media attention shone upon the issue of male suicide, highlighting the pressing need for us to be better at supporting men in crisis, so that they do not reach a point where they feel suicide is the only option. The evidence base for existing psychosocial interventions for self-harm in adults is not encouraging, and even for interventions (CBT & DBT) which do indicate a positive effect on reducing self-harm repetition, the quality of the evidence is moderate to low and there is little to suggest particular benefits for men (Hawton et al., 2016). Men are often identified as being more reluctant to seek help for mental health problems and suicidal thoughts than women (e.g. Biddle et al., 2004) and the question of ‘how can we get more men to access support?’ is frequently asked. To flip the script, potentially a better way of approaching the issue of increasing support and treatment uptake in men is to ask instead ‘how can we build treatments andservices that men want to use?’.

A recent research study by Mackie and colleagues (2017) use qualitative methods to elicit information regarding men’s experiences of receiving a blended therapy intervention, which combined face-to-face problem-solving therapy with an app. Mackie et al’s (2017) study had two main objectives:

1)To inform the development of a treatment manual which to be used in a large cluster-randomised trial of blended therapy. 

2)To describe men’s experiences of receiving this therapy.

Questions

1.      What support do men who self-harm need from health services?

2.      What do you think health care professionals need to consider when seeking to develop a therapeutic relationship with men who self-harm?

3.      How do you think digital technology is currently utilised by men who self-harm and health professionals?

4.      What do you think are the potential benefits of a blended therapy approach (face-to-face problem solving therapy AND a mobile app) to care?

5.      What do you think are the potential risks of blended therapy approach?

Self-harm is an emotional issue and we would urge people to seek support if they become distressed during or after the Tweetchat. Please see the list of suggested post chat resources.

Resources for people in distress and those supporting them

Mental Health Foundation https://www.mentalhealth.org.uk/publications/truth-about-self-harm

Mind https://www.mind.org.uk/information-support/types-of-mental-health-problems/self-harm/#.Wh1NMzd8uUk

Connecting with people http://www.connectingwithpeople.org/healthcare-front

Samaritans https://www.samaritans.org/ Phone number- 116 123

National self-harm network http://www.nshn.co.uk/index.html 

Article reference

Mackie C, Dunn N, MacLean S, et al A qualitative study of a blended therapy using problem solving therapy with a customised smart phone app in men who present to hospital with intentional self-harm Evidence-Based Mental Health 2017; 20:118-122. http://ebmh.bmj.com/content/20/4/118

Thank you Andre Tomlin @mental_elf for writing the prechat information (resources added from previous #wemhns chats)