#WeMHNs - Tuesday 28th November 2017 8pm (GMT Standard Time) Trust and connection

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Trust and Connection

On the 28th 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) 





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 #WeMHNs transcript

 
@WeMHNurses
28 November 2017 20:00
Hello! It's 8.00pm UK time! I'm @markoneinfourhere at #weMHNs for the next hour. Tonights topic is a complicated o… https://twitter.com/i/web/status/935599300674977793
@Jones23Emma
28 November 2017 20:01
@WeMHNurses Hiyaaa ?? #wemhns
@WeMHNurses
28 November 2017 20:02
If you haven't had a chance to look it already, the background to tonight's chat is here http://www.wecommunities.org/tweet-chats/chat-details/4114 #wemhns
@saneresponse
28 November 2017 20:03
@WeMHNurses I just finished the study report, really interesting comments from the men participating. Looking forward to this topic #WeMHNs
@VanessaLGarrity
28 November 2017 20:03
RT @WeMHNurses: If you haven't had a chance to look it already, the background to tonight's chat is here http://www.wecommunities.org/tweet-chats/chat-details/4114 #wemhns
@Mental_Elf
28 November 2017 20:04
RT @WeMHNurses: Hello! It's 8.00pm UK time! I'm @markoneinfourhere at #weMHNs for the next hour. Tonights topic is a complicated o…
@lisa_marzano
28 November 2017 20:04
RT @WeMHNurses: If you haven't had a chance to look it already, the background to tonight's chat is here http://www.wecommunities.org/tweet-chats/chat-details/4114 #wemhns
@Mental_Elf
28 November 2017 20:04
RT @WeMHNurses: If you haven't had a chance to look it already, the background to tonight's chat is here http://www.wecommunities.org/tweet-chats/chat-details/4114 #wemhns
@ScottMHC14
28 November 2017 20:04
@WeMHNurses Good evening Mark & all #WeMHNs
@VanessaLGarrity
28 November 2017 20:04
Hello #WeMHNs
@CraigMacKie12
28 November 2017 20:05
@WeMHNurses Looking forward to chatting. #WeMHNs
@VanessaLGarrity
28 November 2017 20:05
RT @WeMHNurses: Hello! It's 8.00pm UK time! I'm @markoneinfourhere at #weMHNs for the next hour. Tonights topic is a complicated o…
@Jones23Emma
28 November 2017 20:05
Prechat info here #wemhns @UCLanNurses @UCLanMH https://twitter.com/wemhnurses/status/935599883213529088
@h2cm
28 November 2017 20:05
RT @WeMHNurses: Hello! It's 8.00pm UK time! I'm @markoneinfourhere at #weMHNs for the next hour. Tonights topic is a complicated o…
@HatchingHub
28 November 2017 20:06
I’m one of the authors of the paper and happy to take questions. #weMHNs
@WeMHNurses
28 November 2017 20:07
@HatchingHub Can you tell us what it was about and what you found out? In a few tweets. For people who haven't done the reading? #weMHNs
@menhealuk
28 November 2017 20:07
RT @WeMHNurses: Hello! It's 8.00pm UK time! I'm @markoneinfourhere at #weMHNs for the next hour. Tonights topic is a complicated o…
@CraigMacKie12
28 November 2017 20:07
@WeMHNurses @shatchernz @HatchingHub @lisa_marzano @EBMentalHealth Hello. :) #WeMHNs
@HatchingHub
28 November 2017 20:07
What we did was to pilot a blended therapy of face to face treatment with an app for men who came to ED with self-harm. #weMHNs
@MarkOneinFour
28 November 2017 20:08
RT @WeMHNurses: If you haven't had a chance to look it already, the background to tonight's chat is here http://www.wecommunities.org/tweet-chats/chat-details/4114 #wemhns
@edfreshwater
28 November 2017 20:09
Gutted I can't join in tonight #wemhns https://t.co/w6kWi1klZc
@Jones23Emma
28 November 2017 20:14
Interesting chat on research about use of an app for men who self harm #wemhns https://twitter.com/wemhnurses/status/935602493471457280
@Jones23Emma
28 November 2017 20:15
@PTSDhub @WeMHNurses @MarkOneinFour What app did you develop? #wemhns
@lisa_marzano
28 November 2017 20:15
RT @Jones23Emma: Interesting chat on research about use of an app for men who self harm #wemhns https://twitter.com/wemhnurses/status/935602493471457280
@WeMHNurses
28 November 2017 20:15
@HatchingHub "Son?" That made me sound like an old time cowboy mansplaining at you! I meant, 'so' #weMHNs
@pfrench123
28 November 2017 20:15
RT @Jones23Emma: Interesting chat on research about use of an app for men who self harm #wemhns https://twitter.com/wemhnurses/status/935602493471457280
@VanessaLGarrity
28 November 2017 20:16
@WeMHNurses I like the idea of offering face to face and technology together. Too often it seems to be ‘either’ ‘or’ #wemhns
@Jones23Emma
28 November 2017 20:16
@HatchingHub Wow that sounds complex #wemhns
@Jones23Emma
28 November 2017 20:17
@VanessaLGarrity @WeMHNurses Yeah and there should be choice too #wemhns
@WeMHNurses
28 November 2017 20:18
@HatchingHub For non specialists, rx means prescriptions. #weMHNs
@Jones23Emma
28 November 2017 20:18
@ScottMHC14 @HatchingHub Yes absolutely agree #wemhns
@WeMHNurses
28 November 2017 20:18
@HatchingHub Did the men who took part like the mixture? #weMHNs
@VanessaLGarrity
28 November 2017 20:19
@Jones23Emma @WeMHNurses Yes I agree. Tech solutions are not for everyone and I like the idea of a blended approach #wemhns
@CraigMacKie12
28 November 2017 20:19
@WeMHNurses @HatchingHub Hehe "Son". #WeMHNs From my side, the connection seemed similar to the kind of connection… https://t.co/AoWsHP7Vvz
@VanessaLGarrity
28 November 2017 20:19
@HatchingHub Are there any peer support elements within the app? #wemhns
@menhealuk
28 November 2017 20:23
@VanessaLGarrity @Jones23Emma @WeMHNurses #wemhns I've found apps to be good, when I am unable to connect with peop… https://t.co/wyDRWqwp0M
@WeMHNurses
28 November 2017 20:23
RT @menhealuk: @VanessaLGarrity @Jones23Emma @WeMHNurses #wemhns I've found apps to be good, when I am unable to connect with peop…
@WeMHNurses
28 November 2017 20:24
This sounds promising! Men who used app with other support #weMHNs https://t.co/sN6HuzWcwP
@Jones23Emma
28 November 2017 20:24
@UCLanMH @UCLanNurses #wemhns https://t.co/iYeLGFsJQD
@WeMHNurses
28 November 2017 20:26
But what help do you reckon men who self harm need from health services that they don't usually seem to get? #wemhns
@lisa_marzano
28 November 2017 20:26
RT @WeMHNurses: This sounds promising! Men who used app with other support #weMHNs https://twitter.com/HatchingHub/status/935604339757891584
@menhealuk
28 November 2017 20:28
@CraigMacKie12 @VanessaLGarrity @Jones23Emma @WeMHNurses Definitely agree on habits. #WeMHNs. I have been so distre… https://twitter.com/i/web/status/935606248132759557
@lisa_marzano
28 November 2017 20:29
@WeMHNurses @HatchingHub #wemhns do you think this would hold for longer interventions?
@menhealuk
28 November 2017 20:29
@CraigMacKie12 @VanessaLGarrity @Jones23Emma @WeMHNurses #WeMHNs So in short, we need to provide methods that are h… https://twitter.com/i/web/status/935606510260047877
@UCLanMH
28 November 2017 20:29
#wemhns chat on now https://twitter.com/wemhnurses/status/935606297260646400
@Jones23Emma
28 November 2017 20:29
RT @menhealuk: @CraigMacKie12 @VanessaLGarrity @Jones23Emma @WeMHNurses #WeMHNs So in short, we need to provide methods that are h…
@menhealuk
28 November 2017 20:29
@beebopbryant #WeMHNs
@Smacl007
28 November 2017 20:29
#WeMHNs I agree - mobile health technologies seems to easily make the transition into being part of every day life… https://twitter.com/i/web/status/935606603897638912
@WeMHNurses
28 November 2017 20:29
RT @menhealuk: @CraigMacKie12 @VanessaLGarrity @Jones23Emma @WeMHNurses Definitely agree on habits. #WeMHNs. I have been so distre…
@pfrench123
28 November 2017 20:29
RT @lisa_marzano: @WeMHNurses @HatchingHub #wemhns do you think this would hold for longer interventions?
@VanessaLGarrity
28 November 2017 20:29
RT @menhealuk: @CraigMacKie12 @VanessaLGarrity @Jones23Emma @WeMHNurses #WeMHNs So in short, we need to provide methods that are h…
@CatalyseC
28 November 2017 20:29
RT @WeMHNurses: But what help do you reckon men who self harm need from health services that they don't usually seem to get? #wemhns
@gowiththat27
28 November 2017 20:33
@WeMHNurses Trauma Informedness - what happened to you? Safety - being safe and feeling safe #WeMHNs
@WeMHNurses
28 November 2017 20:34
RT @Smacl007: #WeMHNs I agree - mobile health technologies seems to easily make the transition into being part of every day life…
@lisa_marzano
28 November 2017 20:35
@Luciek11K @WeMHNurses #WeMHNs can blended therapies make this easier by letting ppl discuss difficult stuff in their own time and space?
@mervemolla
28 November 2017 20:35
#EBP #WeMHNs @Mental_Elf Just wondering about the aspect of the app that provides clinicians with an alert if par… https://twitter.com/i/web/status/935608143492546560
@WeMHNurses
28 November 2017 20:36
RT @lisa_marzano: @Luciek11K @WeMHNurses #WeMHNs can blended therapies make this easier by letting ppl discuss difficult stuff in their own…
@lisa_marzano
28 November 2017 20:36
@Luciek11K @WeMHNurses #WeMHNs ... rather than necessarily in a face-to-face context ...
@mervemolla
28 November 2017 20:36
#EBP #WeMHNs @Mental_Elf What does this mean for clinician responsibility out of hours? Is this feasible to implement in practice?
@WeMHNurses
28 November 2017 20:36
@menhealuk @CraigMacKie12 @VanessaLGarrity @Jones23Emma From @VanessaLGarrity somehow switched account there #wemhns
@WeMHNurses
28 November 2017 20:37
We're over half way through tonight's chat. Thanks for coming and discussing what is, it will feel to many, such a personal subject #wemhns
@lisa_marzano
28 November 2017 20:37
@CraigMacKie12 #WeMHNs how was this 'resourced'? Who was at the other end in case of crisis?
@Luciek11K
28 November 2017 20:38
@lisa_marzano @WeMHNurses The difficult stuff could wait until the person feels safe and in control #WeMHNs
@VanessaLGarrity
28 November 2017 20:38
@lisa_marzano @CraigMacKie12 Snap! #wemhns
@mervemolla
28 November 2017 20:39
#EBP #WeMHNs @Mental_Elf What does this mean for clinician responsibility out of hours? Is this feasible to implement in practice? 2/2
@JohnBaker_Leeds
28 November 2017 20:39
RT @WeMHNurses: But what help do you reckon men who self harm need from health services that they don't usually seem to get? #wemhns
@SharonHhealth
28 November 2017 20:39
RT @Jones23Emma: Interesting chat on research about use of an app for men who self harm #wemhns https://twitter.com/wemhnurses/status/935602493471457280
@lisa_marzano
28 November 2017 20:40
@Luciek11K @WeMHNurses #WeMHNs agree & really interested in this aspect...do you think this can/should also be done outside therapy context?
@menhealuk
28 November 2017 20:41
@beebopbryant @MattTwoTees Thanks Patricia (and Matt). The chat is here (it's about technology and male self-harm): #WeMHNs
@lisa_marzano
28 November 2017 20:42
@Luciek11K @WeMHNurses #weMHNs & linked to this, how safe/appropriate to have standalone apps for self-harm?
@CraigMacKie12
28 November 2017 20:43
@VanessaLGarrity @lisa_marzano #WeMHNs That's one the major tripping points right there. You need someone on the ot… https://twitter.com/i/web/status/935610043138842624
@Smacl007
28 November 2017 20:46
@HatchingHub #WeMHNs The app does provide connections to after hours care through distress centre lines and emergen… https://twitter.com/i/web/status/935610768698908672
@Jones23Emma
28 November 2017 20:46
@menhealuk @WeMHNurses Really interesting points #wemhns
@WeMHNurses
28 November 2017 20:47
@Smacl007 @HatchingHub Is there a link to the app you used anywhere, or a description of exactly how it works? #weMHNs
@menhealuk
28 November 2017 20:48
@WeMHNurses #wemhns I think it would be immensely difficult to design a system like that which was genuinely unifie… https://twitter.com/i/web/status/935611321776791552
@pfrench123
28 November 2017 20:49
RT @WeMHNurses: @Smacl007 @HatchingHub Is there a link to the app you used anywhere, or a description of exactly how it works? #weMHNs
@menhealuk
28 November 2017 20:49
@WeMHNurses #wemhns Benefits? People who aren't up to face to face at times, could use the app instead. Also the ap… https://twitter.com/i/web/status/935611657056931842
@lisa_marzano
28 November 2017 20:51
@ScottMHC14 @CraigMacKie12 @VanessaLGarrity #weMHNs no easy or universal solutions -but important to be v clear about support actually there
@pfrench123
28 November 2017 20:52
Surely benefits have been hinted at already - anything that increases choice is a positive #wemhns https://twitter.com/menhealuk/status/935611657056931842
@WeMHNurses
28 November 2017 20:52
@organiclemon The desire for dignity and respect are such powerful motivators #weMHNs
@CraigMacKie12
28 November 2017 20:53
@VanessaLGarrity @lisa_marzano #WeMHNs Agreed. That's the model I imagine as well. The question then becomes whethe… https://twitter.com/i/web/status/935612684455723008
@mervemolla
28 November 2017 20:54
@HatchingHub #WeMHNs I guess what I wondered was whether clinician in the study was expected to attend to participa… https://twitter.com/i/web/status/935612876974379009
@pfrench123
28 November 2017 20:54
RT @WeMHNurses: @organiclemon The desire for dignity and respect are such powerful motivators #weMHNs
@menhealuk
28 November 2017 20:54
@HatchingHub @WeMHNurses #WeMHNs Thanks for clarifying. Article: Patients with Challenging Behaviors: Self-Injury a… https://twitter.com/i/web/status/935612994968539137
@CoProNorfolk
28 November 2017 20:55
RT @Jones23Emma: @menhealuk @WeMHNurses Really interesting points #wemhns
@lisa_marzano
28 November 2017 20:55
@WeMHNurses #weMHNs if blended approaches help ppl engage with therapy, how do encourage ppl to engage with blended care in 1st place?
@CraigMacKie12
28 November 2017 20:55
@VanessaLGarrity @lisa_marzano #WeMHNs is somehow maintained solely during something like "billable hours," I do wo… https://twitter.com/i/web/status/935613059669770241
@SharonHhealth
28 November 2017 20:55
@WeMHNurses @WeMHNurses #Wemhns feels OK to use app and face to face when stronger
@organiclemon
28 November 2017 20:55
RT @menhealuk: @WeMHNurses #wemhns Benefits? People who aren't up to face to face at times, could use the app instead. Also the app could i…
@Jones23Emma
28 November 2017 20:56
Last 5 mins #wemhns https://t.co/YuAK7Q7ZV0
@organiclemon
28 November 2017 20:56
@WeMHNurses In your research how would you tackle the silent ones? #WeMHNs
@organiclemon
28 November 2017 20:56
RT @WeMHNurses: @organiclemon The desire for dignity and respect are such powerful motivators #weMHNs
@CatalyseC
28 November 2017 20:56
RT @lisa_marzano: @WeMHNurses #weMHNs if blended approaches help ppl engage with therapy, how do encourage ppl to engage with blended care…
@WeMHNurses
28 November 2017 20:57
RT @lisa_marzano: @CraigMacKie12 #WeMHNs how was this 'resourced'? Who was at the other end in case of crisis?
@WeMHNurses
28 November 2017 20:57
RT @CraigMacKie12: @VanessaLGarrity @lisa_marzano #WeMHNs That's one the major tripping points right there. You need someone on the ot…
@lisa_marzano
28 November 2017 20:57
@organiclemon @WeMHNurses #WeMHNs good point!
@WeMHNurses
28 November 2017 20:57
RT @CraigMacKie12: @VanessaLGarrity @lisa_marzano #WeMHNs is somehow maintained solely during something like "billable hours," I do wo…
@mervemolla
28 November 2017 20:58
@WeMHNurses #WeMHNs benefits could be availability of choice, extra support, being able to get help through the app during daily life.




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 Total tweets: 98
 Total reach: 657,833

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