Hodges' Model: Welcome to the QUAD: seclusion

Hodges' model is a conceptual framework to support reflection and critical thinking. Situated, the model can help integrate all disciplines (academic and professional). Amid news items, are posts that illustrate the scope and application of the model. A bibliography and A4 template are provided in the sidebar. Welcome to the QUAD ...

Showing posts with label seclusion. Show all posts
Showing posts with label seclusion. Show all posts

Thursday, July 06, 2023

Paper: "How can we mainstream mental health in research engaging SDGs? -

A theory of change." i

This paper caught my eye on twitter, quite a while ago - the combination of mental health and SDGs:

Madill A, Bhola P, Colucci E, Croucher K, Evans A, et al. (2022) How can we mainstream mental health in research engaging the range of Sustainable Development Goals? A theory of change. PLOS Global Public Health 2(8): e0000837. https://doi.org/10.1371/journal.pgph.0000837

"The recently updated WHO Comprehensive Mental Health Action Plan 2013–2030 [1] concurs with this vision in that two of its six cross-cutting principles are: (i) a multi-sectoral approach, and (ii) action on social determinants. This acknowledges that “integrating mental health across wider sectors such as education, employment and social welfare helps address social determinants of mental health and ensures a comprehensive and holistic approach” [7 p12]. Shen, Eaton and Snowden [8] investigated mental health mainstreaming in 42 countries in terms of a shift towards providing mental health care from institutional to community settings. They concluded that “different countries have adapted deinstitutionalization in ways to meet idiosyncratic situations and population needs” [7 p313] and that more needs to be done with regard to management and implementation strategies. While the keyword for Shen, Eaton and Snowden [8] is ‘deinstitutionalisation’, for Gómez-Dantés and Frenk [9] it is ‘integration,’ and they provide a dimensional approach with regard to what is involved in mainstreaming mental health: “(i) incorporating mental disorders to the global and local agendas related to NCDs [non-communicable diseases]; ii) moving away both from the biological and sociological reductionisms around mental health prevalent in the past century; iii) addressing the whole range of conditions related to mental health; iv) migrating from the idea that mental diseases have to be treated in secluded clinical spaces; and v) expanding the use of a comprehensive approach in the treatment of these disorders, which includes medication, psychotherapy and other types of therapies” [9 p214]." p.2/23

Selected concepts are related to Hodges' model below. In addition to the 2x2 table below, it may be useful for visitors to consider the paper's figures against the model? There is no doubt an overlap across the care / knowledge domains of Hodges' model, but hopefully the 'holistic bandwidth' of the model and its potential as a generic conceptual framework will also be highlighted. 

Note for example the way mention of 'clinical' tends to attract care (understandably) to clinics, hospitals, institutions, controlled (mechanistic) spaces where resources can be controlled and concentrated. Additionally, to find appropriate concepts, we must appreciate how 'local' is applied not only geographically, regionally, but culturally also - within and across a community, or several.

Hodges' model provides several disciplinary bridges of relevance here:
  • psycho-political
  • psycho-social
  • socio-economic
  • socio-political
  • bio-social
I will revisit the paper again soon ii.

INDIVIDUAL
|
INTERPERSONAL    :     SCIENCES               
HUMANISTIC --------------------------------------  MECHANISTIC      
SOCIOLOGY  :   POLITICAL 
|
GROUP

intra-personal - mental health 
(contribution to individual's
overall health status)

self advocacy

qualitative evidence

mental health practitioners

psychotherapy, counselling

individual health literacy/education

"Implications for researchers include: recognising the potential of their projects to have psycho-

quantitative evidence

time, environment, geography - locale

treatment

resources (time and physical - space)

digital technologies

'clinical' seclusion spaces

multiple locally-appropriate concepts

'clinical spaces' seclusion/isolation

 -social wellbeing impact"*


"collaborating with local communities, researchers, and service providers to effect change."

"developing a more inclusive and flexible language around mental health that bridges cultures and disciplines ..."

multiple locally-appropriate concepts

resources  - social, family, community

LMICs - 'workforce gap'

shift from institutionalised to community settings

security - conflict

advocacy

resources
$$$ income/welfare/micro-finances/
banking/digital access

legislation, policies,
strategies and services


*The paper also refers to "psychosocial disabilities".


My source (twitter):
https://twitter.com/PLOSGPH/status/1565066449798205440?s=20

Madill A, Bhola P, Colucci E, Croucher K, Evans A, et al. (2022) How can we mainstream mental health in research engaging the range of Sustainable Development Goals? A theory of change. PLOS Global Public Health 2(8): e0000837. https://doi.org/10.1371/journal.pgph.0000837

Wednesday, June 28, 2023

ii Design with People in Mind: Seclusion Issue related to Hodges' model

The Seclusion Issue



INDIVIDUAL
|
     INTERPERSONAL    :     SCIENCES               
HUMANISTIC --------------------------------------  MECHANISTIC      
SOCIOLOGY  :   POLITICAL 
|
GROUP

psychological harm / safety / seclusion

privacy, dignity and respect

Sensory stimuli, calm, distraction

Parity of Esteem

psychological restraint/control

Reaching for the person amid complexity

Staff / Service User attitudes to x,y,z

Lived/Patient experience
sensory -

NATURE - outdoors 'Green'

Design: (sterile?) space, colour, temperature, walls, light, warmth, cold, fresh air, homely/clinical, doors - locks, alarms, noise, violence resistant spaces ...

physical agression / harm / safety / seclusion

'built' environment / 'sensory room'

physical restraint/control, clothing, toilet, access to outdoors

Ecological and Integrative Physiology

- modulation

Social spaces

supportive spaces

scope for therapy

social autonomy

community

music / arts

experience in isolation - stigma in-situ?

trauma-informed services

in-patient services, funding

risk reduction; policies

use of technology/observation

length of stay, reporting

impact of restraint on staff






Hodges' model is situated and can be used in all health, educational and policy contexts.

Hodges' model can assist to initially scope, plan and evaluate research studies not only across all the care (knowledge) domains above (including the spiritual) but the model's structure incorporates such dichotomies as subjective-objective; qualitative-quantitative; person-services; patient-staff; therapy-control/restraint; person-centred--service-centred; private/personal-public; care-custodial; psycho-political; socio-technical and others.



There is of course much more that could be added above, and relationships considered between concepts and perspectives: the patient's, nurse's, doctor's, the multidisciplinary team, manager's, policy makers, architect,s anthropologists, public, professional and regulatory bodies and commissioners?





Please keep 'me' safe safely - yes, and the team!


Even though and especially because I may not currently know exactly who - how ...  I am?






My source: https://twitter.com/DIMHN

Related post i

Sunday, June 25, 2023

Design with People in Mind Books - The Seclusion Issue

Design with People in Mind
The Seclusion Issue


Design with People in Mind is the Design in Mental Health Network’s annual round up of the latest research evidence on therapeutic outcomes and the evidence for them relating to the built environment in mental health. In partnership with London Southbank University and Nottingham Trent, so far we’ve looked at a variety of issues, from nature to sound design to boundaries and borders. The latest issue is Seclusion, launched at this years conference and focusing on the evidence for and impact of the practice of seclusion units, how to use them if at all, and best practice in the field to maintain psychological as well as physical safety for service users and staff.



The link to the publication is: 

https://dimhn.org/wp-content/uploads/2023/06/1DWPIM_I8_250x210_24PP_AW_V02_HI_RES.pdf

It’s a member only resource, so you will need to register (free for individuals) before viewing.

Very best,

Hannah

Hannah Chamberlain
CEO
Design in Mental Health Network
m: 07811169609
www.dimhn.org


My source: https://twitter.com/DIMHN

See also:
ii Design with People in Mind