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Mental health nursing

The 13th European Congress of Mental Health in Intellectual Disability (EAMHID) was held in Berlin, Germany, September 23- 25, 2021. The central theme was 'From Science to Practice'. To kick off sharing the knowledge we have interviewed some of the keynote speakers. This is an interview with Trine Lise Bakken, Researcher PhD at Oslo University Hospital in Norway.


 

Research, intellectual disabilities and mental health (or challenging behaviour). What comes to mind reading these key words? 

Research on psychosocial interventions related to mental health issues in intellectual disability (ID) is still in its infancy. However, methods developed for the general population seem to also work for people with ID. So, more interventions should be adapted for people with ID.

 

What is the main research objective/theme/focus of the study you will be presenting? What are the main results from your study?

The main topic of the presentation is how mental health nursing may be adapted for patients with ID. Results from four studies will be presented. One study found that certain ways of communication elicited more organised behaviour in severely disturbed patients with psychosis, intellectual disability, and autism. The same study confirmed clinical experience; that more experienced staff members communicate more effectively than less experienced staff members. Another study found that behavioural equivalents to psychotic symptoms are helpful in the identification of psychosis in patients with ID. A third study examines ways of validating patients with ID in inpatient mental health settings. The last study presents results from a study on patient experiences of the ward atmosphere (read: emotional climate) in a specialised mental health inpatient unit for patients with ID.


 

How might outcomes of your (previous) studies affect daily practice in the support of persons with intellectual disabilities and mental health disorders and/or challenging behaviour? How can daily care improve their support based on your study/work?

Outcomes of studies that I have previously participated in have clinical implications both regarding assessment and interventions in the field of mental health in ID, especially in Norway and Scandinavia. In Scandinavia, there are few practitioners in this field, and mental health services are still fragmented.

The study on behavioural equivalents published in 2007 has been included in book chapters in Scandinavia and has also been quoted in the DM-ID (in the chapter on psychosis). However, the use of behavioural equivalents is also important in mental health nursing for patients with ID and additional psychosis. These patients are known to display a high symptom burden, especially in acute phases of the illness. The symptom burden may shift within days, even minutes. Hence, assessment of the “here-and-now” symptom burden is crucial in mental health nursing.

Research which includes patient input may inform future mental health nursing in this field through the patients’ experiences of ward atmosphere when being admitted to inpatient treatment.


 

Can you suggest topics for future studies you will be working on? How can we better implement scientific findings in daily practices?

I will continue to work on practitioner skills, both in mental health nursing and in psychotherapy for patients with mental illness and additional ID.

In Norway, we recently launched a national network on mental health in ID, only for professionals at present. Later we will include users of the services.

Ward atmosphere (same as emotional climate) is important not only in mental health inpatient units, but also in community services. To conduct high quality research in this field, service users must be included, both regarding planning and conducting studies, and when interpreting results against the backdrop of users’ daily lives.