Mental health crisis assessments

Oral Presentation 2
Dr Paula Houton, Ms Lisa Morrison, Dr May McCann, Prof Gerry Gormley, Prof Gavin Davidson, Dr Helen Reid, Dr Paul Murphy

Mental health crisis assessments: feasibility study using an interdisciplinary, forum theatre-based, simulation framework

Introduction
Mental health crisis assessments are complex, involving a range of professionals including general practitioners, approved social workers, police officers, paramedics and psychiatrists. These assessments necessitate high-level communication skills, interdisciplinary team-working and confidence in making complex decisions. However there are disparities between expected competencies and education, with a call for interdisciplinary, experiential learning. In response, we developed a learning approach; an interdisciplinary, simulation framework based on the principles of forum theatre.

Objectives
To assess the feasibility of using a novel, interdisciplinary, forum theatre-based simulation approach to prepare for mental health crisis assessments. This study assessed participants acceptance of the teaching approach and evaluation design.

Methods
Two half-day simulation training workshops were designed and delivered as part of a feasibility study in line with the Medical Research Council’s framework for developing and evaluating complex interventions. Each workshop commenced with a pre-scripted anti-model play depicting a mental health crisis in the community. Participants (n=68) included approved social worker trainees (n=27), general practitioner trainees (n=22) and police officers (n=19) who each attended a single workshop. Data was collected using pre and post-event questionnaires and eight focus groups. There was personal and public involvement in all aspects of this research. Afterwards, the research team reflected on the feasibility of delivering this educational approach.

Outcomes
Quantitative and qualitative data confirm this training was feasible and popular. All participants would recommend this training approach to a colleague. The overall acceptability rating was high (average rating of 4.73/5). All participants ranked this learning experience as “good” or above, with the majority (58%) giving an “excellent” rating. Template analysis generated eight themes which support this training approach and evaluation design; 1) More of the same: there is a need for training like this, 2) Being present in the moment: embodied learning, 3) Better than role play: authentic learning, 4) Collective perspectives: the benefit of interdisciplinary learning, 5)Safe space to learn, 6) The importance of ground rules, 7) Group size: getting the sweet spot and 8)Evaluation methods: practical and multi-functional.

Conclusion
Feedback was universally positive, supporting the feasibility and acceptability of this novel, interdisciplinary learning approach. This simulation framework has great potential for more effectively preparing people for a wide range of complex, high-risk, high-stress assessment and planning processes across health and social care.