How can a library work with clinical staff in a high secure hospital? Catherine McCafferty Knowledge...
22
How can a library work with clinical staff in a high secure hospital? Catherine McCafferty Knowledge & Library Services Manager
-
Upload
beatrice-little -
Category
Documents
-
view
216 -
download
2
Transcript of How can a library work with clinical staff in a high secure hospital? Catherine McCafferty Knowledge...
How can a library work with clinical staff in a high secure
hospital?
Catherine McCaffertyKnowledge & Library Services
Manager
The setting
• Ashworth Hospital, Liverpool
• 250 patients live in 18 wards
• Referrals courts, prisons, other secure or mental health settings
• Severe mental illness, personality disorder or neuro-cognitive difficulties
As a librarian in this setting….
•Manage a small public library for patients
•Work with clinical staff
•Develop safe practices
•Collaborate with local authority
•Support library staff with delivery
What could library use tell clinicians at Ashworth?
• About general interests of patients• Indicate an interest in private study• Show a continued interest from pre-admission• Demonstrate an interest in the world outside• Indicate ‘attitude’
Day in the life of a patient
Psychiatrist
Rehabilitation Staff
Psychotherapist
Occupational Therapist
NursesSocial Worker
Library?
Security Liaison
Where does the care team get information?
• Previous health and care records• Offence history and accounts• Prison Service reports• Social work records and reports• Psychological tests• Nursing reports• Reports from workshops and education• Telephone conversations• Random drug testing
How does the Care Team use information?
Information gathering
Record keeping
Using information
INFORMATION STAGE
Psychological testing
Information sharing
Use of information
Making Sense
Validation
SENSE MAKING
Truthfulness
Synthesise/Layers
Report writing
Corroboration
Personalities in team
Team dynamics
THE MDT TASK
Complexity of task
Decision making
Team working
Treatment
Personality assessment
CLINICAL TASK
Diagnosis
Risk Assessment
Assessment
Role of the psychotherapist
•gathering information that would inform the relevant psychological tests needed
•making sense of that information by listening to other professionals reports of activities and events in order to corroborate and validate
•regularly attend meetings and contribute to the MDT task
•contributing the psychological perspective to the clinical task
•working towards the overall aim of ASSESSMENT
How I added new information to this process
•Attended care teams over 8 months
•Presented library loans for individuals
•Gave broad context for material
•Recorded responses from care team members
‘Gives an interesting insight’PSYCHIATRIST
Healthy Interest:
.....in discussions the material caused noissues of concern
‘Doesn’t surprise me –
he’s interested in history’ SOCIAL
WORKER
‘All very normal – good for him’ PSYCHIATRIST
‘I’m glad he’s being flexible in his selections’
OCCUPATIONAL THERAPIST
‘Nothing to worry about in that lot’PSYCHIATRIST
‘Are we worried?’ PSYCHIATRIST, ‘There is a theme’
Unhealthy Interest:
....in discussions the material did cause
some concern
‘Was he a member of a gang?’ PSYCHIATRIST
‘This could be an indication of
his illness’PSYCHOTHERAPIST
‘I have seen that film it is horrifically violent’ NURSE MANAGER
‘What a contradiction’’PSYCHIATRIST
Neither healthy nor unhealthy
...comments were very general
‘Nothing too exciting’
PSYCHIATRIST
‘He’s in the music group’SOCIAL WORKER
‘You’d expect it to be all immature
stuff’ PSYCHIATRIST
Other
...a considerationof other factors
‘Different to what he’s asking his
partner for’SECURITY LIAISON
‘Who chooses the books for the library?...Is it appropriate to have books on
gangs?’ PSYCHIATRIST
‘Do we check the content of these titles regarding
present patient population...’
PSYCHOTHERAPIST
That’s his kind of title...Ask him
about the movie – why
did he choose it?’
PSYCHIATRIST
Themes from MDT interviews - 1
•Insight into patients interests•‘..if prior to that people had asked me what do they read what do they watch, I wouldn’t be able to say.’ PSYCHIATRIST
•Clinical relevancy•Indicator of mental state
•‘What they are reading could be a marker – the Bible is a very clear one for some people – if they get the Bible out then they’re deteriorating’ SOCIAL WORKER
•Indicator of risk•‘....not diagnosis possibly risk – if a person with index offences and then they are continuing an interest in these activities that would be helpful I think. CHECK ’PSYCHIATRIST
•Trigger signals
Themes from MDT interviews - 2
•Development of the workAround stock selection ; reporting systems & timing of the information provision
•Practical insightsAround patients organisational skills; literacy ability
Next steps.......
•How to continue with the information provision?
•Support for stock selection?
•How can the care team interpret the meaning?
