Hospital admissions provide a “teachable moment”. Many patients admitted to mental health hospitals have co-existing substance misuse. As acute symptoms decline, a window of increased insight into factors that contributed to becoming unwell and admission may present. This study used this “teachable” opportunity to assess the acceptability of delivering a brief integrated motivational intervention (BIMI) to inpatients and the feasibility of delivery by inpatient staff. Qualitative interviews were completed  with 21 inpatients experiencing co-occurring schizophrenia-related or bipolar disorder diagnoses and substance misuse who received the BIMI. Twelve staff members completed either individual interviews or a focus group. Four themes were identified from the qualitative interviews with participants; these were openness/readiness to talk about substance use, feeling valued, understanding substance use and helpful skills and processes; each with a number of subthemes. Participants appeared to find the intervention useful; although, felt they did not always have the “headspace”. One theme emerged from the staff data, the acceptability of the approach for inpatient ward staff, which had four subthemes; training in the intervention; delivering the intervention; joint working; and feasibility. Staff considered the targeted style of the BIMI useful. Delivery considerations included “timing” and competing ward duties. Hospital admission presents a natural window of opportunity for staff to start conversations with inpatients about substance misuse.

background or methods

/pdf/mental-health-hospital-admissions-a-teachable-moment-and-2lv7j1bgqr.pdf

Brief Integrated Motivational Intervention:a Treatment Manual for Co-occurring Mental Health and Substance Use Problems

Mental Health Hospital Admissions: a Teachable Moment and Window of Opportunity To Promote Change in Drug and Alcohol Misuse

Purpose:
To provide a summary of the principles, theories and basic components of a recently developed brief integrated motivational intervention (BIMI) for working with individuals experience co-ccurring severe mental health and substance use problems in inpatient settings, including the outcomes of a feasiblity randomised controlled trial (RCT). There are greater financial costs and a negative impact on functioning associated with psychiatric admissions for people who experience co-occurring severe mental heath and substance misuse problems. In addition, their engagement in treatment is often problematic.

Design/methodology/approach:
The BIMI described was evaluated via a feasibility RCT that assessed whether the opportunity to discuss use of substances whilst on an inpatient ward represented an opportunity to engage inpatients in thinking about their use and the impact it has on their mental health.
 

Findings:
The BIMI is delivered in short burst sessions of 15-30 minutes over a two-week period adopting a simple 3-step approach that can be delivered by routine ward staff. It incorporates an assessment of substance use, mental health and motivation followed by personalised feedback, a focus on increasing awareness of the impact on mental health and development of goals and a change plan. The intervention has been shown to lead to higher levels of engagement in clients exploration of substance use and the impact on mental health. Findings suggest both staff and inpatients found the intervention feasible and acceptable.

Originality/value:
Routine ward staff were trained to deliver a brief intervention to inpatients during an acute hospital admission.

/pdf/substance-misuse-brief-interventions-during-psychiatric-47n4spsstg.pdf

Brief Integrated Motivational Intervention:a Treatment Manual for Co-occurring Mental Health and Substance Use Problems

Citations

Mental Health Hospital Admissions: a Teachable Moment and Window of Opportunity To Promote Change in Drug and Alcohol Misuse

Substance misuse brief interventions during psychiatric hospital admissions

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