Guest blog post from Professor Len Bowers, Institute of Psychiatry, Kings College London
SUGAR contribution to Safewards study.
The group contributed in different ways to different stages of the Safewards project. Read more about the project here.
Ethics: The preparation of an ethics proposal for a cluster randomised controlled trial was complex and a sensitive issue, especially as we proposed to ask only for staff consent, and for the Trust CEO to give signed consent on behalf of the patient on the ward. As part of our application we developed and ethics statement. SUGAR spent a session consulting on the underlying issues, and this discussion was summarised in the ethics statement – including the opposing views voiced in the group.
Intervention generation: Ideas for interventions were checked out with the group at an early stage. Sometimes this involved significant work, such as a whole session that was taken up with discussing the nature of patient requests to staff, and a workable format for a ‘request book’ that could be presented in a respectful way and that maintained patient confidentiality. At other times the group contributed to a lesser but still significant degree by assisting in the identification of patient-friendly titles for the interventions and what we were trying to do. Most critically, for several of the proposed interventions SUGAR created guidance on the actual content or composition of the intervention. They helped to identify contents for the calm down box. They devised a long list of potentially positive aspects of patients and their behaviour that staff could draw each other’s attention to as part of positive words. And they generated a lengthy list of potential ways that patients could help and support each other on the ward, for inclusion in the mutual help meeting. These were all critical and important contributions for the success of the Safewards interventions.
Intervention selection: SUGAR formed part of the formal consultation process that led to the selection of the final 16 interventions that were included in the pilot study. Their consultation occurred after the two groups of professional experts had met to consider the shortlist of 30 interventions. SUGAR made a distinctive contribution at this stage. They overruled the professional experts and insisted on the inclusion of two interventions rated much lower by the professionals.
Watch videos explaining the Safewards model and its implementation in different mental health settings on their YouTube channel here.