Tamar Jeynes - Academia.edu (original) (raw)
Papers by Tamar Jeynes
Social Psychiatry and Psychiatric Epidemiology, 2022
Purpose We sought to understand how the experiences of people in the UK with pre-existing mental ... more Purpose We sought to understand how the experiences of people in the UK with pre-existing mental health conditions had developed during the course of the COVID-19 pandemic. Methods In September–October 2020, we interviewed adults with mental health conditions pre-dating the pandemic, whom we had previously interviewed 3 months earlier. Participants had been recruited through online advertising and voluntary sector community organisations. Semi-structured qualitative interviews were conducted by telephone or video-conference by researchers with lived experience of mental health difficulties, and, following principles of thematic analysis, were analysed to explore changes over time in people’s experience of the pandemic. Results We interviewed 44 people, achieving diversity of demographic characteristics (73% female, 54% White British, aged 18–75) and a range of mental health conditions and service use among our sample. Three overarching themes were derived from interviews. The first ...
Background: Telemental health (delivering mental health care via video calls, telephone calls or ... more Background: Telemental health (delivering mental health care via video calls, telephone calls or text messages) is increasingly widespread. Telemental health appears to be useful and effective in providing care to some service users in some settings, especially during an emergency restricting face-to-face contact such as the COVID-19 pandemic. However, important limitations have been reported, and telemental health implementation risks reinforcing pre-existing inequalities in service provision. If it is to be widely incorporated in routine care, a clear understanding is needed of when and for whom it is an acceptable and effective approach, and when face-to-face care is needed. Objective: The aim of this rapid realist review was to develop theory about which telemental health approaches work, or do not work, for whom, in which contexts and through what mechanisms. Methods: Rapid realist reviewing involves synthesising relevant evidence and stakeholder expertise to allow timely devel...
BMC Psychiatry, 2022
There is consensus that services supporting people with complex emotional needs are part of a men... more There is consensus that services supporting people with complex emotional needs are part of a mental health care system in which change is needed. To date, service users’ views and co-production initiatives have had little impact on the development of interventions and care. This needs to change, and our paper evidences the experiences and perspectives of a diverse range of people on how community services can best address the needs of people with complex emotional needs. A co-produced qualitative research study. Lived experience researchers led data collection and analysis. Individual interviews were conducted with 30 people across England who had a diverse range of experiences and perspectives of using community services for complex emotional needs. Participants were asked about their experiences of using community services for their mental health, and views on how community services can best address their needs. Thematic analysis was used to analyse the data. Participants reporte...
PurposeWe sought to understand how the experiences of people in the UK with pre-existing mental h... more PurposeWe sought to understand how the experiences of people in the UK with pre-existing mental health conditions had developed during the course of the COVID-19 pandemic.MethodsIn September-October 2020 we interviewed adults with mental health conditions pre-dating the pandemic, whom we had previously interviewed three months earlier. Participants had been recruited through online advertising and voluntary sector community organisations. Interviews were conducted by telephone or video-conference by researchers with lived experience of mental health difficulties, and explored changes over time in people’s experience of the pandemic.ResultsWe interviewed 44 people, achieving diversity of demographic characteristics and a range of mental health conditions and service use among our sample. Three overarching themes were derived from interviews. The first theme “Spectrum of adaptation”: to difficulties in access to, or the quality of, statutory mental health services, through developing ...
BackgroundService provision for people with complex emotional needs (CEN) is recurrently identifi... more BackgroundService provision for people with complex emotional needs (CEN) is recurrently identified as needing to be transformed: there are serious concerns about quality, accessibility, fragmentation of the service system and the stigma and therapeutic pessimism service users say they encounter. We use the term CEN as a working description to refer to the needs experienced by people who may have been diagnosed with a ‘personality disorder’. Understanding clinician perspectives is vital for service transformation, as their views and experiences shed light on potential barriers to achieving good care, and how these might be overcome. In this study, we aimed to explore these views.MethodsWe used a qualitative interview design. A total of fifty participants from a range of professions across specialist and generic community mental health services across England who provide care to people with CEN took part in six focus groups and sixteen one-to-one interviews. We analysed the data usin...
Background There is consensus that services supporting people with complex emotional needs are pa... more Background There is consensus that services supporting people with complex emotional needs are part of a mental health care system in which change is needed. To date, service users views and co-production exercises have had little impact on the development of treatment and care. This needs to change, and our paper evidences the experiences and perspectives of a diverse range of people on how community services can best address the needs of people with complex emotional needs. Methods A co-produced qualitative research study. Lived experience researchers led data collection and analysis. Individual interviews were conducted with 30 people across England who had a diverse range of experiences and perspectives of using community services for complex emotional needs. Participants were asked about their experiences of using community services for their mental health, and views on how community services can best address their needs. Thematic analysis was used to analyse the data. Results ...
Social Psychiatry and Psychiatric Epidemiology, 2021
Purpose Research is beginning to quantify the impact of COVID-19 on people with pre-existing ment... more Purpose Research is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time. Methods We used qualitative interviews (N = 49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team. Results Existing mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to the community. New remote ways to access mental health care, including digital solutions, provided continuity of care for so...
Introduction The need to improve the quality of community mental health services for people with ... more Introduction The need to improve the quality of community mental health services for people with Complex Emotional Needs (CEN) is recognised internationally and has become a renewed policy priority in England. Such improvement requires positive engagement from clinicians across the service system, and their perspectives on achieving good practice need to be understood. Aim To synthesise qualitative evidence on clinician perspectives on what constitutes good practice, and what helps or prevents it being achieved, in community mental health services for people with CEN. Methods Six bibliographic databases were searched for studies published since 2003 and supplementary citation tracking was conducted. Studies that used any recognised qualitative method and reported clinician experiences and perspectives on community-based mental health services for adults with CEN were eligible for this review, including generic and specialist settings. Meta-synthesis was used to generate and synthesi...
PurposeThe COVID-19 pandemic has potential to disrupt and burden the mental health care system, a... more PurposeThe COVID-19 pandemic has potential to disrupt and burden the mental health care system, and to magnify inequalities experienced by mental health service users.MethodsWe investigated staff reports regarding the impact of the COVID-19 pandemic in its early weeks on mental health care and mental health service users in the UK using a mixed methods online survey. Recruitment channels included professional associations and networks, charities and social media. Quantitative findings were reported with descriptive statistics, and content analysis conducted for qualitative data.Results2,180 staff from a range of sectors, professions and specialties participated. Immediate infection control concerns were highly salient for inpatient staff, new ways of working for community staff. Multiple rapid adaptations and innovations in response to the crisis were described, especially remote working. This was cautiously welcomed but found successful in only some clinical situations. Staff had s...
medRxiv, 2020
Background Diagnoses of personality disorder are prevalent among people using community secondary... more Background Diagnoses of personality disorder are prevalent among people using community secondary mental health services. Whilst the effectiveness of a range of community-based treatments have been considered, as the NHS budget is finite, it is also important to consider the cost-effectiveness of those interventions. Aims To assess the cost-effectiveness of primary or secondary care community-based interventions for people with complex emotional needs that meet criteria for a diagnosis of personality disorder to inform healthcare policy making. Method Systematic review (PRESPORO #: CRD42020134068) of five databases, supplemented by reference list screening and citation tracking of included papers. We included economic evaluations of interventions for adults with complex emotional needs associated with a diagnosis of personality disorder in community mental health settings published between before 18 September 2019. Study quality was assessed using the CHEERS statement. Narrative syn...
Purpose The label “Personality Disorder” continues to divide opinion. Challenges to the terminolo... more Purpose The label “Personality Disorder” continues to divide opinion. Challenges to the terminology of personality disorder led by people with lived experience and supported by critical practitioners and academics are tempered by acknowledgement of certain positive social consequences of obtaining a diagnosis. This study aims to engage service users and staff in a process of inquiry to better understand the complexities of views on the terminology of Personality Disorder. Design/methodology/approach This study set out to qualitatively explore the views of a range of people with lived, occupational and dual lived experience/occupational expertise, relating to the diagnostic label of Personality Disorder, via participatory and critical group debate. The World Café approach is an innovative methodology for participatory inquiry into subjective views suited to exploring the contested subject matter. Findings This study identified contrasting opinions towards the label of Personality Dis...
BJPsych Open
Background Diagnoses of personality disorder are prevalent among people using community secondary... more Background Diagnoses of personality disorder are prevalent among people using community secondary mental health services. Identifying cost-effective community-based interventions is important when working with finite resources. Aims To assess the cost-effectiveness of primary or secondary care community-based interventions for people with complex emotional needs who meet criteria for a diagnosis of personality disorder to inform healthcare policy-making. Method Systematic review (PROSPERO: CRD42020134068) of databases. We included economic evaluations of interventions for adults with complex emotional needs associated with a diagnosis of personality disorder in community mental health settings published before 18 September 2019. Study quality was assessed using the CHEERS statement. Results Eighteen studies were included. The studies mainly evaluated psychotherapeutic interventions. Studies were also identified that evaluated altering the setting in which care was delivered and join...
Social Psychiatry and Psychiatric Epidemiology
Purpose Research is beginning to quantify the impact of COVID-19 on people with pre-existing ment... more Purpose Research is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time. Methods We used qualitative interviews (N = 49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team. Results Existing mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to the community. New remote ways to access mental health care, including digital solutions, provided continuity of care for so...
PLOS ONE
Background There is a recognised need to develop clear service models and pathways to provide hig... more Background There is a recognised need to develop clear service models and pathways to provide high quality care in the community for people with complex emotional needs, who may have been given a “personality disorder” diagnosis. Services should be informed by the views of people with these experiences. Aims To identify and synthesise qualitative studies on service user experiences of community mental health care for Complex Emotional Needs. Methods We searched six bibliographic databases for papers published since 2003. We included peer reviewed studies reporting data on service user experiences and views about good care from community-based mental health services for adults with CEN, including generic mental health services and specialist “personality disorder” services. Studies using any qualitative method were included and thematic synthesis used to identify over-arching themes. Results Forty-seven papers were included. Main themes were: 1) The need for a long-term perspective o...
Social Psychiatry and Psychiatric Epidemiology
Purpose The COVID-19 pandemic has many potential impacts on people with mental health conditions ... more Purpose The COVID-19 pandemic has many potential impacts on people with mental health conditions and on mental health care, including direct consequences of infection, effects of infection control measures and subsequent societal changes. We aimed to map early impacts of the pandemic on people with pre-existing mental health conditions and services they use, and to identify individual and service-level strategies adopted to manage these. Methods We searched for relevant material in the public domain published before 30 April 2020, including papers in scientific and professional journals, published first person accounts, media articles, and publications by governments, charities and professional associations. Search languages were English, French, German, Italian, Spanish, and Mandarin Chinese. Relevant content was retrieved and summarised via a rapid qualitative framework synthesis approach. Results We found 872 eligible sources from 28 countries. Most documented observations and ex...
Social Psychiatry and Psychiatric Epidemiology, 2022
Purpose We sought to understand how the experiences of people in the UK with pre-existing mental ... more Purpose We sought to understand how the experiences of people in the UK with pre-existing mental health conditions had developed during the course of the COVID-19 pandemic. Methods In September–October 2020, we interviewed adults with mental health conditions pre-dating the pandemic, whom we had previously interviewed 3 months earlier. Participants had been recruited through online advertising and voluntary sector community organisations. Semi-structured qualitative interviews were conducted by telephone or video-conference by researchers with lived experience of mental health difficulties, and, following principles of thematic analysis, were analysed to explore changes over time in people’s experience of the pandemic. Results We interviewed 44 people, achieving diversity of demographic characteristics (73% female, 54% White British, aged 18–75) and a range of mental health conditions and service use among our sample. Three overarching themes were derived from interviews. The first ...
Background: Telemental health (delivering mental health care via video calls, telephone calls or ... more Background: Telemental health (delivering mental health care via video calls, telephone calls or text messages) is increasingly widespread. Telemental health appears to be useful and effective in providing care to some service users in some settings, especially during an emergency restricting face-to-face contact such as the COVID-19 pandemic. However, important limitations have been reported, and telemental health implementation risks reinforcing pre-existing inequalities in service provision. If it is to be widely incorporated in routine care, a clear understanding is needed of when and for whom it is an acceptable and effective approach, and when face-to-face care is needed. Objective: The aim of this rapid realist review was to develop theory about which telemental health approaches work, or do not work, for whom, in which contexts and through what mechanisms. Methods: Rapid realist reviewing involves synthesising relevant evidence and stakeholder expertise to allow timely devel...
BMC Psychiatry, 2022
There is consensus that services supporting people with complex emotional needs are part of a men... more There is consensus that services supporting people with complex emotional needs are part of a mental health care system in which change is needed. To date, service users’ views and co-production initiatives have had little impact on the development of interventions and care. This needs to change, and our paper evidences the experiences and perspectives of a diverse range of people on how community services can best address the needs of people with complex emotional needs. A co-produced qualitative research study. Lived experience researchers led data collection and analysis. Individual interviews were conducted with 30 people across England who had a diverse range of experiences and perspectives of using community services for complex emotional needs. Participants were asked about their experiences of using community services for their mental health, and views on how community services can best address their needs. Thematic analysis was used to analyse the data. Participants reporte...
PurposeWe sought to understand how the experiences of people in the UK with pre-existing mental h... more PurposeWe sought to understand how the experiences of people in the UK with pre-existing mental health conditions had developed during the course of the COVID-19 pandemic.MethodsIn September-October 2020 we interviewed adults with mental health conditions pre-dating the pandemic, whom we had previously interviewed three months earlier. Participants had been recruited through online advertising and voluntary sector community organisations. Interviews were conducted by telephone or video-conference by researchers with lived experience of mental health difficulties, and explored changes over time in people’s experience of the pandemic.ResultsWe interviewed 44 people, achieving diversity of demographic characteristics and a range of mental health conditions and service use among our sample. Three overarching themes were derived from interviews. The first theme “Spectrum of adaptation”: to difficulties in access to, or the quality of, statutory mental health services, through developing ...
BackgroundService provision for people with complex emotional needs (CEN) is recurrently identifi... more BackgroundService provision for people with complex emotional needs (CEN) is recurrently identified as needing to be transformed: there are serious concerns about quality, accessibility, fragmentation of the service system and the stigma and therapeutic pessimism service users say they encounter. We use the term CEN as a working description to refer to the needs experienced by people who may have been diagnosed with a ‘personality disorder’. Understanding clinician perspectives is vital for service transformation, as their views and experiences shed light on potential barriers to achieving good care, and how these might be overcome. In this study, we aimed to explore these views.MethodsWe used a qualitative interview design. A total of fifty participants from a range of professions across specialist and generic community mental health services across England who provide care to people with CEN took part in six focus groups and sixteen one-to-one interviews. We analysed the data usin...
Background There is consensus that services supporting people with complex emotional needs are pa... more Background There is consensus that services supporting people with complex emotional needs are part of a mental health care system in which change is needed. To date, service users views and co-production exercises have had little impact on the development of treatment and care. This needs to change, and our paper evidences the experiences and perspectives of a diverse range of people on how community services can best address the needs of people with complex emotional needs. Methods A co-produced qualitative research study. Lived experience researchers led data collection and analysis. Individual interviews were conducted with 30 people across England who had a diverse range of experiences and perspectives of using community services for complex emotional needs. Participants were asked about their experiences of using community services for their mental health, and views on how community services can best address their needs. Thematic analysis was used to analyse the data. Results ...
Social Psychiatry and Psychiatric Epidemiology, 2021
Purpose Research is beginning to quantify the impact of COVID-19 on people with pre-existing ment... more Purpose Research is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time. Methods We used qualitative interviews (N = 49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team. Results Existing mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to the community. New remote ways to access mental health care, including digital solutions, provided continuity of care for so...
Introduction The need to improve the quality of community mental health services for people with ... more Introduction The need to improve the quality of community mental health services for people with Complex Emotional Needs (CEN) is recognised internationally and has become a renewed policy priority in England. Such improvement requires positive engagement from clinicians across the service system, and their perspectives on achieving good practice need to be understood. Aim To synthesise qualitative evidence on clinician perspectives on what constitutes good practice, and what helps or prevents it being achieved, in community mental health services for people with CEN. Methods Six bibliographic databases were searched for studies published since 2003 and supplementary citation tracking was conducted. Studies that used any recognised qualitative method and reported clinician experiences and perspectives on community-based mental health services for adults with CEN were eligible for this review, including generic and specialist settings. Meta-synthesis was used to generate and synthesi...
PurposeThe COVID-19 pandemic has potential to disrupt and burden the mental health care system, a... more PurposeThe COVID-19 pandemic has potential to disrupt and burden the mental health care system, and to magnify inequalities experienced by mental health service users.MethodsWe investigated staff reports regarding the impact of the COVID-19 pandemic in its early weeks on mental health care and mental health service users in the UK using a mixed methods online survey. Recruitment channels included professional associations and networks, charities and social media. Quantitative findings were reported with descriptive statistics, and content analysis conducted for qualitative data.Results2,180 staff from a range of sectors, professions and specialties participated. Immediate infection control concerns were highly salient for inpatient staff, new ways of working for community staff. Multiple rapid adaptations and innovations in response to the crisis were described, especially remote working. This was cautiously welcomed but found successful in only some clinical situations. Staff had s...
medRxiv, 2020
Background Diagnoses of personality disorder are prevalent among people using community secondary... more Background Diagnoses of personality disorder are prevalent among people using community secondary mental health services. Whilst the effectiveness of a range of community-based treatments have been considered, as the NHS budget is finite, it is also important to consider the cost-effectiveness of those interventions. Aims To assess the cost-effectiveness of primary or secondary care community-based interventions for people with complex emotional needs that meet criteria for a diagnosis of personality disorder to inform healthcare policy making. Method Systematic review (PRESPORO #: CRD42020134068) of five databases, supplemented by reference list screening and citation tracking of included papers. We included economic evaluations of interventions for adults with complex emotional needs associated with a diagnosis of personality disorder in community mental health settings published between before 18 September 2019. Study quality was assessed using the CHEERS statement. Narrative syn...
Purpose The label “Personality Disorder” continues to divide opinion. Challenges to the terminolo... more Purpose The label “Personality Disorder” continues to divide opinion. Challenges to the terminology of personality disorder led by people with lived experience and supported by critical practitioners and academics are tempered by acknowledgement of certain positive social consequences of obtaining a diagnosis. This study aims to engage service users and staff in a process of inquiry to better understand the complexities of views on the terminology of Personality Disorder. Design/methodology/approach This study set out to qualitatively explore the views of a range of people with lived, occupational and dual lived experience/occupational expertise, relating to the diagnostic label of Personality Disorder, via participatory and critical group debate. The World Café approach is an innovative methodology for participatory inquiry into subjective views suited to exploring the contested subject matter. Findings This study identified contrasting opinions towards the label of Personality Dis...
BJPsych Open
Background Diagnoses of personality disorder are prevalent among people using community secondary... more Background Diagnoses of personality disorder are prevalent among people using community secondary mental health services. Identifying cost-effective community-based interventions is important when working with finite resources. Aims To assess the cost-effectiveness of primary or secondary care community-based interventions for people with complex emotional needs who meet criteria for a diagnosis of personality disorder to inform healthcare policy-making. Method Systematic review (PROSPERO: CRD42020134068) of databases. We included economic evaluations of interventions for adults with complex emotional needs associated with a diagnosis of personality disorder in community mental health settings published before 18 September 2019. Study quality was assessed using the CHEERS statement. Results Eighteen studies were included. The studies mainly evaluated psychotherapeutic interventions. Studies were also identified that evaluated altering the setting in which care was delivered and join...
Social Psychiatry and Psychiatric Epidemiology
Purpose Research is beginning to quantify the impact of COVID-19 on people with pre-existing ment... more Purpose Research is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time. Methods We used qualitative interviews (N = 49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team. Results Existing mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to the community. New remote ways to access mental health care, including digital solutions, provided continuity of care for so...
PLOS ONE
Background There is a recognised need to develop clear service models and pathways to provide hig... more Background There is a recognised need to develop clear service models and pathways to provide high quality care in the community for people with complex emotional needs, who may have been given a “personality disorder” diagnosis. Services should be informed by the views of people with these experiences. Aims To identify and synthesise qualitative studies on service user experiences of community mental health care for Complex Emotional Needs. Methods We searched six bibliographic databases for papers published since 2003. We included peer reviewed studies reporting data on service user experiences and views about good care from community-based mental health services for adults with CEN, including generic mental health services and specialist “personality disorder” services. Studies using any qualitative method were included and thematic synthesis used to identify over-arching themes. Results Forty-seven papers were included. Main themes were: 1) The need for a long-term perspective o...
Social Psychiatry and Psychiatric Epidemiology
Purpose The COVID-19 pandemic has many potential impacts on people with mental health conditions ... more Purpose The COVID-19 pandemic has many potential impacts on people with mental health conditions and on mental health care, including direct consequences of infection, effects of infection control measures and subsequent societal changes. We aimed to map early impacts of the pandemic on people with pre-existing mental health conditions and services they use, and to identify individual and service-level strategies adopted to manage these. Methods We searched for relevant material in the public domain published before 30 April 2020, including papers in scientific and professional journals, published first person accounts, media articles, and publications by governments, charities and professional associations. Search languages were English, French, German, Italian, Spanish, and Mandarin Chinese. Relevant content was retrieved and summarised via a rapid qualitative framework synthesis approach. Results We found 872 eligible sources from 28 countries. Most documented observations and ex...