The perceived challenges of working with patients who use new psychoactive substances: a qualitative study in a medium secure unit

Publication Date04 December 2019
Date04 December 2019
AuthorEmma Mckenzie,Joel Harvey
SubjectHealth & social care,Criminology & forensic psychology,Forensic practice,Sociology,Sociology of crime & law,Law enforcement/correctional,Public policy & environmental management,Policing,Criminal justice
The perceived challenges of working with
patients who use new psychoactive
substances: a qualitative study in a
medium secure unit
Emma Mckenzie and Joel Harvey
Purpose New psychoactive substances (NPS) are increasingly being used in secure mental health
settings. Within these settings, NPS use presents a range of challenges and staff currently lack adequate
training to manage these challenges. The purpose of this paper is to explore nursing staffsperception of the
challenges of working with patients who use NPS and to explore nursing staffsperception of their training
needs in relation to NPS.
Design/methodology/approach A cross-sectional qualitative design was employed. Semi-structured
interviews were conducted with eight nursing staff from a medium secure unit (MSU).
Findings A thematic analysis identified three overarching themes: There Will Always Be Something,We
Are Doing Our Bestand If We Know More, We Can Do More. The findings describe how nursing staff
manage NPS use at present, and their perceptions of how training could improve their management of NPS
use in the future.
Practical implications The findings suggest that MSUs require a local policy for managing NPS use. The
research implies that staff training programmes should recognise the existing methods staff use to manage
NPS use. The findings also suggest that NPS interventions should target the whole peer group and not just
the individual using NPS.
Originality/value This paper contributes to the limited literature on NPS. The findings demonstrate the
importance of developing evidence-based mechanisms for managing NPS use. Changes to practice are
suggested, with the view of developing ways in which staff currently manage NPS use by complementing this
with specific training on NPS.
Keywords Qualitative, Nursing staff, Staff training, Illicit substances, Medium secure unit,
New psychoactive substances
Paper type Research paper
Harmful substance use and dependence on illicit substances is more prevalent amongst people
with mental disorders than the general population (Toftdahl et al., 2016). Within low and medium
secure mental health units, there is an increasing use of new psychoactive substances (NPS),
formally known as legal highs(PHE, 2017). Little is known about the effects of NPS on
individuals with mental disorders and how to manage patients who use these substances in
secure mental health settings (Gray et al., 2016; PHE, 2017).
The challenges of new psychoactive substances
NPS are a diverse group of drugs designed to replicate the pharmacological effects of traditional
illicit substances (PHE, 2017). NPS have different actions which can be broken down into four
Received 2 September 2019
Revised 27 October 2019
Accepted 29 October 2019
A special thank you to the
Psychology Department and the
Drug and Alcohol team at the unit
where this study was conducted.
Emma Mckenzie is based at the
Department of Forensic and
Neurodevelopmental Science,
Kings College London,
London, UK.
Joel Harvey is based at the
Department of Forensic and
Neurodevelopmental Sciences,
Institute of Psychiatry,
Psychology and Neuroscience,
Kings College London,
London, UK.
PAG E 12
VOL. 22 NO. 1 2020, pp. 12-22, © Emerald Publishing Limited, ISSN 2050-8794 DOI 10.1108/JFP-09-2019-0036

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