Codesigning a systemic discharge intervention for inpatient mental health settings (MINDS): a protocol for integrating realist evaluation and an engineering-based systems approach

Corinna Hackmann; Alexander Komashie; Melanie Handley; Jamie Murdoch; Adam P Wagner; Lisa Marie Grünwald; Sam Waller; Emma Kaminskiy; Hannah Zeilig; Julia Jones; Joy Bray; Sophie Bagge; Alan Simpson; Sonia Michelle Dalkin; John Clarkson; Giovanni Borghini; Timoleon Kipouros; Frank Rohricht; Zohra Taousi; Catherine Haighton; Sarah Rae; Jon Wilson

doi:10.1136/bmjopen-2022-071272

Codesigning a systemic discharge intervention for inpatient mental health settings (MINDS): a protocol for integrating realist evaluation and an engineering-based systems approach

BMJ Open. 2023 Sep 13;13(9):e071272. doi: 10.1136/bmjopen-2022-071272.

Authors

Corinna Hackmann^{1

2}, Alexander Komashie³, Melanie Handley⁴, Jamie Murdoch⁵, Adam P Wagner^{6

7}, Lisa Marie Grünwald⁸, Sam Waller⁹, Emma Kaminskiy¹⁰, Hannah Zeilig¹¹, Julia Jones¹², Joy Bray¹³, Sophie Bagge¹⁴, Alan Simpson¹⁵, Sonia Michelle Dalkin¹⁶, John Clarkson⁹, Giovanni Borghini¹⁷, Timoleon Kipouros¹⁸, Frank Rohricht^{19

20}, Zohra Taousi¹⁷, Catherine Haighton¹⁶, Sarah Rae¹³, Jon Wilson^{8

2}

Affiliations

¹ Research and Development, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK Corinna.hackmann@nsft.nhs.uk.
² Noriwch Medical School, The University of East Anglia, Norwich, UK.
³ Department of Enginering, University of Cambridge School of Technology, Cambridge, UK.
⁴ Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK.
⁵ School of Life Course and Population Sciences, King's College London, London, UK.
⁶ NIHR Collaboration for Leadership in Applied Health Research & Care (CLAHRC) East of England, Cambridge, UK.
⁷ Norwich Medical School, University of East Anglia, Norwich, UK.
⁸ Research and Development, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.
⁹ Engineering Design Centre, University of Cambridge, Cambridge, UK.
¹⁰ School of Psychology and Sports Science, Anglia Ruskin University, Chelmsford, UK.
¹¹ London College of Fashion, University of the Arts London, London, UK.
¹² Centre for Research in Primary & Community Care, University of Hertfordshire, Hatfield, UK.
¹³ Independant, Cambridge, UK.
¹⁴ Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.
¹⁵ Health Services and Population Research, King's College London, London, UK.
¹⁶ Department of Social Work, Education & Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
¹⁷ Hertfordshire and Peterborough NHS Foundation Trust, St Albans, UK.
¹⁸ Department of Engineering, University of Cambridge, Cambridge, UK.
¹⁹ Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
²⁰ East London NHS Foundation Trust, London, UK.

Abstract

Introduction: Transition following discharge from mental health hospital is high risk in terms of relapse, readmission and suicide. Discharge planning supports transition and reduces risk. It is a complex activity involving interacting systemic elements. The codesigning a systemic discharge intervention for inpatient mental health settings (MINDS) study aims to improve the process for people being discharged, their carers/supporters and staff who work in mental health services, by understanding, co-designing and evaluating implementation of a systemic approach to discharge planning.

Methods and analysis: The MINDS study integrates realist research and an engineering-informed systems approach across three stages. Stage 1 applies realist review and evaluation using a systems approach to develop programme theories of discharge planning. Stage 2 uses an Engineering Better Care framework to codesign a novel systemic discharge intervention, which will be subjected to process and economic evaluation in stage 3. The programme theories and resulting care planning approach will be refined throughout the study ready for a future clinical trial. MINDS is co-led by an expert by experience, with researchers with lived experience co-leading each stage.

Ethics and dissemination: MINDS stage 1 has received ethical approval from Yorkshire & The Humber-Bradford Leeds (Research Ethics Committee (22/YH/0122). Findings from MINDS will be disseminated via high-impact journal publications and conference presentations, including those with service user and mental health professional audiences. We will establish routes to engage with public and service user communities and National Health Service professionals including blogs, podcasts and short videos.

Trial registration number: MINDS is funded by the National Institute of Health Research (NIHR 133013) https://fundingawards.nihr.ac.uk/award/NIHR133013. The realist review protocol is registered on PROSPERO.

Prospero registration number: CRD42021293255.

Keywords: adult psychiatry; mental health; qualitative research.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Hospitals, Psychiatric
Humans
Inpatients
Mental Health*
Patient Discharge*
State Medicine
Systems Analysis

Grants and funding

NIHR133013/DH_/Department of Health/United Kingdom