Drugs and Alcohol: IntNSA Spotlight 38 th on Annual Substance Educational Misuse Training Conference 15 th 18 th October 2014 Washington D.C., USA Drugs and Alcohol: Spotlight on Substance Misuse Training Daniela A. Collins Dr. Carmel Clancy Lúcia Cajada Middlesex University London, England, UK School of Health and Education Department of Mental Health, Social Work and Integrative Medicine
Middlesex University London More than 130 years experience under our belt, we remain a world-class centre for education, research and skills-based learning. Our roots took hold in 1878, when St. Katherine s College first opened in Tottenham North London. Several colleges and training institutions across North London came together to form the Middlesex Polytechnic in 1973.Established as a University in 1992. More than 40,000 students choose to study with us each year Major International partnerships and international campuses in Malta, Dubai and Mauritius The Queen's Awards for Enterprise, the most prestigious prize available to British businesses was awarded for outstanding achievement in international trade a reflection of Middlesex University s commercial success in growing its operations overseas and boosting the UK economy
Middlesex University London: School of Health and Education One of the leading providers of Mental Health and Social Work Education in the UK. In March 2005 it was awarded status as a Centre of Excellence for Teaching & Learning (CETL) by the Higher Education Funding Council for demonstration of excellence in learning and teaching practice in particular in: learning for practice involvement of patient educators / service user and carers and interagency working in programme development and implementation innovative teaching and learning practices and strategies for student support
Drug and Alcohol Research Centre (DARC) The DARC is a multi-disciplinary Centre engaging staff with social science, health and humanities backgrounds across Middlesex University and the Schools of Health and Education, Law, Business Studies and Science and Technology. Areas of expertise within DARC include alcohol and drug policy, aspects of policy implementation at local level, youth and substance use, substance use and ethnicity, older people and alcohol, drugs/alcohol and the criminal justice system, evaluation of policy and services. The Centre builds on a long tradition of cutting-edge research, teaching and research knowledge transfer. Staff are involved in a wide range of European, national and local research funded mainly by the EU, government departments, research councils and charities.
BSc (Hons) Nursing training Each higher education institution sets its own requirements. This is usually around 5 GCSE s plus two A-levels or equivalent. The candidate also needs to demonstrate: Evidence of literacy and numeracy skills (tested at interview). Complete a health questionnaire and identify any special needs related to a disability. Declare any past convictions & pass an enhanced police crime screening / police record check.
BSc (Hons) Nursing training cont d To work as a nurse in England, candidates need a degree in nursing and a licence (registration to practice nursing) with the Nursing and Midwifery Council (NMC). The nurse training course fees are funded by the National Health Service (NHS). Nursing requires a high level of technical competence and clinical decision-making skills, and candidates are trained 50% at a university and 50% in supervised clinical placements in local hospitals and community settings.
BSc (Hons) Nursing At application to a chosen university the candidates choose from 4 available nurse specialisms: Generalist (Adult) Paediatric (Children) Mental Health Learning Disabilities
Introduction what we know Addiction is a global challenge. Substance misuse and its connection to poor mental health impacts across the lifespan. Health and Social Care professionals have an impact on the individual, family and community. The emergence of new substances, in the UK, such as NPSs has raised awareness about the lack of current scientific research in this area. Despite these concerns, drug and alcohol awareness training in the health and social care curricula is minimal. More training is part of the solution
Aims To investigate at Middlesex University, London, UK, health and social care undergraduate students knowledge and perceptions about drugs and alcohol, including Novel Psychoactive Substances (NPSs) and Performance and Image Enhancing Drugs (PIEDs), in relation to their future professional roles.
Drugs and Alcohol: Spotlight on Substance Misuse Training Research project conducted over one academic year (2013-2014). It investigated health and social care undergraduate students knowledge and perceptions about drugs and alcohol at Middlesex University, at the School of Health and Education across 3 disciplines (nursing, midwifery and psychology). The study also surveyed student s knowledge on Novel Psychoactive Substances (NPSs) and Performance and Image Enhancing Drugs (PIEDs) in relation to their future professional roles.
Methods A mixed methods approach was undertaken in two phases: Phase 1: A cross sectional survey of BSc Nursing (Child, Adult & Mental Health), Midwifery and Psychology students. Phase 2: One focus group with student nurses.
Methods Cont d Phase 1 Students were invited to complete the SAAPPQ and SDDPPQ. Both instruments are validated 10-item Likert questionnaires measuring the attitudes of professionals towards the provision of care to those with alcohol and drug use disorders. 5 pairs of items were each summed (a mean of 7 and greater is positive) to give measures on motivation or willingness to work with drinkers; expectations of work satisfaction; feelings about their adequacy of knowledge and skills; role legitimacy on the right to work with these clients and selfesteem in this specific task.
Methods Cont d Phase 1 The sub-scales of role adequacy and role legitimacy were further summed to measure overall Role Security (a mean of 16 and greater is positive); and the sub-scales of motivation; work satisfaction and task specific self-esteem were summed to measure overall Therapeutic Commitment (a mean of 24 and greater is positive).
Methods Cont d Phase 2 One focus group was conducted with representatives of student nurses. Participants were invited to comment on their overall perceptions regarding their training in relation to drugs and alcohol, and more specifically regarding the Novel Psychoactive Substances (NPSs) and Performance and Image Enhancing Drugs (PIEDs)
Results Phase 1 (Quantitative) A total of 262 respondents (43% response rate) completed the survey 30 19 96 Adult Nursing Midwifery Child Nursing Psychology Mental Health Nursing 50 67
Results Cont d Overall, students across all groups have a more positive attitude with respect to knowledge, skills, and legitimacy in their role when it comes to working with alcohol users (Role Security M: 18.4; SD: 3.4) compared with drug users (Role Security M: 17.3; SD: 3.6). No differences were found across the groups with respect to Therapeutic Commitment (Alcohol M: 28.4; SD: 5.6; Drug M: 28.4; SD: 4.2).
Results Cont d Although differences between student groups on subscales were not statistically significant, three of the student groups: Midwifery (M: 7.1), Child (M: 7.3) and Adult Nursing (M: 7.5) reported lower levels of Role Adequacy with respect to caring for drug users when compared with: Mental Health (M: 8.8) and Psychology students (M: 8.3).
Results Phase 2 (Qualitative) A focus group was conducted with final year BSc Mental Health Nursing students. Social work, midwifery and psychology students did not respond to the focus group invitations. Students view is that their undergraduate Mental Health Nurse training needs more input on drugs and alcohol (e.g. > 1 day per annum training) to support their future professional roles. More training is also needed in all of the BSc Nursing branches (child, adult and MH nursing) in the UG training as well as at CPD / post graduate level.
Results cont d & Future Directions Networking: Interprofessional and Multidisciplinary expert reviews; Masterclasses on substance misuse and drug and alcohol education. Innovation and Research: Build on the existing body of knowledge. Drug policy, substance misuse research, health promotion and education, public health care providers, patients/ service user and families involvement is essential.
Conclusions A review is needed of the current health and social care curriculum across all related disciplines and fields of nursing to ensure parity in relation to drug and alcohol training. Quantitative results are encouraging with respect to the positive attitudes to working with drug and alcohol users. Midwifery, generalist nursing (adult) and child nursing students perceive to be less prepared to work with drug users compared to students in mental health and psychology programmes.
Conclusions Cont d There is evidence to support that new herbal and synthetic psychoactive drugs are not currently included in the syllabus and this should be addressed. General lack of attention to drug and alcohol awareness within the wider BSc Nursing and Midwifery curriculum is of great concern and yet again shines a spotlight on the urgent need for health and social care educators to respond.
References: Advisory Council on the Misuse of Drugs (2011) Consideration of the Novel Psychoactive Substances (Legal Highs). London: ACMD Advisory Council on the Misuse of Drugs (2003) Hidden harm: responding to the needs of children of problem drug users. Report of an inquiry by the Advisory Council on the Misuse of Drugs, Home Office: London. Ayres T.C. & Bonds J.W. (2013). A chemical analysis examining the pharmacology of novel psychoactive substances freely available over the internet and their impact on public (ill) health. Legal highs or illegal highs? BMJ Open 2012;2:e000977.doi:10.1136/ bmjopen-2012-000977 ANSA (1997) Substance Use Guidelines on Good Clinical Practice for specialist nurses. London: ANSA Braun, V. & Clarke, V. (2006). Using Thematic Analysis in Psychology. Qualitative Research in Psychology 3, 77-101. Crome, I., Chambers, P., Frisher, M., Bloor, R., and Roberts, D. (2009) The relationship between dual diagnosis and substance misuse and dealing with mental health issues. SCIE Research briefing 30. London: SCIE Department of Health (2006a) From value to actions: The Chief Nursing Officer's review of mental health nursing, DH, London. European Monitoring Centre for Drugs and Drug Addiction (2013) European Drug Report: Trends and Developments 2013. Lisbon: EMCDDA. Galvani S., and Forrester D. (2008). How well prepared are newly qualified social workers for working with substance use issues? Finding from a national survey in England. Social Work Education, 30(4), June 2011, pp.422-439 Jenkins L. (2013) A survey of midwives attitudes towards illicit drug use in pregnancy. Evidence Based Midwifery 11(1): 10-15 Robson, C. (2011). Real World Research. (3rd Edition). Chichester: Wiley. Rassool GH., and Rawaf S,. (2008) Predictors of educational outcomes of undergraduate nursing students in alcohol and drug education, Nurse Education Today, Vol:28, Pages:691-701
Q & A
Thank you