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Data extraction was completed and formulated in a table in date order of
publications.
Appraisal Tools Used:
Qualitative Appraisal
Tool used: QAT-Q (Taylor et al, 2015).
Quantitative Research (Appendix 4)
Tool used: QAT-E (Taylor et al, 2015)
Method of Synthesis:
Given that this review combines both qualitative and quantitative studies, it was
concluded that the most appropriate method of synthesising data was by using
narrative synthesis. Research was originally selected primarily for relevance to
the topic and effort were made to include opinions from staff, patients and
carers. There were a range of different interventions described but on detailed
reading four main themes emerged and formed the structure for the final review.
Each of the studies was coded against the themes in the topic with the most
robust studies being discussed first. Each piece of research mentioned is
initially described in detail to furnish the reader with sufficient information, and
thereafter briefly. The themes drawn out are:
• Reduction in acute admissions / days spent in acute hospital beds
• Increased staff training
• Increased patient autonomy
• Whole system's approach
Findings:
The research included demonstrates a variety of interventions designed to
reduce pressure on acute services and provide alternative treatments for people
with a diagnosis of EUPD who present in crisis. There is also powerful
testimony from service users as to how their current mental health systems are
failing them. The research by Vandyk et al. (2019) interviews service users
directly in the emergency room. Their experiences mirror the current system in
place currently in Northern Ireland. Anecdotally, there is a cohort of people with
a diagnosis of EUPD who frequently present to the emergency services and
have frequent acute admissions to psychiatric wards. The cyclical nature of
presentations to ED are characterised by lack of specialist community services
at the right time, limited staff training and a lack of alternatives when presenting
in crisis. This research further demonstrates the stigma and shame experienced