Exploring staff's experiences of advice and recommendations in mental health

Clinical guidelines have been used within mental health services for many years. Research has shown that implementing guidelines can help to improve treatment outcomes as well as staff and client satisfaction. However, there is evidence to show that guidelines are not routinely implemented within services, even when staff have the capacity and resources to do so. This suggests that there may be a barrier related to staff’s attitude towards guidelines that then affects whether they are implemented. This review sought to gather the current evidence on staff’s attitudes towards mental health guidelines and to identify what aspects they find helpful and unhelpful. A systematic search revealed 16 papers that were suitable for inclusion. All papers were qualitative studies and were analysed using thematic synthesis in order to extract themes which appeared across studies. Themes identified included: guidelines being tools for improving standards of care; guidelines being untrustworthy; guidelines failing to see the bigger picture; and guidelines being a threat to professional identity. Overall, it appeared that staff did find guidelines to be helpful in improving standards of care, but there were concerns around the applicability of guidelines within clinical practice especially around adapting standardised recommendations to individual clinical situations.