Collaborating to enhance opportunities for teaching and learning, and for the well-being of staff and students at the University of Otago

Introducing Books on Prescription

IntroductionsKatie Jahnke | Health Promoter & Projects CoordinatorSouthern PHO | Katie.Jahnke@southernpho.health.nz

Jodie Black | Registered PsychologistStudent Health, University of Otago | jodie.black@otago.ac.nz

Sarah Gallagher | Subject LibrarianHealth Sciences Library, University of Otago | sarah.gallagher@otago.ac.nz

Richard German | Divisional LibrarianHealth Sciences Library, University of Otago | richard.german@otago.ac.nz

Overview Katie - History of BOP and Southern PHO involvement

Richard - How libraries are changing internationally

Sarah - Why and how the Medical Library became involved

Jodie - The role of the programme at Student Health

What is BOP?A community health initiative whereby GPs, mental health professionals and other health professionals can offer their patients recommended self-help books for mild to moderate mental health problems.

History

• Developed in Wales in 2002 by psychologist Dr Neil Frude

• In 2005 the scheme was rolled out across Wales then throughout the UK following extensive evaluation

• Implemented in Central Otago in 2011 and progressively rolled out in Otago and Southland

Why start a BOP scheme?• 46.6% of the population will meet the criteria for a mental

disorder during their lives

• 39.5% have already had experience of mental disorder

• 20.7% of the population will have experienced a mental health disorder within the past 12 months

• There is significant unmet need for people with mental disorders. Over a 12 month period only 39% of people with a mental disorder had visited health services

Evidence• Clinical evidence shows that books can be as effective as other forms

of therapy and with the advantage of having no potential side effects associated with drugs, and often achieve good results more quickly.

• Bibliotherapy is one of the key self-help strategies recommended in the treatment of depression and anxiety.

• Research suggests that patients benefit from knowing more about their problems, and learning psychological tactics to deal with them.

Southern PHO• 285,852 enrolled patients in 89 practices

• 40% enrolled pop. live outside the main cities important to have a rural focus

• Reduced access to mental health services in rural areas

Hearing UK experiences Watch: ● Reading Well (UK) ● a medical

professional● a librarian ● a patient

University of Otago Libraries● 7 libraries

o Medical, Dental, Science, Education, Law, Central

o Hocken Collections

● Available to all staff and students

What libraries are aboutRanganathan’s five laws of library science:1. Books are for use2. Every reader his/her book 3. Every book its reader4. Save the time of the reader5. The library is a growing organism

Future librariesExtensions of Ranganathan’s ‘laws’ (Crawford and Gorman, 1995):1. Libraries serve humanity2. Respect all forms by which knowledge is communicated3. Use technology intelligently to enhance service4. Protect free access to knowledge5. Honor the past and create the future

More than just books● Libraries are constantly

evolving to meet the needs of our communities

● We are trusted places / people for information provision

CC-BY-NC-ND Dunedin Public Library https://www.flickr.com/photos/dunedinpubliclibraries/13884121976

NZ Public Libraries in 2013

Source: Libraries in Aotearoa 2014, p7

Libraries & health information

“Libraries can build on the fact that many people visit libraries for health information before or instead of engaging with health professionals”

- Ingham 2014

Libraries <3 their communitiesPlaces of refuge & services in times of crisis, eg:

● CHCH earthquakes● Hurricane Sandy● Ferguson Riots

So libraries are a good fit for BOP schemes

BOP in universitiesOtago is one of a few university libraries in the world that have adopted Books on Prescription

• University College Dublin• Brunel University London• Loughborough University

Why is Otago involved?Dual reasons for our involvement:

● Opportunity to support teaching and learning in the Dunedin School of Medicine

● Opportunity to contribute a resource to improve staff and student well-being at the University of Otago

#1 - Teaching & learning

● Approval of teaching staff● Ordered books● Created a guide● Promotion

Our guide

● resource for teaching and learning● a resource for prescribers● to illustrate and provide access to the books in the collection● to present evidence of bibliotherapy & case studies ● to provide access to supplementary material ● www.otago.libguides.com/bop

Promotion

Interest from others● Our launch in August 2013

coincided with the roll out of the scheme across the UK

● Generated interest / RFI from other libraries in NZ

● Reported in LIBROS and HEALTH SIG

- 6th year medical student

“I personally recommended the service to a patient I met in General Practice, who was suffering from a relapse of her depressive illness … she seemed very receptive to the idea … I really appreciated having something additional to offer her however- she was already on medication for her depression, and really responded to the idea of having something that she could do herself. I think it's a really valuable service, and I hope that the medical school incorporates it into the general practice curriculum!”

#2 - Well-beingSupport the well-being of staff and students● Student Health● Disability Information &

Support● Employee Assistance

Programme (EAP)

CC http://pixabay.com/en/reading-manual-docs-help-book-man-99244/

Student Health Services● Largest “enrolled” population in the Southern District● About 50 staff including: nurses, general practitioners,

counsellors, dietitians, psychiatrist and administrative staff

● Majority of students access Student Health during term and return to their family GP over breaks

● 28% of Otago students record their “home area” as the Southern District

Counselling Services● Unique to have counselling services on site● Same day appointments with self referral for brief

assessment, advice, counselling and/or further referrals● Referrals have doubled over the last 5 years● Peak demand periods towards the end of each

semester

Benefits for Student Health● Part of a stepped care approach to mental health● Options for those on a waitlist or returning home over

breaks● Provide options directly accessible by students● Utilizing library infrastructure

Promoting BOP in SHS● Information session provided to SHS staff● Books rotate through staff room● SHS staff have added to scheme - including sexual

health● Link to BOP on SHS website● Bookmarks promoting BOP are available from all clinical

rooms

Challenges to consider● Staff familiarisation with the scheme and books● Client attitudes towards electronic and bibliotherapy self

help are more positive than the clinicians● Some staff already use electronic resources, including

websites and apps

Goals● Further promotion to staff and students as a well-

being aid● Further promotion to teaching staff (Medicine)● Further promotion to health workers on campus

EvaluationThe Southern PHO are undertaking an extensive evaluation in the region, including:

• Surveying prescribers and librarians • Collating issuing data and user feedback • Interviews and focus groups with prescribers and consumers

Continuous improvementOur collaborative practice includes a cycle of review to ensure we continue to improve this programme.

Four step quality cycle• plan > act > review > improve

Source: http://www.uow.edu.au/quality/quality/index

Indicators of success● Website / online guide hits● Books issued and holds placed● Extra copies requested● Student and staff feedback● Prescriptions filled● Evidence of incorporation into learning programs● Cross promotion through other well-being projects

Fig 1. Example of statistics gathered by Springshare software over 12 months of the Books on Prescription Guide www.otago.libguides.com/bop

- 6th year medical student

“I personally find the books on prescription program to be a very valuable resource. Dunedin has limited access to counselling and mental health services, and many of the services which are available have significant wait times for patients who are not acutely unwell. This can have a significant impact on the mental health of patients who are unable to

afford to pay out of pocket for these services.”

Next steps

● Develop opportunities to incorporate into Residential Assistant, peer support and future staff training

● Otago University Student Association (OUSA) Mental Health Awareness Week

● Review the outcomes and adopt any recommendations from the PHO evaluation

Summary● Working in collaboration across departments has made

this project possible● A structure of continuous quality improvement will allow

to project to continue to grow and meet the needs of staff and students

ReferencesIngham A. Can your public library improve your health and well-being? An investigation of East Sussex Library and Information Service. Health Information & Libraries Journal. 2014;31(2):156-60.

LIANZA. Libraries in Aotearoa 2014 http://www.lianza.org.nz/resources/lianza-publications/libraries-aotearoa/libraries-aotearoa-2014 [Accessed 19.08.2014]

NHS Choices. Reading Well Books on Prescription. https://www.youtube.com/watch?v=1H8OpYP0zPg [Accessed 19.08.2014]

New Media Consortium. NMC Horizon Report: 2014 Library Edition http://cdn.nmc.org/media/2014-nmc-horizon-report-library-EN.pdf [Accessed 19.08.2014]

Pratt RJ. The introduction of a healthy reading scheme for people with mental health problems: usage and experiences of health professionals and library staff. Mental Health in Family Medicine. 2008;5(4):219-28.

Thank you

www.booksonprescription.co.nzwww.otago.libguides.com/bop