An Exploration into Attitudes Towards PIEs
Research type
Research Study
Full title
An Exploration into Attitudes Towards Psychologically Informed Environments
IRAS ID
271288
Contact name
Daniel Pratt
Contact email
Sponsor organisation
University of Manchester
Duration of Study in the UK
1 years, 5 months, 0 days
Research summary
Research Summary:
Psychologically Informed Environments (PIEs) are environments that are based on psychological theories and frameworks. PIEs are used in lots of places. The idea is that PIEs support the wellbeing of people who use services in lots of different ways. They have recently have been brought into services designed to help people who are homeless.
This project will look at views about PIEs for homeless people. It will look at the opinions of staff working in homeless services and service users there. Participants will be gathered from homeless services across Greater Manchester.
The project will use Q- methodology. This method allows lots of opinions and ideas to be taken into account without losing each person’s opinion.
There are normally two parts to doing Q-methodology. The first part will involve getting lots of different views people have about PIEs for homeless people. These can be taken from different sources. Sources include academic literature, television, Internet, interviews, and focus groups. This information will then be used to create a lot of statements, known as the “Q-set.”
Participants will then be asked to sort through the “Q-set” statements, putting them in order of how much they agree or disagree with each of the comments. This is done based on their own opinions or beliefs about the topic.
Then features, like age, of the people taking part will be looked at to see which are most important. This is done to help understand the different beliefs, attitudes and opinions that staff and service users have. It can also help to develop PIEs locally and add to the research.
Following this, some participants may be invited to talk in more detail about their attitudes towards PIEs to ensure as wide a range of attitudes as possible has been gathered.Summary of Results:
“Homelessness and Psychologically Informed Environments: Understanding and Responding to the trauma and challenges experienced by homeless individuals” had two aims. Firstly, to explore factors that contribute to the most serious experiences associated with homelessness; homeless youth suicide, and secondly to better understand Psychologically Informed Environments and ascertain staff views on this approach.
Homelessness is a global issue with numbers of homeless individuals continuing to rise in many countries across the world. Homelessness has notable implications for homeless individuals mental and physical health, as well as impacting local communities and services.
Firstly, a systematic review and critical appraisal were conducted exploring psychosocial factors affecting suicidal thoughts and behaviours in homeless youth. Following a systematic search, twenty-nine papers met inclusion criteria. Following analysis, findings indicated that increased incidents of trauma and adverse childhood experiences have a positive relationship with suicidal thoughts and behaviours. This same relationship was found for lack of resilience and risk behaviours, such as substance use and survival sex.
Interventions in homeless services that aim to be trauma informed, such as Psychologically Informed Environments, or those designed to increase resilience may go some way to reducing risk of suicidal thoughts and behaviours for homeless youth. However, as a challenging group to identify and engage, incentives may need to adapt or be developed to adequately meet the needs of homeless youth in order to reduce suicide thoughts and behaviours.Secondly, an empirical study was undertaken. In recognition of the complex needs of homeless individuals, recent years have seen the introduction of Psychologically Informed Environments (PIEs)– models brought into services to specifically address these needs. While there is no ‘one way’ of implementing a PIE, Keats et al. (2012) proposed a framework of five key factors to consider when implementing a PIE which are informally taken as guidelines for implementation in many services. These factors comprise of developing a psychological framework, physical and environment spaces, staff training and support, managing relationships and evaluation of outcomes. Little research has been done exploring their impact to date, and results have yielded mixed results.
The aim of the study was to explore staff attitudes towards PIEs in homeless services, to better understand the reception to PIEs whilst also recognising that staff attitudes have a notable impact on the success of model implementation.
Staff were recruited from Manchester City Council, NHS and voluntary sector organisations in Greater Manchester who worked with homeless individuals in services that had employed a PIE to varying degrees. Participating staff were asked to complete a “Q-sort”, where an array of statements gathered about PIEs are sorted into how much the participant agrees or disagrees with them. This was completed remotely with video or phone support for assistance and participants were provided with instructions and asked to complete demographic information and a Pizazz – a tool used to reflect on how far the PIE in their service had progressed.
Data was analysed using PQMethod (Stevenson, 2009), a programme specifically designed to analyse Q-sorts and run a Q- factor analysis exploring similarities and trends in attitudes.
Findings from conducting Q-factor analysis indicated a two-factor solution which accounted for the most variance. The first factor, conceptualised as ‘relationships and support’, showed that staff loading onto this factor endorsed statements that related to the importance of relationships in PIEs and around the importance of adequate support and guidance. This factor was mostly comprised of council and voluntary staff. This group also rated their service PIEs as being less developed on the Pizazz than factor two. Factor two was comprised mostly of NHS staff. Staff loading onto this factor focussed more on procedural aspects and was conceptualised as ‘frameworks and development’. Staff loading onto factor two also, overall, rated their PIEs as being further developed than staff loading onto factor 1. Consensus statements focussed around agreeing that PIEs have a strong psychological underpinning, and that they are considerate of clients’ mental health needs and complex histories. Staff also collectively disagreed that PIEs are harmful, negative or unhelpful.
These results suggest that staff endorse ideas and attitudes consistent with Keats et al. (2012) framework or core factors for PIE implementation, but these appear inconsistent across service types, with a notable difference in NHS staff compared to their council or voluntary service counterparts. Whilst the reason for this difference is unclear, it is hypothesised that this could be due to the different means of implementation of PIEs, or that potentially different implementation dates mean that NHS staff are in a more progressed PIE that emphasises frameworks and development.
Training, dissemination of information, and a consistent model may result in more aligned attitudes and opinions across staff groups and services. Research suggests this may yield a more successful implementation of the model, whilst also ensuring consistent care across services designed in supporting those with a transient lifestyle.
Further exploration, potentially through qualitative means, may elicit a deeper understanding of these differences and allow additional detail to be understood.REC name
West of Scotland REC 5
REC reference
20/WS/0035
Date of REC Opinion
20 Feb 2020
REC opinion
Further Information Favourable Opinion