A multi-site evaluation of technology in mental health inpatient wards, specifically the use of vision-based patient monitoring systems and body worn cameras

Working in collaboration with the Digital Health Innovation Hub and Essex Partnership University NHS Trust, this project aims to evaluate the impact of digital technologies, specifically vision-based patient monitoring systems and body worn cameras, on mental health inpatient wards.

VBPMS and BWCs have recently been introduced in inpatient services by mental healthcare providers. This research aims to assess the prevalence of use and the impact of these technologies on staff and patients, providing information to guide commissioning decisions on their future use.

VBPMS were introduced to mental health inpatient wards in England in 2020, and are in use by approximately 50% of the country’s 54 mental healthcare provider organisations in the NHS (National Mental Health and Learning Disability Nurse Directors’ Forum, 2022).

This technology comprises cameras placed in patients’ bedrooms to monitor movement, provide location-based alerts, and has potential to measure pulse rate and breathing rate (Malcolm et al., 2022).

Healthcare providers have implemented this technology with the aim of improving patient safety, specifically risk of self-harm and falls, and reducing the need for patients to be woken at night to conduct mandatory observations, but there is no robust evidence to date to support these aspirations.

BWCs are small transportable cameras that attach to clothing to produce video and audio recordings (Essex Police, 2022).

These were introduced in healthcare settings in the UK around 2015, with eight million pounds' investment subsequently pledged by government in piloting them to strengthen staff safety and support prosecution of violence towards staff (NHS Long Term Plan, DHSC, 2019).

The exact number of mental health provider organisations using the BWCs in the UK is not known, but a survey conducted in 2021 indicated their use in approximately 20 in England at that time (Wilson et al., 2022). As with VBPMS, there is a lack of evidence to support the use of BWCs in mental healthcare settings.

This study aims to address these evidence gaps, and will include the following seven modules:

  1. Conducting a review of existing evidence.
  2. Assessing the prevalence of VBPMS and BWC in England.
  3. Exploring organisational governance of the interventions.
  4. Recruitment of sites which use the technology, and an equal number which do not (20 organisations in total).
  5. Evaluating the impact of the technology on the frequency and severity of incidents of falls, self-harm, and violence and aggression.
  6. Exploring the views of patients, carers, ward staff and senior staff around the technology.
  7. Exploring the impact that differing methods of implementing the technology may have had on safety as measured by incident rates.

We will recruit patients and their carers, ward staff and senior staff in mental healthcare provider organisations across England. For more information, please contact [email protected]

ARU team

Dr Fiona Nolan

Fiona Nolan

Fiona Nolan holds a joint appointment as Clinical Professor of Mental health Nursing with ARU and Deputy Director of Nursing and Research with Essex Partnership University NHS Foundation Trust, and is Chief Investigator on the study to evaluate digital technology in mental health inpatient wards.

She has combined senior clinical roles with an academic career and since 2008 has developed programmes to build capacity and strengthen opportunities for nurses to lead healthcare research. She has led two NIHR grants and been co-applicant on several others.

Most recently, she led an EU funded project to develop postgraduate mental health nurse training in a low-income country (Mongolia), the results from which are being extended to other countries and modified to support integration of internationally educated nurses working in mental health services in the UK.

Fiona holds visiting professorships at La Trobe University, Melbourne, Western Sydney University and the Mongolian National University of Medical Sciences. She was awarded honorary life membership of the Mongolian Nurses Association in 2019 in recognition of her services to nursing.

She is current Chair of Mental Health Nurse Academics UK and the annual International Mental Health Nursing Research Conference. She is also Chair of the board of trustees of the UK-based Zimbabwe Life Project (ZLP) charity, which supports mental health workers in Zimbabwe.

View Fiona's ORCID profile

Dr Nicola Armstrong

Nicola Armstrong

Nicola Armstrong is a mental health nurse and has worked in the NHS in Commissioning roles, post-graduate education and patient safety roles. She is currently employed in Essex Partnership University NHS Foundation Trust as a Consultant Nurse.

Nicola has completed Professional Doctorate in Nursing and is an alumni member of the NIHR Senior Nurse Research Leader Programme (2019-2022). She is working on this study as a Postdoctoral Nursing Research Fellow, combining her research with her clinical work as a consultant nurse.

Nicola’s PhD thesis is titled The Impact on the Family of Young Onset Dementia. Until recently, she was Deputy CEO of the Zimbabwe Life Project.

Dr Silvia Cirstea

Silvia Cirstea

Silvia Cirstea’s areas of expertise include data, signal and image processing, statistical, machine learning and AI methods, neural networks, numerical modelling and optimization of physical and industrial processes (electromagnetics, acoustics, quantum mechanics, workflows).

Since 2010, she has worked with the Vision and Eye Research Institute (VERI) on the role of acoustic cues, like level and reverberation, as conveyors of information about the environment and to facilitate better navigation of the visually impaired.

She has a keen interest in digital healthcare and, in particular, assisted living for the visually impaired using acoustic cues and smart technologies.

Silvia has worked on research projects funded by Innovate UK, the EU, UK Central Laboratory of the Research Councils, Radiocommunications Agency, Medical Research Council and British industry.

EPUT partners

Ella Dowling

Ella Dowling

Ella graduated from Loughborough University with a First Class Honours BSc in Psychology with Criminology and a Diploma in Professional Studies (DPS). To be awarded her DPS, Ella worked as an Honorary Assistant Psychologist within West Essex Adult Community Psychosis team.

Since graduating, Ella has been a support worker in an mental health adult acute inpatient ward, a community adult secondary mental health team, a specialist psychology service for 18-25 year olds, and an Urgent Care Pathway Crisis Service.

She is working part-time on this study as a Research Associate in Essex Partnership University NHS Trust, and also works part time as an Assistant Psychologist within the Paediatric and Adolescent Psychological Medicine division at University College Hospital.

Ella is passionate about becoming a Clinical Psychologist, and with this has a strong interest in research within mental health settings, including promoting patient safety and opening access to psychological support.

Madeleine Devon

Madeleine Devon

Madeleine is a Research Associate at Essex Partnership University NHS Foundation Trust (EPUT), within the Patient Safety Research team.

After completing a BSc (Hons) Psychology from City, University of London, she went onto achieve a Distinction in her MSc in Mental Health Studies (Occupational Psychology and Psychiatry) from Kings College London's Institute of Psychiatry, Psychology and Neuroscience.

Madeleine is a graduate member of the British Psychological Society (GMBPsS) and a National Institute of Health Research (NIHR) Applied Research Collaboration (ARC) Early Career Research Network Committee member.

She has worked in the NHS over the past 15 years and is passionate about quality improvement. She has attained a PG Cert in Business Studies from the University of Essex.

Madeleine enjoys promoting research as part of her ARC role as a career development and mentoring coordinator, and she is an NIHR Clinical Research Network (CRN) Mental Health Research For All Champion.