Mental health model is put to the test

A model to help mental health nurses communicate with confused patients has been trialled on inpatient wards for the first time.

The Validation, Emotion, Reassurance, Activity (VERA) framework was developed by academics at Anglia Ruskin University after pre-registration nursing students often found it difficult to respond to patients where communication was confused.

An evaluation of the framework has been published today in the Nursing Standard after staff working on two wards at the Crystal Centre, in Chelmsford, were trained in the techniques and used them in practice.

The VERA framework forms part of the course content for Anglia Ruskin's Mental Health Nursing students and has been cited by the Royal College of Nursing as one of two central articles on communication in dementia. At the heart of the approach is that communication should be compassionate and kind.

VERA's four stages consist of:

• Validation: explanations for acts of behaviour or communication that value a person and avoid negative and unhelpful assumptions;
• Emotion: understanding and engaging with the emotional context of a conversation even when the actual words used make less sense;
• Reassurance: To show that the person is safe;
• Activity: doing something with the person to help with their concern, such as helping them look for something they think they have lost.

David Hawkes, Lecturer in Mental Health Nursing at Anglia Ruskin, said: "There are several conditions, such as dementia and Alzheimer's, which can result in people becoming confused and anxious.

"This is a very upsetting situation for people and their carers and the VERA framework has been designed so that even if it is difficult to understand exactly what a person wants to say, they feel reassured and valued by nursing staff.

"The evaluation showed that staff and student nurses on two older-adult inpatient wards found the VERA model helped communication and they have provided feedback which will pave the way for specific research and development in this area.

"We are faced with a rapidly ageing population and the number of people suffering from mental health conditions is likely to increase in the future. It is vital that healthcare workers are trained in the most effective way to ensure that those in their care feel safe and valued."

In partnership with the North Essex Partnership University Foundation Trust, academics have produced a training package including a workbook and instructional DVD. The video can be viewed at take1.co.uk/vera.htm. They also plan to work with carers and families to see if the model can be effective outside of settings such as hospitals and care homes.