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Introduction: People with a borderline personality disorder (BPD) diagnosis or symptoms may experience emotional crises which necessitate use of the emergency department (ED). No existing reviews focus specifically on experiences of consumersa, carersb and clinicians in relation to ED presentations by people diagnosed with BPD. Aim/Question: The aim of this study was to synthesise knowledge on consumer, carer and clinician experiences of BPD in the ED. Method: An integrative review methodology was chosen as it best captures the complexity of varied perspectives and emergent phenomena from diverse literature sources. EMBASE, CINAHL, PsycInfo and Medline were searched for papers published before 16 February 2022. Results: Nine papers met the inclusion criteria (five qualitative, one quantitative, one mixed methods and two letters to the editor). Key themes were barriers to timely and adequate care, and stigmatising attitudes and practices towards people diagnosed with BPD. Negative attitudes were perceived to perpetuate harmful outcomes and further ED visits. Discussion: Predominantly negative ED experiences were expressed by clinicians, consumers and carers. Further work is needed in ED models of care and staff education to improve the experience of care for consumers, carers and clinicians alike. Implications for Practice: Opportunities for change will exist through co‐designed innovation, education, advocacy and leadership. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the topic?: Mental health‐related problems in pregnancy are now becoming a global health concern. However, most studies have reported that midwives are unable to assess and support maternal mothers due to poor preservice education. The findings of these studies needed to be explored further from the available literature to address the gap. What does the paper add to existing knowledge?: The paper has identified maternal mental health core competencies and innovative clinical teaching strategies that nurse educators can utilize when supporting students theoretically and during clinical practice so that students should be adequately prepared for maternal mental health practice.Challenges and recommendations for clinical teaching were also identified. However, there are still gaps in the literature related to the effectiveness of teaching strategies to promote competence acquisition in maternal mental health. What are the implications for education?: The study results can be used by nurse educators to develop effective clinical teaching practices in maternal mental health care. The findings can be used in the development of best clinical teaching guidelines for maternal or perinatal mental health to be used by nurse educators for the undergraduate midwifery training programmes. Introduction: Maternal mental health problems are commonly experienced by women; however, they are usually not adequately recognized and treated by midwives in Malawi. Evidence suggests poor preservice education by nursing colleges which affects the development of essential maternal mental health competencies. Aim: The aim of the study was to review existing evidence on clinical teaching practices by nurse educators in teaching student midwives maternal mental health care. Method: Integrative review method was used, and various databases were searched. Out of 1768 articles, 27 research articles met the inclusion criteria. The critical appraisal skills programme checklist tools were used to assess data quality. Thematic analysis was done by comparing, grouping and integrating data. Results: Six themes emerged, namely: core maternal mental health competencies, professional regulation, interactive teaching strategies, collaborative partnerships, capacity building and shortage of resources. Discussion: Clinical teaching is an important aspect of midwifery education. Utilizing student‐centred teaching approaches helps students acquire competencies in maternal mental health care. Further research is required to identify the effectiveness of the clinical teaching methods. The Implication to Practice: The study results can assist nurse educators to provide comprehensive clinical teaching practices in maternal mental health care which will aid in the development of maternal mental health competencies among student midwives. [ABSTRACT FROM AUTHOR]

Accessible summary: What this paper adds to existing knowledge?: Service users report telehealth interventions to be useful in terms of access and convenience however, a preference for face‐to‐face interventions remains.Nurses are using telehealth interventions in clinical practice however, further research is necessary in this area as the evidence of their involvement is limited. What are the implications for practice?: This paper highlights the use of telehealth interventions should augment rather than replace face‐to‐face care provision. Introduction: The Covid‐19 pandemic saw the swift implementation of physical and social distancing that impacted the way in which mental health services were facilitated. Consequently, telehealth/e‐health interventions are increasing in use. Aim: This integrative review aims to explore existing literature regarding mental health service users' experiences of telehealth interventions facilitated through the COVID‐19 pandemic, to determine the visibility of nursing involvement in the facilitation of telehealth interventions and to use these experiences to inform nursing practice. Method: A methodical search of eight (n = 8) academic databases was undertaken using CINAHL, SCOPUS, EMBASE, PsycINFO, Web of Science, Cochrane, MEDLINE and Academic Search Complete between January 2020 and January 2022. Results: A total of 5133 papers were screened by title and abstract of which (n = 77) progressed for full‐text screening. Five (n = 5) papers met the inclusion criteria for this review and results were mapped onto the four meta‐paradigms of nursing: person; where the findings discuss the acceptability of telehealth interventions; environment; where the findings highlight barriers and facilitators to the use of telehealth interventions; health; where the findings discuss staff time and logistical issues relating to telehealth interventions and nursing; where the findings centre around the therapeutic relationship. Discussion: This review highlights there is a paucity of direct evidence relating to nursing involvement in the facilitation of telehealth interventions. However, there are benefits to the use of telehealth interventions that include increased access to services, less perceived stigma and increased engagement which are relevant to nursing practice. A lack of individual contact and concerns relating to infrastructure indicates a fondness for face‐to‐face interventions remains high. Implications for Practice: There is a need for further research on the role of the nurse in the facilitation of telehealth interventions, specific interventions used and outcomes of such interventions. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Nurses work in mental health services around the world, constituting the largest professional group.Nurses have been identified as being potentially able to carry out a much wider range of functions than are typically allowed in practice, when provided with suitable training.There are long‐term concerns regarding shortages of mental health nurses in England and many other countries.Workforce data is rarely subject to analysis in peer‐reviewed journals. What the paper adds to existing knowledge?: This paper provides a case study of the workforce patterns of a national mental health nurse (MHN) workforce overtime allowing comparison with other countries and specialities.MHN numbers reduced from 2011 to 2017, then increased to near the 2011 level by 2021, not meeting ambitious national plans for increasing numbers.The mental health nursing proportion of the total NHS nursing workforce decreased through this period.Advanced practice roles and skills are widely, but unevenly, distributed and are provided by a small proportion of nurses.The proportion of nurses working in community settings has increased to constitute more than half of all nurses for the first time.The ratio of support workers to nurses increased in inpatient settings and will continue to change. What are the implications for practice?: Historical challenges in recruiting MHNs suggest that future plans to expand the profession are overly optimistic.To support the development of advanced practice roles and new skill sets, clearer research evidence of impact is required and clearer national guidance regarding best practice models.Good workforce data are essential to inform good workforce planning. Introduction: Data regarding changes in characteristics of the MHN workforce is commonly cited in governmental publications, but is rarely analysed in peer‐reviewed journals, despite ongoing concerns regarding high vacancy rates within mental health services. Aim: The aim of the study was to characterize changes in the MHN workforce, implementation of new nursing roles/skills and alignment with national policy. Method: Analysis of nationally published workforce data, peer‐reviewed publications and governmental policy/planning documents. Results: Nurse numbers declined from 2011 to 2017, subsequently returning to near 2011 levels, but remaining below national targets. Nurses in community settings increased to constitute more than half of all nurses, whilst inpatient numbers declined, although more slowly than bed numbers. The ratio between nurses and support workers changed due to more support workers in inpatient settings. New advanced skills and roles for nurses have increased, but are unevenly distributed, constituting a small proportion of the total workforce. Implications for Practice: This paper provides a case study against which comparisons may be made with the nursing workforce in other countries and specialities. Even clear policy commitment to nursing growth may not deliver planned changes in numbers and introducing new roles may have uneven impact, especially in the absence of a robust evidence base. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Sleep problems are common among those with depression, and there is increasing evidence that sleep problems should be addressed during treatment simultaneously rather than treating depression alone.The first‐line treatment for insomnia is cognitive behavioural therapy for insomnia (CBT‐I), due to a lack of well‐trained therapists and patient time constraints (travelling, work), CBT‐I has not been popularized.The development of digital cognitive behavioural therapy for insomnia (dCBT‐I) is making the treatment more accessible. What this paper adds to existing knowledge: Interventions for dCBT‐I were significantly better than other control conditions in both reducing insomnia and improving depression in patients with depression and insomnia comorbidities.The effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention and therapist‐involved dCBT‐I has less shedding than self‐help. What are the implications for practice: It's important for mental health practitioners to realize that insomnia in depressed people needs to be treated.Future trials may explore the effectiveness of therapist‐guided dCBT‐I in depressed populations and analyse the cost‐effectiveness of this treatment. Aim: The aim of the study was to systematically identify and synthesize the evidence for the effectiveness of digital cognitive behavioural therapy in insomnia with comorbid depression. Design: Systematic review and metaanalysis. Methods: A search was conducted on five English and four non‐English databases from the inception of the databases to November 2023. This review adhered to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta‐analysis Statement 2020 and the included studies were evaluated using version 2 of the Cochrane risk of bias tool. This review examined sleep‐related outcomes, including insomnia severity and sleep diaries, along with psychological outcomes, such as depression. We conducted a meta‐analysis of each outcome using a random effects model. Heterogeneity was assessed by the I2 statistic. Results: A total of seven articles with 1864 participants were included in this review. The results showed that the digital cognitive behavioural therapy group demonstrated a statistically significant amelioration in the severity of insomnia symptoms, as well as a reduction in depressive symptomatology compared with the control groups. The post‐intervention effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention. Conclusions: Digital cognitive behavioural therapy for insomnia application in patients with depression and insomnia was demonstrated to be effective, less time‐consuming and more accessible. Relevance to Clinical Practice: We may consider incorporating nurses into treatment plans and conducting nurse‐led interventions in specific programs. In the future, nurses may be able to provide exclusive digital behavioural therapy for insomnia to patients with depression to achieve greater effectiveness. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject?: Loneliness is common among young and middle‐aged stroke survivors. It not only hinders the recovery of their neurological and physical functions but also increases the risk of stroke recurrence, disability, and even death.Improving the mental health of young and middle‐aged stroke survivors is of utmost importance. However, previous research has not yet investigated the impact of interpersonal sensitivity and resilience on the relationship between stigma and feelings of loneliness. What the paper adds to existing knowledge?: This study confirms that stigma has a positive impact on loneliness among young and middle‐aged stroke survivors.Interpersonal sensitivity partially mediates the relationship between stigma and loneliness, and resilience plays a moderating role in the mediating mechanism. What are the implications for practice?: Mental health nurses can formulate nursing interventions to reduce loneliness of young and middle‐aged stroke survivors with the goals of improving stigma, reducing interpersonal sensitivity and cultivating resilience. Introduction: Previous studies have not explored the impact of interpersonal sensitivity and resilience on the relationship between stigma and loneliness. However, improving the resilience of young and middle‐aged stroke survivors and increasing their social participation is of great significance for reducing patients' loneliness of patients and promoting their physical and mental rehabilitation. Aims: To investigate the influence of stigma, interpersonal sensitivity and resilience on loneliness among young and middle‐aged stroke survivors. Methods: A cross‐sectional design was used to collect data. A total of 330 participants completed measures of stigma, resilience, interpersonal sensitivity and loneliness. The descriptive statistical approach, Pearson's correlation analysis and Hayes' PROCESS Macro Model 4 and 7 in regression analysis were used to analyse the available data. Results: The results revealed that young and middle‐aged stroke survivors' stigma, resilience, interpersonal sensitivity and loneliness were significantly correlated between every two variables, with coefficients ranging between −0.157 and 0.682. Interpersonal sensitivity played a partial mediating role in stigma and loneliness, accounting for 63.27% of the total effect; This process was moderated by resilience. Discussion: Stigma positively predicts participants' loneliness. As a mediating mechanism with moderating, interpersonal sensitivity and resilience further explain how stigma affects loneliness. Implications for Practice: Understanding this mechanism is of guiding significance to reduce loneliness of young and middle‐aged stroke patients and promote their physical and mental rehabilitation. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Psychiatric hospitals have input from a range of professionals, including Clinical Psychologists.Most evidence used to guide what Clinical Psychologists do is based on their work with individuals rather than staff teams.Some evidence shows working with staff teams is important, but most of this is based on interviews rather than measuring the impact using numbers and statistics.The current study aimed to investigate the effectiveness of staff‐level interventions provided by a Psychology team within a psychiatric inpatient setting. What the paper adds to existing knowledge?: Training sessions were effective at increasing staff levels of confidence and understanding in psychological approaches, and the perceived usefulness of the session to their practice.Case discussion sessions were effective at increasing staff levels of understanding a service user, compassion towards the service user, perceived opportunities for change with the service user, their perceived skills to work with the service user and their perception of the usefulness of the session to their practice.Reflective practice sessions were effective at providing a space for learning, sharing ideas and reflecting.Other interventions were highly valued by nursing staff. What are the implications for practice?: Staff‐level interventions are effective and valued by mental health nursing staff and should be considered in allocation of psychology resources.Interventions improved staff psychological thinking which could positively impact service user experience.There is potential for people with lived experience to participate in these interventions, which could facilitate the therapeutic relationship and reduce restrictive practices. Introduction: The role of Psychologists in psychiatric inpatient settings is well established and involves intervention at various levels; however, quantitative exploration of the effectiveness of staff‐level interventions is lacking. Aim: The aim of the study was to examine the effectiveness of a variety of staff‐level interventions provided by a Psychology team within a psychiatric inpatient setting. Methods: The evaluation used a mixed methods approach incorporating pre–post quantitative data and post‐intervention feedback. Additional data were collected via survey. Key Findings: Results indicated all staff‐level interventions were effective in achieving their aims and were highly valued by staff. Qualitative data supported the quantitative findings and showed tentative suggestion of a change to clinical practice. Discussion: Indirect psychology provision was found to significantly impact a range of staff attitudes and was highly valued by the staff team, supporting previous qualitative findings in psychiatric inpatient settings. Further quantitative evidence of the impact of staff‐level interventions should be sought. Implications: Staff‐level interventions are effective and valued by mental health nursing staff and should be considered in allocation of psychology resources. Furthermore, there is potential for people with lived experience to participate in these interventions, which could facilitate the therapeutic relationship and reduce restrictive practices, however this requires future research. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Children and adolescents' mental health problems, such as autism spectrum disorder, anxiety disorder and attention‐deficit hyperactivity disorder, are a global public health concern, and nurses require advanced expertise and skills to properly care for this population.There is a gap between the required competencies and the actual skills and knowledge of CAMHN practitioners. Previous studies suggest that educational interventions for nurses are necessary to enhance the quality of care for children and adolescents with mental health problems. However, the corresponding evaluation indicators have not been verified, making it difficult to determine the most effective methods. What this paper adds to existing knowledge?: The present study developed the two‐factor (direct care for children and their family members and approach to the care environment) Clinical Competency Assessment Scale in Child and Adolescent Mental Health Nursing (CCAS‐CAMHN).We demonstrated that the assessment scale was reliable and valid, based on its adequate internal consistency and temporal stability, the acceptable range of its model‐fit indexes, and its good concurrent and divergent validity. What are the implications for practice?: The newly developed scale is useful for assessing nurses' competency and could help them identify their difficulties in CAMHN.The scale could contribute to the development of effective educational interventions to enhance the quality of care for children and adolescents with mental health problems. Introduction: Caring for children and adolescents with mental health problems, such as autism spectrum disorder, anxiety disorder and attention‐deficit hyperactivity disorder, requires expertise and skills. A quantitative clinical competency measurement tool in child and adolescent mental health nursing (CAMHN) is needed to evaluate the indicators of advanced expertise. Aim: The aim of this study was to develop a clinical competency assessment scale in CAMHN and evaluate its psychometric properties. Method: Scale items were derived from previous studies and adjusted based on cognitive interviews with five CAMHN experts. In total, 505 nurses in CAMHN from 29 hospitals in Japan participated in the self‐administered survey. The scale's construct validity, criterion‐related validity, internal consistency and test–retest reliability were assessed. Results: A two‐factor (direct care for children and their family members and approach to the care environment) scale was constructed. A secondary structural model showed that a two‐factor model fits best. The total score was significantly and positively correlated with excellence in nursing practice, amount of clinical experience and mental status. The overall scale exhibited good validity and reliability. Discussion: The scale is reliable and valid for assessing CAMHN clinical competency. Implications for Practice: The scale is useful for assessing nurses' competency and evaluating educational interventions' effectiveness for nurses. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Storytelling is an effective tool for communication, is universally comprehensible and transcends linguistic barriers, adapting to cultures easily.Storytelling has a strong influence on children and has been used for knowledge retention and for developing imagination, creativity and prosocial behaviours. What this paper adds to existing knowledge?: The systematic review offers essential insights into the effects of storytelling interventions on the development of resilience in children.It indicates the various forms of storytelling interventions implemented and also the specific measures of resilience employed in the studies.The review has demonstrated that storytelling plays a crucial role in the development of protective factors in children including resilience. What are the implications for practice?: Psychiatric and mental health nurses working in community, hospital or mental health units play an important role in mental health interventions, particularly when it comes to children and young adults.Employing storytelling techniques can help psychiatric and mental health nurses provide timely and consistent support to children while helping them explore support systems, mechanisms and coping strategies helping build resilience.This holds particular importance for low‐ and middle‐income countries where limited resources pose challenges in providing adequate support for mental health programmes for children. Methods such as storytelling are simple and adaptable to the specific challenges faced in the mental health setting. Introduction: Resilience is a crucial aspect of mental health and coping that enables individuals to effectively recover from challenges. Fostering resilience in children becomes a significant objective. Storytelling is known to positively affect resilience, providing opportunities to share and develop narratives that help make sense of difficult experiences, find meaning in them, and building beliefs around our capacity to adapt well to challenging experiences. Aim: The aim of this review is to synthesize peer‐reviewed studies on the impact of storytelling interventions in developing resilience in children. Method: The review adhered to the updated PRISMA 2020 guidelines and was registered with PROSPERO (CRD42022365474). We conducted searches in 12 databases with search strings comprising of concepts regarding storytelling, resilience and children. Results: The review included 11 studies published between 2012 and 2022. The narrative synthesis of the studies indicates that storytelling interventions enhanced psychological resilience in children. Discussion: Storytelling‐based interventions in school settings with participatory approaches using cultural stories, and positive psychology‐based interventions were effective and feasible. Implications for Practice: This review has scope for informing future interventions with children, especially those who live in marginalized communities in low‐ and middle‐income countries (LMICs). [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Recovery‐oriented services have been shown to promote recovery in people with mental illness; their implementation is important for current psychiatric practice and is being considered by many professional institutions.The Japanese government released the policy 'A Vision for Reform of Mental Health and Medical Welfare' (Ministry of Health, Labour and Welfare, 2004; https://www.mhlw.go.jp/topics/2004/09/dl/tp0902‐1a.pdf), aiming to update public consciousness, reorganize the mental healthcare welfare system and strengthen the foundation of mental healthcare to promote a basic policy focusing on the transition 'from hospital to community life'. What the paper adds to existing knowledge?: This is the first study to clarify recovery‐oriented attitudes among psychiatric nursing directors and related factors in Japan. It shows an association between recovery‐oriented attitudes and hospital size. What are the implications for practice?: A relationship exists between the recovery knowledge and recovery‐oriented attitudes of psychiatric nursing directors. It may thus be valuable for directors to see and hear about the experiences of patients living in the community during their recovery process. As hospital size and organizational climate may hinder the successful implementation of recovery‐oriented practices, these factors must be considered when introducing such practices.Further research is needed on the relationship between psychiatric nursing directors' recovery‐oriented attitudes and practices. Moreover, to develop intervention studies that uncover success factors for enhancing recovery‐oriented attitudes, organizational factors that enable recovery‐oriented practices must be further investigated. Introduction: Recovery‐oriented practices in mental health services have become a global priority. Despite their proven effectiveness, Japanese hospitals have not widely implemented such practices. Aim: This study clarified psychiatric nursing directors' recovery‐oriented attitudes and factors regarding promoting recovery‐oriented practices to identify methods for developing these practices in Japan. Method: This cross‐sectional study used a questionnaire survey with 250 nursing directors from 1287 Japanese psychiatric hospitals. Multivariable regression analysis assessed how socio‐demographic variables and Recovery Knowledge Inventory (RKI) scores affected Recovery Attitudes Questionnaire (RAQ‐7) scores. Results: The analysis revealed that more clinical and managerial experience was associated with more negative recovery‐oriented attitudes. High RKI scores, knowledge of strength, hospital size and outpatient work experience were associated with more positive recovery‐oriented attitudes. Discussion: Implementing recovery practices requires consideration of knowledge and experience in recovery and hospital size alongside recovery training based on a hospital's organizational structure. Although the low response rate could influence the study's generalisability, it could also indicate low interest in recovery‐oriented practices among professionals. Implications for Practice: Acquiring more knowledge and experience regarding recovery promotes recovery‐oriented attitudes among nursing directors. An appropriate organizational culture and consideration of hospital size are required when introducing such recovery practices. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Restraining and secluding health consumers for safety reasons continue to be used in psychiatric inpatient facilities even though they have no therapeutic value and have negative effects on consumers, families and staff.Six Core Strategies (6CS) for reducing seclusion and restraint have been developed to address this problem but there are very few effectiveness studies in inpatient adolescent psychiatric facilities. What the paper adds to existing knowledge: We used a mixed methods approach to evaluate the implementation of 6CS in an adolescent psychiatric facility. The implementation was successful. It eliminated the use of seclusion, substantially reduced the use of restraints and significantly reduced staff absenteeism.Using thematic analysis on feedback surveys, we identified five dominant themes that described consumers' and carers' experiences during their stay at the facility: communication, service delivery, flexibility, consistency and internal feeling states. What are the implications for practice: This study provides support for the feasibility of a comprehensive and broad‐based intervention program such as 6CS to reduce seclusion and restraint practices in inpatient mental health facilities.This study also demonstrates the value of using surveys to gather consumer and carer feedback and improve outcomes for service users. Introduction: Seclusion and restraint practices are routinely used in psychiatric facilities but are controversial for ethical, legal and safety reasons, and can cause significant harm to consumers, staff and organisations. Six Core Strategies (6CS) for reducing seclusion and restraint were developed to address this problem but very few studies have examined their effectiveness in adolescent settings. Aim/Question: To evaluate the implementation of 6CS in an adolescent inpatient psychiatric facility. Method: We retrieved archival data from an acute adolescent psychiatric ward that implemented the 6CS. Using a mixed methods approach, we evaluated outcomes on the use of seclusion and restraint, nursing staff sick leave and feedback surveys. Results: Findings showed an elimination of seclusion, and a significant reduction in restraint use and staff absenteeism in the 12 months after project implementation. Thematic analysis of feedback survey responses identified communication, service delivery, flexibility, consistency and internal feeling states as dominant themes in consumers' and carers' experience on the unit. Discussion: The 6CS is feasible and may be effective in reducing seclusion and restraint, which in turn may have a positive impact on staff wellbeing. Implications for Practice: Implementation of the 6CS with executive support, combined with staff and programmatic changes at a local level is recommended. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Seclusion is a harmful and traumatising intervention for people accessing mental health services.People who are subject to seclusion in inpatient mental health services often first experience this within the first 24 h following admission.There is limited research examining how recent contact with services impacts the likelihood of seclusion when people are admitted to inpatient services. What the paper adds to existing knowledge?: Males, Māori and Pasifika experience higher rates of seclusion within the first 24 h following inpatient admission.People perceived by clinicians as overactive, aggressive, disruptive or agitated are seven times more likely to be secluded within the first 24 h.People referred from police or justice services are three times more likely to be secluded within the first 24 h.People who had frequent contact with community mental health services prior to inpatient admission were less likely to be secluded. What are the implications for practice?: The first 24 h of inpatient admission is a critical focus for eliminating the use of seclusion. Initial interactions with people recently admitted should focus on nurturing relationships and reducing distress.Mental health staff should consider the person's cultural needs, referral pathway, recent service contact and baseline ratings on the Health of the Nation Outcomes Scales (HoNOS) when working proactively to prevent the use of seclusion in the first 24 h following admission.Strengthening the focus on nurturing relationships, cultural understanding and non‐coercive de‐escalation approaches requires leadership support and strategic workforce development. Introduction: People who experience seclusion in inpatient mental health services often do so within the first 24 h following admission. There is limited research examining the potential contributing factors, particularly recent contact with services. Aim/Question: To identify factors associated with seclusion within the first 24 h following admission into acute inpatient mental health services. Method: A retrospective analysis was undertaken using routinely collected data from Aotearoa New Zealand mental health services. Results: A higher likelihood of seclusion within the first 24 h following admission was associated with: males, Māori, Pasifika, referrals from police/justice services, inpatient transfers, recent contact with crisis assessment teams and clinician perceptions of aggression, problematic substance use, cognitive problems and hallucinations or delusions. Recent contact with community mental health services was associated with a lower likelihood. Discussion: People's cultural needs, referral pathway, recent service contact and HoNOS scores should be considered when working to prevent the use of seclusion in the first 24 h following admission. Implications for Practice: The first 24 h following inpatient admission is a critical period for preventing the use of seclusion. Nurturing relationships, cultural understanding and use of non‐coercive de‐escalation approaches can support better outcomes for people recently admitted. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: People diagnosed with serious mental illness have a high risk of diabetes and are more likely to develop type 2 diabetes at ages below 60 years.Effective diabetes self‐care behaviours among people diagnosed with serious mental illness can improve glycaemic control and reduce vascular complications.Few studies have investigated diabetes self‐care behaviours and their associations with health literacy and self‐efficacy in people diagnosed with serious mental illness. What the paper adds to existing knowledge?: Diabetes self‐care behaviours in people diagnosed with serious mental illness were suboptimal; the least frequently performed self‐care activities were self‐monitoring of blood glucose.Factors associated with diabetes self‐care behaviours are gender, age, communicative and critical health literacy and self‐efficacy.Self‐efficacy is the strongest predictor of self‐care behaviours among people diagnosed with comorbid serious mental illness and type 2 diabetes. What are the implications of practice?: Mental health nurses should assess diabetes‐specific health literacy of people diagnosed with serious mental illness to ensure that they possess the knowledge and skills related to diabetes self‐care.When treating young people and those with newly diagnosed type 2 diabetes, nurses should incorporate strategies to minimise their perceptions of diabetes‐related distress and increase their confidence in managing comorbid diabetes. Introduction: People diagnosed with serious mental illness (SMI) experience greater challenges in managing their type 2 diabetes mellitus (T2DM) than do those diagnosed with T2DM alone. Aim: This study investigated diabetes self‐care activities and the factors associated with these activities in people diagnosed with SMI in a hospital setting. Methods: A cross‐sectional correlational study was conducted among 126 people diagnosed with comorbid SMI and T2DM in Taipei, Taiwan, between October 2020 and April 2021. Data were collected using self‐report questionnaires and a chart review. Three‐step hierarchical multiple regression analysis was used to identify factors associated with diabetes self‐care behaviours. Results: Diabetes self‐care behaviours in people diagnosed with SMI were suboptimal overall. Hierarchical multiple regression analyses revealed that age (β = 0.18, p =.037) and self‐efficacy (β = 0.27, p =.004) significantly associated with diabetes self‐care behaviours. Discussion: Self‐efficacy is the strongest predictor of self‐care behaviours among people diagnosed with comorbid SMI and T2DM. Implications for Practice: Mental health professionals should focus on enhancing confidence in managing comorbid diabetes in people diagnosed with comorbid SMI, especially young people and those with newly diagnosed T2DM. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Self‐harm by ligature is common within inpatient mental healthcare settings and is a dangerous method of self‐harm. Most fatal and non‐fatal suicidal behaviours in inpatient settings are a result of ligature use.There is a lack of research which has explored the experiences of staff members who work within inpatient settings where patients may self‐harm by ligature. What the paper adds to existing knowledge: Key issues related to self‐harm by ligature reported by staff included (1) understaffing increasing risk of ligature incidents, (2) spreading of self‐harm by ligature within inpatient settings and (3) negative attitudes of staff related to patients who self‐harm by ligature.Working with self‐harm by ligature can have negative impacts on staff's personal (e.g. fear of blame) and professional lives (e.g. increased cautiousness). Many staff members currently feel underprepared by training related to working with self‐harm by ligature, and unsupported after responding to a ligature incident. What are the implications for practice: Training about self‐harm by ligature needs to be improved and be accessible for all inpatient mental healthcare staff. Training should be coproduced, and could include practical components, education on potential reasons for self‐harm, and acknowledgement of the emotional impact on staff.Support for staff members who respond to ligature incidents should be available for all staff members who respond to self‐harm by ligature incidents. Stigma associated with accessing support should be challenged, alongside blame cultures within the workplace. Introduction: Self‐harm by ligature is a common form of self‐harm within inpatient mental health services in England, where most suicides within inpatient settings involve hanging or suffocation. However, little research has examined the experiences of staff members working with this method of self‐harm. Aim: We explored the experiences of clinical staff who work with patients who self‐harm by ligature. Method: A staff survey was developed and disseminated to clinical staff working in inpatient settings in England. Quantitative data were analysed using descriptive statistics, and qualitative data using the framework approach. The study was STROBE checklist compliant. Results: 275 staff members participated. Challenges most frequently reported about working with self‐harm by ligature included understaffing (210, 76.6%), spreading of ligature incidents (198, 72.8%) and negative attitudes held by clinical staff towards such patients (185, 68.5%). Participants' responses indicated that this work could have significant impacts on their professional and personal lives. Staff often reported inadequate training and lack of preparedness, alongside insufficient support opportunities following ligature incidents. Discussion: Staff had a diverse range of professional and personal experiences and identified multiple challenges associated with working with patients who have self‐harmed by ligature. Implications for Practice: There is a need to improve accessibility, format and content of training and support for staff working within inpatient settings where patients may self‐harm by ligature. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known?: SDM improves clinical outcomes by increasing attendance and treatment adherence in adolescents diagnosed with depression.SDM could reduce treatment disagreements and enhance consumers' and their families' satisfaction with mental healthcare services.Healthcare professionals are a critical part of SDM. However, MHPs' practices of SDM in the daily management of adolescents diagnosed with depression need to be clarified. What the paper adds to existing knowledge?: From the viewpoints of MHPs, SDM was not extensively applied in the daily management of adolescents diagnosed with depression.MHPs who trust their consumers and have received training related to SDM are more likely to practice SDM in the daily management of adolescents diagnosed with depression.The positive preferences for providing information and family involvement in treatment decision‐making are facilitators; working in closed inpatient mental health wards and open inpatient mental health wards are hindering factors for MHPs' practices of SDM. What are the implications for practice?: MHPs should encourage information sharing with consumers and their family members to help them participate in treatment decision‐making actively.A trusting and friendly therapeutic relationship with consumers should be maintained in the daily management of adolescents diagnosed with depression.SDM‐related training should be encouraged for MHPs to promote widespread SDM. Introduction: Shared decision‐making (SDM) is an ideal model for a therapeutic relationship that can improve health outcomes. Healthcare professionals are a critical part of SDM, and they play an important role in the practices of SDM in the clinical setting. Evidence suggests that adolescents diagnosed with depression can benefit substantially from SDM. However, mental health professionals' (MHPs) practices of SDM for adolescents diagnosed with depression in China are not well‐documented. Aim: This study aimed to investigate the practices of SDM for adolescents diagnosed with depression from the viewpoints of MHPs in China. Method: In this cross‐sectional study, we recruited a total of 581 MHPs by convenience sampling. The Shared Decision‐Making Questionnaire—Physician Version (SDM‐Q‐Doc) was used to evaluate the MHPs' practices of SDM for adolescents diagnosed with depression. Results: The mean SDM‐Q‐Doc was 80.47 (±16.31). Within the six specific decision‐making situations, most MHPs selected non‐SDM (52.7%–71.6%). Substantial numbers of respondents believed that MHPs made the final decision, especially with regard to the development (37%) and adjustment of medication regimens (42%). The practice of SDM was predicted by MHPs' preference for providing information, their trust in consumers, preference for family involvement in treatment decision‐making, working in an outpatient clinic and receiving SDM training (F = 23.582; p =.000; R2 =.198; adjusted R2 =.189). Discussion: Although the MHPs' self‐rated score of SDM‐Q‐Doc was high, SDM was not extensively applied in the daily management of adolescents diagnosed with depression. Thus, SDM needs to be further promoted by enhancing SDM‐related training for MHPs, thereby actively promoting the involvement of families, facilitating the information sharing for consumers and families, and building an active, trusting consumer‐practitioner relationship. Implications for Practice: MHPs should prioritise information sharing with consumers and families, as well as build trusting and friendly therapeutic relationships. Family involvement in treatment decisions should be encouraged when adolescents diagnosed with depression are in need. Actively participating in training related to SDM is also important. Future high‐quality evidence is still needed to explore the facilitators and barriers to SDM practices from a tripartite perspective of MHPs, adolescents diagnosed with depression and their families. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Negative attitudes towards mental illness lead to the formation of stigma. Stigma prevents the recovery of people diagnosed with mental illness.There is evidence of stigmatic attitudes towards mental ill health among mental health professionals.Anti‐stigma initiatives, such as education and training, may be effective in enhancing or maintaining positive attitudes towards mental illness among mental health professionals. What this paper adds to existing knowledge?: Education and training that is designed and delivered around a specific mental health diagnosis or condition appears an appropriate strategy that could benefit mental health professionals to develop a deeper appreciation and understanding of mental ill health and its impacts on individuals.Consumer involvement in the education and training of mental health professionals regarding the stigma of mental illness is recommended; however, this is an under‐explored area of investigation.There is a weak evidence base regarding the long‐term sustainability of effects from anti‐stigma education and training. This should be addressed via further research in future. What are the implications for practices?: Anti‐stigma initiatives can support mental health professionals to develop stigma‐free, recovery‐oriented practices in their work. Further, such initiatives can improve the provision of evidence‐based quality care for the consumers, facilitating their recovery. Introduction: Despite an increasing focus on stigma, evidence shows prejudicial attitudes towards mental illness among mental health professionals still exist. It is suggested that anti‐stigma initiatives can aid in enhancing the attitudes of mental health professionals. However, research on initiatives targeting stigma of mental illness among mental health professionals is limited. Aim: To identify and analyse scientific literature pertaining to the effectiveness of anti‐stigma initiatives regarding mental ill health among mental health professionals. Method: A systematic literature review was performed using the databases MEDLINE, CINAHL, PsycINFO, PubMed, Scopus, Google Search engine and Google Scholar. The papers were limited to English language, published in peer‐reviewed journals with full‐text articles available and published between the years 2008 and 2020 to understand the most recent trends in the attitudes of mental health professionals including nurses. The Population, Intervention, Comparison and Outcome (PICO) strategy was used to identify papers meeting the inclusion criteria. Results: A total of 439 papers were identified. However, papers not meeting the inclusion criteria were excluded from selection. Three appraisers reviewed the selected papers individually using the Joanna Briggs Institute [JBI] critical appraisal tool. Finally, eight unanimously accepted papers were included in the systematic review. Several effective anti‐stigma initiatives were identified through the review, and these had positive impacts on mental health professionals' attitudes towards mental illness, for at least a short period. It was identified that contact‐based interventions are relevant and effective although the involvement of consumers and caregivers in the design and delivery of interventions was not explicitly addressed in detail in studies included in the review. Education strategies tailored for specific mental illness may be more appropriate, rather than approaches that refer to mental illness in general. Conclusions: This review shows the evidence of pessimistic attitudes towards mental illness persists among mental health professionals. Anti‐stigma initiatives identified in the selected papers were effective in changing these attitudes. Future research should be focused on the effectiveness of contact‐based interventions and understanding the longer‐term effects of the interventions among homogeneous groups. Full consideration of the varying level of clinical experience and expertise in mental health should guide the development and implementation of anti‐stigma initiatives in this context. Implications for practice: Anti‐stigma interventions can have a positive impact on mental health professionals' knowledge, attitudes and supportive caring for people diagnosed with mental illness. Such anti‐stigma interventions may meaningfully support stakeholders to address the impact of negative attitudes on the physical and mental health status of people diagnosed with mental illness. With sustained leadership, effort and reinforcement, it is possible to create workplace cultures that prioritize stigma‐free and recovery‐oriented behaviours and practices within mental health services. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known about the subject?: Although sexual violence is prevalent, incidents of stranger rape remain statistically uncommon.Societal stigma and myths surrounding sexual violence are widespread.An individual's experience in the immediate aftermath and beyond can be shaped by the perception/s of sexual violence which are held and expressed by those they come into contact with. What this paper adds to existing knowledge?: This paper adds to the limited literature base and the population and practical‐knowledge gap around a specific form of sexual violence.This paper also demonstrates the need for reflection and discussion in minimizing blame that can unconsciously be shifted onto survivors in the form of myths and stereotypical views of sexual violence. What are the implications for practice?: Perceptions may be held around sexual violence, and by extension about the survivor, which may impede engagement and the building of trust within a therapeutic relationship.Myths that are synonymous with rape and all forms of sexual violence can be held by professionals, and lead to blame, negative judgement and lack of empathy towards survivors.Given the prevalence of sexual violence, this paper is applicable across all health and social care settings, and in particular mental health nursing professionals who may be more likely to meet people who have experienced sexual trauma. Introduction: This narrative illustrates the lived experience of a specific form of sexual violence (stranger rape) and its resulting implications as experienced by the second author, which is discussed under the following headings: your body as a crime scene, how lived experience compares to the myth of the 'real rape' and the wellbeing and health consequences arising from the experience. [Correction added on 5 September 2022, after first online publication: The preceding paragraph has been corrected in this version.] Aim: In their capacity as mental health nurses, the authors invite readers to consider the spoken, or more likely unheard stories of sexual violence, which are unfortunately commonplace among those who access mental health services. Implications for Practice: For professionals holding the privileged position of hearing these stories, there is a need to be reflective as to how fear, and personal or professionally held myths and stigmatizing views of sexual violence, and by extension views towards the survivor, are carried into therapeutic spaces, and the implications these can have. Practical suggestions as to how to discuss and manage disclosure of sexual violence in the context of trauma informed care are also provided. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: The use of chemical restraint in emergency situations is to control aggression or violence to protect consumers and staff and is to be used as a last resort when all other behavioural control alternatives have been exhausted.Chemical restraint involves the use of medication. What the paper adds to existing knowledge?: This is the first paper to systematically review the prevalence of the use of chemical restraint.The use of chemical restraint is common across emergency departments and acute psychiatric inpatient units worldwide.Consumers who are restrained are also likely to receive chemical restraint.The studies reviewed demonstrate that there is a need for more standardized data collection so that clearer comparisons can be made between healthcare settings and countries. What are the implications for practice?: Implications of practice include the need to report adverse events post‐chemical restraint as these can deleteriously affect a person's physical health.Identification of and staff education about first‐line management techniques before chemical restraint is administered are significant to reduce its use. Introduction: Chemical restraint is used to manage uncontrolled aggression, agitation or violent behaviours of consumers with mental health disorders admitted to acute psychiatric or emergency settings. Aim: This systematic review aimed to synthesize the international prevalence of chemical restraint for non‐consenting adults. Method: PsycINFO, CINAHL, MEDLINE/PubMed and Google Scholar databases were searched for peer‐reviewed literature published between January 1996 and July 2018. This paper reports on data extracted from retrospective audits of chemical restraint practice. Results: Forty‐eight papers were included. The median prevalence of use of any restraint was 21.2% (25th% 8.0 to 75th% 36.3). Median prevalence of people who were chemically restrained, of all people restrained in any manner, was 43.1% (25th% 22.9% to 75th% 70.7%). Of all people admitted to facility(ies), the median prevalence of chemical restraint was 7.4% (25th% 2.7 to 75th% 17.6). There was no statistically significant difference in any prevalence measure considering healthcare setting or country. There was a significant decrease over the review period in the use of any restraint, including chemical restraint. Discussion and implications for practice: This is the first known comprehensive meta‐view of chemical restraint use worldwide, highlighting the need for standardized data collection to enable comparisons between healthcare settings and countries. Relevance statement: There is an international imperative to reduce or eliminate the use of coercive practices, such as physical and chemical restraint, in mental health care. This study provides important information for mental health nursing by synthesizing the international prevalence of chemical restraint for non‐consenting adults. This meta‐view of the worldwide use of chemical restraint can inform ongoing efforts to reduce its use. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Major depressive disorder is the most prevalent of all mental illnesses.10%–20% of patients with depression and 1% of the population overall have treatment‐resistant depression (TRD).DBS is an emerging investigational treatment for TRD with documented clinical efficacy and safety.The framework of the recovery model includes both clinical and personal recovery. Personal recovery is a self‐process in which hope, empowerment and optimism are embraced to overcome the impact of mental illness on one's sense of self.Although clinical and functional outcomes of DBS for TRD have been well documented in the previous studies, personal recovery as an outcome has been explored only in a handful of studies. What this paper adds to existing knowledge?: This is the first qualitative study exploring personal recovery from DBS treatment specific to the target of subcallosal cingulate cortex in patients with TRD. Since the existing literature on personal recovery in DBS studies is limited, the contribution of this paper is crucial to this field.For individuals who responded to deep brain stimulation clinically, neither participants nor family believed it cured their depression, but rather there was a significant decrease in the severity of symptoms of depression. A holistic‐oriented framework (that includes personal recovery) is significant for those individuals with TRD undergoing DBS. Personal and clinical recovery are two different constructs, and individuals may experience one or the other or both.The experience of participants who responded to deep brain stimulation recognized that the recovery from depression is a process of reconstructing self. This process involved a period of adjustment that evoked a deeper self‐awareness, re‐engagement with daily living and newfound gratitude in living. Individuals transitioned from an emotionally driven life to one where future goals were considered. Supportive relationships were instrumental in this process. What are the implications for practice?: A deep brain stimulation intervention for treatment‐resistant depression offered individuals an opportunity for personal recovery where a reconstruction of self occurred.Personal recovery can be considered as an outcome in conjunction with clinical and functional outcomes in future DBS trials for TRD. The relevance of personal recovery in the prevention of relapses needs further investigation.To advocate for care and services that facilitate the process of recovery from depression, it is important to understand the personal dimensions and experience of recovery that may influence the process.To develop recovery‐oriented interventions to help patients and families in recovery post‐deep brain stimulation, further understanding of support and negotiating relationships during this life‐altering experience is needed. Introduction: Multiple trials of antidepressant treatments in patients with depression pose a major challenge to the mental health system. Deep brain stimulation (DBS) is an emerging and promising investigational treatment to reduce depressive symptoms in individuals with treatment‐resistant depression (TRD). The clinical and functional outcomes of DBS for TRD have been well documented in previous studies; however, studies of personal recovery as an outcome of DBS specific to the target of subcallosal cingulate cortex in patients with TRD are limited. Aim: To explore the processes of personal recovery in patients with treatment‐resistant depression following subcallosal cingulate‐deep brain stimulation. Method: Participants were 18 patients with TRD who participated in the subcallosal cingulate (SCC)‐DBS trial and 11 family members. They also participated in add‐on individual cognitive behavioural therapy during the trial. A qualitative constructivist grounded theory approach was used to conceptualize the personal recovery process of patients and families. Results: While every participant and their families' journey were unique following the deep brain stimulation intervention, a theoretical model of Balancing to Establish a Reconstructed Self emerged from the data. The themes underlying the model were (1) Balancing to Establish a Reconstructed Self: A Whole‐Body Experience, (2) The Liminal Space in‐between: Balancing with Cautious Optimism, (3) Hope: Transitioning from Emotion‐Focussed Living to Goal‐Oriented Planning and (4) Support: Negotiating Relationships. Discussion: This is the first study examining recovery from patients' perspectives as an outcome of SCC‐DBS intervention for TRD. The study shows that personal recovery is a gradual and continual process of reconstruction of the self, developing through supportive relationships. Clinical and personal recovery are two distinct constructs, and individuals may experience one or the other or both. Most patients who do respond clinically experience improvement in terms of having optimism and hope. Some patients, however, respond with significant symptom reduction but are not able to achieve personal recovery to experience joy or hope for improved quality of living. Implications for Practice: Strategies for personal recovery for both patients and family need to be considered during and post deep brain stimulation intervention. Nurses working with these patients and families may benefit from education, training and support to assess and engage in conversations about their recovery process. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Home treatment teams help people in a mental health crisis to recover. The staff goes to the person's home, avoiding the need to go to the hospital and providing care in the person's environment.The teams have been created in our country in recent years, becoming part of the mental health care network. What this paper adds to existing knowledge?: The paper presents the functioning of a CRHTT, the type of care it provides, and the coordination with the rest of the care network. It also shows the clinical results obtained in the first two years since its creation, supporting the CRHTT's effectiveness in accompanying people with mental health crises and reducing the need for hospital care.The outstanding factors in the team operation were coordination fluidity with referral services (facilitating accessibility), a prolonged care time (about two months), and continuity of care during the CRHTT intervention (the same CRHTT professionals visited the user and the family at home) and upon discharge (CRHTT staff organized joint visits with the professionals who would care for the user and the family after home treatment).The CRHTT followed a person‐centered orientation based on horizontality and dialogue. The CRHTT fostered the inclusion of the family and social network in the treatment and a deep understanding of the crisis considering social determinants. What are the implications for practice?: Flexibility, approach to the person's environment, dialogue, shared decision‐making, and the inclusion of the family and social network in the treatment are central factors in CRHTT functioning. It helps the person regain control over their life and enhance their resources to face possible future crises.Training in crisis management, community mental health and family care, and teamwork (which implies joint home visits and co‐responsibility with the rest of the staff, user, and the family) are relevant for CRHTT professionals. Introduction: Crisis resolution and home treatment teams (CRHTTs) provide intensive home care to people in a mental health crisis, becoming an increasingly widespread alternative to hospital admissions. However, there are wide variations in service delivery, organization, and outcomes, and little literature on how these teams work in clinical practice and different settings. Aim: To share the organizational functioning, the therapeutic approach, and the outcomes obtained in a CRHTT in Catalonia, Spain. Method: A descriptive analysis of the functioning of a home treatment team, the characteristics of the people served, and the clinical results from November 2017 to December 2019 are presented. Results: One hundred and five people were served, with an average stay of 57 days. And 55.24% were women, and the mean age was 41. Most people could overcome the crisis at home, and 5.71% required hospital admission during home care. A statistically significant improvement was observed in the results of the GAF and HoNOS scales at admission and discharge. Discussion: Despite reduced staff, home care was an alternative to hospital admission for most people treated. Implications for Practice: Flexibility, teamwork, and collaboration with the social network are relevant factors when accompanying the recovery process at home. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Supervised Quarantine has been shown to impact the psychological well‐being of those in quarantine both during the COVID‐19 pandemic and in previous pandemics.There are few studies regarding the psychological impact of supervised quarantine for the purpose of COVID‐19 mitigation.There is little research regarding the psychological well‐being of professionals maintaining quarantine, despite the fact they risk potential psychological distress. What the paper adds to existing knowledge?: This paper addresses the paucity of knowledge regarding the psychological well‐being of those undergoing quarantine in a purpose‐built facility.The quarantined study population involved uniquely domestic arrivals and also professionals maintaining quarantine.Lack of control, isolation and miscommunication were perceived as challenging mental well‐being. What are the implications for practice?: Although psychological distress in Domestic arrivals appeared low, there are still identifiable stresses on mental well‐being.Mental health workers need to be cognizant that point entry to COVID‐19 quarantine (Domestic vs. International as well as specific regions) may influence risk of psychological distress.Mental Health nurses supporting those in quarantine should afford quarantined individuals a degree of choice, establish regular clear communication and consider how to establish peer support mechanisms within the quarantine environment. Introduction: Supervised quarantine may compromise psychological well‐being. There is equivocal evidence regarding psychological distress in compulsory supervised quarantine facilities. Aims: To evaluate the mental well‐being of people undergoing and working in a supervised COVID‐19 quarantine facility. Method: Mixed methodology was used, including a cross‐sectional analysis of psychological distress (DASS‐21) and individual semi‐structured interviews (10 professionals maintaining quarantine and 10 quarantined persons). Results: Overall levels of psychological distress were low. Those quarantining from Victoria had significantly lower depression scores compared to all other departure points. Qualitative analysis identified distress being linked to a lack of control, isolation and miscommunication. Discussion: Quarantine was associated with low levels of psychological distress. This was lower in people travelling from Victoria, a state where there were higher rates of infections and restrictions. Interviews showed that psychological distress was conceptualized as being associated with supervised quarantine, but participants recognized the overall importance of quarantine. Implications for Practice: Mental health professionals supporting quarantined people should consider original departure points may predict levels of psychological distress. Implementing ways of gaining control through affording choice, improving communication channels and establishing peer support networks within quarantine settings may help maintain mental well‐being. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Women are more likely to experience intimate partner violence (IPV) than men; 19.2%–69.0% of women have experienced IPV, and the percentage is increasing.Survivors of IPV suffer from physical, psychological, social and reproductive health problems and numerous adverse health consequences such as post‐traumatic stress disorder, depression and anxiety. These are considered IPV comorbidities, especially among women. What the paper adds to existing knowledge?: This study reviews and reinforces existing scientific knowledge regarding the application of trauma‐informed care (TIC), including intervention content or type, frequency, duration of session and length.This study focused on the effects of TIC. Furthermore, it examines short‐term (3 months) and medium‐term (6 months) outcome effects, which are more significant for clinical practice. What are the implications for practice?: Development of a standardized protocol to address specific needs for TIC in IPV care settings.Among multidisciplinary teams, nurses are the ideal professionals to support women experiencing IPV. They can understand their traumatic experiences better, improve their therapeutic relationships and engage patients in collaborative care. Introduction: Post‐traumatic stress disorder (PTSD), depression and anxiety are considered intimate partner violence (IPV) comorbidities, especially among women. Trauma‐informed care (TIC) is the most common element of IPV care. Aim: This study analysed the short‐term (3 months) and medium‐term (6 months) outcomes of TIC on PTSD, depression and anxiety in women experiencing IPV. Method: The Preferred Items for Systematic Reviews and Meta‐Analysis guidelines were followed, and databases were searched from their inception to September 2022. Results: Thirteen randomized controlled trials included 850 women randomly assigned to the TIC and usual care groups. Overall, TIC showed a superior psychological health‐improving effect. Depression and anxiety significantly improved after treatment and at three and 6 months. No difference was observed in PTSD between the two groups at 3 and 6 months. Discussion: The growing evidence demonstrates that the lack of IPV intervention effects reported by reviews may be due to the attributes of PTSD, heterogeneity of TIC intervention design and components of TIC. Therefore, its clinical efficacy remains inconclusive. Implications for Practice: We analysed studies by stratifying intervention frequencies of once or twice a week. Regardless of the intervention frequency, length and design, PTSD decreased immediately after the TIC intervention. However, a significant difference in depression was observed after a TIC intervention of above 9 weeks. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Nurses often encounter traumatic events in their clinical practice.Trauma can have both negative effects, such as post‐traumatic stress disorder and positive effects, such as growth and positive emotions.Posttraumatic growth is beneficial for nurses, as it contributes to positive mental health outcomes and increases life satisfaction. What the paper adds to existing knowledge?: Our study confirms that nurses commonly experience posttraumatic growth after being exposed to traumatic events, and the level of growth is moderate.We have identified individual, work‐related, and social and organizational factors that may influence the occurrence of posttraumatic growth among nurses. What are the implications for practice?: Our findings provide valuable insights for interventions aimed at promoting posttraumatic growth among nurses. It is crucial to consider individual factors, work‐related factors, and social and organizational factors when designing these interventions. By addressing these factors, healthcare professionals can support nurses in coping with trauma and facilitate their posttraumatic growth. Introduction: While the negative effects of trauma on nurses have been well‐documented, it is equally important to focus on ways to promote posttraumatic growth (PTG) among nurses. Aim: This study aims to explore the levels and related factors of PTG among nurses. Method: A comprehensive search was conducted across nine databases up to 26 December 2022. The pooled mean score for PTG was calculated and presented with a 95% confidence interval. Subgroup and meta‐regression analyses were performed to identify potential moderators of PTG among nurses. Results: A total of 55 studies, involving 35,621 nurses from 11 countries and regions, were included in this review. The pooled scores of the PTG indicated that nurses experienced a moderate level of PTG (55.69, 95% CI: 50.67–60.72). Discussion: Nurses commonly experience PTG following exposure to traumatic events, with a moderate level of PTG. Our systematic review highlights the potential determinants of PTG among nurses, including individual, work‐related, and social and organizational factors. Implications for Practice: Targeting these factors in interventions can provide nurses with the necessary resources and support to effectively cope with stress and trauma, and potentially facilitate PTG. [ABSTRACT FROM AUTHOR]

What Is Known about the Subject?: Immigrant, refugee and asylum seeker populations worldwide are at high risk of mental health issuesNational mental health policies call for recognising Australian society's multicultural characteristics to ensure adequate mental health services to CALD communitiesSeveral barriers exist for people from CALD communities in Victoria to access and utilise mental health servicesImproving mental health professionals' knowledge of mental health service provision and cultural responsiveness can enhance CALD community access to services. What Does this Paper Add to Existing Knowledge?: We analysed the perspectives of people from CALD communities in Victoria regarding their needs and experiences with mental health services. Participants reported diverse perceptions and understanding of mental health issues and servicesVarious challenges were identified regarding health service utilisation for the CALD community in Victoria, including language barriers, stigma towards mental health issues, mental health illiteracy, distrust and lack of familiarity with mainstream mental health services. These challenges were acknowledged by community members even after a long residence in AustraliaThe data generated on the beliefs about mental health issues and consequent help‐seeking behaviours highlight the importance of culturally sensitive targeted prevention and early intervention strategies and ongoing commitment to building mental health literacy in the wider community What Are the Implications for Practice?: The information from the study can be adapted for quality improvement and culturally responsive practicesThe strategies for effective service delivery drawn by this paper can be a comprehensive resource tool for mental health professionals, organisations and policymakersThe findings imply that CALD mental health service users and their families will likely benefit from improved service assessment and quality of mental health care and equity when MHNs undertake cultural competence training and bring that into their practice. Introduction: Victoria is one of the most multicultural states in Australia. Many CALD communities in Victoria may have encountered complicated migration journeys and complex life stressors during their initial settlement, leading to adverse mental health concerns. This diversity necessitates public policy settings to ensure equity and access in health services planning and delivery. While the MH policies and services take cultural diversity into account, there needs to be more implementation of those components of MH policies that relate to the particular needs of various CALD communities in Victoria. Even though mental health services prevent and address mental health issues, many barriers can impair CALD community access and utilisation of mental health services. Furthermore, the recent Royal Commission inquiry into the Victorian Mental Health system drives a renewed policy imperative to ensure meaningful engagement and cultural safety of all people accessing and utilising mental health services (Department of Health, 2023). Aim: This study focused on the perspectives of people from CALD communities in Victoria regarding their mental health service needs, understandings of and experiences with mental health services to prepare an education package for mental health nurses as part of a larger multi‐method research project. Method: A qualitative descriptive design was used to collect and analyse the perspectives of 21 participants in Victoria, using telephone interviews, followed by thematic analysis. Results: The themes and sub‐themes identified were: Settling issues; Perceptions of understanding of mental health issues (help‐seeking attitudes toward mental health issues; the need for CALD community education); perceived barriers to accessing and utilising mental health services in Victoria (socio‐cultural and language barriers; stigma, labelling and discrimination; knowledge and experience of accessing health facilities); experience with mental health services and professionals. Discussion: Community participation, mental health professional education and robust research regarding the mental health needs of CALD people are some of the recommended strategies to improve access and utilisation of mental health services in Victoria. Implications for practice: The current study can contribute to the existing knowledge, understanding, practice and quality improvement as it vividly portrays the issues of various CALD communities in Victoria. The findings of this study imply that CALD MH service users and their families are likely to benefit in terms of improved service assessment and quality of MH care and equity when MHNs undertake CC training and bring that into their practice. [ABSTRACT FROM AUTHOR]

Accessible Summary: What Is Known on the Subject?: Australia is a commonwealth of federated states and territories with each having unique mental health legislation. Victoria implemented advance statements based on legislation from overseas jurisdictions such as Scotland. The aim of this Victorian legislation was to underpin an individual's autonomy and decision‐making in relation to treatment, particularly compulsory treatment.Advance statements allow individuals within the healthcare setting to document preferences for care and treatment during times of decompensated mental health, including informing nominated persons and preferences for recovery‐oriented care; however, advance statements continue to attract barriers in their implementation and use. What this Study Adds to Existing Knowledge?: This paper focuses on legislation within one jurisdiction, Victoria, highlighting that several barriers to uptake exist, including uncertainty around the legal status of advance statements, the ideal setting to implement advance statements and concern around perceived consumer capacity to contribute to developing advance statements.There are substantial differences of opinion regarding adherence to treatment and recovery preferences contained within the advance statement, especially when decisions are made in the context of decompensated mental health.The Theoretical Domains Framework (TDF) model has been used to formulate recommendations in several other health studies, but to date has not been used to provide recommendations for greater implementation of advance statements.Implementation science is a contemporary research translation movement that seeks to identify factors and strategies that influence the adoption and integration of interventions like advance statements in real world settings. For this study it has been useful to identify barriers, consider implementation strategies and link this with policy frameworks to support practice change. What are the Implications for Practice?: Our study revealed that real challenges exist for mental health clinicians in adopting advance statements despite them having a strong held intention to empower service users to play a greater role in their own treatment and care decisions.The facilitators identified in this study highlight the notion that advance statements, and the concept of supported decision‐making are needed in contemporary mental health care.Implementation science can assist in identifying barriers and suggesting facilitators including enhanced training, incentivization of advance statement creation, and greater awareness of the overarching purpose and principle of advance statement creation.Continued support and training in implementing and maintaining advance statements is required if mental health clinicians are to drive the uptake of this important reform to mental health legislation. Training needs to be provided that will address attitudes, and strongly held beliefs that pose barriers to the use of advance statements. Introduction: Advance statements, also known as advance directives or psychiatric wills, provide individuals the opportunity to document care and recovery preferences during a period of mental ill health. Although the use of advance statements has gained momentum, little research has explored the factors that promote or hinder further uptake. Aim: To determine the factors that promote or hinder the uptake of advance statements. Method: Cross‐sectional online survey of healthcare workers (n = 190). Results: Promoting factors include high perceived value of advance statements, particularly their role in recovery focussed care, while hindering factors include disagreement or responsibility for advance statement creation and legal status. Discussion: This study indicates that several hindering factors or barriers to advance statement uptake remain, and until these factors are addressed future implementation is arguably hindered. In this paper, we have used the Theoretical Domains Framework (TDF) model to outline suggestions to address hindering factors to implementation and guide future implementation strategies for advance statement uptake and practice change. Implications for Practice: The ongoing uptake of advance statements requires tailored implementation strategies address hindering factors. Strong promoting factors, such as the shared belief in the advance statement model and its role in recovery focused care, should be considered a strong foundation for implementation strategies. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Researchers have examined several interventions for psychological distress, mindfulness being a popular one. One intervention that fosters mindfulness is mantram repetition.Mantram repetition is an ancient traditional practice of repeating a sacred word/phrase at various times throughout the day and whenever needed. Psychologically, mantram repetition can mitigate immediate stressors. When used consistently, mantram repetition promotes resilience and deepens mindfulness, thereby promoting recovery from distress. What the paper adds to existing knowledge?: This paper examines the overall effect of mantram repetition on psychological distress symptoms (i.e., depression, anxiety and somatization). What are the implications for practice?: The portable, cost‐effective, mantram repetition intervention outperformed standard therapies.In people who are prone to psychological distress, practitioners might teach this technique, encouraging them to use it initially as they go through their day and then when they are experiencing distress.Mantram repetition can quiet the mind and pairs well with breathing exercises and routine activities such as walking or exercising, or during chores, thus, integrating the mantram into daily life. Introduction: Researchers have examined several interventions for psychological distress, mindfulness being a popular one. One mindfulness intervention is mantram repetition. Mantram repetition is an ancient traditional practice of repeating a sacred word/phrase at various times throughout the day and whenever needed. Aim: To examine the evidence of the effect of mantram repetition on psychological distress (i.e., depression, anxiety and somatization). Method: We searched 16 databases and retrieved 12 studies testing the effects of mantram repetition; only four of these measured aspects of psychological distress with comparison groups. Results: All studies showed positive effects ranging from very mild (.08) to very strong (.71). The summary effect across all studies was small (.23, p =.015). Importantly, this small effect was found when compared to treatment as usual and even psychotherapy. Discussion: The portable, cost‐effective, mantram repetition intervention outperformed standard therapies. Implications for Practice: In patients who are prone to psychological distress, practitioners might teach this technique, encouraging them to use it initially as they go through their day and then when they are experiencing distress. Mantram repetition could be practiced with breathing exercises, when walking or exercising, or during chores, integrating the mantram into daily life. [ABSTRACT FROM AUTHOR]

What is known on the subject?: Reminiscence therapy is a common psychosocial intervention in mental health nursing.Numerous secondary studies have explored the effects of reminiscence therapy interventions in older adults, and while the effects are significant, conflicting results remain. What this paper adds to existing knowledge?: To date, research on reminiscence therapy has examined different disorders in isolation from one another.By illustrating the evidence gaps between studies, this paper highlights the need for a new evidence‐based summary overview of reminiscence therapy research.The results suggest that reminiscence therapy can be beneficial to the improvement of mental health and quality of life for older people.However, we found that the secondary studies were not of high quality and that further high‐quality literature supporting the evidence is still needed. What are the implication for practice?: Reminiscence therapy may be considered a useful non‐pharmacological intervention for older people with mental and psychological problems.However, there is a lack of normative guidelines for reminiscence therapy in terms of intervention time, frequency, and form.The development of a global standard protocol for the application of reminiscence therapy may be necessary for future randomized controlled trials (RCTs). Introduction: Reminiscence therapy is an alternative to pharmaceutical intervention provided during long‐term care, especially for older people with mental and psychological problems. However, the effects of reminiscence therapy remain inconclusive. Aim: The present study aimed to systematically identify, synthesize and describe the research evidence and quality of systematic reviews (SRs) related to reminiscence interventions for older people through an evidence‐mapping approach. Methods: Commonly used English and Chinese databases, including PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, WANFANG, VIP and SinoMed, were searched from inception till 31 March 2022. The study type was restricted to SRs with or without meta‐analysis. The methodological quality of the included SRs was assessed by A Measurement Tool to Assess Systematic Reviews (AMSTAR‐2). The Microsoft Excel 2019 tool was used for data extraction and coding, and bubble charts were used to synthesize information on the study population, intervention category, original study sample size and classification of findings. Results: A total of 28 SRs were enrolled, including 514 original studies, 91.4% of which were randomized controlled trials. The main participants of the study were depressed older people (7 publications), older people with dementia (10 publications) and ordinary older people (8 publications). The findings of 26 (92.8%) publications were categorized as either "beneficial" or "potentially beneficial." The primary outcome indicators of the effectiveness of the reminiscence intervention for older people are mental and psychological problems (especially depressive symptoms and cognitive functioning), quality of life and categories of positive psychology (e.g., life satisfaction, happiness and self‐esteem). The main factors influencing the intervention effect were the intervention period, residential setting, intervention format (group/individual) and intervention intensity. The intervention settings/contexts were mainly community and long‐term care facilities. However, the methodological quality of 27 (96.4%) of the SRs was scored as either "Low" or "Critically Low." Discussion: Reminiscence therapy has been used to study the mental health and quality of life of older people in various conditions, with significant results. However, due to the limited evidence included in the studies and the low methodological quality, there is still a need to focus on the issue of effectiveness and evidence gaps for different interventions in the field of recall in the future, in addition to efforts to improve the methodological quality and standardize the reporting process for the evaluation of reminiscence intervention systems. Implications for Practice: Reminiscence therapy may be considered a useful non‐pharmacological intervention for older people with mental and psychological problems. A standard protocol for reminiscence therapy may be necessary for future studies. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Well conducted randomized controlled trials provide the highest level of evidence of effectiveness of healthcare interventions, including those delivered by mental health nurses.Trials have been conducted over the years but there has not been a comprehensive review since 2005, and never one including studies conducted outside the UK. What the paper adds to existing knowledge?: The paper provides a comprehensive overview of results from randomized controlled trials of mental health nurse‐delivered interventions conducted in the UK, Ireland, US, Australia, New Zealand, or Canada and reported 2005 to 2020.It highlights that the trial evidence is limited and offers only partial evidence for interventions that are central to mental health nursing practice. What are the implications for practice?: Much mental health nursing practice is not supported by the highest level trial evidence. Mental health nurses need to carefully select evidence on which to base their practice both from the mental health nursing literature and beyond.Mental health nurses and other stakeholders should demand greater investment in trials to strengthen the evidence base. Introduction: Nurses are the largest professional disciplinary group working in mental health services and have been involved in numerous trials of nursing‐specific and multidisciplinary interventions. Systematic appraisal of relevant research findings is rare. Aim: To review trials from the core Anglosphere (UK, US, Canada, Ireland, Australia, New Zealand) published from 2005 to 2020. Method: A systematic review reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta‐Analyses. Comprehensive electronic database searches were conducted. Eligible studies were randomized controlled trials of mental health nurse‐delivered interventions conducted in relevant countries. The risk of bias was independently assessed. Synthesis involved integration of descriptive statistics of standardized metrics and study bias. Results: Outcomes from 348 between‐group comparisons were extracted from K = 51 studies (N = 11,266 participants), Standardized effect sizes for 68 (39 very small/small, 29 moderate/large) statistically significant outcomes from 30 studies were calculable. All moderate/large effect sizes were at risk of bias. Discussion: Trial evidence of effective mental health nurse‐delivered interventions is limited. Many studies produced few or no measurable benefits; none demonstrated improvements related to personal recovery. Implications for Practice: Mental health nurses should look beyond gold standard RCT evidence, and to evidence‐based interventions that have not been trialled with mental health nurse delivery. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Because the definition of spirituality is complex and has cultural and individual dimensions, it is important to be receptive to individual differences in the perception of spirituality during clinical practice of mental health nurses.Although enhancing spiritual care is beneficial to patients diagnosed with mental illnesses, the extrinsic (e.g., education) and intrinsic factors that would affect nurses' attitudes towards spiritual care have not been investigated.Notwithstanding the known impact of certain intrinsic factors (e.g., personality‐related) of mental health nurses on their coping strategies as well as their emotional and mental health, the link to their spiritual care attitudes has received little attention. What this paper adds to existing knowledge?: This paper is the first to identify the beneficial impacts of extrinsic factors including postgraduate education, working experience, participation in palliative care education programmes, and spiritual care experience on spiritual care attitudes among mental health nurses.Certain intrinsic factors, including those personality‐related such as "Extraversion," "Openness/Intellect," "Conscientiousness," and "Agreeableness," were also associated with higher awareness of providing spiritual care among mental health nurses. What are the implications for practice?: The finding of an association of certain intrinsic factors with more positive attitudes towards spiritual care could encourage further studies to explore possible links between these factors and attitudes of spiritual care.Those less aware of the patients' spiritual needs may benefit through participating in relevant education and on‐the‐job training programmes that involves actual practice and collaboration in a multidisciplinary team. Introduction: Although enhancing spiritual care can facilitate the communication of mental health nurses with patients diagnosed with mental illnesses, extrinsic and intrinsic factors that may influence their spiritual care attitudes remain unclear. Aim: To conduct a questionnaire‐based survey on mental health nurses from eight hospitals. Method: A total of 239 psychiatric nurses were assessed based on (1) "big‐five Mini‐Markers" questionnaire and (2) spiritual care attitudes scale on three components (i.e., core values, growth, and nursing) to investigate the associations of spiritual care attitudes with social/occupational characteristics and personality. Results: A positive attitude was significantly associated with working experience, higher educational level, previous participation in palliative care education programmes, spiritual care experience, and personality factors including "Extraversion," "Openness/Intellect," "Conscientiousness," and "Agreeableness." Discussion: Despite demonstrating impacts of intrinsic factors (e.g., personality) on mental health nurses' spiritual care attitudes, other modifiable extrinsic factors (e.g., education) were important in enhancing their awareness towards spiritual care. Implications for Practice: Our findings encourage further studies to explore possible links between intrinsic factors and attitudes of mental health nurses towards spiritual care as well as suggest benefits of continuing education and on‐the‐job training that involves actual practice and collaboration in a multidisciplinary team to provide spiritual care. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mentalizing is the capacity to understand both one's own and other people's behaviour in terms of mental states, such as, for example, desires, feelings and beliefs.The mentalizing capacities of healthcare professionals help to establish effective therapeutic relationships and, in turn, lead to better patient outcomes. What this paper adds to existing knowledge?: The personal factors positively associated with the mentalizing capacities of healthcare professionals are being female, greater work experience and having a more secure attachment style. Psychosocial factors are having personal experience with psychotherapy, burnout, and in the case of female students, being able to identify with the female psychotherapist role model during training. There is limited evidence that training programmes can improve mentalizing capacities.Although the mentalization field is gaining importance and research is expanding, the implications for mental health nursing have not been previously reviewed. Mental health nurses are underrepresented in research on the mentalizing capacities of healthcare professionals. This is significant given that mental health nurses work closest to patients and thus are more often confronted with patients' behaviour compared to other health care professionals, and constitute a large part of the workforce in mental healthcare for patients with mental illness. What are the implications for practice?: Given the importance of mentalizing capacity of both the patient and the nurse for a constructive working relationship, it is important that mental health nurses are trained in the basic principles of mentalization. Mental health nurses should be able to recognize situations where patients' lack of ability to mentalize creates difficulties in the interaction. They should also be able to recognize their own difficulties with mentalizing and be sensitive to the communicative implications this may have. Introduction: Mentalizing capacities of clinicians help to build effective therapeutic relationships and lead to better patient outcomes. Few studies have focused on factors associated with clinicians' mentalizing capacities and the intervention strategies to improve them. Aim: Present a systematic review of empirical studies on factors associated with healthcare professionals' mentalizing capacities and the effectiveness of intervention programmes designed to improve these capacities. Method: Following PRISMA‐guidelines, a systematic literature search was conducted in PubMed, PsycINFO, Cochrane Library and CINAHL. Results: Out of a systematic search with 1537 hits, 22 studies were included. Personal factors positively associated with mentalizing capacities of healthcare professionals are being female, greater work experience and having a more secure attachment style. Psychosocial factors are having personal experience with psychotherapy, burnout, and in the case of female students, being able to identify with the female psychotherapist role model during training. Evidence that training programmes improve mentalizing capacities is limited. Discussion: Mental health nurses are underrepresented in research on mentalizing capacities of healthcare professionals and training programs to improve these capacities are practically absent. Implications for Practice: For mental health nurses, training in basic mentalizing theory and skills will improve their capacities in building effective working relationships with patients. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Young‐onset dementia (YOD) refers to a phenomenon in which dementia symptoms appear under age 65. Diagnosing YOD is difficult and its progression is fast. Furthermore, it limits the socio‐economic careers of people living with YOD, regardless of their needs.People living with YOD and their carers have unstable occupational status and their dependents also have to face a high burden of care. They claim that existing social support for dementia is limited to the elderly and is not suitable for them. What the paper adds to existing knowledge?: The characteristics of non‐pharmacological intervention studies for people living with YOD and/or their carers so far, and an analysis of the needs supported via the applied interventions.A theoretical basis and direction for the interventions to be studied in the future. What are the implications for practice?: Research and intervention development should focus more on the needs of people living with YOD. In addition, it is necessary to understand and reflect on carers who directly care for people living with YOD.A multidisciplinary programme that supports wide area of the needs should be developed. Introduction: Young‐onset dementia (YOD) is a highly influential disease that exerts force on the normal life of those who still have to continue social life. Research has been lacking in spite of its seriousness, which accounts for about 9% of all dementia cases. Aim: This study aimed to examine non‐pharmacological interventions for people living with YOD and/or their carers, and to analyse how those interventions support their needs. Method: A scoping review methodology was utilized to search the studies examining interventions for people living with YOD and/or their carers, and in English or Korean. The information was extracted, summarized and analysed in CANE categories. Results: Sixteen studies were included in the review. Five types of interventions were drawn. 'Memory' was the most covered part of the needs by the interventions. Discussion: This study found that interventions currently do not match the needs of people living with YOD and their carers. Multidisciplinary research would be eligible to cover the subjects' wide range of the needs as much as possible. Implications for Practice: We suggest the development of a specialized needs assessment tool and specialized interventions for people living with young‐onset dementia and their carers. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known?: The nurse–patient relationship in mental health care is an important focus of mental health nursing theories and research.There is limited evidence about which factors influence nurse‐sensitive patient outcomes of the nurse–patient relationship. This hinders the development, planning, delivering, and quality assurance of the nurse–patient relationship in nursing practice and nursing education. What this paper adds to existing knowledge?: To our best knowledge, this is the first study to examine associations between nurse‐sensitive patient outcomes of the nurse–patient relationship and a range of patient characteristics and relationship‐contextual factors.In this study, we found that gender, age, hospital characteristics, nurse availability when needed, nurse contact, and nurse stimulation were associated with the scores on the nurse‐sensitive patient outcome scale. What are the implications for practice?: Having insight into the factors associated with nurse‐sensitive patient outcomes of the nurse–patient relationship can help nurses, nursing students, nursing management and also patients to enhance the nurse–patient relationship, trying to influence outcomes of nursing care. Introduction: The lack of evidence on patient characteristics and relational‐contextual factors influencing nurse‐sensitive patient outcomes of a nurse–patient relationship is a possible threat to the quality and education of the nurse–patient relationship. Aim: To measure nurse‐sensitive patient outcomes of the nurse–patient relationship and to explore the associations between nurse‐sensitive patient outcomes and a range of patient characteristics and relational‐contextual factors. Method: In a multicenter cross‐sectional study, 340 inpatients from 30 units in five psychiatric hospitals completed the Mental Health Nurse‐Sensitive Patient Outcome Scale. Descriptive, univariate and Linear Mixed Model analyses were conducted. Results: Overall, patient‐reported outcomes were moderate to good. Female participants, nurse availability when needed, more nurse contact and nurse stimulation were associated with higher outcomes. Age differences were observed for some of the outcomes. Outcomes also varied across hospitals but were not related to the number of times patients were hospitalized or to their current length of stay in the hospital. Discussion: The results may help nurses to become more sensitive and responsive to factors associated with nurse‐sensitive patient outcomes of the nurse–patient relationship. Implications: The nurse‐sensitive results can support nurses in designing future nurse–patient relationships. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Traditionally, treatment for eating disorders (EDs) has been provided on an inpatient or outpatient basis, but more recently other levels of treatment provision to include, day care (DC) and community outreach programmes, have been developed.There is limited research exploring the experience of patients who have transitioned from inpatient ED treatment to a remote DC treatment. This lack of knowledge can impact mental health nurses' understanding of what that experience is like for patients and hence may influence the efficacy of collaboration and inclusion between patients and nurses. What this paper adds to existing knowledge?: This research addresses this dearth of knowledge and adds to our understanding of patients' experiences of attending a remote DC programme following a period of inpatient treatment for an ED.This is an important study for nurses and other mental health professionals working with people in ED treatment, as it highlights the specific challenges and anxieties of transitioning from inpatient to a remote DC programme and the individualized supports advisable during this process. What are the implications for practice?: This research provides a basis on which nurses can understand and address the challenges experienced by patients after transitioning to a less intensive supportive ED programme.The understanding of these experiences will enhance the therapeutic alliance between the nurse and patient, which will in turn support the patient in increasing agency as they progress through their recovery.This research provides a foundation on which to develop specific supports that need to be in place to help patients manage the anxieties they experience as they transition to a less intense and remote treatment.Findings from these lived experiences can be used to support the development of similar DC programmes for EDs in other settings. Introduction: Day care (DC) treatment for people with an eating disorder (ED) provides for an easier transition from hospital to home, along with a treatment milieu where patients can maintain occupational and social functioning and allow for the transfer of newly acquired skills to everyday life. Aim: To explore patients' experiences of attending a remote day programme following intense inpatient treatment in an adult ED service. Method: A qualitative descriptive methodology informed the study. In‐depth semi‐structured interviews were conducted with 10 consenting patients. A thematic analysis framework was used to guide the process of data analysis. Results: Three themes reflected participants' experiences: 'Moving On: Preparing for Change', 'Navigating a New Support System' and 'Increasing Agency'. Discussion: An underlying issue for participants was an ongoing but changing experience of anxiety. While anticipatory anxiety is evident in preparing for discharge, this is replaced with a real‐time anxiety as they endeavour to negotiate an effective support network. Implications for Practice: The findings from this study provide a basis on which mental health nurses can develop timely and effective treatment and support systems with patients who are transitioning from a high support inpatient ED programme to a less intensive ED remote DC programme. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is Known on the Subject?: Staff working with other people's mental health are in more danger of experiencing high stress at work.These members of staff are more likely to have mental health problems themselves.Previous research has suggested that training these members of staff to deal with their daily stress and become mentally tougher can protect them. What this Paper Adds to Existing Knowledge?: The findings showed that higher levels of perceived stress and reduced quality of life in mental health workers were related to lower levels of mental toughness.This research provides a detailed understanding of the current issues experienced in a range of different mental health settings, which may contribute to stress and quality of life.The research highlights the importance of protecting staff mental wellbeing, controlling and reducing levels of stress and suggests that one route to doing this is improving mental toughness. What are the Implications for Practice?: These findings suggest a need to increase the awareness of and further protect the mental health of staff working in the mentioned settings.Staff working in mental health settings should be provided with information about how to enhance mental toughness and how to reduce stress.This will lead to a better quality of life for mental health staff and in turn improve the quality of care provided. Introduction: Clinicians working in mental health services are at increased risk of stress at work. Previous work suggests that mental toughness is a protective mechanism for stress in other professions. This has not yet been examined in mental health workers. Aim/Question: To examine whether mental toughness predicts perceived stress and quality of life in mental health workers, to develop an understanding of the factors contributing to and techniques used to deal with stress in this population. Method: Sixty‐two workers completed measures of mental toughness, perceived stress, quality of life and answered questions regarding their personal experience of stress at work. Results: Mental toughness was a predictor of stress (F(7, 54) = 10.58, p <.001) and quality of life (F(6, 55) = 7.58, p <.001, F(7, 54) = 7.15, p <.001 and F(7, 54) = 6.81, p <.001, for compassion satisfaction, burnout and secondary traumatic stress, respectively), with particular roles for the interpersonal confidence and control of life components. Qualitative analysis revealed sources of stress for health workers and a variety of stress management techniques to cope with workplace stress. The findings suggested that mental toughness develops in some but not all health workers due to the demands of their role. Discussion: The findings provide an insight into stress, quality of life and protective factors for stress in mental health workers and suggest that future research should consider mental toughness training in mental health workers. Implications for Practice: There is a need to increase the awareness of factors contributing to stress in mental health workers, such as a lack of resources and staff, and to promote organizational change to improve their professional quality of life. Future research should also explore the potential of mental toughness training in this population. [ABSTRACT FROM AUTHOR]

Accessible Summary: What Is Known on the Subject?: Economic and educational opportunities are usually the principal driving forces for migration.There is a large body of quantitative research studies, mainly from the U.K., supporting the high prevalence of psychiatric disorders, mainly psychotic disorders, in Afro‐Caribbean immigrants which increases across generations.The process of migration and acculturation can present significant risk factors for psychiatric disorders in immigrants.Research involving members of the Black community is generally conducted with the perception that Blacks are a homogenous group, ignoring the cultural and ethnic differences among the subgroups. What the Paper Adds to Existing Knowledge?: It provides a broadened understanding of the experiences, thoughts and feelings of Afro‐Caribbean immigrants, and the factors within the processes of migration and acculturation that negatively impacts their mental health.It provides context to the volume of quantitative studies indicating a high prevalence of psychiatric disorders, particularly psychotic disorders, in Afro‐Caribbean immigrants and their offspring. What Are the Implications for Practice?: Nurses conducting mental health evaluations and assessments for members of the Black community should be culturally competent. Cultural competence entails an understanding of cultural beliefs, race, ethnicity and values. Additionally, knowledge of the effects of migration and acculturation as mental health risks is also important to improve mental health outcomes.Cultural competence will help reduce health disparities by increasing trust in the health care system and providers, not only for Afro‐Caribbean immigrants, but all immigrant groups. Introduction: There is evidence to support migration as a significant risk factor for psychiatric disorders in immigrants. Unfortunately, as an immigrant group, little is known about the mental health of Afro‐Caribbean immigrants and the factors that threaten their mental health. Aim: To explore the perceived effects of migration on the mental health of Afro‐Caribbean immigrants. Methods: A qualitative narrative synthesis was employed to interpretively integrate 13 primary qualitative research findings. Eleven of the primary studies were conducted in the U.K., one in the U.S. and one in Canada. Results: The themes gleaned: (1) experiences of racism, (2) generational conflicts, (3) feelings of powerlessness, (4) limited socioeconomic resources, (5) unfulfilled expectations, (6) fragmented family and community and (7) ignoring cultural/ethnic identity. Discussion: The findings broadened the understanding and experiences of Afro‐Caribbean immigrants and their mental health vulnerabilities as they navigate through migration and acculturation. Implications for Practice: Addressing the mental health of Afro‐Caribbeans will require health care providers to: (1) be cognizant of their immigrant status; (2) understand how migration and acculturation influence the mental health of immigrants; (3) be aware of the ethnocultural differences among Black subgroups. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Physical restraint is widely used in the elderly at home, and cognitive impairment is an important risk factor. Family caregivers of people with dementia are the main decision makers and implementers of physical restraint at home.Most people with dementia in China receive home care, and family caregivers face enormous care and moral pressures influenced by Confucian culture.Current research on physical restraints focuses on quantitative analysis of its prevalence and reasons within the institutions. There is little research on how family caregivers perceive physical restraints in home care context, especially under Chinese culture. What the paper adds to existing knowledge?: Many family caregivers face approach – avoidance conflict and moral dilemmas when making decisions to restrain, and they make difficult choices in these dilemmas.In China, family caregivers are influenced by many unique factors, including traditional Confucian culture, family affection, and rural home environment.Inadequate laws and policies provide the ground for abuse of physical restraints, and family caregivers rarely consider legal and policy restrictions when using physical restraints. What are the implications for practice?: With limited medical resources, nurse‐led dementia management is the hope to reduce physical restraints in home.Mental health nurses need to assess for the appropriateness of physical restraints associated with psychiatric symptoms in people with dementia.At both organizational and community levels, improving effective communication and relationships between professionals and family caregivers are important to address. Improvements in this context require education and time for staff to develop skills and experience which is necessary to provide family caregivers with ongoing information and psychological support within their communities.Considering Confucian culture will be of value for mental health nurses working in other countries where there are Chinese communities to better understand perceptions of family caregivers. Introduction: The use of physical restraints is a common practice in home care. Family caregivers face care‐related and moral pressures due to the influence of Confucian culture in China. The use of physical restraints in the Chinese cultural environment may differ from the use of such restraints in other cultures. Scientific Rationale: Current research on physical restraints focuses on quantitative analysis of its prevalence and reasons within the institutions. However, there is little research on how family caregivers perceive physical restraints in home care context, especially under Chinese culture. Aim: To explore the perceptions of family caregivers on physical restraints in people diagnosed with dementia receiving home care. Method: A descriptive, qualitative study of Chinese family caregivers of people diagnosed with dementia in home care. Framework method analysis was adopted using the multilevel socio‐ecological model. Results: Beliefs about benefit lead to a dilemma for family caregivers. Cherishing family's affection encourages caregivers to reduce physical restraints, but lack of help from family members, professionals and the community forces them to restrain their loved ones. Discussion: Future research should explore the complex issue of culturally specific physical restraints decisions. Implications for Practice: Mental health nurses must receive education regarding the negative outcomes of the use of physical restraints for family members of people diagnosed with dementia. A more liberal approach to mental health and relevant legislation, which is an emerging global phenomenon that is currently in an early phase of development in China, grants human rights to people diagnosed with dementia. Effective communication and relationships between professionals and family caregivers can contribute to the establishment of a dementia‐friendly community in China. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Self‐management comprises five core skills: "Problem Solving, Decision‐Making, Resource Utilization, Forming a Patient/Healthcare Provider Partnership and Taking Action."Effective self‐management among patients diagnosed with anxiety can reduce the number of relapses and improve treatment outcomes.Knowledge of the impact of the family atmosphere, well‐being and illness symptoms on self‐management in patients diagnosed with anxiety disorders is limited. What does the paper add to the existing knowledge?: This is the first study in China to explore whether family atmosphere and well‐being of patients diagnosed with anxiety disorders affects self‐management.This paper adds to the list of factors influencing self‐management among patients diagnosed with anxiety disorders.SAS scores are a major factor influencing self‐management among patients diagnosed with anxiety disorders.The subjective well‐being of patients diagnosed with anxiety disorders can influence their self‐management behaviour.Patients who experienced family harmony had significantly higher self‐management scores than those who experienced family disharmony. What are the implications for practice?: Nurses should encourage patients diagnosed with anxiety disorders to manage their condition while receiving treatment at home.Nurses should focus on patients diagnosed with anxiety disorders who have significant anxiety symptoms and low well‐being.Nurses should emphasize the importance of the home environment in family self‐management and affirm that a good home environment promotes patient self‐management. Introduction: Better self‐management can improve treatment outcomes and reduce the number of relapses for patients diagnosed with anxiety disorders. However, the impact of well‐being and the home environment on self‐management among patients diagnosed with anxiety disorders is unclear in China. Aim: This study sought to determine the impact of the home environment, well‐being and illness symptoms on self‐management during home treatment for patients diagnosed with anxiety disorders. Method: This cross‐sectional study was conducted with patients diagnosed with anxiety disorders. Data were collected with SAS, Self‐Management Scale for People with Anxiety Disorders and Index of Well‐being. Frequency, percentage, analysis of variance, Kruskal–Wallis and multiple linear regression analyses were used. Results: Home environment (p <.001), self‐perceived quality of life (p =.015), well‐being index (p =.002) and SAS total score (p =.033) had a major impact on self‐management in patients diagnosed with anxiety disorders (n = 245). Discussion: Family disharmony, poor self‐perceived quality of life, high SAS scores and low levels of well‐being were significant influences on self‐management among people diagnosed with anxiety disorders. Implications for Practice: Nurses should focus on the self‐management of patients diagnosed with significant anxiety symptoms and low well‐being and value the importance of the home environment in facilitating self‐management among patients diagnosed with anxiety disorders. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Dementia affects an increasing number of people and a person with dementia requires significant levels of care.Dementia care is often delivered by family members.Caring for someone with dementia places significant demand on the carer and support for the carer is often needed. What the paper adds to existing knowledge?: Research has been conducted into caregivers' experiences of caring for someone with dementia, but a synthesis of findings for studies from the UK is needed to collate the research evidence and provide an account of the common trends within the existing research.This paper adds to existing knowledge by highlighting the key difficulties experienced by carers of a person with dementia in their caring role and their experiences with support services across the existing research evidence. What are the implications for practice?: Improvements to the process of dementia assessment and the process of receiving a dementia diagnosis are needed.Information and support needs to be more accessible for the carer of a person with dementiaCultural differences need to be acknowledged in the support and information offered to carers of a person with dementia. Aim: To understand the experiences of informal carers' of individuals with dementia in the UK when engaging with services for support in their caring role. Methods: Following the PRISMA guidelines, a qualitative systematic literature review was carried out. Six Internet databases were searched. Results were screened, and eligible studies were appraised using Critical Appraisal Skills Programme (CASP, 2019) and data synthesized using Evan & Pearson (2001) and Evans (2002). Results: The search returned 231 records, 11 were selected for critical appraisal and data synthesis. Four main themes (information for carers, process of diagnosing dementia, difficulties accessing support and cultural differences of experiences of services) were extracted. Discussion: Carers experience services as providing inadequate support for the Person with Dementia (PwD) and themselves for support relating to dementia. Difficulties in receiving information and support were experienced from before diagnosis to end‐of‐life (EoL) care. Additionally, cultural differences were found in carers' experiences. Implications for practice: The provision of and access to dementia support should be improved; more information for carers about dementia and dementia services is needed; cultural differences need to be appreciated in the support and information offered. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Many studies have investigated the attitudes of mental health nurses towards a range of targets. These targets are person‐oriented (for example groups of people with a similar mental health diagnosis) or practice‐oriented (for example practices such as seclusion or restraint).It is thought that attitudes contribute to the practice of mental health nurses because research suggests attitudes have a role in shaping behaviour. What the paper adds to existing knowledge?: To date, research about mental health nurses' attitudes has examined different attitudes in isolation from one another. By demonstrating a lack of connectedness across studies this paper highlights the need for new theory‐informed approaches to attitudinal research.By standardizing measurements across different studies this review demonstrates that the most negatively appraised attitudinal targets—indicated by large proportions of respondents who appraise negatively—concern people with diagnoses of borderline personality disorder, substance misuse, and acute mental health presentations. What are the implications for practice?: Significant numbers of mental health nurses may have attitudes, especially towards people with borderline personality diagnoses and those who misuse substances, that may not be concordant with good practice.There is insufficient evidence about what the actual implications this has for practice because the body of relevant research lacks coherence, interconnectedness and a grounding in contemporary theoretical developments.Training programmes that focus on attitudinal change need to be more rigorously evaluated. Introduction: Attitudes are considered integral to mental health nursing practice. Aims: To comprehensively describe the (i) measured attitudes of UK mental health nurses towards people and practice; (ii) effectiveness of interventions to change attitudes; and (iii) relationships between their attitudes, other variables/constructs and practice. Methods: Using systematic review methodology, multiple databases (CINAHL, Scopus, PsycINFO, Web of Science Core Collection, Google Scholar) were searched. Eligible studies involved measurement of UK‐based mental health nurses' attitudes with multi‐item scales. Studies were quality appraised, mean (SD) attitudinal data were standardized, and other results converted to standardized effect sizes. Results: N = 42 studies were included. Negatively appraised attitudinal targets were people with a borderline personality disorder diagnosis, substance misuse, and acute mental health presentations. Educational interventions were associated with immediate increases in positive appraisals but sustainability was poorly evidenced. There was very limited study of attitude‐practice links. Discussion: This review identifies priority attitudinal targets for action but also demonstrates that future work must consider the interconnectedness of attitudes and their relationship with practice. Implications for Practice: Priority areas for consideration are attitudes to borderline personality disorder, substance misuse and mental health co‐morbidity. Addressing disparities between nurses' attitudes and those of service users is important. More robust research is required into the effectiveness of interventions to change attitudes and into attitude‐practice links. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mental health nursing staff may experience psychological stress and burnout. Exercise provision for mental health staff may improve staff physical and mental wellbeing and mitigate against psychological burnout.Existing research suggests the provision of exercise equipment for mental health nursing staff may improve staff attitudes towards physical activity and staff confidence in motivating physical activity amongst patient groups they care for, although more research is needed, and research investigating the attitudes of mental health staff towards such initiatives is warranted. What this paper adds to existing knowledge?: Access to fitness facilities in the workplace for mental health staff was endorsed.Logistical and practical concerns (i.e. shower access, time) were noted as barriers to implementation of fitness facilities in the workplace for staff use.Mental health staff expressed desire to have access to varied gym equipment at work What are the implications for practice?: The introduction of fitness facilities in the workplace environment for staff use was actively endorsed by mental health professionals, suggesting such initiatives may be warranted in mental health settings. However, barriers to successful implementation were noted and are worth considering in preparation for trialling provision of exercise equipment for staff use. Introduction: Exercise equipment for mental health staff may improve staff wellbeing, mitigate against stress and improve staff attitudes towards physical activity. This said, there is a lack of researching investigating the attitudes of mental health staff towards the provision of fitness facilities in the workplace. Aim: The study investigated staff attitudes towards being offered exercise bikes in the workplace. Method: Three focus groups and one individual interview were conducted with 12 healthcare professionals. Data were subject to a thematic analysis. Results: Three themes were identified. (1) 'This sounds like a good idea', which reflected positive views in the provision of exercise in the workplace for staff use. (2) 'I'm not sure it would work because ...', which reflected implementation concerns including not having access to shower facilities and time constraints. (3) 'Balancing choice', which reflected participant's desire to have access to varied gym equipment. Discussion: The introduction of fitness facilities in the workplace for staff use was endorsed. However, implementation barriers were noted. Implications for Practice: This research provides justification for the exploration of the feasibility and benefits of providing exercise equipment for mental health staff in the workplace but presents implementation barriers that are worth considering before trialling provision of exercise equipment. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Coercive measures represent an ethical conflict because they limit the person's freedom, compromising their personal autonomy, self‐determination and fundamental rights.The reduction of the use of coercive measures implies not only regulations and mental health systems, but also cultural aspects, such as societal beliefs, attitudes, and values.There is evidence about the professionals' views on coercion in acute mental health care units and community settings, but they remain unexplored in inpatient rehabilitation units. What the paper adds to existing knowledge?: The knowledge about coercion varied from not knowing at all the meaning of the word, to a proper description of the phenomenon.Coercive measures are considered a necessary evil or normalized in mental health care and considered implicit to daily practice. What are the implications for practice?: The perceptions and attitudes towards coercion might be influenced by the knowledge about the phenomenon. Training of mental health nursing staff in non‐coercive practice could help professionals to detect, be conscious towards, and question coercive measures, thus orienting them to the effective implementation of interventions or programmes with evidenced effectiveness to reduce them. Introduction: Creating a therapeutic and safe milieu with the minimum coercive measures requires knowing professionals' perceptions and attitudes towards coercion, but they remain unexplored in medium and long‐stay inpatient psychiatric rehabilitation units. Aim: To explore the knowledge, perception and experience of coercion among nursing staff at a rehabilitation medium‐stay mental health unit (MSMHU) in Eastern Spain. Method: Qualitative phenomenological study including 28 face‐to‐face, semi‐structured interviews based on a script. Data were analysed using content analysis. Results: Two main themes were found: (1) therapeutic relationship and treatment in the MSMHU, which included three subthemes: qualities of the professionals for building the therapeutic relationship; perceptions about the persons admitted to the MSMHU; views of the therapeutic relationship and treatment in the MSMHU; (2) Coercion at the MSMHU, comprising five subthemes: professional knowledge; general aspects; emotional impact of coercion; opinions; alternatives. Discussion: Coercive measures are often normalized in mental health care and considered implicit to daily practice. A proportion of participants who did not know what coercion is. Implications for Practice: Knowledge about coercion might influence attitudes towards coercion. Mental health nursing staff could benefit from formal training in non‐coercive practice, facilitating the operative implementation of effective interventions or programmes. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Research suggests that the Dynamic Appraisal of Situational Aggression (DASA) is a useful risk assessment instrument to identify individuals who might be at risk of aggression in mental health inpatient units.Although, risk assessment research has typically focused on an individual's risk of aggression, recent research has begun exploring whether the DASA could be used to assess the likelihood that a group of patients would be aggressive. What the paper adds to existing knowledge: While the DASA was useful for assessing whether an individual was likely to be aggressive, the group average score was not a useful indicator for the likelihood of aggression once the individual DASA score was taken into consideration.Unexpectedly, patients who were assessed as high risk on the DASA were more likely to be aggressive on settled units compared to unsettled units, which included other individuals whose risk was elevated. What are the implications for practice: There is not enough evidence to suggest that the group DASA average improves the identification of aggression above the individual DASA score. Introduction: The Dynamic Appraisal of Situational Aggression (DASA) is an inpatient aggression risk assessment instrument. Recently, research explored whether the unit atmosphere, as indicated by a unit's average DASA score, was related to inpatient aggression risk, but failed to control for individual risk. Aim: Investigate whether the DASA unit average score or an interaction between the unit average and an individual patient's DASA score was related to the likelihood that an individual would act aggressively. Method: Cox regression with repeated assessments and recurrent events was used to analyse 11,243 DASA risk assessments of 113 inpatients collected via retrospective file review. Results: The unit DASA average score was not related to aggression towards staff. There was a negative interaction between the individual and the unit DASA average scores when identifying patient‐to‐patient aggression; high‐risk patients engaged in less aggression when the unit average was heightened relative to units with lower DASA average scores. Discussion: It is possible that there were more nursing interventions and/or patients engaged in greater self‐regulation on unsettled units, thus reducing aggression. Implications for Practice: Currently, there is insufficient evidence to suggest that the unit average score should be used to supplement individual DASA scores to identify aggression risk. [ABSTRACT FROM AUTHOR]

What is known on the subject: Supported housing approaches that include case management and increased opportunities for independence and personal autonomy for people who are living with severe and persistent mental illness (SPMI) have been found to help reduce hospitalizations and use of the emergency department.What is not fully clear is if these types of supported housing arrangements also influence the use of primary health care and other specialist services. What the paper adds to existing knowledge: This study uncovered that individuals experiencing SPMI who lived in supported housing used more primary health care and specialist physician services, in the year following transition to this housing arrangement. What are the implications for practice: The findings of this study suggest that supported housing arrangements for people experiencing SPMI may help in improving the personalization of health services for individual residents, including increasing access to both primary health care and specialist services.This is important for nursing practice, as the findings of the study show that supported housing arrangements for people experiencing SPMI may assist in better supporting their complex health care needs. Introduction: Supported housing for people who are living with severe and persistent mental illness (SPMI) has been found to help reduce hospitalizations and use of the emergency department. What is not fully clear is if these types of supported housing arrangements also influence the use of primary health care and other specialist services. Aim/Question: The aim of this study was to compare the use of health services use of individuals with SPMI, before and after transition to the new supported housing program. Method: Using health care administrative databases, a pre‐post cohort study was conducted examining the health system use of residents who transitioned from custodial to supported housing arrangements between 2017 and 2019. Results: Individuals with SPMI used more primary health care and specialist physician services after transition to the supported housing model. Discussion: The results suggest that a supported housing model may be associated with increased usage of outpatient person‐centred health services in people experiencing SPMI. Implications for Practice: The findings of this study suggest that supported housing arrangements for people experiencing SPMI may help in improving the personalization of health services for individual. This is important for nursing practice, as the findings of the study show that supported housing arrangements may assist in better supporting complex health care needs of individuals. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: During the COVID‐19 pandemic, there has been research considering the impact on medical healthcare professionals and the mental health needs of the general population. However, limited focus has been placed on mental health services or mental health staff providing care in the community and in hospitals. While nurses make up the largest section of the mental health workforce in the UK, the impact that this pandemic has had on their work has been largely ignored. What the paper adds to existing knowledge?: This paper provides a unique insight into the experiences and impact that the COVID‐19 pandemic has had on mental health nurses across a range of community and inpatient settings to understand what has changed in their work and the care they can and do provide during this crisis. This includes exploring how services have changed, the move to remote working, the impact of the protective equipment crisis on nurses and the difficult working conditions facing those in inpatient settings where there is minimal guidance provided. What are the implications for practice?: By understanding the impact the pandemic has had on mental health nursing care, we can understand the gaps in guidance that exist, the challenges being faced and the impact the crisis has had on care for mental health service users. By doing so, we can plan for the ongoing nature of this pandemic and the aftermath that the crisis may leave for our service users and workforce alike. Introduction: While evidence has emerged concerning the impact of COVID‐19 on the general population and the challenges facing health services, much less is known regarding how the pandemic has directly affected the delivery of mental health nursing care. Aim: This paper aimed to explore how COVID‐19 has affected the ability of mental health nurses to deliver care in community and inpatient mental health services in the UK. Method: We investigated staff reports regarding the impact of the COVID‐19 pandemic on mental healthcare and mental health service users in the UK, using a mixed‐methods online survey. A total of 897 nurses across a range of inpatient and community settings participated. Discussion: Key themes within the data explore the following: new ways of working; remote working; risks of infection/infection control challenges; and the impact on service users. Targeted guidelines are required to support mental health nurses providing care and support during a pandemic to people in severe mental distress, often in unsuitable environments. Implications for Practice: Service developments need to occur alongside tailored guidance and support for staff welfare supported by clear leadership. These findings identify areas requiring attention and investment to prepare for future crises and the consequences of the pandemic. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Engagement is regarded as important and beneficial for service users and mental health servicesA universal definition of engagement is not yet fully agreed upon. What this paper adds to existing knowledge?: Based upon their experience, mental health staff use varied engagement approaches to fit with the changeable and unique needs of people who use services (service users).Mental health staff demonstrate qualities such as persistence and adaptability to successfully engage with service users. What are the implications for practice?: Irrespective of professional background, the role of community mental health staff is not restricted to any single approach. Practical help and social support are as seen as important as clinical treatment to establish successful engagement.Little is known about the engagement experiences of mental health staff working in early intervention settings as most studies in this review focused on the perspectives of staff based in assertive outreach or community mental health teams. There is a need to further understand staff experiences of engagement with service users in early intervention settings.Role descriptions and expectations of community mental health workers should account for the wide‐ranging flexible approach required in order to deliver appropriate interventions. This may involve a focus on engagement in training programmes. Introduction: Effective mental health care is dependent on engaging service users, but some individuals do not actively attend appointments, and may stop engaging with mental health services. Quantitative studies reveal some salient factors that seem to predict engagement, but these studies miss the nuances of good clinical practice in this area. A number of qualitative studies of health professionals' experiences and understanding of effective engagement have been published. Aim: This review aimed to systematically identify, evaluate and synthesize results from these studies with a view to informing effective practice in this area. Methods: Electronic databases MEDLINE, EMBASE, CINAHL, PsychINFO and AMED were searched (PROSPERO systematic review protocol registry (www.crd.york.ac.uk/prospero/; ID CRD42017083976). Of 799 records, ten papers met the inclusion criteria. All papers were subjected to quality appraisal based on the CASP checklist and data systematically extracted. A thematic synthesis of included studies examining mental health practitioners' experiences of engagement in community mental health settings was conducted. Results: Mental health practitioners see engaging service users as depending upon complex, multi‐dimensional phenomena which should include individualized person‐centred approaches as well as practical, social and clinical support. Mental health practitioners demonstrate qualities such as determination and adaptability to establish and maintain engagement with service users. Implications for practice: As a core aspect of nurse education, registered mental health nurses and other professionals would benefit from systematic guidance regarding engagement strategies. Most studies in this review focused on assertive outreach or community mental health teams, more clarification is needed of practitioner's engagement experiences in early intervention settings. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Police and ambulance staff are increasingly asked to help people experiencing mental health crises, but they often feel under‐prepared.The single frontline service approach is time‐intensive and risks a coercive pathway to care.The emergency department is the default location for transfers by police or ambulance involving a person involved in a mental health crisis, despite being viewed as suboptimal. What the paper adds to existing knowledge: Police and ambulance staff struggled keeping up with the mental health demand, reporting inadequate mental health training, little enjoyment and negative experiences when trying to access help from other services.Most mental health staff had adequate mental health training and enjoyed their work, but many experienced difficulties getting help from other services.Police and ambulance staff found it hard to work with mental health services. What are the implications for practice: The combination of limited training, poor interagency referral processes, and difficulties accessing support from mental health services means that when police and ambulance services attend mental health crises alone, distress may be heightened and prolonged. Enhanced mental health training for first responders and more streamlined referral processes may improve process and outcomes.Mental health nurses have key skills that could be utilized in assisting police and ambulance staff who attend 911 emergency mental health calls.New models such as co‐response teams, whereby police, mental health clinicians and ambulance staff respond conjointly should be trialled and evaluated. Introduction: First responders are increasingly called to assist people experiencing mental health crises but little research exists canvassing multi‐agency perspectives of such work. Aim/Question: To understand the views of police officers, ambulance and mental health staff attending mental health or suicide‐related crises in Aotearoa New Zealand and to discover how they experience current models of cross‐agency collaboration. Methods: A descriptive cross‐sectional survey involving mixed methods. Quantitative data were analysed using descriptive statistics and free text by content analysis. Results: Participants included 57 police officers, 29 paramedics and 33 mental health professionals. Mental health staff felt adequately trained, but only 36% described good processes for accessing inter‐agency support. Police and ambulance staff felt undertrained and unprepared. Accessing mental health expertise was considered difficult by 89% of police and 62% of ambulance staff. Discussion: Frontline services struggle managing mental health‐related 911 emergencies. Current models are not working well. Miscommunication, dissatisfaction and distrust exist between police, ambulance and mental health services. Conclusion: The single‐agency frontline response may be detrimental to service users in crisis and under‐utilizes the skills of mental health staff. New ways of inter‐agency cooperation are required, such as co‐located police, ambulance and mental health nurses responding in partnership. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Family‐involved interventions can result in better outcomes than traditional mental health care for both service users and their families.Nurses' attitudes towards family involvement can affect family participation in care.Earlier studies on psychiatric nurses' attitudes towards family involvement in care report ambiguous findings. Hong Kong's unique integrated cultures may influence Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care. What the paper adds to existing knowledge?: The majority of psychiatric nurses had positive views on family involvement in care in Hong Kong.Four variables (i.e. gender, clinical experience, nature of working unit and family nursing training) of psychiatric nurses are associated with their attitudes towards family involvement in care in Hong Kong. What are the implications for practice?: Policy makers should develop strategies to increase psychiatric nurses' awareness of the importance of family involvement in patient care.Nurse educators help to design family nursing training to enhance psychiatric nurses' competence in collaborating with families of people suffering from mental disorders. Introduction: In Hong Kong, involving the family in nursing care is still optional and mainly depends on nurses' attitudes and the willingness of the family. Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care may be influenced by the unique integrated Eastern and Western cultures, however earlier studies report ambiguous findings. Aims: This study aimed to assess Hong Kong psychiatric registered nurses' attitudes towards family involvement in care and its associated factors. Methods: This study is a cross‐sectional descriptive online survey with convenience sampling based on the Families' Importance in Nursing Care‐Nurses' Attitudes (FINC‐NA) instrument. Results: Most of the psychiatric nurses had supportive attitudes towards family involvement in care. Females with more clinical experience, working in a rehabilitation‐related unit and having attended a family nursing education course were associated with positive attitudes towards family involvement in care. Discussion: The supportive attitude of psychiatric nurses may be explained by the shift of mental health nursing care from hospital care to community care in recent decades. Implications for practice: Mental health nurse education and training in Hong Kong could place more emphasis on building family work skills, particularly for newly qualified nurses and those working in acute inpatient settings. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Much research has been conducted on the relationship between recovery orientation and people diagnosed with mental illnesses such as schizophrenia and mood disorders. A recovery‐oriented approach by mental health professionals can reduce hospital stays and medical costs for people diagnosed with mental illness.There are similarities and differences between recovery‐oriented approaches for individuals diagnosed with dementia and those diagnosed with mental illness. This reflects the characteristics of irreversible dementia.Although dementia courses at recovery colleges are increasing, dementia recovery is in its infancy and course content varies. The core of the recovery framework for individuals diagnosed with dementia is 'Continue to be me'.Recovery‐oriented approaches and programmes have been developed by mental health workers for older adults, including those with dementia, but there are no outcome measures that reflect the characteristics of dementia care. What the paper adds to existing knowledge?: We developed a scale to assess nurses' recovery orientation in dementia care, which has been found to be reliable, and although some validity issues remain, it is the first scale to objectively assess recovery orientation in dementia care.The emphasis is on helping people diagnosed with dementia maintain their identity, which is not adequately covered by existing measures of recovery. What are the implications for practice?: The ability to objectively assess recovery orientation in dementia care allows us to identify areas of inadequacy.It can be used to reduce variation in the content of recovery college courses and as an indicator for evaluating training in recovery‐oriented approaches to dementia care. Introduction: Programmes regarding recovery‐oriented approaches for older people, including those with dementia, have been developed, but there are no clear indicators, and the process is still in its infancy. Purpose: We developed a scale to assess nurses' recovery orientation in dementia care. Methods: A draft of a 28‐item scale was developed based on interviews with 10 nurses, skilled in dementia care with a Japanese mental health perspective, and a literature review. A self‐administered questionnaire was developed for nurses working in a dementia ward, and an exploratory factor analysis was conducted. A confirmatory factor analysis was conducted to test for convergent and discriminant validity. The Recovery Attitude Questionnaire was used to examine criterion‐related validity. Results: An exploratory factor analysis produced a 19‐item scale and identified five factors (KMO value: 0.854). The Cronbach's alpha for the overall scale was.856, with each subfactor showing a range of.742–.792, validating its reliability. Discussion: The results of confirmatory factor analysis supported the five‐factor construct. Reliability was verified, but some issues remained in convergent and discriminant validity. Implications for Practice: This scale can be used to objectively assess nurses' recovery orientation in dementia care and as a measure of training in recovery‐oriented approaches. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mental health legislation is currently under review following recommendations for repeal and replacement.Through the statutory role of the second health professional, mental health nurses are in a strong position to offer a unique clinical perspective, engagement and advocacy for tangata whaiora (person seeking wellness) and whānau.Māori are more likely to be subject to a compulsory treatment order than non‐Māori.Whānau involvement in care is a core element to well‐being from a Te Ao Māori (Māori world view) perspective. What this paper adds to existing knowledge?: Understanding the level of whānau involvement in the MHA process.Understanding challenges for nursing practice for consideration in the current review of MHA legislation.Identification of the opportunity nurses have to contribute to reducing high rates of Māori under CTOs. What are the implications for practice?: The current MHA review needs to include the resourcing required to support the clinicians practising in statutory roles.More emphasis is needed to build the cultural knowledge and capability of the nursing workforce to integrate principles of a Te Ao Māori worldview into care delivery.These learnings highlight the importance of nursing responsibility in the SHP role. Introduction: Clinical practice within statutory roles is an important issue for the nursing profession. There is increasing involvement of nurses undertaking statutory roles and opportunities for nurses to advocate and offer their unique clinical opinion regarding the need for restrictive measures imposed by mental health act legislation. Aim: The aim of this study was to analyse whether registered nurses who undertake the role of second health professional (SHP) within New Zealand's Mental Health (Compulsory Assessment and Treatment) Act (1992) (MHA) are meeting the expectations of that role. Method: A retrospective analysis of 156 cases was undertaken of clinical reports completed by registered nurses. The reports were measured against an established competency framework modified to include MHA expectations for whānau (family) involvement. Results: From a sample of 156 cases, 22 were identified as reviews of initial orders for assessment and treatment while 134 were opinions related to the application for a compulsory treatment order (CTO). In most cases, reports achieved a good standard. There were limitations in nurses completing the documentation to the required standard, and adaptations were evident in efforts to meet clinical and legal expectations. There was a significant absence of evidence of whānau consultation. Discussion Resourcing through education, support and ongoing development are required to ensure that nurses are equipped to meet the expectations of the legislation. There is an opportunity for nurses to influence decision‐making and support the reduction in use of community treatment orders. A review of the existing competency framework is required to include cultural approaches and involvement of whānau. Implications for Practice: It is important to understand the factors that strengthen nursing practice to improve health outcomes and tangata whaiora and whānau experience. This study uses methods of clinical audit to describe current practice and establish an evidence base to measure change. It also offers important learnings for consideration within MHA legislation review and for nursing workforce development. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Communication between nurses and patients is essential in mental health nursing.Lack of communication during seclusion causes dissatisfaction among patients.Coercive practices can cause psychological discomfort for patients and staff members.Research related to nurses' perceptions of nurse–patient communication during seclusion events is scant.In Finland, the use of coercive practices has been high despite efforts to reduce the need for coercive practices through the National Mental Health Policy since 2009.Nurse–patient communication is referred to in the Safewards model as one issue of delivering high‐quality care. What this paper adds to existing knowledge?: Nurses aim to achieve high‐quality communication while treating patients in seclusion.Nurses aim to communicate in a way that is more patient‐centred.Various issues affect the quality of communication, such as nurses' professional behaviour and patients' state of health. What are the implications for practice?: Improved communication between nurses and patients will support therapeutic relationships and could lead to a better quality of care.Nurses' enhanced communication may promote the use of noncoercive practices more frequently in psychiatric settings.Improving nurses' communication skills may help support the dignity and autonomy of secluded patients, resulting in patient experiences that are more positive in relation to care offered in seclusion.Nurses should be offered opportunities to take part in further training after education to enhance communication skills for demanding care situations.Further research that incorporates the perspectives of patients and those with lived experience of mental health problems is needed.Components of evidence‐based Safewards practices, such as using respectful and individual communication (Soft Words), could be relevant when developing nurse–patient communication in seclusion events. Introduction: Communication between nurses and patients is essential in mental health nursing. In coercive situations (e.g. seclusion), the importance of nurse–patient communication is highlighted. However, research related to nurses' perceptions of nurse–patient communication during seclusion is scant. Aim: The aim of this study was to describe nurses' perceptions of nurse–patient communication during patient seclusion and the ways nurse–patient communication can be improved. Method: A qualitative study design using focus group interviews was adopted. Thirty‐two nurses working in psychiatric wards were recruited to participate. The data were analysed using inductive qualitative content analysis. Results: Nurses aimed to communicate in a patient‐centred way in seclusion events, and various issues affected the quality of communication. Nurses recognized several ways to improve communication during seclusion. Discussion: Treating patients in seclusion rooms presents highly demanding care situations for nurses. Seclusion events require nurses to have good communication skills to provide ethically sound care. Conclusion: Improved nurse–patient communication may contribute to shorter seclusion times and a higher quality of care. Improving nurses' communication skills may help support the dignity of the secluded patients. Safewards practices, such as respectful communication and recognizing the effect of non‐verbal behaviour, could be considered when developing nurse–patient communication in seclusion events. Relevance Statement This study deepens the understanding of nurse–patient communication during seclusion events from the perspective of nurses. Caring for patients in seclusion presents challenging situations for nurses and demands that they have good communication skills. To enhance their communication skills in seclusion events, nurses require opportunities to take part in further training after education related to communication skills for demanding care situations. Knowing the appropriate ways to interact with individual patients during seclusion can help nurses create and maintain communication with patients. For mental health nursing, nurses' enhanced communication may promote increased use of noncoercive practices in psychiatric settings. For patients, improving nurses' communication skills may help support dignity and autonomy during seclusion and shorten the time spent in seclusion, resulting in a better quality of care and more positive patient experiences related to care offered in seclusion. In this, the perspectives of people with lived experience of mental health problems should be acknowledged. Components of Safewards practices, such as using respectful and individual communication and paying attention to one's non‐verbal communication (Soft Words), could be useful when developing nurse–patient communication in seclusion events. [ABSTRACT FROM AUTHOR]