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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 about the subject?: There are many qualitative studies that explore what it is like for children who live with a parent who has a mental illness. These studies are sometimes criticized because they have small sample sizes which limits their application. What this paper adds to existing knowledge?: We conducted a systematic review of qualitative papers with an aim to strengthening our understanding of what it is like for children who live with a parent who has a mental illness. We used stringent criteria to make sure that only the voices of children affected by parental mental illness were included in the review. In addition, the paper presents a timely update on previous reviews completed in this area. What are the implications for practice?: The findings of this review highlight the impact that parental mental illness has on children and the important role that mental health nurses can play in maximizing opportunities for building resilience in affected children. Mental health nurses are in a key position to provide timely and age‐appropriate information and support to both parents and children to assist in the development of appropriate coping and support mechanisms. Abstract: Introduction: This paper brings together what is known about what it is like for children who live with a parent with a mental illness with a view to strengthening our understanding of their experiences. This paper presents an update on previous reviews that were completed in this area and used a systematic approach and stringent inclusion/exclusion criteria to ensure that the voices of children were central in the included papers. A systematic review of this nature could not be located in the literature. Aims: This paper presents the findings of a systematic review which explored the experiences of children who were affected by parental mental illness. Methods: CINAHL, PubMed, PsychINFO, Pubmesh and EMBASE were searched for qualitative studies which explored children's experiences, and eight studies were included following review and quality appraisal. Pertinent data were extracted, coded and analysed using a thematic approach. Results: Four themes emerged from the analytic process which described the children's understanding of mental illness, their relationship with their parents, their coping strategies and their social connections. Implications for Practice: Mental health nurses need to recognize the psychosocial needs of children, and to acknowledge, the wider impact mental illness has of the family. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Humanizing the world of health is a complex process that includes all the dimensions of the person. When a person has from a mental illness, the humanization of care becomes more important, as the disorder itself prevents the person to participate in their health process, even when showing self‐harm or aggressive behaviours.These situations jointly with other factors related with professionals (insufficient ratio, inadequate treatment or lack of training) may cause the patient admitted to the acute psychiatric hospitalization unit to require the use of restrictive measures (involuntary admissions, mechanical restraints or forced administration of medication). What the paper adds to existing knowledge?: We identify the relevance of the perception the patient and family have regarding the care received, as well as the relevance of factors related to the professionals, among which the attitude, the staff ratio, the nursing time of direct dedication, and the therapeutic environment and safety of the patient and the professionals. All patients must be treated with dignity, respect, regardless of the aggressive manifestations caused by their pathology. What are the implications for practice?: A greater understanding of the care offered to admitted people affected by a mental disorder, their families and professionals who care for them in acute mental health units, giving greater importance to "caring" and not exclusively to "curing." Introduction: Humanization in Mental Health refers to give the same relevance to the clinical needs and to the social, emotional and psychological needs. Aim: To identify the published knowledge on current care models related to the humanization of care in acute psychiatric units. Method: Scoping review based on the methodological model of Arksey and O'Malley, and PRISMA methodology. Database searches (Pubmed, Cinahl, Virtual Library, Cuiden, Academic Google and PsycInfo) with the terms: "Humanization," "Hospitals Psychiatric," "Emergency Psychiatric," "Psychiatric Service" and "Psychiatric intensive care units." Results: Twenty‐two articles met the inclusion criteria. Four thematic units were identified: aspects related to (i) patient perceptions; (ii) Government policies and hospitality organizational culture; (iii) external factors such as the environment, family or associations; and (iv) safety and security. Discussion: Only one of the articles mentions the concept analysed, although all of them contribute with key aspects of healthcare humanization, such as the empowerment of the patient, the care model, the staff ratio, the therapeutic relationship, the nursing time of direct dedication to the patient, the therapeutic environment, safety and patient and staff perception of feeling safe. Implications for Practice: The present study can help to improve the care offered in acute mental health units. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Stigma involves connecting individuals with a particular label to negative characteristics; this is based not on the stigmatized condition itself, but cultural reactions to it., Stigma exists towards nurses with mental illness., What this paper adds to existing knowledge? This paper offers a first-person account of experiencing stigma as a nurse with a mental illness., This paper incorporates the existing literature to offer a broader cultural perspective on the experiences of a nurse with a mental illness., What are the implications for practice? Nurses are likely to encounter a nurse with a mental illness at some point in their practice., Nurses' reactions towards colleagues with mental illness can have significant implications for those colleague(s)' wellbeing., Nurses with mental illness will have to navigate their person and professional journey while giving consideration to the attitudes of their nursing peers and leaders., Abstract Limited research has been done on the stigma faced by nurses with mental illness from their nursing peers. Mental illness is not generally considered acceptable within the context of nursing culture, so when nurses do experience mental illness, their experiences in a professional context may be influenced by stereotypes, particularly those relating to dangerousness. Using autoethnography as a research method, the author examines her own subjective experiences of stigma as a nurse with a mental illness, and draws upon existing literature on stigma, deviance and the phenomenon of mental illness in nurses to analyse broader cultural implications for nursing. Assessment of suitability to return to work arises throughout the narratives, and consideration is given to the way that risk assessment by nursing leaders is impacted by negative stereotypes that surround mental illness. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Although the seminal work of McCormack et al. (International Practice Development Journal, 2015, 5, 1) and Nolan, Davies, Brown, Keady, and Nolan () provides useful conceptual frameworks in person‐centred care, research is needed to understand how theoretical concepts can be applied into practice to support dementia care. Also, evidence is needed to demonstrate the impacts of implementing person‐centred care and staff experiences. What does this paper add to existing knowledge?: This paper adds to the emerging work that is providing a greater understanding of how team education in practice can make a difference in building capacity to improve dementia care.We offer timely evidence and useful insights into how an education programme, Gentle Persuasive Approaches (GPA), was implemented ("what worked" and "how") in a large Canadian hospital to improve knowledge and skills among staff in dementia care.The GPA education helped hospital staff enact person‐centred care by cultivating shared values and a learning environment to change attitudes, practices and conditions for continuous practice development. What are the implications for practice?: Mental health nurses in advance practice are well positioned to lead dementia education and advocate for person‐centred care in hospitals.Hospital leaders are responsible for providing resources to cultivate a supportive environment for continuous learning to ensure the workforce gains the capacity to meet the changing demands and needs of the ageing population. System support is essential for creating conditions to enable person‐centred care. Introduction: Hospital staff lacks knowledge and skills in dementia care. There is a need to understand how person‐centred care theory can be operationalized in staff's practices to improve dementia care. Aims: To describe the staff's experiences of learning and applying the Gentle Persuasive Approaches (GPA) to enact person‐centred care in a hospital. Methods: Mixed methods, including posteducation survey and focus groups, were used. Thematic analysis was conducted to identify themes that describe participants' experiences. Results: Three hundred and ten staff and leaders in a hospital participated in the GPA education and completed a posteducation survey (n = 297). After 1 year, two follow‐up focus groups were conducted with interdisciplinary staff (n = 24) across medicine and mental health programmes. Our analysis identified three themes to enable person‐centred care: (a) changing attitudes, (b) changing practices and (c) changing conditions. Discussion: This study contributes to the literature by providing evidence of how an education programme was implemented in a large Canadian hospital to build capacity for dementia care. Joint education for interprofessional staff offers value in enabling person‐centred care. Implication: Mental health nurses are in position to lead dementia education and advocate for person‐centred care in hospitals. Staff need structural support to engage in team learning for practice improvement. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Risk assessment and management in mental health services are contested and perceived as problematic by both professionals and service users.There is substantial emphasis on risk as a core component of professional practice. However, recovery for people with mental health problems emphasizes self‐determination which seems to conflict with risk management.A critique is emerging of risk assessment and management. However, there is a lack of empirical evidence which seeks to explore how professionals manage the conflicts between recovery orientated practice and risk management. What the paper adds to existing knowledge?: The paper reports on qualitative research which highlights people with mental health problems are objectified and frequently associated with the potential for harm.Risk dominates the work of mental health professionals and undermines individualized care.Service users are subject to increased surveillance and medication as a result. What are the implications for practice?: Service users' subjective experiences need to be prioritized in mental health care by renewed focus on the relationship between professionals and service users.Mental health professionals should question the centrality of risk to their practice. Introduction: The emergence of recovery, alongside significant focus on risk management, creates potential for conflicting influences in mental health care. Although evidence has critiqued risk assessment, there is a lack of research that seeks to explore how professionals make decisions within these apparently incompatible agendas. Aim: To explore how practitioners, experience potential tensions arising from delivering recovery‐orientated care and enforcing containment. Method: This paper reports on a case study inquiry, using interviews with mental health professionals and observations in an acute ward and an assertive outreach team. Results: Risk governed the practice of mental health professionals to such an extent it defined how service users were understood and treated. Service users were constructed as objects of risk, first by being objectified and secondly by creating a link between that object and harm. Discussion: Hilgartner's (1992, Organizations, uncertainties and risk (pp. 39–53). Boulder, CO: Westview Press) theory of risk explains how risk dominates the identity of people with mental health problems at the cost of recovery. This results in increased monitoring, surveillance and medication to enact control. Implications for practice: To undermine the dominance of risk, professionals should reconnect with the subjective experiences of people with mental health problems and challenge the acceptance of risk as central to their role. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Established research from the United States and other Western countries has found that lesbian, gay, bisexual and transgender (LGBT) populations are at an elevated risk for suicide.Suicidality among LGBT individuals is understudied in Thailand and other Asian countries, warranting additional research to better understand risk factors and to create effective treatment and suicide prevention interventions. What the paper adds to existing knowledge?: The study examined rates and predictors of suicidality in Thai LGBT adults.Study findings suggest that general (e.g. stress and loneliness) and minority stressors (e.g. discrimination and victimization) played important roles in predicting lifetime and past‐year suicidal ideation, while socio‐demographic and health‐related factors (e.g. living in high poverty area and having chronic diseases) were associated with suicide attempts among LGBT individuals. What are the implications for practice?: Changes in the nursing curriculum and continuing education resources are needed to improve knowledge and core competencies in the mental health and treatment needs of LGBT individuals in Thailand.Among LGBT serving practitioners, routine assessment of suicidality is needed to increase the early identification and treatment of individual at risk for suicidal behaviours.Standardized measures of sexual orientation and gender identity should be included in all patient intake forms.In conducting research on strategies to improve mental health outcomes among LGBT populations, standardized measures of sexual orientation/gender identity and minority‐specific stressors should be used.Suicide prevention interventions aimed at reducing general and minority stress among LGBT populations should be a priority in mental health nursing. Introduction: A large and rigorous body of research in the United States has demonstrated that lesbian, gay, bisexual and transgender (LGBT) populations are at an elevated risk for suicide. However, scant research aimed at understanding the rates and predictors for suicidality among Thai LGBT individuals exists. Aim: To examine rates and predictors of suicidality among Thai LGBT adults (N = 411). Method: Data collection was conducted via online and in‐person surveys. Guided by the Minority Stress Model, standardized measures of demographics, health‐related factors, general and minority‐specific stressors and suicidality were completed. Results: Thirty‐nine per cent of participants reported lifetime suicidal ideation, 19.0% past 12‐month suicidal ideation and 13.1% lifetime suicide attempts. Lifetime suicidal ideation was associated with higher levels of social discrimination, stress, loneliness and chronic disease (OR = 1.12, 1.16, 2.75, and 1.46, p ≤.05, R2 = 0.327). Past‐year suicidal ideation was associated with victimization, stress, loneliness and being a former smoker (OR = 1.52, 1.20, 2.34, and 4.89, p <.05, R2 = 0.345). Suicide attempts were associated with internalized homophobia, poverty, chronic disease, alcohol use and physical health (OR = 1.44, 1.06, 1.59, 1.45 and 0.95, p ≤ 0.05, R2 = 0.187). Discussion: General and minority‐specific stressors negatively impacted suicidality among LGBT participants. Implication for practice: Study findings have implications for nursing education, practice and research. Nursing education should include information about the influence of sexual orientation and gender identity on mental health outcomes. Further, systematic screening for suicidality should be conducted by LGBT serving psychiatric and mental health nurses. Finally, research is needed to determine best practices for interventions aimed at reducing suicidality risk among LGBT individuals. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: The strength of a relationship between people with mental health difficulties and professionals has been linked to patients feeling suicidal. A relationship has been found between how defeated and trapped people with mental health difficulties feel and how suicidal they feel. What this paper adds to existing knowledge?: This study explored the relationship between alliance, suicidality, defeat and entrapment in people admitted to mental health wards as previous research has focused on people in the community. Patient‐rated defeat, entrapment and suicidality are related in this sample of people admitted to mental health wards. A relationship was found between how well nurses said they bonded with their named patient and how trapped the patients felt by their environment. What are the implications for practice?: Nurses should consider if patients are feeling defeated or trapped when helping people with mental health difficulties to feel less suicidal. Abstract: Introduction: Suicidality is prevalent worldwide, particularly in people who access mental health services. The quality of therapeutic alliance between people with mental health difficulties and staff has been associated with suicidality but only in community settings. Defeat and entrapment are correlated with suicidality and may mediate any relationship between alliance and suicidality. Therefore, this exploratory study explored these relationships in people admitted to mental health wards. Aim: To explore defeat, entrapment, suicidality and alliance between nurses and people admitted to mental health wards. Method: Fifty inpatient nurse–patient dyads completed questionnaires regarding demographics, defeat, entrapment, suicidality and alliance with their named nurse. Nurses completed questionnaires on demographics, alliance with their patient and the patients’ suicidality. Results: Defeat, entrapment and suicidality were correlated. A correlation between nurse‐rated bond and external entrapment was found, but no other correlations between alliance, defeat, entrapment and suicidality were statistically significant. Discussion and clinical implications: Ward‐based nurses should consider the relationship between defeat, entrapment and suicidality when developing interventions to improve suicidality. Although there was no evidence of a relationship between total alliance and suicidality, developing closer bonds with patients may reduce patients’ feelings of being trapped by their environment. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? There is a growing body of evidence that many people with an autism spectrum condition suffer anxiety in their daily life and a realization among practitioners that admission to a mental health unit for this population is usually a negative anxiety-inducing experience., Anxiety is driven by the intolerance of uncertainty that is being unsure of what is going to happen, how long the uncertainty will exist and the insistence of sameness which, when compromised, can be anxiety provoking. Equally, confusion in understanding personal emotional responses and those of others is a source of anxiety., What this paper adds to existing knowledge? This paper builds upon existing understanding of anxiety as a causative factor of mental ill-health for people with an autism spectrum condition., Specifically, this paper explores the potentially anxiety-inducing experience of mental health unit admission; how anxiety is felt, triggered, expressed and managed., What are the implications for practice? As many different anxiety responses could be exhibited during hospitalization, including violent acts and self-harming, for mental health practitioners working in the inpatient units, it is essential that the thoughts, feelings and responses of the patient with an autistic spectrum condition (ASC) are better understood and that support offered during their stay in a mental health facility is from an informed position., Abstract Background This qualitative study explored how mental health inpatients with autistic spectrum conditions (ASCs) experience and cope with anxiety when admitted to an acute mental health inpatient facility in the United Kingdom. Anxiety is a common characteristic for people who live with ASCs and whilst a plethora of studies on anxiety in this population is published which correlate anxiety with mental health service experience, little is known about the actual triggers of anxiety and its manifestations. This study adds to a body of evidence which considers anxiety experienced by people with autism. The rationale for this study includes the need to heighten mental health practitioners' understanding, of the responses, motivations to engage and support required to overcome fears and anxieties when admitted to a mental health inpatient unit. Method The study used a qualitative naturalistic research design, to explore the emotional and psychological experiences of being a mental health inpatient living with an ASC. During 2015-2017. audio-recorded semistructured interviews captured the experiences of 20 adults from the east of England who were former psychiatric inpatients with an established diagnosis of ASC. Interpretative phenomenological analysis enabled the identification of broad themes which explained in rich detail, participant reflections regarding the situations and events within the acute care mental health facility that triggered their anxiety, manifestations of anxiety and responses to their anxiety. Findings Broad response patterns were identified that could be associated with their anxiety that is isolating themselves from others, including patients and staff, ceasing to eat and sleep adequately and all too often self-harming or exhibiting aggressive and violent responses. Conclusions The anxiety caused by the physical environment appears to be overlooked by mental health practitioners so attention to anxiety-inducing encounters is needed when planning acute care mental health service improvement and research is required to clearly understand the experiences of this vulnerable group. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? The experiences of transgender people are becoming increasingly more visible in popular culture, biographical literature and the media., The topic has received little attention within the psychiatric and mental health nursing literature., There is a paucity of literature exploring the impact on relationships following a disclosure of transgenderism., What does this paper add to existing knowledge? A narrative account of the consequences for the wife of one transwoman and their relationships with friends and family following the disclosure of transgenderism., The article identifies a range of issues that require further attention in relation to healthcare provision. These include the mental health needs of partners and spouses; attitudes of healthcare professionals towards transgender issues; and the adequacy of the formal support offered to partners and spouses of transgender people., What are the implications for practice? There is a need for healthcare practitioners to explore their understanding of transgender issues and how these may impact on the mental health of partners and spouses., It is important that healthcare professionals provide a hopeful and supportive environment to enable couples to explore their relationships following disclosure of transgenderism. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Depression affects 1 in 20 Americans, and people living with HIV experience depression at 2–3 times the rate of the general population.Recent research has shown that a person's level of social connectedness (e.g., social networks) is important to understanding their health and ability to get help when they need it.The scientific rationale of this work is to determine whether there is a direct relationship between levels of depression and a measure of social connectedness in people with HIV who are at higher than normal risk of depression and depressive symptoms. What this paper adds to existing knowledge?: We examined the relationship between levels of depression and social capital in people living with HIV to determine whether depression may influence their beliefs about their social connectedness and available resources.We found that as depression increases, self‐reported social capital decreases, suggesting that people living with HIV who are depressed may feel less socially connected and/or not be confident they can access resources when they need them. What are the implications for practice: Mental health nurses are particularly well‐positioned to help people living with HIV who are living with depression by helping them build skills for building and maintaining relationships, adhering to co‐administered HIV and mental health medical treatments, and helping these individuals to identify and address barriers to social connectedness.Helping people living with HIV to address depression and promoting social connectedness can not only improve quality of life, but have major long‐term health benefits. Introduction: People living with HIV (PLWH) are disproportionately burdened by depression, with estimates as high as 80% of PLWH reporting depressive symptoms. Depression in PLWH is complex, and has been linked with biological and psychosocial causes, including low social capital. Few studies have examined the relationship between social capital and depression in PLWH. Aim/Question: We conducted a secondary analysis of the relationship between social capital (Social Capital Scale score) and depression (Beck Depression Inventory‐II scores) to determine whether depression predicted levels of social capital in a sample of 108 PLWH. Results: Depression was significantly associated with lower social capital r(105) = −.465 p <.001. Depression remained a significant predictor of social capital in the linear regression model, F(5,101) = 8.508, p <.000, R2 = 0.296, when controlling for age and education level. Discussion: Our results suggest that depression may be a significant predictor of low social capital, and these factors may have cyclical relationships that explain persistent depression in this population. Implications for practice: Mental health nurses are particularly well‐positioned to help PLWH who are living with depression by helping them build skills for building and maintaining relationships, adhering to co‐administered HIV and mental health medical treatments, and helping these individuals to identify and address barriers to social connectedness. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Contemporary mental health policy stipulates consumer participation in all aspects of mental health services including service evaluation and other forms of mental health research.Research is identified as underpinning quality mental health services, and therefore, consumers researchers could enhance the mental health sector by contributing to the quality, credibility and relevance of mental health research. What this paper adds to existing knowledge?: Non‐consumer researchers generally supported the concept of a consumer expert reference group for researchers at the individual and institutional level.A consumer expert reference group should reflect diversity and offer expertise relevant to the topic of research and may represent one way to normalize partnerships with consumer researchers and realize the benefits they can bring to research. What are the implications for practice?: Quality mental health services are underpinned by robust research evidence. It is crucial that consumers are active participants in research activity.The availability of a consumer expert reference group could facilitate collaborations between consumer and non‐consumer researchers and contribute to a stronger consumer focus embedded in mental health research. Introduction: Contemporary mental health policy identifies consumers as active participants in all aspects of mental health services from design to evaluation. Consumer researchers should be actively involved in mental health research and contribute to quality service delivery. Aim: To gain a snapshot of mental health researcher views on strategies for increasing research by or with consumers in mental health through the establishment of an Expert Consumer Researcher Group (ECRG). Methods: Cross‐sectional survey of 41 non‐consumer mental health researchers from Australia or New Zealand. Results: The introduction of an ECRG was considered an effective strategy for linking consumer and non‐consumer researchers and providing specialist advice on research design and methodology. The most suitable location for this group was identified as within consumer advocacy agencies (71%), universities (66%) or research funding bodies (66%). Participants rated their likelihood of seeking advice from the ECRG as high. Discussion: Research participants supported the value of an ECRG. They emphasized the importance of ensuring the group reflected a diversity of views and offered specialized expertise related to the specific topic. The ECRG could benefit both individual researchers and larger research organizations. Implications for practice: An ECRG could facilitate collaborations with consumer researchers and in turn enhance the quality of mental health research. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? While smoking rates within the general population in Australia are dropping, 32% of Australians with a mental illness smoke, increasing to 73% among those with severe or chronic mental illness., In Australia and elsewhere, smoking bans within mental health facilities have been implemented., What this paper adds to existing knowledge? We surveyed 98 mental health professionals in Australia to gather information on attitudes toward smoke-free policies in mental health/psychiatric units within Australia., While previous research has sought information on agreement or disagreement with smoking-bans, very little research has been conducted focusing on attitudes held by mental health professionals towards smoke-free policies., This study utilized a mixed-methods approach in which the qualitative data provides a rich source of information to assist in developing programmes or interventions to influence attitudes and therefore change behaviours of mental health professionals., What are the implications for practice? This paper can be useful in providing a better understanding of the theories linking smoking and mental illness, and the common 'myths' which influence attitudes to smoking cessation in clinical populations., Results will influence the development of training and education resources for mental health practitioners, and particularly for nursing staff working within psychiatric facilities, in relation to smoking cessation., Importantly, this issue has implications in the areas of policy planning and development, education relating to smoking behaviour and smoking cessation programmes, together with holistic health care., Abstract Introduction Mental health units in Australia and internationally are increasingly implementing smoke-free policies. Due to the high prevalence of smoking among clinical populations, this has become an important research area. Purpose of study This study explored the attitudes of mental health professionals toward smoke-free policies in mental health units within Australia. Method Using an online survey design, 98 Australian mental health professionals participated in the study. Results Results indicated that only 25.5% agreed with a total smoking ban. Although supporting smoke-free initiatives within the wider community, participants commonly held attitudes that were unsupportive of smoking bans, and indicated beliefs inconsistent with a smoke-free policy for clinical populations. Discussion Results suggest the need for appropriate staff education and training regarding smoking behaviours and risks, and smoking cessation treatments for clinical populations if smoke-free policies are to be successfully implemented. Implications for practice Findings suggest important implications for holistic mental health care, staff education and training, as well as policy, planning and development, particularly in relation to this treatment group, who are likely to have entered a psychiatric unit in crisis. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Standardized patient ( SP) simulation is an internationally recognized learning strategy that has proven effective in enhancing nursing students' competencies necessary for mental health practice., What does this paper add to existing knowledge? A deeper exploration of the process from the perspective of SPs and more particularly drama students, revealed the complexity they need to navigate and the personal vulnerability they are exposed to when creating an authentic learning opportunity for nursing students., What are the implications for practice? Their vulnerability justifies deeper consideration of support, as well as research on the ethical implications of SP simulation., Nursing students need to be well grounded in therapeutic communication before engaging with mental health users. This should include opportunities to question personal frames of reference that could hinder therapeutic engagement with diverse others., In future, the drama students can be involved in scenario development to enhance the authenticity of simulations., Abstract Introduction The effectiveness of Standardized patient ( SP) simulation in enhancing students' mental health nursing competencies is well published. Nevertheless, the believable and accurate portrayal of a patient with a mental health issue during SP simulation is complex. Though vital to the creation of safe authentic learning experiences, the perspectives of SPs and particularly of drama students involved in SP simulation are unknown. Aim The aim of this paper is therefore to explore and describe the experiences of 11 drama students engaged in mental health simulations for nursing students. Method A qualitative approach was taken and data were gathered using various techniques. Findings The content analysis revealed that these SPs negotiated three roles during this interdisciplinary learning experience, namely of a facilitator of learning, a drama student and the person within. Discussion The study provided valuable insight into the world of an SP, including the complexities they navigate and the vulnerability they experience. Implications for Practice Nurse educators are alerted to SP's need for support and the necessity of establishing good interpersonal skills before nursing students enter the practice setting. Involvement of SPs in scenario development could enhance the authenticity of future simulations. The ethical implications of SP simulation requires further exploration. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on this subject?: There is a need to shed light on healthcare professionals' reactions to the use of the Guided Self‐Determination method in a mental health hospital to better understand and adjust the implementation process of evidence‐based practice.Healthcare professionals´ values and beliefs play an important role when implementing evidence‐based practice in real‐world healthcare settings. What this paper adds to existing knowledge?: The study identifies opposite positions in mental healthcare professionals: being ready or resistant to change when implementing an evidence‐based intervention. The positions are elaborated in four thematic dynamic continuums describing reactions to using the intervention.In addition, this is the first study to explore mental healthcare professionals´ reactions to using the Guided Self‐Determination method in a mental health context. What are the implications for practice?: When preparing implementation of an evidence‐based intervention, it is important to consider adaptation of the intervention, the mental healthcare professionals' acceptability, support from management and participation in supervision.In future research, it is important to consider collecting data from mental healthcare professionals trained in using an evidence‐based intervention, however not using it in clinical practice, to understand barriers towards evidence‐based practice. Introduction: Evidence‐based interventions are required in mental health nursing to improve quality and outcome for patients. However, there is a need to shed light on professionals' reactions to the use of evidence‐based interventions to better understand and adjust the implementation process. Aim: To explore mental healthcare professionals´ reactions to using the evidence‐based intervention Guided Self‐Determination method in the care of inpatients with severe mental illness. Method: A qualitative study conducted in relation to an 8 months implementation program. Data collection: 9 qualitative interviews and field notes generated from supervision of the intervention. Results: Four themes emerged from a thematic analysis: "The expert becomes novice," "Theory used as a looking glass," "Guided Self‐Determination perceived as an interruption" and "Becoming an informer of the impact of GSD." Discussion: Using the themes may help leaders or researchers predict or discover the support needed by individual professionals. Implications for practice: When preparing implementation of an evidence‐based intervention, it is important to consider adaptation and acceptability, as well as support from management and participation in supervision. Finally, it is worth to consider collecting data from trained professionals, who did not use the intervention in practice to understand barriers towards evidence‐based practise. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Recovery‐oriented care is a means of providing mental health treatment, focused on the patient's individual needs and active involvement in one's own care. However, this approach presents with challenges, particularly in psychiatric hospitals, which tend to be focused on symptom reduction. What does the paper adds to existing knowledge?: This study examines the influence of three different recovery‐oriented training programmes/interventions (namely, illness management and recovery, peer support, and psychiatric advance directives) on the attitudes and practice of mental health staff (including nurses) in an inpatient setting, using a mixed‐methods methodology. We quantitatively assess the knowledge, attitudes and practices developed following recovery‐oriented training, compared to staff not trained in these interventions. We interviewed staff exposed to the different interventions to learn about their personal views and characterized the benefits and challenges they experienced.Mainly, the illness management and recovery training created a positive change in the work attitude and some work‐related practices of mental health staff and the increased presence of a person‐centred approach supporting patient autonomy. However, and contrary to expectations, there was no increase in practices that support personal goals or provide individually tailored services.Peer support had an experiential impact among mental health staff, initiating a more humane, positive approach to patients.Psychiatric advance directives were reported as more challenging to implement and with limited impact. What are the implications for practice?: Recovery‐oriented trainings can be internalized and implemented by staff in medical model psychiatric settings.Despite recovery‐oriented training, challenges do occur—notably, they are hardest to implement in acute wards/patient states and by psychiatric nurses.Using multiple recovery‐oriented programmes/interventions can accelerate the momentum for change in traditional settings and promote positive practice.Ongoing comprehensive mental health staff training on recovery‐oriented care programmes is essential in order to sustain change over time.Training is not enough in itself—hospital administrations need to be actively involved in promoting recovery‐oriented policies. Introduction: Developing person‐centred recovery‐oriented care is a challenge in mental health systems, particularly psychiatric hospitals. Aim: To assess the knowledge, attitudes and practices developed following recovery‐oriented training of nurses and other staff; to identify the benefits and challenges involved in the implementation of recovery‐oriented intervention in psychiatric wards. Method: A mixed‐methods study compared recovery knowledge, attitudes and practices of 37 mental health ward staff trained in recovery‐oriented intervention, against 35 staff not trained. Fifteen staff were interviewed about their experiences, and protocols were qualitatively analysed. Results: The quantitative outcomes partially confirmed positive changes in attitudes and some practices. Qualitative interviews complemented these findings, revealing greater use of a person‐centred approach and support for patient autonomy. However, we did not find differences between groups in quantitative outcomes pertaining to personal goals or providing individually tailored services. Discussion: This study validates the implementation of recovery training and practices in psychiatric settings, and identifies the challenges involved. We discuss psychiatric nurse conflicts in implementation in acute wards. Implications for practice: Our findings support the need for broader staff training in recovery‐oriented interventions. Recruiting the support of the hospital administration for recovery‐oriented intervention programmes is key, both ethically and structurally. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Substance abuse, poor lifestyle and side effects of medication often occur and cause oral health problems in patients diagnosed with severe mental illness (SMI). Oral health in SMI is related to quality of life, self‐esteem, and daily functioning. Despite its importance, oral health in mental health care is still a postponed healthcare pathway. Treatment guidelines on patients after a first episode psychosis (FEP) indicate that interventions are recommended, but clinical advice is lacking. However, no research on the experiences of young adults' oral health after FEP has been conducted. What does this paper add to existing knowledge?: This study is the first study to gain insight into most important experiences in patients after FEP regarding oral health. After FEP, participants experience many risk factors, for example substance use, poor diet and financial problems, and participants are not able to adequately attend to their oral health. There is a lack of awareness among participants after FEP about oral health and participants do have high burden. After FEP, participants need support and help from their environment to maintain their oral health. What are the implications for practice?: In FEP, oral health needs more attention to avoid the negative consequences in a later phase of the illness. To fill the gap between patients' needs regarding oral health care and the attention of mental healthcare professionals, the awareness of patients and mental health professionals concerning oral health should be heightened, and clinical interventions to support these needs should be developed. Introduction: Oral health affects quality of life, self‐esteem, physical health and daily functioning. Treatment guidelines on patients after first episode psychosis (FEP) recommend interventions, but clinical interventions are lacking. No research on the experiences of young adults' oral health after FEP has been conducted. Aims: This study aimed to explore the lived experiences and needs of patients after FEP with regard to their oral health. Design and Methods: Single‐centre phenomenological study using open interviews (N = 30). Data were analysed using the Colaizzi method. Results: Patients reported oral health problems since their FEP. The problems that patients encountered were dental care in general (e.g., a lack of awareness), risk factors (e.g., substance use, poor diet and financial problems), overall experiences with dentists/dental hygienists and the gap between needs and interventions. Discussion: There is a lack of awareness among patients after FEP about oral health while patients are not able to adequately attend to their oral health and patients have high burden on this topic. Implications for mental health nursing: To bridge the gap between patients' needs regarding oral health, the awareness of patients and mental health professionals should be heightened, and patients should be better supported by mental health professionals. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: In the United States, 15.5% of nursing home residents without qualifying diagnoses of schizophrenia, Huntington's' Disease, and/or Tourette Syndrome receive antipsychotic medications.Antipsychotic medications are used off‐label (i.e., used in a manner the United States Food and Drug Administration's packaging insert does not specify) to treat neuropsychiatric symptoms, often before attempting nonpharmacologic interventions, despite evidence that this drug class is associated with significant adverse events including death.Less than optimal staffing resources and lack of access to geropsychiatric specialists are barriers to reducing antipsychotic use. What the paper adds to existing knowledge?: Antipsychotic use occurred in 11.6% of nursing home residents without qualifying or potentially qualifying diagnoses (bipolar disorder and psychotic disorder); antipsychotic use was more prevalent in residents with a dementia diagnosis than those without.One additional registered nurse hour per resident day could reduce the odds of antipsychotic use by 52% and 56% for residents with and without a dementia diagnosis respectively. What are the implications for practice?: Given the influence of total staffing and professional staff mix on risk of antipsychotic use, nursing home administrators may want to consider aspects of facility operation that impact antipsychotic use.More stringent Unites States' survey and certification standards for dementia care implemented in 2017 demand proactive person‐centered care that promotes maximal well‐being and functioning without risk of harm from inappropriate psychoactive medications.Mental health nurses have requisite training to provide expert person‐centered care to nursing home residents with mental illness and geropsychiatric disorders. Introduction: Antipsychotic use in nursing homes varies widely across the United States; inadequate staffing, skill mix, and geropsychiatric training impede sustained improvement. Aim: This study identified risk factors of antipsychotic use in long‐stay residents lacking qualifying or potentially qualifying diagnoses. Method: This secondary analysis used 2015 Minimum Data Set and cost report data from 458 Missouri nursing homes. The full sample (N = 29,679) was split into two subsamples: residents with (N = 15,114) and without (N = 14,565) a dementia diagnosis. Separate logistic regression models were run. Results: Almost 15% of the dementia subsample and 8.4% of the nondementia subsample received an antipsychotic medication in the past week. Post‐traumatic stress disorder, psychosis indicators, behavioral symptoms, anxiety medication with and without anxiety diagnosis, depression medication with and without depression diagnosis, and nurse staffing were among the strongest predictors of antipsychotic use in both subsamples. Simulation analyses showed decreased odds of receiving an antipsychotic in both subsamples when registered nurse hours matched the national average. Discussion: Matching nurse staffing mix to the national average may improve antipsychotic use in nursing homes. Implications: Knowledge of antipsychotic use risk factors use can inform care planning and staff education to minimize use of these medications in all but severe cases. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? The GQ-6 is one of the most widely used self-report questionnaires to evaluate the level of gratitude among adults. The GQ-5 appears suitable for adolescents., What this paper adds to existing knowledge? We developed a Chinese version of the GQ-5 and examined evidence for its reliability and validity. Results demonstrated adequate reliability and validity, indicating that it is appropriate for the assessment of gratitude in Chinese adolescents., In addition, Chinese early adolescent females reported higher gratitude than adolescent males., What are the implications for practice? Screening adolescents who have lower levels of gratitude through the GQ-5 could help identify students who may benefit from empirically validated interventions to promote higher levels of gratitude in an effort to promote positive psychosocial and academic outcomes., Abstract Background This study was conducted to evaluate the psychometric properties of the Chinese version of the 5-item Gratitude Questionnaire ( GQ-5). Method The sample consisted of 2093 middle school students (46.8% males) in mainland China. Confirmatory factor analysis and multigroup confirmatory factor analysis were performed to examine the factor structure and the measurement equivalence across gender. The convergent validity, Cronbach's α and mean interitem correlations of the GQ-5 were also evaluated. Results The results provided evidence of internal consistency reliability through a Cronbach's α of 0.812 and a mean interitem correlation of 0.463 for the total sample. The results also supported a one-dimensional factor structure. In addition, convergent validity was assessed by statistically significant positive correlations between the GQ-5 and the two subscales of the Children's Hope Scale ( CHS) and the Brief Multidimensional Students' Life Satisfaction Scale ( BMSLSS) total score. Finally, multigroup confirmatory factor analysis also demonstrated measurement equivalence across gender. Subsequent analyses of latent mean revealed gender differences in early adolescent male and female students. Conclusions The Chinese version of the GQ-5 appears to be a reliable and valid measure of gratitude among Chinese early adolescents. Early adolescent female students reported higher gratitude than early adolescent male students. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Studies show that psychological capital (PsyCap) is a protective factor against psychological distress, such as depressive symptoms. However, few have attempted to address the role of coping styles in the relationship between PsyCap and psychological distress., What does this paper add to existing knowledge? Our study found moderate levels of PsyCap among nurses in China. Among the subcategories of PsyCap, optimism and hope were most highly correlated with psychological distress. Psychological distress was positively associated with negative coping and negatively associated with positive coping., This study confirmed the partial mediating effect of coping styles in PsyCap and psychological distress among Chinese nurses. In other words, this study found direct and indirect effects of PsyCap on psychological distress mediated via coping styles., What are the implications for practice? The significant mediating effect of negative and positive coping styles between PsyCap and psychological distress has implications for hospital administrators, especially nurse leaders. Effective strategies should be implemented to improve PsyCap and coping styles among Chinese nurses, and alleviate psychological distress. Optimism and hope should be emphasized in PsyCap investment. Different styles of coping are influenced and modified by teaching and experience. Therefore, it is essential that nurse managers organize educational and training programmes to provide nurses with relative coping knowledge and techniques, and improve their coping ability. Several studies suggest that coping styles are affected by social support. Thus, nurse managers should assist nurses with social support and enhance coping strategies to reduce psychological distress., Abstract Introduction PsyCap includes four categories namely self-efficacy, hope, optimism and resilience. Research has demonstrated that PsyCap and coping styles affect current psychological distress. Nevertheless, few studies have explored the role of coping styles in PsyCap and psychological distress. Aim This study investigated the role of coping styles as a mediator in PsyCap and psychological distress among Chinese nurses. Methods Participants included 538 nurses who completed self-report questionnaires assessing PsyCap, coping styles and psychological distress. Linear regression analyses were used to explore the role of coping styles. Results PsyCap, coping styles and psychological distress were significantly correlated. Among the subcategories of PsyCap, optimism and hope were most highly correlated with psychological distress. Coping styles is a partial mediator of PsyCap and psychological distress. Implications for mental health nursing The significant role of negative and positive coping styles in PsyCap and psychological distress has implications for hospital administrators, especially nurse leaders. Effective strategies should be implemented to improve PsyCap and coping styles among Chinese nurses, to alleviate psychological distress. Optimism and hope should be the focus of the improvement. Different styles of coping are developed from education and experience. Therefore, it is necessary for nurse managers to organize educational and training programmes to improve coping skills among nurses. Studies suggest that coping styles are affected by social support. Thus, nurse managers should also assist nurses with social support and enhance coping strategies to reduce psychological distress. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Caregivers of adolescents with ADHD experience major difficulties as care providers and are in need of guidance and support., Adolescents with ADHD may develop oppositional and criminal behaviour. More than 50 % have the symptoms in adulthood, and up to one-fourth with severe emotional or antisocial difficulties., There is a lack of evidence of caregivers′ supporting intervention although caregiver groups have been found to contribute to better coping, decreased stress and improvements in ADHD symptoms., What does this paper add to existing knowledge? Primary caregivers of adolescents with ADHD experienced better quality of life after the Therapeutic Conversation Intervention., The intervention contributed to better social functioning among secondary caregivers., What are the implications for practice? The content of the Therapeutic Conversation Intervention is significant and highlights the utility of a combination of group and private sessions for caregivers of people with ADHD., The intervention can influence how services for families are organized, such that a Therapeutic Conversation Intervention could be offered on a regular basis., Abstract Introduction Caregivers of adolescents with Attention Deficit Hyperactivity Disorder are burdened with tasks and many suffer from distress. Adolescents with ADHD may develop antisocial behaviour and caregiver′s group can empower caregiver's supporting role. Aim/Question To evaluate the effectiveness of a Therapeutic Conversation Intervention on caregivers of adolescents with ADHD regarding strengthening the supportive role. Method The study utilized a quasi-experimental design. The participants ( n = 60) were caregivers of adolescents (13-17 years old) with ADHD. The intervention consisted in-group and parent sessions. The Calgary Family Model and the Family Illness Beliefs Model were used as theoretical frameworks. Results The study revealed significant differences in the improvement of quality of life; regarding primary caregiver ( PC) worry, daily activities, family relationships and collaboration post-intervention, as well emotional functioning at both post-intervention and follow-up. Secondary caregiver ( SC) social functioning was significantly improved at follow-up. Discussion The intervention proved to be beneficial to the caregivers and is filling a gap in much needed intervention. Implication for practice The results will expand health care professionals' knowledge of how to increase PC quality of life when supporting their adolescent with ADHD. This treatment information should improve service at health care centres/hospitals where adolescents with ADHD receive care. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Ulcerative colitis (UC) is a chronic inflammatory disorder associated with high perceived psychological stress., The attachment theory provides a psychodynamic perspective to investigate the relationship between close interpersonal relationships and stress in UC., Researchers have hypothesized that the chronic illness might affect personality trait as the attachment style of patients., What this paper adds to existing knowledge? UC patients exhibit a more pronounced attachment insecurity that, in turn, resulted as a determinant of psychological stress., This study suggests that UC could determine a shift towards insecurity in the attachment style that, in turn, promotes psychological stress and increases the risk of psychopathologies., What are the implications for practice? The more accurate knowledge of attachment insecurity in patients with chronic disorders such as UC may help the nurses to face with often dysfunctional patients' styles of manifesting distress, patterns of help seeking and expectations of health professionals., The knowledge of psychopathological mechanisms in patients with UC could improve the prevention and treatment of psychological disorders in affected patients., Abstract Introduction Ulcerative colitis (UC) is a chronic disorder characterized by recurrent intestinal symptoms. The attachment theory provides a psychodynamic perspective to investigate the relationship between interpersonal relationships and stress in UC. Aim The aim of this study was to compare the attachment dimensions between UC patients and controls and to evaluate the impact of these dimensions on perceived stress in patients. Method In all, 101 patients with UC completed the attachment style questionnaire and the perceived stress questionnaire (PSQ). Clinical and psychometric parameters were added as predictor variables in a regression with the PSQ score as dependent variable. One hundred and five healthy subjects took part in the study as controls. Results Compared to controls, UC patients exhibited greater scores in relationships as secondary, need for approval and preoccupation with relationships. In UC, disease activity, confidence and preoccupation with relationships resulted predictors of perceived stress. Discussion Compared to healthy controls, UC patients exhibited more pronounced attachment insecurity that, in turn, was a significant predictor of the perceived stress. Implications for practice The knowledge of attachment insecurity may help the nurses and all health care providers to face with dysfunctional patients' styles of manifesting distress, help seeking and expectations of health professionals. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? According to estimates more than half of adult mental health service users are parents, but their experiences are largely lacking from research literature., Parental mental illness can often be viewed from a risk perspective., Parents with mental illness and their families have unmet support needs., What this paper adds to existing knowledge? Parents with mental illness want acknowledgement that they can be able and responsible., Many parents adopt an expert by experience identity., Fathers can feel their parental role is not recognized and mothers express fears of being judged if they discuss their illness., What are the implications for practice? Adult mental health services need to recognize and support parental role of service users., Joint care planning and family oriented care should be promoted., Professionals should take advantage of the knowledge of these parents and they could be more actively engaged in service development., Abstract Introduction Parental mental illness is often viewed from a risk perspective. Despite this, being a parent can be both valuable and motivating. Research literature lacks the perspective of mothers and fathers, who have experienced mental illness. Aim This study explores how parents with mental illness construct their identities as mothers and fathers and their experiences with health and social care services. Method Three focus groups with 19 participants were conducted in Finland and Scotland. Methods of discourse analysis have been used in to analyse the interview data. Results Adult service users want their parenting role recognized and supported. Parents have knowledge and skills which can be utilized and many have adopted an expert by experience identity. Discussion Being able to see oneself as a 'good' parent can be challenging but important. Parents may require support, but want to be included in the planning of their care. Services could make more use of the knowledge and skills parents and families have, and joint working could lessen parents' anxieties. Implications for practice Mental health practitioners are in a key position in providing more family centred, resource focused care. Service user expertise should be acknowledged in clinical practice. [ABSTRACT FROM AUTHOR]

Accessible summary What is known about the subject? Loneliness among people diagnosed with schizophrenia is a serious problem. Recent studies have focused on the loneliness; however, no study has examined the relationships between loneliness and both individual and environmental factors comprehensively., What this paper adds to existing knowledge? The main results indicated that the community-dwelling people diagnosed with schizophrenia in Japan as well as in other countries experienced higher levels of loneliness. Both individual and environmental factors were related to loneliness. Increasing the self-efficacy for community life and self-esteem of individual factors, and not being socially isolated and increasing community integration of environmental factors would improve their loneliness., What are the implications for practice? Health practitioners, in particular, public health nurses in mental health care, should work to develop a partnership with people diagnosed with schizophrenia, their family members, friends and other community-dwelling people in order to decrease and prevent loneliness. For individuals diagnosed with schizophrenia, interventions by cooperating with community resources and using the technique of nurses to assist them with continuous community activity could be useful. For environmental interventions, population approach such as developing daily programmes which family members can participate in, and cooperating with educational institutions and community events could have a positive effects., Abstract Introduction Loneliness among people diagnosed with schizophrenia living in communities can decrease quality of life and may contribute to suicide. Aim The aim of this study was to examine the levels of loneliness among Japanese people diagnosed with schizophrenia and to identify individual and environmental factors related to their loneliness. Method A cross-sectional survey was conducted with 264 people diagnosed with schizophrenia who use local activity support centres in urban areas. The self-administered questionnaires included questions on loneliness, demographic characteristics, individual factors including self-efficacy for community life and self-esteem, and environmental factors including social isolation, community integration and service use. Results The study results indicated that people diagnosed with schizophrenia in Japan experience higher levels of loneliness, corroborating results from other countries. Multiple regression analysis showed that a lower level of self-efficacy for community life, self-esteem, community integration and social isolation predicted a higher level of loneliness, accounting for 55.3% of variance. Implications for Practice Public health nurses in mental health care in Japan can work with individuals diagnosed with schizophrenia and communities using the technique to assist them with continuous activity and cooperating with community resources and educational institutions in order to decrease and prevent loneliness. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Some research suggests that holding a free will perspective may offer mental health and physical health benefits., What this paper adds to existing knowledge? This study is the first to examine links between free will perceptions and psychiatric symptoms in patients diagnosed with schizophrenia., What are the implications for practice? Study results suggest that helping people with a diagnosis of schizophrenia to recognize situations where they do have some freedom of choice over their actions and emotional reactions (free will) may assist them in improving their experiences and better managing their symptoms., Abstract Introduction Some research indicates that having a strong sense that one possesses free will may be associated with better psychological and physical health. This study is the first to examine the relationship between free will perceptions and psychiatric symptoms in patients with a diagnosis of schizophrenia. Method Thirty-two participants were interviewed using the Brief Psychiatric Rating Scale to assess symptom severity and the Free Will Subscale of the Free Will and Determinism Scale to assess free will perceptions. Results As hypothesized, a negative association was found between free will perceptions and total symptom severity, though it appears that this was mainly accounted for by positive symptoms. A content analysis was also conducted to qualitatively examine how patients conceptualize the construct of free will and its role in coping with their own mental illness. Discussion Study results suggest that holding a free will perspective may mitigate psychiatric symptoms in patients with a diagnosis of schizophrenia. Thus, psychiatric nurses and other mental health clinicians may improve current treatments for schizophrenia by helping patients recognize situations where they do have some freedom of choice over their actions and emotional reactions (free will) to stressful life events. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Although the use of prone restraint should be avoided, it may remain a last resort emergency intervention for violent behaviour in psychiatric settings. However, when used as a last resort, concerns remain about the ability of staff to maintain the dignity, welfare and safety of the patient and minimize the potential adverse outcomes associated with restraint., This study builds on existing research regarding the risks of prone restraint by focusing on the psychological perceptions of individuals held in this position., What this paper adds to existing knowledge? Individuals, who were asked to rate the psychological impact of two different prone-restraint positions (Supported and Unsupported Prone Positions) reported that the Supported Prone Position was more comfortable, less anxiety inducing and less limiting to breathing., Although no individual found prone restraint a positive experience, it shows that individuals found the psychological impact of the Supported Prone Position was less than the Unsupported Prone Position., What are the implications for practice? Mental health professionals have a clear responsibility to maintain the dignity, safety and wellbeing of individuals subject to prone restraint as a short-term emergency procedure for the management of violent behaviour., Reducing both the physiological and psychological impact of prone restraint will help to reduce any adverse impact on individuals subject to such interventions. The findings will help influence current practice and promote the removal of the USPP as a specific prone-restraint intervention., Abstract Aim Restraint-related deaths are multi-factorial with prone restraint remaining a concern due to the physiological and psychological risks. This study builds on evidence presented by (Barnett et al. Medicine, Science and the Law (2012b): 1) that the Supported Prone Position ( SPP) reduces physiological risks, by examining if the SPP also reduces the psychological impact of prone restraint. Methods Twenty participants ran to near maximal exertion before being held in two prone-restraint positions: SPP and Unsupported Prone Position ( USPP). Perceptions of comfort, anxiety and breathing limitation were measured using Visual Analogue Scales . Results Results showed that (1) comfort was 23% greater in the SPP; (2) anxiety was 55% less in the SPP; and (3) perception of breathing limitation was 32% less in the SPP when compared with the USPP. Negative perceptions expressed for the USPP included feeling trapped, vulnerable and concern over heart rate. Discussion In addition to reducing physiological risks, this study shows that the SPP reduced the psychological impact of prone restraint compared to USPP. Implications for Practice Settings where prone restraint cannot be avoided should remove the USPP as an emergency procedure in favour of the SPP as a way of maintaining safety and reducing the psychological impact of prone restraint. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Outreach services are often successful in engaging and housing street homeless individuals., People experiencing homelessness have greatly increased rates of mental illness and substance abuse., What this paper adds to existing knowledge? Given the relative lack of research involving street homeless individuals, this ret-rospective chart review examined factors associated with successful housing by a multidisciplinary street outreach team, including the use of hospitalization as an intervention within a housing first framework., The majority of clients were successfully housed by the end of outreach team involvement., An admission to hospital was strongly associated with successful housing for those with a psychotic disorder., What are the implications for practice? Multidisciplinary outreach teams, specifically those with psychiatric and nursing support, successfully work with and house people experiencing street homeless-ness and psychosis., Mental health nurses embedded in the community are an essential link between inpatient and outpatient care for highly vulnerable street homeless individuals., Abstract Introduction Housing-first strategies have helped establish housing as a human right. However, endemic homelessness persists. Multidisciplinary outreach teams that include nursing, social and psychiatric services allow for integrative strategies to engage and support clients on their housing trajectory. The following retrospective review focused on the identification of demographic, clinical, and service characteristics that predicted the obtainment of housing, and explored the role of psychiatric hospitalization as an intervention, not an outcome measure, in contrast to previous studies. These have rarely focused on street homelessness. Method A retrospective chart review of 85 homeless, primarily rough-sleeping, clients was conducted to determine housing outcomes and the factors associated with obtaining housing through care provided by a psychiatric street outreach team in Toronto, Canada. Demographics, homelessness duration, diagnosis, hospitalization and housing status were tracked during team involvement. Results Overall, 46% (36/79) were housed during the study term. Securing housing at the end of treatment/data collection was significantly enhanced by hospitalization (OR = 9.04, 95% CI [2.43, 33.59]). It was significantly diminished by psychosis (OR = 0.22, 95% CI [0.05, 0.95]) and prior homelessness >36 months (OR = 0.10, 95% CI [0.02, 0.50]). Twenty-three of 31 (74%) hospitalized clients with psychosis were subsequently housed, compared to 4 of 30 (13%) not hospitalized (Fisher's exact, P < .001). Discussion Multidisciplinary street outreach teams successfully house long-standing homeless clients (>12 months without a permanent address) with serious mental illness and/or substance abuse. Hospitalization can be utilized as a complimentary intervention, particularly for those with psychosis, in the continuum of housing first initiatives, and can contribute to securing housing for those with persistent psychotic disorders. Implications for nursing practice Community mental health nurses are uniquely positioned to translate care between hospital and community settings, ensuring timely assessment, intervention and treatment of clients who are historically difficult to engage. [ABSTRACT FROM AUTHOR]

Accessible summary What is known about the subject? Citizenship is an important yet largely overlooked concept within psychiatric and mental health nursing practice, Many service users are subject to legally mandated restrictions that place conditions on their rights and responsibilities as citizens., What this paper adds to existing knowledge? Even though service users have legal status as citizens, they continue to experience many conditions on their rights and responsibilities., Concerns about services users' trustworthiness and doubts about their levels of insight impact on their status as full citizens., What are the implications for practice? Nurses' understandings of the conditions placed on the citizenship rights and responsibilities of service users will ensure inclusive and less restrictive care and treatment, Integration of the principles of therapeutic reciprocity and procedural justice within practice will help nurses balance both the rights of services users and legal restrictions on their liberty and autonomy, Abstract Introduction Service users have long been lobbying for equal participation as citizens, yet citizenship is an important and largely overlooked concept within nursing education and practice. Aims The study explored service users' understandings of their rights and responsibilities of citizenship and the conditions placed on these. Methods A total of 17 service users participated in semi-structured interviews. Isin's theory of the content of citizenship was used to analyze the data using a framework approach. Results Service users experience conditional citizenship that includes barriers to their participation and their rights and responsibilities that others in society enjoy. Discussion When the world of the service user is constructed through the language of the biomedical model, nurses may unwittingly reinforce psychiatric labels and thus perpetuate the stereotype that service users lack the competence to fully enact their rights and responsibilities. Implications for practice When providing care, nurses should incorporate the notion of therapeutic jurisprudence and the principles of reciprocity, procedural justice and the implementation of advanced directives to reduce conditions on service users' status as citizens. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? The time of discharge from a mental health hospital can be challenging for mental health service users, with high rates of readmission in the immediate months following discharge., Although some research exists that explores service users' perspectives of being discharged, little evidence exists that explores the processes influencing or used by service users' to adapt to the transition from in-patient acute mental health service., What this papers adds to existing knowledge? The findings of this grounded theory study demonstrates the strategies service users used to managed their own, as well as their social audiences, preconceived expectations arising from their new identity as 'psychiatric patients' following their discharge from hospital., While there is a move to develop recovery-orientated mental health services, key indicators of recovery-oriented practices were often absent from service users' experiences of service provision., What are the implications for practice? Nurses and other mental health professionals need to recognize their contribution to the architecture of stigma that transcends the physical structures of hospital or ward and are entrenched within attitudes, interactions and practices., The findings of this study can provide guidance to those working with service users and help them to understand the complexities of their experiences when using mental health services, which go far beyond the management of their symptoms., Abstract Introduction Following a period of hospitalization, the transition to home can result in increased vulnerability and a source of stress for mental health service users. Readmission rates have been suggested as one indicator of the success of the transition from hospital to community care. Despite knowledge of some of the factors that impact on service users following discharge, no coherent model or theoretical framework could be located in the literature, which explains or aides an in-depth understanding of the transition from hospital to community for service users. Aim The aim of this study was to develop a grounded theory that explored service users' experiences of going home from hospital. Method This qualitative study used grounded theory, and a total of 35 interviews were conducted with 31 service users. Results The core category was 'Managing Preconceived Expectations', which had seven subcategories, describes how the participants were negatively perceived by themselves and others following their admission and discharge from hospital. Implications for Practice This theory presents the strategies that the participants used to manage this new identity. This theory demonstrates that although there has been a move to adopt recovery-orientated services, key indicators of recovery were often absent for service users being admitted and subsequently discharged. [ABSTRACT FROM AUTHOR]

Accessible summary Borderline personality disorder (BPD) is a complex and challenging mental health condition for the person and service providers who support them., This paper reports on the results of a survey of 153 people with a diagnosis of BPD about their experiences of attempting to receive support in managing this mental health condition. It provides their perceptions of a range of experiences not reported in the existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types., People with a diagnosis of BPD continue to experience significant discrimination when attempting to get their needs met within both public and private health services. Further education for nurses and other health professionals is indicated to address pervasive negative attitudes towards people with a diagnosis of BPD., Abstract There is limited understanding of the experience of seeking and receiving treatment and care by people with a diagnosis of borderline personality disorder ( BPD), their perceptions of barriers to care and the quality of services they receive. This study aimed to explore these experiences from the perspective of Australians with this diagnosis. An invitation to participate in an online survey was distributed across multiple consumer and carer organizations and mental health services, by the Private Mental Health Consumer Carer Network ( Australia) in 2011. Responses from 153 people with a diagnosis of BPD showed that they experience significant challenges and discrimination when attempting to get their needs met within both public and private health services, including general practice. Seeking help from hospital emergency departments during crises was particularly challenging. Metropolitan and rural differences, and gender differences, were also apparent. Community supports were perceived as inadequate to meet their needs. This study provides data on a range of experiences not reported in existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types. Its findings can help inform better training for health professionals and better care for this population. [ABSTRACT FROM AUTHOR]

Accessible summary Little is known about how the prison environment may impact upon the mental health of adult prisoners., This paper highlights that prisoners perceive that the prison environment has a negative influence upon their mental health. However, a small number regarded prison as a place of respite, which afforded structure and an opportunity to access health services., There is a need for more research in this area specifically relating to the impact the prison climate may have upon those from black and minority ethic groups., Nurses must recognize the aspects of the prison environment that may impact upon the mental health of prisoners and demonstrate innovation and imagination in their application of interventions., Abstract Little is known regarding how the prison environment may affect the mental health of adult prisoners. Consequently, there is a need to investigate how this setting may exacerbate mental distress among this community. This literature review explores how the prison climate influences the mental health of adult prisoners. A thematic synthesis approach was used to elicit data relating to the aspects of the prison climate, which influence the mental health of prisoners. Four primary themes emerged from the synthesis: social, emotional, organizational and physical aspects. Prisoners perceive the prison climate to have a negative influence upon their mental health. However, perceived positively, prison was regarded as a place of respite, which afforded structure and an opportunity to access health services. There is limited research available specifically exploring the potential impact of the prison climate upon those from black and ethnic minorities groups. Nurses must recognize the aspects of the prison environment that may impact upon the mental health of prisoners and demonstrate innovation and imagination in their application of interventions. Additionally nurses need to take an active role in influencing and structuring the political agenda, which governs the clinical setting. [ABSTRACT FROM AUTHOR]

The article offers information on discussion of facilitative threats to introduce a threat‐based beliefs model of treatment‐seeking for depression. Topics discussed include the discussion focuses to propose potential treatment strategies that mental health and psychiatric nurses can utilize to encourage their patients to receive treatment for depression; views on importance of perceived threat for engaging in health behaviors; and role of loss of control in mental health distress.

The article focuses on how proposed changes to preregistration nurse preparation in Great Britain may impact on the future of undergraduate mental health nursing workforce. It states that undergraduate nursing education in Great Britain is now in a period of instability and flux and faces an immediate radical change. It states that education of mental health nurses in Great Britain has formed into a business model predominated by reducing costs, increasing efficiencies and productivity.

The article explores the recent literature on the efficacy of Peer Workers (PW) and discusses the mechanisms influencing their roles such as the therapeutic relationship. It notes that mental health nurses (MHNs) who often work with PWs has to engage in critical discussions around the potential implications for the mental health workforce as PWs become an increasingly established component of the workforce. It cites the need for MHNs to critically consider existing PW programmes.

Accessible summary Homeless persons are known to be highly vulnerable to psychological trauma, in events triggering periods of homelessness and the considerable social isolation and adversity suffered when homeless. This study provides an account of how mental health support work is experienced by homeless service users when it is informed by a person-centred, non-directive approach and implemented by trainee health and social care professionals under the auspices of a specialized psychological trauma service. The study draws upon material gathered from interviews with service users domiciled in supported housing for homeless persons and support workers who practiced on the programme., The service users who participated in the study valued support work that combined practical and relational elements, but would have preferred a longer-term involvement. They also spoke of feelings of disconnection and estrangement from others including their peers in supported housing. The support worker participants valued the flexibility they had when working on the programme to tailor their intervention to service users' individual needs., Practice implications of the study are discussed. These include the need to minimize barriers to accessing support, facilitate informal time between professionals and homeless service users, and manage intervention endings sensitively when temporary staffing arrangements are in place., Abstract Homeless people are a population known to be highly vulnerable to trauma, in triggering events to becoming homeless and the considerable social isolation, discrimination, and adversity suffered when homeless. Currently, there is a paucity of research into mental health service delivery to homeless persons and the influence it imparts in individual lives. This article presents a qualitative 'practice research' study into a pilot programme of social support work delivered in a specialized psychological trauma service to homeless service users. The programme was grounded in a non-directive, person-centred approach and staffed by student social workers. The study aim was to explore the support work programme as it was received by service users domiciled in supported housing for homeless persons, encompassing experiencing the programme, worker-service user engagement and contextual influences bearing upon positive outcomes. Narrative interviews gathered the impressions of service users and support workers and the data arising from these interviews was analysed thematically. Service user participants valued support work that combined practical and relational elements, but would have preferred a longer-term involvement. They also spoke of feelings of disconnection and estrangement from their peers in the supported accommodation and their families. The worker participants valued the flexibility of person-centred work tailored to service users' individual needs and echoed service user concerns around the short-term nature of their involvement. Psychiatric nurses carrying out, or supervising, mental health support work with homeless service users should be mindful of the potential impact of temporary staffing arrangements on continuity of care. They should also consider how working from a person-centred perspective and addressing client's practical needs may aid in developing rapport and trust with homeless service users. [ABSTRACT FROM AUTHOR]

Accessible summary The aim of this study was to explore and describe the stigmatization experienced by individuals with mental health problems ( IMHP) and the relationships between stigmas associated with mental health problems, psychiatric diagnoses, treatments, and social environments and their consequences., Our findings show that almost all IMHP were concerned about being stigmatized by others, society, their family, and health care professionals. Another concern that IMHP reported was self-stigmatization. Stigmatization serves as a barrier to treatment adherence and socialization in IMHP. Furthermore, stigmatization has a significant impact on the lives of IMHP, and methods of coping with stigmatization are commonly ineffective., It is important for the nurses to reduce stigma by dealing with the illness, IMHP, their relatives, and professionals in an unprejudiced manner., Abstract The aim of this study was to explore and describe the stigmatization experienced by individuals with mental health problems ( IMHP) and the relationships between stigmas associated with mental health problems, psychiatric diagnoses, treatments, and social environments and their consequences. Thirty-three IMHP were recruited from outpatient and day clinics at the psychiatry department of a university hospital within a 5-month time period for this qualitative, descriptive study. Data were gathered using a structured interview form with open-ended questions to explore the changes in everyday life experienced by IMHP during the course of their illness. Data were analysed using the Colaizzi method of analysis. Our findings show that almost all IMHP were concerned about being stigmatized by others, society, their family, and health care professionals. Another concern that IMHP reported was self-stigmatization. Stigmatization serves as a barrier to treatment adherence and socialization in IMHP. Furthermore, stigmatization has a significant impact on the lives of IMHP, and methods of coping with stigmatization are commonly ineffective. However, stigmatization can be reduced by dealing with the illness, IMHP, their relatives, and professionals in an unprejudiced manner. [ABSTRACT FROM AUTHOR]

The article reflects on the social and environmental influences on mental disorder. Topics discussed include complex interactions between these factors like biological, social and environmental influences in infancy; association between adult mental disorders and childhood adversity; and chronobiology as an example that how social and environmental manipulation can impact on biological and psychological levels.

The article reflects on advancements in areas of transgender mental health. It mentions that there is a wide diversity in relation to transgender needs before, during and after transition; and discusses differences in needs relating to transgender men and women. It also reflects on location of gender dysphoria in psychiatric diagnostic manuals to serve to confuse the issues wherein psychiatric diagnosis serves as a means of access to treatment and surgery for gender reassignment.