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Accessible Summary: What is known on the subject?: Open Dialogue was developed in Finland in the 1980s by clinical psychologist, Jaakko Seikkula. It is a development of family therapy, recognises previous trauma and has proven to be very effective in situations of acute mental illness, and in particular psychosis.Trauma Informed Care is a practice based on the understanding of and responsiveness to the impact of trauma. When people have experienced trauma, they may have difficulties in their everyday life and experience negative physical health outcomes as well as the risk of developing mental ill health.Open Dialogue is aligned to mental health care which aims to be trauma‐informed, person‐centred and rights‐based. Examples exist of the use of both approaches for service delivery with limited evaluation. What the paper adds to existing knowledge?: To our knowledge, no formal evaluation has been made of the use of open dialogue as a Trauma Informed therapy approach to support individuals and their family networks.Although both approaches recognise the impact of trauma on individuals, no study has explored the effectiveness of this treatment combination for use by mental health nurses.This review is timely as it provides insights into contemporary services that are trauma informed and have used Open Dialogue to extend therapy work with individuals and their family/networks.This scoping review was able to determine whether recommendations for clinical practice and training in Open Dialogue with Trauma Informed Care approaches could be identified. What are the implications for practice?: This review provided a broad overview on the current types of trauma‐informed care services incorporating Open Dialogue approaches into their practice.The literature, though sparce, identifies that Trauma Informed Care recognises multiple origins for mental ill health. Open dialogue has an affinity with the common values of mental health nurses. As combined therapies, they are demonstrating usefulness in engaging families and people in their journey towards recovery.Rigid adherence to Open Dialogue focus and delivery as well as training practices could be revised to make them more open to what people and their families wish to discuss. The person with mental ill health and previous trauma should be able to direct the narrative. Trauma Informed Practice principles could be adapted to improve consumer satisfaction with Open Dialogue approaches. Introduction: A large proportion of people who access mental health services have a lived experienced of trauma and are more likely to have a history of complex trauma. Open Dialogue and Trauma Informed Care practices identify previous trauma as a factor related to later psychosis. This scoping review has identified similarities and contrasts in how an Open Dialogue and Trauma Informed Care approach have been combined to complement one another for clinical work with people presenting with psychosis and previous trauma. Aim: We aimed to answer the following research question in this scoping review: What is known of the combined use of Open Dialogue and Trauma Informed Care practice when working with consumers and their family networks? As such, the purpose of this paper was to explore the application to practice and identify if any training existed and been evaluated. Method: This scoping review was based on the Arksey and O'Malley's framework. A comprehensive search was performed across five electronic databases. Grey literature was also searched through Psyche Info and Google Scholar for books, Dissertation and Theses, alongside hand searching of the reference of the studies. Articles searched was from January 2013 to January 2023. Results: Five distinct themes were identified from the literature: (1) Linking open dialogue with trauma, (2) Response to treatment, (3) Empowerment and information sharing, (4) Interpretation by clinical services, (5) Staff training outcomes. Discussion: Some tentative recommendations for practice recognised the individuals' unique story and perspective, suggested that trauma is an important concept to assess. Services practising as Trauma Informed Services that have incorporated an Open Dialogue approach have mixed experiences. The use of Open Dialogue may have some benefits for family work and exploring consumer narratives while building a network of support. However, consumers identified similar frustrations with service delivery as with the family therapy literature. For example, it was difficult to bring family members together and difficult to discuss previous traumatic events in front of family. People experiencing training in Open Dialogue reported it taking a slow pace and not what they were familiar with. Implications for Practice: Open Dialogue can facilitate engagement of consumers and their family networks and greater recognition of the peer workforce to promote collaboration in therapy is needed. Future research should also focus on evaluating the effectiveness of such services and comparing their outcomes across regions. [ABSTRACT FROM AUTHOR]

This paper is the second in a series of two which reviews the current UK evidence base for recovery in mental health. As outlined in the previous paper, over the last 4 years a vast amount has written about recovery in mental health (approximately 60% of all articles). Whereas the first review focused on the peer-reviewed evidence; this paper specifically focuses on the grey/non-peer-reviewed literature. In total, our search strategy yielded the following: 3 books, a further 11 book chapters, 12 papers, 6 policy documents and 3 publications from voluntary sector organizations. Each group of publications was analysed for content, and they are discursively presented by publication group. The findings are then presented as themes in the discussion section. The themes are: social, historical and political critique; philosophy of hope for the individual; individual identity and narrative; models and guidance for mental health practice.We conclude that there is a need for both empirical research into recovery and a clearer theoretical exposition of the concept. [ABSTRACT FROM AUTHOR]

This paper is the first in a series of two which reviews the contemporary British evidence-base relating to recovery in mental health over a 4-year period. This review uses a systematic approach analysing the British peer-reviewed literature relating to recovery and mental health. The second paper in the series reviews the non-peerreviewed literature. Recovery is not a new concept; however, it has recently become increasingly prevalent in practitioner, policy and research discourses. In total 12 papers met the inclusion criteria. Five main themes emerged from the analysis: hope and optimism, meaning to life, activities promoting recovery, definitions and discourses and implications for mental health practice. By including only peer-reviewed literature this paper is in a strong position to analyse the theoretical development of the recovery concept and highlight future directions for recovery in mental health services. [ABSTRACT FROM AUTHOR]

Accessible summary • Mental Health and Social Exclusion, published by the Department of Health in 2004, suggested that mental health practitioners may be contributing to the social exclusion of people with mental health problems. •Social exclusion can be defined as people not being involved in different areas of life and their community, e.g. being unemployed and having a limited social network. This is more commonly experienced by people who are perceived to be ‘different’, e.g. people who use mental health services. •Despite there being links between social exclusion and mental health problems getting worse, there is very little research on this issue. The authors suggest that there are many factors which mean that mental health practitioners may contribute to social exclusion, including stigma and restrictive practices. •This paper discusses the relationship between social exclusion and mental health practitioners. The authors argue from the perspective of valuing the lived experiences of people with mental health problems. The authors believe that social inclusion is an important pathway to recovery in relation to mental health problems. Over the last 10 years, the social inclusion agenda has been gaining momentum as a policy driver in mental health services. Prior to the seminal Social Exclusion Unit (SEU) report, Mental Health and Social Exclusion, there was a lack of awareness concerning the pervasive links between social exclusion and mental health problems. In the report, the SEU suggested that mental health practitioners themselves may actually be contributing to this social exclusion. This finding has been given limited coverage in both social inclusion literature and research. The current paper is a positioned commentary further exploring the relationship between practitioners and the social exclusion of mental health service users. A literature review was conducted in order to identify themes among factors which appear to moderate and contribute to this relationship. These factors are presented and implications for inclusive practice are explored. [ABSTRACT FROM AUTHOR]

The purpose of this discussion paper is to explore the existing literature from Canada on transitioning from military to civilian life for veterans of recent deployments. A number of topics relating to the transition experience emerged: interpersonal readjustment, emotional including mental health needs, school needs, and social needs. Implications for nursing will be discussed in terms of veterans as a cultural group and culturally competent nursing care. Recommendations for future nursing research include how well current services are meeting the needs of the younger, more recent veterans transitioning to civilian life; conducting longitudinal studies on the impact of transitioning to civilian life for veterans and their families; comparing the transition experience at an international level; developing a transition model that situates the veteran culture as the overarching framework for testing and understanding the experience of transitioning to civilian life. [ABSTRACT FROM AUTHOR]

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

Accessible Summary: What is known on the subject?: Severe and prolonged loneliness is known to be detrimental to mental well‐being. Eating disorders and loneliness are linked to each other with loneliness often acting as a barrier during the recovery journey. What this paper adds to existing knowledge?: This paper explores the experience of loneliness while recovering from an eating disorder, as framed within the context of childrearing and challenging family dynamics. While loneliness has negative connotations, it may act as a 'companion' to the person experiencing it. What are the implications for practice?: The first visible need is that for public figures to raise awareness of loneliness and mental well‐being. Another emerging issue is the need to re‐think automatic negative assumptions associated with loneliness. Importantly, professionals and caregivers have to consider the co‐morbidity of loneliness and mental illness. Links between loneliness and unhealthy family dynamics also need to be assessed when providing support. [ABSTRACT FROM AUTHOR]

Accessible Summary: What the paper adds to existing knowledge?: Personality disorder is a serious mental health condition affecting up to 52% of psychiatric outpatients and 70% of inpatients and forensic patients. People with a diagnosis of personality disorder have higher morbidity and mortality than those without.Service users and carers reported a lack of training for staff in the management of individuals with a diagnosis of personality disorder, particularly with regard to self‐harm and suicidal behaviours.Staff burnout creates barriers to compassionate person‐centred care for individuals with a diagnosis of personality disorder as staff struggled to accommodate the nature of the presentation when under significant emotional, psychological and professional strain caused by understaffing and lack of support. What are the implications for practice?: This paper adds new knowledge by informing services of ways to improve care provision from the perspectives of both carers and service users.A more holistic and less medicalised approach to the treatment of problems associated with a diagnosis of a personality disorder should be adopted, and personality disorder training introduced for all healthcare practitioners, to improve patient outcomes. Introduction: There is limited understanding of the experience of people with complex mental health (CMH) needs, including those with a diagnosis of personality disorder (PD) and carers of those individuals. Little is known about carers of those in inpatient forensic settings, yet it has been identified that they may have additional needs when compared to general carers. Research highlights that community carer support services were perceived as inadequate and out‐of‐area placements were described as putting an added strain on ability to support loved ones. Understanding PD within a population of people with CMH needs and how a diagnosis described as PD impacts on care and treatment experience is vital to providing high‐quality care. Aim: To evaluate the care experience of service users and carers with lived experience of a diagnosis of PD and out‐of‐area placements. Method: Semi‐structured interviews were conducted with six service users and four carers to explore the experiences and perspectives of people with a diagnosis of PD. Interviews were audio recorded and thematically analysed. Results: Four interrelated themes were developed; Influence of a diagnosis of PD on Staff, Early and Appropriate Intervention, Recognition of the Individual and Training and Knowledge of people with a diagnosis of PD. Discussion: Anti‐stigma interventions for staff, research on care provision and structural changes to services including more evidence‐based therapy for individuals with a diagnosis of PD may help reduce disparate treatment and improve prognosis for recovery. Implications for Practice: This paper informs services of ways to improve care provision from the perspective of carers and service users. A more holistic and less medicalised approach to the treatment of problems associated with diagnoses of PD should be adopted, and PD training for all healthcare practitioners to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject? What this paper adds to existing knowledge? What are the implications for practice? Introduction Aims Methods Results Discussion Implication for Practice In the past 2 years, the COVID‐19 pandemic had a robust negative impact on the mental health of healthcare providers, with increasing rates of depression, anxiety, acute stress and burnout. Healthcare workers experiencing poor mental health are reluctant to seek help and treatment because they are afraid of being stigmatized and excluded by their colleagues and employers. During the pandemic positive emotions, resilience and psychological well‐being buffered distress and burnout in healthcare workers. This paper describes positive mental health, depression, anxiety and burnout in healthcare workers during the second wave of the pandemic. Forty‐eight per cent of healthcare workers were flourishing (high levels of positive emotions and well‐being), 10% languishing (absence of well‐being and positivity). Flourishing individuals reported lower levels of depression, anxiety and burnout. These findings documented a relevant number of resilient healthcare workers, who restored/maintained their well‐being also under stressful conditions. Vulnerable healthcare workers were less than 20%, and they reported severe anxiety, depression and burnout. No differences emerged between languishing and moderate mental health groups in their levels of anxiety, depression and burnout. The condition of flourishing is the only one that provides protection from depression and anxiety and burnout, while moderate mental health does not differ substantially from the languishing state. The study confirms the importance of maintaining and/or promoting the well‐being of healthcare workers. Interventions for promoting positive mental health of vulnerable workers are needed. Mental health nurses can have the skills and expertise for evaluating early symptoms of psychological distress and for implementing interventions for promoting and restoring well‐being. These interventions may include informational campaign (i.e. preparing and distributing pamphlets and guidelines) and emotional support programmes (psychoeducation and training, mental health support team, peer support and counselling) that can be delivered also via digital platforms. Few studies focused on healthcare workers' positive mental health (i.e. high levels of psychological well‐being) and its association with anxiety, depression and burnout in the second wave of the pandemic.To evaluate the protective role of well‐being in buffering burnout and psychological distress.We evaluated 173 Italian healthcare workers with indicators of psychological distress (Depression Anxiety Stress Scales [DASS]‐21), burnout (Copenhagen Burnout Inventory [CBI]) and positive mental health (Mental Health Continuum) and we cross‐classified them according to their levels of mental health (flourishing, languishing and moderate mental health) and their levels of anxiety, depression and burnout.Forty‐eight per cent of health workers were classified as flourishing, 10% as languishing and 42% as moderate mental health. Flourishing individuals presented lower scores on DASS and CBI scales, whereas no differences emerged between languishing and moderate mental health groups. More than 80% of health workers with clinically significant symptoms of anxiety, depression and risk of burnout were classified as not flourishing.This investigation documented the presence of flourishing mental health in almost half of the sample of Italian healthcare workers. However, those with moderate or languishing mental health manifested higher levels of anxiety, depression and higher risks of burnout.The study confirms the importance of maintaining and/or promoting the well‐being of this population, with a crucial role of mental health nurses who can easily approach other healthcare workers and provide them informational (training, guidelines) and emotional support programmes (psychoeducation, mental health support team, peer support and counselling) when facing adverse working conditions. [ABSTRACT FROM AUTHOR]

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

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

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

Accessible Summary: What is known on the subject?: The principles of personal recovery are primarily applied in outpatient and community settings as these settings provide continuity of care and recovery‐based community programs supporting consumers' recovery journey.A range of healthcare professionals are involved in the care of people within mental health in‐patient units, including nurses, psychiatrists, psychologists, occupational therapists and social workers.The integration of recovery‐oriented care in mental health inpatient units may be impaired by a lack of confidence among mental health professionals. What this paper adds to existing knowledge?: Developing hope and a safe place is an integral part of recovery‐oriented practice within mental health inpatient units.Instilling connectedness is a relevant recovery principle; however, there may be greater barriers in mental health settings which traditionally prioritise safety and risk mitigation practices to prevent perceived harmful behaviours.Staff workload and inadequate understanding of recovery concepts present challenges to promoting recovery‐oriented care in everyday practice.Using strength‐based practice is critical in promoting a safe space for consumers by providing psychosocial interventions and person‐centred care. What are the implications for practice?: The provision of recovery‐oriented practice requires adopting a collaborative approach that places a strong emphasis on the involvement of consumers and their families.Empowering mental health professionals to believe that recovery‐oriented practice is possible in mental health inpatient units is crucial.Mental health professionals need to create a safe environment and positive relationships through respect and empathy for consumers and their family members. Introduction: Recovery‐oriented practice underpins an individual's personal recovery. Mental health nurses are required to adopt a recovery‐oriented approach. Globally, a paucity of literature exists on mental health professionals' experience of recovery‐oriented practice in mental health inpatient units. Aim: The aim of this synthesis was to explore the experiences of healthcare professionals regarding recovery‐oriented care in mental health inpatient units by appraising and synthesising existing qualitative research. Method: Three databases, including MEDLINE, PsycINFO and CINAHL were searched between 2000 and 2021. Data were extracted and synthesised using thematic integrative analysis. The quality of included studies was assessed with the CASP Critical Appraisal Checklist. Results: Ten qualitative research projects met the inclusion criteria. Four themes were identified (i) developing a safe and hopeful space, (ii) promoting a healing space, (iii) instilling connectedness and (iv) challenges to realising recovery‐oriented care. Discussion: Mental healthcare professionals perceived the principles of recovery‐oriented care to be positive and include: therapeutic space, holistic care and person‐centred care. Nevertheless, findings revealed limited knowledge and uncertainty of the recovery concept to be key barriers that may hinder implementation into practice. Implications for Practice: Recovery‐oriented practice must underpin consumer and family engagement, treatment choices and continuity of care to facilitate consumer's personal recovery. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The COVID‐19 pandemic has induced a considerable amount of mental health difficulties, ranging from anxiety and depression to psychosis. As services struggle to cope with the demand for support, the effect of such psychological challenges on quality of life remains a major concern. What does the paper add to existing knowledge?: Since the beginning of the COVID‐19 pandemic, a vast amount of research has focused on the physical consequences of the virus. Gradually, studies on the mental health effects related to the pandemic started to emerge, as it became clear that mental health difficulties were as present and as concerning as the physical ones. Whilst such studies commonly explore the prevalence and nature of the presenting mental health challenges, the publication of personal mental health experiences linked to the ongoing situation is lacking. Introducing the human element in literature is an important means of raising awareness on the mental health difficulties that can be triggered by the pandemic. Using public figures such as the individual in this paper is additionally powerful due to the role model effect. What are the implications for practice?: The paper highlights the need for enhanced awareness and monitoring of mental health especially by health professionals who therefore need to receive adequate mental health training. Furthermore, mental health awareness efforts need to be considered as being a part of the role of the psychiatric and mental health nurse who is at a prime position to educate, monitor and support those receiving care. [ABSTRACT FROM AUTHOR]

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

This contribution aims to highlight the theoretical and epistemological premises of the co‐writing experience, a practice where a clinician and a patient are mutually engaged in jointly or collaboratively writing a narrative related to the patient's experience. Unlike a typical set of therapeutic techniques, co‐writing is based on sharing perspectives and meanings about the experience of crisis, recovery, and the therapeutic process. The paper identifies and briefly describes four non‐clinical epistemological paradigms on which it is grounded: ethnography, values‐based practice, narrative care, and phenomenology. Although they differ in several ways, at the same time, they seem to share some common features that the paper investigates and comments. For clinicians, nurses, researchers and Mental Health Service managers, attention to the users and to the improvement of their active roles represents not only a strategy for the empowerment of results, but also the access door to a different perspective which relies on a renewed conceptualization of the mental disease nature that may lead to overcoming the epistemic asymmetry between the 'expert' and the 'other' in favor of intersubjective dialogue. [ABSTRACT FROM AUTHOR]

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

Accessible Summary: What is known on the subject?: Only 8.6% Asian Americans (AAs) report seeking mental health services compared to nearly 18% of the general population.There is a stigma against seeking mental health services among AAs.Mental illness is thought to be caused by a lack of harmony of emotions or evil spirits leading to delay in treatment among AAs. What the paper adds to existing knowledge?: Asian students are hesitant to use mental health services because they are balancing their desire to be part of the two cultures.Concepts used to define culture were found to have overlapping aspects of how researchers operationally define them, and few studies examined a combination of these concepts as a means of examining interactions between the concepts.AA emerging adults feel pressure through personal stigma from elders to 'save face' by keeping their problems to themselves or within the family to maintain a positive reputation for the family. What are the implications for practice?: The overlap of conceptual definitions to understand cultural beliefs and values affecting measurement have complicated the interpretation of the research.Future research should include a multidimensional operationalization of culture that includes acculturation, ethnic identity, personal stigma and their effect on mental health help‐seeking attitudes.Differences between South Asian and East Asian philosophical and cultural perspectives could influence access to mental health services; therefore, future studies should consider sampling that would allow for comparison of the groups.Understanding the factors that influence mental health help‐seeking behaviours can determine intervention strategies to improve AA emerging adult mental health. Introduction: Only 8.6% of Asian Americans (AA) sought mental health services compared to 18% of United States population. AA college students report higher levels of mental health concerns compared to White students. Aim: The purpose of this systematic review was to identify the factors that influence AA students' mental health help‐seeking behaviours. Method: Employing a data‐based convergent synthesis design. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the sample. Inclusion criteria were peer‐reviewed studies published in English, focused on AA college students' mental health seeking attitudes in United States. Results: The final sample was forty‐four studies. Four themes emerged: acculturation, ethnic identity, racism and stigma. There were discrepant findings regarding how acculturation affects mental health help‐seeking attitudes. Several studies included more than one theme in their analyses. The different concepts included across studies make it difficult to compare the findings. Discussion: There is some overlap between acculturation and ethnic identity that could affect the analysis in studies where both concepts are included. Personal stigma negatively influences mental health help‐seeking attitudes. Implications for Practice: Defining culture to include acculturation, ethnic identity, personal stigma can help in understanding their effect on mental health help‐seeking attitudes. [ABSTRACT FROM AUTHOR]

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

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

Accessible Summary: What is Known on the subject?: Working on the frontline during the pandemic has had a negative impact on the mental health of health professionals. A significant proportion experienced anxiety, insomnia, posttraumatic stress or depression. What the paper adds to existing knowledge?: Analysis and synthesis of the evidence of the impact of the COVID‐19 pandemic on the mental health of nurses based on their work context. There exists a gap in the literature as no studies were found that analysed the effects on nurses' mental health according to the level of care they worked in (hospital–primary care–nursing home). What are the implications for practice?: There is an urgent need to assess and respond to the impact of COVID‐19 on the physical and mental well‐being of nurses, and to monitor international policies for the improvement of nurses' working conditions. Introduction: Health professionals have suffered negative consequences during the COVID‐19 pandemic. No review has specifically addressed the impact of the pandemic on the mental health of nurses exclusively according to the work context. Aim: To analyse the impact of the COVID‐19 pandemic on the mental health of nurses who have worked in hospitals, primary care centres and social health centres. Method: PubMed, CINAHL, PsychINFO and Cochrane databases were searched (Prospero number: CRD42021249513). Out of 706 papers, 31 studies (2020–2021) were included in the systematic review. A qualitative synthesis method was used to analyse the data. Results: Most studies were conducted in hospitals or frontline settings. The prevalence of moderate‐to‐severe symptoms was for anxiety 29.55%, depression 38.79%, posttraumatic stress disorder 29.8%, and insomnia 40.66%. Discussion: This review highlights the mental health effects among nurses working in acute hospital settings. It also evidences a data gap on mental health effects among nurses working in primary health care and in nursing homes. Implications for practice: In the post phase of the pandemic, there is an urgent need to assess and respond to the impact on the mental well‐being of nurses, and to monitor international policies for the improvement of nurses' working conditions. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mental health clients experience higher estimated rates of domestic violence, yet mental health services are less likely to screen for domestic violence. What the paper adds to existing knowledge?: This paper qualitatively explores the perspectives and experiences of mental health practitioners in inpatient and community teams in a publicly funded hospital and health service (i.e. public mental health service).Mental health practitioners described a lack of domestic violence training, as well as a lack of knowledge of domestic violence and support mechanisms for victims, when domestic violence is disclosed by clients.The paper highlights the unique difficulties and barriers experienced by clinicians in screening for domestic violence while also dealing with clients suffering a mental health crisis. What are the implications for practice?: The paper sheds more light on the issue of domestic violence in mental health in terms of screening, and identifies avenues for improvement in mental health services; particularly the need for staff training and education. Introduction: Domestic violence is particularly prevalent within mental health client groups, though screening for domestic violence within mental health services is often overlooked. Aim: To investigate the experiences and opinions of domestic violence screening by mental health clinicians in a publicly funded hospital and health service. Methods: Semi‐structured interviews were conducted with twelve clinicians working in publicly funded mental health services in Queensland, Australia. Transcripts were thematically analysed. Results: Four main themes emerged from the data: staff training and experience; prioritizing domestic violence screening; attitudes to domestic violence; and victim support. Participants discussed a lack of training for, or expectations of, domestic violence screening in mental health services. They also highlighted a lack of resources enabling them to appropriately respond when domestic violence was identified. Discussion: Education, attitudes and resources relating to domestic violence are major factors that should be addressed for the successful screening and treatment of clients in mental health. Implications for Practice: This paper informs services of the gaps in knowledge and care around domestic violence and mental health. A less medicalized approach to the treatment of mental health should be adopted, and domestic violence training introduced for all healthcare practitioners, to improve client outcomes. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Seclusion involves isolating a patient in a room away from other patients in order to contain aggressive behaviour, and it is used in psychiatric hospitals.Research has found that seclusion is often viewed by patients as negative; however, there is limited in‐depth understanding of the deeply personal experience. What this paper adds to existing knowledge?: This systematic review found that the published research may have flaws with the quality of analysis, mainly due to limited researcher reflexivity.The review of qualitative research revealed that during seclusion, patients feel vulnerable, neglected and abused, disconnected from the experience and that it is dangerous to their mental health. What are the implications for practice?: For clinicians facilitating the seclusion process to use their therapeutic skills to provide patients with a sense of being cared for.For clinical supervision to allow space to explore interpersonal dynamics during seclusion in order to enhance therapeutic staff–patient interaction. Introduction: There is limited understanding of patients' seclusion experience. A 2013 systematic review provides some insight; however, more knowledge is required in order to improve patient care. This is a systematic review of qualitative research into the patient experience of seclusion. The qualitative focus enables the phenomena to be the central focus. Question: "What are adult psychiatric inpatients' experience of seclusion?" and "What is the quality of the applicable research?" Method: Electronic searches for qualitative research published between 2006 and 2017 were undertaken. Data were excluded if it was not explicitly related to seclusion. Research was appraised using three standardized appraisal criterion. Themes were generated through thematic synthesis. Results: Eight papers met inclusion criteria; four had been translated into English. Four themes were identified: "feeling vulnerable," "feeling neglected and abused," "disconnecting" and "seclusion is dangerous to mental health." Participants felt vulnerable and without control. They experienced staff and room as neglectful and abusive. Participants mentally disconnected. The experience threatened participants' mental health. Discussion: Participants' experience is an amalgamation of interpersonal experience and the environment. Disconnecting may be a coping strategy. Implications for practice: The findings have implications for seclusion practice, staff training and clinical supervision. Specific attention needs to be paid to the staff–patient interaction. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Bisexual people experience significantly poorer mental health and higher rates of self‐harm and suicidality than their gay, lesbian or heterosexual counterparts.Although little is understood about why these disparities exist, bisexual people have been found to have unique life experiences that separate them from other sexual minority groups.Despite these health disparities and unique experiences, in research and in clinical settings, bisexual people are often incorporated under the LGBTQI+ umbrella and their needs are not seen as being different to those of other sub‐groups. What the paper adds to existing knowledge?: This paper brings together the findings of the small but growing body of literature reporting on the psychosocial support needs of bisexual people.The findings reported on herein provide novel insights, collated and synthesized that will prove valuable to policy makers, service providers and researchers. What are the implications for practice?: This paper clearly illustrates that bisexual people experience significant barriers to accessing the support services they need and that current competent service provision for this population is severely limited.The findings presented in this paper shed light on the unique psychosocial needs of bisexual people and highlight the need for practice change to reduce barriers to service access and ensure inclusive and culturally competent care for this community. Introduction: Despite consistent evidence of poor mental health among what is a relatively large population group, research examining bisexual mental health remains sparse. Aim: To identify the psychosocial needs of people who are bisexual and establish factors that may support or inhibit access to appropriate psychosocial interventions and supports. Method: A qualitative evidence syntheses of the empirical evidence. Results: A total of 15 papers were included in the review. The PRISMA process was used. Following data analysis, four main themes emerged that were (a) experiences of being bisexual, (b) mental health experiences and concerns, (c) service access and responses and (iv) communities and supports. Discussion: Bisexual people have unique and specific psychosocial support needs that relate to, but are also different from, the needs of the broader LGBTIQ+ community. This study provides valuable insights into how future policy, practice, education and training and research can better address the needs of this highly vulnerable group. Implications for Practice: This study highlights the psychosocial complexities associated with bisexuality and provides evidence for the need for improvement in current support services to ensure inclusivity and culturally competent care. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: In mental healthcare environments, there are times when people are forced into care (i.e. to take medications or be hospitalized) when they may not want it.It is difficult to understand how person‐centred care (i.e. supporting patients to lead decisions about their care) can occur within coercive settings.There is a gap in the literature about this topic as few studies have explored it. What this paper adds to existing knowledge?: This paper examines the research publicly available to better understand if person‐centred care can exist at times when people are forced into mental health care.The paper develops a conceptual framework, RAISe (Relationship, Agency, Information, Safe environment), for understanding this matter in order to help people apply this concept in practiceIn certain situations, with caring and respectful approaches, with and for patients, it is possible to provide person‐centred care at times when mental health care is forced.RAISe identifies ways in which this can be done by clinicians while working with people. What are the implications for practice?: These person‐centred approaches need to be applied across mental health systems so that people in forced mental healthcare scenarios continue to experience dignity and respect.This is particularly important for nurses who are often the ones providing direct care to patients in these environments. Introduction: Person‐centred care (PCC) is founded on a theoretical premise that the person who the care issue pertains to directs the decisions relating to them. This can raise ethical challenges when mental health care is forced. Aim: This paper reports on how PCC is provided in coercive mental healthcare environments and its outcomes, where reported. Method: A scoping review methodology was utilized to search the literature in English until December 2019 (inclusive). Results: Twenty articles were included in the review. The information found was diverse and addressed different aspects of PCC in coercive mental healthcare environments. Discussion: Overall, this area is understudied. Despite ethical challenges, there are opportunities to provide PCC in coercive mental healthcare environments. A novel conceptual framework, RAISe (Relationship, Agency, Information, Safe environment), is presented to assist in applying PCC in these environments. Further research investigating how to employ these practices across systems should occur. Implications for Practice: This review acknowledges the challenges of providing PCC in coercive mental healthcare environments, while suggesting that this type of care can still be delivered in general as well as specific ways. This is especially relevant for nurses who provide direct care within these environments. [ABSTRACT FROM AUTHOR]

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

Accessible Summary: What is known on the subject?: Anxiety is common in women, nurses and nurse educators and can negatively impact overall mental well‐being and work–life satisfaction.Anxiety increased during the COVID‐19 pandemic.Hope is a personal resource that can be employed to help cope with anxiety.Professional identity, 'our why', is important to recognize and revisit as a way to add value to daily work in anxious times. What this paper adds to existing knowledge?: Compassion fatigue has contributed to burnout and turnover of nurses and nursing faculty.Knowing our 'why' helps understand the motivation in our work.Using hope as a personal resource, and sharing my lived experience, could be useful to other nursing faculty struggling with anxiety. What are the implications for mental health nursing?: There is a need for mental health resources within healthcare and education systems to support nurses and nurse educators not only during the COVID‐19 pandemic but through future healthcare crises.Support programmes and interventions need to be developed to sustain and retain both nurses and nursing faculty. Background: Providing patient care and nurse education in today's healthcare environment is high‐stress, often resulting in high‐anxiety among both nurses and nurse educators. The impact of the COVID‐19 pandemic on nurse faculty is largely unexplored. Aims: The aim was to share the experience of living and work working with anxiety in the nurse faculty role during the COVID‐19 pandemic. Materials & Methods: This is a lived experience narrative of one nurse faculty member. Results: Through daily purposeful self‐motivation and reflection, yoga, and brief outdoor respites, the author was able to strengthen professional identity, to see value in her work and to activate the personal resource of hope (Nursing Management, 52, 2021, 56; Journal of Occupational and Organizational Psychology, 93, 2020, 187). Discussion: 'Nursing faculty are essential to the profession' and likely experienced 'emotional exhaustion' during the pandemic (Nursing Education Perspectives, 42, 2021, 8) in their efforts to buoy students. It needs to be acknowledged that nursing faculty can experience anxiety, secondary trauma (International Journal of Environmental Research and Public Health, 17, 2020, 8358) and compassion fatigue, through listening to students' experiences and offering reinforcement during chaotic times. Conclusion: Little is known about what nursing faculty experienced as they attempted to support students (Nursing Education Perspectives, 42, 2021, 285). It is hoped that by sharing this lived experience, nurses and nurse faculty will understand how employing hope as a personal resource and re‐engaging with their professional identity will help them cope with the significant stresses that future healthcare pandemics or disasters may bring. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject? What this paper adds to existing knowledge? What are the implications for mental health nursing? This paper acknowledges the profound and lasting impact of childhood abuse on substance use and homelessness. It underscores the inherent value and humanity of every individual, regardless of their struggles. That a comprehensive approach to mental health care, encompassing medication, therapy and a secure environment, is imperative. Early intervention and recognising individuals who suffer in silence are paramount. Mental health nurses must have the courage to ask uncomfortable questions and truly hear the unspoken words. Mental health nurses should never underestimate the power of simply being present with someone during their darkest moments. This simple act can wield significant influence. [ABSTRACT FROM AUTHOR]

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

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

Accessible Summary: What is known on the subject?: International guidelines for trans‐and‐gender‐non‐conforming (TGNC) exists in outpatient settings.Compared to cisgender and heterosexual people, TGNC individuals are at a higher risk of mental health difficulties and have higher rates of inpatient mental health treatment. What does this paper add to existing knowledge?: An international scoping review identifying the lack of guidelines existing for TGNC individuals in inpatient mental health settings. Compared to psychiatrists and psychologists, mental health nursing has the most contact with patients admitted for inpatient psychiatric treatment. The study identifies unaddressed needs in gender affirming policies and outlines preliminary policy recommendations to assist mental health staff in improving TGNC patient quality of care within the United States. What are the implications for practice?: Reforming existing guidelines or creating new guidelines based on the identified themes and gaps to improve the well‐being and treatment outcomes of TGNC individuals in inpatient psychiatric settings within the United States. Introduction: Access to culturally sensitive care is critical for addressing known mental health disparities among trans‐and gender‐non‐conforming (TGNC) individuals. Although there has been a proliferation of TGNC healthcare guidelines from accrediting bodies, policies have failed to address the needs of TGNC patients in inpatient psychiatric settings. Aim: To identify unaddressed needs in policies and policy recommendations for the care of TGNC patients to inform recommendations for change. Method: A scoping review protocol was developed following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses 850 articles were reduced to seven relevant articles with six themes identified via thematic analysis. Results: Six themes were identified: lack of consistency in preferred and pronoun use, lack of communication among providers, lack of training in TGNC healthcare, personal bias, lack of formal policies, and housing segregation by sex rather than gender. Discussion: The creation of new guidelines or bolstering of existing guidelines to specifically address identified themes and gaps may improve the well‐being and treatment outcomes of TGNC individuals in inpatient psychiatric settings. Implications for practice: To provide a foundation for future studies to integrate these identified gaps and inform the future development of comprehensive formal policies that generalize TGNC care in inpatient settings. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: ECT is a treatment which has a long and complicated history. There is no consensus on its effectiveness and there is a great deal of polarized debate as to whether it should be used. MHNs are asked to work with people who are receiving ECT as part of their duties. What the paper adds to existing knowledge?: The paper seeks to move beyond the polarized arguments and to consider how MHNs can work with people where ECT is being considered or administered as part of their treatment in a manner which satisfies their professional obligations. Implications for practice: MHNs may need to broaden their understanding of ethics beyond the traditional biomedical ethics model of beneficence, non‐maleficence, justice and autonomy, as well as improving their understanding of social and political factors which may have an unseen effect of the use of ECT as a treatment in order to meet their professional obligations when working with people being administered ECT. INTRODUCTION: Electroconvulsive therapy (ECT) has a complex and contentious place in psychiatric care. Mental health nurses (MHNs) are of obligated to be part of this practice despite ethical concerns. Aim: To consider the ethical dilemmas and decision‐making processes facing MHNs involved in the administration of ECT. Method: A critical realist review of the literature surrounding ethical considerations and ECT was undertaken using thematic analysis. Findings: Four key themes emerged: the MHN as an advocate and conflict in their role, issues surrounding consent, questionable efficacy and unknown method of action, side effects, and legal issues and clinical guidelines. Discussion: Using a critical realist framework for understanding, the decision‐making process and ethical considerations are viewed as part of the empirical and actual parts of reality, while the potential for other, unseen causal powers to be at play is acknowledged. Implications for practice: MHNs need to ensure they have an adequate ethical underpinning to their practice to enable them to navigate contentious areas of practice such as ECT to practice effectively and preserve safety. This may require moving beyond the traditional biomedical model of ethics. Developing an appreciation of unseen causal factors is also an essential part of MHNs' developing professional competency. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject?: In a survey conducted by the World Health Organization (WHO) in the summer of 2020, 93% of countries worldwide acknowledged negative impacts on their mental health services.Previous research during the H1N1 pandemic in 2009 established an increase of patient aggression in psychiatric facilities. What the paper adds to existing knowledge?: Despite expected worsening of mental health, our hospital observed reductions in aggressive behaviour among inpatients and subsequent use of coercive interventions by staff in the months following Covid‐19 pandemic restrictions being implemented.The downward trend in incidents observed during the pandemic has suggested that aggression in mental health hospitals may be more situation‐specific and less so a factor of mental illness. What are the implications for practice?: We believe that the reduction in aggressive behaviour observed during the pandemic is related to changes in our organization that occurred in response to concerns about patient well‐being; our co‐design approach shifted trust, choice and power. Therefore, practices that support these constructs are needed to maintain the outcomes we experienced.Rather than return to normal in the wake of the pandemic, we are strongly encouraged to sustain the changes we made and continue to find better ways to support and work with the individuals who rely on or use our services. The global COVID‐19 pandemic has dramatically changed the operation of health care such that many services were put on hold as patients were triaged differently, people delayed seeking care, and transition to virtual care was enacted, including in psychiatric facilities. Most of the media dialogue has been negative; however, there have been some silver linings observed. Coinciding with the pandemic has been a reduction in aggressive incidents at our psychiatric hospital, along with the decreased need to use restraints and seclusion to manage behaviour. In this paper, we are taking stock of the changes that have occurred in response to the pandemic in an attempt to share our learnings and offer suggestions so that health care does not necessarily return to "normal". [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Between policing and health, there are many shared issues. Mental health distress and crises and caring for people who may be vulnerable are priority areas.Working together in partnership is challenging, and fragmented systems and processes are the result. This leads to poor experiences for the police, health professions and the public. What the paper adds to existing knowledge?: This paper describes an event that brought together 26 stakeholders involved in law enforcement and public health.The aim of this work was to identify the biggest shared challenges that they experience in their day to day jobs.The five key priorities were as follows: vulnerability; mental health crisis; decision‐making around assessment and triage across professional groups and professional roles; peer support and organizational well‐being; and information and data sharing. What are the implications for practice?: This paper demonstrates the strength of bringing partners together throughout law enforcement and public health, making proper time to actually discuss the "big issues" which affect them, how they each experience these issues, and how they might have overcome these within their own professions.Only through working together as partners and having everyone on the same page with the shared priorities can we really start to make a difference in the areas and with the people who matter.The focus on "vulnerability" and "mental health crisis" demonstrates the complexity of the issues between the professions, and that they need to find effective ways to work together to support people.No one professional group can solve inter‐professional challenges alone. Introduction: Law enforcement professions now assume more responsibility for tackling mental health issues alongside public health colleagues than ever before. The term "vulnerability" is frequently used within Law Enforcement and Public Health (LEPH) to identify those requiring emergency mental health care. However, there are ongoing challenges within LEPH to determine whose responsibility this is. Aim: To co‐create the most important priorities for LEPH research in Scotland. Method: The paper describes a collaborative workshop which brought together an Expert Advisory Group (EAG) of 26 senior stakeholders, from academia, policing, mental health nursing, psychiatry, paramedics, emergency medicine, people with lived experience, policy makers and third sector. Results: The five key priorities included: vulnerability; mental health crisis; decision‐making around assessment and triage across professional groups and professional roles; peer support and organizational well‐being; and information and data sharing. Discussion: The paper discusses the EAG group event as a co‐production process, focusing on how key LEPH research priorities were derived. Implications for practice: This paper demonstrates the inextricable link between co‐production and co‐creation of value via EAG group consensus on LEPH research priorities. Shared vision and professional will are not enough to ensure progress: there must also be shared policy, knowledge and access. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Four out of every five people with mental health disorders face stigma.Mental health and, consequently, mental health stigma are very common among youth living in the Middle East countries.Several studies have investigated mental health among adolescents in the Middle East, but studies on stigma are very scattered.There is no systematic review on stigma among adolescents with mental disorders across all the Middle East countries despite the common historical roots, similar cultural backgrounds, and recent widespread problems in the area. What this paper adds to existing knowledge?: This paper will aim to review and analyse the studies on stigma among adolescents with mental disorders in the Middle East countries, from different aspects such as the age rang, kind of stigma and risk factors of stigma. The study will cover studies on all kinds of stigma among Middle Eastern adolescents up to 18 years old published between 2000 and 2019.The study terms are generally focused on four categories: (a) kinds of Stigma, (b) Mental health problems, (c) Age range and (d) Region of study population. What are the implications for practice?: Increasing understanding and awareness of different angles of mental health stigma among adolescents may be helpful for better coping with this challenge.Understanding the nature of stigma may give adolescents the ability of ignoring it and avoid starting self‐stigma and/or stopping to seek help. Introduction: Although many epidemiological and interventional investigations regarding improving mental health among youth in the Middle East have been performed, there is no systematic review specifically analysing the studies on stigma among adolescents with mental disorders (A‐MDs) across all Middle East countries despite their common historical roots, similar cultural backgrounds, and recent widespread problems in the area. Purpose: We will aim to systematically review and analyse the English language studies on stigma among A‐MDs in the Middle East published between 2000 and 2019. Method: The Web of Knowledge, Science Direct, PsycINFO and MEDLINE are electronic databases that will be included in this study. Furthermore, the bibliography lists of eligible articles will be manually searched for additional included articles. Descriptive statistics will be represented by mean score and standard deviation for continuous data and number/percentage for categorical data. Discussion: This study may act as a resource for future studies attempting to assess and/or reduce stigma among children and adolescents with mental health issues specifically in the Middle East. Implications: It is important for healthcare providers, including nursing professional, to improve their knowledge and vision towards stigma in their community. The outcomes of this study can be a shortcut reaching this information. [ABSTRACT FROM AUTHOR]

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

Accessible summary: What is known on the subject?: Absconding refers to patients leaving psychiatric hospitals in an unexpected and/or unauthorized way and is often recognized as a form of challenging behaviour.There is some research about the rates of absconding, risks associated with it and interventions to try and reduce it; however, relatively little is known about the experience from the perspective of patients and this evidence has not previously been systematically reviewed. What this paper adds to existing knowledge?: Patients abscond to find relief, to regain power and control over their lives and/or to address unmet needs.Absconding can therefore be viewed as a means of seeking freedom. What are the implications for practice?: Nurses need to be aware that absconding is a positive act from the patient perspective and work collaboratively with them to reduce factors which motivate this behaviour.From the point of admission, nurses have an important role to play in reducing the sense of fear, isolation and powerlessness which motivates patients to abscond.Practical interventions such as giving patients the time and information necessary to be involved in decision‐making, or asking about their responsibilities and commitments outside of hospital, may have a significant impact on the experience of admission and reduce the risk of absconding. Introduction: Absconding from psychiatric hospitals is associated with significant risks, but is difficult to assess. It is often considered a form of challenging behaviour for mental health nurses, yet there is little evidence considering the behaviour from the patient perspective. Aim: To identify and review evidence pertaining to the experience of patients who abscond from hospital, paying particular attention to their reasons for doing so. Method: A systematic review and thematic synthesis of eight peer‐reviewed studies. Results: The meaning patients associated with absconding is best characterized as an act of seeking freedom. Within this, four sub‐themes were identified: 1) seeking freedom to find relief, 2) to regain power and control over their lives, 3) to address unmet needs and 4) opportunistically. Discussion: Perspectives on absconding are markedly different between nurses and patients. Nurses may view absconding as challenging or deviant behaviour, whilst patients understand it as a positive experience. This is because the hospital environment is not meeting their needs. Implications for practice: Patients decide to abscond from hospital for valid and rational reasons. Mental health nurses are in a position to understand and address the issues underpinning them with a view to reducing absconding. Further research on absconding from hospital, taking the patient's perspective, is needed. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is Known on the Subject?: Digital tools such as video calls or mobile phone applications (apps) are increasingly used in the provision of mental healthcare.There is evidence that people with mental health problems are more likely to face digital exclusion: that is, they do not have access to devices and/or skills to use technology.This leaves some people unable to use digital mental health services (e.g., apps or online appointments) or to benefit more generally from access to the digital world (e.g., online shopping or connecting with others virtually).People can be digitally included through initiatives that provide devices, Internet and digital mentoring to increase knowledge and confidence when using technology. What the Paper Adds to Existing Knowledge?: Some initiatives in academic studies and grey literature have been shown to increase access to and knowledge of technology, but this has been outside of mental health care settings.There are currently limited digital inclusion initiatives that take into consideration the specific needs of people with mental health problems, and how they can be equipped and familiarised with digital technologies to help their recovery journey and everyday life activities. What are the Implications for Practice?: Further work is needed to improve the provision of digital tools in mental health care, with more practical digital inclusion initiatives to ensure equal access for all.If digital exclusion is not addressed, the gap between people with and those without digital skills or access to technology will continue to grow, enlarging mental health inequalities. Introduction: The rise in the provision of digital healthcare during the pandemic has called attention to digital exclusion: inequality in access and/or capacity to use digital technologies. Digital exclusion is more profound in people with mental health problems, leaving an implementation gap of digital practice in mental health services. Aim: Identify the available evidence of (a) addressing digital exclusion in mental health care and (b) the practical solutions to enhance uptake of digital mental health. Method: Digital inclusion initiatives were searched from both academic and grey literature available and published between the years 2007 and 2021. Results: A limited number of academic studies and initiatives were found that supported people with mental health difficulties who had limited skills and/or access to overcome digital exclusion. Discussion: Further work is needed to combat digital exclusion and establish ways to reduce the implementation gap in mental health services. Implications for Practice: Access to devices, Internet connectivity and digital mentoring for mental health service users is essential. More studies and programmes are needed to disseminate impact and results for digital inclusion initiatives for people with mental health problems and to inform best practice for digital inclusion within mental health services. [ABSTRACT FROM AUTHOR]

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

Accessible Summary: What is known on the subject?: PhotoVoice as a participatory methodology has been used within mental health to support marginalized communities in addressing the challenges they encounter.The PhotoVoice methodology aims to encourage and foster collaborative and equal partnerships. However, reports of previous projects highlight that not every stage of the process remains participant‐centric.There is limited reporting on participant involvement in the latter stages of projects, such as exhibition design. What the paper adds to existing knowledge?: It provides a detailed description of the phases involved in planning and executing a mental health PhotoVoice project.It provides an illustration of how collaborative partnerships can extend into the design and construction of a photography exhibition and its narrative. What are the implications for practice?: PhotoVoice is an ideal methodology for use within the field of mental health nursing as it promotes service user inclusion in research, places value on lived experiences and provides a creative medium through which service users and family members can advocate for themselves and others.PhotoVoice is an effective and creative methodology for disseminating and communicating both the individual and collective outcomes to the general public.When implementing this methodology, clinicians and researchers need to be cognisant of the necessity to include participants as equal partners at every stage, including in the design of photography exhibitions and disseminating the findings to academic and public audiences. Introduction: PhotoVoice is a participatory methodology in which marginalized communities represent their lived experiences through photography. While the methodology aims to foster partnerships throughout all phases, the literature suggests that in the field of mental health, some phases are often completed without participant involvement. Aims: This paper elaborates on how the PhotoVoice method was used to engage service users and family members around their experience of involvement in a co‐produced and co‐facilitated mental health education intervention, in order to enhance public and policymakers knowledge of the project. Methods: Ten participants were recruited and trained in the PhotoVoice method. Participants documented, through photography, their experiences of involvement in the education intervention. Following this, participants came together to co‐produce and disseminate the photography exhibition to the public. Results: PhotoVoice proved to be a flexible and creative method by which to include marginalized groups. By adhering to the collaborative principles of the methodology, service users and family members can retain decision‐making power from the project's inception to its conclusion. Implications for Practice: PhotoVoice is ideal for use within mental health nursing as it coincides with the recovery principle of promoting collaborative partnership between service users, family members and clinicians. Mental health nurses work directly with service users and family members throughout their recovery journey. The PhotoVoice methodology is coherent with the recovery principles of empowerment, collaboration and prioritizing the lived experiences of the individual. As such, this methodology has the potential to enhance greatly what mental health nurses can know and understand about the lived experiences of service users and family members. In turn, engaging with the PhotoVoice methodology can provide a platform from which further collaborative engagement between service users, family members and clinicians can take place. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: There are individuals living with serious mental illness in both healthcare and academia.The high stress nature of these fields can worsen or trigger mental illness, burnout, moral injury, and compassion fatigue in employees.Mental health nurses have the needed skillset to foster change in these settings. What this paper adds to existing knowledge?: This paper describes the holistic experiences of a nurse faculty member living with serious mental illness and highlights lessons learned in both healthcare and academic settings.In addition to insights from the experience, the paper also shares suggestions for moving forward, reducing burnout, and supporting employees in these fields. What are the implications for practice?: This lived experience narrative showcases the effect that high‐pressure occupations have on individuals with serious mental illness.Mental health nurses have the training and experience to transform the experiences of employees in healthcare and academia.Through assessment, deep listening, and powerful questioning, these nurses in partnership with the employees themselves can design and implement interventions that have a lasting impact for these populations. Introduction: First‐hand accounts from clients living with mental health challenges deepen provider understanding and offer direct insight into the lives of those with chronic mental illness. There is a gap in the literature surrounding the lived experience of serious mental illness in the professional setting. Aim: This narrative outlines the challenges and opportunities for those living with serious mental illness in healthcare and academia. Methods: The author reviewed personal journals and reflected upon her years as both a nurse and faculty member to highlight the experience of living with serious mental illness in these professions. Findings: These high‐pressure fields place inordinate demands on faculty and staff; yet, there are few organizational supports in place for employees. Despite the push to improve resiliency and ease burnout, healthcare organizations and academic institutions still struggle to identify the best interventions and methods of support for staff. Discussion: Mental health nurses and nurse coaches are uniquely positioned to ease this burden and help create inclusive workplaces for those with serious mental illness. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Nurses' experience challenges of managing risk, boundaries and emotional responses when working with people who self‐harm.Adolescent self‐harm is a growing problem, with rates increasing in the UK.Existing research has failed to differentiate and specifically explore nurses' experiences of working with adolescents who self‐harm. What the paper adds to existing knowledge?: This paper provides an understanding of the impact of working with adolescents who self‐harm in the community on nurses, and highlights recommendations to improve staff and patient experiences and care.Community CAMHS nurses experience personal and professional conflicts when working with adolescents who self‐harm. They experience interpersonal conflicts balancing the needs of adolescents with the needs of the systems around them, and intrapersonal conflicts regarding experiencing mixed emotions, and balancing the care they want to provide with service pressures.Community CAMHS nurses experience feelings of self‐doubt and shame due to their emotional responses, self‐care behaviours, personal and professional boundaries. They use their feelings of pride, honour and enjoyment to manage these experiences. What are the implications for practice?: Nurses working in CAMHS should be provided with more opportunities for reflective practice and self‐care, to enable reflection and learning regarding the emotional impacts and working with systems. Managerial investment is required to facilitate this.Nurses working with adolescents who self‐harm in CAMHS could benefit from training regarding understanding and managing self‐harm (such as dialectical behavioural therapy), and effectively working with families and people who support these adolescents (such as attachment‐based family therapy). Introduction: Nurses often work in the community with adolescents who self‐harm. There is a lack of qualitative research exploring nurses' experiences of working with adolescents who self‐harm. Aim: This study aimed to gain an understanding of community nurses' experiences of working with adolescents who self‐harm. Method: Ten semi‐structured interviews were conducted with registered nurses working in Child and Adolescent Mental Health Services (CAMHS) in the United Kingdom (UK). Results: Data were analysed using interpretative phenomenological analysis (IPA). Two superordinate themes were identified, each consisting of two subordinate themes: personal and professional conflicts, describing interpersonal and intrapersonal conflicts the nurses experienced working with adolescents who self‐harm and the systems around them, and personal and professional development, outlining processes of management of conflicts and development. Discussion: Nurses feel conflicted about working with adolescents who self‐harm within the context of working with systems surrounding the adolescent. They report positive experiences, which they use to reframe their experiences and feelings of shame as a result of their emotional responses, self‐care behaviours and personal and professional boundaries. Implications for Practice: Nurses working with adolescents who self‐harm would benefit from training, reflective practice and self‐care. CAMHS managers should encourage and invest in these areas. [ABSTRACT FROM AUTHOR]

Accessible Summary What Is Known on the Subject What the Paper Adds to Existing Knowledge Implications for Practice Introduction Aim Methods Results Discussion Limitations Implications Recommendations Pre‐registration nursing students report high rates of stigma, leading to low help‐seeking attitudes when seeking help for mental health issues. Traditional mental health clinical placements can improve stigma related to attitudes and social distance for pre‐registration nursing students. There are nil recorded clinical placement interventions that have decreased self‐stigma for pre‐registration nursing students, with this study highlighting a clinical placement model that is effective in significantly decreasing self‐stigma. The knowledge around the mental health struggles experienced by pre‐registration nursing students, and the effect of a non‐traditional mental health placement in decreasing self‐stigmatizing attitudes in this population, is important for the future of retaining mental health nurses. There is an opportunity to use the clinical placement model presented, and design interventions for nursing students that aims to promote help‐seeking behaviours. Traditional mental health clinical placements can improve pre‐registration nurse stigma toward mental illness, particularly in measures of attitudes and social distance. However, they have not yet been shown to improve self‐stigma, which affects mental health disclosure and help‐seeking behaviour.The present study investigates nursing students' stigma following a non‐traditional mental health placement immersed alongside people living with mental illness.Three stigma subtypes were measured using the Opening Minds Scale for Healthcare Providers: Attitudes, Social Distance, and Disclosure/Help‐seeking.Pre‐registration nurses (N = 848) completed the instrument pre‐ and post‐placement. A multivariate analysis of variance (MANOVA) identified a large effect of placement on stigma (p < .001, ηp2$$ {\eta}_p^2 $$= .101). Post hoc pairwise comparisons revealed all three types of stigma decreased after the non‐traditional placement (Attitudes: p < .001, ηp2$$ {\eta}_p^2 $$= 0.09, Social Distance: p < .001, ηp2$$ {\eta}_p^2 $$= 0.07, Disclosure/Help‐seeking: p < .001, ηp2$$ {\eta}_p^2 $$= 0.04).These findings emphasize that attending a non‐traditional mental health clinical placement can effectively reduce multiple types of nursing student stigma.Further research in this area could focus on which attributes of the clinical placement setting foster positive help‐seeking.These results are noteworthy for stigma surrounding disclosure/help‐seeking, as traditional (i.e. hospital‐based) mental‐health clinical placements have been found ineffective in reducing nursing student stigma in this domain.Further research into the effectiveness of non‐traditional clinical placements in reducing nursing students' stigma regarding mental health disclosure and help‐seeking, is required. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject? What this paper adds to existing knowledge? What are the implications for practice? Mental health nurses in the UK play a critical role in providing care, advocating for patients and navigating the complexities associated with mental health challenges. Acknowledging and supporting the efforts of mental health nurses is essential for advancing mental health care, promoting inclusivity and fostering community resilience amidst ongoing challenges within existing health care organisations. Highlights the integral role of mental health nurses in the UK's health system as both care providers and advocates, underpinning the importance of addressing the growing demand for mental health services Introduces innovative digital tools like the ‘Hub of Hope’ and the potential of social prescribing as effective strategies for improving access to mental health care and support. Emphasises the need for enhanced support and recognition of mental health nurses to ensure the sustainable advancement of mental health services and the well‐being of communities. Mental health nurses should integrate innovative digital tools like the ‘Hub of Hope’ into their practice to improve signposting and access to mental health resources for individuals in need. There is a critical need for ongoing education and support for mental health nurses within practice settings to maintain their well‐being and enhance their ability to provide holistic care despite increasing clinical demands. Advocacy for increased investment in mental health resources and support for research activities lead by mental health nurses is essential to address current service gaps and promote the development of more effective interventions. [ABSTRACT FROM AUTHOR]

Accessible Summary The Relevance of Our Study to Mental Health Nursing What is known on the subject? What this paper adds to existing knowledge? What are the implications for practice? Summary Statement of Implications for Practice What Does This Research Add to Existing Knowledge of Cyberbullying Among Adolescents? What are the Implications of This New Knowledge for Nursing Care with Adolescents? How Could the Findings Influence Policy, Practice, Research, or Education? Background Methods Results Conclusion Patient or Public Contribution Implications for Nursing Practice The study's findings are crucial for mental health nursing, as they highlight the significant impact of cyberbullying on adolescents' mental health in Egypt. By establishing a clear link between cyberbullying, family income, and mental health issues such as anxiety, stress, and depression, the research underscores the need for targeted interventions and support systems. Mental health nurses can utilize this information to develop effective prevention and treatment strategies, advocate for policy changes, and educate families and communities. Addressing cyberbullying and its effects can lead to improved mental health outcomes, demonstrating the critical role of mental health nursing in supporting affected adolescents. This study brings attention to the widespread occurrence of cyberbullying among adolescents in Egypt and its substantial impact on their mental health. The research indicates that cyberbullying, along with family income, collectively explains more than 60% of the variation in mental health. These results underscore the importance of developing strategies to address cyberbullying and taking socioeconomic factors into account when addressing mental health issues in adolescents. School nurses should be knowledgeable about the prevalence and effects of cyberbullying on the mental well‐being of teenagers. They need to be equipped to recognize signs of cyberbullying and associated mental health issues, such as anxiety, depression, and stress. Educating adolescents, parents, and school staff about the dangers of cyberbullying and prevention methods is a crucial role that school nurses can play. This may involve teaching safe internet usage, promoting open communication about online experiences, and encouraging positive online behaviour. When evaluating mental health needs and planning care for adolescents, school nurses should consider their economic status. They should advocate for resources and assistance for low‐income families to help alleviate the impact of financial stress on mental health. It is important to introduce policies that provide financial support to families with lower incomes, as the research has shown a strong connection between a family's monthly income and its members' mental well‐being. Educational institutions, including schools, should introduce programs to prevent bullying, with a specific focus on cyberbullying. It would be beneficial for researchers to explore the effectiveness of various interventions in reducing cyberbullying and improving mental health outcomes. It is crucial to integrate education on cyberbullying into school curricula in order to raise awareness about this issue and to teach students how to respond if they or someone they know becomes a victim of cyberbullying. Educating parents and teachers about the indicators of cyberbullying and its potential impact on mental health is important so that they can offer support to adolescents who are experiencing cyberbullying. Further research is needed to address other covariates that could impact cyberbullying, such as addictive personality traits, impulsive seeking behaviours, and parenting styles. Cyberbullying, a significant concern in today's digital age, has a profound impact on teenagers' mental health, leading to stress, depression, anxiety, low self‐esteem, and, in severe cases, suicidal ideation. This study aimed to explore the effects of cyberbullying on adolescents' mental health.The study employed a cross‐sectional descriptive research design conducted at five public secondary schools in El‐Beheira governorate, Egypt. A total of 500 students were selected through a multistage sampling technique, yielding a response rate of 96%. The instruments used for data collection were the European Cyberbullying Intervention Project Questionnaire and the Depression Anxiety Stress Scale‐21.The findings revealed that 27.4% and 32.0% of respondents reported high levels of victimization and cyberaggression, respectively. Furthermore, 72.2%, 44%, and 52.6% of students exhibited severe to extremely severe levels of anxiety, stress, and depression, respectively. The study also found that cyberbullying and family monthly income accounted for 61.6% of the variance in stress, anxiety, and depressive symptoms (adjusted R2 = .614).The study concludes that cyberbullying is a prevalent issue among adolescents in Egypt, with a majority of students experiencing moderate to high levels of cybervictimization and aggression. This leads to varying degrees of anxiety, stress, and depression. The study also established a significant relationship between cyberbullying and mental health issues among adolescents. Moreover, both cyberbullying and family monthly income were found to significantly influence mental health, with higher levels of cyberbullying and lower income associated with increased stress, anxiety, and depressive symptoms.No Patient or Public Contribution.It is important for nurses working with adolescents to have an understanding of how common cyberbullying is and how it can affect mental health. They should receive training to be able to recognize signs of cyberbullying and mental health issues, such as anxiety, depression, and stress. Nurses can teach adolescents, parents, and school staff about its dangers and ways to prevent cyberbullying. This may involve educating adolescents on safe internet practices, promoting open communication about online experiences, and encouraging positive online behaviour. Lastly, considering the strong connection between income and mental health, nurses should also take into account the socioeconomic status of adolescents when assessing their mental health needs and planning care. They should work to secure resources and support for low‐income families to help alleviate the impact of financial stress on mental health. Additionally, further research is needed to address other covariates that could impact cyberbullying, such as addictive personality traits, impulsive seeking behaviours, and parenting styles. [ABSTRACT FROM AUTHOR]

Accessible Summary What Is Known on the Subject What the Paper Adds to Existing Knowledge What Are the Implications for Practice Introduction Methods Findings Discussion Conclusion Following their experience, patients with physical restraints often experienced traumatic sensations. The experiences of healthcare professionals' (HCPs') are primarily concerned with moral distress or conflicts between loyalty to the treatment and oppression of the patient's freedom when implementing RIs. Improving the competency of HCPs can help establish therapeutic relationships rooted in compassionate care and facilitate appropriate assessments to determine whether and how often RIs are necessary. Furthermore, fostering an environment that guarantees patient safety and dignity, assuring a sufficient staffing ratio, and providing opportunities to share RI experiences can help improve the quality of care and build safe environments for RIs. Effective interaction between HCPs and patients, thorough patient assessment, and compassionate patient care may improve competency of HCPs intervene RIs procedures. Creating a safe therapeutic environment, including improvements to structural environments, increasing the staff‐to‐patient ratio, establishing organizational policies that guarantee staff debriefing, provide emotional support, provide appropriate training programs to HCPs to their coping skills during RIs also reduce the use of RIs and improve the quality of mental health care. Restrictive interventions (RIs) are used in psychiatric inpatient units for ensuring safety. However, few studies have comprehensively reviewed physical restraint and seclusion experiences from the perspectives of both patients and healthcare professionals' (HCPs'). This study aims to gain an in‐depth understanding of the RI experiences of mental health inpatients and HCPs.A meta‐synthesis was undertaken of qualitative studies exploring the RI experiences. Five electronic databases were searched and additional manual searches were performed for studies published within the last decade. Twelve articles were included, and a thematic analysis was conducted. The Critical Appraisal Skills Program (CASP) checklist was used to assess data quality.Two main subthemes were identified: ‘Competency of HCPs’ (three subthemes: interaction between patients and HCPs, assessment methods, and care) and ‘systems’ (three subthemes: environment, protocols with training, and debriefing), including both positive and negative experiences.The Competency of HCPs and the ward environment are critical factors related to patients' unmet needs. Effective interactions between HCPs and patients, thorough patient assessments, and compassionate patient care are important elements of RI implementation.An environment that guarantees safety and care with dignity, sufficient staffing ratios, and opportunities to share RI experiences may improve quality of care and create safe environments for RIs. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject? What does this paper add to existing knowledge? What are the implications for practice? Background Aim Methods Results Discussion Implications for Practice Relevance Statement Clinical guidelines and staff training recommend using de‐escalation over restrictive practices, such as restraint and seclusion Evidence suggests that restrictive practices continue to be used frequently despite training This suggests a lack of impact of existing staff de‐escalation training. The features of de‐escalation training that are acceptable to staff and perceived to be impactful A co‐designed and co‐delivered training session on a trauma‐informed approach to de‐escalation on mental health wards was acceptable and perceived to be impactful Those attending training particularly valued how lived experience was incorporated into the training content and co‐delivery The organizational and team context may need more consideration in adapting the training. De‐escalation training that adopts a trauma‐informed approach and considers the context of ward environments is acceptable to staff Co‐delivery models of training to tackle restrictive practice can be acceptable and impactful Further research will show how clinically effective this training is in improving outcomes for service users in ward contexts. Evidence suggests a discrepancy between recommended and routine practice in de‐escalation in mental health settings, suggesting a lack of impact of existing training.To investigate the acceptability and perceived impact of a co‐designed/delivered training intervention on a trauma‐informed approach to de‐escalation on mental health wards.Trainees were invited to complete the Training Acceptability Rating Scale (TARS) post‐training. Responses to the quantitative items were summarized using descriptive statistics, and open‐text responses were coded using content analysis.Of 214 trainees, 211 completed the TARS. The trainees rated the training favourably (median overall TARS = 55/63), as acceptable (median 33/36) and impactful (median 23/27). There were five qualitative themes: modules of interest; multiple perspectives; modes of delivery; moulding to context; and modifying other elements.The EDITION training was found to be acceptable and impactful, with trainees particularly valuing the co‐delivery model. Trainees suggested several ways in which the training could be improved, particularly around the need for further moulding of the intervention to the specific ward contexts/teams.We recommend co‐designing and co‐delivering staff training to mental health professionals that tackles restrictive practices.This research is relevant to lived experience practitioners who want to be involved in training mental health professionals around restrictive practices, demonstrating the value and importance of their voice. It is relevant to current providers of de‐escalation training, and to staff receiving training, outlining a novel, but acceptable and impactful, form of training on a key area of mental health practice. It is relevant to anyone with an interest in reducing restrictive practice via co‐delivered training. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? What the paper adds to existing knowledge? What are the implications for practice? Introduction Aim Method Results Discussion Implications for Practice Recovery‐oriented practices in community‐based mental health services are of increasing importance. The recovery journey of individuals with mental illness starts with a sense of agency, and a therapeutic relationship with the providers who support them is a prerequisite. In Japan, the construction of community‐based integrated care systems for individuals with mental illness is positioned as a priority health issue, with communication with familiar individuals being particularly important for recovery in Japanese and Asian cultures. This study is the first to examine effective communication factors for personal agency in the recovery of individuals with mental illness, focusing on addressing uncertainty about treatment choices and dissatisfaction with decision‐making, and considering the user's personal recovery journey. In recovery‐oriented practice, it is important to prioritize addressing the emotional aspects of decision‐making alongside the mental illness condition, supporting users' self‐determination in their unique recovery journeys. The findings emphasized the need to actively engage with users' perspectives and emotions, emphasize shared life planning, and foster a therapeutic relationship based on partnership. Providers should approach dialogue as carefully as medication prescriptions, prioritizing the establishment of an effective therapeutic relationship with the user. These characteristics are essential for developing a strong therapeutic relationship and effectively facilitating users' recovery. The findings are applicable not only to nurses but to all mental health service providers, contributing to the advancement of recovery‐oriented practice. Recovery‐oriented practice in community‐based mental health services is crucial for individuals with mental illness, with communication with familiar individuals being important for recovery in Japanese and Asian cultures.This study aimed to examine effective communication factors for personal agency in recovery by investigating the association between perceived support provided through communication and personal agency of individuals with mental illness.A cross‐sectional study was conducted among community‐dwelling Japanese mental health service users, assessing subjective agency, decisional conflict, staff support for personal recovery, activation for mental health self‐management, demographic variables and living difficulties. Multiple linear regression analysis identified factors predicting subjective agency, revealing characteristics of effective provider communication for recovery.Data from 222 users were analysed, revealing negative correlations between uncertainty about treatment choices and ineffective decision‐making with higher subjective agency, while staff support for personal recovery positively correlated with higher subjective agency.In recovery‐oriented practice, prioritizing users' emotional experiences during decision‐making and supporting their self‐determination in their unique recovery journeys is crucial.Providers should approach dialogue as carefully as medication prescriptions, prioritizing therapeutic partnerships with users. The findings extend beyond nursing to all mental health service providers, advancing the theory of recovery‐oriented practice. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Experts by experience involvement in the education of health professionals demonstrate positive attitudinal change.Meaningful positions for Experts by Experience are limited and ad hoc, due to attitudinal and other barriers to innovation within the higher education sector.Experiences of allies who have supported the implementation of Expert by Experience positions have not been researched. This is important knowledge that could be utilized by potential allies. What the paper adds to existing knowledge?: Academic allies to experts by experience have a crucial role to play in identifying opportunities to establish, implement and sustain expert by experience positions.Allies who have successfully implemented positions for experts by experience have identified influential factors including: right person, right role, collaboration and coproduction, support, and career pathways.Understanding these factors can provide an important basis for other academics to support a widespread increase in academic roles for experts by experience in mental health education. What are the implications for practice?: Establishing and maintaining genuine relationships with service users require significant attitudinal change on the part of mental health professionals. Involving experts by experience in mental health education provides an innovative approach to the challenging of attitudes and the enhancement of more collegial relationships with service users as colleagues in the workplace.This paper demonstrates the importance of allyship to the establishment, implementation and sustainability of expert by experience roles, and highlights critical factors allies have utilized in support of such roles.Nurses and other mental health professional academics have the potential to become allies and support change and innovation. Introduction: Experts by experience in academia have demonstrated more positive student attitudes towards relationships with service users. Notwithstanding this supportive evidence, academic positions for EBE have not grown substantially. Enhanced understanding of positions that have been implemented is important knowledge for others with similar aspirations. Aim: To enrich understanding of the role of allies in identifying and pursuing opportunities to support academic positions for experts by experience. Methods: Qualitative exploratory approach, involving In‐depth interviews with allies with expertise in supporting academic positions for experts by experience. Results: Participants were enthusiastic about creating or taking opportunities to secure expert by experience involvement within their programs. Factors facilitating success included right person, right role, collaboration and coproduction, support and career pathways. Conclusions: Significant barriers have prevented proliferation of academic roles for experts by experience. Despite barriers, allies have been successful in supporting the implementation and sustaining of positions, and gained considerable expertise, which may be invaluable to academics with similar aspirations. Implications for practice: Realization of policy goals regarding service user involvement in mental health services requires health professionals with the will to embrace partnerships. By creating and taking opportunities, allies have developed expertise to facilitate implementation of positions more widely. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Traditional mental health services are not meeting the needs of service users.Peer support is an alternative approach of providing support founded on relationship where there is respect and shared responsibility.Peer support relationships are mutual and reciprocal. What the paper adds to existing knowledge?: The experience of peer‐led care can be transformative.A key aspect is the validation and valuing of lived experience and being seen as a person not as an illness.The nature and quality of relationships is paramount and needs to be based on equity. What are the implications for mental health nursing?: Nurses have a key role to advocate and promote peer support services.Relationships need to be based on respect and "being alongside" service users in their recovery journey rather than trying to "fix the problem." Introduction: Peer‐led services provide an approach to support based on mutuality, respect and shared experience. Aim: To provide an understanding of my experiences of receiving help from a peer‐led service. Method: Journaling experiences captured in detail the reality of my experiences at the time and were used to inform this paper. Results: The Narrative describes entering a Peer‐Led Acute Alternative Service when I was amid a mental health crisis and feeling broken. Here, relationships were based on connecting with others who have experienced similar struggles, being seen as an individual rather than a patient, treated with dignity and respect, being heard, having my feelings acknowledged rather than medicated and feeling understood. This created a shift in me to a place of healing and finding meaning in my experiences of mental distress which led to me training in peer support. Discussion: Peer‐led services can be a transformative experience which redefines the relationship and shifts the person from being a passive recipient of help to an active participant in their recovery. Choice and increased options for peer services as an integral aspect of services available for individuals on their mental health journey is critical. [ABSTRACT FROM AUTHOR]