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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., (© 2023 John Wiley & Sons Ltd.)

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., (© 2022 John Wiley & Sons Ltd.)

WHAT IS KNOWN ON THE SUBJECT?: Obsessive-compulsive personality disorder (OCPD), which is experienced by 2.1-7.9% of the population, is characterized by an excessive need for orderliness, neatness and perfectionism. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Existing studies on OCPD commonly focus on the physiological aspects, treatment and/or comparison of features with other disorders. Studies that explore the personal experiences related to OCPD are lacking and so the human element of this condition is missing. This paper contributes to this gap by presenting a glimpse into life with OCPD. The narrative is provided by the daughter of a person who lived with OCPD and presents the ordeals, victories and aspects of everyday life as framed by the condition. Whilst personality disorders such as OCPD are subjected to a high level of stigma, this relative's story shows that love and compassion can be found even in the darkest corridors that OCPD can take one to. As the story shows, behind every disorder there is a human being and the disorder is not the totality of that being. In this view, the paper sheds light on the human element related to the condition. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The paper highlights the need for continuous, hands-on community support to those experiencing OCPD and their significant others. In order to enhance continuity of care, support is ideally centralized and provided by one keyworker who builds a strong therapeutic relationship with the person and their loved ones., (© 2021 John Wiley & Sons Ltd.)

WHAT IS KNOWN ON THE SUBJECT?: Research indicates many clients using mental health services have trauma histories. Consequently, mental health professionals must be aware of the impact of trauma and of how they can avoid retraumatizing service-users. Care delivered with this awareness is known as trauma-informed care (TIC). There is little research on attitudes towards TIC. To date, only one study explored these attitudes among MHNs exclusively. Additionally, a richer understanding of TIC attitudes using methods like in-depth interviews is needed. It is unclear whether knowledge of TIC results in more favourable attitudes. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: MHNs in this study had little knowledge of TIC but expressed overall favourable TIC attitudes. Traumatic histories were not appreciated as causes of challenging behaviour. On rehabilitation wards, clients come to be perceived as family members and this makes it harder for MHNs to not take challenging behaviour of clients personally. MHNs face work-related traumas which interfere with their ability to provide TIC. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Findings of this study can be used to guide plans to implement TIC in psychiatric hospitals. Policymakers are called to appreciate that ensuring MHN well-being on the workplace will facilitate their delivery of TIC. TIC training initiatives for MHNs must stress the importance of acknowledging traumatic histories as causes of challenging behaviour and of maintaining professional boundaries with long-term clients. This would benefit service-users by ensuring MHNs are more trauma-informed. More research on attitudes towards TIC among MHNs is needed. ABSTRACT: Introduction Quantitative studies exploring trauma-informed care (TIC) attitudes have not used samples made up exclusively of mental health nurses (MHNs). Qualitative methods were sparingly used. Aim To examine nurses' TIC attitudes at a psychiatric hospital. Method A mixed-method design was used. One hundred and thirty-six MHNs completed the Attitudes Related to Trauma-Informed Care scale. Data were analysed using inferential statistics. A focus group interview among ten MHNs ensued. Thematic analysis was used. Results MHNs demonstrated favourable TIC attitudes. Ambivalent attitudes for the subscale "Causes" were identified. MHNs employed for less than 5 years at the hospital and those in acute settings displayed more favourable attitudes on some subscales. Three themes "Awareness," "Unhealthy boundaries" and "Inhibition" emerged from qualitative analysis. Discussion Challenges uncovered in the provision of TIC include the unacknowledged impact of trauma on challenging behaviour among MHNS, the influence of blurred professional boundaries with long-term clients on the cycle of perpetuated trauma identified by previous research and MHNs work-related traumas. Implications for practice Identified challenges to TIC integration among MHNs can facilitate the implementation of TIC in hospitals. TIC educational packages for MHNs should acknowledge traumatic histories in the aetiology of challenging behaviour and stress the importance of maintaining professional boundaries with clients., (© 2021 The Authors. Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.)