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Accessible Summary: What is known on the subject: Because of increasingly stressful, dangerous and unpredictable psychiatric nursing work, psychiatric nurses have experienced higher job stress than general ward nurses.Little is known about the factors that affect the turnover intention of Chinese psychiatric nurses. Understanding the influencing factors of nurses' turnover intention will help to formulate targeted measures to stabilize psychiatric nursing teams. What does this paper add to existing knowledge: The results showed that 70.2% of psychiatric nurses had higher turnover intention. The strong turnover intention of Chinese psychiatric nurses is a problem that needs to be considered by managers.The results showed that having more children, between 31 and 39 years old, and having a part‐time job were strongly associated with turnover intention. In addition, "job stress" was also an important factor, psychiatric nurses' turnover intention decreased as their job stress level decreased. What are the implications for practice: Nursing managers should pay attention to nurses who have more children, between 31 and 39 years old, and take on part‐time jobs. Additionally, nursing managers should reduce job stress and implement targeted programmes to prevent psychiatric nurses' turnover.Experience‐sharing meetings and mindfulness‐based stress reduction training are also useful to improve the mental health status of psychiatric nurses with great job stress. Nursing managers should arrange human resources and shifts appropriately to give nurses with more children more time with their families. Provide more development opportunities for psychiatric nurses between 31 and 39 years old. Managers explore the reasons why nurses take on part‐time jobs and take targeted interventions (such as increasing income) to reduce the behaviour that happens. Introduction: Nurses' turnover is the main cause of nursing shortages, greatly affected by nurses' intention to leave. Nurses' turnover rate is particularly high in psychiatric wards. Several factors influencing the turnover intention of psychiatric nurses have not been well identified in China, and the association between job stress and turnover intention is still limited. Aims: To examine the relationship between job stress and turnover intention and identify the influencing factors of psychiatric nurses' turnover intention. Methods: Data were collected from 2355 psychiatric Chinese nurses using a cross‐sectional design with an online questionnaire investigation. Results: Psychiatric nurses had higher turnover intention. Significant factors influencing their turnover intention were job stress, having more children, age between 31 and 39 years old, part‐time jobs, education, income and patient‐to‐nurse ratio. Discussion: Demographics and job‐related factors should be considered when developing strategies to reduce the turnover intention of psychiatric nurses. Implications for practice: Nursing managers should pay attention to nurses with higher job stress levels and different demographic characteristics. Effective measures should be taken to reduce psychiatric nurses' job stress and turnover intention, such as arranging reasonable shifts, implementing targeted family‐friendly policies, increasing their occupational possibilities and promoting mental health. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mental Health First Aid Training Programmes with a pathogenic perspective are implemented worldwide for different participants and contexts. These interventions can promote the medicalization and psychiatrization movement of human suffering.Training programmes should teach about mental health nursing problems rather than disorders. However, there seem to be no studies describing these healthier interventions targeting adolescents in upper secondary schools. Nurses can explore these interventions and target them towards these participants and contexts. What the paper adds to existing knowledge?: The perspective of nurses on the characteristics of Mental Health First Aid Training Programmes for adolescents in Portuguese upper secondary schools is reported.Experts recognize that the nurses who perform these interventions must have personal, pedagogical and mental health competencies. Therefore, mental health nurses may be considered. The components of mental health literacy, mental health nursing problems and a dynamic first aid plan can be taught using different classroom training strategies. What are the implications for practice?: The role of mental health nurses in promoting health literacy is highlighted. They have the opportunity to lead multidisciplinary teams in using these healthier training programmes.These expert opinions can shape the planning, implementation and evaluation of these interventions. In turn, training programmes can promote the identification, assistance and/or adequate and timely referral of people with mental health nursing problems. Introduction: Mental Health First Aid Training Programmes performed by nurses can empower adolescents to aid people with mental health problems. There do not appear to be any studies that describe these healthier interventions aimed at adolescents in upper secondary schools. The development of these educational interventions benefits from the input of their participants and facilitators. Aim: To explore the perspective of nurses about Mental Health First Aid Training Programmes for adolescents in upper secondary schools. Method: A qualitative, descriptive and exploratory study was conducted. Data were collected from seven mental health nurses during two focus group sessions. Data were analysed using content analysis. Results: Twelve themes were identified around nine main areas: facilitators, intervention foci, outcomes assessment methods, process assessment methods, participants, implementation context, duration and frequency, intervention methods and strategies, and contents. Discussion: Mental health nurses can regularly perform these classroom interventions to improve the mental health competencies of adolescents. Various educational methods can facilitate learning related to mental health literacy components, mental health nursing problems and the first aid plan. Valid and appropriate assessment methods enhance a good representation of these interventions. Implications for Practice: This evidence can guide the creation and modelling of these first aid training programmes. [ABSTRACT FROM AUTHOR]

Accessible summary This is a review of 36 papers published in the peer reviewed literature on the subject of social inclusion, exclusion and mental health., Many of the reviewed papers offered only simplistic definitions of the concept., We identify the relationship between exclusion, inequality and injustice and question the application of the findings to current and future mental health policy., Abstract Social inclusion and exclusion are concepts which have been widely associated with politics and policy in the first decade of the 2000s. People with mental health problems have become the focus of a range of social inclusion initiatives. A literature review was conducted to explore the peer-reviewed evidence relating social inclusion/exclusion and mental health. In total 36 papers were included in the review from the UK, Canada, Australia and Scandinavia. The papers had used a range of different approaches to research and evaluation. The included papers associated being socially included to: social roles and responsibilities such as employment, participation in social activities, environmental work and voting. Although some papers engaged in a critical discussion of the concept, many offered only simplistic accounts or definitions. Social inclusion is such a widely used term within political and policy discourses that it is surprising so little research is available within the mental health realm. There was a lack of clarity related to the concept of social exclusion and the qualitative studies focused entirely on the experiences of being excluded within an institutional or semi-institutional setting. The relationship between exclusion, inequality and injustice is identified and the relevance of the concept to current and future mental health policy is questioned. [ABSTRACT FROM AUTHOR]

Accessible summary Service user involvement is an important part of pre-registration nursing programmes, as it can give students the opportunity to learn from users about their experiences of health and illness, but so far there have been limited studies in this area., This literature review provides an opportunity to explore how service user involvement in classroom settings can impact on student learning, and describes methods of best practice., Further research is needed to understand the influence of service user involvement on student nurses' clinical practice., Abstract Service user involvement in pre-registration nurse education is now a requirement, yet little is known about how students engage with users in the classroom, how such initiatives are being evaluated, how service users are prepared themselves to teach students, or the potential influence on clinical practice. The aim of this literature review was to bring together published articles on service user involvement in classroom settings in pre-registration mental health nurse education programmes, including their evaluations. A comprehensive review of the literature was carried out via computer search engines and the Internet, as well as a hand search of pertinent journals and references. This produced eight papers that fitted the inclusion criteria, comprising four empirical studies and four review articles, which were then reviewed using a seven-item checklist. The articles revealed a range of teaching and learning strategies had been employed, ranging from exposure to users' personal stories, to students being required to demonstrate awareness of user perspectives in case study presentations, with others involving eLearning and assessment skills initiatives. This review concludes that further longitudinal research is needed to establish the influence of user involvement in the classroom over time. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on this subject?: Police are often called on to respond to student mental health needs in schools.School nurses, who are part of interdisciplinary mental health teams, may collaborate with responding police officers.Currently, there are no reviews of the literature describing the use of police to respond to mental health crises in schools. What this paper adds to existing knowledge?: This systematic review found six articles addressing police response to student mental health needs in elementary and secondary schools.Articles primarily focused on the School Resource Officer programme; however, there was a lack of research on the effectiveness of this and other programmes in addressing the mental health needs of students.This paper highlights a significant gap in knowledge about how police are involved in responding to student mental health crises within schools. What are the implications for practice?: Understanding how police respond to mental health crises on school campuses will help nurses serve in collaborative roles with responding officers.This study highlights gaps in research that need to be addressed for researchers and policymakers to best support students in crisis. Introduction: Response to student mental health crises involves interdisciplinary school–community teams, which can include police officers. This paper presents the first systematic review of literature on how police address mental health in school settings. Results have implications for school nurses interacting with responding police. Question/Aim: How are police involved in responding to student mental health needs in elementary and secondary schools? Method: Using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) framework, six articles met criteria for inclusion in this review. Results: Two themes were identified: (1) descriptions of roles of police in schools and (2) studies presenting programmes or models of police engagement. The most common use of police in schools is through the School Resource Officer model. Discussion: There are very few studies examining police involvement in mental health response in schools and little data available on whether prevailing models are effective. We are therefore unable to ascertain what impact school police have in responding to mental health crises or the extent to which they interact with school nurses. Implications for practice: Understanding mental health crisis responses in schools can inform policy, practice, research and education for police and school providers, including nurses. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The need for recovery narratives written by people with lived experience of mental illness is widely acknowledged in mental health research.Insights from lived experience narratives can assist nurses to reflect on practice in new ways. What this paper adds to existing knowledge?: By describing the lived experience of one man's journey through adolescence crippled by anxiety to become one of the Australia's leading consumer advocates, this paper emphasizes the importance of retaining hope no matter how difficult challenges become. What are the implications for practice?: Flexibility regarding service age limits for young people who experience mental illness is important, particularly if therapeutic relationships have been established.Services should provide longer‐term treatment options for youth who experience mental illness.Mental health nurses need to guard against too much focus on getting rid of symptoms. Nursing should seek to develop the whole of a person's life as they move along their recovery journey. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Adults who support an adult family member with a severe and enduring mental health problem often experience carer burden. Over time, this often negatively affects their mental and physical health and social well‐being.Understanding and communicating about mental health problems in families can help to improve resilience and coping among both adults and children. What does this paper add to existing knowledge?: We conducted a review of studies looking at how adult relatives understand and communicate about an adult family member's mental health problem.The findings highlight that how relatives make sense of MHP is related to historical family relationships, their mental health literacy and whether they see themselves as a "carer" or not.The findings also show that little research to date has explored how adult relatives talk with children about their parent's difficulties, and how the adults' understanding might affect what children learn about the MHP. What are the implications for practice?: There is a research gap to be addressed regarding family communication with children about parental mental health problems. This knowledge gap likely impacts family‐focused mental health nursing and therapy provision.Mental health nursing, therapeutic and support workers and advocates are ideally positioned to assist relatives with improving their mental health literacy and confidence communicating about mental health, and to promote inclusion of relatives and children in interventions. Introduction: Relatives are profoundly affected by an adult family member's severe and enduring mental health problem (MHP). The burdens of caring impact on adult relatives' emotional, physical and social well‐being. How relatives make meaning and communicate about the MHP is thought to affect family talk about mental health, and this can impact family coping and well‐being. Aim: No review has yet drawn together research about how adult relatives of people with severe and enduring MHP make meaning and communicate about their relatives' difficulties. We aimed to address this gap. Method: We conducted a systematic review of peer‐reviewed primary research. SCOPUS, PubMed, Psychnet, SCIE, Cochrane and CINAHL+ databases were searched. Results: Nineteen papers qualified for inclusion. Findings are organized under four themes: making meaning about the MHP and affected individual; conceptualizing the self in the presence of the MHP; meaning‐making processes underlying relatives' well‐being outcomes; and relatives' perspectives on family talk about the MHP. Discussion: Historical relationships, caregiver identity and mental health literacy moderate relatives' understanding and talk about the MHP. Implications for practice: Psychoeducation and communication support for relatives should be provided by mental health practitioners. Future research should address familial communication about MHP, including with children. [ABSTRACT FROM AUTHOR]

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The article discusses that the purpose of this paper is to address the reality that sexual violence on inpatient mental health wards in the British National Health Service may well be a common problem. It mentions that this paper argues that a partnership approach involving users and providers of services working together has much to offer, and argue that talking with and learning from each other's experiences can open up new possibilities for change.

Aims and objectives: To explore the preparation that mental health nurses receive to address sexual health in practice. Background: People who use the mental health services often have complex sexual health needs. Mental health nurses are well placed to offer support. However, this rarely happens in practice, and therefore, people's sexual health needs are not being routinely addressed. It is not known why this is the case. Design: Systematic review and meta‐ethnography. Methods: EBSCO, PsycINFO, MEDLINE and ASSIA databases were searched using Booleans with Mesh and key terms including “mental health nurse” and “sexual health”. Date range was June 2006 to June 2016. Discursive papers were excluded. Included papers (n = 7) were synthesised using a meta‐ethnographic approach. Results: The search yielded seven studies. Five key themes were identified: the (not so) therapeutic relationship; personal values dictating professional ones; institutionalised fear; being human; and education: the answer but where is it? Conclusions: The findings illustrate the complexity of supporting people with mental health and sexual health needs. They show the discomfort many nurses have about broaching sexual health. Arguably more than with most issues, personal values impacted strongly on professional practice. Understanding the depth and multifaceted nature of these themes is important, because strategies can then be developed to mitigate the barriers to best practice. For example, the findings presented here offer a framework from which structured education and support can be built. Relevance to clinical practice: There is a need for Mental health nurses to be more responsive to concerns around sexual health and it should be routinely included in their practice. This study illuminates why this is not currently the case. By understanding this, remedial action can be taken by nurse educators. Implications are also discussed in relation to policy, research and practice. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Mental health assessment is a common topic in horticultural therapy (HT).Some study findings were contrary to positive findings, although several studies have explored the effect of HT on mental health and reported positive results.There is weak evidence in the benefits of HT based on evidence‐based medicine. Stronger evidence of the link between HT and mental health will help in policy making by health policy makers and governments. What the paper adds to existing knowledge?: The purpose of this meta‐analysis of randomized controlled trials (RCTs) was to explore the effect of HT on mental health.This study is the first meta‐analysis of RCTs to provide critical evidence that HT has a positive effect on mental health.The effect size of HT on mental health was medium (0.55). The included studies had no negative effects on mental health. What are the implications for practice?: HT should be considered a useful therapy to be integrated in healthcare settings by horticultural therapists to improve mental health.In the HT program, indoor and outdoor plant activities, plant‐related arts, crafts and other activities were common interventions to improve specific mental health problems through at least eight sessions. Introduction: HT has been widely used to promote mental health. However, heterogeneity and sample size issues of randomized controlled trials made it challenging to illustrate effect sizes across the evidence. Aim: The purpose of this meta‐analysis was to explore the effect of HT on mental health. Methods: We used the PRISMA framework. A keyword search of Web of Science, PubMed, ProQuest and Cochrane was performed. The inclusion criteria were HT with RCTs and mental health assessments. A random‐effects model was used to perform the meta‐analysis. Results: A total of 1,056 records were searched, and 18 eligible studies were extracted. The included RCTs had no statistical heterogeneity and publication bias. The meta‐analysis showed that the HT experimental groups had a significant and positive impact on mental health compared with the control groups (effect size = 0.55). Discussion: HT should be considered for enhancing mental health. The included studies had no negative outcomes and the most common HT intervention was at least eight sessions. Therefore, HT should be considered to enhance mental health. However, the concealed allocation and blinding processes should be improved in future studies. Implications for Practice: This study recommends that HT should be integrated into healthcare settings to improve mental health. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: In the initial months of the pandemic, there was no significant increase in demand for mental health servicesDuring the pandemic, there was an increase in people reporting an increase in suicidal thoughts.Understanding of the experience of seeking help for self‐harm during lockdown is lacking, in terms of availability and accessibility of support services What the paper adds to existing knowledge?: People who self‐harm found that their support structures were significantly impacted by lockdownLockdown presented relational difficulties for people who self‐harm What are the implications for practice?: Learning about the experience of receiving support from mental health liaison services during lockdown from a first‐hand perspective is essential to improving the provision of these services in the future.In times of national crisis, services should be prepared to support clients via alternative means including telephone and online.Public facing messages about service availability should be carefully expressed to minimize misunderstandings. Introduction: National lockdown caused disruption to health services and third‐sector organizations offering support to people who self‐harm. Early reports suggested self‐harm‐related hospital attendances declined. Lack of knowledge related to the availability and accessibility of support provisions for people who self‐harm warrants exploration into how they experienced help‐seeking during lockdown. Aims: This study aimed to explore the experiences of people who self‐harm and perspectives on help‐seeking. Method: We conducted a qualitative study based on telephone and email interviews with 14 people who self‐harm in England. Results: Participants identified challenges to coping with life in lockdown, emphasizing the role of self‐harm. Help‐seeking was impeded by feeling like a burden and potential for spreading the virus. People who self‐harm exercised self‐reliance in response to "stay home" messaging, but some may have struggled without formal support. Online support served an important role in continuity of care during lockdown but could widen inequalities from limited resources and access. Implications for practice: Helping mental health liaison nurses to understand the experiences of people who self‐harm during lockdown is critical to providing continuing support to this population. Services should consider how and when they communicate changes to their provisions to the public, and the impact this will have on those in need of support. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Dual diagnosis is a term used to describe persons who have a co‐occurring mental health and substance misuse disorders.It is the cause of significant economic burden to health care, justice and educational systems.It is well reported that to date dual diagnosis is under‐diagnosed and poorly treated within the confines of mental health services What the paper adds to existing knowledge?: It demonstrates that the need for service reform where all services are equipped with the necessary tools required to adequately support a person with dual diagnosis. What are the implications for mental health nursing?: The narrative provides a real‐life, candid description of how trauma in early childhood can cause significant challenges when one becomes older.The narrative identifies the dangers of not diagnosing a dual diagnosis early, resulting in only treating half the presenting issues.This narrative also offers hope to individuals in current distress, as well as for those supporting such individuals, as it clearly demonstrates that with the right supports and encouragement, recovery is possible. Introduction: Dual diagnosis describes when a person has two co‐occurring disorders. It is often difficult to diagnose and this can lead to prolonged suffering on behalf of the individual. Aim: To provide a lived experience narrative of the early recovery journey of a person with a dual diagnosis. Method: This aim was achieved through the use of a narrative based methodology. Results: The journey of life leading to a dual diagnosis and beyond is described under the following headings: Formative Years, Substance Misuse, When Life gives you Lemons, They Say Nothing lasts Forever, From the Ashes, Early Recovery and Luck or Fate? Discussion: The narrative presented describes a first hand experience of the struggles leading to a dual diagnosis and how receiving the diagnosis has supported the recovery journey of the first author. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to explore the impact of the pandemic on the emotional and mental well‐being of family carers, care home staff and residents, in light of changing restrictions, increased testing and vaccination rollout in the UK. Design Longitudinal, qualitative semi‐structured interview study. Methods: Remote semi‐structured interviews were conducted with family carers of care home residents with dementia and care home staff from different care homes across the UK. Baseline and follow‐up interviews were conducted in October/November 2020 and March 2021, respectively. Data were analysed using inductive thematic analysis involving members of the public with caring experiences. Results: In all, 42 family carers and care home staff participated at baseline, with 20 family carers and staff followed up. We identified four themes: (1) Developing anger and frustration; (2) Impact on relationships; (3) Stress and burnout; and (4) Behavioural changes, and perceived impact on residents. The mental health of everyone involved, including family carers, care home staff and residents, has been negatively affected, and relationships between family carers and staff have been severely strained. There was a general lack of adequate mental health support, with little relief. Conclusions: The pandemic has had a detrimental impact on the lives of those surrounding care homes—from residents and staff to family carers. Consideration should be given on how to best support the mental health needs of all three groups, by providing adequate easily accessible mental health care for all. This should also focus on rebuilding the relationships between family carers and care home staff. Impact This is the first paper to highlight the effects of the long‐lasting and miscommunicated restrictions on residents, carers and care home staff, and highlight the urgent need for continued mental health support. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The Safewards model has been introduced to forensic mental health wards with mixed results.Research has identified a need to consider the addition of factors that may be relevant to forensic mental health services to enhance the introduction of Safewards. What the paper adds to existing knowledge?: This study elicits factors specific to forensic mental health settings missing from the original Safewards model, which have the potential to enhance nursing care, improve safety and improve adherence to Safewards in a forensic mental health setting. What are the implications for practice?: This study provides the adaptation required in a forensic mental health setting to enhance the implementation of the Safewards model of care, originally developed to assist nurses to prevent and manage conflict and containment in acute general mental health settings.The development of Safewards Secure has incorporated perspectives from expert Safewards and forensic mental health nurse leaders and healthcare clinicians and is inclusive of consumer and carer perspectives to ensure the model is applicable and broadly acceptable. Introduction: Safewards is a model designed specifically for acute mental inpatient wards. Research investigating the introduction of Safewards has identified a need to consider factors relevant in forensic mental health services, such as offence and risk issues. Aim: To identify adaptations needed to address gaps in the Safewards model to assist forensic mental health nurses to prevent and manage conflict and containment. Method: A Delphi study was employed to engage a group of international Safewards and forensic mental health experts (n = 19), to elucidate adaptation of the Safewards model. Results: Experts identified necessary elements and reached consensus on key considerations for Safewards interventions. To ensure the Safewards Secure model was robust and developed on a platform of research, all items suggested by Delphi experts were cross‐referenced and dependent on empirical evidence in the literature. Discussion: This study identified a number of key differences between civil and forensic mental health services, which informed the development of Safewards Secure, an adjunct to the original Safewards model. Implications for Practice: The development of person‐centred models of nursing care adapted to specific settings, such as forensic mental health, provides a potential solution to preventing and managing conflict and containment, and improving consumer outcomes. Relevance Statement: Managing conflict and containment in mental health services remains an ongoing challenge for mental health nurses. Safewards is a model of care designed for acute mental health inpatient settings to prevent conflict and containment. To date, there has been mixed results when introducing Safewards in forensic mental health settings, and reported reluctance and scepticism. To address these issues, this study employed a Delphi design to elicit possible adaptions to the original Safewards model. From this study, Safewards Secure was developed with adaptations designed for forensic services, to enhance the management of conflict and containment, assist implementation and improve consumer outcomes. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Oral health consists of more than having good teeth; it is an important factor in general health and well‐being. Despite its importance, oral health care is still largely overlooked in mental health nursing.There is no research available about oral health risk factors and OHRQoL in patients diagnosed with a psychotic disorder with a psychotic disorder (first‐episode). What does this paper add to existing knowledge?: This study provides insight into the severity of the problem. It demonstrates the differences in risk factors and OHRQoL between patients diagnosed with a psychotic disorder (first‐episode) and the general population.A negative impact on OHRQoL is more prevalent in patients diagnosed with a psychotic disorder (first‐episode) (14.8%) compared to the general population (1.8%).Patients diagnosed with a psychotic disorder (first‐episode) have a considerable increase in odds for low OHRQoL compared to the general population, as demonstrated by the odds ratio of 9.45, which supports the importance of preventive oral health interventions in this group. What are the implications for practice?: The findings highlight the need for oral health interventions in patients diagnosed with a psychotic disorder (first‐episode). Mental health nurses, as one of the main health professionals supporting the health of patients diagnosed with a mental health disorder, can support oral health (e.g. assess oral health in somatic screening, motivate patients, provide oral health education to increase awareness of risk factors, integration of oral healthcare services) all in order to improve the OHRQoL. Introduction: No research is available about the oral health risk factors and oral health‐related quality of life (OHRQoL) in patients diagnosed with a psychotic disorder. Aim: To compare oral health risk factors and OHRQoL in patients diagnosed with a psychotic disorder (first‐episode) to people with no history of psychotic disorder. Method: A case–control comparison (1:2) multivariable linear regression analysis and an estimation of prevalence of impact on OHRQoL. Results: Patients diagnosed with a psychotic disorder (first‐episode) have lower OHRQoL with more associated risk factors. Of the patients diagnosed with a psychotic disorder (first‐episode), 14.8% reported a negative impact on OHRQoL, higher than the prevalence of 1.8% found in people from the general population. Discussion: The high prevalence rate of a negative impact on OHRQoL in patients diagnosed with a psychotic disorder (first‐episode) shows the importance of acting at an early stage to prevent a worse outcome. Implications for practice: The findings highlight the need for oral health interventions in patients diagnosed with a psychotic disorder (first‐episode). Mental health nurses, as one of the main health professionals supporting the health of patients diagnosed with a mental health disorder, can support oral health (e.g. assess oral health in somatic screening) in order to improve the OHRQoL. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: There is only limited information on how the COVID‐19 pandemic has affected people diagnosed with mental health disorders, especially people admitted to psychiatric wards.We surveyed the views of inpatients at Qatar's only psychiatric hospital regarding how the pandemic had affected their mental health and social changes they had experienced during the pandemic. What the paper adds to existing knowledge?: Nearly half (43%) of those who completed the survey reported that the pandemic had led to a deterioration in their mental health.Those who reported deterioration in their mental health during the pandemic were significantly more likely to have experienced negative social changes during the pandemic. Examples included increased stress from the home and reduced ability to discuss emotions/feelings with family members. What are the implications for practice?: Mental health services need to ensure ongoing support for patients during and after the pandemic. Mental health nurses have a pivotal role including identifying early warning signs of relapse of mental disorders, delivering talking treatments and providing practical advice and COVID‐19‐related education.Further work is needed to assess the views of people diagnosed with mental health problems in different countries and at a different time point during the pandemic. Introduction: The impact of the COVID‐19 pandemic on people under the care of mental health services has received relatively little attention in the scientific literature. Aim: To assess psychiatric inpatients' views regarding their mental health and experience of social change during the pandemic. Method: Cross‐sectional survey of consecutive patients admitted to Qatar's only psychiatric hospital between mid‐June and mid‐October 2020. Results: Data were analysed for 114/284 (40%) patients admitted during the study period. 8 (7%) reported a history of COVID‐19. 43% reported that the pandemic had led to deterioration in their mental health, 11% to an improvement and 39% that there had been no attributable change. Those reporting worsened mental health, attributable to the pandemic, were significantly more likely to report having experienced four negative social changes during the pandemic, namely reduced ability to discuss emotions/feelings with family members, decreased time spent exercising, decreased time spent relaxing and increased stress from the home. Demographic factors did not distinguish those reporting worsened mental health from those whose mental health was improved or unchanged. Discussion: A large proportion of psychiatric inpatients reported negative social and mental health changes during the pandemic. However, the study cannot determine causality. Implications for practice: Mental health services should consider the psychological and social aspects of people's lives, including their interactions with family, friends and the community. This is especially relevant during the COVID‐19 pandemic due to its wide impact on society. Interventions for people diagnosed with mental health disorders should address their psychological and social needs. [ABSTRACT FROM AUTHOR]

Accessible summary A number of studies have highlighted issues around the relationship between service users and providers. The recovery model is predominant in mental health as is the recognition of the importance of person-centred practice. The authors completed an in-depth search of the literature to answer the question: What are service users' experiences of the mental health service?, Three key themes emerged: acknowledging a mental health problem and seeking help; building relationships through participation in care; and working towards continuity of care., The review adds to the current body of knowledge by providing greater detail into the importance of relationships between service users and providers and how these may impact on the delivery of care in the mental health service. The overarching theme that emerged was the importance of the relationship between the service user and provider as a basis for interaction and support., This review has specific implications for mental health nursing. Despite the recognition made in policy documents for change, issues with stigma, poor attitudes and communication persist. There is a need for a fundamental shift in the provider-service user relationship to facilitate true service-user engagement in their care., Abstract The aim of this integrative literature review was to identify mental health service users' experiences of services. The rationale for this review was based on the growing emphasis and requirements for health services to deliver care and support, which recognizes the preferences of individuals. Contemporary models of mental health care strive to promote inclusion and empowerment. This review seeks to add to our current understanding of how service users experience care and support in order to determine to what extent the principles of contemporary models of mental health care are embedded in practice. A robust search of Web of Science, the Cochrane Database, Science Direct, EBSCO host ( Academic Search Complete, MEDLINE, CINAHL Plus Full- Text), Psyc INFO, Psyc ARTICLES, Social Sciences Full Text and the United Kingdom and Ireland Reference Centre for data published between 1 January 2008 and 31 December 2012 was completed. The initial search retrieved 272 609 papers. The authors used a staged approach and the application of predetermined inclusion/exclusion criteria, thus the numbers of papers for inclusion were reduced to 34. Data extraction, quality assessment and thematic analysis were completed for the included studies. Satisfaction with the mental health service was moderately good. However, accessing services could be difficult because of a lack of knowledge and the stigma surrounding mental health. Large surveys document moderate satisfaction ratings; however, feelings of fear regarding how services function and the lack of treatment choice remain. The main finding from this review is while people may express satisfaction with mental health services, there are still issues around three main themes: acknowledging a mental health problem and seeking help; building relationship through participation and care; and working towards continuity of care. Elements of the recovery model appear to be lacking in relation to user involvement, empowerment and decision making. There is a need for a fundamental shift in the context of the provider-service user relationship to fully facilitate service users' engagement in their care. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Nursing observations at night are conducted on psychiatric wards to ensure the safety and well‐being of patients as well as to reduce the risk of suicide or severe harm.To our knowledge, no studies have examined the lived experience of the psychiatric ward environment and of nursing observations at night. What does the paper add to existing knowledge?: The main complaint from patients was the constant interruption of their sleep, as most of the patients in this study were observed 2–4 times an hour. Their sleep was interrupted by (a) the light from torches shone into their faces by staff checking on their safety, (b) the noises produced by the opening and closing of bedroom/ward doors, and/or (c) staff talking to each other during the observation. Patients also reported that they found having somebody enter the room in the middle of the night intimidating and unsettling. What are the implications for practice?: Poor sleep has been associated with an increase in suicide risk and mental health problems.Identifying practices that promote sleep hygiene is vital.The study could be used to develop a Quality Improvement Project to improve patients' sleep and perhaps reduce duration of stay. Introduction: A fundamental component of nursing care is observations at night to ensure the well‐being of patients. However, there is no literature on the lived experience by inpatients of such observations or of the general environment of a psychiatric ward at night. Aim/Question: This study aims (a) to understand the lived experience of being an inpatient on a psychiatric ward at night with a focus on intermittent observations and (b) contribute to developing a tool to monitor the psychiatric ward environment for use in quality improvement projects. Method: Semi‐structured interviews were conducted with twelve inpatients from five psychiatric wards who had experienced intermittent observations at night. These interviews were subsequently transcribed and analysed using content analysis. Results: Environmental disturbances including light and noise, invasion of privacy and safety considerations on the ward all contributed to sleep disturbance. The unintended consequences of disturbances caused by intermittent night observations, and by staff in general and other patients formed the core of the inpatients' experience. We developed a clinical tool that could be used to identify the factors that are relevant on an individual ward. Discussion: Participants interviewed unanimously agreed that poor sleep quality had a significant negative impact on their psychological and social well‐being. These were discussed in relation to the environment and the experience of observations at night. Implications for nursing practice: Deprivation of inpatients' sleep is currently under‐reported, and the usefulness of intermittent observations at night in psychiatric wards is questioned. Much could be done to adjust the environment at night to support quality sleep and improve psychiatric symptoms. This paper aims to highlight the lived experience of patients to help bring improvements. [ABSTRACT FROM AUTHOR]

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Aim: To summarise the psychological impacts of social isolation amongst older adults during COVID-19 and review the benefits and limitations of online interventions used to combat social isolation. Design: A scoping review was performed. Data Sources: A systematic search was performed from October 2020 to January 2021 in seven electronic databases: China National Knowledge Infrastructure (CNKI), PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Cochrane Library and Web of Science. A hand search of the reference lists of included papers and WHO publications was performed. Grey literature search was carried out from Scopus, ProQuest Dissertation and Google Scholar. Review Methods: Studies were screened, appraised and extracted independently by two reviewers. Thematic analysis was used to synthesise data, which were presented in a descriptive manner and organised into categories and themes. Results: Totally, 33 studies were included. Four themes and eight sub-themes emerged: (1) negative impacts and experiences of older adults during social isolation, (2) adopting coping behaviours in the midst of COVID-19, (3) online interventions to combat the consequences of social isolation, (4) barriers to online intervention. Conclusion: The COVID-19 pandemic has taken an emotional toll on older adults' psychological wellbeing and has highlighted the untapped strengths of older adults facing isolation. Online interventions, which could be a new normal in the COVID era, were beneficial in combating social isolation. Strategies by various stakeholders were recommended to tackle the barriers of online interventions. Impact: With the COVID-19 pandemic still in progress, this review provides insights on the psychological impacts of social isolation amongst older adults. Nurses in the community and long-term care facilities could adopt strategies and online intervention to better support the older adults, contribute to a stronger COVID-19 response and support system, and an overall better road to recovery from this crisis. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is compounding the distress of millions of refugees (made up of displaced persons, forced migrants, refugees and asylum seekers) throughout the world. This discursive paper pitches a challenge for the global nursing profession, within the multidisciplinary context, to consider its collective agency in responding to the health and well-being needs of a priority portion of the global population. Nursing leaders are encouraged to renew their commitment to the International Council of Nurses' Code of Ethics and consider the role of their profession in assisting global refugees, because the extent of present need has become an escalating major global humanitarian crisis. The nursing profession comprises half the world's healthcare workforce. The World Health Organization considers that nurses play a fundamental role in ensuring access to universal healthcare as a basic human right, addressing the global need for health promotion care, disease prevention and primary and community healthcare (International Council of Nurses, The ICN code of ethics for nurses; 2012). It is a human right to seek asylum from persecution, and in doing so, people should not be subjected to cruel, inhumane or degrading treatment or circumstances. Nurses are increasingly interested in fostering a healthy and adaptive environment in which people can thrive, despite personal, political, emotional, physical or social adversity. Nursing care is indispensable for the easement of human distress and for the promotion of comfort and coping. Nurses have an essential role in advocating for policies that will enhance immigrants' access to health/mental health services and address barriers irrespective of migrant/refugee/asylum seeker status. These are challenging times as the world responds to the pandemic crisis, and nurses are called to rise to global and local leadership roles and join with other health and social care colleagues in addressing the universal human health, social and political crisis of our time. The global nursing collective must come to terms with the need to initiate additional compelling ways to improve and integrate health and social care processes so that nursing care, mental health and social care augment a holistic achievement of appropriate care for refugees. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Current policy advocates for the participation of family carers in care planning., Caring for a person with a mental illness requires a significant commitment from families to support their relative's recovery., What this paper adds to existing knowledge? The evidence of family involvement in care planning is generally fraught with conflicting experiences related to different requirements between mental health professionals, families and service users., Confidentiality remains contentious at a practice level in terms of information sharing and decision-making., There is a requirement and need for a shared understanding around care planning between families and mental health professionals., What are the implications for practice? The provision of written information pertaining to families regarding confidentiality is required at service level., Educational workshops concerning care planning and treatment options should be provided for service users, families and mental health professionals., Further research into effective service-wide strategies that explore with families how their engagement can be positively fostered in mental health services is warranted., Abstract Introduction Mental health service policy stipulates that family carers be involved in care planning. Aim To identify families' experiences of care planning involvement in adult mental health services. Method An integrative review where electronic databases and grey literature were searched for papers published between 01 January 2005 and 10 February 2016. Results Fifteen papers met the inclusion criteria. Thematic analysis generated three themes: (1) families' experience of collaboration, (2) families' perceptions of professionals and (3) families' impressions of the care planning process. Collaborative decision-making is not regularly experienced by families with an 'us' and 'them' divide, perpetuated by a lack of communication, confidentiality constraints and a claim of 'insider knowledge' of service users. When involved, families perceive care planning to be uncoordinated and that their lived experiences are not always appreciated. Discussion Families need to be valued, empowered and engaged in care planning and the partnership distance be addressed. Accommodating the views of family, service user and professionals is preferable but not always possible. Our findings suggest that the key element for professionals is to value all 'insider knowledge' where possible. Implications for Practice Services should develop written information on confidentiality for families and facilitate open communication concerning their involvement in care planning. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: There are many international studies on CRHTTs; however, there has been little research on nurses' experiences of working with CRHTTs.Earlier studies focused on the nurses' gatekeeping role but did not explore nurses' perception of care as a construct. What does the paper add to existing knowledge?: This study provides information based on mental health nurses' experiences. It explains the home environment, the therapeutic relationship and the process of mental health nursing care during a crisis. Also, the study explains nurses' satisfaction with care provided at patients' home.Unlike other studies, this study focused on nurses' experiences while providing care, rather than on nurses' general responsibilities and the services they provide. This study is the first of its kind in Spain with such a focus. What are the implications for practice?: Acknowledging nurses' experiences and their perspectives about the care they provide could help shift mental health nursing paradigms from those based on biomedical models to newer perspectives found in recovery models. Furthermore, this knowledge could improve the quality of care in mental health settings due to its potential to guide nursing practices.Raising mental health care providers' awareness of mental health nurses' personal and professional care constructs would help implement support systems to meet the professional's needs. Meeting the needs of nurses related to the care they provide is likely to impact patient care positively. Introduction: Crisis resolution home treatment teams (CRHTTs) provide short‐term, intensive home treatment to people experiencing mental health crises. There is limited research on nurses' experiences with CRHTTs. While earlier studies mainly focussed on mental health nurses' gatekeeping responsibilities, more investigation is needed in this field. Aim: To explore nurses' perceptions and constructions about care in CRHTT services. Method: A qualitative case study was employed. Ten semi‐structured interviews were performed to nursing staff working in CRHTT services. Results: Three main categories emerged from the data analysis: nurses' perspectives of the care provided, nursing setting of care at home and nursing care plan at home. Discussions: Findings revealed that nurses experienced greater satisfaction providing care in the home settings, and therefore, it positively impacted the quality of care and reduced patient's stigma. This study also relates the value of developing care plans centred on patients' environments increasing Mental Health Nursing (MHN) work satisfaction. Implications for practice: Knowledge of the intrinsic experiences of care provided by nurses in CRHTTs may help facilitate the development of the nursing role in CRHTT by improving understanding of care in mental health settings. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject: Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors.Mental health nurses often describe role confusion in relation to other health professionals.Opportunities for interdisciplinary communication with other professionals may benefit health care. What the paper adds to existing knowledge: The current large‐scale study is the first to investigate whether mental health and SUD nurses' perceptions of their opportunities to accommodate patients' needs are related to interdisciplinarity in the treatment unit and a nursing role with clearly defined responsibilities.Strong interdisciplinarity was associated with greater perceived opportunities to accommodate patients' psychosocial, somatic, and economic and legal needs, while strictly defined nursing roles/responsibilities were related to weaker opportunities to do so. What are the implications of practice: The findings highlight the need to address how mental health and SUD nurses organize practice to meet patients' diverse needsInterdisciplinary teamwork could strengthen nurses' ability to address patient needsFinding the best possible balance of providing service in teams or individually could improve resource utilization at the same time as strengthening patient care, and making sure that the patients' various needs are met. Introduction: Nurses' roles in specialist mental health and substance use disorder (SUD) treatment services are multidimensional and complex. Their responsibility, autonomy and interdisciplinary collaboration may be of importance for their perceived opportunities to accommodate patients' health needs. Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors, and included relatively small samples. The studies have also mainly been conducted in other sectors than the mental health and SUD nursing sectors. Aim/Question: The aim of this study is to examine the associations between nurses' roles, interdisciplinarity and their perceived opportunities to accommodate patients' psychosocial, somatic and economic/legal needs. Method: A cross‐sectional web‐based questionnaire survey was conducted in a nationwide sample of Norwegian nurses in the mental health, SUD treatment and combined mental health and SUD treatment sectors. Of 5,501 contactable nurses (74% of the population), 1918 (35%) responded. Results: The results revealed that interdisciplinarity was significantly associated with greater perceived opportunity to accommodate patient needs, whereas strictly defined nursing roles/responsibilities were associated with less opportunity to accommodate these needs. Discussion/Implication for practice: Facilitation of interdisciplinary collaboration may improve quality of care for patients in mental health and SUD treatment services. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The literature shows a clear relationship between a good therapeutic relationship (TR) and the efficacy of nursing interventions.For the implementation of nursing psychotherapeutic interventions, the initial establishment of a good TR is essential.Several instruments assess the relationship established between the therapist and the patient in psychotherapy. However, no tool has been found to assess the quality of the TR established between the nurse and the patient. What this paper adds to existing knowledge?: This study allowed the development and evaluation of the psychometric properties of a scale to assess the TR between the nurse and the patient in a sample of mental health nurses.The developed scale (Therapeutic Relationship Assessment Scale‐Nurse) has psychometric properties that attest its reliability (internal consistency and test–retest) and construct validity as an instrument to assess the quality of the TR established between the nurse and the patient from the nurse's perspective. What are the implications for practice?: As the TR is crucial for providing nursing care and, in particular, for implementing nursing psychotherapeutic interventions, the scale developed is a valid tool to assess the quality of the TR established between the nurse and the patient in the perspective of the mental health nurse.The use of instruments to assess the quality of the nurse–patient TR facilitates the identification of the relationship's gaps, which can serve as a basis for improving the relationship itself and the nursing care provision. Introduction: The therapeutic relationship (TR) is essential to providing psychiatric and mental health nursing care. Nevertheless, no assessment tools exclusive for assessing nursing TR were found in the literature. Aim: To describe and evaluate the psychometric properties (reliability and construct validity) of a scale that allows assessing the quality of TR established between the nurse and the patient. Method: A survey method was adopted, using a convenience sample of 356 mental health nurses. Internal consistency was assessed by Cronbach's alpha and Omega index. Results: A total of 221 mental health nurses participated in the study (response rate = 62.08%). The scale's final structure has 25 items. Cronbach's alpha was 0.93, ranging from 0.78 to 0.88 for each of the factors. The cumulative variance explained in a four‐factor structure was 71.12%. Discussion: The Therapeutic Relationship Assessment Scale (TRAS)‐Nurse presents good psychometric properties. In the light of Benner's theory, it can be an useful tool for novice nurses to better understand what aspects they should pay attention to for establishing a successful TR. Implications for Practice: Mental health nurses can use the TRAS‐Nurse, thus having a scale available that allows them to self‐assess the quality of TR they establish with their patients. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mental health support workers (MHSWs) are frequently employed in mental health services in order to augment and diversify the workforce and to promote recovery centred careResearch shows that while MHSWs positively support service user mental health recovery, these roles are often unclear or not well understood by MHSWs and other mental health practitioners What the paper adds to existing knowledge?: Through arts‐based research methods, three MHSWs communicated their personal vulnerabilities and anxieties in supporting others with mental health issues; these insights are rarely presented in mental health research.MHSW experiences of not having recovery‐oriented expertise recognized or valued by healthcare team were powerfully conveyed through arts narrative. These findings promote recognition of the strengths and contributions of MHSWs to mental health practice.Arts‐based inquiry is a means of providing additional depth to what is already known and contributes novel insights regarding the occupational experiences and perceptions of MHSWs. What are the implications for practice?: Mental health nurses and healthcare teams need to engage fully with recovery‐oriented principles acknowledging the vulnerabilities of all practitioners and establishing adequate supervision and support.There needs to be greater clarity concerning roles/scope of practice for MHSWs to enable productive working partnerships in mental health teams. This can be achieved through open communication, education and planning among the wider mental healthcare team. Introduction: Mental health support workers (MHSWs) make positive contributions to mental health recovery practice yet their roles and support needs are often unclear. This research explored the occupational lived experiences of three MHSWs working in Irish mental healthcare services. Aim: The study examined the experiences and perceptions of MHSWs regarding their mental health recovery work. Method: A narrative design was used incorporating participatory art‐based inquiry as a collaborative means of engaging participants. This innovative methodology enabled exploration and evocative expression of participants' occupational experiences and stories. Results: Participants revealed feelings of vulnerability and anxiety regarding personal mental health and supporting the mental health of others; a finding not commonly explored in previous research. MHSW skills and knowledge were evident; however, this expertise and recovery focus was not valued in mental health services. Discussion: The strengths and challenges of MHSW engagement in service provision are discussed. Interdisciplinary team integration is explored in terms of contrasting recovery philosophies, practitioner vulnerability and professional demands and imperatives. Implications for practice: Mental health teams need to engage with recovery principles, acknowledging strengths and vulnerabilities of all practitioners and establishing adequate supervision and support. Greater clarity and education is required concerning roles/scope of practice for MHSWs to enable productive interdisciplinary partnerships. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: An important step towards improving mental health outcomes is the realignment of tertiary mental health education and research in a way which places strategic value on experience‐driven involvement in mental health and addiction‐related care.One of the most widely recognized ways of achieving this is by increasing representation of individuals with first‐hand experience of mental health and addiction distress (also known or referred to as Experts by Experience or EBE) within the tertiary sector. What this paper adds to existing knowledge?: Benefits of tertiary EBE representation such as improving student's preparedness for practice and the empowerment of mental health consumers are consistently reported throughout the literature. In striving towards these outcomes, it is crucial we remain mindful of relevant and often‐reported hurdles such as stigma and improper implementation.By using Aotearoa New Zealand as a case study, the need for approaches to increasing EBE representation which is conscious of diverse cultural contexts, perspectives and identities is highlighted. What are the implications for practice?: This review draws together a broad range of factors associated with improving clinical practice. These include the potential for EBE representation to improve outcomes for trainee clinicians, and the incorporation of consumer‐driven perspectives into evidence‐based practice.This review further highlights the need for EBE representation to be implemented in a way which is responsive to the cultural needs and nuances of mental health education and practice in Aotearoa New Zealand, and, similarly in other countries. Introduction: There is potential value in increasing representation of expert by experience (EBE) involvement in mental health education sectors. This approach to improving mental health outcomes is here explored in the context of Aotearoa New Zealand's tertiary education sector. Aim/Question: This review sought to identify potential outcomes, benefits and barriers associated with EBE representation in tertiary institutions, whilst critically analysing these strategies in the context of Aotearoa New Zealand's mental health education sector. Method: Data retrieved from electronic databases were subjected to critical appraisal and thematic analysis. The integrative review drew from a final data set of 113 articles. Results: An integrative review of our search results indicated that moving towards a tertiary mental health model in which lived experience plays a central role has the potential to benefit both teaching and research in the tertiary sector. Discussion: The interplay between contemporary perspectives on tertiary EBE representation and the cultural needs and nuances of Aotearoa New Zealand's tertiary sector highlights the need for critical and careful approaches to EBE representation. Implications for clinical practice: Findings surrounding tertiary EBE representation have direct implications for the training of mental health practitioners and the evaluation and development of clinical practice outcomes and procedures. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known about the topic?: Our present understanding of mechanical restraint is heterogenous, largely due to the important differences between countries/regions. In Spain, the use of this restrictive practice is not regulated, nor is its use protocolized.Previous studies that have investigated the impact of organizational factors and changes in these protocols are often short and not conducted within a framework designed to establish a long‐term plan for reducing the use of mechanical restraint. What this paper adds to existing knowledge?: We demonstrate that the implementation of administrative and protocol changes in our psychiatric unit significantly reduced the use of mechanical restraint, thus laying the foundations for a regulatory framework.Our analysis shows that the profile of patients who require mechanical restraint is highly variable, but that certain clinical and institutional aspects within the framework of a long‐term plan for the reduction in mechanical restraint can be targeted with long‐lasting positive effects. What are the implications for practice?: Organizational changes focussed on training staff, promoting family support and requiring the registration and close monitoring of episodes empower the role of the nursing staff in the prevention, monitoring and regulation of mechanical restraint. Introduction: Mechanical restraint is a controversial restrictive practice to manage agitation or violent behaviour. Numerous studies have evaluated the factors and organizational changes that influence on mechanical restraint, but only for short time periods. None of those studies have assessed the effects of measures applied within the framework of a long‐term plan to reduce the use of mechanical restraint. Given the lack of specific legislation in Spain, more data are required for its proper regulation. Aim/Question: To evaluate the risk factors associated and the impact of specific measures designed to minimize the application of mechanical restraint in an acute mental health unit over an 8‐year period and previous observation of 5 years. Methods: Cross‐sectional study based on a retrospective analysis of mechanical restraint records. We compared admissions requiring ≥one episode of restraint versus admissions not requiring this coercive measure. Results: Between 2007 and 2014, 412 admissions (12%) required mechanical restraint. The data show that the measures applied in the previous five years had significantly reduced the total hours of restraint per semester. The factors associated with admissions requiring mechanical restraint were involuntary, unscheduled and longer admissions. The best predictor of restraint was involuntary admission (OR = 6.37), followed by the diagnosis of personality disorder (OR = 5.01). Discussion: Identification of the factors associated with mechanical restraint would allow for early detection strategies. Our results provide additional evidence on the usefulness of organizational changes to reduce coercive measures, even in a country without specific legislation. Implications for Practice: Organizational changes, such as staff training and increased family support during admission of episodes of mechanical restraint, can reduce the use of this measure. These measures also give the nursing staff greater responsibility in terms of their role in registering and monitoring the restrictive practice, thus helping to prevent or minimize the use of mechanical restraint. [ABSTRACT FROM AUTHOR]

Accessible summary In this paper we review past research that suggests video conferencing (VC) can be successfully used in a number of ways in mental health services. These ways include holding staff meetings remotely, conducting assessment and treatment when it is not easy for the clinician and service user to be at the same location, and running staff training remotely., We also present some guidance regarding issues to be considered when introducing VC into mental health settings, such as the importance of staff and service user consultation, the necessity for training in VC and advice about how to conduct meetings by VC., Beginning to use VC can represent a significant cultural change for staff and service users. We hope that this paper will provide a useful summary of things that may help support this change., Abstract The aim of this paper is to provide an overview of the evidence base regarding the use of video conferencing (VC), implementation issues, policies, procedures, technical requirements and VC etiquette. The paper is based on a literature review of VC within the mental health sector and the authors' experience in implementing VC. Six themes emerged from the literature review: applications of VC, VC assessments, treatment, training and supervision, practitioner anxiety, and VC administrative processes. The results of the review support the use of VC in mental health services. Guidelines for the implementation of VC are discussed, including the importance of staff and service user consultations, training in the use of VC, clear guidance for staff with regards to usage, confidentiality and data protection policies, and VC etiquette. Challenges that can arise when implementing VC in a mental health context are also discussed. Arguably, it is not the technology, but the cultural change it represents to staff which seems to be the most important factor regarding successful implementation. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject?: Risk in psychiatry involves harm to self or others owing to mental health difficulties, for example iatrogenic effects of treatment, self‐harm, suicide and violence.Risk management is a framework to minimize risks, comprising of risk assessment, generation of risk management plans and evaluation of interventions.Literature has extensively explored risk management and presented a critique that its practices can lead to patient harm. However, there is a paucity of literature about what patients identify as helpful risk management practices, despite the potential for such patient views to ameliorate harm and improve mental health care. What this paper adds to existing knowledge: Interpersonal relationships with clinicians, and communication that keeps patients involved and informed of management processes, were found to be central to beneficial risk management practices, while patients having agency and autonomy to influence their participation was also important.Beneficial interpersonal relationships and connectivity in the form of patients' wider community of support were found to be influential in aiding risk management. Meaningful relationships, and particularly peer support, that maintained personal and collective identities were prevalent in the literature. What are the implications for practice?: Rendering risk management more visible and accessible in practice might cultivate an openness that promotes patient participation. This includes drawing on a wider network of support, for example the patient's friends and family, as well as having advocacy utilizing peer support. Introduction: Minimizing the harm that patients pose to themselves and others, due to mental health difficulties, is a central component of risk management in psychiatry. However, risk management itself can cause patient harm, but despite this and the potentially informative value of lived experience, little is known about what patients want or expect from risk management. Aim: To review research and explore what patients consider beneficial in risk management practice. Method: A mixed studies systematic review utilizing PRISMA guidelines, alongside a convergent qualitative design to categorize findings. Results: Twelve papers were identified, generating two categories of beneficial practices: interpersonal relationships and communication with clinicians; coupled with patient agency in their own risk management. Discussion: Connectivity appears important. Particularly patients feeling involved, and their voices being heard in both the identification of risks and then shaping risk management practice. Moreover, this included involvement of friends, family and peers to widen input and supportive networks beyond clinical relationships. Implications for Practice: Risk management needs to be an accessible part of care, which is more inclusive of patient views and needs. The latter might also be aided by drawing on the patient's wider community in order to provide more effective support and risk management. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject? (Scientific Rationale): Mental health care in Poland lags behind that of many other countries, and coercive measures are used on a regular basis.Scant research has been conducted in Poland regarding the treatment of psychiatric patients.The perspectives of Polish psychiatric nurses towards aggression remain unknown. What does this paper add to the existing knowledge?: The translated and validated Attitude Towards Aggression Scale (ATAS) in Polish will serve as an instrument that gauges Polish nurses' attitudes towards aggression. The Polish nurses have unenlightened and negative attitude towards aggression. What are the implications for practice?: There is now an instrument in Polish by which we can gauge the attitudes of mental health nurses, which must precede any educational efforts. Polish nurses showed more restrictive and antiquated attitudes about patient violence than nurses in some other parts of the world. With a shift to more positive attitudes, the use of coercion could be reduced, resulting in improved patient care. Introduction: In Poland, the mode and site of patient treatment have changed little in the past 75 years, despite therapeutic advances worldwide. There is limited information regarding attitudes of nurses towards aggression in psychiatric settings in Poland, nor has there been an instrument in Polish to measure it. Aim: To translate and validate the Attitudes Towards Aggression Scale (ATAS) for use in Poland, and to assess the attitudes of three groups of nursing personnel towards aggression. Method: We surveyed 980 psychiatric and general nurses as well as nursing students. We translated the ATAS into Polish, and validated it using exploratory factor analysis. Results: The Polish version of the ATAS showed good psychometric properties. We found that Polish nurses perceived patient aggression extremely negatively. Discussion: Polish nurses perceive aggression as destructive, negative and not to be tolerated, leading to use of restraints. Among the three groups, psychiatric nurses showed the most negative attitude towards aggression. Thus, education is needed for preservice and inservice nurses alike to address this issue. What this study adds to existing evidence: We now have a validated instrument to assess nurses' attitudes about aggression. We also know that Polish nurses have exceedingly negative attitudes towards aggression. Implications for Practice: The Polish version of ATAS was found valid and reliable. Therefore, we can now measure the attitudes of Polish nurses towards aggression, which was not possible previously. The baseline data provide a starting point from which to determine effects of educational efforts. [ABSTRACT FROM AUTHOR]

Accessible summary The analysis of the concept of mental health recovery in young adulthood uses Rodger's (2000) evolutionary method., This concept analysis suggests that in some contexts the word 'recovery' does not reflect the conceptual components identified in this paper and reveals a disparity between professional and personal interpretations of mental health recovery., A new conceptual definition of mental health recovery in young adulthood is presented., Conceptual clarity will facilitate the congruence of mental health recovery and nursing practice with the process of recovery experienced by young adult service users., Abstract Recovery, as a concept, emerged as a core philosophy of the service user movement that began in the late 1960s and 1970s. Previous reviews on recovery in mental health have presented definitions or a conceptual framework; however, over time it has been open to disparate interpretations. The aim of this paper was to conduct the first concept analysis of mental health recovery in young adulthood within various multidisciplinary contexts. Rodgers's (2000) six-stepped evolutionary method enabled the analysis of recovery's conceptual characteristics, the identification of an exemplar and the proposition of a hypothesis with implications for practice. This analysis has revealed the derivation of the term recovery does not convey its identified conceptual characteristics. Identified attributes include the reawakening of hope, reclaiming a positive self and meaning through personal growth. Antecedents include the disruption of illness, stigmatization, internal inventory and contemplative recovery. Identified consequences include the return to normality, reconstruction of self and active social connection. The new conceptual definition is the reawakening of hope and rediscovery of a positive sense of self through finding meaning and purpose within personal growth and connection using creative self-care coping strategies. This paper reveals an apparent disparity between professional and personal interpretations of recovery. Therefore, the implication for mental health nursing is the congruence of recovery-orientated practice with the process of recovery experienced by young adult service users. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: There is evidence that the LGBT communities experience greater health disparities, particularly in relation to their mental health needs.The LGBT communities are often faced with stigma and discrimination within mental health services. What the paper adds to existing knowledge?: People within the LGBT communities have identified that their experiences of mental health services reinforce stigma and lack an understanding of their specific needs.Their needs can be addressed by mental health services that challenge heteronormative assumptions and promote self‐acceptance and equity. What are the implications for practice?: The existing heteronormative culture in mental health nursing practice needs to be challenged.Practice needs to demonstrate self-awareness of personal and societal LGBT biases, prejudices, and stigma.Practice needs to demonstrate knowledge of important LGBT health care and psychosocial issues.Practice needs to reflect LGBT clinical skills grounded in professional ethics, guidelines, and standards of care. Introduction: The lesbian, gay, bisexual and transgender (LGBT) communities are a minority population that experience a range of health disparities, including mental health. Because these groups have higher rates of mental disorder than the general population it is, therefore, pertinent to identify their specific mental health needs and their experiences when accessing mental health care. Aim: To identify the mental health needs of the LGBT communities and their experiences of accessing mental health care. Methods: An integrative review of qualitative studies was conducted. Results: A total of fourteen studies were selected for this review. The studies identified that participants' experiences of accessing mental health care were related to (a) experiencing stigma and (b) staff's lack of knowledge and understanding of LGBT people's needs. They identified a need for mental health care that promotes the principles of equity, inclusion and respect for diversity. Discussion: The LGBT communities while not a homogenous group, face unique challenges when dealing with their mental health needs. Services that promote health equity and self‐acceptance are important for this group. Implications for practice: It is vital that mental health nursing education incorporate models that promote equity, inclusion and respect for diversity regarding this group of people. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Shared decision‐making is a concept originating in the medical field, and it is ideally based on a trustful relationship between the patient and the health professionals involved.Shared decision‐making shows potential to strengthen patient autonomy and encourages patients to become involved in decisions regarding their treatment. What does the paper add to existing knowledge?: A universal concept and understanding of shared decision‐making with relevance specifically to psychiatric clinical practice could not be identified in the analysed literature.Shared decision‐making refers to a process, and how and whether the patient wishes to participate in the decision‐making process should be clarified from the very beginning.On the basis of this synthesizing review, a process model for psychiatric practice was specified and illustrated to help lead health professionals, patients and other supporters through the decision‐making process. What are the implications for practice?: The process of shared decision‐making should be made visible to all persons involved, and it should be stated at the beginning that a decision must be made.Decisions regarding treatment are usually not limited to a single consultation.A collaborative approach including multiple health professionals and other supporters, such as peer workers and family members, is required.Psychiatric nurses could support patients during the process of decision‐making and provide additional information, if requested. Introduction: Patient involvement in decisions regarding treatment has increasingly been supported in health care, and therefore, shared decision‐making (SDM), as an informative and participative approach, is promoted in the scientific literature. Aim: To review the current state of research regarding the conceptual understanding and implementation of SDM in psychiatric clinical practice. Method: An integrative review that included empirical, theoretical and conceptual research published between 1997 and 2019 was conducted. For this, five health‐related databases were searched. Results: Fourteen articles were included in the synthesis. No universal conceptual understanding of SDM regarding psychiatric care could be identified, although several articles highlighted the link with other concepts, such as autonomy and patient‐centeredness. Furthermore, four additional key themes with relevance for the successful implementation of SDM in clinical practice were determined. Discussion: SDM refers to a process and is usually not limited to a single consultation. SDM shows the potential to enhance patient‐centred and recovery‐oriented care. A collaborative approach including multiple health professionals, peer workers and family members is required. Implications for Practice: The process of SDM should be made visible for all parties involved. Nurses in particular could play a key role by collecting information regarding patient's preferences and by providing support. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Developing sex type is the process in which one develops behavioural attributes and personality characteristics socially defined as matching one's biological sex."Psychological androgyny" means that a person should not be judged in terms of his or her traditional sex role. "Androgynous" sex type means that a person could have both female and male characteristics, depending on the circumstances. "Androgynous" sex‐type individuals show higher capacity to deal with a variety of roles and a healthier and more adaptive behaviour than those with the same gender sex typingPrevious studies focused on caring behaviours while examining the difference between female and male nurses but there are no studies on differences between female and male nurses in the mental health field in relation with sex types. What this paper adds to existing knowledge?: From a theoretical point of view, our study adds important information on specific associations between sex types and caring in mental health nurses.Nurses with different sex type perform caring behaviours at different levels. "Androgynous" sex‐type nurses perform caring behaviours at a higher level than others do. What are the implications for practice?: Our findings can contribute to raising awareness among head nurses and policy makers in the mental health field, of the differences between nurses, and among female and male nurses in mental health centres, regarding their caring behaviours.Understanding this association can assist in the recruitment and allocation of candidates in mental health nursing settings and later on, in developing appropriate instruction programs for these employees. Introduction: Understanding differences in caring behaviours by sex is crucial in light of the need to encourage men to join the nursing profession. Aims: To study the association between sex types and caring behaviours in female and male nurses in the mental health field. Methods: Cross‐sectional study including a convenience sample of 114 nurses in three mental health centres in Israel. Data were self‐reported in a structured form including validated scales for the assessment of sex types and caring behaviours. ANOVA and linear regression tests were used were performed with SPSS version 21. All the analyses were 2‐tailed, and p < 0.05 was considered statistically significant. Results: Androgynous female and male nurses displayed higher levels of caring than other sex types. Higher levels of caring were observed in female compared with male nurses overall (p = 0.011) and in behaviours showing respect (p = 0.020) and attentiveness to patients' needs and safety (p = 0.002). Conclusion: Our results suggest that different sex‐typed female and male nurses in the mental health field display different levels of caring behaviours. Implications for Practice: Our findings can help head nurses and policy makers in recruitment and allocation of nurses in mental health settings, as well as in developing educational programs for employees and nursing students. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: ECT is a fast‐working and potentially life‐saving treatment, but it is still considered a controversial treatment choice.Due to lack of knowledge and public stigma, ECT can be an anxiety‐inducing treatment for people experiencing severe depression.The nurse's role is to alleviate this anxiety, aid recovery and minimize the risk of relapse. They manage this onerous task ideally through the therapeutic relationship, and use the skills of assessment and risk identification in order to maximize patient outcomes. What this paper adds to existing knowledge?: The views of mental health nurses who provide care for adults receiving treatment of ECT for severe depressive illness are in the main positive.The knowledge of and attitude towards ECT among nurses may reflect on patients and influence treatment choice. If stigma is not addressed, then patients will not be appropriately informed regarding their treatment options.Mental health nurses need to engage in reflective practice to ensure that the dignity of the patient is maintained throughout this treatment. What are the implications for practice?: Mental Health nurses should engage with additional training, formalized clinical supervision and avail of peer support in order to improve confidence, skills and quality of care in the delivery of ECT.Education modules should include a presentation of evidence of effectiveness of ECT as a treatment option.Dialogue among mental healthcare colleagues is important about caring for people presenting for ECT treatment. This will ensure that the mental health nurse can remain cognizant of the potential for patient distress throughout this treatment. Background: There is a considerable dearth of literature on attitudes towards Electroconvulsive Therapy (ECT) as a treatment for severe depression. Despite being a highly effective treatment, it is still stigmatized even among professionals. Understanding perceptions and knowledge related to ECT treatment among healthcare providers is important for ensuring that treatment can be safely explored as a treatment option with patients. Aim: The overall aim of this study is to explore the views of mental health nurses who provide nursing care to people receiving ECT for severe depressive illness in a mental health setting. Methods: This is a qualitative study using focus groups (n = 2) with 14 mental health nurses who had a minimum of 3 months experience caring for older adults receiving ECT. Transcripts were subjected to a thematic analysis. Full ethical approval was granted for this study. Results: In total, four themes were identified exploring attitudinal changes, managing patient dignity, reflecting changes in practice and managing the unknown. In general, participants experienced ECT as a positive treatment option for adults with severe depressive illness contributing to an enhanced quality of life. Conclusion: Findings indicate a desire to improve person‐centred care for patients undergoing ECT. Educational support for nurses who work in this area would improve confidence on work practices and lead to improved patient experience. Mental health personnel without direct experience of the treatment should be exposed to educational modules to decrease stigma and to best facilitate informed decision‐making among the patient cohort. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject: Integrating strengths‐based, co‐produced, consumer‐driven resources into mental health workforce education has the potential to dissolve hierarchical mental health care relationships. What the paper adds to existing knowledge: Humanities‐based pedagogy that draws from photography and multi‐voiced narratives is a powerful reflective learning tool to bridge clinical and human experiences of Borderline Personality Disorder (BPD).The Depth of Field reflective learning methodology aims to provoke, prod, reveal and challenge assumptions and/or unconscious bias towards BPD and stimulate raw and reflective discussions that have the potential to inspire critical reflection and move health professionals towards more humanistic, recovery centred models of mental health care. What are the implications for mental health nursing: At the core of co‐production in research, education and practice lies a reciprocal, transformational learning experience. This relationship needs to be further explored in order to reframe mental health education that honours and legitimizes consumers as experts of their own lives and recovery experiences. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Electroconvulsive therapy (ECT) has existed worldwide for nearly 80 years. ECT is a fast‐working and potentially life‐saving treatment, but it is considered controversial. Although frequently mentioned, stigmatization in relation to ECT has not been systematically explored so far. What this paper adds to existing knowledge?: This paper provides new insight into both recipient and expert perspectives on ECT. It identifies several issues of stigmatization related to ECT and suggests that full recovery following ECT might be jeopardized due to both stigmatization and self‐stigmatization. The study suggests that most of the stigmatizing behaviors can be ascribed to (a lack of) available knowledge of and experience with ECT. What are the implications for practice?: Being aware of and listening to the needs of former ECT‐recipients seems essential to increase their treatment options and support care as well as a will to prioritize this patient group. For example, by addressing the potential stigma issues in follow‐up groups and helping to distribute sober, factual information about ECT in society. Providing written information and psychoeducation for patients and relatives before, during, and after ECT, in addition to supporting active use of diaries, might be valuable remedies for helping patients feel adequately informed and able to accept the pros and cons of ECT during and after treatment period. Abstract: Introduction: Electroconvulsive therapy (ECT) has existed worldwide for nearly 80 years. Although fast‐working and potentially life‐saving treatment, ECT is regarded as a strongly controversial treatment and stigmatization is frequently mentioned in relation to it. However, no systematic research in this area has taken place so far. Aim: The aim of this qualitative study was to explore the experiences and attitudes of former recipients of ECT and of experts professionally involved with ECT to identify potential stigmatization. Method: Two focus groups, one comprising four recipients of ECT and the other seven professional experts, were conducted. Data from each focus group were analyzed separately using a framework‐analysis. Results: The analysis yielded three major themes for the first focus group interview: ambivalent attitudes, discrediting and exclusion, and survival strategies and three major themes for the second focus group interview: dramatic depictions of ECT, an overlooked and rare treatment, and anti‐stigmatization strategies. Discussion and implications for practice: Stigmatizing attitudes and behaviors in relation to ECT are closely related to one's personal and factual knowledge, and there is a great need for multi‐facetted approaches if social acceptance and recognition are to be achieved. This study provides new knowledge on a scarcely examined area while also introducing suitable methods for anti‐stigmatization and empowerment. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: There are high rates of tobacco smoking in people living with mental illness, and rates are much higher than the general population. People living with mental illness experience high rates of cardiovascular disease and other physical health problems as a result of tobacco smoking. There is a lack of evidence on successful interventions for reducing the rates of smoking in people living with mental illness. What this paper adds to existing knowledge?: A meta‐synthesis of data from a number of studies to support mental health nurses to access data quickly and support the translation of findings into practice. Studies found staff working in mental health services expressed they did not have the confidence to adequately address smoking cessation for people living with mental illness. People living with mental illness would like support and encouragement support to help them achieve successful smoking cessation. People living with mental illness want support from mental health service staff to increase their confidence in smoking cessation rather than mainstream smoking cessation services. What are the implications for practice?: Existing evidence‐based interventions for smoking cessation has had limited impact on the smoking rates of people living with mental illness. Research is needed into innovative smoking cessation interventions and the service delivery of these interventions for people living with mental illness. Interventions to support people living with mental illness in smoking cessation could be part of mainstream mental health service delivery. Opportunities for smoking cessation training for mental health service staff could be provided. Abstract: Introduction: People with mental illness are up to three times more likely to smoke and experience greater challenges and less success when trying to quit and therefore have higher risk of smoking‐related morbidity and mortality. There is a lack of evidence on successful interventions to reduce the smoking rates in people living with serve mental illness. A meta‐synthesis was undertaken to summarize the data from multiple studies to inform the development of future smoking cessation intervention studies. Methods: MEDLINE, PsycINFO, Embase and CINAHL were searched in March 2017. A total of 965 titles and abstracts were screened for inclusion with 29 papers reviewed in full and 15 studies that met inclusion criteria. Included studies were assessed for quality using the Critical Appraisal Skills Programme tool. Key data across studies were examined and compared, and a thematic analysis was conducted. Results: Analysis and synthesis developed five analytical themes: environmental and social context, living with a mental health illness, health awareness, financial awareness and provision of smoking cessation support. Themes generated the interpretive construct: “Whose role is it anyway?” which highlights tensions between staff perspectives on their role and responsibilities to providing smoking cessation support and support service users would like to receive. Relevance to mental health nursing: Routine smoking cessation training for mental health professionals and research on innovative smoking cessation interventions to support people living with mental illness are needed. The Cochrane tobacco group has not found sufficient direct evidence of existing evidence‐based interventions that have beneficial effect on smoking in people living with mental illness. With this in mind, mental health professionals should be encouraged to engage in future research into the development of new interventions and consider innovative harm reduction strategies for smoking into their practice, to reduce the morbidity and mortality many people living with mental illness experience from tobacco smoking. [ABSTRACT FROM AUTHOR]

What is known on the subject?: There is very limited literature on the health of Middle Eastern immigrants in the United States, and the available studies were mostly conducted on small convenient samples in local communities.There is also a need to understand changes in the rates of serious psychological distress (SPD) during the 15 years after 2001, as there were negative effects on Arabs' health since the September 2001 aftermath. What does this paper add to existing knowledge?: The study examined the rates of SPD, the risk of SPD and its associated factors in a national sample of Middle Eastern immigrants in the United States from 2001 to 2015.The study found that serious psychological distress rate was high among Middle Eastern immigrants. Being a female and having obesity were associated with a higher risk of reporting serious psychological distress among this population. What are the implications for practice?: These outcomes necessitate mental health nursing interventions that provide culturally sensitive mental health care to immigrantsFor example, developing community‐based prevention programmes is required to address risk factors of psychological distress and to increase awareness about psychological distress among Middle Eastern immigrants. Introduction: While Middle Eastern immigrants are a fast‐growing population in the United States, there is very limited literature on their mental health. Most of the available studies were conducted on small convenient samples in local communities. Aims: To examine rates of serious psychological distress (SPD) and its associated factors among Middle Eastern immigrants in the United States, compared with US‐born, non‐Hispanic Whites. Methods: Data from the National Health Interview Survey (NHIS) from 2001 to 2015 were analysed. The survey included 1,246 Middle Eastern immigrants and 232,392 US‐born, non‐Hispanic Whites. SPD was measured by the Kessler‐6 psychological distress scale. Survey analysis procedures, sampling weights and variance estimates were conducted. Descriptive statistics and regression analyses were employed to examine differences and factors associated with SPD. Results: SPD rate was the highest among Middle Eastern immigrants (5.99%) between 2006 and 2010. Among Middle Eastern immigrants, being female and obese were significantly associated with a higher risk of SPD. Discussion: Middle Eastern immigrants in the United States suffered high rates of SPD. Gender and obesity were factors associated with SPD risk. Implications: These outcomes indicate the need for mental health nursing interventions that provide culturally sensitive mental health care to immigrants, such as developing community‐based prevention programmes. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The loss of a parent for an adult can be devastating and can impact other relationships.The adult, in absence of parental love and support, may question their own identity. What this paper adds to existing knowledge?: A narrative is used to explain the adults' experience of parental death and their new identity of being orphaned. What are the implications for practice?: Increased awareness for adults grieving the loss of a parent(s), as to the normalcy of feeling orphanedAdults grieving the death of a parent(s) are provided resources and support in addressing their grieving process. Introduction: When a parent dies during their child's adulthood, the life of the adult is altered as the familiarity of parental love and safety changes. The isolation and loneliness penetrates deeply as the orphaned adult must now navigate their world in absence of the most significant people in their lives, their parents. Aim: To assist persons affected by parental death in understanding the normalcy of feeling orphaned while grieving. Method: The use of a personal narrative to provide mental health support to others. Results: The resumption of a routine that existed before parental death is possible, but takes time. Intermittent periods of grief can occur throughout one's life. Discussion: When grief interrupts one's ability to function daily and the affected adult has relationships impacted by their parent's death, it is recommended that the adult seek mental health treatment. Implications for Practice: Narratives can be used with persons affected by parental loss, to provide an example of normal versus complicated grieving and identify when mental health treatment is needed. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine discrimination and resilience experiences of people who identify as transgender and establish potential health service responses. Background People who identify as transgender face many challenges in society in terms of the knowledge, understanding and acceptance of a person's gender identity. Design A narrative review of quantitative empirical research. Methods A comprehensive search of CINAHL, MEDLINE, Psyc INFO and Sociological Abstracts electronic databases from 2006-2016 was conducted. Results The search yielded 1,478 papers and following the application of rigorous inclusion and exclusion criteria a total of 19 papers were included in the review. The findings reveal that there is a need to ensure that the needs of transgender people are represented, fully integrated and clearly linked to outcomes that improve their health and quality of life. Conclusions Discrimination experiences can result in poorer health outcomes; however, many people have developed resilience and positive coping strategies. Relevance to clinical practice Nurses need to recognise and respond appropriately to the care and treatment needs of this population. Comprehensive nursing assessments and plans of care that encompass all aspects of the person should be in place supported by clear policy guidelines and evidence-based research. The education requirements of practitioners are outlined. [ABSTRACT FROM AUTHOR]

Aims and objectives To highlight different ways that healthcare professionals can promote health and reduce health inequalities of lesbian and bisexual women using a health promotion framework that focusses on the wider healthcare context. Background Lesbian and bisexual women experience numerous health disparities that place them at high risk of poor health outcomes. The Frieden health impact pyramid ( American Journal for Public Health, 100, 2010 and 590) identifies five tiers of public health interventions. This pyramid could be used to promote health in lesbian and bisexual women in healthcare settings. Design A discursive paper. Methods Literature was searched from 2008-2015 using PubMed, ScienceDirect and published grey literature. Individual key words were used to locate articles that focused on lesbian and bisexual women's health inequalities and to identify the interventions to address these. Results Examples are presented across the tiers of the health impact pyramid in the context of healthcare settings that healthcare practitioners could action to promote health in lesbian and bisexual women. Conclusions The use of the Frieden triangle offers an alternative way to promote health by conceptualising health promotion interventions that promote lesbian and bisexual women without just focusing on behaviour change. The importance of changing areas of practice in healthcare organisations to be more supportive of lesbian and bisexual women and their healthcare needs is highlighted. Relevance to clinical practice This study highlights the ways that healthcare professionals can promote health of lesbian and bisexual women within their healthcare practice to help reduce health disparities. [ABSTRACT FROM AUTHOR]

Accessible summary It helps people with mental illnesses to recover if they are not deprived of their rights of citizenship. The right to vote is an important marker of citizenship., Ensuring citizenship through the right to vote is especially important when someone is committed under mental health legislation, yet it is unclear how and whether this occurs in practice., This paper discusses what occurs for this population in Australia and overseas and reviews the role of capacity and supported decision making in the context of the right to vote., Solutions are offered for how mental health practice can protect the interest that Australians with mental illnesses have in voting., Abstract A central feature of recovery-based practice for people with mental illness is that they are able to exercise rights and experience membership of a community. This notion of citizenship is especially important when someone has had rights removed after being committed under mental health legislation. The right to vote is a central marker of citizenship. Supporting a person's right to vote is important for recovery-based practice. In this paper, we review the issue of voting for people who have been committed under mental health legislation, why it matters for recovery, and what occurs from the Australian and international perspective. We briefly review the concepts of capacity and supported decision making in the context of the right to vote. We also consider the usefulness of the American ' Doe Standard', which has been used with the Competency Assessment Tool ( CAT- V), to determine capacity to vote. Some solutions are offered that would protect the interest that Australians with mental illnesses have in voting. [ABSTRACT FROM AUTHOR]

Accessible summary This paper compares two post-modern methodological approaches, post-structuralist and narrative, and considers their usefulness in relation to emancipatory research in mental health., The paper finds that post-structural analyses can be useful in deconstructing oppressive practices and in indicating emerging forms of resistance., Narrative approaches potentially offer greater emancipatory scope than post-structuralism as they enable people with mental health problems to restore their lives and enact their own subjective transformation., However, narrative templates may perpetuate injustice if they erase the complexity of people's stories. This raises ethical issues in relation to narrative interpretation., Abstract Concerns with social justice have been traditionally associated with a modernist concept of the individual whose actions express an underlying, essential and unified self. This paper compares the usefulness of two methodologies (post-structuralist and narrative) that are based on a rejection of identity of a unified self and compares their usefulness in relation to the development of a social justice paradigm within mental health. It considers how professional forms of knowledge may be deconstructed by post-structural analyses, arguing that these have also been used by service users to articulate more enabling discursive alternatives. The notion of agency is central to our understanding of social justice. We question the commonly held assumption that although post-structuralism deconstructs power and challenges its legitimacy, it is nevertheless unsuited to facilitating the necessary agency to put forward viable alternatives. The second half of the paper considers how narrative research offers greater emancipatory potential by enabling the research subject to author their stories and thereby brings about their own subjective transformation. Nevertheless, the interpretation of people's stories by researchers may result in the imposition of narrative templates that erase complexities and contribute to the perpetuation of oppression. This raises ethical implications in relation to how people's stories are interpreted. [ABSTRACT FROM AUTHOR]

Aims To explore responses to indirect trauma reported by health professionals and to identify issues of potential salience for midwives. Background Indirect exposure to a traumatic event can lead to the development of distressing and potentially enduring responses. Little is understood about the impact that perinatal trauma exposure could have on midwives. Design An integrative review design was used. Data sources PsychInfo, Medline, PsychArticles, Web of Knowledge, CINAHL, MIDIRS and Scopus databases were search for papers published between 1980-November 2012. Review methods Studies providing quantitative or qualitative exploration of healthcare professionals' responses to indirectly experienced traumatic events were selected. Results Forty-two papers fulfilled the inclusion criteria. Four of these studies included professionals engaged in maternity care or exposed to traumatic perinatal events. Findings indicate evidence of intrusion, avoidance and arousal in healthcare professionals, with differing degrees of frequency. Empathy, work-related stress and the extent of professional experience were identified as associated with traumatic stress responses. Conclusions Evidence derived from healthcare professionals suggests that indirect exposure to the traumatic events of recipients of care can sometimes elicit traumatic stress responses. Factors increasing risk for traumatic stress were identified as empathy and organizational stress. These factors hold specific salience in midwifery. Responding to trauma in a midwifery context, as informed by findings from other healthcare professionals, could adversely affect midwives' well-being, care provided to women and contribute to an adverse organizational climate. Large-scale research considering the experiences of midwives is recommended. [ABSTRACT FROM AUTHOR]

Accessible summary Mental health nurses working in forensic services require a model to guide their practice although to date it is unclear which if any model is most appropriate., The Health Career Model is a guide for nurses to help them assess people with mental health problems so that they can help them with their physical, psychological and social needs and assist with any problems in their relationship with health, social and criminal justice services., This paper proposes that the Health Career Model should be used by forensic mental health nurses to guide their practice and to promote the recovery of people who are in their care., In order to maintain standards and improve their practice it is important that forensic mental health nurses structure their judgement and decision making with an evidence-based model and more research in this area is required., Abstract Forensic mental health nursing is increasingly recognized as a speciality of mental health nursing. Despite this, there are limited examples of theoretical models to underpin this specialism. This paper describes a conceptual framework known as the Hodges' Health Career - Care Domains - Model, hereafter referred to as the Health Career Model (HCM). Readers will learn of the model's origins, development, structure and content together with its application in forensic mental health nursing. Created in the 1980s, the model was developed in the North West of England by Brian E. Hodges. Overall, the purpose of the paper is to demonstrate the model's potential in forensic mental health nursing, its flexibility, adaptability and its increasing relevance to the problems of 21st century health, social care and well-being. Forensic nursing is discussed and the rationale for a nursing model is made. Hodges' model is introduced by explaining its original purposes, structure, its four knowledge (care) domains, its current status, publications and resources. The model's relevance and application in forensic nursing is explored, in particular the demands and unique constraints of this care environment as exercised upon service users, the multidisciplinary team, families, carers and other stakeholders. Future implications for research and recovery-orientated practice are discussed. [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?: Traumatic brain injury (TBI) has been linked to poor outcomes in terms of mental health, specifically, PTSD, depression and alcohol abuse.A lack of research evidence exists relevant to exploring the presence and implications of TBI in the police in the UK and globally, despite the elevated risk of physical and emotional trauma specific to policing. What does the paper add to existing knowledge?: The rate of traumatic brain injury is highly prevalent in a small sample of police officers.Traumatic brain injury is a major source of post‐concussion symptoms (physical, cognitive and emotional deficits) in police officers, which, in general, are associated with greater mental health difficulties and drinking alcohol to cope. What are the implications for practice?: Traditional mental health treatments should be supplemented with elements of concussion care to address any cognitive, emotional and physical issues due to head injury.Interventions should be made more accessible to those suffering from a mild brain injury. This can be done through regular reminders of appointments, pictograms and by providing a concrete follow‐up. Introduction: Police officers have a high risk of injury through assaults, road traffic incidents and attending domestic calls, with many officers developing post‐traumatic stress disorder (PTSD) as a consequence. Traumatic brain injury (TBI) is a common injury in populations involved in conflict and has been extensively linked to mental health difficulties. However, current research has not explored the frequency and sequelae of TBI in police populations, despite the elevated risk of physical and emotional trauma specific to policing. Aim: To explore self‐reported TBI, PTSD, post‐concussion symptoms, depression and drinking to cope in a small sample of UK police, to determine the frequency of these conditions and their relationships. Method: Measures of TBI, mental health, and drinking alcohol to cope were administered to 54 police officers from a Midshire Police Constabulary. Results: Mild TBI with loss of consciousness was reported by 38.9% of the sample. TBI was associated with increased post‐concussion symptoms (PCS). PCS were associated with greater severity of PTSD, depression and drinking to cope. Discussion: Exploring TBI in the police could identify a major factor contributing towards ongoing mental health difficulties in a population where, based on previous research, the implications of TBI should not be overlooked, highlighting the need for further research in this area. Implications for Practice: This research spans to identify the importance of routine assessment and increasing awareness within mental health services. Mental health treatments should be made amenable to a population with potential memory, planning and impulse control deficits. Further work in mental health services is needed to understand the level of ongoing issues that are due to post‐concussion symptoms and those that are due to other mental health difficulties, such as PTSD, thereby educating patients on the association between TBI and emotional difficulties. A graduated return‐to‐work plan should be developed to enable a safe transition back to work, whilst managing any ongoing symptoms. [ABSTRACT FROM AUTHOR]