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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? Nationally and internationally there has been a movement away from the traditional medical model towards a more holistic recovery-oriented approach to mental health care delivery., At every level of service provision the emphasis is firmly on recovery and on facilitating active partnership working and involvement of service users, their carers and family members., What this paper adds to existing knowledge? This is the first study to identify on a national level specific areas of care that are addressed most or least by psychiatric and mental health nurses in care planning for mental health service users in Ireland., In addition, this is the first study to identify nationally how the recovery approach is being implemented by psychiatric and mental health nurses in relation to current recovery-orientated policy., What are the implications for practice? Mental healthcare staff require more education on the recovery concept and this needs to be multidisciplinary team wide. Further research is required to establish how best to develop a shared approach to working with service users and their families within the mental healthcare environment., Further investigation is required to help determine how funding could be allocated appropriately for education and training and service development nationally., Abstract Introduction The restructuring of national mental health policy to an integrated recovery ethos demands a clarification in the psychiatric/mental health nurse's role, skills and competencies. Aim/Question To explore the psychiatric/mental health nurse's role and identify skills, competencies and supports required to adopt recovery-orientated policy in practice. Method An exploratory mixed methods study in multiple health services in Ireland with N = 1249 psychiatric/mental health nurses. Data collection used a survey, focus groups and written submissions. Data analysis used descriptive statistics and thematic analysis. Results The medical profession use a symptom-focused approach to mental healthcare delivery. Nurses viewed this as a primary inhibitor to recovery-orientated practice. Professional development in prevention and earlier intervention within primary care environments requires development. Nurses require research support to measure the effectiveness of the mental health interventions they provide. Implications and conclusion The effective implementation of the recovery approach requires a multitude of strategies and narrative threads in an overall medical assessment. Nurses need support from medics in providing consistency of assessments/documentation of required psychosocial interventions. A greater range of specialist services provided by nurses including psychosocial interventions and health promotion is fundamental to quality care and improving service user outcomes in primary care. [ABSTRACT FROM AUTHOR]

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

Accessible summary The aim of the study was to elicit the views and opinions of transgender people in relation to mental health concerns., Four people who identified as transgender participated in semi-structured interviews., The main results showed that challenges existed for people around mental health issues., Mental health nurses can play a key role in the provision of psychosocial supports to transgender people and their families., Abstract Government policy makers are becoming increasingly interested in the views and experiences of people who utilize mental health services to inform rights-based and socially inclusive health and social care initiatives. However, very little information exists in the available literature about transgender people in this regard. The current research was part of a larger mixed methods study that used surveys and in-depth semi-structured interviews. This paper reports on the findings from the interview data that relate to the unique mental health experiences of the people whom identified as transgender ( n = 4). The data were subject to thematic analysis, and the main themes that emerged included service experiences, treatment issues, other supports, and hopes and aspirations. Participants identified challenges and opportunities for enhancing mental health service provision for transgender people and their families. Some of the highlighted concerns related to practitioner attributes and relevant psychosocial supports. Mental health nurses are well placed to use their knowledge and therapeutic skills to support people who identify as transgender and significant people in their lives. [ABSTRACT FROM AUTHOR]

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Aims and objectives: To explore barriers to midwives and nurses addressing mental health issues with women during the perinatal period. Background: Perinatal mental health is considered an important public health issue with health policy internationally identifying the importance of psychological support for women in the perinatal period. Midwives and primary care nurses are ideally positioned to detect mental distress early, but evidence suggests that they are reluctant to discuss mental health issues with women during pregnancy or in the postnatal period. Design: The research used a descriptive design. Methods: A total of 809 midwives and nurses completed an anonymous, online or hard copy survey. Designed by the research team, the survey listed 26 potential barriers to the provision of perinatal mental health care. Results: Participants identified organisational factors as presenting the greatest barriers. Organisational barriers included lack of perinatal mental health services, absence of care pathways, heavy workload, lack of time, lack of privacy and not seeing women regularly enough to build a relationship. Over 50% of participants identified practitioner‐related barriers, such as lack of knowledge on perinatal mental health and cultural issues; lack of skill, in particular, skills to respond to a disclosure of a mental health issue; and fears of causing women offence and distress. Findings also indicated that the context of care and education influenced the degree to which participants perceived certain items as barriers. Conclusions: Midwives and primary care nurses encounter many organisational‐ and practitioner‐related barriers that negatively impact on their ability to incorporate mental health care into their practice. Relevance to clinical practice: Midwifery and nursing services need to develop strategies to address system‐ and practitioner‐related barriers, including the development of services and care pathways, and the provision of culturally sensitive education on perinatal mental health in order to support practitioners to address issues with confidence and competence. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore public health nurses’ engagement, competence and education needs in relation to perinatal mental health care in Ireland. Background: It is estimated that 15%–25% of women will experience a mental health problem during or postpregnancy, either as a new problem or a reoccurrence of a pre-existing problem. Public health nurses, or their equivalent, are ideally positioned to support women’s mental health and improve health outcomes for the woman and baby, yet little is known about their role and engagement with mental health issues, other than with postnatal depression. The objectives of the study were to identify public health nurses’ knowledge, skills and current practices in perinatal mental health and establish their education needs. Design: The research used a descriptive design. Method: A total of 186 public health nurses completed an anonymous, online survey, designed by the research team. Results: While public health nurses are positive about their role in supporting women’s mental health, they lack the knowledge and skills to address all aspects of mental health, including opening a discussion with women on more sensitive or complex issues, such as trauma and psychosis and providing information to women. Those who received education reported statistically significant higher knowledge and confidence scores than those without. Conclusion: Public health nurses lack the knowledge and skills required to provide comprehensive perinatal mental health care to women. Future education programmes need to move beyond postnatal depression and address the range of mental health problems that may impact on women in the perinatal period. Relevance to clinical practice: Without knowledge and skill among nurses in all aspects of perinatal mental health, women with significant mental health needs may be left to cope alone and lack the necessary prompt evidence-based interventions and supports. [ABSTRACT FROM AUTHOR]

Aim This study aimed to identify levels of depressive symptoms, social and personal college adjustment and peer support among nursing and midwifery students. Background Student mental health is of international concern, particularly among students who are undertaking professional qualifications in health care. Design Cross-sectional design. Methods Data were collected in 2013 using the Centre for Epidemiology Depressive Symptoms Scale, two subscales of the Student Adaptation to College Questionnaire; and a subscale of the Peer Support Evaluation Inventory with 417 students in Ireland. Results Findings indicated that 34% of participants experienced depressive symptoms, 20% were poorly personally adjusted and 9% poorly socially adjusted. Most students had good levels of peer support. Statistically significant relationships were found between all key variables. Students in their second year of study had significantly higher rates of depressive symptoms. Participants who reported having poor relationships with their fathers were at higher risk and had more difficulties personally and socially adjusting to university life and study. The alcohol consumption of participants had a statistically significant relationship with depressive symptoms with higher consumption rates having a positive impact on symptoms. Conclusion The mental health of undergraduates undertaking professional healthcare studies needs to be a key research, educational and clinical priority. High rates of adjustment and mental health difficulties, particularly in the second year of the programme need to be examined and more effective interventions developed. [ABSTRACT FROM AUTHOR]

Accessible summary Despite increasing focus on researching users' experiences of mental health provision, there are few studies which report adolescents and parents' experiences of attending child and adolescent mental health clinics in Ireland., We found that a lack of information and availability of services made it difficult for participants to access help. They want to be included in information sharing and decision making, but adolescents in particular felt that their voices were not heard in the decision-making process., Frequent staff changes were particularly difficult for adolescents as they need consistent relationship with a key professional to build trust and disclose thoughts and feelings., Provision of flexible consultations (both single and shared), with sensitivity to the differing perspective of adolescents and parents, coupled with inclusion in information sharing and decision making would significantly improve the experience for adolescents and parents., Abstract Service user involvement is essential for quality care in the Child and Adolescent Mental Health Services ( CAMHS). This study was conducted to explore adolescents' and parents' experiences of CAMHS in relation to accessibility, approachability and appropriateness. This study used a descriptive qualitative design, and focus groups and single interviews were conducted with adolescents ( n = 15) and parents ( n = 32) from three mental health clinics. Data were analysed using thematic analysis. Accessing mental health services was a challenging experience for many parents and adolescents due to knowledge deficit, lack of information and limited availability of specialist services. Some parents and adolescents reported positive experiences while others reported negative experiences. They expressed a need for more information, involvement in decision making, flexible scheduling of appointments, school support and parent support groups. The nature and quality of the relationship with staff was critical to positive experience with the service; therefore, frequent changes of medical staff was disruptive. Mental health nurses can play a vital role in ensuring continuity, assessing adolescents' participation preferences and advocating for their information needs with other members of the interdisciplinary team. [ABSTRACT FROM AUTHOR]

higgins a., callaghan p., devries j., keogh b., morrissey j., nash m., ryan d., gijbels h. & carter t. (2012) Evaluation of mental health recovery and Wellness Recovery Action Planning education in Ireland: a mixed methods pre-postevaluation. Journal of Advanced Nursing 68(11), 2418-2428. Abstract Aim. To report a study evaluating the effectiveness of a Wellness Recovery Action Planning education programme. Background. Internationally, mental health policy is advocating using recovery approaches to care. Underpinning these approaches is investment in education in recovery principles and methods and a need to provide evidence of the impact of this education. Design. The study design employed a mixed methods approach. Methods. Using questionnaires and focus groups, we evaluated 2- and 5-day Wellness Recovery Action Planning Education Programmes and assessed participants' attitudes towards recovery, knowledge of recovery and Wellness Recovery Action Planning beliefs. Data were collected between 2009 and 2010. Participants were people with personal experience of mental health problems, practitioners in mental health services and family members/carers of those with mental health problems. Results. Comparing the pre and postmeasures showed that the programme increased participants' knowledge of and attitudes towards recovery and Wellness Recovery Action Planning. Although this increase was statistically significant for the 2-day programme, it was not so for the 5-day programme. Participants reported being very positive and enthusiastic about the programme and the benefits they had achieved personally and professionally as a result of participating. Conclusions. This exploratory study shows that providing mental health practitioners and people with personal experience of mental health problems with a systematic education and training in recovery principles using the Wellness Recovery Action Planning approach leads to positive changes in people's knowledge, skills and attitudes towards recovery. This education appeared to inspire, invigorate and empower people, and for many, it was a life changing experience. [ABSTRACT FROM AUTHOR]

Aims and objectives. To test the validity and reliability of the newly developed Irish Nursing Minimum Data Set for mental health (I-NMDS (MH)) to ensure its clinical usability. Background. Internationally, difficulties exist in defining the contribution mental health nursing makes to patient care. Structured information systems, like the Nursing Minimum Data Set, have been developed internationally to gather standardised information to increase the visibility of nursing in the health care system. Design. This study employed a quantitative, longitudinal research design. Method. A convenience sample of mental health nurses ( n = 184) collected data on the nursing care of patients ( n = 367) from care settings attached to 11 hospitals across Ireland. Exploratory factor analysis (EFA), ridit analysis and Cronbach’s alpha coefficient were used to establish the construct and discriminative validity and scale score reliability of the I-NMDS (MH). Results. Goodness of Fit scores indicated that the I-NMDS (MH) possesses good construct validity. Alpha coefficients for each factor were above the recommended 0·7 level. Ridit analysis inferred that the I-NMDS (MH) discriminated between elements of nursing care across acute inpatient and community based care settings. Conclusions. The I-NMDS (MH) possesses a sound theoretical base, has scale score reliability and possesses good discriminative validity. The valid and reliable I-NMDS (MH) is the first NMDS to be developed specifically for mental health. Relevance to clinical practice. Data collected using the I-NMDS (MH) will increase the visibility of the contribution mental health nurses make to healthcare delivery. In addition, it will support evidence based practice in mental health to improve further the effectiveness of nursing care in the future. [ABSTRACT FROM AUTHOR]