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Purpose: Chronic mental illness disrupts the ability to work, often resulting in the need for vocational rehabilitation in which occupational therapists play a role. Namibia does not have an occupational therapy vocational rehabilitation practice framework for service users with chronic mental illness. This study explored the contextual factors that should be considered for a vocational rehabilitation practice framework in Namibia. Materials and methods: A qualitative collective case study design was utilized. In-depth interviews were conducted with nine mental health service providers that were purposively selected from two study sites. An inductive thematic analysis of data was done using ATLAS.ti. Results: The need for collaborative advocacy for service users to raise awareness and engage stakeholders such as family members, employers and policy makers was highlighted. Vocational rehabilitation resources needed include sheltered workshops, financial resources and trained human resources. Recognition that vocational rehabilitation services are too limited to meet the needs of mental health service users. A vocational rehabilitation policy and strategy is required. Supported employment and self-employment are potential strategies that should be considered. Conclusion: Vocational rehabilitation for service users with chronic mental illness is limited in Namibia and there is a need to collaboratively improve the service. IMPLICATIONS FOR REHABILITATION: Occupational therapists should collaboratively advocate for vocational rehabilitation of mental health service users in low-income and middle-income countries such as Namibia Occupational therapists should employ a human rights approach to vocational rehabilitation with emphasis on promotion of reasonable accommodation of service users in the workplace. [ABSTRACT FROM AUTHOR]

There is no consensus on the definition of recovery of people with psychosis. This may be attributed to the broad concept including clinical, functional and personal recovery domains and the diverse interests of stakeholders involved. We hypothesized that service users, informal caregivers and healthcare professionals would exhibit differences in prioritization, reflecting varying roles and viewpoints. Through an open online anonymous questionnaire, stakeholders shared their perspectives on most important aspects of clinical, functional and personal recovery and on facilitators and barriers of recovery. Stakeholder collaboration in study design and interpretation enhanced the study's robustness. The answers on open questions of respondents were categorized for statistical analyses to compare the answers between respondent groups on the different aspects of recovery. 226 stakeholders participated. While commonalities prevailed, distinctions emerged in recovery domain priorities. Service users and informal caregivers accorded equal importance to clinical, functional and personal recovery, whereas healthcare professionals emphasized clinical recovery. Regarding functional recovery, service users seemed to focus on practical issues while informal caregivers addressed the underlying causes. Disparities were notable in the role of healthcare that was considered as both a facilitator or a barrier to recovery, with informal caregivers prioritizing aspects of healthcare more frequently as most important than healthcare professionals. While commonalities prevailed, we identified several differences in prioritizing recovery domains among stakeholder groups. Awareness and understanding of these differences is crucial for effective communication and collaboration between stakeholders in recovery-oriented healthcare. The study underscores the need for ongoing dialogue between stakeholders. [ABSTRACT FROM AUTHOR]

Background: The concept of recovery in mental health has been extensively documented in the Western context. Yet, little is known about this concept in the Arab context, particularly in Jordan. Aim: The aim of this study was to explore the conceptuality of recovery in mental health from the perspectives of both Jordanian service users and their families. Methods: A qualitative descriptive design was used, and semi structured interviews were conducted with 16 service users and 16 family members, selected from three different mental health sectors in Jordan: Government, Military and University Sectors. The data were transcribed verbatim, translated into English, and then analyzed using an inductive thematic analysis approach. Results: Three main themes were identified as a result of the qualitative data analysis: (1) the definition of recovery implies functional recovery, (2) the definition of recovery implies symptomatic recovery, and (3) the definition of recovery from a religious perspective. Conclusions: The findings of the present study shed light on how recovery in mental health is perceived by service users and their families in the Jordanian context, and they generate insight into what to consider when targeting the development and implementation of recovery-supporting care within the mental health services (MHSs) in Jordan. [ABSTRACT FROM AUTHOR]

Research on patient safety in mental health settings is limited compared to physical healthcare settings. Recent qualitative studies have highlighted that patient safety is more than just physical safety but includes psychological safety. Traditionally, psychological safety has been defined as the belief that it is safe to take interpersonal risks, such as speaking up, without a fear of negative consequences. However, to date, it is not clear what constitutes psychological safety for service users of inpatient mental health settings. To understand this, we conducted 12 interviews with former inpatient mental health service users. Interviews were analysed with Reflexive Thematic Analysis, and five themes were developed. All themes had subthemes. Overall, we found that participants were more readily able to draw on situations where they felt psychologically unsafe, rather than safe. Psychological safety in service users was influenced by (1) healthcare staff attitudes and behaviours towards them, (2) their relationships with other service users, (3) whether they felt they had any control over their environment and medical decision‐making regarding their care, (4) their experiences of physically safety, feeling listened to and believed and (5) access to meaningful occupation on the wards. These findings suggest that changes are needed to enhance inpatient mental health service users' general experiences of psychological safety. Further research will need to (1) further develop understanding of the concept of psychological safety for service users and (2) identify interventions, and such interventions should be co‐designed with service users. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: The use of restrictive interventions is described as a violation of patients' rights and autonomy. It must only be used as a last resort to manage dangerous behaviour, to prevent or reduce the risk of mental health patients harming themselves or others.International mental health policy and legislation agree that when restrictive interventions are applied, the least restrictive alternative should be chosen. What the paper adds to existing knowledge?: The results are ambiguous, as to which restrictive intervention is preferred over others, but there are tendencies towards the majority preferring observation, with mechanical restraint being the least preferred.To make the experience less intrusive and restrictive, certain factors are preferred, such as a more pleasant and humane seclusion room environment, staff communicating during the application and staff of same gender applying the intervention. What are the implications for practice?: When applying restrictive interventions, mental health professionals should consider environment, communication and duration factors that influence patient preferences, such as the opportunity to keep some personal items in the seclusion room, or, when using restraint, to communicate the reason and explain what is going to happen.More research is needed to clarify patients' preferences regarding restrictive interventions and their views on which are the least restrictive. Preferably, agreement is needed on standard measures, and global use of the same definition of restrictive interventions. Introduction: The use of restrictive interventions is a violation of patients' rights that causes physical and psychological harm and which is a well‐known challenge globally. Mental health law and legislative principles and experts agree that when restrictive interventions are applied, the least restrictive alternative should be used. However, there is no consensus on what is the least restrictive alternative, especially from the patient perspective. Aim: To investigate the literature on mental health patients' preferences regarding restrictive interventions applied during admission to a psychiatric hospital. Method: An integrative review informed by the PRISMA statement and thematic analysis were undertaken. Results: There were tendencies towards patients preferring observation and, for the majority, mechanical restraint was the least preferred restrictive intervention. Factors such as environment, communication and duration were found to influence patients' preferences. Discussion: There is a lack of agreement on how best to measure patients' preferences and this complicates the choice of the least restrictive alternative. Nonetheless, our findings show that staff should consider environment, communication and duration when applying restrictive interventions. Implications for Practice: More research on restrictive interventions and the least restrictive alternative is warranted, but agreement is needed on standard measures, and a standard global definition of restrictive interventions. [ABSTRACT FROM AUTHOR]

Abstract Background The efforts of early psychosis intervention programmes can be impeded by difficulties in maintaining the engagement of service users. As disengagement is often an autonomous decision made by service users, the main aim of this study was to gain insight into the reasons for service user disengagement through qualitative interviews with the service users themselves, and caregivers as proxies or secondary informants. Methods Participants recruited for the study were enrolled in the Early Psychosis Intervention Programme in Singapore for at least a year, aged 21 and above, able to communicate in English, and had disengaged for at least three months. The recruitment and interview processes were conducted independently for service user and caregiver participants. Potential participants were invited to a face-to-face semi-structured interview over video call or in-person. Each interview spanned one to two hours, and comprised five phases – icebreaker, exploration of the participant’s experience with EPIP before deciding to disengage, discussion of reasons for disengagement, exploration of the post-disengagement experience, and feedback and suggestions for EPIP. Recruitment aimed to conclude after 10–15 participants were interviewed for both service user and caregiver groups, with the expectation that data sufficiency would be reached with no new themes being generated. Results Ultimately, 12 service user and 12 caregiver participants were recruited. There were six pairs of service user and caregiver dyads, where the caregivers interviewed were caring for service users also enrolled in the study. Valuable qualitative insights were gathered, including the type of disengagement, medication compliance during disengagement, the decision-making process behind disengaging, and circumstances surrounding re-engagement. A total of five categories each with subthemes were identified from the reasons for service user disengagement – individual factors, stigma, progression, treatment factors, and external factors. Conclusions There is a need to narrow down urgent areas of attention, aligning the study themes with established risk factors so that feasible solutions can be developed and appropriate care models can be adopted, to minimise adverse outcomes related to disengagement. It is important to keep an open mind to understand what personal recovery means to the individual service user, so that treatment goals can be better harmonised.

Abstract Background Human rights, recovery, and value-based approaches are integral to strategic changes and development in mental health care. Successfully integrating such person-centred values in mental health services requires a paradigm shift from traditional biomedical models of care to a more human rights-based approach. An important aspect of this is shared decision making (SDM) between mental health staff and service users. Whilst it is widely acknowledged SDM leads to improved outcomes, there are barriers and challenges to implementing this approach effectively in clinical practice. Objectives This systematic review aimed to assess existing empirical research exploring mental health service users and/or staff’s attitudes towards and experiences of SDM in adult mental health care settings. Methods The review and protocol were registered on PROSPERO (CRD42023369472). Systematic searches were run on four databases. Search terms pertained to studies reporting on mental health staff or service users’ experiences of SDM in adult mental health care. Initial searches yielded 721 results. Included studies were analysed using a meta-ethnographic approach. Results Thirteen articles were included. Data were synthesised using meta ethnographic synthesis, which produced four higher order themes with related subthemes; the role of service user ownership, the influence of fluctuating capacity, the importance of therapeutic alliance and changing clinicians’ behaviours and attitudes. Implications Both staff and service users found SDM to be an important factor in delivering high quality, effective mental health care. Despite this, participants had very little experience of implementing SDM in practice due to several personal, professional, and organisational challenges. This suggests that differences exist between what services strive towards achieving, and the experience of those implementing this in practice. These findings suggest that further research needs to be conducted to fully understand the barriers of implementing SDM in mental health services with training delivered to staff and service users about SDM.

Background: The efforts of early psychosis intervention programmes can be impeded by difficulties in maintaining the engagement of service users. As disengagement is often an autonomous decision made by service users, the main aim of this study was to gain insight into the reasons for service user disengagement through qualitative interviews with the service users themselves, and caregivers as proxies or secondary informants. Methods: Participants recruited for the study were enrolled in the Early Psychosis Intervention Programme in Singapore for at least a year, aged 21 and above, able to communicate in English, and had disengaged for at least three months. The recruitment and interview processes were conducted independently for service user and caregiver participants. Potential participants were invited to a face-to-face semi-structured interview over video call or in-person. Each interview spanned one to two hours, and comprised five phases – icebreaker, exploration of the participant’s experience with EPIP before deciding to disengage, discussion of reasons for disengagement, exploration of the post-disengagement experience, and feedback and suggestions for EPIP. Recruitment aimed to conclude after 10–15 participants were interviewed for both service user and caregiver groups, with the expectation that data sufficiency would be reached with no new themes being generated. Results: Ultimately, 12 service user and 12 caregiver participants were recruited. There were six pairs of service user and caregiver dyads, where the caregivers interviewed were caring for service users also enrolled in the study. Valuable qualitative insights were gathered, including the type of disengagement, medication compliance during disengagement, the decision-making process behind disengaging, and circumstances surrounding re-engagement. A total of five categories each with subthemes were identified from the reasons for service user disengagement – individual factors, stigma, progression, treatment factors, and external factors. Conclusions: There is a need to narrow down urgent areas of attention, aligning the study themes with established risk factors so that feasible solutions can be developed and appropriate care models can be adopted, to minimise adverse outcomes related to disengagement. It is important to keep an open mind to understand what personal recovery means to the individual service user, so that treatment goals can be better harmonised. [ABSTRACT FROM AUTHOR]

This article uses data from a doctoral thesis concerning service users' views on what works for them in relation to their mental health wellness following a suicidal ideation/attempt in Aotearoa New Zealand. In particular, it focuses on the experiences of service users regarding mental health crisis team responses and what they wanted from their crisis teams specifically. Participants indicated that what they wanted was to feel heard, respected and not judged, consistent with the core conditions of therapeutic alliance within such professions as social work, counselling and psychology. Social work has a valuable role to play in emphasising and advocating for social, contextual and non-medical responses within crisis teams and service delivery. [ABSTRACT FROM AUTHOR]

When people talk about their healthcare experience, compassion is often a common ingredient in the stories they share. After a decade of healthcare reforms and research on compassion, the experience of receiving compassionate care has been shown to be important to patients and their families. Yet, there is little guidance to inform compassionate practice in the context of providing mental health care. In this article, the authors suggest three things that mental health nurses can use in their practice to demonstrate compassion. [ABSTRACT FROM AUTHOR]

Recent attention to public service logic (PSL) has resulted in the creation of several theoretical guidelines for value creation. This empirical study applies PSL framework to explore how PSL is fit to and can adapt to the evolving landscape of the digitalization of public services. This research is based on 12 semi-structured interviews with managers of digital health services in Norway. Our results demonstrate that digital technology alters service users' involvement in value co-creation, helps solve capacity problems, empowers service users to take care of themselves, and cultivates several societal values but additional resources facilitating the co-creation process are needed. [ABSTRACT FROM AUTHOR]

Purpose: To access the attitudes of service users about the sharing of health records for research and to foster collaboration between municipal health services and the specialist health services in Norway. Methods: Members (n ≈ 2000) of the Norwegian mental health service users' organizations (SUO's), ADHD Norway, the Autism Association and the Tourette Association, representing Central Norway, participated in the study, (N = 108, 5.4% response rate). Descriptive statistics were used to evaluate distributions of responses to the questionnaire. Results: Service users reported being aware that municipal health services collaborate with the specialist health service (62%), with mental health care in the specialist health service (57%), and child and adolescent psychiatric services (61%). A large proportion of individuals were aware of the benefits of sharing their health records (93%), have trust in the use of data by health authorities (81%), and were willing to share records to benefit fellow patients (84%). Personal experience (69%) and impressions from mainstream media (55%) had the most influential impact on users' views of the Health Platform, an electronic health communication system. A majority of users had a negative perception of the Health Platform, even though some expect it to become a valuable tool in the future (50%). Conclusions: Service users are aware of and positive about benefiting others by sharing health records. They trust the health authorities, however, have negative attitudes about the Health Platform, apparently based on personal experiences and media influence. However, service users can see the potential usefulness of the Health Platform in the future. [ABSTRACT FROM AUTHOR]

Social work students' experience of supervision during practice learning or field education has a significant influence on their development. The value of service user participation in social work education, practice and research is increasingly acknowledged, however there is little consideration of its role in the supervision of students. Similarly, while service users are obvious stakeholders in practice education, this is seldom recognized. This Australian qualitative study examined if service user perspectives are integrated in social work student supervision. Field educators (FEs) and students were asked about the contribution of service user perspectives within supervision, how such perspectives might be integrated and the factors that inhibit or enhance their occurrence. Four main influences were identified: the purpose of supervision; the strategies used to integrate service user perspectives; the organizational context; and barriers and enhancers to integrating service user perspectives in supervision. The study concluded that the position of social work in relation to meaningful service user participation needs attention and that there is a gap between social work education and practice. [ABSTRACT FROM AUTHOR]

Background: Human rights, recovery, and value-based approaches are integral to strategic changes and development in mental health care. Successfully integrating such person-centred values in mental health services requires a paradigm shift from traditional biomedical models of care to a more human rights-based approach. An important aspect of this is shared decision making (SDM) between mental health staff and service users. Whilst it is widely acknowledged SDM leads to improved outcomes, there are barriers and challenges to implementing this approach effectively in clinical practice. Objectives: This systematic review aimed to assess existing empirical research exploring mental health service users and/or staff's attitudes towards and experiences of SDM in adult mental health care settings. Methods: The review and protocol were registered on PROSPERO (CRD42023369472). Systematic searches were run on four databases. Search terms pertained to studies reporting on mental health staff or service users' experiences of SDM in adult mental health care. Initial searches yielded 721 results. Included studies were analysed using a meta-ethnographic approach. Results: Thirteen articles were included. Data were synthesised using meta ethnographic synthesis, which produced four higher order themes with related subthemes; the role of service user ownership, the influence of fluctuating capacity, the importance of therapeutic alliance and changing clinicians' behaviours and attitudes. Implications: Both staff and service users found SDM to be an important factor in delivering high quality, effective mental health care. Despite this, participants had very little experience of implementing SDM in practice due to several personal, professional, and organisational challenges. This suggests that differences exist between what services strive towards achieving, and the experience of those implementing this in practice. These findings suggest that further research needs to be conducted to fully understand the barriers of implementing SDM in mental health services with training delivered to staff and service users about SDM. [ABSTRACT FROM AUTHOR]

Purpose: This article builds on the Practice Research Collaboratives (PRCs) as an initiative that developed from the Fifth Conference on Practice Research to provide a platform for practice researchers to engage actively around impact and influence. Research question: The unique features of research activities that enable transformational impact in three cases in social work practice research involving long-term community and university research partnerships. Methodology: Literature review and comparison of case studies. Results: The cases show how the processes of implementation are not only seen as linear, but constantly evolving at the same time as intervention fidelity in social work is crucial to improving outcomes for people, which can have transformative impacts for individuals and systems alike. Conclusion: We conclude by describing the importance of understanding the feasibility of complex problems and complex social situation which requires meaningful communication between partners, transparency and involvement of all players throughout the process. [ABSTRACT FROM AUTHOR]

Background and Hypothesis Cognitive health in schizophrenia spectrum psychosis has received substantial empirical attention in recent decades, coinciding with the development and implementation of interventions including cognitive remediation. Subjective experience in psychosis, including qualitative explorations of service user perspectives, has also proliferated; however, there is no available synthesis of service user representation in the psychosis cognitive health literature. This scoping review investigated prevalence and characteristics of qualitative research reporting service user perspectives across the extant research on cognitive health and related interventions in psychosis. Study Design We conducted a literature search on qualitative methods in cognitive health and/or related interventions across PubMed, Web of Science, and PsycInfo databases. The review followed the PRISMA-ScR guidelines for scoping reviews and identified 23 papers. Data extraction included study design and sample characteristics, qualitative methodology, and reporting. Study Results Of 23 articles, 18 reported on user experiences of interventions, most often in the context of feasibility/acceptability for otherwise quantitative trials. Five studies described service user experiences of cognitive health separately from interventions. Only 3 included any service user involvement or participatory methods. Twenty articles reported any demographic characteristics, and fewer than half (11) reported any racial or ethnic sample characteristics. There was substantial variability in qualitative methodology and reporting across studies. Conclusions Qualitative methodology is lacking in its representation and rigor across the cognitive health literature for schizophrenia spectrum psychosis. Additional inclusion of service user lived experience is critical for future research to better characterize cognitive health and inform interventions to promote recovery. [ABSTRACT FROM AUTHOR]

Objective To explore the views of social prescribing service providers on the barriers and enablers to recruitment of service users in social prescribing research.Design A qualitative study design, using semi-structured interviews with social prescribing service providers in the voluntary, community, faith, and social enterprise sector. Data were analysed using Thematic Framework Analysis.Results Ten interviews were conducted with service providers from five different social prescribing services. Three analytical themes were created. (1) What are you talking about?, related to service provider experiences of attempting to engage service users in social prescribing research, specifically confusion about the term social prescribing. (2) You’ve got a friend in me, focused on the positive impact of quality relationships between service providers and service users on recruitment. (3) No, no, no. Not today, reflected the experiences of service providers who reported that service users will often experience fluctuations in their mental and physical health, limiting their capacity to engage with structured research activity. Conclusions Key implications arising from this study is a need for more accessible and person-centred strategies for strengthening recruitment to, and participation in, social prescribing research. Increasing accessibility of research language (and information about participation), providing flexibility in recruitment methods, and conduct of research can also improve recruitment and retention. Service providers are vital for supporting engagement of service users in social prescribing research.

Abstract Background The COVID-19 pandemic has increased worldwide mental health conditions, substantially affecting the demand and provision of mental health services. To continue services and safeguard the health and well-being of mental health service users, service providers have responded to the pandemic with the adoption of remote services. The objective of our study was to identify and compare the promoters and challenges of the adoption of remote mental health services experienced by service users in Finland and the Netherlands during the COVID-19 pandemic with help of the FITTE framework. Methods The study adopted a qualitative descriptive approach, consisting of in-depth semi-structured interviews with mental health service users in Finland (n = 12) and the Netherlands (n = 13) during the COVID-19 pandemic. Qualitative content analysis with both inductive and deductive approach was utilized, and the extended FITTE framework was applied to identify the factors related to the fit between individual, task, technology, and environment that influenced the adoption of remote services. Results Overall, the adoption of remote mental health services during the COVID-19 pandemic involved several promoters related to easy access to mental health services, support for mental health and well-being, and benefits of the home environment such as not having to leave outside for services and having less risk of getting the corona virus. Most of the challenges were related to lack of non-verbal communication, difficulties with expressing oneself and interpreting others, technological issues, the organization of remote services, usability and suitability of services, affinity of the health professional with the provision of remote services, and the safety and security of remote services. Conclusions While remote services are accessible, support our well-being and mental health and protect us against the coronavirus, our findings also show that face-to-face contact was often indispensable when adopting mental health services. Therefore, the design of future mental health services should include both remote and face-to-face delivery. Further research should be done on blended approaches and on ways in which the challenges and development needs which emerged from this study can be tackled to improve remote mental health services.

Background: The COVID-19 pandemic has increased worldwide mental health conditions, substantially affecting the demand and provision of mental health services. To continue services and safeguard the health and well-being of mental health service users, service providers have responded to the pandemic with the adoption of remote services. The objective of our study was to identify and compare the promoters and challenges of the adoption of remote mental health services experienced by service users in Finland and the Netherlands during the COVID-19 pandemic with help of the FITTE framework. Methods: The study adopted a qualitative descriptive approach, consisting of in-depth semi-structured interviews with mental health service users in Finland (n = 12) and the Netherlands (n = 13) during the COVID-19 pandemic. Qualitative content analysis with both inductive and deductive approach was utilized, and the extended FITTE framework was applied to identify the factors related to the fit between individual, task, technology, and environment that influenced the adoption of remote services. Results: Overall, the adoption of remote mental health services during the COVID-19 pandemic involved several promoters related to easy access to mental health services, support for mental health and well-being, and benefits of the home environment such as not having to leave outside for services and having less risk of getting the corona virus. Most of the challenges were related to lack of non-verbal communication, difficulties with expressing oneself and interpreting others, technological issues, the organization of remote services, usability and suitability of services, affinity of the health professional with the provision of remote services, and the safety and security of remote services. Conclusions: While remote services are accessible, support our well-being and mental health and protect us against the coronavirus, our findings also show that face-to-face contact was often indispensable when adopting mental health services. Therefore, the design of future mental health services should include both remote and face-to-face delivery. Further research should be done on blended approaches and on ways in which the challenges and development needs which emerged from this study can be tackled to improve remote mental health services. [ABSTRACT FROM AUTHOR]

Telehealth is increasingly being adopted in mental health service delivery, particularly since the onset of COVID-19. However, the literature on the uses and applications of telehealth in mental health social work is still emerging, and a critical understanding of telehealth practice is vitally needed. This research explored how the use of telehealth impacts the practice of mental health social workers and what this means for service users. Ten semistructured interviews were undertaken with mental health social workers. It was found that although telehealth is becoming embedded into service delivery, there are implications for workload, training and support, and skills in reflexively adapting practice to ensure ethical practice when using telehealth technologies. Telehealth can align with the profession of social work if the practical benefits are clearly understood and the limitations of the approach are monitored and supported with adequate training and support.IMPLICATIONSTelehealth has many practical benefits for practice, but it presents a challenge for the relational skills social workers rely on for face-to-face practice.Social workers should be critically reflective on how telehealth can impact ethical practice.Training and support around the practical implications of telehealth for those implementing telehealth would be beneficial.Telehealth has many practical benefits for practice, but it presents a challenge for the relational skills social workers rely on for face-to-face practice.Social workers should be critically reflective on how telehealth can impact ethical practice.Training and support around the practical implications of telehealth for those implementing telehealth would be beneficial. [ABSTRACT FROM AUTHOR]

Cognitive behaviour therapy for psychosis (CBTp) should be offered to patients receiving psychiatric inpatient care, yet very little is known about patients' perspectives on this. The aim of this study was to examine patients' experiences of a CBTp‐informed intervention delivered in inpatient settings. We recruited 10 participants from the intervention arm of a randomised controlled trial examining the feasibility and acceptability of a CBTp‐informed intervention for psychiatric inpatient settings. We undertook semistructured interviews examining their experiences of the intervention and analysed them using thematic analysis. The study was conducted in partnership with a coproduction group of key stakeholders (people with lived experience, family and carers, and clinicians). The intervention was found helpful by almost all participants, and all participants would recommend it to others in similar situations to themselves. The results demonstrated that participants valued the therapist's professionalism and emphasised the importance of the therapeutic relationship. Participants highlighted the importance of the therapy focusing on navigating admission and developing skills to manage the crisis experience so they could return to their normal lives. Participants described challenges to having psychological therapy in the acute crisis context including therapy interruptions and ongoing distressing experiences of psychosis. The study demonstrated the importance of prioritising the therapeutic relationship, that therapy was a valued process to navigate admission and discharge, but that some environmental and patient‐level challenges were present. Further research is needed to explore inpatients' experiences of psychological interventions in this setting. Trial Registration: ISRCTN trial registry: ISRCTN59055607 [ABSTRACT FROM AUTHOR]

ABSTRACTWhen people talk about their healthcare experience, compassion is often a common ingredient in the stories they share. After a decade of healthcare reforms and research on compassion, the experience of receiving compassionate care has been shown to be important to patients and their families. Yet, there is little guidance to inform compassionate practice in the context of providing mental health care. In this article, the authors suggest three things that mental health nurses can use in their practice to demonstrate compassion.

Abstract Background While healthcare policy has fostered implementation strategies to improve inclusion and access of under-served groups to clinical care, systemic and structural elements still disproportionately prevent service users from accessing research opportunities embedded within clinical settings. This contributes to the widening of health inequalities, as the absence of representativeness prevents the applicability and effectiveness of evidence-based interventions in under-served clinical populations. The present study aims to identify the individual (micro), organisational (meso) and structural (macro) barriers to clinical research access in patients with comorbid alcohol use disorder and alcohol-related liver disease. Methods A focused ethnography approach was employed to explore the challenges experienced by patients in the access to and implementation of research processes within clinical settings. Data were collected through an iterative-inductive approach, using field notes and patient interview transcripts. The framework method was utilised for data analysis, and themes were identified at the micro, meso and macro levels. Results At the micro-level, alcohol-related barriers included encephalopathy and acute withdrawal symptoms. Alcohol-unrelated barriers also shaped the engagement of service users in research. At the meso-level, staff and resource pressures, as well as familiarity with clinical and research facilities were noted as influencing intervention delivery and study retention. At the wider, macro-level, circumstances including the ‘cost of living crisis’ and national industrial action within healthcare settings had an impact on research processes. The findings emphasise a ‘domino effect’ across all levels, demonstrating an interplay between individual, organisational and structural elements influencing access to clinical research. Conclusions A combination of individual, organisational and structural barriers, exacerbated by the COVID-19 pandemic, and the socioeconomic landscape in which the study was conducted further contributed to the unequal access of under-served groups to clinical research participation. For patients with comorbid alcohol use disorder and alcohol-related liver disease, limited access to research further contributes towards a gap in effective evidence-based treatment, exacerbating health inequalities in this clinical population.

Background: While healthcare policy has fostered implementation strategies to improve inclusion and access of under-served groups to clinical care, systemic and structural elements still disproportionately prevent service users from accessing research opportunities embedded within clinical settings. This contributes to the widening of health inequalities, as the absence of representativeness prevents the applicability and effectiveness of evidence-based interventions in under-served clinical populations. The present study aims to identify the individual (micro), organisational (meso) and structural (macro) barriers to clinical research access in patients with comorbid alcohol use disorder and alcohol-related liver disease. Methods: A focused ethnography approach was employed to explore the challenges experienced by patients in the access to and implementation of research processes within clinical settings. Data were collected through an iterative-inductive approach, using field notes and patient interview transcripts. The framework method was utilised for data analysis, and themes were identified at the micro, meso and macro levels. Results: At the micro-level, alcohol-related barriers included encephalopathy and acute withdrawal symptoms. Alcohol-unrelated barriers also shaped the engagement of service users in research. At the meso-level, staff and resource pressures, as well as familiarity with clinical and research facilities were noted as influencing intervention delivery and study retention. At the wider, macro-level, circumstances including the 'cost of living crisis' and national industrial action within healthcare settings had an impact on research processes. The findings emphasise a 'domino effect' across all levels, demonstrating an interplay between individual, organisational and structural elements influencing access to clinical research. Conclusions: A combination of individual, organisational and structural barriers, exacerbated by the COVID-19 pandemic, and the socioeconomic landscape in which the study was conducted further contributed to the unequal access of under-served groups to clinical research participation. For patients with comorbid alcohol use disorder and alcohol-related liver disease, limited access to research further contributes towards a gap in effective evidence-based treatment, exacerbating health inequalities in this clinical population. [ABSTRACT FROM AUTHOR]

This type of research is qualitative research. This research has the aim of knowing the perception of service users towards baggage labor services at Makassar port. The subjects of this study consisted of 308 service users. The method used in this research is a survey using a questionnaire given to service users. The data obtained were analyzed using qualitative descriptive analysis. The results of the descriptive analysis show that the perception of the safety aspect is in accordance with the percentage of 47.40%, the perception of the security / order aspect is in accordance with the percentage of 49.11, the perception of the reliability / order aspect is in accordance with the percentage of 42.66%, the perception of the comfort aspect is in accordance with the percentage of 49.15, the perception of the convenience aspect is in accordance with the percentage of 52.16%, the perception of the equality aspect, which is 50.78%. So, in conclusion, the perception of service users towards baggage labor services at Makassar Port is generally in the good category for all aspects. The choice of the majority of service users chose appropriate for the questions given, then very appropriate in second place. [ABSTRACT FROM AUTHOR]

Aims and method: Non-Western literature on the core competencies of mental health peer supporters remains limited. Therefore, we used a three-round Delphi study with peer supporters, service users (i.e. someone using peer support services) and mental health professionals to develop a core competency framework for peer supporters in the Chinese context. Results: The final framework included 35 core competencies, the conceptual origins of which were local (14.3%), Western (20%) and both local and Western (65.7%). They were grouped into five categories in ascending peer supporter role specificity: (1) self-care and self-development, (2) general work ethics, (3) work with others, (4) work with service users and (5) peer support knowledge. Clinical implications: A culturally valid mental health peer support competency framework can minimise role confusion and refine training and practice guidelines. In a Chinese context, peer supporters were valued as generic support companions, whereas functions highlighted in the West, such as role modelling, were perceived as less critical. [ABSTRACT FROM AUTHOR]

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The term 'service user' is an amorphous concept that can refer to a variety of groups. It refers to people who use or have used a service, or to the carers or parents of service users, or it can be used to refer to lay people, the public or non-professionals. It can also be used to refer to all or any combination of these. To maximise the potential of simulation, it is crucial to involve service users: their inclusion in the co-design of simulations, alongside patient educators and participatory decision-makers, provides invaluable input from a patient perspective. They also make an important contribution by portraying patients in the scenarios within which students interact, providing perspectives based on real-life experiences, offering students an insight into how patients could respond. Such an approach to designing simulations as part of nursing education will help develop professionals who are more patient-centred, culturally competent and more responsive to patient needs. [ABSTRACT FROM AUTHOR]

Minna Richards,1 Saija Inkeroinen,1 Jouko Katajisto,2 Sasu Muje,1 Heli Virtanen,1 Helena Leino-Kilpi1,3 1Department of Nursing Science, University of Turku, Turku, Finland; 2Department of Mathematics and Statistics, University of Turku, Turku, Finland; 3Turku University Hospital, Turku, FinlandCorrespondence: Saija Inkeroinen, Department of Nursing Science, University of Turku, Medisiina B, Kiinamyllynkatu 10, Turku, 20520, Finland, Email saanin@utu.fiPurpose: Feedback from service users is a valuable source for improving the quality of care and services, potentially reflecting the successes and failures in providing empowering healthcare. In supporting empowerment, the multidimensionality of knowledge of service users is assumed to be a crucial factor, yet feedback has not been explored from the perspective of empowering knowledge. In this study, the aim was to analyze the knowledge areas expressed in the service users’ feedback from the point of view of empowering knowledge.Patients and Methods: This was a retrospective study utilizing systematically collected service-user feedback from a feedback register of one university hospital district in Finland. Free-form feedback (n = 26,374) along with structured evaluative feedback was given by the patients themselves or their significant others, either by text message or using a feedback form, in 2019. The content of the feedback was analyzed according to the empowering knowledge areas (biophysiological, cognitive, functional, experiential, ethical, social, and financial), quantified, and analyzed statistically in relation to the background characteristics of service users.Results: Service users gave multidimensional free-form feedback about the knowledge and educational practices in care and services. In the free-form feedback, the most common empowering knowledge areas were biophysiological and cognitive ones, whilst experiential, ethical, social, and financial areas were the least common. The highest ratings of structured evaluative feedback were associated with the cognitive and ethical areas.Conclusion: Register-based feedback is systematic data for quality evaluation. In this study, service users seem to actively evaluate the knowledge procession in care and services, and therefore, they can be actors involved in developing the quality of educational practices. It does, however, indicate a need to add multidimensionality and improve the quality of the knowledge, and by that, advance the potential of empowerment among diverse service users.Keywords: empowerment, feedback, health information, hospitals, district, knowledge, patient satisfaction, service users

Summary This paper explores the potential for occupational therapists (OTs) to manage medicines and support patients in an in-patient psychiatric ward to effectively and safely self-administer their medication. Connelly House is an occupational therapy-led six-bed, open psychiatric rehabilitation in-patient ward supporting people transitioning from being in-patients to living in the community. Policy, process, governance and training needs are identified and discussed. Positive feedback was received from patients and staff involved with the service development, opening the door for OTs to manage medicines and support the self-administration of medication on other psychiatric rehabilitation in-patient wards using focused occupational interventions.

Abstract Background Individuals with serious mental illness (SMI) are more likely to experience functional decline, low well-being, comorbidities, shorter lifespan, and diminished quality of life than the general population. This qualitative study explores determinants of health that individuals with SMI perceive as important to their health, well-being, and ability to live a meaningful life. Method We conducted interviews with 13 individuals with early detected first episode psychosis as part of a 20-year follow-up study of a larger cohort. Interview data were analyzed using qualitative content analysis. Results Analysis identified two themes comprising eight categories representing determinants of health. The first theme reflected management of mental and physical health. Categories in this theme were: access to mental healthcare adapted to individual needs, strategies during deterioration, use of psychotropic medication, maintenance of physical health and lifestyle. The second theme reflected social health determinants in coping with mental illness and comprised three categories: family and friends, engaging in meaningful hobbies and activities, and the influence of employment on mental health. Conclusions Individuals with SMI outlined mental, physical, and social determinants of health that were important for their health, well-being, and ability to live a meaningful life. In future clinical practice, coordinated care addressing the complexity of health determinants will be important.

Background: There is limited research on what, when and how outcomes should be measured in psychological therapy trials in acute mental health inpatient wards. Objectives: This study aimed to consider what outcomes service users think are important to measure. Methods: This qualitative study explored the views of 14 participants, who had an inpatient admission within the last year, on outcomes of psychological therapies using semistructured interviews. Data were analysed using thematic analysis from a critical realist perspective with both inductive and deductive coding. Results: The 126 outcomes that were important to participants were mapped onto an established taxonomy of outcomes across different health areas and the socioecological framework to consider the wider context and help summarise the outcomes. Most of the outcomes were mapped to the intrapersonal and interpersonal level. In addition to the outcome mapping, three themes were constructed from the qualitative data: (1) I am not a problem I am a person, (2) Feeling cared for and loved, (3) What does getting better look like. Conclusions: Our results highlight the need for patient‐reported outcomes which are cocreated with service users, disseminating research and training on preventing dehumanising experiences, enhancing psychological safety and therapeutic relationships and improving access to psychological therapy. Patient or Public Contribution: The wider People with Personal Experience Involvement Committee at the University of Bath were consulted which included a focus group during the early planning stages. We also collaborated with a person with personal experience, at every stage of the research. This included developing our research question and aims, protocol, participant documents (e.g., information and debrief forms), advertisement and recruitment strategy, interview topic guide, the codes, the final themes and quotes and reviewing the manuscript. People with lived experience of being admitted to an acute mental health inpatient ward participated in our study. [ABSTRACT FROM AUTHOR]

Introduction: Service users are increasingly participating in health research. Although collaborative research is assumed to give users a sense of psychological ownership, little is known about the specific psychosocial processes through which ownership develops and is displayed. The present study yields insight into a process in which service users, researchers and a website designer collaborated to design a website. Aim: The aim of this study was to explore how participants developed and displayed feelings of ownership during a collaborative process to design a website. Methods: A case study design was adopted by which audio recordings were subjected to thematic analysis and interpreted by drawing on the concept of psychological ownership. Findings: A sense of psychological ownership of the website design process emerged in two distinct and overlapping phases. In the first phase, 'sense of ownership during the early design phase', only researchers and the website designer displayed a sense of ownership, which was facilitated by the research context preceding the collaborative workshops. In the second phase, 'sense of ownership during the collaborative design phase', service users gradually started to develop parallel feelings of ownership that were facilitated by workshop design activities. These activities enabled service users to increasingly control the process, to invest themselves in the process and to gain intimate knowledge of the process and its outcome. Service users' sense of ownership was displayed in their statements about the website and its elements. Conclusion: Participants engaged in codesign processes may develop a sense of psychological ownership at different speeds because of contextual factors. It is important to take this into account as it may complicate the formation of egalitarian work groups. Patient and Public Contribution: Parents of children with suicidal behaviour and a counsellor participated as service users in a website design process. [ABSTRACT FROM AUTHOR]

The literature on youth work emphasises the importance of ‘relationship’ to good practice, moreover, the characteristics of the youth-work relationship have been posited as a defining feature of youth work in the British-influenced tradition. Despite this, little attention is paid to the choice of language used to describe how professional youth workers relate to young people, or how language choices reflect political framing of youth work and of power relationships within their practice. Language choice has implications for how youth workers perceive their professional identity, for how accountability is construed, and for inter-professional working. In this article we undertake a thematic analysis to identify, analyse and critique various language options, drawing on international literature, with an application focus on Irish and Australian contexts. We address the question, ‘what language choices offer most precision and clarity about youth work professional relationships in different contexts?’ We identify three main ways the relationship between youth workers and young people has been framed: as collaboration; as transaction; or, as rights-based entitlement. We conclude with discussion of how different relational language choices in youth work should be selected to be congruent with the youth work context, power relationships and purposes. [ABSTRACT FROM AUTHOR]

In the context of increasing regulation of social workers internationally, this study examines allegations made to a UK social work regulator, the Northern Ireland Social Care Council (NISCC), by service users and carers. A retrospective review of 134 records relating to such allegations during the ten-year period 2006–2015 was undertaken, representing just over one-third (36.4 per cent) of all allegations received. Allegations were made primarily about family and child-care social workers (91.0 per cent) and reflected the four inter-linking categories of concerns about the honesty of social workers, reports that service users/carers were treated unequally, allegations that social workers failed to demonstrate respect in their interactions with service users/carers, and concerns about technical aspects of social workers' practice. The nature of these allegations forms the acronym HURT that describes both the experiences of service users/carers and the stressful context in which social workers practice. This article concludes that addressing the stress and HURT of both parties is important and makes suggestions regarding how the findings can strengthen the role of the regulator, influence social work practice and empower service users and carers. [ABSTRACT FROM AUTHOR]

There is national recognition that the participation of the public in educational curricula of health professionals benefits all. Feedback from both service users and students confirms that collaborative working should be considered as best practice, particularly in healthcare education. The evidence suggests that these developing models of educational delivery can lead to a change in health professionals' perceptions, enhancing practice that may be far reaching and helping to support future service delivery. [ABSTRACT FROM AUTHOR]

This study examined and reflected on the frequency of people with psychotic symptoms and features as the target population in design studies for mental health care innovation. [ABSTRACT FROM AUTHOR]

The study investigated the influence of the humanistic orientation on the perspectives of service providers working with individuals with intellectual and developmental disabilities (IDD) and the self‐evaluation of service users. The humanistic orientation, which emerged in the 1990s, emphasizes the rights of people with IDD to lead a meaningful life based on their personal needs and desires. However, challenges persist as some service providers prioritize the acquisition of normative life skills over fostering autonomy. The study was based on quantitative methodology and included 61 service providers and 95 of their service users. The study's findings indicate that the humanistic orientation was endorsed by nearly one half of the service providers compared with one third who endorsed a medical orientation. Those endorsing a humanistic orientation also reported that their service users had higher levels of efficacy than those with a medical perception of IDD. Positive correlations were found regarding the assessments made by service providers and their service users on self‐efficacy. Findings suggest that a humanistic orientation encourages optimism among service providers and a positive dyadic interaction between providers and users. It is suggested that the humanistic orientation be applied as a guiding principle underlying the daily support provided to adults with IDD. [ABSTRACT FROM AUTHOR]

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

Abstract Objective To understand how materiality affects patient and public involvement (PPI) for commissioning and leading health and care services in the English National Health Service (NHS) context. Context From April 2013 groups of general practitioners (GPs) became members of NHS clinical commissioning groups (CCGs) to assess needs and procure core health services for and with local communities. Since July 2022, integrated care systems (ICSs) have subsumed this responsibility. NHS reorganisations have been driven by the promise of more effective and efficient health care and have led to a long history of PPI on economic, political, and moral grounds. Few studies researching PPI in clinical commissioning exist and fewer still have explored a more agentic understanding of materiality and its impact on PPI. Study Design A focused ethnography was used to examine PPI for clinical commissioning within two CCG case study sites in England. Three CCG Governing Body lay representatives, nine GP commissioners and seven service user representatives took part in focus groups and/or were interviewed. Fifteen nonparticipant observations were also carried out at CCG meetings and the associated materiality was examined. Findings The materiality of activities involved in clinical commissioning influences and shapes the nature of PPI. These forms of materiality may dilute and subvert meaningful engagement and involvement that relies on trust, leadership, learning, and partnership working. Conclusion System leaders in ICSs should consider the significance of materiality in centrally driven processes involved in PPI commissioning to reduce barriers and ensure meaningful partnerships within local communities. Patient and Public Contribution The study design ensured PPI throughout the research process in keeping with contemporary research practice guidance. The project steering committee included service users with current or recent PPI clinical commissioning experience outside of the study sites. There was PPI involvement in the original study proposal and its development including the bid for doctoral funds on which this study is based. All were involved in assessing the rigour of the data collection, interpretation of the findings and ensuring the project remained true to the aims of the study. Two members have also participated in presentation of the study findings.

Under standard care, psychotic disorders can have limited response to treatments, high rates of chronicity and disability, negative impacts on families, and wider social and economic costs. In an effort to improve early detection and care of individuals developing a psychotic illness, early intervention in psychosis services and early detection services have been set up in various countries since the 1980s. In April 2016, NHS England implemented a new ‘access and waiting times’ standard for early intervention in psychosis to extend the prevention of psychosis across England. Unfortunately, early intervention and early detection services are still not uniformly distributed in the UK, leaving gaps in service provision. The aim of this paper is to provide a business case model that can guide clinicians and services looking to set up or expand early detection services in their area. The paper also focuses on some existing models of care within the Pan-London Network for Psychosis Prevention teams.

Small financial incentives have been proven effective at promoting healthy behaviours across medicine, including in psychiatry. There are a range of philosophical and practical objections to financial incentives. Drawing on the existing literature, specifically attempts to use financial incentives to promote antipsychotic adherence, we propose a ‘patient-centred’ view of evaluating financial incentive regimes. We argue that there is evidence that mental health patients like financial incentives, considering them fair and respectful. The enthusiasm of mental health patients for financial incentives lends support to their use, although it does not invalidate all objections against them.

The purpose of this article is to understand and analyze the legal liability of PT. Pos Indonesia (Persero) Sirah Pulau Padang District and Kayuagung City regarding loss of goods of service users. normative legal research, which focuses on the analysis of applicable legal theories and regulations. The research method used is empirical juridical with primary and secondary data sources. The research results showed that there were several cases of lost goods at PT. Pos Indonesia area. PT. Pos Indonesia, based on its internal regulations and policies, has an obligation to provide compensation to service users in the event of loss of goods. However, the compensation claim process often experiences obstacles and often causes customer dissatisfaction. The recommendation from this research is the need to improve the compensation claim mechanism and increase the quality of service so that public trust in PT. Pos Indonesia can be maintained.

Quality of life (QoL) is a widely recognized and valuable social outcome measure in drug treatment and rehabilitation services, but the discrepancies in QoL perceptions between service users and providers remain under-explored. In this study, semi-structured interviews were conducted with service users (n = 22) and providers (n = 29) to capture their perceptions of QoL and explore the similarities and discrepancies between their views. A thematic analysis and contrast exploration revealed a shared understanding of QoL that extends beyond health to six dimensions and prioritizes empowerment and connection. However, divergent views emerged regarding the priorities of material conditions, emotional well-being, and physical health. Findings underscore the importance of using shared decision-making as a strategy to effectively address these discrepancies and promote a more patient-centered approach in treatment and rehabilitation services. [ABSTRACT FROM AUTHOR]

Much of the discussion on the ethics of the framing of service users in fundraising and marketing materials focuses on the ethical dilemma of whether the means of using negative framing and negatively‐framed images—which it is argued are more effective at raising money—justify that end if they cause harm by stereotyping and "othering" the people so framed, rob them of their dignity, and fail to engage people in long‐term solutions. Attempts to find the right balance between these two ethical poles have proved elusive. This paper posits a new ethical solution by removing these two poles from the equation and making the ethicality of fundraising frames contingent on the voice and agency of service users/contributors to tell their own stories and contribute to their own framing: as the Niger proverb says, "a song sounds sweeter from the author's mouth." [ABSTRACT FROM AUTHOR]