COVID-19 under the SARS Cloud: Mental Health Nursing during the Pandemic in Hong Kong.

The author reviewed the literature published since 1972 concerning restraint and seclusion. The review began with a computerized literature search. Further sources were located through citations from articles identified in the original search. The author synthesized the contents of the articles reviewed using the categories of indications and contraindications; rates of seclusion and restraint as well as demographic, clinical, and environmental factors that affect these rates; effects on patients and staff; implementation; and training. The literature on restraint and seclusion supports the following. 1) Seclusion and restraint are basically efficacious in preventing injury and reducing agitation. 2) It is nearly impossible to operate a program for severely symptomatic individuals without some form of seclusion or physical or mechanical restraint. 3) Restraint and seclusion have deleterious physical and psychological effects on patients and staff, and the psychiatric consumer/survivor movement has emphasized these effects. 4) Demographic and clinical factors have limited influence on rates of restraint and seclusion. 5) Local nonclinical factors, such as cultural biases, staff role perceptions, and the attitude of the hospital administration, have a greater influence on rates of restraint and seclusion. 6) Training in prediction and prevention of violence, in self-defense, and in implementation of restraint and/or seclusion is valuable in reducing rates and untoward effects. 7) Studies comparing well-defined training programs have potential usefulness.

Skellern Lecture and the Journal of Psychiatric and Mental Health Nursing Lifetime Achievement Award 2015.

Mental health and psychiatric nurses are considered important and integral members of the multidisciplinary mental health care team offering 90% of mental health services in Kenya. Stigma towards mental health nursing practice has led to acute shortage in mental health nursing workforce and consequently poor quality of mental health care. Aim : to assess the correlates of stigma towards mental health nursing practice among Bachelor of Science Nursing students. Research Method : Cross-sectional study was conducted among 90 Undergraduate nursing students at the Universities of Nairobi and Eastern Africa-Baraton. Only students who had completed and passed both theory and clinical experience in mental health nursing course were selected for the study. A structured questionnaire and focus group discussion were used. Ethical approval was sought form the UON/KNH ERC. Data Analysis : The SPSS version 22 was used to analyze the quantitative data whereas the qualitative data from the focus group discussion were analyzed using deductive approach. The correlates were tested using chi-square test and at a P-Value of ≤ 0.05. The final data presented using frequency distribution tables, pie charts, graphs. Findings : Stigma in mental health nursing practice stands at 85.6% (N=87). Marital status significantly correlated with stigma towards mental health nursing practice p=0.04 (χ2 = 7.731). Belief that mental illness is due to demonic possession, shorter clinical placement, a motivation by the course lecturers and poor environment of practice correlated significantly with stigma towards mental health nursing practice. Recommendations : Improve minimum clinical placement hours, over emphasize on psychopathology of mental disorders, encourage thorough orientation of students in clinical area upon arrival. Dissemination : Results will be delivered in scientific conferences, the schools of nursing and to policy makers in mental health care to guide policy development.

Mental health, mental illness, or some of each? The need for care with the use of language

Mental health and addiction services in the criminal justice system: Where do we sit?

Nurses suffering in silence: Addressing the stigma of mental health in nursing and healthcare.

Knowledge about the practice and roles of mental health nurses in New Zealand is currently limited. In a sociopolitical climate where the views of users of mental health services are increasingly incorporated into education and the planning and delivery of services, there is a need for research that reflects the perspective of users. In this study a qualitative descriptive methodology with focus group interviews was used to explore with users of mental health services, the attitudes, knowledge and skills that they need in mental health nurses. Users of mental health services valued the therapeutic work of mental health nurses, and identified positive attitudes towards users of mental health services as essential in mental health nurses. However, they did not consistently experience a therapeutic approach in their interactions with mental health nurses.

There is a raft of policy guidelines indicating that mental health nurses should be increasing the social inclusion of mental health service users. Despite this there is no universally accepted definition of social inclusion and there is a dearth of empirical evidence on the successful outcome of increasing inclusion for mental health service users. Recognizing the lack of clarity surrounding the concept we have a produced a social inclusion framework to assist mental health professionals and service users to co-produce social inclusive outcomes. Although we agree that social inclusion can be a positive aspect of recovery, we question the extent to which mental health nurses and service users in co-production can overcome the social, economic and political structures that have created the social exclusion in the first place. An understanding and appreciation of the structure/agency conundrum is required if mental health nurses are to engage with service users in an attempt to co-produce socially inclusive outcomes.

Background: Mental health nurses play an important role in caring for patients with mental illnesses. In order to provide comprehensive mental health nursing care, it is important to establish periodic educational interventions about mental health and psychiatric nursing in any mental health institution. The presence of frequent educational programs can lead to improvements in mental health nurses' clinical competency. Aim: To evaluate the effectiveness of an educational intervention on the clinical competency of mental health nurses. Methods: A quasi-experiment study pretest and posttest with one group study design were conducted among 80 nurses in a large mental health hospital in Tabuk city, Saudi Arabia. Data were collected by using the clinical competence evaluation in mental health nurses scale to evaluate the effectiveness of an educational intervention on the clinical competency of mental health nurses by comparing the result of the pretest and posttest scores. Result & Discussion: The total score for the pre-test was (74.83±14.25/Average), and then the score increased dramatically for the post-test (96.18±26.53/Good) also, the Wilcoxon signed-rank test indicated that Post-test (Mean rank=102) significantly higher than pre-test (Mean rank=59) (U=1480, p<0.001). As a result of the current study, the program showed great effectiveness (p<0.001) with an advantage for post-test. Conclusion: The collected data analysis revealed a statistically significant positive effect of educational programs on improving mental health clinical competency, hence, Healthcare organizations and senior decision-makers should develop well designed periodic mental health programs that involve nurses who have a master's and doctorate degrees in mental health nursing to enhance mental health clinical competency.

Why revised standards of practice will not be enough.

The first aim of this study was to examine differences in work characteristics (autonomy, social support and workload) and work reactions (emotional exhaustion and job involvement) between general and mental health nurses. The second aim was to validate whether a specific pattern of relationships between work characteristics and reactions was the same for mental health and general nurses. Nurses are generally being considered as an above risk group regarding work stress. However, health care is a diverse sector and literature suggests important differences regarding the work of different categories of nursing, such as general and mental health nurses. In addition, little empirical evidence exists about these differences. In order to improve their work situation, more insight is needed regarding differences and similarities in the work of general and mental health nurses. The demand-control-support (DCS) model was used as a research framework. We hypothesized that autonomy, job involvement, and emotional exhaustion are higher in mental health nursing, whereas social support is expected to be lower. Next, in line with the propositions of this model and several recent studies, we hypothesized that emotional exhaustion is primarily predicted by workload and social support, whereas job involvement is primarily predicted by autonomy. In addition, we investigated whether this pattern of relationships was similar in both groups. Questionnaires were distributed to nurses working in a general and a psychiatric hospital in the Netherlands. We used MANOVA and MSA (by means of LISREL) to analyse the data. Regarding the differences in work characteristics and work reactions between mental health and general nurses, our hypotheses were confirmed, except for social support and job involvement. Autonomy and emotional exhaustion were higher among mental health nurses, whereas their job involvement proved to be significantly lower. Emotional exhaustion was primarily predicted by workload and lack of social support. Contrary to our expectations, the relationship between autonomy and job involvement was not significant in both samples. Finally, we found that the proposed pattern of relationships appeared to be invariant across the two samples.

This chapter is all about helping you to understand what mental health nursing is. To this end, we will consider what you must know and do when you first meet people with mental health problems. We will introduce a personal account from a mental health service user early in the chapter in order to help you begin to understand what working with people with mental health problems is like and what service users want from mental health nurses. In an effort to help you become familiar with what mental health nursing is, we will explore the following issues: what is a profession; what is nursing; what beliefs and values inform nursing; why is it important for mental health nurses to be self-aware; and what do mental health nurses need to know? In the final part of this chapter we explore the nature of boundaries in professional relationships and the implications of this for practice as a mental health nurse. Before you read any further we would encourage you to recognize that mental health service users are, quite rightly, the real experts in their care and needs. It is vitally important that you listen and really attend to what they are saying to you. We have asked a service user, Deborah Living, to represent for you some of the important issues that she would like mental health nurses to be aware of, and Deborah is going to tell you part of her own life story. I consider myself to be a survivor…not just a survivor of mental health difficulties but also a survivor of mental health services. I feel I am a survivor because I have reclaimed my life after more than ten years of mental health diagnoses and treatments: diagnoses from clinical depression to cyclothymia (described as a ‘milder’ form of manic depression); antidepressants and mood stabilisers from prozac to lithium; and interventions from counselling to psychiatry, through ECT to being an inpatient. It took me over a decade and a 12-month stay in a residential therapeutic community to stop the ‘revolving door’ approach within the mental health service, whereby I would gain short-term stability only to relapse yet again.

WHAT IS KNOWN ON THE SUBJECT?: At the outset of the COVID-19 pandemic, little was known about ways of delivering registered nurse practice within CMHTs under restrictions associated with a global pandemic. Emerging research focused on broad healthcare staff wellbeing during the pandemic. Qualitative research explored the overall response of COVID-19 on people with existing health needs or remote working more specifically. Over the past 2 years studies have emerged detailing experiences but no studies have used qualitative research to understand community mental health nurses and service users experience of services. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This co-produced qualitative study is the first to explore the changes to CMHT care from the experience of service users and nurses later in the COVID-19 pandemic. The study questions whether recovery-based approaches are possible in a hybrid way of working. The findings identify challenges for nurses' well-being and work-life boundaries when working from home. The study adds to historical professional narratives of mental health nursing. WHAT ARE THE IMPLICATIONS FOR PRACTICE: While hybrid approaches developed in response to COVID-19 restrictions may offer more choice these approaches need further co-produced evaluation on the impact of recovery-focused care and therapeutic relationships. Mental health nurses need to review how future hybrid working continues to impact nurses' mental health and emotional safety. Nurses and service users need to raise awareness within society and policy on the impact that COVID-19 had on people with existing mental health conditions. ABSTRACT: Introduction Community Mental Health Team responses to COVID-19 included fundamental service delivery adaptations. Aim/Question Our co-produced study sought to understand which service delivery changes experienced by service users and registered nurses were helpful or unhelpful to caregiving and receiving. Method Qualitative semi-structured interviews were undertaken with 10 service users and 13 registered nurses from 3 NHS England sites. Co-produced throughout, people with lived experience of mental health services and nurses wishing to improve their research experience undertook interviews following training. Data were analysed thematically. Findings Care radically changed from in-person to large phone or video contact. This reportedly altered therapeutic relationship building and raised questions about whether recovery-focused care was possible. Hybrid working was viewed as helpful but raised challenges for nurse wellbeing. Discussion Changes to care delivery challenged the fundamentals of recovery-focused interventions and therapeutic relationships. Service users and nurses well-being consequently suffered. The impact of the pandemic on people with existing mental health conditions was poorly acknowledged in the media. Implications for Practice Recovery-focused interventions and relationship building need evaluating in the light of ongoing hybrid working. Teams need to consider the well-being of nurses engaged in complex service-user interactions from home.

Not even "just a nurse": Institutional invalidation of mental health nursing.

Purpose – As well as working with people who have serious mental health problems, mental health nurses have to maintain a values-based approach to their interactions with mental health service users. However, some have suggested that students and newly qualified nurses are unprepared for this role. The purpose of this paper is to explore perceptions of practising mental health nurses, third year mental health nurse students and lecturers about how well students are being prepared for practice. Design/methodology/approach – A two-phase phenomenological study within a mental health nurse training institution and with staff from a Mental Health Trust in England. The study collected questionnaire responses from 87 participants (42 third year mental health nurse students, 39 practising mental health nurses and six nurse lecturers). A Likert scale questionnaire with written feedback produced data that formed the schedule for ten subsequent focus groups with 41 participants from the above categories. Focus group data were analysed using a process of interpretive phenomenological analysis. This led to the development of three main study themes. The transition from student to registered nurse is difficult, the importance of learning from experience, violence and aggression is difficult to manage, working effectively with victims of sexual abuse or those who have a diagnosis of personality disorder is difficult. Findings – Whilst the study found some evidence to suggest the development of positive values there is a perception that newly qualified mental health nurses lack confidence in other important areas. Participants also expressed doubt about whether it was possible to prepare someone for practice completely. Another finding was that the relationship between student and the mentor is critical to the quality of practice learning. Research limitations/implications – Study limitations are that this is a small selection of participants from one particular area. The researcher attempted to ensure that this study has internal validity. However, it is possible to question the extent to which findings may apply to other areas. Therefore, this study may be most useful to others as a basis for the discussion and comparison of these issues within mental health nurse educators. Practical implications – The need to encourage proactive learning approaches in students is emphasised. Universities should facilitate the sharing of clinical learning experiences as well as developing realistic training in the management of violence and aggression. It is possible to question how well nurses are prepared to work with the physical health needs of service users. Originality/value – This paper gives information about mental health nurse preparation for practice, which will be of value to training organisations as well as to employers of newly qualified mental health nursing staff.