‘It Was Like a Family’: Nurses as Change Makers in Mental Hospitals

Oral history has become firmly established as a method to delve into and bring to light the experiences and viewpoints of individuals who have been suppressed or marginalised in the history of psychiatry and mental healthcare. This article aims to provide an overview of the ways in which oral history has been deployed, both as a method and as a source, to address the absence of voices and the silences that continue to persist within the history of mental healthcare in the British context. The article argues for the relevance of oral history methodology to the history of psychiatry in restoring and amplifying the voices of the less powerful. The article will evidence how the collection of and re-use of oral histories of those at the receiving end of mental healthcare, and of those who provide it, has the potential to promote democratic relations in mental healthcare research by challenging traditional power relations in what historically has constituted the history of psychiatry. It has the power to bring to the fore the perspectives of key actors, particularly those with serious, long-term mental health conditions who remain under-served all along throughout the long history of mental healthcare, albeit in different ways. The article will show how oral history methodology can broaden the history of psychiatry and mental healthcare by addressing and redressing the silences and erasures therein in a range of disciplinary contexts and perspectives.

Although research findings point to the importance of leisure activities for people with severe mental illness, there is no research into the specific effects of holiday trips. This Open Forum describes the experience of going on holiday trips for people with chronic mental health problems in the Netherlands. A qualitative research design was used. Material for the research was collected by participant observation on two trips and in-depth interviews of 11 travelers and four psychiatric nurses who accompanied the travelers. The trips contributed to rehabilitation by promoting and supporting, among other things, community participation, social relations, skill development, and new perceptions of identity. The trips also helped travelers to maintain balance in everyday life. For the nurses the trips provided a learning environment outside of medical institutions.

Although research findings point to the importance of leisure activities for people with severe mental illness, there is no research into the specific effects of holiday trips. This Open Forum describes the experience of going on holiday trips for people with chronic mental health problems in the Netherlands. A qualitative research design was used. Material for the research was collected by participant observation on two trips and in-depth interviews of 11 travelers and four psychiatric nurses who accompanied the travelers. The trips contributed to rehabilitation by promoting and supporting, among other things, community participation, social relations, skill development, and new perceptions of identity. The trips also helped travelers to maintain balance in everyday life. For the nurses the trips provided a learning environment outside of medical institutions

Review| May 01 2022 Care & Custody: Past Responses to Mental Health, National Library of Medicine Care & Custody: Past Responses to Mental Health. National Library of Medicine. Anne E. Parsons, Guest Curator; Patricia Tuohy, Head, Exhibition Program; Jiwon Kim, Exhibition Educator; Carissa Lindmark, Pathways Intern; Jane Markowitz, Traveling Services Coordinator; Erika Mills, Community Outreach Coordinator; Tannaz Motevalli, Exhibition Coordinator; Jill L. Newmark, Exhibition Registrar; Healykohler Design, Exhibition Design; Link Studio, Website Design & Development. https://www.nlm.nih.gov/exhibition/careandcustody/index.html. Created 2021; Accessed March 2022. Jessica Martucci Jessica Martucci University of Pennsylvania Search for other works by this author on: This Site PubMed Google Scholar The Public Historian (2022) 44 (2): 117–121. https://doi.org/10.1525/tph.2022.44.2.117 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Jessica Martucci; Care & Custody: Past Responses to Mental Health, National Library of Medicine. The Public Historian 1 May 2022; 44 (2): 117–121. doi: https://doi.org/10.1525/tph.2022.44.2.117 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentThe Public Historian Search The National Library of Medicine (NLM) digital exhibit, Care & Custody: Past Responses to Mental Health helps visitors explore mental health care in America from the nineteenth century to the present day. Originally intended as an auxiliary website to a traveling exhibit by guest-curator Anne E. Parsons, from the department of history at UNC Greensboro, the online exhibit has launched ahead of the in-person exhibit due to the ongoing pandemic. The in-person exhibit will feature six large panels, each exploring a different theme as it traces shifting debates about the role of institutions, communities, medicine, and the state in the history of mental health care.3 The digital exhibit supports this exploration and provides convenient access to digitized primary sources that will help researchers and students examine this past through materials in the NLM’s collection. The opening text on the exhibit home page mirrors the opening panel of the in-person... You do not currently have access to this content.

This study aimed to investigate the factors influencing mental health nurses' attitudes towards people with mental illness. A descriptive correlation design was used. A sample of 180 Taiwanese mental health nurses was recruited from mental health-care settings. Data were analyzed with descriptive statistics, Pearson's product-moment correlation, Student's t-test, one-way anova, and a hierarchical multiple regression analysis. Negative attitudes were found among mental health nurses, especially with respect to individuals with substance abuse compared with those with schizophrenia and major depression. Mental health nurses who were older, had more clinical experiences in mental health care, and demonstrated greater empathy expressed more positive attitudes towards people with mental illness. Mental health nurses working at acute psychiatric units demonstrated more negative attitudes towards mental illness compared with those working in psychiatric rehabilitation units and outpatient clinics or community psychiatric rehabilitation centres. Particularly, length of mental health nursing practice and empathy significantly accounted for mental health nurses' attitudes towards mental illness. Understanding nurses' attitudes and their correlates towards people with mental illness is critical to deliver effective mental health nursing care.

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.

A secret history

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

In-prison violence by detainees is a problem worldwide, but despite evidence of a much higher prevalence of a range of psychiatric disorders than in the general population, little is known about psychopathology among violent detainees. Our aim was to explore the psychopathology and mental healthcare history of Dutch detainees who were transferred to the highly restrictive facility for uncontrollably violent detainees following severe in-prison violence. Anonymised data for all 253 male detainees incarcerated at any time between January 2016 and January 2020 in the specialist national facility for those seriously violent while in prison-'the Violence Facility'-were obtained from the Dutch Ministry of Justice together with similarly recorded data for a matched comparison group of 253 detainees admitted to an in-prison psychiatric facility-'the Psychiatric Facility'. There was no record of any psychiatric assessment for 29% of the Violence Facility men. Almost all of the detainees who had been assessed were classified with at least one disorder. Compared to detainees in the Psychiatric Facility, Violence Facility men were more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD), anxiety, behavioural and personality disorders; Psychiatric Facility men were more likely to be diagnosed with psychosis or substance use disorder. Most men in both groups had previously used mental health services. This first study of detainees in the Dutch in-prison facility for violent detainees raises questions about whether the extent of violence among these men may have masked mental healthcare needs and leads to questions about potential benefits from establishing more systematic mental health assessments for them, and a need for more specialist services.

This study sought to describe the extent to which community hospitals, in a sample of states, are caring for patients with psychiatric disorders in medical-surgical beds (scatter beds) and to compare the characteristics of patients treated in scatter beds with those of patients treated in psychiatric units in community hospitals. Information on hospital discharges in 12 states for patients with a principal psychiatric diagnosis was gathered from the Healthcare Cost and Utilization Project State Inpatient Databases. Discharges of patients who were treated in community hospital psychiatric units (N=370,984) were compared with those of patients who were treated in scatter beds (N=26,969). Overall, only 6.8% of discharges were from scatter beds. The rate of total psychiatric discharges per 10,000 total state population ranged from a high of 62.3 in one study state to a low of 9.6 in another. The average rate of scatter bed discharges per 10,000 state population ranged from 1.6 to 5.8, whereas the average rate of psychiatric unit discharges ranged from 7.4 to 58.9. A comparison of discharges of patients treated in scatter beds with discharges of patients treated in psychiatric units indicated that patients in scatter beds were more likely to have somatic conditions and were half as likely to have an accompanying substance use disorder. Discharge codes indicated that almost 40% of patients from scatter beds had a diagnosis of schizophrenia, episodic mood disorder, or depression; about two-thirds were admitted from emergency rooms; and about one-fifth were transferred to another facility. More research is needed to determine the optimal supply of psychiatric unit beds across regions and whether and how scatter beds should be used to address the lack of psychiatric beds.

Psychiatric Discharges in Community Hospitals With and Without Psychiatric Units: How Many and for Whom?

The authors report the latest findings from a 32-year longitudinal study of 269 back-ward patients from Vermont State Hospital. This intact cohort participated in a comprehensive rehabilitation program and was released to the community in a planned deinstitutionalization effort during the mid-1950s. At their 10-year follow-up mark, 70% of these patients remained out of the hospital but many were socially isolated and many were recidivists. Twenty to 25 years after their index release, 262 of these subjects were blindly assessed with structured and reliable protocols. One-half to two-thirds of them had achieved considerable improvement or recovery, which corroborates recent findings from Europe and elsewhere.

Introducing Special Issue on History of Mental Health Care and Mental Health Nursing

Until very recently, the history of mental health care received little critical investigation. This paper seeks to explore how the western scientific tradition shaped mental health nursing and investigates the pivotal influences which affected its early development, emphasising the role played by mid-19th century asylum care.

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.