RESUMEN
Contrary to the expectations and intentions of inpatient mental healthcare, reports of adverse experiences by people admitted to inpatient settings are common and on the rise. Such experiences negatively impact individuals' mental health and recovery and incur costs to their networks, mental health providers, the healthcare system, and society at large. Research indicates ongoing challenges in understanding and addressing the complex interplay of factors that contribute to a diverse range of adverse experiences, from seclusion, restraint, and coercion, to boredom, loneliness, and lack of therapeutic relationships. There is a pressing need to better understand the mechanisms of adverse inpatient mental health experiences and identify frameworks to aid in more efficient and effective translation of knowledge into practice. This paper proposes self-determination theory (SDT) as a framework that can assist nurse researchers and practitioners elucidate the nature of adverse experiences and guide developments to mitigate adverse outcomes. Critically, SDT prioritises human psychological needs and wellbeing, and thus has potential to inform rights-based, person-centred, recovery-oriented research and development. This paper provides an overview of recent literature on adverse experiences before introducing SDT. It then considers adverse inpatient mental health experiences through the lens of SDT, providing actionable guidance for nursing research and development.
RESUMEN
BACKGROUND: Concerns have been raised that international students are at high risk of poor mental health and wellbeing. AIMS: The aim of this study was to systematically review the literature on the mental health and wellbeing of international students in Australia. METHODS: A literature search was conducted using CINAHL, MEDLINE, PsycINFO, and Academic Search Complete using EBSCOhost interface for articles published from 2000. A pre-determined set of eligibility criteria was used to screen articles and eligible articles were quality appraised using the Mixed Methods Appraisal Tool. Due to considerable heterogeneity, the data was narratively analysed, considering the statistical significance and the text narratives. Nineteen studies (N = 19) met the inclusion criteria. RESULTS: Mental health issues experienced by international students included anxiety (2.4-43%, N = 5), depression (3.6-38.3%, N = 6), psychological stress/distress (31.6-54%, N = 9) and gambling problems (3.3-50.7%, N = 3). Factors affecting student wellbeing included loneliness/isolation (60-65%, N = 4), work/financial difficulties (15.4-95%, N = 4) and discrimination/safety concerns (9-50%, N = 3). Other factors affecting students included cross-cultural transition experiences, language difficulties, social interaction, university belonging, technology difficulties, self-harm, use of counselling services and mental health literacy. CONCLUSION: International students in Australia experience various issues affecting their mental health and wellbeing. More effort needs to be made to better support students.