RESUMEN
People living with mental illness experience poorer oral health outcomes compared to the general population, yet little is known about their oral health knowledge, attitudes, and practices. The aim of this mixed-methods systematic review was to synthesise evidence regarding oral health knowledge, attitudes, and practices of people living with mental illness to inform preventative strategies and interventions. Database searches were conducted in PubMed, MEDLINE, PsycINFO, CINAHL, ProQuest, and Scopus with no limitations placed on the year of study. All studies available in the English language, that explored the oral health knowledge, attitudes, and/or practices of people with a mental illness were included. Articles were excluded if they primarily pertained to intellectual disability, behavioural and psychological symptoms of dementia, drug and alcohol or substance use, or eating disorders. A thematic synthesis was undertaken of 36 studies (26 high-moderate quality), resulting in 3 themes and 9 sub-themes. Study participants ranged from n = 7 to n = 1095 and aged between 15-83 years with most having a diagnosis of schizophrenia, schizoaffective, or bipolar affective disorder. People diagnosed with a mental illness were found to have limited oral health knowledge, particularly regarding the effects of psychotropic medication. Various barriers to oral health care were identified, including high dental costs, the negative impact of mental illness, dental fears, lack of priority, and poor communication with dental and health care providers. Study participants often displayed a reduced frequency of tooth brushing and dental visits. The findings highlight the potential for mental health care providers, oral health and dental professionals, mental health consumers, and carers to work together more closely to improve oral health outcomes for people with mental illness. The systematic review protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO), (registration ID CRD42022352122).
Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Trastornos Mentales , Salud Bucal , Humanos , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Adulto , Adolescente , Anciano , Adulto Joven , Persona de Mediana Edad , Anciano de 80 o más AñosRESUMEN
More contemporary personal recovery conceptualisation of mental health recovery emphasize the need to consider the perspectives of people who experience mental ill-health. Most lived experience research has been done in Western cultures with relatively few studies in Asian ones, creating a gap that needs to be addressed due to differences in cultural worldviews. This study explores the notion of recovery from the lens of people experiencing mental health challenges in Singapore. We adopted a constructivist grounded theory perspective to evaluate qualitative data from 21 participants. The core category which best represented what recovery meant was "reconciling and living with experiences of mental ill-health". Our findings suggest that a variety of societal aspects greatly influence perceptions of mental health recovery in Singapore, as participants often shared their desire to live a meaningful life within society but could only do so if they found a way to manage their symptoms more effectively.
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Recuperación de la Salud Mental , Servicios de Salud Mental , Humanos , Teoría Fundamentada , Singapur , Salud Mental , Investigación CualitativaRESUMEN
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
Nurses practising in mental health are faced with challenging decisions concerning confidentiality if a patient is deemed a potential risk to self or others, because releasing pertinent information pertaining to the patient may be necessary to circumvent harm. However, decisions to withhold or disclose confidential information that are inappropriately made may lead to adverse outcomes for stakeholders, including nurses and their patients. Nonetheless, there is a dearth of contemporary research literature to advise nurses in these circumstances. Cognitive Continuum Theory presents a single-system intuitive-analytical approach to examining and understanding nurse cognition, analogous to the recommended single-system approach to decision-making in mental health known as structured clinical judgement. Both approaches incorporate cognitive poles of wholly intuition and analysis and a dynamic continuum characterised by a 'common sense' blending of intuitive and analytical cognition, whereby cues presented to a decision-maker for judgement tasks are weighed and assessed for relevance. Furthermore, Cognitive Continuum Theory promotes the importance of determining pattern recognition and functional relations strategies, which can be used to understand the operationalisation of nurse cognition.
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Revelación , Enfermeras y Enfermeros , Humanos , Toma de Decisiones , Salud Mental , Cognición , ConfidencialidadRESUMEN
For nurses working in mental health, the inappropriate handling of confidential information may cause issues for stakeholders. However, there is a paucity of research literature to guide nurses. Therefore, this study aimed to add to the extant literature on risk-actuated public-interest disclosure practices of nurses. The study found participants understood exceptions to confidentiality, but not the concept of public interest. Furthermore, disclosure for risk management in perceived risk laden scenarios, was described by participants as a collaborative endeavour, albeit one where peer advice was not necessarily followed. Finally, participants' risk-actuated disclosure-related decision-making focussed on protecting a patient or others from harm.
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Revelación , Enfermeras y Enfermeros , Humanos , Salud Mental , ConfidencialidadRESUMEN
This historical discussion paper is an overview for nurses working in mental health of medieval and Early Modern texts known as Ars Moriendi literature, which focuses on the art of dying, grief and loss. Primary and secondary historical documents are used to describe Ars Moriendi literature and how historical understandings of death and dying were shaped within a spiritual context. Ars Moriendi concepts are compared with modern Western secularised and medicalised notions to prompt reflection on historical versus modern approaches to dying, grief and loss.
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Salud Mental , Enfermeras y Enfermeros , Humanos , Actitud Frente a la Muerte , PesarRESUMEN
Lunatic asylums formed part of the civic infrastructure that was constructed out of British colonists invading and subsequently colonising unceded, Indigenous Australian lands during the eighteenth and nineteenth century. This historical narrative examined nineteenth century primary and secondary sources including, patient lists, medical files, and government correspondence, to provide insight into the experiences of Indigenous Australians admitted to Australia's earliest lunatic asylums. Awareness that lunatic asylums formed part of the structure imposed during colonisation, provides nurses and other health professionals with greater historical literacy regarding the impact of colonial lunatic asylums on Indigenous Australians. Such impacts continue to be experienced through transgenerational trauma and emphasise the importance of culturally safe mental health services.
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Trastornos Mentales , Servicios de Salud Mental , Humanos , Historia del Siglo XIX , Trastornos Mentales/historia , Aborigenas Australianos e Isleños del Estrecho de Torres , Australia , Hospitales PsiquiátricosRESUMEN
Incorporating anthropological principles, microhistory is a research methodology useful for exploring the interplay between ordinary people and social abstractions such as, the market, social systems, and governments. In this paper, the background and characteristics of microhistory are described, and a novel six-stage approach for conducting microhistories in mental healthcare is introduced. Each stage of the process is illustrated using sections from a microhistory focussed on the earliest recorded case comparison between British colonial mental healthcare and Aboriginal Australian traditional healing. Microhistory provides a way to uncover new insights about past mental healthcare, which may contribute to re-conceptualisations of modern-day beliefs and practices.
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Investigación Biomédica , Salud Mental , Humanos , Investigación Biomédica/métodosRESUMEN
BACKGROUND: Personal recovery is a relatively novel concept in many Asian countries, and recovery-oriented interventions are usually adapted from western conceptualizations of recovery. AIM: To understand what personal recovery in mental health means to people in Asia, what meanings they give to their conditions, and what factors they perceive as hindering or facilitating their recovery. METHOD: The review focused on peer-reviewed papers published in English between the years 2000 and 2020. Arksey and O'Malley 5-stage method was used to guide the review. RESULTS: Thirty studies were included. Personal recovery in Asia meant a return to a pre-illness state and involved a transformative process. Mental illness was explained as being biomedically oriented, although religious/culturally bound explanations were also present in some studies. Social support, religion, meaningful activities, supportive professionals, and personalized coping strategies were viewed as supporting recovery. Religious stigma, discrimination, gendered norms, and negative societal perceptions of mental illness hindered recovery. CONCLUSIONS: The concept of personal recovery in Asia is extremely diverse. Studies exploring personal recovery among people experiencing mental illness in Asia remains in its early stages and more research is needed to better understand how it is conceptualized. Such knowledge could benefit frontline implementation of recovery-oriented services.
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Trastornos Mentales , Salud Mental , Humanos , Adaptación Psicológica , Trastornos Mentales/psicología , Estigma Social , Pueblo Asiatico , AsiaRESUMEN
BACKGROUND: Mental health recovery has shifted from clinical conceptualizations to more personal ones. However, much of the lived experience literature has focused on people living with mental health conditions, and less attention has been placed on various mental health professionals, especially in Asian countries, where the personal recovery literature base is in its nascent stage. AIM: We sought to contribute to a growing body of work by exploring recovery from the lens of different mental health professionals in Singapore. METHODS: Mental health professionals in Singapore were invited to participate in an online interview through social media. The recordings were transcribed verbatim and analyzed using a constructive grounded theory approach. RESULTS: Nineteen participants were interviewed. A single core category, "living in society once more", and three categories, "An ongoing process", "Regaining ability to function in society", and "A normality report card" were identified from our data. CONCLUSIONS: Recovery within the Singapore mental health professional perspective focuses on helping individuals return to society and function productively while considering existing societal norms such as the highly competitive and pragmatic culture in Singapore. Future research can explore in greater depth the impact of these factors on the recovery process.
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Trastornos Mentales , Salud Mental , Humanos , Singapur , Teoría Fundamentada , Personal de Salud , Investigación CualitativaRESUMEN
OBJECTIVE: Mental Health Acts (MHAs) are important pieces of legislation which include essential definitions of mental illness and mental disorder and are used to guide decision-making regarding treatment, including involuntary admissions. In Australia, responsibility for reviewing this legislation falls under the jurisdiction of State and Territory Governments, resulting in interstate variations of legislative definitions and care requirements. In this paper, we outline some of the main differences between MHAs, and argue that it is time for Australia to enact nationally consistent Mental Health Legislation. CONCLUSIONS: Substantial divergence exists between definitions of mental illness and mental disorder, differing criteria for involuntary treatment and discrepancies between treatment requirements for Indigenous Australians. While variations between MHAs are understandable considering the historical context, in an increasingly integrated society, it is time for Australia to enact nationally consistent mental health legislation.
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Trastornos Mentales , Trastornos Psicóticos , Humanos , Salud Mental , Australia , Trastornos Mentales/terapiaRESUMEN
Past histories charting interactions between British healthcare and Aboriginal Australians have tended to be dominated by broad histological themes such as invasion and colonization. While such descriptions have been vital to modernization and truth telling in Australian historical discourse, this paper investigates the nineteenth century through the modern cultural lens of mental health. We reviewed primary documents, including colonial diaries, church sermons, newspaper articles, medical and burial records, letters, government documents, conference speeches and anthropological journals. Findings revealed six overlapping fields which applied British ideas about mental health to Aboriginal Australians during the nineteenth century. They included military invasion, religion, law, psychological systems, lunatic asylums, and anthropology.
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Salud Mental , Nativos de Hawái y Otras Islas del Pacífico , Antropología , Australia , Hospitales Psiquiátricos/historia , HumanosRESUMEN
Research indicates a strong bond between those who are homeless and their companion animals. This relationship provides a number of benefits to the homeless person as well as to the animal, including safety, responsibility and improved emotional and mental health. However, the relationship can also add challenges, including decreased access to accommodation, decreased effort to find shelter as a consequence, and emotional vulnerability relating to fear of losing their companion pet. This integrative review examined the benefits and challenges of companion animals for the homeless to determine the consistency of findings to aid better service delivery to the homeless population.
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Amigos/psicología , Personas con Mala Vivienda/psicología , Salud Mental , Mascotas , Animales , Emociones , Salud Ambiental , Femenino , Vivienda , Humanos , Relaciones Interpersonales , MasculinoRESUMEN
Despite making a substantial contribution to the development of mental health services in colonial Australia, until now the story of Dr Patrick Hill's (1794-1852) life has been overlooked by historians. This paper reviews primary sources including clinical notes, patient lists, letters, government documents and newspaper articles which reveal that Dr Hill was a dedicated physician who played a vital role in the development of Australian mental healthcare. He was held in such esteem that by the time of his sudden death in 1852 he had been elevated to the most senior medical office in New South Wales. Dr Hill's career serves to exemplify how the local practice of individual colonial doctors helped build the reputation of medicine in the modern era.
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Servicios de Salud Mental/historia , Australia , Colonialismo/historia , Historia del Siglo XIX , Nueva Gales del Sur , Cirujanos/historiaRESUMEN
The Clubhouse model is a widely used approach to psychosocial rehabilitation that has been a pioneer in supporting recovery-oriented programmes. Little consideration has been given however, to the theories that guide research of the recovery practices used by Clubhouses. In this paper, we provide a description of self-determination theory, including its philosophical background followed by explanation of its relevance to health care and Clubhouse contexts. We argue that self-determination theory provides a robust social constructionist theoretical framework that is well-suited to informing research related to psychosocial rehabilitation, recovery-oriented practices and the Clubhouse model.
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Investigación en Enfermería Clínica , Centros Comunitarios de Salud Mental , Trastornos Mentales/enfermería , Trastornos Mentales/rehabilitación , Teoría de Enfermería , Autonomía Personal , Rehabilitación Psiquiátrica/métodos , Conducta Cooperativa , Humanos , Trastornos Mentales/psicología , Motivación , Grupo de Atención al Paciente , Medio Social , Apoyo SocialRESUMEN
Recovery-oriented mental health services promote the principles of recovery, such as hope and optimism, and are characterized by a personalized approach to developing consumer self-determination. Nurse leaders are increasingly developing such services as social enterprises, but there is limited research on the leadership of these programs. Leading a recovery-oriented mental health nurse social enterprise requires visionary leadership, collaboration with consumers and local health providers, financial viability, and commitment to recovery-focused practice. This article describes the framework of an Australian mental health nursing social enterprise, including the service attributes and leadership lessons that have been learned from developing program sustainability.
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Participación de la Comunidad , Liderazgo , Servicios de Salud Mental/organización & administración , Enfermería Psiquiátrica , Australia , Humanos , Evaluación de Programas y Proyectos de SaludRESUMEN
Anorexia nervosa has a high mortality rate and is often treated in the inpatient setting, where close monitoring and medical support are available. Consistent with objective biomedical benchmarks, conventional inpatient treatment is often focussed on weight gain. Consumers report that clinicians provide care focussed on weight and physical restoration without adequate consideration of their full spectrum of needs. The aim of this study was to explore consumers' perspectives of the biomedical focus on weight gain in the inpatient care of anorexia nervosa. This study employed a qualitative approach, involving semistructured interviews, and participants were recruited from relevant social media communities. This study was ethically approved by a university ethics committee and the COREQ checklist ensured ethical reporting. Ten women participated in interviews. Participants reported that the biomedical imperative of weight gain is focussed on at the exclusion of other relevant determinants of well-being, and the narrow focus on weight gain does not suitably prepare consumers for discharge. The conflict between clinicians' biomedical focus and consumers' broader unmet needs leads to harmful interpersonal dynamics and feelings of invalidation. The inpatient care of anorexia nervosa needs to develop beyond biomedically driven objectives and incorporate the merits of an approach that substantively integrates person-centred care, therapeutic relationships and trauma-informed principles.