How patient participation is constructed in mental health care: a grounded theory study.

AIM: The aim of the study was to explore how patient participation is constructed in social interaction processes between nurses, other health professionals and service users, and which structures provide a framework for the participation of service users in a psychiatric context? METHODOLOGICAL DESIGN: Ten tape-recorded interviews of nurses and observations of interactions between nurses, other health professionals and service users reflected differing constructed views of patient participation. Charmaz's interpretation of the grounded theory method was used, and the data were analysed using constant comparative analysis. ETHICAL ISSUES AND APPROVAL: The study was designed in accordance with the ethical principles of the Helsinki Declaration (1) and Danish law (2). Each study participant in the two psychiatric departments gave informed consent after verbal and written information. FINDINGS: The articulation of patient participation emphasises the challenge between, on the one side, orientations of ethical care, and, on the other, paternalism and biomedicine. The core category was generated from four inter-related categories: (i) taking care of the individual needs; (ii) the service user as expert; and (iii) biomedicine, and (iv) paternalism, and their 13 subcategories. CONCLUSIONS: This study illuminates the meaning of patient participation in a psychiatric context based on social interaction between nurses, other health professionals and service users. This can contribute to dealing with the challenges of incorporating patient participation as an ideology in all service users in a psychiatric context and is therefore important knowledge for health professionals.

When holistic care is not holistic enough: The role of sexual health in mental health settings.

AIMS AND OBJECTIVES: To explore the preparation that mental health nurses receive to address sexual health in practice. BACKGROUND: People who use the mental health services often have complex sexual health needs. Mental health nurses are well placed to offer support. However, this rarely happens in practice, and therefore, people's sexual health needs are not being routinely addressed. It is not known why this is the case. DESIGN: Systematic review and meta-ethnography. METHODS: EBSCO, PsycINFO, MEDLINE and ASSIA databases were searched using Booleans with Mesh and key terms including "mental health nurse" and "sexual health". Date range was June 2006 to June 2016. Discursive papers were excluded. Included papers (n = 7) were synthesised using a meta-ethnographic approach. RESULTS: The search yielded seven studies. Five key themes were identified: the (not so) therapeutic relationship; personal values dictating professional ones; institutionalised fear; being human; and education: the answer but where is it? CONCLUSIONS: The findings illustrate the complexity of supporting people with mental health and sexual health needs. They show the discomfort many nurses have about broaching sexual health. Arguably more than with most issues, personal values impacted strongly on professional practice. Understanding the depth and multifaceted nature of these themes is important, because strategies can then be developed to mitigate the barriers to best practice. For example, the findings presented here offer a framework from which structured education and support can be built. RELEVANCE TO CLINICAL PRACTICE: There is a need for Mental health nurses to be more responsive to concerns around sexual health and it should be routinely included in their practice. This study illuminates why this is not currently the case. By understanding this, remedial action can be taken by nurse educators. Implications are also discussed in relation to policy, research and practice.

Released potential: a qualitative study of the Mental Health Nurse Incentive Program in Australia.

The Mental Health Nurse Incentive Program (MHNIP) is a Commonwealth Government funded scheme that supports people living with a mental illness. Despite its significance, the program has received little attention from researchers nor critical discussion within the published work. This paper first critically examines the MHNIP from the contexts of identities, autonomy, and capabilities of mental health nurses (MHN) and then reports on findings from a qualitative study that explored the experiences of staff working in the MHNIP. Key findings from this qualitative study include four main themes indicating that both the program and the nurses working within it are addressing the unmet needs of people living with a mental illness. They achieve these ends by adopting holistic and consumer-centred approaches and by providing a wide range of therapeutic interventions. As well, the MHN in this study valued the freedom and autonomy of their practice outside public health services and the respect received from colleagues working in other disciplines. Findings suggest that MHN within the study were experienced as having autonomous identities and roles that may be in contrast to the restrictive understandings of MHN capability within the program's funding rules.

Meeting spiritual needs in mental health care.

Belief in Recovery is a project introduced into Northumberland, Tyne and Wear Foundation Trust between 2010 and 2012 to develop nursing staff members' confidence and skills in meeting the spiritual, religious and cultural needs of patients in mental health recovery. This article describes how we assessed and understood their training needs and developed a training programme, and how this led to positive outcomes for staff.

Faith community nursing: supporting mental health during life transitions.

The Faith Community Nurse can be an important agent in supporting the mental health of individuals during important life transitions by providing social support, spiritual care, referral services, and health education. Faith communities often include individuals of many generations; the young and old, newly married and recently widowed, new parents, and families whose young adults have recently left home. Nurses who provide care in these settings will likely have unique and frequent opportunities to provide mental health services and referrals to individuals experiencing transitions related to crisis, hospitalization, death, and other important life changes. Faith Community Nurses are at the frontline, aiding faith communities in supporting holistic health of the mind, body, and spirit.

An analysis of discourses shaping mental health practitioners.

A mental health practitioner (MHP) role was introduced to health services in southern England in 2003. The paper will discuss the initial phase within a longitudinal research study. A discursive approach will be adopted in order to understand how healthcare discourses constrain and provide possibilities for the emergence of a new worker role in mental health. The manner in which MHPs understand and talk about their work is socially constructed in interaction and constantly being modified by competing discourses. This paper will analyse three overarching health discourses, namely, the biomedical, person-centred and psychological discourses that have shaped MHP trainees. Discourses intersect to inform the role, where practices of nursing, psychology, medicine and occupational therapy are combined. Thus, the inclusion of physical, psychological and person-centred components of care serve as a multifaceted approach to care. This form of interprofessionalism leads MHPs one step closer in the advance towards an interdisciplinary discourse of holistic care.

An emergency department-based mental health nurse practitioner outpatient service: part 2, staff evaluation.

The nurse practitioner role incorporates enhancing access to health-care services, particularly for populations that are underserved. This entails working collaboratively with colleagues across multidisciplinary teams and emphasizing a nursing model of practice within the nurse practitioner role. In Australia, the added value associated with establishing mental health nurse practitioner (MHNP) positions based in the emergency department (ED) is emerging. This paper presents qualitative findings from a study using a mixed-method design to evaluate an ED-based MHNP outpatient service in Sydney, Australia. One component of the evaluation involved semistructured interviews conducted with a random selection of study participants and a stratified sample of ED staff. This is the second of a two-part paper that presents an analysis of the qualitative data derived from the staff interviews (n = 20). Emergency staff were very supportive of the outpatient service, and perceived that it enhanced overall service provision and improved outcomes for patients. Moreover, staff expressed interest in receiving more formal feedback on the outcomes of the service. Staff also felt that service provision would be enhanced through additional mental health liaison nurses working in the department, especially after hours. An ED-based MHNP outpatient service expedites access to follow up to individuals with a broad range of problems, and supports ED staff in the provision of safe, effective, and more holistic care.

Successful aging: choosing wisdom over despair.

This article defines wisdom and despair as choices for cognitively intact older adults. Some individuals are able to integrate the conditions of old age while others respond in ways that inhibit effective integration. The conscious aging theory, as well as Erikson's developmental theory regarding achievement of integrity/wisdom, provides a theoretical basis for exploration of this topic. Constructs of personality, including self-concept, self-acceptance, destiny control, interiority, rigidity, and flexibility, are described. Finally, guidelines for nurses working with older adults who are facing this developmental stage of life are provided.

[The creation of an art workshop within a hospital]. / La création d'un atelier d'arts plastiques en intra-hospitalier.

Organising an arts activity within a hospital unit is not simple. But if it is well thought out and forms part of a healthcare process, it can have an important role to play. An example at Montperrin hospital in Aix-en-Provence.

The Mental Health Nurse Incentive Program: the benefits from a client perspective.

It is now acknowledged that a substantial proportion of the Australian population will experience a mental health condition at some time during their lives. Only a small proportion will access care and treatment for these conditions, and those who do are more likely to access general medical practitioners than specialist mental health providers. The Mental Health Nurse Incentive Program (MHNIP) was introduced by the Commonwealth Government to enhance access to mental health care by engaging mental health nurses in collaboration with general practitioners and private psychiatrists. The aim of the current study was to explore the experiences and opinions of clients utilising these services. A qualitative exploratory approach involving in-depth semi-structured interviews was utilised to enhance understanding of the client perspective. Interviews were conducted with 14 clients. Data were analysed using NVivo to assist with the identification of major themes. The findings revealed the major themes to be: initial reactions; a comfortable setting; flexibility; holistic care; and affordable care. These findings suggest that clients perceive the MHNIP as a valuable intervention that met the mental health needs of clients to a greater extent than had previously been possible.

Does prescribing participation in arts help to promote recovery for mental health clients?

BACKGROUND: Although recovery has become the focus of mental health policy in the UK, few models of practice show how mentalhealth nurses may promote recovery through participatory arts. AIM: To explore the experiences of people who engaged with an arts on prescription programme. METHOD: This study used narrative inquiry and participants were interviewed three times over one year. RESULTS AND DISCUSSION: Participants clearly benefited, especiallyin terms of having a "safe place" to come to, and from making new friends and experiencing peer support. It also enabled some to access education an d voluntarywork. CONCLUSION: Engaging with community based arts activities may provide opportunities for clients to make friends, become more socially engaged and have a greater sense of belonging.

My life: my encounters with insanity.

Evocative memories of an early career in mental health nursing contextualize an alienation from traditional psychiatric practices. These memories tell tales that center on exploring a personal rejection of mental health nursing practices that were based on a reductive-pharmacological approach. In its place, it is suggested, should be the adoption of more holistic ideology that places the person at the very center of mental health nursing as a holistic, human-centered activity. This process may be guided by, for example, the adoption of the principles of the Tidal Model.