Preparing master-level mental health nurses to work within a wellness paradigm: Findings from the eMenthe project.

Mental health promotion remains an important component of mental health nursing practice. Supporting wellness at both the individual and societal levels has been identified as one of the key tenets of mental health promotion. However, the prevailing biomedical paradigm of mental health education and practice has meant that many nurses have not been equipped to incorporate a wellness perspective into their mental health practice. In the present study, we report on an exploratory study which details the knowledge, skills, and attitudes required by master-level mental health nurses to practice within a wellness paradigm from the perspective of three groups of key stakeholders: (i) service users and family members (n = 23); (ii) experienced mental health nurses (n = 49); and (iii) master-level mental health nursing students (n = 37). The findings, which were reported from individual and focus group interviews across five European countries, suggested a need to reorientate mental health nursing education to include a focus on wellness and resilience to equip mental health nurses with the skills to work within a strengths-based, rather than a deficits-based, model of mental health practice. Key challenges to working within a wellness paradigm were identified as the prevailing dominance of the biomedical model of cause and treatment of mental health problems, which focusses on symptoms, rather than the holistic functioning of the individual, and positions the person as passive in the nurse-service user relationship.

Participatory theatre and mental health recovery: a narrative inquiry.

AIMS: To identify the potential relationship between participation in theatre and mental health recovery. To give voice to the stories told by participants of Teater Vildenvei, a theatre company that has been part of the rehabilitation programme for mental health service users in Oslo since 1995. METHODS: Twelve narrative interviews were conducted among participants of Teater Vildenvei, and the data were subject to a narrative analysis process following the philosophy of Paul Ricoeur and the specific methods of thematic, event and relational analysis as identified by Riessman. RESULTS: The narratives are considered in the theoretical light of the mental health recovery framework as identified by Leamy et al. Each participant had experienced a transformation in identity; the sense of belonging within the group was perceived as highly important to their mental health; engagement with the theatre company gives people something meaningful to do, a sense of hope and individuals feel empowered. CONCLUSIONS: This narrative inquiry gave opportunity for participants to elaborate on their stories of their engagement with Teater Vildenvei. It is through the richness of the data that the depth of the significance of meaning that people ascribe to their stories demonstrates the potential power of participatory theatre for mental health recovery. Because of its effects, people make life-changing and life-saving claims.

Arts, health & wellbeing: reflections on a national seminar series and building a UK research network.

An account is provided of a UK national seminar series on Arts, Health and Wellbeing funded by the Economic and Social Research Council during 2012-13. Four seminars were organised addressing current issues and challenges facing the field. Details of the programme and its outputs are available online. A central concern of the seminar programme was to provide a foundation for creating a UK national network for researchers in the field to help promote evidence-based policy and practice. With funding from Lankelly Chase Foundation, and the support of the Royal Society for Public Health, a Special interest Group for Arts, Health and Wellbeing was launched in 2015.

A critical narrative analysis of shared decision-making in acute inpatient mental health care.

Shared decision-making (SDM) is a high priority in healthcare policy and is complementary to the recovery philosophy in mental health care. This agenda has been operationalised within the Values-Based Practice (VBP) framework, which offers a theoretical and practical model to promote democratic interprofessional approaches to decision-making. However, these are limited by a lack of recognition of the implications of power implicit within the mental health system. This study considers issues of power within the context of decision-making and examines to what extent decisions about patients' care on acute in-patient wards are perceived to be shared. Focus groups were conducted with 46 mental health professionals, service users, and carers. The data were analysed using the framework of critical narrative analysis (CNA). The findings of the study suggested each group constructed different identity positions, which placed them as inside or outside of the decision-making process. This reflected their view of themselves as best placed to influence a decision on behalf of the service user. In conclusion, the discourse of VBP and SDM needs to take account of how differentials of power and the positioning of speakers affect the context in which decisions take place.

No hope without compassion: the importance of compassion in recovery-focused mental health services.

BACKGROUND: Whilst current policy is replete with recovery language and references to the need for services to create a sense of hope and optimism, there is less understanding about how such hope may be engendered within services. We propose that an understanding of compassion is necessary to appreciate what actually stimulates hope-inspiring practices. AIMS: An examination of the continuing relevance of compassion to mental health care and an exploration of its place within modern mental health policy and practice. METHODS: A review of the compassion deficit in mental health care and a critical examination of whether the direction of current mental health policy in the UK is likely to facilitate compassionate care. RESULTS: Compassion needs to be viewed not merely as an individual expression or property but something which must be nurtured in context, through relationships, cultures and healing environments. However, current mental health policy and practice does not appear to prioritise the development of such contexts. CONCLUSION: Attention to fostering compassion would help to shift the language of "recovery" (or "well-being") beyond the twin dangers of rhetoric and/or imposing preconceived definitions, models or expectations of what recovery "should" be. Therefore, the development of compassionate contexts should have a stronger place in modern mental health practice and policy.

How do nurses cope when values and practice conflict?

BACKGROUND: A lack of opportunity to express values in nursing practice and a conflict of ideals with organisational constraints are associated with low job satisfaction and high attrition rates. AIM: To explore the stories of mental health nurses to find how values influence their experience of nursing practice. METHOD: Twelve participants, who had between six months', and three years' experience of post-registration practice, were interviewed. RESULTS: Nurses' values were often established before they started training. Participants described values that were consistent with a commitment to person-centred care and professional and ethical principles expected by governing bodies. CONCLUSION: Mental health nurses are aware of the dissonance that arises when there is a conflict between their values and their practice. They respond to this in a variety of ways, notably through acceptance, rejection or innovation.