Nurses' promotion of Mental Health First Aid Training Programmes for upper secondary students: a modified Delphi approach.

BACKGROUND: Mental Health First Aid Training Programmes can be carried out by nurses in schools. Adolescents have reported the importance of these interventions, the contents to be addressed, and intervention strategies that should be used. Mental health nurses have also discussed the characteristics of these training programmes. This study sought to create a consensus on the features of Mental Health First Aid Training Programmes promoted by nurses aimed at upper secondary students. METHODS: A descriptive mixed method study was developed using the modified e-Delphi technique. Original statements on the topic were drawn from the results section of previous studies with nurses and adolescents. The statements were included in a structured online questionnaire. An expert panel of 78 mental health nurses participated in the two-rounds online survey from October to December 2021. Absolute and relative frequencies of responses were analysed. The experts' comments were also considered. RESULTS: In the first round, experts suggested 4 new ideas about training programmes. Experts took a position on a total of 59 declarations. At least 75% of participants agreed with 58 statements about training programmes, namely about facilitators, intervention foci, evaluation methodology, participants, the implementation context, period and regularity, intervention strategies and content. The experts' opinions differed only in one statement that expressed the impaired sexual behaviour as a mental health problem to be addressed in the training programmes. CONCLUSIONS: Mental health nurses can lead the delivery of training programmes in upper secondary schools, improving adolescent competencies in mental health. Several educational approaches can be used to teach about mental health, related problems and actions underlying these conditions. Valid and appropriate assessment methods must be used. Our findings guide the planning, implementation and evaluation of these interventions in upper secondary schools and encourage nurses to explore these programmes and include them in their educational curricula.

Nurses' perspective about the Mental Health First Aid Training Programmes for adolescents in upper secondary schools: A focus group study.

WHAT IS KNOWN ON THE SUBJECT?: Mental Health First Aid Training Programmes with a pathogenic perspective are implemented worldwide for different participants and contexts. These interventions can promote the medicalization and psychiatrization movement of human suffering. Training programmes should teach about mental health nursing problems rather than disorders. However, there seem to be no studies describing these healthier interventions targeting adolescents in upper secondary schools. Nurses can explore these interventions and target them towards these participants and contexts. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The perspective of nurses on the characteristics of Mental Health First Aid Training Programmes for adolescents in Portuguese upper secondary schools is reported. Experts recognize that the nurses who perform these interventions must have personal, pedagogical and mental health competencies. Therefore, mental health nurses may be considered. The components of mental health literacy, mental health nursing problems and a dynamic first aid plan can be taught using different classroom training strategies. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The role of mental health nurses in promoting health literacy is highlighted. They have the opportunity to lead multidisciplinary teams in using these healthier training programmes. These expert opinions can shape the planning, implementation and evaluation of these interventions. In turn, training programmes can promote the identification, assistance and/or adequate and timely referral of people with mental health nursing problems. ABSTRACT: Introduction Mental Health First Aid Training Programmes performed by nurses can empower adolescents to aid people with mental health problems. There do not appear to be any studies that describe these healthier interventions aimed at adolescents in upper secondary schools. The development of these educational interventions benefits from the input of their participants and facilitators. Aim To explore the perspective of nurses about Mental Health First Aid Training Programmes for adolescents in upper secondary schools. Method A qualitative, descriptive and exploratory study was conducted. Data were collected from seven mental health nurses during two focus group sessions. Data were analysed using content analysis. Results Twelve themes were identified around nine main areas: facilitators, intervention foci, outcomes assessment methods, process assessment methods, participants, implementation context, duration and frequency, intervention methods and strategies, and contents. Discussion Mental health nurses can regularly perform these classroom interventions to improve the mental health competencies of adolescents. Various educational methods can facilitate learning related to mental health literacy components, mental health nursing problems and the first aid plan. Valid and appropriate assessment methods enhance a good representation of these interventions. Implications for Practice This evidence can guide the creation and modelling of these first aid training programmes.

Sexuality in people living with a serious mental illness: A meta-synthesis of qualitative evidence.

WHAT IS KNOWN ON THE SUBJECT: A serious mental illness influences sexual life and people affected have worries about their sexual health. People living with a serious mental illness can and want to participate in interventions related to sexual health. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: People who suffer a serious mental illness are interested in maintaining an active sex life. People who suffer a serious mental illness experience rejection when they open up and they lose intimate relationships or possibilities of meeting other people because of ignorance and prejudices surrounding mental health. WHAT ARE THE IMPLICATIONS FOR PRACTICE: Mental health services must respond to this need, that is including sexual needs assessment among routine standard practices or training nurses on sexual education to allow them to advise patients and their families and friends. Health systems should promote awareness programmes and reduce the stigma surrounding mental health and sexuality. ABSTRACT: INTRODUCTION: Sexuality-related nursing care is scarce and mainly focuses on biological issues. There is also a lack of knowledge about how serious mental illnesses affect sexuality. AIM: To explain how people with a serious mental illness perceive and experience their sexuality. METHOD: A meta-synthesis was conducted to integrate qualitative studies. Four databases were used to perform the search, focused in the last ten years. Nine articles were included, and their results analysed thematically. RESULTS: Four categories were identified: "Pathologized sexuality," which explains how the disorder and treatment affect sexuality; "Not my sexuality anymore," which describes feelings emerging from the perceived limitations and the role of self-acceptance; "Learning to manage intimate relationships," which explains the desire to establish intimate personal relationships and define their meaning; and "Reconstructing my sexuality," which elucidates the influence of the environment on sexuality. DISCUSSION: Sexuality is influenced by several factors, the main ones being: the clinical complications, the side effects of drug treatment, the social support, the relationship with the health sector and stigma. IMPLICATIONS FOR PRACTICE: Having a serious mental illness affects sexuality and can provoke suffering and social isolation. Mental health services should address this issue and carry out community interventions to reduce stigma.

A qualitative study exploring adolescents' perspective about Mental Health First Aid Training Programmes promoted by nurses in upper secondary schools.

Mental Health First Aid Training Programmes are educational interventions that aim to disseminate basic first aid skills in the community. Adolescents in the context of their secondary school education are a particularly appropriate population for literacy promotion interventions. This study explores adolescents' perspectives on Mental Health First Aid Training Programmes promoted by nurses in Portuguese upper secondary schools. A qualitative and exploratory study was conducted. Data were collected through semi-structured interviews with 12 adolescents who participated voluntarily and with the consent of their parents. Data were analysed using content analysis. Fourteen themes were identified around three main areas: (i) Relevance of training programmes, (ii) Content of training programmes and (iii) Intervention methods of training programmes. The results obtained indicate that adolescents consider Mental Health First Aid Training Programmes in school relevant and necessary. Adolescents identified the content they deemed most appropriate and how it could be taught. These results can guide the development of training programmes. Nurses should take the lead in implementing these interventions in schools. Adolescents can take a more active role in mental health issues by improving their literacy.

La relación terapéutica como eje de los cuidados enfermeros en las unidades de agudos de salud mental: análisis del contexto en Cataluña / A relação terapêutica como núcleo central dos cuidados de enfermagem em unidades de saúde mental aguda: análise do contexto na Catalunha / The therapeutic relationship as the core of nursing care in acute mental health units: analysis of the context in Catalonia

Múltiples factores de tipo individual y contextual condicionan la calidad de la relación terapéutica en unidades de salud mental. El objetivo fue describir las características de estructura, de equipo, de normativa y de dinámica de cuidados que intervienen en el establecimiento de la relación terapéutica en las unidades de salud mental de Cataluña. El estudio forma parte un proyecto multicéntrico que incluye 18 unidades de salud mental de Cataluña y que pretende mejorar la relación terapéutica a través de una Investigación-Acción Participativa. Este trabajo es la primera etapa en la cual se realizó un análisis del contexto de estudio. Los datos se recogieron a través de guías observacionales cumplimentadas por las enfermeras coordinadoras de cada centro. Los resultados se agruparon en 3 temas: i) estructura de las unidades y dimensión de las plantillas, ii) normativa y dinámica de las unidades y iii) indicadores de calidad de los cuidados. La principal conclusión del estudio es la gran variabilidad observada en las unidades en relación con su estructura, ratios y normativas. Debido a estos factores del entorno, los cuidados que se brindan y, en consecuencia, la relación terapéutica; es considerablemente distinta en función del área en la que reside cada paciente.(AU)

Multiple individual and contextualfactors influence the quality of thetherapeutic relationship in mental healthunits. The objective was to describe the characteristics of structure, teamwork, wardrules and care dynamics that intervene in theestablishment of the therapeutic relationshipin mental health units in Catalonia. Thestudy is part of a multi-centre project thatincludes 18 mental health units in Catalonia,and which aims to improve the therapeuticrelationship through Participatory Action-Research. This work is the first stage inwhich an analysis of the study context wascarried out. The data were collected throughobservational guides filled in by thecoordinating nurses of each centre. Theresults were grouped into 3 themes: i)structure of the units and size of theteamworks, ii) rules and dynamics of theunits and iii) indicators of quality of care.The main conclusion of the study is the greatvariability observed in the units in relation totheir structure, ratios and rules. Due to theseenvironmental factors, the care providedand, consequently, the therapeuticrelationship, is considerably differentdepending on the area in which each patientresides.(AU)

Vários fatores individuais econtextuais condicionam a qualidade darelação terapêutica nas unidades de saúdemental. O objetivo foi descrever ascaracterísticas da estrutura, trabalho emequipa, regulamentação e dinâmica decuidados que intervêm no estabelecimentoda relação terapêutica em unidades de saúdemental na Catalunha. O estudo faz parte deum projeto multicêntrico que inclui 18unidades de saúde mental na Catalunha e quevisa melhorar a relação terapêutica atravêsda Investigação-Ação Participativa. Estetrabalho é a primeira etapa em que foirealizada uma análise do contexto do estudo.Os dados foram recolhidos através de guias observacionais preenchidos pelosenfermeiros coordenadores de cada centro.Os resultados foram agrupados em 3 temas:i) estrutura das unidades e tamanho dosgabaritos, ii) regulamentação e dinâmica dasunidades e iii) indicadores de qualidade daatenção. A principal conclusão do estudo é agrande variabilidade observada nas unidadesem relação á sua estrutura, relações eregulamentos. Devido a estes fatoresambientais, os cuidados prestados e,consequentemente, a relação terapêutica, sãoconsideravelmente diferentes dependendoda área em que cada paciente reside

Un día en la unidad de hospitalización de psiquiatría / Um dia na unidade de internação psiquiátrica / A day in the psychiatric inpatient unit

Se presenta el relato de la que podría ser la experiencia vivida por una persona hospitalizada en una unidad de psiquiatría cualquiera. Los datos se generan mediante la observación no participante, entrevistas informales y la propia experiencia asistencial de los autores. La persona protagonista está hospitalizada de forma involuntaria en una unidad de agudos de psiquiatría, ha recibido del 'sistema' la etiqueta diagnóstica de psicosis. A través de su mirada, los autores reflexionan en torno a las percepciones y vivencias que le acontecen en relación con el devenir cotidiano del hospital, y por supuesto con el cuidado recibido por las enfermeras de la unidad (AU)

We present the story of what could be the experience of a hospitalized person in whatever psychiatric unit. The data are generated by non-participant observation and care experience of the authors. The protagonist person is involuntarily admitted in a psychiatric acute unit; he has received the diagnostic label of psychosis by the 'system'. Through his eyes, the authors reflect about perceptions and experiences that happen him in relation to the daily workings of the hospital, and of course with the care received by nurses in the unit (AU)

Nós apresentamos a história do que poderia ser a experiência de uma pessoa internada em qualquer unidade psiquiátrica. Os dados são gerados pela observação não participante e experiência de cuidado dos autores. A pessoa protagonista é involuntariamente internado em uma unidade psiquiátrica aguda; ele recebeu o rótulo diagnóstico de psicose pelo 'sistema'. Através de seus olhos, os autores refletem sobre as percepções e experiências que lhe suceder em relação aos trabalhos diários do hospital, e, claro, com o cuidado recebido por enfermeiras da unidade (AU)