The psychiatric-mental health nurse practitioner as coordinating practitioner in the Netherlands: A multiple case study.

BACKGROUND: Psychiatric-mental health nurse practitioners (PMHNPs) in the Netherlands have been allowed to perform the role of coordinating practitioner (CP) since 2018. This role is reserved for mental health care specialists who are trained and qualified at the master's degree level. Earlier studies have not addressed how PMHNPs perform that role and what mechanisms and contextual factors determine their performance. This understanding could help optimize their performance in this role and promote effective deployment of PMHNPs in mental health care. PURPOSE: To understand how PMHNPs perform this role and what mechanisms and contextual factors underlie that performance. METHODOLOGY: A multiple case study involving PMHNPs who work in various settings as CPs. Data were collected and analyzed using the realistic evaluation approach. RESULTS: We identified four mechanisms related to the performance of PMHNPs in the role of CP: (1) autonomous performance; (2) unique expertise; (3) accessibility, availability, and professional involvement; and (4) additional roles. The extent to which these mechanisms are present is largely determined by organizational factors, team factors, and individual factors. CONCLUSIONS: Psychiatric-mental health nurse practitioners are seeking to identify and interpret the role of CP. This study helps to elucidate the mechanism of role performance by PMHNPs and what they should focus on to deliver effective and patient-centered mental health care. IMPLICATIONS: Policymakers, health care professionals, and educators should consider the mechanisms and contextual factors to facilitate and support PMHNPs' employment and training in the role of CP.

The use of photography in perceiving a sense in life: A phenomenological and existential approach in Mental Health Care.

This article is about the therapeutic use of photography in mental health care. We will first describe the intelligent nature of perception as we understand on the basis of neurobiological research findings. We will link our interpretation of visual perception with the phenomenology of perception from the theory of Merleau-Ponty.. Then we will discuss how patients in mental health care with mental health problems may profit by an experiential approach that is concomitant with the existential reality described by Merleau-Ponty. The experiential approach we go into more detail is Focusing. We will demonstrate the limitations and feasibility of Focusing in the procedures of working with photography as a therapeutic medium.

Living with severe mental illness: perception of sickness.

AIM: This article is a report of a study on how participation in photo groups influenced the perception of the impact of sickness on daily life. BACKGROUND: Living with severe mental illness can have a strong impact on daily life and the experience of self. In combination with self-stigmatization, this can lead to a sense of being no more than a patient. METHOD: A mixed-methods design was used to measure the perception of sickness impact. Consumers of psychiatric services participated in photography groups that aimed at integration of illness and developing new goals in life. These groups were conducted by nurses and data were collected between the years 2005 and 2009. The Sickness Impact Profile (SIP) questionnaires were completed by the respondents before and after intervention. The SIP was used to differentiate between respondents who perceived less impact of illness on their daily lives after following a photogroup and those who did not perceive so or remained the same. A sample of these three groups was used to complement the quantitative findings with in-depth interviews with consumers and mentor nurses. RESULTS: Findings indicated absence of important changes in the sickness impact scores except in the domain of mobility. Consumers did, however, show signs of progress in terms of increasing openness, understanding of their feelings and situation and abilities to cope with them. CONCLUSION: Participating in photo groups can help patients get along with their life and make it more bearable. No signs of demoralization and self-stigmatization were found.

Facades of suffering: clients' photo stories about mental illness.

In this article, photo stories are examined that were the result of working with photography as a therapeutic instrument dealing with suffering in mental health care settings. The purpose is to describe the role of facades in the process of suffering and acceptance. Clients took photographs, talked about them in group meetings, and exhibited them to a broader audience. Their photo stories were analyzed using a mixed-methods model. Data from two narrative approaches (semiotics and hermeneutics) were compared with information from other informants and official records to find discrepancies between the photo story and the real life context. Although facades are usually perceived as an obstacle for personal growth, the visual narratives revealed that facades can function as an alternative to common acceptance strategies, such as facing one's losses and reconciliation. Facades can create a distance between the person and the suffering. We conclude that visual narratives can reveal and foster agency in clients.