'We try' - how nurses work with patient participation in forensic psychiatric care.

RATIONALE: Patients in secure forensic psychiatric care have reduced autonomy because of the constraints imposed on them by compulsion laws. Thus, it is vital that nurses enable patient participation whenever possible. Patient participation, and it's clinical use in forensic psychiatric care, is an understudied field. AIM: To describe nurses' experiences of their work with patient participation in forensic psychiatric care. METHODS: Managers at different secure forensic psychiatric institutions in the south of Sweden approved the study, and oral consent was retrieved from informants. Interviews guided by a semi-structured interview guide were conducted with nine nurses from five different forensic psychiatric institutions and analysed with content analysis. FINDINGS: Nurses describe diverse understandings and abilities in an inflexible setting. This indicates that what participation is, and how to achieve it, is not the same for nurses as for patients. Moreover, patients have different abilities to participate, and the secure setting in itself is perceived as hindering participatory work. Still, participation is described as a crucial part of work that requires a caring relationship. Furthermore, nurses pronounce potentially excluding attitudes and strategies that may obstruct patient participation for all, and at the same time, they have a belief that improvement is possible. CONCLUSION: Compulsory forensic psychiatric care is a complex care context that requires constant efforts from nurses to balance patients' rights and needs with mandatory care. The very nature of this caring context appears to be a major obstacle when promoting patient participation. Nevertheless, nurses express that they do aim for patient participation, 'they try'. From a patient's perspective, trying is not sufficient and a need for improvement is evident. The results can be of clinical interest in similar secure forensic psychiatric nursing settings, and a point of departure in future development of care striving for increased patient participation for all.

TeleMental Health: Standards, Reimbursement, and Interstate Practice [Formula: see text].

BACKGROUND: TeleMental Health (TMH) is gaining widespread acceptance in the United States. OBJECTIVE: Summarize current evidence regarding TMH risks and benefits, standards of care, practice guidelines, reimbursement, and interstate practice issues pertinent to psychiatric nurses and consumers. DESIGN: A targeted review of literature, current practice, and TMH websites was generated using the following key search words: clinical outcomes, practice guidelines, regulations, interstate practice, and reimbursement for TMH. A search of government and professional organization websites and a literature review of PubMed and PsychINFO databases was limited to the past 15 years. RESULTS: Studies demonstrate TMH services are equal in efficacy to that provided in face-to-face encounters and preferred by some populations. Current TMH practice guidelines, reimbursement, and regulatory issues are reviewed. CONCLUSIONS: Providers, including psychiatric advanced practice registered nurses, can use TMH to effectively address the growing need for mental health services, although regulatory, licensure, and clinical issues must be addressed prior to offering TMH services.

[The latest best practice guidelines relating to seclusion and restraint]. / Les dernières recommandations de bonnes pratiques sur l'isolement et la contention.

Several measures relating to seclusion and restraint are included in the French public health code. The best practice guidelines of the French National Health Authority, published in 2017, define these two notions and advise on the behaviour to adopt with regard to their implementation and monitoring. Likewise, informing and supporting the patient when these measures are lifted are critical moments which the teams must also be able to manage correctly.

[Preventing violence during hospitalisations in psychiatry]. / Prévenir les moments de violence lors des hospitalisations en psychiatrie.

Over recent years, the psychiatric sector has endeavoured to develop community-based care. Paradoxically, the number of compulsory hospitalisations is increasing. At the same time, the legal framework is evolving and measures relating to the deprivation of liberty in the context of psychiatric care have given rise to extensive guidelines. The work of the French National Health Authority represents, in this context, a certain continuity, with regard to the legal, ethical and social discussions around restriction of liberty practices within psychiatric units. The main focus is on the prevention and management of violent outbursts.

[Court-ordered therapy, a measure for preventing reoffending]. / L'injonction de soins,une mesure pour éviter la récidive.

In France, court-ordered therapy is a measure applicable in the framework of socio-judicial supervision, created by the law of 17th June 1998 relating to the prevention and suppression of sex offences, as well as the protection of minors. Since its introduction, its indications have been extended to include other offences. By organising a triangulation of the relations between the legal and health care systems (doctors and psychologists) through the intermediary of the doctor-coordinator, this programme aims to prevent reoffending.

[The interaction between the judge and doctors with court-ordered therapy]. / L'interaction entre juge et médecins dans l'injonction de soins.

Faced with the increase in convictions for sex offences, legislators in the 1990s studied the possibility of monitoring these criminals and offenders, considered to be among the most dangerous, following their imprisonment. This resulted in the law of 17th June 1998, establishing socio-judicial supervision. Inspired by several high-profile cases, the resulting changes to the legislation have reinforced judicial measures aimed at preventing repeat offending with regard to the most serious crimes. Socio-judicial supervision in particular is routinely ordered as part of certain safety measures while court-ordered therapy has become a cornerstone in the management of the most dangerous prisoners. An analysis of the connection between the judge and court-ordered therapy enables its role to be better understood.

["For us, as 'patients/users', the essential point remains the respect of the person"]. / « Pour nous "usagers patients", le point essentiel reste le respect de la personne ¼.

The first organisation to bring together the users of care in the history of the speciality, the French National Federation of Patient Associations in Psychiatry has always campaigned for the respect of users' freedom of movement. Despite the progress made in terms of legislation, the federation presents a mixed picture. For Claude Filkenstein, its president, there remains a long way to go, notably in the field of the culture of psychiatric care. In her opinion, training should be a major advantage.

[Care and restraint, when the law questions nursing practice]. / Soins sous contrainte, quand le droit interroge la pratique.

With the reforms of 2011 and 2013 relating to psychiatric hospitalisation, raises the question of the suitability of modern psychiatric practice with regard to a person's recognised principles and basic rights. Achieving a balance is difficult and the Constitutional Council has joined the debate, bringing to an end any idea of compromise between safety and freedom. A decision which was made as a result of a clarification of certain regulations which have proved controversial from the point of view of individual liberties.

[The risk of reoffending, a major concern of the doctor-coordinator]. / Le risque de récidive, une préoccupation majeure du médecin coordonnateur.

Doctor-coordinators are nominated by the judge for the enforcement of sentences as soon as socio-judicial supervision with court-ordered therapy is to be implemented. Their mission is to facilitate the contact between offenders and the general practitioner likely to be working with them on the therapeutic level. The experience of the doctor-coordinator in Bordeaux sheds light on the conditions in which this function is performed. Identifying elements which may be considered as indicators of the risk of reoffending is, in daily practice, a constant concern for this specialist.

[Court-ordered therapy, the case of sex offenders in Belgium]. / Injonction de soins, le cas des délinquants sexuels en Belgique.

Following the Dutroux affair which rocked Belgium in 1996, the Belgian minister for justice signed cooperation agreements with the country's three regions (Flanders, Wallonia and Brussels-Capital), imposing on sex offenders therapy or treatment as an alternative to imprisonment. What legal programme is now in place for their management? Experience of the Brussels support centre.

The Impact of Organizational Factors and Government Policy on Psychiatric Nurses' Family-Focused Practice With Parents Who Have Mental Illness, Their Dependent Children, and Families in Ireland.

Government policy and organizational factors influence family-focused practice (FFP) in adult mental health services. However, how these aspects shape psychiatric nurses' practice with parents who have mental illness, their dependent children, and families is less well understood. Drawing on the findings of a qualitative study, this article explores the way in which Irish policy and organizational factors might influence psychiatric nurses' FFP, and whether (and how) FFP might be further promoted. A purposive sample of 14 psychiatric nurses from eight mental health services completed semi-structured interviews. The analysis was inductive and presented as thematic networks. Both groups described how policies and organizational culture enabled and/or hindered FFP, with differences between community and acute participants seen. This study indicates a need for policies and organizational supports, including child and family skills training, to promote a whole family approach in adult mental health services.

[Health and justice coordination in prisons]. / Articulation santé et justice en milieu carcéral.

The question of health-justice coordination has been present since the law of 18th January 1994. Since then, professional relations between prison staff and health carers have been regularly questioned in terms of their aims. The texts structuring this interinstitutional health-justice coordination constitutes a framework which the various professionals must appropriate and implement by drawing on specific knowledge and skills. It is an invitation to work together around the same population, on their respective and different missions. The implementation of a structured therapeutic group with sex offenders constitutes a positive experience.

[Prisoners in units for difficult patients]. / Les détenus en unités pour malades difficiles.

Prisoners, on remand or convicted, can be placed for a variable amount of time in a unit for difficult patients if their pathological mental state so requires. For the most part, their therapeutic care does not depend on their status as prisoner. The treatments provided are those indicated for their psychological pathologies and their potential or known dangerousness. However, some administrative measures make a distinction between their treatment and that of non-prisoner patients placed in these secure psychiatric units.

[The management of perpetrators of sexual violence]. / La prise en charge des auteurs de violence sexuelle.

Sexual violence and crimes arouse rejection and hatred in our society. Perpetrators of sexual violence must comply with psychiatric treatment, without necessarily having requested it. Caregivers find it extremely difficult to engage themselves in the management of these patients. This context has favoured the setting up of specific consultations, signalling a potential new area of care.

[The status of the psychiatric nurse as a guarantor in Taiwan: a case study].

BACKGROUND: Psychiatric nurses have a special obligation and legal duty as guarantor against criminal negligence. The guarantor role and medical negligence in psychiatric nursing are topics that have been neglected in Taiwan. PURPOSE: (1) Identify the status of psychiatric nurses as guarantors; (2) Understand the causal relationship in a legal context between this status and Non-Genuine Omission in the current case; (3) Understand the facts and the dispute in the current case. (4) Explore the reasons why the psychiatric nurse was convicted for criminal negligence in the current case. METHODS: A literature review and case study were used to analyze the high court criminal judgment and sentence reconsideration of the first instance No. 122 (2005). RESULTS: (1) Psychiatric nurses hold two guarantor roles in Taiwan. One role is as legally protected interest guarantor and the other is as supervisors' dangerous source guarantor. (2) The three sources of guarantor status relevant to the current case are: nurses' voluntary commitments; medical contract; duty of care of supervisors. (3) In this case, the psychiatric nurse did not discharge her obligations as guarantor and failed to prevent the patient from committing suicide. Negligence resulted in patient death and the psychiatric nurse was found guilty. CONCLUSIONS: In order to prevent criminal acts, psychiatric nurses should gain a better understanding of their status as guarantor and the obligations entailed in this status. This article is intended to assist psychiatric nurses understand their responsibilities under current laws.

[The challenges and perspectives of collaborative networking]. / Enjeux et perspectives du travail en réseau.

The mental health action plan for Europe dates back to 2005 and sets out the terms for drawing up, implementing and strengthening global mental health policies in all European countries. While in the area of psychiatry, the advantages of working in a network must be emphasised, it can be developed on the level of the local community, the health care territory or the department as well as on a regional basis.

The Mental Health Act: exploring the role of nurses.

This paper examines the role of approved mental health professional (AMHP) which was introduced by the Mental Health Act 2007. It outlines the scope and functions of the role and explores the likely impact on the nursing profession. While the expansion of the role does offer opportunities for career progression and enhancing professional autonomy and status, it must be accompanied by a corresponding increase in resources and training, to enable nurses to fully harness the AMHP role. This expansion will inevitably bring with it increased legal responsibility and accountability and the extent to which mental health/learning disability nurses will be willing to shoulder that remains to be seen.

[After "transsexualism"]. / Après le "transsexualisme".

Sex reassignment protocols in France do not meet the demands of people in transition. Consequently, transsexual people draw up what are called "free" transitions, without any psychiatric follow-up, opening the way for discussion on the place of the law and the need for psychiatry in these cases.

Mental health nursing and the politics of recovery: a global reflection.

The concept of recovery increasingly dominates mental health policy and practice agendas in most Western countries. However, the many, often conflicting, definitions of recovery have led to theoretical and practical confusion. More importantly, the concept clashes with some of the established assumptions of psychiatric/mental health nursing, especially the traditional notion that the person is "ill" and requires "treatment" or some other active "intervention." The implications of recovery for the further development of person-centered care, especially within a globalized form of mental health nursing, are discussed with specific reference to the Tidal Model, an international midrange theory of mental health nursing.

Nurse migration in an increasingly interconnected world: the case for internationalization of regulation of nurses and nursing regulatory bodies.

Psychiatric/Mental Health nursing has a long history of professional self-regulation; nevertheless, interest in how governments protect consumers of health care from poor or dangerous practice(s) is on the increase. Correspondingly, there have been calls, in several parts of the world, for greater watchfulness and due diligence from regulatory bodies. Mindful of the concept of "globalization" and the unequivocal data regarding the significant increase in the migration of nurses, it is difficult to ignore/deny the reality of an increasingly mobile and connected international nursing workforce. However, the extant literature also indicates the existence of significant disparities between countries and even states/provinces within countries as to the enforcement of professional regulation. What this means is that decisions made by one regulatory body can have a direct impact on the standard(s) of nursing quality and practice in a country on the opposite side of the world. As a result, the authors attempt to advance the debate that there is a clear need to reconcile these positions, and they introduce the argument for the creation of an international oversight body. Using case study material, the relevant theoretical and policy literature in this area (such as it is), and by drawing on examples of analogous oversight bodies from other areas, we draw attention to the need to create a genuinely international body for the oversight of nurse regulation.