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

Mental Health Nurses Overcoming Adversity: A Discursive Review

The mental health nursing profession has experienced various challenges since its inception. This discursive review considers these challenges, including how mental health nurses have and can continue to overcome adversity as individuals and as a profession. The discussion examines the influence of the profession's historical involvement in institutionalization and coercive care; the continuing impact of stigma; and the increasing demand for mental health services, amidst chronic staff shortages. Collectively, mental health nurses must harness strong therapeutic relationships, intra- and multi-disciplinary collaboration, personal and professional resilience, education that prepares them for the future, and sector-wide planning and innovation, to respond positively to these challenges. These approaches will support mental health nurses to overcome adversity and achieve positive outcomes for the profession and people with the lived experience of mental illness.

Experiences of an Equine-Assisted Therapy Intervention among Children and Adolescents with Mental Illness in Sweden - A Nursing Perspective

Mental illness among children and adolescents is increasing globally, and prescription of psychiatric drugs for children and adolescents with mental illness is increasing worldwide, including Sweden. Holistic health-promoting interventions have shown promising long-lasting significant health benefits in young individuals with mental illness, but holistic health-promoting mental health interventions are often disregarded due to a lack of systematic theory-based knowledge. Consequently, the lack of scientific knowledge thwarts implementation of equine-assisted therapy as an established intervention in mental health nursing for children and adolescents with mental illness. The purpose of the study was to better understand experiences of equine-assisted therapy among children and adolescents with mental illness. The study adopted an inductive approach and data was collected using photovoice methodology. Six young persons, 7-18 years of age, referred by a psychologist to the equine-assisted intervention due to mental health issues, were included in the study. Data was analyzed using qualitative content analysis. The results could be summarized by an overarching theme, a physical, emotional, and social milieu for growth, consisting of three subcategories: feeling relief from everyday stress and anxiety; nurturing self-esteem in a mutual friendship; and strengthening self-reliance through synchronized interplay. The results indicate that equine-assisted therapy has essential values closely related to the goals of mental health nursing. Further research should strive to attain even gender distribution in study samples and focus on how equine-assisted therapy could be thoroughly integrated into established nursing intervention for children and adolescents with mental illness.

What should be the future focus of mental health nursing? Exploring the perspectives of mental health nurses, consumers, and allied health staff

The landscape of mental health care and service delivery is changing, as is our understanding of the underlying causes for mental distress. It is now apparent that biogenic explanations have been overstated and instead experiences of trauma and adversity constitute the main contributor to people's experiences of mental health challenges. The shortcomings of treatments traditionally used in mental health care are also evident, and with a contemporary focus on person-centred care, the utility of diagnostic labels has been called into question. Taking all this into consideration, this study sought to explore, what should be the future focus of mental health nursing? Three separate focus groups were conducted. One with a sample of senior clinical mental health nurses, one with a sample of consumer representatives and another with allied health professionals. The common theme across all three focus groups was the centrality of the therapeutic role of mental health nurses (MHNs). Consumers and allied health participants, in particular, advocated for a de-emphasis on medications, psychiatric diagnoses, and custodial practices. The MHNs role in health promotion, working collaboratively with consumers, being hopeful, understanding the individual perspective, and appreciating the social determinants of mental health were all highlighted in framing the future focus of MHN practice.

Impact of Mental Health on Wellness in Adult Workers

Wellness in adult workers is intimately associated with better quality of life in individuals, as well as in the family, community, workplace, and country. This study aimed to examine the status of wellness in adult workers and to identify the factors that influence wellness. A descriptive survey was conducted with 260 adult workers. T- test and one-way ANOVA with post-hoc Scheffe test were used to analyze the data. Multiple regression analysis was performed on stress, depression, anxiety, well-being, self-efficacy, and perceived health status. The regression model for wellness in adult workers was significant (F = 42.21, p < 0.001), with an explanatory power of 0.558. Depression (β = −0.306) was identified as the most influential factor for wellness in adult workers, followed by self-efficacy (β = 0.280) and well-being (β = 0.264). Depression, stress, and anxiety negatively influenced wellness, whereas self-efficacy, well-being, and perceived health status positively influenced wellness. Study findings suggest the need to develop intervention programs for workers that decrease stress, depression, and anxiety, and incorporate self-efficacy strategies.

The nursing team work process in Children and Adolescents Psychosocial Care Centers

OBJECTIVE

To know the nursing team work process in Children and Adolescents Psychosocial Care Centers in a city of the state of São Paulo.

METHOD

This is a qualitative, descriptive, and exploratory study, based on the approach of historical and dialectical materialism, carried out with the nursing team through participant observation and semi-structured interviews.

RESULTS

Eleven subjects from the nursing team participated in the study. The nursing team work process emerges from the dialectical tension of two categories: the non-knowledge, based on the alienation of the nursing work process and subordination to the knowledge of the multidisciplinary team, and the knowledge based on the nursing clinic outlined within the biological and relational perspectives.

CONCLUSION

The nursing team work process takes place when guided by a non-knowledge resulting from alienation due to the knowledge of the other, and by knowledge through the implementation of the Nursing Process through the Nursing Care Systematization based on a biological perspective, considering relational and administrative aspects, which emerges as a contradiction.

Dilemmas in delivering health promotion activities: findings from a qualitative study of mental health nurses in Denmark

OBJECTIVE

Recent studies have shown that people with mental illnesses have higher mortality and morbidity rates due to long-term conditions and lifestyle diseases. This knowledge has led to health promotion initiatives in mental health care to improve the physical health of people with mental illness. This article explores how mental health nurses experience working with health promotion activities in mental healthcare practices.

DESIGN

We adopted a qualitative research design using an interactive approach. Qualitative content analysis was used to develop the analytical framework.

PARTICIPANTS

Focus groups (n=7; n=5) were conducted with two groups of mental health nurses who attended health specialist training sessions in Denmark in the spring and fall of 2018.

RESULTS

The findings showed that working with health promotion activities in mental health care created two dilemmas for the mental health nurses: (1) dilemmas related to health promotion that involved discrepancies between the health promotion activities that were offered and patients' autonomy and wishes, and (2) system-related dilemmas stemming from working with screening for risk factors and documentation programmes. The mental health nurses developed different strategies to navigate these dilemmas, such as devising interview techniques for the screening questions and bending guidelines.

CONCLUSIONS

Mental health nurses found it challenging to implement health promotion activities in mental health care, although they generally found these activities meaningful. The findings show that new health promotion activities need to be adapted to nurses' existing mental healthcare practices; however, this may require some adaptation of existing nursing practices.

To Identify and Support Youths Who Struggle with Living-Nurses' Suicide Prevention in Psychiatric Outpatient Care

Nurses working in psychiatric care daily encounter youths who are struggling with living. Despite this, nurses' suicide-prevention work is seldom addressed in research or in recommendations for care. The overall aim of this paper is to discuss how nurses, with their caring science perspective, may contribute to suicide prevention. The paper presents how nurses in psychiatric outpatient care may identify and support suicidal youths, according to experts in suicide prevention. The interviews with six experts in suicide prevention resulted in three themes: Engagement necessary but demanding, Acknowledgement of warnings signs and Supportive relationship. The respondents elaborated on how suicide-risk can be assessed. A good rapport with the youths was stressed and the recommended act of care included: to listen openheartedly without interrupting as well as to listen after risk- and protective factors to emphasize or to penetrate. To ask about suicidality as well as to let the person elaborate on what's important for him or her. To endure in the patients' suffering as well as steering the conversations toward hope. The paper also presents warning signs that need to be noticed according to the experts and the literature consensus. Our findings suggest that communication in suicide-prevention is an "art and act" that cannot be reduced to a method or simple guidelines. We argue that the recommended acts of care demand sensitivity and skills and that nurses as well as the domain of caring science may contribute to this competence.

Swedish Mental Health Nurses' Experiences of Portrayals of Mental Illness in Public Media

News reporting about mental illness lack perspectives of the mentally ill themselves and it is almost exclusively psychiatrists who are accessed when healthcare staff is consulted. The perspective of mental health nurses might contribute to the public understanding of mental illness. The purpose of this study was to describe mental health nurses' experiences of how mental illness is portrayed in media. Eight semi-structured interviews were conducted with qualified mental health nurses. A qualitative content analysis resulted in three categories: Negative portrayals of mental illness, Inconclusive images of mental illness and Biased dissemination of different perspectives. The conclusion of this study is that mental health nurses experience media portrayals of mental illness as negative and misleading with too much emphasis on the medical perspective while a holistic mental health nursing perspective is heavily obscured. Mental health nurses need to take a more prominent role in public reporting on mental health to resolve the current lack of relevant facts regarding mental illness. Further research is needed regarding portrayals of mental illness in social media and how the current lack of perspectives affects public perceptions of mental illness. In addition, further studies regarding the viewpoints of journalists reporting on mental illness are required.

Experiences of community mental health nurses in Japan as the basis of their nursing philosophies

PURPOSE

To investigate the experiences of Japanese community mental health nurses (CMHNs) that help form the basis of their nursing philosophies.

DESIGN AND METHODS

This study uses the narrative research method. I conducted participant observation and narrative interviews with nine CMHNs in Japan.

FINDINGS

Four themes emerged: (1) experiences as consumers' peers; (2) nurses' own recovery; (3) high levels of spirituality; and (4) a free spirit.

PRACTICE IMPLICATIONS

Recognizing these nurses' intrinsic experiences could help to shift mental health nursing paradigms from those based on biomedical models to newer perspectives found in recovery models.

Increasing Psychiatric Rehabilitation Knowledge in a Supported Housing Setting: Pre- and Posttest Analysis

The current study investigated the effectiveness of a state-wide Community Support Services training grounded in work-based learning to improve knowledge about psychiatric rehabilitation principles and skills. Supervisory staff and direct care staff in supported housing settings completed a 17-item, multiple choice, preand posttest after attending a 48-hour training series. Results indicated that participants gained psychiatric rehabilitation knowledge. These findings support the effectiveness of the training series grounded in work-based learning. [Journal of Psychosocial Nursing and Mental Health Services, 57(6), 39-44.].

Importance of families in care of individuals with mental disorders: nurses' attitudes

Abstract Objectives: To characterize the attitudes of nurses working in primary health care on the importance of involving families in nursing care to the person with mental disorder. Method: A cross - sectional descriptive study with a quantitative approach performed with 328 nurses who work in primary health care in Porto, Portugal. Families Importance in Nursing Care - Nurses Attitudes (FINC-NA) scale was applied. Results: Scale scores were elevated, mean value was 85.9 (Maximum possible 104). The significant correlations were with the variables: academic qualifications (p = 0.001), specialization (p = 0.002) and professional activity context (p = 0.001). Conclusion and implications for practice: Nurses demonstrate a high degree of agreement about the importance of families in nursing care to the person with mental disorder. Positive attitudes of nurses regarding the importance of involving families in care are fundamental to enhance the quality of care in the presence of mental disorder.

Exploring health promotion and health education in nursing

The term health promotion has been used in healthcare for several years. However, the meaning of this term is debated, particularly in nursing. Some nurses might believe that, because they are healthcare practitioners working in healthcare services, that they are 'by default' automatically involved in health promotion activities; however, this is often not the case. Instead, they are more likely to be engaging in health education activities; that is, simply providing individuals with health-related information, rather than seeking to empower individuals, families, groups and communities. While health education is related to health promotion, these terms are not interchangeable, since health education is a component of health promotion. This article clarifies these concepts and describes approaches to illness prevention and promoting well-being that nurses can use in their practice with patients across the lifespan.

Master's level mental health nursing competencies, a prerequisite for equal health among service users in mental health care

PURPOSE

This discussion paper aims to explore the need of a clarified definition of master's level mental health nursing competencies in terms of knowledge, skills and attitudes in a European context. Mental health service users have, in spite of their right to equal overall health, higher rates of physical illness and are more likely to experience premature death than the general population. Implementation of a holistic concept of health comprising mental, physical and social aspects of health in mental health services has previously proved to be challenging.

METHODS

Master's level mental health nursing competencies in recent literature are discussed and illuminated in terms of knowledge, skills and attitudes in order to enable the promotion of equal overall health among service users in mental health services.

RESULTS

The discussion show contents, values and utility of master's level mental health nursing competencies in mental health services and contribute to reduced role ambiguity by distinguishing master's level responsibilities from undergraduate nursing tasks and obligations of other professionals in mental health care.

CONCLUSION

This discussion paper shapes implications for developments in master's level mental health nursing education curricula.