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Ropaj E, Haddock G, Pratt D. Developing a consensus of recovery from suicidal ideations and behaviours: A Delphi study with experts by experience. PLoS One 2023; 18:e0291377. [PMID: 37729121 PMCID: PMC10511083 DOI: 10.1371/journal.pone.0291377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Understanding recovery in mental health has received significant attention and consequently, recovery has been incorporated into health policy across many countries in the Global North. In comparison, the concept of 'recovery' from suicidal thoughts and behaviours has received little attention. However, the few studies in this area appear to suggest that recovery is a complex and an idiosyncratic process with many contributing factors. This can present a challenge for clinicians and services seeking to become more recovery focused. Thus, it seems of importance to develop a consensus on how recovery from suicidal thoughts and behaviours is conceptualised. AIM The study aimed to use the Delphi design to establish a consensus of how recovery is defined by those with lived experience of suicidal thoughts and behaviours. The Delphi method draws on the expertise of a panel, often involving clinicians, researchers and lived experience experts to develop consensus over a topic by inviting them to rate the importance of, often a series of statements to a given topic area. METHOD Lived experience experts were asked to complete two rounds of questionnaires distributed online to capture their views on recovery. RESULTS A total of 196 individuals gave their views on the first round of the study and 97 gave their views on the second round. A final list of 110 statements was developed that 80% or more of participants defined as essential or important. Statements covered items that were important in defining, facilitation and hindering the process of recovery. CONCLUSION Findings are consistent with the wider literature that suggests that recovery is an idiosyncratic process, but with many commonly shared features. Here we also show that a comprehensive definition of recovery must include factors that hinder the process of recovery. Implications and recommendations for practice, policy development and future research are discussed.
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Affiliation(s)
- Esmira Ropaj
- Division of Psychology & Mental Health, Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Gillian Haddock
- Division of Psychology & Mental Health, Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Daniel Pratt
- Division of Psychology & Mental Health, Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
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Søndergaard R, Buus N, Berring LL, Andersen CB, Grundahl M, Stjernegaard K, Hybholt L. Living with suicidal thoughts: A scoping review. Scand J Caring Sci 2023; 37:60-78. [PMID: 36527267 DOI: 10.1111/scs.13137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/04/2022] [Accepted: 11/13/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND There is a significantly higher number of people experiencing severe levels of suicidal thoughts compared to that of suicidal deaths and suicide attempts. In suicide prevention research, there is a shift towards greater emphasis on people's experiences of living with suicidal thoughts. This can expand the existing evidence base, which is dominated by a biomedical approach. The aim of this review was to summarise and disseminate existing research on the lived experiences of living with suicidal thoughts. METHODS A scoping review by Arksey & O'Malley consisting of six stages: (1) formulating the research question, (2) identifying relevant studies, (3) selecting studies, (4) mapping data, (5) summarising the results and (6) consulting stakeholders. PubMed, PsycINFO and CINAHL were searched for studies in English, Danish, Swedish and Norwegian. Peer-reviewed articles examining people's experiences of living with suicidal thoughts using qualitative methods were included. The search was supplemented with a citation pearl search in the Web of Science database. Twenty-eight studies were included. RESULTS The findings were organised under two thematic headings: (a) the significance of social connections and (b) a loss of the personal self. CONCLUSION There is a need for further qualitative research of people's experiences of living with suicidal thoughts from an everyday life perspective. Awareness about social connections and attachment in mental health prevention and governance is crucial. Trauma-informed care could be a useful approach to prevent suicidal thoughts as the review found that many participants had traumatic experiences in both childhood and adulthood. As part of the treatment of suicidal thoughts, it might be useful to have a focus on narrative and communicative methods and their clinical application.
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Affiliation(s)
- Rikke Søndergaard
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark
| | - Niels Buus
- Monash Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Lene Lauge Berring
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | | | | - Karina Stjernegaard
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,PsykInfo, Psychiatry Region Zealand, Region Zealand, Denmark
| | - Lisbeth Hybholt
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark.,Research Unit, Mental Health Services East, Psychiatry Region Zealand, Roskilde, Denmark
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Sunnqvist C, Berngarn A, Ezinne Ekezie P, Lundgren E, Nilsson E, Örmon K. A pilot evaluation of a prehospital emergency psychiatric unit: The experiences of patients, psychiatric and mental health nurses, and significant others. Perspect Psychiatr Care 2022; 58:2255-2262. [PMID: 35148425 PMCID: PMC9790504 DOI: 10.1111/ppc.13055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To explore the significance of the alliance with the Prehospital Emergency Psychiatric Unit for patients, psychiatric and mental health nurses, and significant others, and to evaluate their experiences of treatment and care. DESIGN AND METHODS A qualitative inductive interview study with 11 participants: four patients, six nurses, and one significant other. The interviews were analyzed with content analysis. FINDINGS The analysis resulted in four subcategories: To be met with respect, presence and time, knowledge and experience, and feeling of support, and one category: A psychiatric team with knowledge and experience creating stability and a sense of self-worth. PRACTICE IMPLICATION The Prehospital Emergency Psychiatric Unit enables a safe, person-centered service.
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Affiliation(s)
- Charlotta Sunnqvist
- Department of Care Sciences, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | | | | | - Emma Lundgren
- Office of Psychiatry and Habilitation, Region Skane, Malmö, Sweden
| | - Emma Nilsson
- Office of Psychiatry and Habilitation, Region Skane, Malmö, Sweden
| | - Karin Örmon
- Department of Care Sciences, Faculty of Health and Society, Malmö University, Malmö, Sweden.,Office of Psychiatry and Habilitation, Region Skane, Malmö, Sweden
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Derblom K, Lindgren BM, Johansson A, Molin J. Engagement, Responsibility, Collaboration, and Abandonment: Nurses' Experiences of Assessing Suicide Risk in Psychiatric Inpatient Care. Issues Ment Health Nurs 2021; 42:776-783. [PMID: 33443452 DOI: 10.1080/01612840.2020.1864686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Suicide risk assessment is a complex task for nurses working in psychiatric inpatient care. This study explored psychiatric inpatient nurses' experiences of assessing suicide risk. A qualitative design was used, and 10 interviews were subjected to qualitative content analysis. Nurses described suicide risk assessments as requiring them to create caring alliances and to take responsibility. Collaborating with colleagues was another part of nurses' experiences, as was feeling abandoned. To make the assessment safely, nurses need a combination of caring alliances, support from colleagues, clear guidelines, training and time for collegial reflection to create a supportive working climate.
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Affiliation(s)
| | | | | | - Jenny Molin
- Department of Nursing, Umeå University, Umeå, Sweden.,Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden
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Lorien L, Blunden S, Madsen W. Implementation of recovery-oriented practice in hospital-based mental health services: A systematic review. Int J Ment Health Nurs 2020; 29:1035-1048. [PMID: 33063396 DOI: 10.1111/inm.12794] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 09/07/2020] [Accepted: 09/07/2020] [Indexed: 02/06/2023]
Abstract
Recovery-oriented practice has become the dominant paradigm of practice in mental health services internationally. The exception is hospital-based mental health services where the biomedical model continues to prevail, in this context defined by high acuity and safety concerns. This review aims to identify the approaches to, and feasibility of, implementing recovery-oriented practice in hospital-based mental health services. A systematic review of the literature (2010-2019) identified seventeen studies of recovery-oriented practice implementation in hospital-based mental health services. One study was excluded based on quality assessment. Of the remaining studies, seven reported on staff training initiatives, four reported service user programmes facilitated by staff, and five were implementations of models of care. The findings indicate that it is feasible, albeit challenging, to implement recovery-oriented practice in hospital-based mental health services. More successful approaches are multimodal, applied over several years and have organizational support. The main barriers to implementation include resistance to change from the embedded, biomedical model, staff attitudes towards recovery, and an absence of consumer involvement in the implementation of recovery-oriented practice.
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Affiliation(s)
- Leonie Lorien
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Queensland, Australia
| | - Sarah Blunden
- School of Health, Medical and Applied Sciences, CQUniversity, Sydney, New South Wales, Australia
| | - Wendy Madsen
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Queensland, Australia
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Gyamfi N, Bhullar N, Islam MS, Usher K. Knowledge and attitudes of mental health professionals and students regarding recovery: A systematic review. Int J Ment Health Nurs 2020; 29:322-347. [PMID: 32162835 DOI: 10.1111/inm.12712] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/11/2020] [Accepted: 02/16/2020] [Indexed: 02/06/2023]
Abstract
This review was conducted to synthesize and critically appraise the literature on knowledge, attitudes, understanding, perceptions, and expectations of mental health professionals (MHPs) and mental health professional (MHP) students' regarding recovery. A systematic search in Scopus, CINAHL, PsycINFO, Web of Science, Medline, and Embase as well as Google scholar and web-based repositories was conducted. The searches were conducted using a combination of key terms: "mental health professionals", "students", 'knowledge', "understanding", "perception" "attitude", "expectation", "recovery". After screening and quality assessment, the review included 29 studies (18 quantitative, 8 qualitative, and 3 mixed-method studies) published in English, from January 2006 to June 2019, and was analysed systematically using a mixed-method synthesis. The findings revealed that there is increasing evidence (especially among MHPs) of knowledge, attitudes, understanding, perceptions, and expectations regarding recovery. However, there are disparities in how MHPs perceive and understand recovery. While some understood it to mean a personal process, others explained it as a clinical process. In addition, there was limited knowledge among the MHPs and MHP students regarding the nonlinearity nature of the recovery process and expectations regarding recovery. The implications from these findings are the need for more in-service training for MHPs, and examination of the curriculum used to educate MHP students. In particular, they should be sufficiently informed about the nonlinearity nature of the recovery process and how to develop hopeful and realistic expectations for consumers throughout the recovery process. The review was preregistered with PROSPERO (Registration No: CRD42019136543).
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Affiliation(s)
- Naomi Gyamfi
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Navjot Bhullar
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Md Shahidul Islam
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Kim Usher
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
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Sellin L, Kumlin T, Wallsten T, Wiklund Gustin L. Experiences of a Recovery-Oriented Caring Approach to Suicidal Behavior: A Single-Case Study. QUALITATIVE HEALTH RESEARCH 2019; 29:2084-2095. [PMID: 31204575 DOI: 10.1177/1049732319854229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Research considering the basis for mental health nurses wanting to enable recovery among people who suffer from suicidal behavior is sparse. The aim of this study is to explore and evaluate how a new recovery-oriented caring approach (ROCA) was experienced by a suicidal patient in a context of close relatives and nurses. A single-case study with a qual-quan mixed-method design was chosen. Participants were recruited from a psychiatric clinic in Sweden and consisted of one patient, one close relative to the patient, and three nurses. The results reveal that the ROCA enabled the patient to narrate, bear experiences of hopelessness, and ask for support, rather than view suicide as the only possible solution. ROCA has the potential to support patients, relatives, and nurses to develop a common language, considering the patient's life situation and struggles and to use this as a source for the patient's individual care planning.
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Affiliation(s)
| | | | - Tuula Wallsten
- Centre for Clinical Research Västerås, County of Västmanland and Uppsala University, Sweden
| | - Lena Wiklund Gustin
- Mälardalen University, Västerås, Sweden
- UiT/The Archtic University of Norway, Campus Narvik, Norway
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