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Cleary M, West S, Hungerford C. Mental Health Nurses Overcoming Adversity: A Discursive Review. Issues Ment Health Nurs 2023; 44:944-950. [PMID: 37616589 DOI: 10.1080/01612840.2023.2236698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
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.
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Affiliation(s)
- Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Sancia West
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Catherine Hungerford
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
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2
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Lakshman SJ, Mohd Daud TI, Midin M, Ahmad F, Tommy K. Validation of the Malay-Version of Recovery Knowledge Inventory among mental health providers in Malaysia. Front Psychiatry 2023; 14:1078423. [PMID: 37383615 PMCID: PMC10293667 DOI: 10.3389/fpsyt.2023.1078423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/30/2023] [Indexed: 06/30/2023] Open
Abstract
Background The Recovery Knowledge Inventory (RKI) is a widely used self-report instrument that assesses recovery-oriented knowledge among mental health professionals. The purpose of this study is to translate the RKI into the Malay language (RKI-M) and to examine its psychometric properties among Malaysian health care workers. Methods A cross-sectional study involving 143 participants was conducted at an urban teaching hospital, an urban government hospital, and a rural government hospital. Following the translation of the RKI, its internal reliability was determined using Cronbach's alpha. Construct validity was also determined using confirmatory factor analysis. Results The Malay-Version RKI (RKI-M) has good internal reliability with a Cronbach's alpha of 0.83. However, the Malay-version RKI failed to replicate the original four-factor structure. The final model only achieved the best model fit after the removal of 9 items with two-factor loadings: (GFI = 0.92; AGFI = 0 0.87; CFI = 0.91; RMSEA = 0.074). Conclusion The 20-item RKI-M is reliable but has poor construct validity. However, the modified 11-item Malay-version RKI is a more reliable measure as it has good construct validity, with room for future studies to examine the psychometric properties of the modified 11-item RKI among mental health care workers. More training on recovery knowledge should be done, and a simple worded questionnaire should be developed in keeping with local practitioners.
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Affiliation(s)
- Stella Jane Lakshman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
- Department of Psychiatry, Hospital Selayang, Batu Caves, Selangor, Malaysia
| | - Tuti Iryani Mohd Daud
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Marhani Midin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | | | - Kezia Tommy
- Faculty of Business and Economics, University Malaya, Kuala Lumpur, Malaysia
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3
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Kang KI, Kang CM. Roles and Effects of Peer Recovery Coach Intervention in the Field of Substance Abuse: An Integrative Literature Review. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:256-264. [PMID: 36243312 DOI: 10.1016/j.anr.2022.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/01/2022] [Accepted: 10/05/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE There are ongoing public initiatives to help substance abusers by involving peer recovery coaches (PRCs) in the field of substance abuse worldwide. This study examines the contents and delivery methods of PRC intervention programs and their effects from the participants' standpoint. METHODS An integrative literature search was conducted in seven electronic databases using English and Korean search terms. Two researchers independently reviewed the extracted papers and rated their quality based on predetermined inclusion and exclusion criteria, resulting in the selection of nine papers. RESULTS Research on PRC participation in substance abuse treatment were predominantly US-based, and all articles derived were quantitative studies. The main roles of PRCs included liaising between treatment and community resources, assisting with stress management and coping skills, counseling and case management, and recovery and recurrence prevention education. In addition, the PRC-delivered intervention was tested with various outcome variables. It reduced participants' substance use and enhanced their treatment adherence rates, self-efficacy, quality of life, and stress control. CONCLUSIONS This study confirmed the need to extend existing studies by testing the effects of PRC-delivered intervention through multidisciplinary efforts in more regions and establishing PRCs' role definition and concretization. The results of this study will serve as significant basic data in developing and applying for nursing intervention programs with PRCs in clinical and community nursing settings in the future.
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Affiliation(s)
- Kyung Im Kang
- College of Nursing, Institute of Health Sciences, Gyeongsang National University, Republic of Korea.
| | - Chan Mi Kang
- Department of Nursing, Dong-Eui Institute of Technology, Republic of Korea.
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4
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Loughhead M, Hodges E, McIntyre H, Procter NG, Barbara A, Bickley B, Harris G, Huber L, Martinez L. A model of lived experience leadership for transformative systems change: Activating Lived Experience Leadership (ALEL) project. Leadersh Health Serv (Bradf Engl) 2022; ahead-of-print. [PMID: 35943397 DOI: 10.1108/lhs-04-2022-0045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE This discursive paper presents a lived experience leadership model as developed as part of the Activating Lived Experience Leadership (ALEL) project project to increase the recognition and understanding of lived experience leadership in mental health and social sectors. The model of lived experience leadership was formulated through a collaboration between the South Australian Lived Experience Leadership & Advocacy Network and the Mental Health and Suicide Prevention Research and Education Group. DESIGN/METHODOLOGY/APPROACH As one of the outcomes of the ALEL research project, this model incorporates findings from a two-year research project in South Australia using participatory action research methodology and cocreation methodology. Focus groups with lived experience leaders, interviews with sector leaders and a national survey of lived experience leaders provided the basis of qualitative data, which was interpreted via an iterative and shared analysis. This work identified intersecting lived experience values, actions, qualities and skills as characteristics of effective lived experience leadership and was visioned and led by lived experience leaders. FINDINGS The resulting model frames lived experience leadership as a social movement for recognition, inclusion and justice and is composed of six leadership actions: centres lived experience; stands up and speaks out; champions justice; nurtures connected and collective spaces; mobilises strategically; and leads change. Leadership is also guided by the values of integrity, authenticity, mutuality and intersectionality, and the key positionings of staying peer and sharing power. ORIGINALITY/VALUE This model is based on innovative primary research, which has been developed to encourage understanding across mental health and social sectors on the work of lived experience leaders in seeking change and the value that they offer for systems transformation. It also offers unique insights to guide reflective learning for the lived experience and consumer movement, workers, clinicians, policymakers and communities.
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Affiliation(s)
- Mark Loughhead
- Mental Health and Suicide Prevention Research and Education Group, University of South Australia, Adelaide, Australia
| | - Ellie Hodges
- Lived Experience Leadership and Advocacy Network SA, Adelaide, Australia
| | - Heather McIntyre
- Mental Health and Suicide Prevention Research and Education Group, University of South Australia, Adelaide, Australia
| | - Nicholas Gerard Procter
- Mental Health and Suicide Prevention Research and Education Group, University of South Australia, Adelaide, Australia
| | - Anne Barbara
- Lived Experience Leadership and Advocacy Network SA, Adelaide, Australia
| | - Brooke Bickley
- Lived Experience Leadership and Advocacy Network SA, Adelaide, Australia
| | - Geoff Harris
- Mental Health Coalition of South Australia Inc., North Adelaide, Australia
| | - Lisa Huber
- Department of Health and Wellbeing, Government of South Australia, Adelaide, Australia
| | - Lee Martinez
- Department of Rural Health, University of South Australia, Adelaide, Australia
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5
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Wall A, Lovheden T, Landgren K, Stjernswärd S. Experiences and Challenges in the Role as Peer Support Workers in a Swedish Mental Health Context - An Interview Study. Issues Ment Health Nurs 2022; 43:344-355. [PMID: 34569894 DOI: 10.1080/01612840.2021.1978596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The focus on recovery within psychiatric care is increasing, where peer support may play a pivotal role. Previous research shows both mixed and promising results in terms of beneficial outcomes for patients and peer support workers (PSW). The study's aim was to investigate PSW' experiences of their professional role and associated relationships with healthcare staff and patients. Semi-structured in-depth interviews were conducted with 10 PSW. Data was analyzed with content analysis. Three themes were constructed; "Experience of stigma", "Authenticity and balance in the patient relationship" and "Opportunities and setbacks in the team". Challenges included stigmatization, loyalty conflicts, lack of a clear job description and feelings of insecurity and disinterest among other staff. However, the peer support role was perceived as deeply meaningful. The peer support role comes with challenges and opportunities for the PSW, and potentially for the patients and the surrounding work team. Further research is needed to illuminate the value of peer support for patients, PSW and healthcare staff, and potential barriers and facilitators to the integration of peer support within psychiatric care.Supplemental data for this article is available online at https://doi.org/10.1080/01612840.2021.1978596 .
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Affiliation(s)
- Anna Wall
- Department of Psychosis Care, Region Skåne, Malmö, Sweden
| | | | - Kajsa Landgren
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
| | - Sigrid Stjernswärd
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
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6
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Lambert C, Egan R, Thomas SDM. What does effective allyship between social work and lived experience workers look like in the Australian forensic mental health context? QUALITATIVE RESEARCH IN PSYCHOLOGY 2021. [DOI: 10.1080/14780887.2020.1869357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Caroline Lambert
- RMIT University, Social and Global Studies Centre, School of Global, Urban and Social Studies, Melbourne, Australia
- Victorian Institute of Forensic Mental Health, Fairfield, Melbourne, Australia
| | - Ronnie Egan
- RMIT University, Social and Global Studies Centre, School of Global, Urban and Social Studies, Melbourne, Australia
| | - Stuart DM Thomas
- RMIT University, Social and Global Studies Centre, School of Global, Urban and Social Studies, Melbourne, Australia
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7
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Student beliefs about their practice within a non-traditional mental health clinical placement. Nurse Educ Pract 2020; 47:102836. [PMID: 32814305 DOI: 10.1016/j.nepr.2020.102836] [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: 09/07/2018] [Revised: 01/07/2020] [Accepted: 07/07/2020] [Indexed: 11/20/2022]
Abstract
Therapeutic recreation programs utilize leisure to maximize a person's overall health and well-being. The focus of this study is a professional experience placement held within an outdoor recreation center involving student nurses and people with a lived experience of mental illness. The study aimed to explore student nurse's beliefs about their practice within the program setting. An ethnographic case study approach was used to focus on the development of student nurse practice in this setting. The analytic strategy derived the themes of the ethnographic case study, namely 'who's who', 'clinical contrast' and 'recreation as practice'. A non-traditional mental health clinical placement would seem to have the potential in providing a new set of skills and experiences to these future nurses that may complement the scope of recovery-orientated care. The therapeutic recreation program provided the student with an experience where they could develop therapeutic relationships with people a lived experience of mental illness.
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8
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Debyser B, Berben K, Beeckman D, Deproost E, Van Hecke A, Verhaeghe S. The transition from patient to mental health peer worker: A grounded theory approach. Int J Ment Health Nurs 2019; 28:560-571. [PMID: 30575270 DOI: 10.1111/inm.12561] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2018] [Indexed: 11/28/2022]
Abstract
Peer workers are increasingly being engaged in contemporary mental healthcare. To become a peer worker, patients must evolve from having a patient identity to a peer worker identity. This study aims to understand how mental health peer workers experience their transition and how it affects their view of themselves and their direct working context. A grounded theory approach was used. Seventeen mental health peer workers in Belgium were recruited through theoretical sampling. Semi-structured interviews were conducted and analysed according to the constant comparative method. The results indicate that novice peer workers experience peer work as an opportunity to liberate themselves from the process of mental suffering and realise an acceptable form of personal self-maintenance. As peer workers become more experienced, they are confronted with external factors that influence their self-maintenance and personal development. Experiencing clarity in their duties and responsibilities, equality, and transparency in the workplace reinforce their experience of self-maintenance and positively influence their self-development. Experiencing a lack of clarity in their duties and responsibilities, inequality, and lack of openness discourage peer workers' self-development process. These experiences challenge their personal motivations to become peer workers, which are usually linked to building a meaningful life for themselves. The insights can encourage organisations to build up a supportive environment collaboratively with peer workers and ensure that peer workers can exert their authentically unique role in mental healthcare.
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Affiliation(s)
- Bart Debyser
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,VIVES University of Applied Sciences, Kortrijk, Belgium.,Psychiatric Hospital, Centre for Psychiatry & Psychotherapy Clinic St-Joseph, Pittem, Belgium
| | - Kevin Berben
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Alexian Psychiatric Hospital, Tienen, Alexianen Care Group, Tienen, Belgium
| | - Dimitri Beeckman
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,School of Health Sciences, Örebro University, Sweden.,School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Eddy Deproost
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,VIVES University of Applied Sciences, Kortrijk, Belgium.,Psychiatric Hospital, Centre for Psychiatry & Psychotherapy Clinic St-Joseph, Pittem, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Staff member Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Sofie Verhaeghe
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,VIVES University of Applied Sciences, Kortrijk, Belgium
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9
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Cleary M, Raeburn T, Escott P, West S, Lopez V. 'Walking the tightrope': The role of peer support workers in facilitating consumers' participation in decision-making. Int J Ment Health Nurs 2018; 27:1266-1272. [PMID: 29741237 DOI: 10.1111/inm.12474] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2018] [Indexed: 11/27/2022]
Abstract
In adult mental health services, the participation of consumers is essential. The aim of this study was to explore the challenges faced by peer support workers when involving mental health consumers in decision-making about their care and the strategies they employed to overcome these challenges so as to improve mental health consumers' participation in decision-making and recovery. Semi-structured individual interviews were conducted with six peer support workers currently employed in psychiatric hospitals and/or community mental health systems. Thematic analysis identified challenges related to role definition, power imbalance, doctor-centric medical approaches to care, and lack of resources. Strategies to overcome these challenges that were reported, included the following: facilitating meaningful involvement for service users, appropriate use of the lived experience, building relationships and communication, promoting rights and advocacy, and promoting professionalism of peer support workers (PSWs). Nursing staff need ongoing support and education to understand and value the varied roles of PSWs and thereby empower PSWs to engage in enhancing consumer decision-making. The roles of the PSWs should be viewed as complementary, and greater appreciation and understanding of roles would better support recovery-oriented care.
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Affiliation(s)
- Michelle Cleary
- School of Health Sciences, University of Tasmania, Sydney, New South Wales, Australia
| | - Toby Raeburn
- Sydney Nursing School, The University of Sydney, Sydney, New South Wales, Australia
| | - Phil Escott
- School of Health Sciences, University of Tasmania, Sydney, New South Wales, Australia.,Sydney Local Health District Mental Health Service, Sydney, New South Wales, Australia
| | - Sancia West
- School of Health Sciences, University of Tasmania, Sydney, New South Wales, Australia
| | - Violeta Lopez
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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10
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Affiliation(s)
- Violeta Lopez
- a Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore , Singapore
| | - Michelle Cleary
- b School of Health Sciences , University of Tasmania , Sydney , NSW , Australia
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11
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Piat M, Sabetti J, Padgett D. Emergent leadership among tenants with psychiatric disabilities living in supported housing. Int J Ment Health Nurs 2018; 27:1127-1136. [PMID: 29277953 DOI: 10.1111/inm.12428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2017] [Indexed: 11/29/2022]
Abstract
The overall aim of this study was to explore the experiences of people with psychiatric disabilities living as tenants in independent, supported apartments for the first time. Supported housing provides an alternative to structured, custodial housing models, such as foster homes, or board-and-care homes, for clients in public mental health systems. This article reports findings on how leadership emerged among tenants after making the transition from custodial to supported housing. Semi-structured interviews were conducted with tenants (n = 24) and included questions on their housing history, current living situation, relationships with staff, participation, and understanding or experience of leadership. Interviews were transcribed verbatim, codes generated, and a thematic analysis conducted using a constructivist approach. The findings revealed an understanding and appreciation of leadership among tenants, who identified six pathways to leadership in their housing as a response to unmet tenant needs. Most tenant leaders emerged outside of formal authority or power structures. Supported housing provides a unique social setting and empowering community where the potential of persons with psychiatric disabilities to assume leadership may be realized and further developed. Mental health professionals working in community housing networks are well placed to harness these face-to-face tenant communities, and their natural leaders, as an additional tool in promoting tenant recovery, mutual help, neighbourhood integration, and the broader exercise of citizenship.
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Affiliation(s)
- Myra Piat
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Judith Sabetti
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Deborah Padgett
- Silver School of Social Work, New York University, New York City, NY, USA
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12
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Debyser B, Duprez V, Beeckman D, Vandewalle J, Van Hecke A, Deproost E, Verhaeghe S. Mental health nurses and mental health peer workers: Self-perceptions of role-related clinical competences. Int J Ment Health Nurs 2018; 27:987-1001. [PMID: 29194905 DOI: 10.1111/inm.12406] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2017] [Indexed: 11/27/2022]
Abstract
In a mental healthcare that embraces a recovery-oriented practice, the employment of mental health peer workers is encouraged. Although peer workers are increasingly working together with nurses, there is a lack of research that explores how nurses and peer workers perceive their role-related competences in clinical practice. The aim of this study was to clarify and understand these self-perceptions in order to identify the specificity and potential complementarity of both roles. This insight is needed to underpin a successful partnership between both vocations. A qualitative descriptive research design based on principles of critical incident methodology was used. Twelve nurses and eight peer workers from different mental healthcare organizations participated. A total of 132 reported cases were analysed. Rigour was achieved through thick description, audit trail, investigator triangulation and peer review. Nurses relate their role-related competences predominantly with being compliant with instructions, being a team player and ensuring security and control. Peer workers relate their role-related competences with being able to maintain themselves as a peer worker, building up a relationship that is supportive for both the patient and themselves, and to utilize their lived experience. Both nurses and peer workers assign a major role to the team in determining their satisfaction with their competences. Consequently, what is perceived as important for the team appears to overshadow their self-assessment of competences. The findings highlighted the importance of paying more attention to identity construction, empowerment and role competence development of nurses and peer workers in their respective education and ongoing training.
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Affiliation(s)
- Bart Debyser
- Department of Public Health, Ghent University, Ghent, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium.,Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium
| | - Veerle Duprez
- Department of Public Health, Ghent University, Ghent, Belgium
| | | | - Joeri Vandewalle
- Department of Public Health, Ghent University, Ghent, Belgium.,Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium
| | - Ann Van Hecke
- Department of Public Health, Ghent University, Ghent, Belgium.,Department of Nursing, Ghent University Hospital, Ghent, Belgium
| | - Eddy Deproost
- Department of Public Health, Ghent University, Ghent, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium.,Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium
| | - Sofie Verhaeghe
- Department of Public Health, Ghent University, Ghent, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium
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13
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Vandewalle J, Debyser B, Beeckman D, Vandecasteele T, Deproost E, Van Hecke A, Verhaeghe S. Constructing a positive identity: A qualitative study of the driving forces of peer workers in mental health-care systems. Int J Ment Health Nurs 2018; 27:378-389. [PMID: 28371127 DOI: 10.1111/inm.12332] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2017] [Indexed: 11/29/2022]
Abstract
There is growing recognition in mental health for the perspective of individuals with lived experience of mental health problems and mental health service use. As peer workers, these individuals can use their specific experience to benefit and support peers and professional caregivers, and to participate at all levels of mental health-care systems. The aim of the present study was to develop a conceptual framework representing the driving forces of peer workers to fullfil their position in mental health-care systems. A qualitative interview approach was employed using principles of grounded theory. Over a period of 5 months in 2014-2015, semistructured interviews were conducted with 14 peer workers in residential and community mental health-care systems. The emerged conceptual framework reveals that peer workers strive towards constructing a positive identity. This process is powered by driving forces reflecting a desire for normalization and an urge for self-preservation. Peer workers realize a meaningful employment by using their lived experience perspective as an asset, liberating themselves out of restrictive role patterns, and by breaking down stigma and taboo. As a precondition to engage in these normalization processes, peer workers perceive they need to secure their self-preservation by balancing the emergence of adverse emotional fluctuations. The conceptual framework can inform the development of work contexts in which peer workers have an authentic and meaningful contribution, while being offered sufficient support and learning opportunities to manage their well-being.
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Affiliation(s)
- Joeri Vandewalle
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Psychiatric Hospital Pittem, Pittem, Belgium.,Research Foundation-Flanders, Brussels, Belgium
| | - Bart Debyser
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Psychiatric Hospital Pittem, Pittem, Belgium.,Department Health Care, VIVES University College, Roeselare, Belgium
| | - Dimitri Beeckman
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Tina Vandecasteele
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department Health Care, VIVES University College, Roeselare, Belgium
| | - Eddy Deproost
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Psychiatric Hospital Pittem, Pittem, Belgium
| | - Ann Van Hecke
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department of Nursing, Ghent University Hospital, Ghent, Belgium
| | - Sofie Verhaeghe
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department Health Care, VIVES University College, Roeselare, Belgium
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14
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Scholz B, Bocking J, Happell B. Improving exchange with consumers within mental health organizations: Recognizing mental ill health experience as a 'sneaky, special degree'. Int J Ment Health Nurs 2018; 27:227-235. [PMID: 28145617 DOI: 10.1111/inm.12312] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2016] [Indexed: 12/25/2022]
Abstract
Stigmatizing views towards consumers may be held even by those working within mental health organizations. Contemporary mental health policies require organizations to work collaboratively with consumers in producing and delivering services. Using social exchange theory, which emphasises mutual exchange to maximise benefits in partnership, the current study explores the perspectives of those working within organizations that have some level of consumer leadership. Interviews were conducted with 14 participants from a range of mental health organizations. Data were transcribed, and analyzed using thematic analytic and discursive psychological techniques. Findings suggest stigma is still prevalent even in organizations that have consumers in leadership positions, and consumers are often perceived as less able to work in mental health organizations than non-consumers. Several discourses challenged such a view - showing how consumers bring value to mental health organizations through their expertise in the mental health system, and their ability to provide safety and support to other consumers. Through a social exchange theory lens, the authors call for organizations to challenge stigma and promote the value that consumers can bring to maximize mutual benefits.
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Affiliation(s)
- Brett Scholz
- SYNERGY Nursing and Midwifery Research Centre, University of Canberra and ACT Health, The Canberra Hospital, Garran, Australian Capital Territory, Australia
| | - Julia Bocking
- SYNERGY Nursing and Midwifery Research Centre, University of Canberra and ACT Health, The Canberra Hospital, Garran, Australian Capital Territory, Australia
| | - Brenda Happell
- SYNERGY Nursing and Midwifery Research Centre, University of Canberra and ACT Health, The Canberra Hospital, Garran, Australian Capital Territory, Australia
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15
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McMaster R, Lopez V, Kornhaber R, Cleary M. A Qualitative Study of a Maintenance Support Program for Women at Risk of Homelessness: Part 1: Personal Factors. Issues Ment Health Nurs 2017; 38:500-505. [PMID: 28350483 DOI: 10.1080/01612840.2017.1292570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In this article, a qualitative study of homeless women and their experiences attending a Maintenance Support Programme (MSP) is discussed. The overarching theme that emerged from the study of women in the MSP was 'A life-changing event: I have the power to change'. The article focuses on the first of the sub-themes: personal factors including: (a) health status, (b) beliefs and attitudes, (c) knowledge, and (d) life and interpersonal skills. Findings demonstrate the influence that these factors have on the capacity of homeless women to change their lives. The MSP was instrumental in supporting these women to manage personal issues, by assisting with accessing health and social services, and developing life skills and achieving life goals. Understanding the homeless women's experiences may inform the development of future programmes and services in order to support and empower them to break the cycle of homelessness and help them to lead meaningful lives within society.
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Affiliation(s)
- Rose McMaster
- a School of Health Sciences, University of Tasmania , Sydney , Australia
| | - Violeta Lopez
- b Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore
| | - Rachel Kornhaber
- c School of Health Sciences, University of Tasmania , Sydney , Australia
| | - Michelle Cleary
- c School of Health Sciences, University of Tasmania , Sydney , Australia
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16
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Byrne L, Happell B, Reid-Searl K. Risky business: Lived experience mental health practice, nurses as potential allies. Int J Ment Health Nurs 2017; 26:285-292. [PMID: 27650999 DOI: 10.1111/inm.12245] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2016] [Indexed: 11/26/2022]
Abstract
Mental health policy includes a clear expectation that consumers will participate in all aspects of the design and delivery of mental health services. This edict has led to employment roles for people with lived experience of significant mental health challenges and service use. Despite the proliferation of these roles, research into factors impacting their success or otherwise is limited. This paper presents findings from a grounded theory study investigating the experiences of Lived Experience Practitioners in the context of their employment. In-depth interviews were conducted with 13 Lived Experience Practitioners. Risk was identified as a core category, and included sub-categories: vulnerability, 'out and proud', fear to disclose, and self-care. Essentially participants described the unique vulnerabilities of their mental health challenges being known, and while there were many positives about disclosing there was also apprehension about personal information being so publically known. Self-care techniques were important mediators against these identified risks. The success of lived experience roles requires support and nurses can play an important role, given the size of the nursing workforce in mental health, the close relationships nurses enjoy with consumers and the contribution they have made to the development of lived experience roles within academia.
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Affiliation(s)
- Louise Byrne
- School of Nursing and Midwifery, Higher Education Division, CQ University Rockhampton, Rockhampton, Australia
| | - Brenda Happell
- SYNERGY: Nursing and Midwifery Research Centre, University of Canberra, and ACT Health, Canberra, Australia
| | - Kerry Reid-Searl
- School of Nursing and Midwifery, Higher Education Division, CQ University Rockhampton, Rockhampton, Australia
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17
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Scholz B, Bocking J, Happell B. Breaking through the Glass Ceiling: Consumers in Mental Health Organisations' Hierarchies. Issues Ment Health Nurs 2017; 38:374-380. [PMID: 28448229 DOI: 10.1080/01612840.2017.1280106] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Contemporary mental health policies call for consumers to be engaged in all levels of mental health service planning, implementation, and delivery. Critical approaches to traditional healthcare hierarchies can effectively challenge barriers to better engagement with consumers in mental health organisations. This qualitative exploratory study analyses how particular strategies for consumer leadership facilitate or hinder relationships between consumers and mental health services, and how these strategies influence hierarchical structures. Fourteen participants from a range of mental health organisations were interviewed. These interviews were analysed using thematic analytic and discursive psychological techniques. The findings highlight several benefits of having consumers within mental health organisational hierarchies, and elaborate on ways that employees within mental health services can support integration of consumers into existing hierarchies. Specific barriers to consumers in hierarchies are discussed, including a lack of clarity of structures and roles within hierarchies, and resistance to consumers reaching the highest levels of leadership within organisations. Alternative hierarchical models which privilege consumers' control over resources and power are also discussed. Mental health organisations are encouraged to integrate consumer leaders into their hierarchical structures to improve their organisational offerings, their reputation, and their service innovation.
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Affiliation(s)
- Brett Scholz
- a SYNERGY Nursing and Midwifery Research Centre , University of Canberra and ACT Health, The Canberra Hospital , Garran , ACT , Australia
| | - Julia Bocking
- a SYNERGY Nursing and Midwifery Research Centre , University of Canberra and ACT Health, The Canberra Hospital , Garran , ACT , Australia
| | - Brenda Happell
- a SYNERGY Nursing and Midwifery Research Centre , University of Canberra and ACT Health, The Canberra Hospital , Garran , ACT , Australia
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18
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Cleary M, Lees D, Molloy L, Escott P, Sayers J. Recovery-oriented Care and Leadership in Mental Health Nursing. Issues Ment Health Nurs 2017; 38:458-460. [PMID: 28448230 DOI: 10.1080/01612840.2017.1314738] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Michelle Cleary
- a School of Health Sciences , University of Tasmania , Sydney , NSW , Australia
| | - David Lees
- a School of Health Sciences , University of Tasmania , Sydney , NSW , Australia
| | - Luke Molloy
- b School of Nursing , University of Wollongong , NSW , Australia
| | - Phil Escott
- c Sydney Local Health District Mental Health Service , Sydney , NSW , Australia
| | - Jan Sayers
- a School of Health Sciences , University of Tasmania , Sydney , NSW , Australia
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19
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Scholz B, Gordon S, Happell B. Consumers in mental health service leadership: A systematic review. Int J Ment Health Nurs 2017; 26:20-31. [PMID: 28093883 DOI: 10.1111/inm.12266] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2016] [Indexed: 11/29/2022]
Abstract
Contemporary mental health policies call for greater involvement of mental health service consumers in all aspects and at all levels of service planning, delivery, and evaluation. The extent to which consumers are part of the decision-making function of mental health organizations varies. This systematic review synthesizes empirical and review studies published in peer-reviewed academic journals relating to consumers in leadership roles within mental health organizations. The Cochrane Library, Medline, and PsycINFO were searched for articles specifically analysing and discussing consumers' mental health service leadership. Each article was critically appraised against the inclusion criteria, with 36 articles included in the final review. The findings of the review highlight current understandings of organizational resources and structures in consumer-led organizations, determinants of leadership involvement, and how consumer leadership interacts with traditional mental health service provision. It appears that organizations might still be negotiating the balance between consumer leadership and traditional structures and systems. The majority of included studies represent research about consumer-run organizations, with consumer leadership in mainstream mental health organizations being less represented in the literature. Advocates of consumer leadership should focus more on emphasizing how such leadership itself can be a valuable resource for organizations and how this can be better articulated. This review highlights the current gaps in understandings of consumer leadership in mental health, including a need for more research exploring the benefits of consumer leadership for other consumers of services.
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Affiliation(s)
- Brett Scholz
- SYNERGY Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Canberra, Australian Capital Territory, Australia
| | - Sarah Gordon
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Brenda Happell
- SYNERGY Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Canberra, Australian Capital Territory, Australia
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20
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Cleary M, Lees D, Escott P, Molloy L. Leadership and mental health recovery: Rhetoric or reality. Int J Ment Health Nurs 2016; 25:267-9. [PMID: 27534386 DOI: 10.1111/inm.12250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - David Lees
- School of Health Sciences, University of Tasmania, Launceston, Australia
| | - Phil Escott
- Sydney Local Health District Mental Health Service, Sydney, New South Wales, Australia
| | - Luke Molloy
- School of Health Sciences, University of Tasmania, Sydney
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21
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Vandewalle J, Debyser B, Beeckman D, Vandecasteele T, Van Hecke A, Verhaeghe S. Peer workers’ perceptions and experiences of barriers to implementation of peer worker roles in mental health services: A literature review. Int J Nurs Stud 2016; 60:234-50. [DOI: 10.1016/j.ijnurstu.2016.04.018] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 03/31/2016] [Accepted: 04/29/2016] [Indexed: 10/21/2022]
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22
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Hurley J, Cashin A, Mills J, Hutchinson M, Graham I. A critical discussion of Peer Workers: implications for the mental health nursing workforce. J Psychiatr Ment Health Nurs 2016; 23:129-35. [PMID: 26914867 DOI: 10.1111/jpm.12286] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/23/2015] [Indexed: 11/28/2022]
Affiliation(s)
- J Hurley
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, NSW, Australia
| | - A Cashin
- School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia
| | - J Mills
- Mission Australia, Lismore, NSW, Australia
| | - M Hutchinson
- School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia
| | - I Graham
- School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia
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23
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Cleary M, Horsfall J. Kindness and Its Relevance to Everyday Life: Some Considerations for Mental Health Nurses. Issues Ment Health Nurs 2016; 37:206-8. [PMID: 27028742 DOI: 10.3109/01612840.2016.1140546] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Michelle Cleary
- a University of Tasmania, School of Health Sciences , Sydney , Australia
| | - Jan Horsfall
- b Independent Research Advisor , Sydney , New South Wales , Australia
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24
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Byrne L, Happell B, Reid-Searl K. Lived experience practitioners and the medical model: world’s colliding? J Ment Health 2015; 25:217-23. [DOI: 10.3109/09638237.2015.1101428] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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25
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Raeburn T, Hungerford C, Escott P, Cleary M. Supporting recovery from hoarding and squalor: insights from a community case study. J Psychiatr Ment Health Nurs 2015; 22:634-9. [PMID: 26337594 DOI: 10.1111/jpm.12227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/30/2015] [Indexed: 11/26/2022]
Abstract
People with hoarding behaviours acquire a large number of possessions that are often of limited or no monetary value and which they are unable or unwilling to discard. Such behaviours can substantially impair a person's ability to attend to their normal daily activities, cause substantial distress and lead to squalid living conditions. Living in squalor can compromise a person's health and safety, be a public health issue and present substantial challenges to family, carers, social service agencies and clinical mental health services. Hoarding and squalor behaviours are more common among people with co-morbid organic and mental illness, such as developmental delay, schizophrenia, alcohol dependence and/or obsessive-compulsive disorder. This paper provides a narrative that explores the role of one Australian mental health nurse practitioner in the recovery of a person with hoarding behaviours.
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Affiliation(s)
- T Raeburn
- School of Nursing and Midwifery, University of Western Sydney, Sydney, NSW, Australia.,Sydney Nursing School, University of Sydney, Sydney, NSW, Australia
| | - C Hungerford
- Disciplines of Nursing and Midwifery, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - P Escott
- Sydney Local Health District Mental Health Service, Sydney, NSW, Australia
| | - M Cleary
- School of Nursing and Midwifery, University of Western Sydney, Sydney, NSW, Australia
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26
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Cleary M, Hungerford C. Trauma-informed Care and the Research Literature: How Can the Mental Health Nurse Take the Lead to Support Women Who Have Survived Sexual Assault? Issues Ment Health Nurs 2015; 36:370-8. [PMID: 26090698 DOI: 10.3109/01612840.2015.1009661] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Many women who access mental health services have been subjected to violent acts, including childhood sexual abuse and adult sexual assault, often at the hands of family members and partners. The vulnerability of these women can be further complicated when health professionals lack sensitivity to the issues involved; and the treatment received by the women is insensitive, leading to experiences of re-traumatisation. This article considers the principles of trauma-informed care and practice, as represented in the literature; and explains how mental health nurses can lead the way in multidisciplinary environments to ensure that women who have experienced violence receive the most appropriate health care, and are thereby supported to attain the best possible outcome.
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Affiliation(s)
- Michelle Cleary
- University of Western Sydney, School of Nursing and Midwifery , Sydney, New South Wales , Australia
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27
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Happell B, Platania-Phung C, Byrne L, Wynaden D, Martin G, Harris S. Consumer participation in nurse education: a national survey of Australian universities. Int J Ment Health Nurs 2015; 24:95-103. [PMID: 25739885 DOI: 10.1111/inm.12111] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Consumers of mental health services have an important role to play in the higher education of nursing students, by facilitating understanding of the experience of mental illness and instilling a culture of consumer participation. Yet the level of consumer participation in mental health nursing programmes in Australia is not known. The aim of the present study was to scope the level and nature of involvement of consumers in mental health nursing higher education in Australia. A cross-sectional study was undertaken involving an internet survey of nurse academics who coordinate mental health nursing programmes in universities across Australia, representing 32 universities. Seventy-eight percent of preregistration and 75% of post-registration programmes report involving consumers. Programmes most commonly had one consumer (25%) and up to five. Face-to-face teaching, curriculum development, and membership-to-programme committees were the most regular types of involvement. The content was generally codeveloped by consumers and nurse academics (67.5%). The frequency of consumer involvement in the education of nursing students in Australia is surprisingly high. However, involvement is noticeably variable across types of activity (e.g. curriculum development, assessment), and tends to be minimal and ad hoc. Future research is required into the drivers of increased consumer involvement.
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Affiliation(s)
- Brenda Happell
- Research Centre for Nursing and Midwifery Practice, University of Canberra, Faculty of Health and ACT Health, Rockhampton, Western Australia, Australia
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28
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Byrne L, Happell B, Reid-Searl K. Recovery as a Lived Experience Discipline: A Grounded Theory Study. Issues Ment Health Nurs 2015; 36:935-43. [PMID: 26735501 DOI: 10.3109/01612840.2015.1076548] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Recovery is government mandated and a core facet of mental health reform. However, Recovery implementation in this country (Australia) has been inhibited by a lack of education of, and understanding from, clinicians. A grounded theory study was undertaken to explore the potential and existing role of lived experience practitioners in assisting meaningful implementations of Recovery within the Australian mental health sector. In-depth interviews were conducted with 13 people employed to work from a lived experience perspective. The findings suggest participants have experienced and observed significant barriers to the implementation of Recovery-focused practice while operating in lived experience roles. Three main issues emerged: (1) Recovery co-opted, (2) Recovery uptake, and (3) Recovery denial. For a genuine Recovery-focused mental health system to be developed, lived experience practitioners must be enabled to take their role as Recovery experts and leaders. Lived experience practitioners are the logical leaders of Recovery implementation due to their own internal experience and understandings of Recovery and the wider lived experience movement's development and championing of the concepts.
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Affiliation(s)
- Louise Byrne
- a Central Queensland University , School of Nursing and Midwifery , Rockhampton , Australia
| | - Brenda Happell
- b University of Canberra and ACT Health , SYNERGY: Nursing and Midwifery Research Centre , Canberra , Australia
| | - Kerry Reid-Searl
- a Central Queensland University , School of Nursing and Midwifery , Rockhampton , Australia
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29
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Sayers J, Lopez V, Howard PB, Escott P, Cleary M. The leadership role of nurse educators in mental health nursing. Issues Ment Health Nurs 2015; 36:718-24. [PMID: 26440875 DOI: 10.3109/01612840.2015.1033040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Leadership behaviors and actions influence others to act, and leadership in clinical practice is an important mediator influencing patient outcomes and staff satisfaction. Indeed, positive clinical leadership has been positioned as a crucial element for transformation of health care services and has led to the development of the Practice Doctorate Movement in the United States. Nurse educators in health care have a vital leadership role as clinical experts, role models, mentors, change agents, and supporters of quality projects. By enacting these leadership attributes, nurse educators ensure a skilled and confident workforce that is focused on optimizing opportunities for students and graduates to integrate theory and practice in the workplace as well as developing more holistic models of care for the consumer. Nurse educators need to be active in supporting staff and students in health care environments and be visible leaders who can drive policy and practice changes and engage in professional forums, research, and scholarship. Although nurse educators have always been a feature of the nursing workplace, there is a paucity of literature on the role of nurse educators as clinical leaders. This discursive article describes the role and attributes of nurse educators with a focus on their role as leaders in mental health nursing. We argue that embracing the leadership role is fundamental to nurse educators and to influencing consumer-focused care in mental health. We also make recommendations for developing the leadership role of nurse educators and provide considerations for further research such as examining the impact of clinical leaders on client, staff, and organizational outcomes.
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Affiliation(s)
- Jan Sayers
- a University of Western Sydney, School of Nursing and Midwifery , Sydney , New South Wales , Australia
| | - Violeta Lopez
- b National University of Singapore, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine , Singapore
| | - Patricia B Howard
- c University of Kentucky, College of Nursing , Lexington , Kentucky , USA
| | - Phil Escott
- d Sydney Local Health District Mental Health Service , Sydney , Australia
| | - Michelle Cleary
- a University of Western Sydney, School of Nursing and Midwifery , Sydney , New South Wales , Australia
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30
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Cleary M, Escott P, Horsfall J, Walter G, Jackson D. Qualitative research: the optimal scholarly means of understanding the patient experience. Issues Ment Health Nurs 2014; 35:902-4. [PMID: 25353304 DOI: 10.3109/01612840.2014.965619] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Michelle Cleary
- School of Nursing and Midwifery, University of Western Sydney, Sydney, Australia
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31
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Cleary M, Dean S, Webster S, Walter G, Escott P, Lopez V. Primary health care in the mental health workplace: insights from the Australian experience. Issues Ment Health Nurs 2014; 35:437-43. [PMID: 24857527 DOI: 10.3109/01612840.2013.855853] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In Australia, Primary Health Care and the mental health sector have always shared a philosophy. In 1978, Primary Health Care was first put forward as a strategy to improve "health for all." Recently, the Australian Government included mental health as a national health priority, identifying six strategies consistent with a Primary Health Care approach to address the mental health of all Australians. Throughout this time, Primary Health Care has been highlighted in all models of care. However, in reality, it appears that in mental health services, mental health nurses, despite good intentions, are not delivering care in a planned or systematised way and that much needs to be done to further improve the situation for individuals accessing the health care system. Services currently focus on those identified as seriously mentally unwell; in order to really make an impact it is argued that services should be broader, offered to the population at large and, further, that the emphasis on case work at an individual level should be changed to an approach that considers prevention, maintenance, and follow-up as well as crisis intervention. This article reflects the Australian experience and offers some insights from that experience.
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Affiliation(s)
- Michelle Cleary
- School of Nursing and Midwifery, University of Western Sydney, Sydney, Australia
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32
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Cleary M, Walter G, Hungerford CL. Recovery and the role of humility: insights from a case study analysis. Issues Ment Health Nurs 2014; 35:108-13. [PMID: 24502468 DOI: 10.3109/01612840.2013.838812] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
When the individuals comprising a profession are focused more on competition rather than service to others, and when holding a significant place on the world stage is held in higher esteem than meaningful collaboration with the disempowered, is it possible to be truly consumer-centred? This article considers the notion of humility in the context of recovery and the challenges to the effective implementation of recovery-oriented services that have been identified. Insights are drawn from a case study analysis of the implementation of recovery approaches to health care into a publicly-funded mental health service located in Australia. While challenges to the operationalization of recovery are complex, we argue that the professional quality of humility provides an important means by which genuine and meaningful collaboration can be achieved among health professionals, consumers, carers, and other stakeholders.
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Affiliation(s)
- Michelle Cleary
- School of Nursing and Midwifery, University of Western Sydney , NSW , Australia
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33
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Green CA, Estroff SE, Yarborough BJH, Spofford M, Solloway MR, Kitson RS, Perrin NA. Directions for future patient-centered and comparative effectiveness research for people with serious mental illness in a learning mental health care system. Schizophr Bull 2014; 40 Suppl 1:S1-S94. [PMID: 24489078 PMCID: PMC3911266 DOI: 10.1093/schbul/sbt170] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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34
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Cleary M, Horsfall J, Escott P. The recovery continuum: how do meaningful activities for consumers fit? Issues Ment Health Nurs 2013; 34:911-3. [PMID: 24274248 DOI: 10.3109/01612840.2013.854537] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Michelle Cleary
- National University of Singapore, Yong Loo Lin School of Medicine, Singapore
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35
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McAllister M, Happell B, Bradshaw J. Authenticity, creativity and a love of the job: experiences of grassroots leaders of mental health nursing in queensland. Issues Ment Health Nurs 2013; 34:658-64. [PMID: 24004359 DOI: 10.3109/01612840.2013.766821] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The strength of mental health nursing and its potential contribution to improved consumer outcomes depends upon strong and clearly articulated leadership. However, studies of leadership have tended to focus on nurses holding senior positions rather than exploring the leadership embedded in clinical work. A qualitative exploratory study was undertaken with identified mental health nurse leaders in one Australian state, in order to explore their experiences and what they found to be most meaningful in their work. This article reports the findings from this study. The data was analysed thematically to yield insights significant to mental health nursing and identity. The findings suggest these leaders find intrinsic rewards in the role; aspire to making authentic connections with consumers; appreciate the position of trust that they hold in bearing witness to individuals' distress; and use creative means to solve problems and achieve therapeutic outcomes. Sharing these themes builds knowledge on values that are embedded in mental health nursing practice and offers scope for integrating leadership attributes into the education, supervision and development of all mental health nurses. These findings also reveal the complexity of mental health nursing as a profession and the difficulties that might be encountered in attempts to define it in terms of its component tasks and functions.
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Affiliation(s)
- Margaret McAllister
- Central Queensland University, Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation and School of Nursing and Midwifery, Noosa, Australia
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36
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Byrne L, Happell B, Welch T, Moxham LJ. 'Things you can't learn from books': teaching recovery from a lived experience perspective. Int J Ment Health Nurs 2013; 22:195-204. [PMID: 23020070 DOI: 10.1111/j.1447-0349.2012.00875.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Mental health policy in Australia is committed to the development of recovery-focused services and facilitating consumer participation in all aspects of mental health service delivery. Negative attitudes of mental health professionals have been identified as a major barrier to achieving these goals. Although the education of health professionals has been identified as a major strategy, there is limited evidence to suggest that consumers are actively involved in this education process. The aim of this qualitative study was to evaluate students' views and opinions at having been taught 'recovery in mental health nursing' by a person with a lived experience of significant mental health challenges. In-depth interviews were held with 12 students. Two main themes were identified: (i) 'looking through fresh eyes' - what it means to have a mental illness; and (ii) 'it's all about the teaching'. The experience was perceived positively; students referred to the impact made on their attitudes and self-awareness, and their ability to appreciate the impact of mental illness on the individual person. Being taught by a person with lived experience was considered integral to the process. This innovative approach could enhance consumer participation and recovery-focused care.
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Affiliation(s)
- Louise Byrne
- Central Queensland University, Institute for Health and Social Science Research, Rockhampton, Queensland
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