Applying empowerment in mental health practice

The Core Elements of Psychiatric and Mental Health Nursing: Time, Honest Engagement, Therapeutic Relations, Professional Nursing and Lifetime-Perspective

Defining psychiatric and mental health nursing has been a challenge for decades, and it is still difficult to find a comprehensive definition. We have identified a possibility to clarify psychiatric and mental health nursing based on humanistic philosophy in a general psychiatric care context. The aim was therefore to identify and synthesize the theoretical frameworks from which psychiatric and mental health nursing models are developed. We systematically collected and evaluated articles based on Grounded Theory (GT) methodology regarding psychiatric or mental health nursing. The PRISMA statement for systematic reviews was used and the formal process of synthesis, as a three-step process of identifying first -, second - and third-order themes following the examples of Howell Major and Savin-Baden. The synthesis resulted in a model describing five core elements of psychiatric and mental health nursing: 'professional nursing', 'therapeutic relationships' and 'honest engagement', with time as the all-encompassing theme, including the patients' 'lifetime perspective'. Psychiatric and mental health nursing is a caring support towards recovery, where the patient's lifetime perspective must be in focus during the caring process with a relationship built on an honest engagement. Time is therefore essential for psychiatric and mental health nursing.

Limit setting in mental health: historical factors and suggestions as to its rationale

The task of enforcing behavioural limits in mental health settings is widely regarded as necessary but also potentially counter-therapeutic. There has been little discussion of the ideological basis for limit setting in psychiatry, and this paper attempts to locate the progress of this ideology from the moral treatment movement to contemporary medicalized psychiatry. It is suggested that limit setting has its foundations in the Enlightenment tradition of the autonomous individual and the power of reason, and in the dual functions of psychiatry as a therapeutic and social control system. The account draws on the work of critical psychiatry, as well as on recent research concerning the discourses and practices of mental health nurses, and concludes that these dual functions are inherent to the psychiatric project.

The tidal model: developing a person-centered approach to psychiatric and mental health nursing

TOPIC

Overview of the theoretical and practical basis of a new model of psychiatric and mental health nursing practice.

PURPOSE

To illustrate the history of the development of the model and some of the processes that aim to re-empower the patient and develop genuinely collaborative approaches to care.

SOURCES

Literature review, author's research, and related clinical experience.

CONCLUSIONS

The Tidal Model provides a practice framework for the exploration of the patient's need for nursing and the provision of individually tailored care.

The Tidal Model: developing an empowering, person-centred approach to recovery within psychiatric and mental health nursing

Nursing theories and nursing models have a low profile within psychiatric and mental health nursing in the United Kingdom. This paper describes the philosophical and theoretical background of the Tidal Model, which emerged from a 5-year study of the 'need for psychiatric nursing'. The Tidal Model extends and develops some of the traditional assumptions concerning the centrality of interpersonal relations within nursing practice. The model also integrates discrete processes for re-empowering the person who is disempowered by mental distress or psychiatric services or both. The paper reports briefly on the ongoing evaluation of the model in practice.

Facilitating empowerment groups: dismantling professional boundaries

The purpose of this study was to identify the issues and the process faced by public health nurses facilitating empowerment groups with people with a chronic and persistent mental illness. Five public health nurses facilitated seven groups which met weekly for a period of one year. Nurses kept field notes following each group session and methods of grounded theory were used to develop an understanding of the process of facilitating empowerment groups. A process of dismantling professional boundaries was identified which included three dimensions: experiencing the clash of worlds; joining the lives of people with a mental illness; and an exploration of professional self. The results highlight the need to challenge traditional ways of practicing.