Search

In recent decades concerns about violence and programs for the minimization of physical restraint, amongst other restrictive practices, have proliferated within mental health policy and practice. Whilst nurses are often called upon when violence occurs within mental health care settings, they often find themselves having the conflicting roles of caring and controlling. Within such situations it is service users, who are experts by experience, who perhaps can offer more meaningful insight into being restrained and thus provide a more appropriate approach in dealing with mental distress. This paper presents the findings of a narrative study of individuals' experiences of physical restraint within the mental health care system. In total 11 mental health service users, who had experienced physical restraint, were interviewed. Frank's (2010, Letting stories breathe: a socio‐narratology) guiding questions were used to undertake a dialogical narrative analysis of each story. For the purpose of this paper, four of the 11 stories are presented as these are representative of Frank's 'quest narrative'. However, whilst studies from the service user perspective regarding restraint are scarce, findings are discussed in relation to the grand narrative of restraint. The dialogical relationship between individual stories and the dominant grand narrative implies that the former has the capacity to shape and review the latter within mental health care. Adding to the growing body of evidence of restraint from service users' perspectives could enable nurses to provide more appropriate and meaningful mental health care in times of mental distress. [238]. [ABSTRACT FROM AUTHOR]

Mental health nurses (MHNs) play an important role in dealing with those receiving psychiatric care for self‐harming behaviour. How nurses perceive this group of people is pivotal to timely prevention of such harmful behaviour. This project aimed to assess MHNs perception of self‐harming behaviour among those receiving psychiatric care in the Kingdom of Saudi Arabia (KSA). Descriptive research was conducted with 400 nurses at governmental hospitals affiliated to the Ministry of Health and Population (MOHP) in the KSA. Data were collected using an online survey and questionnaire: the survey was divided into two sections: one concerned with demographic characteristics of the participants, the second section focusing on their workplace characteristics. The Self‐Harm Antipathy Scale‐Swedish Revision (SHAS‐SR) was used to assess perceptions of self‐harm among MHNs. This scale included 19 items categorized into five subscales. Finding showed that more than half of nurses had a low perception of those who self‐harmed. Additionally, there was a highly significant association between the nurses' total self‐harm perception scores and their workplace characteristics. Promoting person‐centred care to those who self‐harm through the creation of a collaborative nurse–patient relationship, may improve insight and understanding of the behaviour. Continuous professional development for staff who provide care for those who self‐harm would promote better understanding of the behaviour. In addition, workshops, presentations and modelling good practice, are all key for transferring information into real‐world applications for MHNs to provide better care for those who self‐harm. [ABSTRACT FROM AUTHOR]

Whilst there is an increasing prevalence of healthcare staff facing aggression, psychiatric nurses are thought to be most at risk; with such events being a hazard to their physical, emotional and psychological health. This study explored how patient violence is experienced by qualified nurses employed in an in‐patient psychiatric facility in the Kingdom of Saudi Arabia (KSA). As male and female patients and nurses are segregated in Saudi healthcare settings, this study focused on female patient violence against female psychiatric nurses. Both the immediate and more long‐term impacts were explored, together with approaches that could potentially facilitate avoiding, reducing and managing aggression within the work setting. The study adopted a qualitative descriptive design and used purposive sampling to recruit nine psychiatric nurses working in an in‐patient setting, from a single KSA medical facility. Inclusion criteria required participants to be licensed, registered nurses, who, during the last 10 years, had worked in an acute in‐patient psychiatric ward for adult females, and to have experienced some form of patient aggression. Semi‐structured, one‐to‐one interviews were used to gather data, which was then subjected to thematic analysis. Two dominant themes were identified: (i) occurrence of violence and (ii) determination of violence. It was concluded that female psychiatric nurses were adversely affected by aggression towards them from female patients. Although the nurses considered this behaviour to be part of their nursing role, they reported minimal support from institutional managers, peers and their relatives. [ABSTRACT FROM AUTHOR]

Globally, an increasing number of people who Self‐Harm (SH) are being treated in mental health hospitals. Incidences of SH are common in secure hospitals, with those using the behaviour being highly dependent on staff for care and support but impacting on often limited resources. While literature related to the lived experiences of people who SH exists, this is in its infancy in African countries. The aim of this study was to explore the lived experiences of people who SH in two secure mental health hospitals in Ghana. Interpretive Phenomenological Analysis (IPA) was used to explore the experiences of people who SH in two secure mental hospitals in Ghana. A convenience sample of nine participants were recruited and face‐to‐face in‐depth semi structured interviews were used to collect data. With the permission of each participant, all interviews were audio recorded and notes were made by the researcher (first author). Each interview was transcribed and analysed using the IPA seven‐step approach, with three superordinate and 11 subordinate themes being identified. The superordinate themes were: Being let down; Living with the negative self; Forces of the supernatural and religion. Findings demonstrate that there is a need to develop a collaborative health care package if appropriate care and support is to be offered to people in secure settings who use high‐risk behaviours, such as SH. To ensure care is holistic, culturally, and temporally relevant research is needed, particularly in Sub‐Saharan Africa. [ABSTRACT FROM AUTHOR]

Child sexual abuse (CSA) is an issue of epidemic proportions in the United Kingdom (UK) and an international public health problem. Evidence suggests that in the UK one in 20 children have been sexually abused, with one in three not telling anyone about it at the time of the abuse. Conservative estimates suggest that around one in six men have experienced sexual abuse before the age of 18. CSA has been correlated with the development of numerous mental health problems, abused men often displaying externalizing behaviours, including substance misuse, 'risky' sexual behaviours, anti‐social behaviour, and offending. This article reports on one aspect of a research study focusing specifically on male survivors of CSA and its effect on their mental health. Using narrative research, face‐to‐face interviews were used to collect the stories of four men who participated in the research. Interviews were audio‐recorded and transcribed verbatim. Analysis used a two‐phase approach; initially, each narrative was analysed as a whole, with an across transcripts analysis then being carried out identifying shared themes emerging from the individual stories. Whilst findings from the second phase of the analysis identify four themes, it is the theme of 'Blocking the Memories' that is the focus for this article. Making a valuable contribution to existent knowledge regarding the experiences of men who were sexually abused as children, this article will help to inform mental health practitioners who are likely to deliver care to male survivors of CSA. [ABSTRACT FROM AUTHOR]

Global estimates suggest 5% to 10% of men report experience of childhood sexual abuse (CSA). However, male CSA is significantly underreported, with men being reluctant to disclose due to vulnerability, stigmatisation, homophobic responses and fearing a loss of masculinity. A lack of research and service provision targeted towards men suggests male survivors of CSA are marginalised. This qualitative study, using a narrative approach, focussed on four adult male survivors of CSA. The aim of the study was to explore their experiences of engaging in counselling and support services for CSA from nonstatutory and voluntary organisations. Face‐to‐face narrative interviews were audio‐recorded and transcribed verbatim. Analysis was undertaken using a two‐phase approach; first, each narrative was analysed as a whole; second, an across‐transcripts analysis was carried out to identify shared themes and divergences that emerged from the individual stories. In this paper, findings from the second phase of the analysis are presented. Three themes regarding male survivors' experiences of specialist counselling services were identified: "Trust Me, I'm a Doctor," "Trust me, I'm a Counsellor" and "Counsellor or Mother?" This is the first academic study focussing specifically on men's experience of support for CSA in the UK from a service user perspective. Making an original contribution to the knowledge base regarding counselling experiences and the effectiveness of therapy for male CSA survivors, it will help to inform professional counselling services which are likely to come into contact with male survivors of CSA. [ABSTRACT FROM AUTHOR]

The purpose of this paper is two-fold: Firstly, it reports on one man's experience of bulimia. After being interviewed it became evident that he did not meet the inclusion criteria for the study, which was focussed on anorexia in men. Secondly, the paper explores the implications for a novice researcher of including someone in a study who does not meet the inclusion criteria. The researcher's story reflects upon the implications of self-doubt when embarking upon sensitive research, and the morality of holding onto a rogue participant's story. It offers others an opportunity to consider and learn from this experience. [ABSTRACT FROM AUTHOR]

Background: Compassion Focused Therapy (CFT) and Compassionate Mind Training (CMT) aim to help people cultivate compassion for self and others. To date, there is little evidence exploring the effects CMT has on those engaged in or embarking on a career in the helping professions. Interventions that encourage self‐reflection and self‐practice may help practitioners cultivate self‐compassion, leading to the promotion of self‐care. Aim: To explore the impact CMT has on students' levels of self‐compassion and self‐criticism, and on their work as healthcare practitioners/counsellors/psychotherapists. Methodology: This was a mixed‐methods study (N = 15). Pre‐ and post‐quantitative data were collected via three questionnaires: The Self‐Compassion Scale‐SF, the Forms of Self‐Criticising/Self‐Attacking and Self‐Reassuring Scale and the Functions of Self‐Criticising/Self‐Attacking Scale. Qualitative data were collected via diaries and a focus group to portray the impact training had on students. Findings: Results revealed a statistically significant increase in self‐compassion post‐training and a statistically significant increase in scores on the reassured self subscale. Statistically significant reductions in self‐correction scores and inadequate self scores were observed post‐training. There was no statistical significant difference post‐training on the hated self or self‐persecution subscales. Themes identified from the weekly diaries included the following: the benefits of compassion; when compassion arises; and difficulties and opportunities. Themes identified by the focus group data included the following: self‐reflection and self‐practice; finding balance; and critical self and compassionate self. Implications: Incorporating interventions into education programmes that help student's foster compassion may help them cultivate a compassionate mindset and learn to be kinder to self. [ABSTRACT FROM AUTHOR]

Background: Stress, and particularly burnout, is a major problem among healthcare workers and can lead to high staff turnover and low patient/client satisfaction. Objective: To explore the impact of 3-day compassion-focused therapy training on those delivering education to healthcare students. The underpinning premise was that the training course could potentially be replicated through the participants' work with students embarking on a career within the helping professions. Design: Mixed-methods study, with the qualitative findings being presented in this paper. Setting: Training course was delivered in one higher education institution in England. Methods: In total, 44 healthcare lecturers attended the course, with 6 taking part in a reflective focus group. Findings: The analysis highlighted four main themes: reassurance and increased knowledge, increased compassion towards others, self-compassion and empathy, and blocks to compassion. Conclusion: Findings add to previous quantitative research findings showing that participants who undertook training were able to engage with their compassionate self and consider the importance of showing compassion towards the self and others in healthcare education. [ABSTRACT FROM AUTHOR]

Globally, the exodus of individuals who have been forced to flee their home and seek refuge in countries of safety has led to a refugee crisis. The United Kingdom (UK) has engaged with the United Nations High Commissioner for Refugees (UNHCR) in playing a significant role in the long‐term resettlement of refugees, half of whom are children and young people. One initiative of such humanitarian resettlement is the Gateway Protection Programme (GPP). To date, there is a dearth of studies investigating aspects of acculturation that affect the mental health of young refugees resettled under the UNHCR humanitarian programme. This study aimed to explore aspects of acculturation that could enhance the mental health of GPP young refugees several years after resettlement. Using narrative research, a purposive sample of 31 GPP young refugees, who had a minimum of three‐year stay in the UK, were recruited from local refugee community organizations. Data were collected through a multi‐method design combining focus group discussions (FGDs) with visual arts‐based narrative research (VABNR) and analysed thematically. Three overarching themes emerged: People and places; Its nearly all new to me; and Finding self. This study contributes important knowledge regarding the mental well‐being of young people who have engaged in a resettlement programme and offers valuable information for policymakers and mental health professionals working with GPP young refugees. [ABSTRACT FROM AUTHOR]

Burnout is a common problem among mental health nurses. High levels of burnout result in job dissatisfaction, rapid turnover of staff, physical and psychological discomfort, and a reduction in the quality of patient care. While there is an abundance of research relating to burnout per se, research regarding the impact of burnout prevention programmes is lacking. This study aimed to measure the effects of a burnout prevention programme on mental health nurses working in Saudi Arabia (SA). A quasi‐experimental design was used to test the effectiveness of a two‐day burnout prevention workshop. The sample consisted of an intervention group (n = 154) and a control group (n = 142). Data collected using the Maslach Burnout Inventory (MBI) measured the effects of the workshop at 1‐, 3‐, and 6‐month intervals after completion of the programme. Data were analysed using the latest version of SPSS. Means, standard deviations, frequencies, and percentages were used to describe the sample and levels of burnout. A t‐test, ANOVA, multiple linear regression, and chi‐squared were used to measure the effect of the workshop before and at the three time points after exposure. Findings indicate the programme was effective with a significant reduction being reported 1 month after the intervention. However, although not returning to baseline scores, burnout scores had increased at 6 months. In conclusion, while the overall efficacy of the burnout reduction programme is evident, mental health nurses would benefit from having opportunity to use some of the strategies on a regular basis. [ABSTRACT FROM AUTHOR]

The number of men diagnosed with anorexia has increased, men now representing 25% of those with eating disorders (EDs). Research has mainly been quantitative and female focused, with only two qualitative studies exploring the experiences of men. This study focused on the lived experiences of men diagnosed with an ED, and its impact on 'everyday' aspects of their lives. Qualitative research adopting narrative interviews was conducted with seven men aged 23–34 years old. Narrative analysis was used to interpret each individual story, with thematic analysis used to explore commonalities across all seven narratives. Four themes were identified, 1) The Final John Doe; 2) Help! I need somebody - Bedlam revisited; 3) Masculinity; 4) Not Working 9 to 5. Narratives highlight the need for further research if men are to receive appropriate mental health care and better understanding and acceptance on the part of society, service providers, employers and men themselves. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: While there is no single definition of the concept of recovery for people with mental illness, hope has been recognized as a guiding principle; the belief that it is possible for a person to regain a meaningful life, despite serious mental illness.Little is known about the recovery process of women diagnosed with schizophrenia per se, with only six studies offering the woman's voice identified and these all having taken place in developed countries.No studies on this topic have been carried out in Sub‐Saharan Africa, including Swaziland. What this paper adds to existing knowledge?: This study provides unique insight into what is important to Swazi women, diagnosed with schizophrenia, in their process of their recovery.Because of current trends in migration, the findings of this study may provide mental health professionals with a better understand of the needs of those from this particular Sub‐Saharan country.The study discusses a range of issues affecting women including being labelled as mentally ill, stigma and discrimination, the importance of the sociocultural context of illness and positive attributes which promote women's recovery. What are the implications for practice?: This study provides mental health practitioners with insights and understanding of the lives of women from a Sub‐Saharan developing country. This will be helpful for better understanding of the context of mental illness both for practitioners supporting the development of services in such countries and for those working in Western countries with migrant populations. Introduction: Globally, twenty‐four million people live with schizophrenia, 90% living in developing countries. While most Western cultures recognize service user expertise within the recovery process, this is not evident in developing countries. In particular, Swazi women diagnosed with schizophrenia experience stigma from family, community and care providers, thus compromising their recovery process. Aim: This study aimed to explore the experiences and meanings of recovery for Swazi women living with schizophrenia. Methodology: Interpretive phenomenological analysis was used. Fifteen women were recruited from Swaziland National Psychiatric Hospital out‐patients' department, and face‐to‐face interviews were conducted. Findings: Four super‐ordinate themes were identified: (a) The emotionality of "illness of the brain"; (b) Pain! Living with the illness and with others; (c) She is mad just ignore her; and (d) Being better. Discussion: Discussion focuses on the findings of this study and a number of positive and negative implications emanating from them: labelling, stigma and the roles of family, culture and religious beliefs on the process of recovery. Implications for practice: This study provides practitioners with insight into the importance of the sociocultural context of the lives of women diagnosed with schizophrenia and how, in understanding this, mental health care could be improved. [ABSTRACT FROM AUTHOR]

Abstract: In Western society, policy and legislation seeks to minimize restrictive interventions, including physical restraint; yet research suggests the use of such practices continues to raise concerns. Whilst international agreement has sought to define physical restraint, diversity in the way in which countries use restraint remains disparate. Research to date has reported on statistics regarding restraint, how and why it is used, and staff and service user perspectives about its use. However, there is limited evidence directly exploring the physical and psychological harm restraint may cause to people being cared for within mental health inpatient settings. This study reports on an integrative review of the literature exploring available evidence regarding the physical and psychological impact of restraint. The review included both experimental and nonexperimental research papers, using Cooper's (1998) five‐stage approach to synthesize the findings. Eight themes emerged: Trauma/retraumatization; Distress; Fear; Feeling ignored; Control; Power; Calm; and Dehumanizing conditions. In conclusion, whilst further research is required regarding the physical and psychological implications of physical restraint in mental health settings, mental health nurses are in a prime position to use their skills and knowledge to address the issues identified to eradicate the use of restraint and better meet the needs of those experiencing mental illness. [ABSTRACT FROM AUTHOR]

Introduction: In the UK, almost 50% of illness diagnosed among working age adults is mental distress, with depression and chronic anxiety cited as the two most prevalent psychological illnesses. However, only 24% of those who experience anxiety and depression, consistent with diagnoses, receive National Health Service (NHS) interventions. Effective mental health care is predicated on understanding the lived experiences of those using services in order to provide sensitively attuned therapy. An understanding of the process of counselling and what makes it effective will only be achieved through hearing the voices of service users. However, with regard to counselling, the literature foregrounding the perspectives of those using services remains sparse. Method: This study reports on a qualitative research project, the aim of which was to explore the experiences of people who have used North Staffs MIND’s Adult Counselling Service in order to elicit the strengths of and/or opportunities for improving the service. Twelve participants, five males and seven females, were interviewed on a one‐to‐one basis and six themes were identified; Mindful of the Gap; Easing Like Sunday Morning; Magic Moments; Love is in the Air; Lighting up a Future and Following up the Changes: Spreading the Word. Results: Findings suggest the participants in this study found the service beneficial, with therapeutic interventions being tailor‐made to meet the person's needs, and one which ensures a safe environment and compassionate care for those in distress. [ABSTRACT FROM AUTHOR]

Background: In the UK, only one in four people with a diagnosis of depression receive any form of treatment. To address this, the Improving Access to Psychological Therapies (IAPT) programme was established with the main therapeutic approach being cognitive behavioural therapy (CBT). This raised concern regarding client choice, prompting the development of a new evidence‐based manualised therapy, namely ‘Counselling for Depression’ [CfD]. To date, the client's view of the effectiveness of CfD has not been researched. Aims: The aims of this study were twofold: (1) to explore and evaluate CfD from the perspective of the client and (2) to inform the counselling profession of the client's perception of what is occurring within this therapeutic approach. Methodology: This qualitative study used Interpretative Phenomenological Analysis, the ideographic aspect valuing each individual narrative and the contribution it makes towards a larger account of the phenomenon from a small group of people. Twelve participants receiving CfD completed a Helpful Aspects of Therapy questionnaire after each counselling session, with ten participating in a semi‐structured interview post counselling. Findings: Four superordinate themes were identified: A helpful process, Client's view of a counsellor, Gains and Negative aspects. Participants perceived this model of therapy as helpful, feeling understood by their counsellors and able to work through issues in a safe therapeutic relationship. Negative findings related to counselling being ‘hard work’ and a dislike of the time limitation that curtailed the work. Implications: Participants believed this type of counselling met their needs, reassuring practitioners that CfD is helpful to their clients. [ABSTRACT FROM AUTHOR]

Individuals working for the emergency services often bear witness to distressing events. This outcome study examines therapeutic interventions for Fire Service personnel (FSP) experiencing symptoms of trauma, depression, anxiety and low levels of self-compassion. This study aims to investigate the effectiveness of using Compassion-Focused Therapy (CFT) as an adjunct to Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) in reducing symptoms of trauma, anxiety and depression and increasing self-compassion. A convenience sample (n = 17) of participants, referred for therapy following a traumatic incident, were allocated to receive 12 sessions of either TF-CBT or TF-CBT coupled with CFT. The study employed a repeated-measures design. Data were gathered pre- and post-therapy, using three questionnaires: (1) Hospital Anxiety and Depression Scale; (2) Impact of Events Scale-R; (3) Self-Compassion Scale – Short Form. TF-CBT combined with CFT was more effective than TF-CBT alone on measures of self-compassion. Significant reductions in symptoms of depression, anxiety, hyperarousal, intrusion and avoidance and a significant increase in self-compassion occurred in both groups post-therapy. The study provides some preliminary evidence to suggest that FSP may benefit from therapeutic interventions aimed at cultivating self-compassion. Further research is warranted using a larger sample size and adequately powered randomized controlled trial, to detect statistically significant differences and to negate the risk of confound due to low numbers resulting in significant differences between groups at baseline. Using CFT as an adjunct to TF-CBT may help FSP, who bear witness to the distress of others, cultivate compassion for their own suffering. [ABSTRACT FROM AUTHOR]

Background: There has been much debate by both academics and clinical agencies about the motivations and abilities of nurse graduates to work in mental health nursing. The aim of this study was to recruit student nurses from a dedicated mental health nursing program in the United Kingdom (UK) and a comprehensive nursing program in Australia and illuminate their motivations towards considering mental health nursing as a career choice. Methods: This study comprised of two UK and four Australian Schools of Nursing within Universities. A 12 item survey was developed for the purpose of this study and was checked for face validity by experienced mental health nurses. Convenience sampling was used and 395 responses were received. Results: The comprehensive program represented by the Australian sample, revealed a third of respondents indicated that mental health nursing was definitely not a career option, while only 8 % of the UK specialised program reported mental health nursing was not seven for them. In both groups a higher level of motivation to work in mental health emanated from personal experience and/or work experience/exposure to mental health care. Conclusions: A greater focus on clinical exposure in comprehensive programs could enhance professional experience needed to increase student motivations for mental health nursing. [ABSTRACT FROM AUTHOR]

The authors report on a service evaluation of blueSCI, a social inclusion and cultural wellbeing service in the north west of England. It is a not-for-profit social enterprise that supports people who may be experiencing emotional or psychological distress. The evaluation describes, from a client perspective, what the service has been able to offer to date and how it might improve and grow in the future. A questionnaire was developed in consultation with service users and completed by 103 people who were randomly selected from blueSCI records. It was found that gender, age and relationship status of service users did not reflect the local population, and that the issue of disability was complex. Other issues highlighted included the need for friendship, socialisation and structured activities in an environment of understanding and reassurance. Seven recommendations are made relating to child care, name badges, disability, impact of blueSCI, communication, further evaluations and access for younger and older age groups. [ABSTRACT FROM AUTHOR]

The authors report on a service evaluation of blueSCI, a social inclusion and cultural wellbeing service in the north west of England. It is a not-for-profit social enterprise that supports people who may be experiencing emotional or psychological distress. The evaluation describes, from a client perspective, what the service has been able to offer to date and how it might improve and grow in the future. A questionnaire was developed in consultation with service users and completed by 103 people who were randomly selected from blueSCI records. It was found that gender, age and relationship status of service users did not reflect the local population, and that the issue of disability was complex. Other issues highlighted included the need for friendship, socialisation and structured activities in an environment of understanding and reassurance. Seven recommendations are made relating to child care, name badges, disability, impact of blueSCI, communication, further evaluations and access for younger and older age groups. [ABSTRACT FROM AUTHOR]

The incidence of adolescent self-harm and suicidal behaviour has increased globally, with many adolescents repeating the behaviour. While studies indicate that large numbers of adolescents who self-harm do not seek professional help, research focusing on barriers to help seeking from an adolescent perspective is limited. Locally, a rise in reported and unreported rates of self-harm and a number of suspected child suicides prompted the commissioning of a research project to ascertain young people's experiences of help and support for self-harm and how their future needs could be best met. Qualitative research, adopting an interpretive phenomenological analysis, was used to elicit narratives of adolescents engaging in self-harm. Data were collected via 1:1 interviews with seven participants and analysed in two stages: an analysis of each individual narrative, and thematic analysis across the group. Three themes were identified: (i) cutting out the stress; (ii) stepping onto the path of help; and (iii) cutting to the chase. In conclusion, mental health nurses have a vital role in providing knowledge and support to those likely to have initial contact with this vulnerable group and to the wider population, ensuring we more effectively address the increasing use of this risky behaviour among young people. [ABSTRACT FROM AUTHOR]

Background:Female Genital Mutilation/Cutting (FGM/C) is the procedure of removing healthy external genitalia from girls/women for socio-cultural reasons. There is much scientific literature on the adverse physical health complications that can result from having FGM/C, but little is known about its psychological impact and treatment.Objective:To identify psychological problems that may follow from a woman having FGM/C and success of treatment herein, and relate findings to the role of the maternity care professional.Study design:A structured narrative review, which identified 10 studies, was carried out.Findings:Eight of ten studies reported psychological consequences, such as Post-Traumatic Stress Disorder (PTSD) and affective disorders. Also identified were socio-cultural differences in the meaning of perceived consequences for different individuals. Two studies reported inconclusive results regarding the psychological impact of FGM/C on women’s lives.Key conclusion:While these findings provide an indication of adverse psychological effects of women/girls having FGM/C, more studies are needed. In particular, studies that focus on the role that cutting extent, circumstances surrounding the cutting, and girls’ level of knowledge of what was going to take place, and their relationships to psychological outcomes.Implications for Practice:Raising awareness of the risk of negative psychological consequences is important, with maternal health care professionals requiring training on how to treat and care for women/girls who are suffering problems that result from having FGM/C. [ABSTRACT FROM AUTHOR]

Background:Female Genital Mutilation/Cutting (FGM/C) is the procedure of removing healthy external genitalia from girls/women for socio-cultural reasons. There is much scientific literature on the adverse physical health complications that can result from having FGM/C, but little is known about its psychological impact and treatment.Objective:To identify psychological problems that may follow from a woman having FGM/C and success of treatment herein, and relate findings to the role of the maternity care professional.Study design:A structured narrative review, which identified 10 studies, was carried out.Findings:Eight of ten studies reported psychological consequences, such as Post-Traumatic Stress Disorder (PTSD) and affective disorders. Also identified were socio-cultural differences in the meaning of perceived consequences for different individuals. Two studies reported inconclusive results regarding the psychological impact of FGM/C on women’s lives.Key conclusion:While these findings provide an indication of adverse psychological effects of women/girls having FGM/C, more studies are needed. In particular, studies that focus on the role that cutting extent, circumstances surrounding the cutting, and girls’ level of knowledge of what was going to take place, and their relationships to psychological outcomes.Implications for Practice:Raising awareness of the risk of negative psychological consequences is important, with maternal health care professionals requiring training on how to treat and care for women/girls who are suffering problems that result from having FGM/C. [ABSTRACT FROM PUBLISHER]

The terms 'Female Circumcision' ( FC), 'FG Cutting' ( FGC) and 'FG Mutilation' ( FGM) refer to procedures involving the partial or total removal of the external female genitalia for non-medical reasons. In practicing countries, FGC/ FC is more widely used, as it is believed to be inoffensive, providing more impartial ways of discussing the practice. Positive beliefs about FC/ FGC include virginity, marriage prospects, family reputation, or passage to adulthood. Regardless of terminology, the practice exists in at least 28 African counties, and a few Asian and Middle Eastern countries. In Western society, FGM is considered a breach of human rights, being outlawed in a number of countries. With immigration trends, FGC is now prominent in Western society among practicing communities. While the past decade has seen an increase in studies and recommendations for health-care support related to the physical health consequences of FGM, little is known about the psychological impact and its management. For many girls and women, FGC is a traumatic practice, transforming it to FGM and affecting their mental health. This discussion paper focuses on evidence relating to the mental health consequences of FGM, therapeutic interventions, and the mental health nurse's role in addressing the needs of this group of women. [ABSTRACT FROM AUTHOR]

Quality nursing plays a central role in the delivery of contemporary health and social care, with a positive correlation being demonstrated between patient satisfaction and the quality of nursing care received. One way to ensure such quality is to develop metrics that measure the effectiveness of various aspects of care across a variety of settings. Effective mental health nursing is predicated on understanding the lived experiences of service users in order to provide sensitively-attuned nursing care. To achieve this, mental health nurses need to establish the all-important therapeutic relationship, showing compassion and creating a dialogue whereby service users feel comfortable to share their experiences that help contextualize their distress. Indeed, service users value positive attitudes, being listened to, and being able to trust those who provide care, while mental health nurses value their ability to relate through talking, listening, and expressing empathy. However, the literature suggests that within mental health practice, a disproportionate amount of time is taken up by other activities, with little time being spent listening and talking to service users. The present study discusses the evidence relating to the therapeutic relationship in acute mental health wards and explores why, after five decades, it is not recognized as a fundamental metric of mental health nursing. [ABSTRACT FROM AUTHOR]

There is considerable interest in the various ethical problems associated with undertaking health and social science research. Participants in such research are often considered vulnerable because of their health status, social position, or dependence on others for health and welfare services. Researchers and ethics committees pay scrupulous attention to the identification and amelioration of risks to participants. Rarely are the benefits to participants of engaging in research highlighted or drawn to the attention of potential participants. Such potential benefits need to be considered by researchers and reviewers when considering the balance of benefits and harms associated with research projects. In this paper, we particularly consider the psychotherapeutic benefits of participation in research. [ABSTRACT FROM AUTHOR]

ABSTRACT International studies consistently demonstrate that individuals diagnosed with severe mental illness (SMI) have an increased risk of co-morbid physical health problems and premature death. During the past decade, government policy in the UK has focused on improving the physical health of those with SMI. Despite this, international research has continued to report barriers to accessing appropriate services. These have been identified as emanating from service users and professionals alike, and also from institutional bureaucracy. Most of this research has reported difficulties from the perspective of various professional groups, with little attention being paid to the service user voice. Studies from the service user perspective undertaken in the past 10 years equate to six qualitative and three quantitative studies, and it appears that poor physical health care remains a problem in the developed world. The quality of this care is compromised by practical problems and interpersonal difficulties between service users and health-care providers and between providers of mental health services and those providing physical health care. This paper presents a review of the nine international studies and discusses the implications for developing policy and practices that could lead to improved physical health-care services for people experiencing SMI. [ABSTRACT FROM AUTHOR]

Suicidality among young people is a global concern, with international studies demonstrating an increased prevalence among young gay men. Being gay is not inevitably linked to mental illness, but growing up gay in a heterosexist society can compromise mental well being. This qualitative study, using free association narrative interviewing, offers an in-depth understanding of gay men's experience. One shared experience that emerged was 'knowing and not knowing,' the story of gay children growing up in a heterosexist society. This story provides valuable insights for mental health nurses becoming more attuned to the importance of providing professional nurturing of gay children. [ABSTRACT FROM AUTHOR]

ABSTRACT Young carers are a global phenomenon. The UK estimates it has in excess of 175 000 young carers, the onset of their caring role often occurring between 8 and 10 years of age. Of these, 17 000 are caring for a parent who has severe mental illness, a significant factor for children entering the health and social care system, as up to 60% experience mental health difficulties themselves. This paper reports on the outcome of a participatory project aimed at better understanding the needs of young people. A World Café event was hosted, bringing together those involved in promoting the mental health of young people in a partnership consortium. The event was led by young service users and carers. Important issues raised by the young carers were being excluded from being included; stuck in the here and now, ignoring the future; a hole in the net; and ensuring the hidden is on the agenda. The World Café gave the university the privilege of insight into what local young carers need to improve their mental health, and more importantly, how we can utilize our skills to help them achieve their goals. [ABSTRACT FROM AUTHOR]

International studies report increased rates of mental health problems and subsequent suicidality among homosexual populations. While international health-care policy is concerned with reducing suicide among young people, important research findings relating to gay people and suicidality remain unacknowledged in the Suicide Prevention Strategy for England. This qualitative study, utilizing single case studies, was used to gain an in-depth understanding of the life experiences contributing to the suicidality of four gay men. The methodology was psychoanalytically informed, using free association narrative interviewing. The initial data analysis involved interpretation of each of the case studies and a subsequent analysis exploring the shared experiences found in each of the individual narratives. Thematically, these are described as ‘knowing and not knowing’, ‘the centrality of the father–son relationship’, ‘the loneliness of outsiderness’, ‘leading a double life’, and ‘crime and punishment’. The significance of the life experiences these themes illustrate reveal why some gay men might not only experience long-term mental health problems, but also engage in suicidality. Individually and collectively, the analyses provide important insights for mental health nurses becoming more attuned to provide sensitive mental health care to those who have a gay sexual orientation. [ABSTRACT FROM AUTHOR]

Contemporary standards and policies advocate carer involvement in planning, implementing, and evaluating mental health services. Critics have questioned why such standards and policies fail to move from rhetoric to reality, this particularly being applicable to carer involvement within acute psychiatric settings. As there is only limited UK research on this topic, this interpretive phenomenological study was undertaken to explore the perceived level of involvement from the perspective of carers of service users who were admitted to acute inpatient settings within the previous 2 years. Interviews were conducted with four individuals who cared for a loved one with a mental illness. The interview analysis was influenced by Van Manen, whose interpretive approach seeks to generate a deeper understanding of the phenomenon under study. Four main themes emerged: powerlessness, feeling isolated, needing to be recognized and valued, and a desire for partnership. The findings reflect the views expressed by carers in other studies, identifying that while carers seek to work in partnership with health-care professionals, at a clinical level they often feel excluded. The study concludes by discussing ways of improving and promoting carer involvement and advocating a partnership in care approach within acute psychiatry. [ABSTRACT FROM AUTHOR]

As mental health nurses acquire and utilize knowledge for practice, both emotion and learning become interrelated, interactive, and interdependent aspects of personal functioning and professional practice. Emotion and learning in combination are powerful sources of meaning and direction. This paper explores how, in addressing these important aspects of ‘becoming’ and ‘being’ a mental health nurse with students, the medium of painting was used to facilitate the exploration of their self in relation to others encountered in recent clinical practice. Broad principles of psychoanalytic theory are used in analysing the experiences depicted in the student paintings, and their explanatory accounts, in order to explore the emotionality of mental health nursing and the complexities of addressing this within current educational processes. What is revealed is that in the uncertainties of everyday clinical and educational practice, working and learning in the place between knowing and not knowing can give rise to unconscious defence mechanisms being used to achieve emotional homeostasis. This paper argues that while working and learning in this hinterland can sometimes be experienced as being threatening and anxiety provoking, it is also a place for personal and professional development and growth. The tutor's role in facilitating such opportunities for growth is seen as being crucial. However, this will require tutors to actively engage in critical reflection in and on their educational practice in order to better understand and use their authentic self in more effectively supporting the student. [ABSTRACT FROM AUTHOR]

Peggy Mulongo and Sue McAndrew respond to a review of the law surrounding protection orders, published in the July issue of the British Journal of Midwifery, and call for a national commissioner [ABSTRACT FROM AUTHOR]

This discussion paper seeks to explore an approach that metal health nurses can adopt that ensures the patient is at the centre of training and professional development opportunities. Although nurse training and education is shaped by practice and theory, the lived experiences of the patients as an educational resource often become lost in the milieu of ‘doing’ nursing. We argue that in addition to theoretical knowledge and practice knowledge, there is the need to harness the equally important patient experience knowledge. Drawing upon Ptolemaic concepts, this paper explores the potential tensions for mental health nurses resulting from the imbalance in power when engaging in therapeutic relationships with patients. It is argued that in order for mental health nurses to become more effective, they need to learn how to relinquish some of their power, even where this gives rise to uncomfortable tensions for the nurse. Such tensions result from the centrality afforded to theoretical knowledge and ritualized practice that underpins nursing and the difficulties this may cause for many nurses in accepting the value of patient experience as a primary source of knowledge. The difficulties of adopting this approach point to a need for mental health nurses and nurse educationalists to take a more reflexive approach to their patient encounters and within their encounters with each other. [ABSTRACT FROM AUTHOR]

Deliberate self-harm predominantly occurs in women under the age of 30 years. This qualitative case study using feminist methods explored the experiences of three women who each had a long history of self-harming behaviour. Psychoanalytical concepts are used to explore the meaning of the conflicts that these women experience. Emergent themes include: great expectations, I speak but no one hears, sexual naivety meets sexual violence, and redrawing the sexual map. This thematic analysis helps facilitate an insight into what these women are trying to communicate, and provides guidance for mental health professionals to more effectively respond to the challenges of working with women who self-harm. [ABSTRACT FROM AUTHOR]

Background: Therapeutic engagement (TE) has been described as the crux of mental health nursing but despite its perceived importance, to date, there is no measurement tool that captures it. As a result, there is no way of determining the contribution of mental health nursing interaction to service user recovery, in acute inpatient mental health settings or the wider care quality agenda. Methods: To develop and validate a TE measurement tool in partnership with Service Users (SUs) and Registered Mental Health Nurses (RMHNs). The TEQ was developed in 3 stages: 1) item generation (and pre-testing), 2) item reduction using Principal Component Analysis (PCA), and 3) validation across Mental Health Trusts in England. Results: The final questionnaire has two versions, (SU and RMHN version), each scored within two contexts (1–1 SU-RMHN interactions and overall environment and atmosphere of the ward) and includes 20 items with two sub-scales (care interactions and care delivery). Psychometric evaluation of the TEQ shows high inter-scale correlations (0.66–0.95 SU; 0.57–0.90 RMHN), sound sub-scale internal consistency (> 0.95), concurrent validity (> 0.60) and adequate score variability for both versions of the TEQ. In summary, the TEQ behaves well as a measurement tool. Conclusions: The TEQ can determine the collaborative and empathic nature of RMHN-SU interactions, capture if SUs are treated with dignity and respect and recognise that the principles of the recovery approach are being respected. The TEQ can also provide robust monitoring of nursing activity, offer opportunity for transparency of activity, feed into healthcare organizations' key performance indicators and provide reassurance about the nature and quality of nurses' work. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including one on the profession of mental health nursing, the other on the role of gestures in the communication and the third on defensiveness on the part of the mental health.

Comments on health care-related issues in Great Britain. Implementation of a plan to improve patient services by the Changing Workforce Programme; Growth in the use of assistant practitioners by health and social-care system; Problems associated with clinical competencies.

Discusses the development of mental health assistant practitioners (MHAP) in Great Britain. Adoption of the whole systems approach to service redesign; Development of roles within the health and social care workforce; Impact of the development of MHAP on mental health nurses.