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The term 'mental health crisis' is a widely used concept in clinical practice and research, appearing prominently in mental health literature across healthcare and social science disciplines. Within these contexts, the term is frequently either left undefined or defined rather narrowly, confined to clinical observations or guidelines targeted at healthcare providers and negating the multifaceted nature of crisis as described by those with lived experience. Therefore, the aim of this paper is to explore the characteristics of and provide a conceptual definition for the concept of 'mental health crisis'. Rodgers' method of evolutionary concept analysis was employed and 34 articles, ranging from 1994 to 2021 and a variety of disciplines, were analysed. The results highlighted the contrast between clinically oriented surrogate terms and related concepts and those used by individuals with lived crisis experience. Antecedents of crisis included underlying vulnerabilities, relational dysfunction, collapse of life structure and struggles with activities of daily living. The concept's attributes encompassed the temporality of crisis, signs and symptoms of crisis, functional decline and crisis in family and caregivers. Finally, the consequences comprised looking inward for help, looking outward for help, and opportunities and dangers. This concept analysis serves as a foundational step in understanding 'mental health crisis' and its various dimensions, facilitating more nuanced discussions and interventions in the realm of mental healthcare., (© 2024 The Author(s). International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)

Purpose: COVID-19 pandemic-related restrictions have significantly changed the environment and the delivery of direct care in all health services, including psychiatric hospitals. The aim of the study is two-fold: 1) to retrospectively assess the incidence of seclusion and mechanical restraint in a Quebec mental health hospital over 4 years; and 2) to assess the impact of the COVID-19 pandemic on their incidence., Methods: We conducted a retrospective study based on medical records from a Quebec mental health hospital collected (a) from April 2016 to March 2019), (b) from April 2019 to March 2020 (pre-COVID onset), and (c) from April 2020 to March 2021 (post-COVID onset). Descriptive statistics, chi square tests, Mann-Kendall test and Welch's t-test were performed., Results: Following several years during which the use of restrictive measures remained stable, we have noted a significant increase within the first year following the COVID-19 pandemic. This increase can be seen in the use of both seclusion and restraints, which have risen 205% and 170% respectively., Conclusion: There are a multitude of factors associated with the incidence of seclusion and restraint that have the potential to be triggered during emergencies and global crisis situations, impacting in turn the rights of an already vulnerable population., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Goulet, Cassivi, Hupé, Jean-Baptiste and Dumais.)

Crisis situations are frequent among people with mental health disorders. Several interventions have been developed to act in prevention, including crisis plans recognized as particularly effective in reducing coercive measures. In the literature, several models of crisis plans are proposed with similar aims and contents. Based on the methodology proposed by the Joanna Briggs Institute, a scoping review was conducted to map the state of knowledge on crisis plans in adult mental health settings. The literature search conducted on six databases (CINAHL, PubMed, Medline, EMBASE, PsychINFO and Cochrane) yielded 2435 articles. Of these, 122 full-text articles were assessed for eligibility, and 78 met the inclusion criteria. Studies were critically appraised using the Joanna Briggs Institute appraisal tools, and data were extracted by two independent reviewers. Content analysis identified a typology of crisis plans: (1) the legal crisis plan and (2) the formal crisis plan. Five modalities were identified for its completion: the sections, the moment, the completion steps, the people involved and the training of key actors. Most identified outcomes are consistent with the main purpose of the intervention, which is crisis prevention. However, the most identified outcomes focused on the service user's recovery and indicated that crisis plans could provide an opportunity to operationalize recovery in mental healthcare, thus suggesting an evolution in the aim of the intervention. Future research should further focus on the modalities of crisis plans to guide the implementation in clinical practice., (© 2023 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)

Competing Interests: Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://mhealth.amegroups.com/article/view/10.21037/mhealth-23-26/coif). The authors have no conflicts of interest to declare.

Introduction: The importance of a quality relationship between young adults living with dual diagnosis and their health care providers is well documented., Context: Although this complex phenomenon was mostly studied from an individual perspective, the results indicated the systemic nature of this relationship., Objective: This study aims to better understand the relationship between young adults living with dual diagnosis and their health care providers, with a systemic perspective., Method: Six data bases were consulted; manual research in gray literature and references screening enhanced the process., Results: Of a total of 532 studies and reports identified, 44 were included in the review. Thematic data analysis was carried out, and two themes were identified: the health care system as a constraining environment; and the relationship at the heart of care., Discussion: This study confirms the joint role played by the young adult in question and their health care provider in developing and maintaining the relationship, by acknowledging the importance of the care, of mutual confidence, and of a hierarchic relationship., Conclusion: This integrative review provides a basis for future nursing interventions that foreground the relationship and take a systemic approach.