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In New Zealand, people receiving care from specialist mental health and addiction services experience poorer health outcomes compared to the general population. Māori (Indigenous) specialist mental health and addiction service users experience disproportionate inequities. This study aims to: (1) Describe and understand mental health staff perspectives on the quality of care delivered to specialist mental health and addiction service users in their service – including specifically for Māori; and (2) Identify areas staff report as opportunities for quality improvement. In 2020, Southern District Health Board (now Te Whatu Ora – Southern) mental health staff were invited to participate in a cross‐sectional study assessing their perceptions of a range of service aspects. This paper presents quantitative and qualitative analyses about quality of care. Among the 319 staff who completed the questionnaire; 272 provided quality‐of‐care responses. Among these, 78% reported the quality of care delivered to service users as 'good' or 'excellent'; only 60% reported this for Māori service users. Participants identified individual, service and broader system level factors influencing the quality of care delivered to service users, including factors specific for Māori. This study has identified, for what appears to be the first time, empirical and concerning differences in staff ratings of the quality of care delivered to Māori and SMHAS users overall. Findings highlight the need for institutional and managerial prioritization of hauora Māori, and incorporating tikanga Māori and Te Tiriti into practice. [ABSTRACT FROM AUTHOR]

The peer workforce has increased significantly in recent years; however, structured development and support for the roles are lacking. This paper explores the role of executive and senior management understanding in the employment of peer roles. In‐depth, semi‐structured interviews and one focus group were conducted with 29 participants from a range of nongovernment and public mental health services within Queensland, Australia. Findings of this study suggest management exposure to and understanding of peer work are essential to the development of an effective peer workforce. Exposure and understanding of peer roles reportedly led to greater acceptance and commitment from management. This commitment inspired action in the form of; enhanced support including advocacy/championing, increased development of roles and influenced culture within the organization to be more accepting of peer work. There was a perception that developing an 'accepting' organizational culture supported the integrity and expansion of peer roles including designated 'peer management' positions. Development of peer management positions is suggested as an effective means of improving the impact of peer perspectives, advocating for peer work and providing ongoing and timely supervision. Recommendations include the need for training and information for management on the unique function, purpose and value of peer roles; and the development of networks, including mentoring opportunities, for organizations with limited experience to gain support and advice from those with greater experience developing peer roles. [ABSTRACT FROM AUTHOR]

When nurses practise recovery‐focused care, they contribute positively to the consumer's mental health recovery journey and empower the person to be actively engaged in the management of their illness. While using recovery‐focused care is endorsed in mental health policy, many health professionals remain uncertain about its application with consumers who have a risk for aggression during their admission to an acute mental health inpatient setting. This paper reports on Australian research using Q‐methodology that examined the knowledge and skill components of recovery‐focused care that nurses use to reduce the risk for aggression. The data from forty mental health nurses revealed five factors that when implemented as part of routine practice improved the recovery outcomes for consumers with risk of aggression in the acute mental health settings. These factors were as follows: (I) acknowledge the consumers' experience of hospitalization; (II) reassure consumers who are going through a difficult time; (III) interact to explore the impact of the consumer's negative lived experiences; (IV) support co‐production to reduce triggers for aggression; and (V) encourage and support consumers to take ownership of their recovery journey. These findings provide nurses with a pragmatic approach to use recovery‐focused care for consumers with risk for aggression and contribute positively to the consumers' personal recovery. [ABSTRACT FROM AUTHOR]

Eliciting clinicians' views about antipsychotic medication side-effects may assist in understanding strategies that could enhance the identification and management of these side-effects. The present paper details the development and psychometric evaluation of a questionnaire that captures clinicians' perceptions about these issues. An initial item set was derived from a literature review, and then refined by an expert content validity panel that assessed the relevance of the items. The online questionnaire was distributed to Australian mental health nurses and 140 fully completed questionnaires were returned. Principal components analysis yielded two robust scales that conceptually tapped 'system responsibility' and 'personal confidence'. These scales may be used to advance knowledge about how mental health nurses' attitudes towards the assessment and management of antipsychotic medication side-effects influences their clinical behaviour. [ABSTRACT FROM AUTHOR]

The Mental Health Nurse Incentive Program ( MHNIP) was established in Australia during 2007. The program enables mental health nurses to work in partnership with general practitioners ( GPs) in the assessment and treatment of people with severe mental health problems. This paper provides insights into the demographic and clinical profile of 403 people enrolled in the MHNIP in the Ipswich area of Queensland. The clinical presentation (illness severity and symptoms) of those referred to the MHNIP is compared to that of: (i) people referred to a related program known as Access to Allied Psychological Services ( ATAPS); and (ii) to clients admitted to acute inpatient care in Queensland. While people referred to the MHNIP presented with more severe problems than those referred to ATAPS, they had less severe problems than those admitted to acute inpatient care. The findings indicate that the MHNIP is meeting the needs of people with complex mental and physical health problems. Further evaluation work is required to determine if the findings from this study can be generalized more broadly. At the national level, consideration should be given to the routine collection of clinical, cost, and demographic data to enable the ongoing monitoring of the program. [ABSTRACT FROM AUTHOR]

People with schizophrenia and type 2 diabetes face complex challenges in daily life and the management of both illnesses is burdensome. This qualitative interview study aimed to explore perceptions and understandings of the day‐to‐day management of schizophrenia and type 2 diabetes. Fourteen semi‐structured interviews were conducted between January 2020 and October 2021 in the participants' respective mental health clinics, in their homes or by phone. Thematic analysis led to four themes representing participants' self‐management strategies and perceived challenges. The first theme showed that participants use self‐learned strategies for managing schizophrenia. In contrast, they perceived type 2 diabetes self‐management as governed by a set of rules and guidelines given by health professionals. The second theme showed that both psychotic and negative symptoms present challenges to diabetes management. Theme 3 illustrated that participants consider their type 2 diabetes to be a very serious illness. They worried about potential long‐term consequences and expressed wishes and motivation to improve their lifestyle. The final theme showed that participants discuss challenges related to their schizophrenia with family and friends but not type 2 diabetes. In conclusion, this study highlights the importance of considering individual challenges and everyday routines when supporting this population. It underlines the need for future research to further explore the complexity of managing the illnesses and to understand the needs for treatment and support. [ABSTRACT FROM AUTHOR]

In the context of pressures faced by the nursing profession including increasing patient acuity and global nursing shortages, the importance of nurse resilience has gained attention in research and practice. Resilience is viewed as a protective factor that enables individuals to avoid psychological harm and continue in their work. There is limited evidence on the impact of external factors such as work conditions on nurse resilience. This study aimed to explore how external factors influence nurse resilience and to incorporate this knowledge into an updated definition of nurse resilience. As part of a two‐phase mixed methods study, focus groups were conducted to obtain qualitative data to explore nurse's perceptions of resilience and factors they felt affected their resilience. Data analysis identified three main themes derived from 10 subthemes: Perceptions of Resilience, Pressures and Challenges, and Support and Strategies contributed to understanding how external factors can affect nurse resilience. A range of factors emerged including the impact of workplace conditions, organizational philosophy, the performance of managers, and the teams nurses work within, which were not reflected in an earlier definition of nurse resilience derived through a concept analysis. These factors were incorporated in an updated definition of nurse resilience. Understanding resilience in the nursing profession and the external factors that affect it is critical to the development of effective research, policies, interventions, and work environments to protect nurse well‐being, promote nurse retention, and ensure the provision of quality patient care. [ABSTRACT FROM AUTHOR]

This study assessed the physical activities of Mental Health Nurses (MHN) in New Zealand against the 2018 World Health Organization recommended minimum levels of moderate‐to‐vigorous physical activity. The research design was exploratory and descriptive as there were no previous studies about physical activity levels of MHNs in New Zealand. Quantitative and qualitative data were collected using the International Physical Activity Questionnaire (IPAQ, Long Version) which included options for free‐text responses. Data were analysed using descriptive and inferential statistics. A total of 266 participants returned the survey, a response rate of 4%, and a limitation of the study. More than 50% of MHNs reported <150 min of moderate‐to‐vigorous exercise per week for each of the four physical activity domains. When individual physical activity domains were combined, only 10% spent <150 min on moderate‐to‐vigorous physical activity. Work‐related physical activities were higher for those working in the inpatient area than in community settings. Transport‐related physical activities were higher for those working in community settings. Participants registered from 6 to 20 years had more time sitting than other groups. Nurses aged 55 years and above showed the highest total physical activity levels. Moreover, healthcare organizations and nurse leaders need to promote physical activity and provide wellness intervention for their staff. Nurses who are physically active may be more effective in supporting their patients to increase their physical activity. [ABSTRACT FROM AUTHOR]

Recovery‐oriented principles have progressively been accepted as a standard of mental health practice in many countries, including Australia. A private mental health Clinic in Melbourne, Australia, is dedicated to embedding the principles of recovery‐oriented practice into care by (i) providing recovery education and training for their staff and (ii) co‐designing resources with consumers to promote active consumer engagement and participation. The purpose of this study was to evaluate the impact of these initiatives on staff knowledge and provision of recovery‐oriented care in acute care. Two groups of study participants were recruited: the first group completed the staff training programme introducing the concept of recovery‐oriented practice, and the second group was a convenience sample of nurses recruited 12 months later working on the acute inpatient wards at the study site. Nurses completed Recovery Knowledge Inventory (RKI) and Recovery Self‐Assessment (RSA‐Provider) surveys and participated in a focus group discussion. The three major themes identified from the focus group discussion were as follows: (i) nurses' understanding of personal recovery‐orientated practice, (ii) how to embed personal recovery‐oriented care into practice, and (iii) barriers to consumer participation in recovery‐oriented activities in acute care. There were significant differences between the two groups on the RKI subscale scores of 'Expectations regarding recovery' and the 'Roles of self‐definition and peers in recovery' and 'Life goals' and 'Choice' factors on the RSA subscale scores. There were some gaps in the nurses' knowledge and implementation of personal recovery‐oriented concepts, highlighting the need for further training and cultural change. [ABSTRACT FROM AUTHOR]

The study aimed to explore mental health professionals' perceptions of patient safety issues across community and inpatient mental health services. Fourteen mental health professionals across community and inpatient settings participated in qualitative interviews. Framework analysis, guided by the Yorkshire Contributory Factors Framework – Mental Health, was used to analyse the data. Safety issues identified by mental health professionals mapped on to 19 of the 21 factors in the Yorkshire Contributory Factors Framework – Mental Health. The factors most frequently mentioned by participants were 'safety culture' which focused on raising concerns, learning from incidents and the influence of targets; 'communication systems' to support effective communication between staff; 'service user factors' including a perceived increase in illness acuity; 'service process' including how patients access and interact with services; and 'staff workload' perceived being as unmanageable. Mental health professionals consider there to be a broad range of safety issues associated with mental health services. Future research should aim to develop interventions to improve safety focused across the factors raised by professionals. [ABSTRACT FROM AUTHOR]

Nurse–patient therapeutic engagement on acute mental health wards is beneficial to service users' outcomes and nurses' job satisfaction. However, engagement is not always fulfilled in practice and interventions to improve engagement are sparse and ineffective. We explored the experiences of service users, carers, and clinicians drawing from 80 hours of non‐participant observations in an acute mental health ward and semi‐structured interviews with 14 service users, two carers, and 12 clinicians. Analysis of these data resulted in 28 touchpoints (emotionally significant moments) and eight overarching themes. Service users, carers, and clinicians identified a lack of high‐quality, person‐centred, collaborative engagement and recognized and supported efforts to improve engagement in practice. Potential solutions to inform future intervention development were identified. Our findings align with previous research highlighting negative experiences and support the need to develop multicomponent interventions through participatory methods. [ABSTRACT FROM AUTHOR]

Despite health policy and research increasingly advocating for recovery‐enabling principles to be better integrated into mental health services, finding solutions to enhance the translation of recovery policy into practice remains a challenge. This study sought to understand whether a co‐facilitated group education intervention for service users and family members reached beyond the intervention and impacted the everyday recovery promoting beliefs and practices of the practitioners involved and the wider organization. The study employed a qualitative design involving semi‐structured interviews with a purposively selected sample of 28 participants (mental health nurses and other members of the multidisciplinary team) who were involved in delivering the intervention. Data were analysed using thematic analysis, with the assistance of NVivo. Participants reported that not only did involvement with the programmes help them reconnect with the contextual realities of service user and family members lived experience, but it enabled them to move beyond traditional power relationships and pathologizing discourses. Having engaged with and experienced the feasibility and positive impact of the co‐facilitation process practitioners' self‐efficacy around partnership working and co‐production was enhanced. In addition, those involved demonstrated a willingness to challenge paternalistic practices and advocate for the perspectives of service users and families to be further embedded within the organizational infrastructure and operational spaces. Providing mental health practitioners with real‐life examples of partnership working and peer support in action within a co‐facilitated psychoeducation context has potential to be a forum for promoting second‐order change around recovery‐oriented practice within mental health services. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate a mentoring programme embedded in a work‐based personal resilience enhancement intervention for forensic nurses. This qualitative study formed part of a wider mixed‐methods study that aimed to implement and evaluate the intervention. Twenty‐four semistructured interviews were carried out with forensic nurse mentees and senior nurse mentors; these explored their experiences of the mentoring programme and any benefits and challenges involved in constructing and maintaining a mentor–mentee relationship. Qualitative data were analysed thematically using the Framework Method. Four key themes relating to the initiation and maintenance of mentor–mentee relationships were identified: finding time and space to arrange mentoring sessions; building rapport and developing the relationship; setting expectations of the mentoring relationship and the commitment required; and the impact of the mentoring relationship for both mentees and mentors. Study findings highlight the benefits of senior nurses mentoring junior staff and provide evidence to support the integration of mentoring programmes within wider work‐based resilience enhancement interventions. Effective mentoring can lead to the expansion of professional networks, career development opportunities, increased confidence and competence at problem‐solving, and higher levels of resilience, well‐being, and self‐confidence. [ABSTRACT FROM AUTHOR]

Seclusion and restraint are regularly used to manage patient aggression events in psychiatric inpatient care, despite occupational safety concerns. There is currently a lack of information on how nurses perceive the use of patient seclusion and restraint as a risk for occupational safety. The aim of this study is to describe the risks for occupational hazards in patient seclusion and mechanical restraint practices as well as ideas for improvement identified by nurses. A qualitative descriptive design was adopted, using focus groups comprising nurses (N = 32) working in psychiatric inpatient care. The data were analysed using inductive content analysis, and the results were reported using the consolidated criteria for reporting qualitative studies (COREQ). Four themes of risk for occupational hazards were identified: patient‐induced, staff‐induced, organization‐induced, and environment‐induced risks. One significant finding was that nurses described that their actions can strongly contribute to occupational hazards during seclusion and mechanical restraint practices. The nurses gave various ideas for how occupational safety could be improved during seclusion and mechanical restraint events, ideas involving staff, the organization, and environmental enhancements. [ABSTRACT FROM AUTHOR]

This study aimed to implement and evaluate a work‐based personal resilience enhancement intervention for forensic nurses. A mixed methods design consisting of surveys, interviews, and a case study approach, whereby the experiences of a group of nurses were studied in relation to their experiences of an intervention programme to enhance personal resilience, was utilized. Nurses working on forensic inpatient wards were invited to participate. Senior nurses were recruited as mentors. Data were collected via pre‐ and post‐programme surveys to evaluate nurses' levels of resilience. Post‐programme interviews were undertaken with nurses and mentors to explore their experiences of the programme. Descriptive statistics of survey data examined changes in nurses' resilience levels pre‐ and post‐intervention. Free‐text survey data and interview data were analysed thematically. The SQUIRE 2.0 checklist was adhered to. Twenty‐nine nurses participated. Levels of personal resilience (M = 4.12, SD = 0.60) were significantly higher post‐programme than pre‐programme (M = 3.42, SD = 0.70), (t49 = 3.80, P = 0.000, 95% CI = 0.32, 1.07). Nurses felt the programme had a marked impact on their personal resilience, self‐awareness, confidence, and professional relationships. The benefits of the programme demonstrate the advantages of providing a nurturing environment for nurses to consolidate their resilience levels. Findings demonstrated that resilience enhancement programmes can increase nurses' levels of resilience and confidence and improve inter‐professional relationships. Our findings are important for clinicians, nurse managers, and policymakers considering strategies for improving the workplace environment for nurses. The long‐term impact of resilience programmes may improve nurse retention and recruitment. [ABSTRACT FROM AUTHOR]

People with severe mental illness have significantly reduced life expectancy and higher risk of cardiovascular diseases than the general population. There is a critical need for quality physical health care to improve consumers' health outcomes. There is minimal knowledge, however, on the impact of mental health nurse practitioner candidate (NPC) practices on consumers' health outcomes. The aim of this proof‐of‐concept study was to describe the impacts of NPC practices on the quality of physical healthcare provision and physical health outcomes (cardiovascular and cardiometabolic) of consumers in community mental health service settings. Using a mixed methods design, quantitative data were collected for 12 months prior to (Period 1), and 12 months during (Period 2), the candidacy period. Qualitative interviews were conducted with a purposive sample of n = 10 consumers to explore their perspectives on physical healthcare provision by the NPCs. During the 12‐month candidacy period, the number of metabolic monitoring assessments rose from n = 55 in Period 1 to n = 146 in Period 2 (P < 0.01, χ2 = 41.20). Advanced practices provided by NPCs included taking an extensive holistic history and clinical examination, ordering diagnostic pathology, and clinical simulation of physical health medication prescription (under medical supervision). Analysis of consumer interviews resulted in two themes: (i) positive and helpful NPC health care and (ii) improvements in physical and mental health. The findings add new knowledge on specialist mental health nurse practitioner candidate roles and demonstrate the benefits these roles can have in reducing the significant morbidity and mortality of mental health consumers. [ABSTRACT FROM AUTHOR]

Mental health nurses have traditionally lagged in terms of physical healthcare skills and have been found to have poorer cultural safety‐related attitudes relative to other nurses. Organizational culture, including safety‐related culture, is associated with important aspects of care quality. The aim of the current study was to examine the relationships between safety‐related attitudes, physical healthcare‐related knowledge and organizational culture among mental health nurses. By doing so, the intention was to inform decisions about interventions to improve attitudes and care related to severe physiological deterioration among mental health nurses. The study design was cross‐sectional and correlational. The safety‐related attitudes of N = 133 nurses from the inpatient mental health services of one Local Health District in New South Wales, Australia, were examined in terms of a range of potential predictor variables of safety attitudes (Safety Attitudes Questionnaire) including individual organizational‐perceiver type (Organisational Climate Assessment Inventory), knowledge of emergency medical healthcare (Lambeth In situ Training Questionnaire), use and perception of medical emergency teams (purpose‐designed questionnaire) and a range of demographic variables. Regression analyses revealed that those who perceived the organization to have a primarily market‐oriented culture had poorer safety‐related attitudes than those who perceived a more clan‐type culture. Number of years qualified was negatively associated with safety attitudes. To our knowledge, this is the first study in mental health which demonstrates a link between organizational culture‐perception and safety attitudes related to physical healthcare. Results suggest that, among nurses, individuals have quite different perceptions of the organizational culture. In turn, this suggests that the 'one‐size fits all' approach to changing organizational culture may be inappropriate. [ABSTRACT FROM AUTHOR]

Suicide prevention is an important imperative in psychiatric hospitals, where nurses have a crucial role in and make essential contributions to suicide prevention and promoting the recovery of patients experiencing suicidal ideation. The present qualitative grounded theory study aimed to uncover and understand the actions and aims of nurses in psychiatric hospitals during their interactions with patients experiencing suicidal ideation. Interviews were conducted with 26 nurses employed on 12 wards in four psychiatric hospitals. The data analysis was inspired by the Qualitative Analysis Guide of Leuven. The findings show that nurses' actions and aims in their interactions with patients experiencing suicidal ideation are captured in the core element 'promoting and preserving safety and a life‐oriented perspective'. This core element represents the three interconnected elements 'managing the risk of suicide', 'guiding patients away from suicidal ideation', and 'searching for balance in the minefield'. The enhanced understanding of nurses' actions and aims can inform concrete strategies for nursing practice and education. These strategies should aim to challenge overly controlling and directing nursing approaches and support nurses' capacity and ability to connect and collaborate with patients experiencing suicidal ideation. [ABSTRACT FROM AUTHOR]

This study explores the patterns and features of methamphetamine‐related presentations to emergency departments (EDs) in Queensland. Despite an overall decrease in the use of methamphetamine in Australian, an increase in the use of the crystalized form of methamphetamine has been noted over recent years. A descriptive observational study was utilized to analyse emergency department (ED) injury surveillance data sourced from Queensland Injury Surveillance Unit (QISU) from 2005 to 2017. Data were analysed for presentations related to stimulants (n = 564) with methamphetamine (n = 250) included as a subcategory. Descriptive statistics were used to identify patterns and features of presentations related to methamphetamines. The relationship between demographic variables, service type variables, and drug type was assessed using chi‐square and z‐tests. Results included the following: 84.4% of methamphetamine‐related presentations were allocated a triage score of 1, 2, or 3; 14.8% of all methamphetamine‐related presentations required police involvement; 18% were brought in by ambulance; and 15.6% exhibited behaviour that was either, agitated, aggressive, or violent in nature. Methamphetamine‐related presentations more frequently required police or ambulance services and more often included aggression or agitation. Methamphetamine‐related presentations to ED have a high acuity and often require other emergency resources (police and ambulance). There is a need to develop policy for managing aggressive and agitated people presenting to EDs as a result of methamphetamine use and to further explore the experience of personnel (police and ambulance) managing persons under the influence of methamphetamine. [ABSTRACT FROM AUTHOR]

Better assessment of consumer behaviour and intentions prior to the granting of approved leave may reduce failure to return from such episodes of leave. The aims of this study were (i) to gain consensus on the factors associated with failure to return, and (ii) use these factors to construct a checklist to aid in assessment of consumers prior to being granted leave. Following a review of the literature a pool of 36 factors was identified. These were then assessed for relevance to absconding from approved leave using a modified Delphi approach. After two Delphi rounds, 10 factors were retained and these were collapsed under 6 domains; history of absconding, current substance use, behaviour cues, verbal cues, lack of engagement, and changes in mental state. While staff reactions to the checklist were positive, further testing of its effectiveness in the clinical setting is required. [ABSTRACT FROM AUTHOR]

This qualitative study aimed to illuminate patients' experiences of taking part in the nursing intervention Time Together. The data were drawn from 11 individual semi‐structured interviews with patients and analysed with qualitative content analysis using an inductive approach. The results show that patients taking part in Time Together felt confirmed and participated on equal terms; thus, they experienced being seen as humans among other humans. Time Together offered patients a break, and they felt strengthened, which contributed to their hopes for recovery. Furthermore, when Time Together was absent patients felt disconfirmed, which fostered feelings of distance from staff. The results support the effectiveness of the intervention, indicating that Time Together may be a tool to facilitate patients' personal recovery. However, the success of the intervention depends on staff compliance with the predetermined structure of the intervention in combination with engagement. [ABSTRACT FROM AUTHOR]

The prevalence of depressive symptoms among older residents in long-term care facilities (LTCFs) is high. Nurses are the main healthcare providers in LTCFs and also the persons responsible for detecting changes in residents' mental function and providing subsequent care. Therefore, it is necessary to understand nurses' knowledge, attitudes, and confidence regarding care for older residents with depressive symptoms or depression. This study aimed to understand nurses' level of knowledge of late-life depression, attitudes towards depression, and confidence levels in caring for older adults with depressive symptoms or depression in LTCFs. A cross-sectional descriptive and correlational research design was used. A nationwide self-report survey was conducted in 2016. Ultimately, 556 valid questionnaires were returned. The study found that LTCF nurses' knowledge about late-life depression was poor, and they also lacked confidence in managing and caring for older persons with depressive symptoms or depression, but nurses' attitudes towards depression were neutral or slightly positive. Moreover, nurses who had greater confidence in providing care for older persons with depression were those with more positive attitudes towards depression, a greater interest level in taking care of older adults with depression, less late-life depression knowledge, longer nursing experience in LTCFs, and a greater interest level in late-life depression issues, and who had read late-life depression pamphlets or taken courses or classes in late-life depression. The findings suggest an urgent need to develop strategies to improve nurses' late-life depression knowledge and increase their confidence in providing care to older residents with depressive symptoms or depression. [ABSTRACT FROM AUTHOR]

Abstract: Coproduction of research between consumers of mental health services and nonconsumer mental health researchers is increasing. There is some research available describing consumer perspectives of this experience. However, there is a notable lack of research on other (nonconsumer) researcher experiences of and views about consumer involvement in coproduced research. A qualitative exploratory study was undertaken to examine perspectives of mental health researchers about consumer involvement in research. In‐depth individual interviews were undertaken with 11 nonconsumer mental health researchers in Australia and New Zealand. Interview transcripts were analysed to identify major themes. There were three interacting themes: the salience of experiential difference, expanded learning, and enhanced research. The dynamic between different perspectives and learning had the effect of enhancing research across the spectrum of study phases and in ensuring research was of value to different groups. The findings emphasize the important contribution consumer researchers can make to mental health research by bringing their unique perspective and enhancing an environment of mutual learning. Findings also point to the need for foregrounding the numerous benefits of joint research between consumer and other researchers to enhance and improve clinical practice and the development of policy. [ABSTRACT FROM AUTHOR]

Abstract: Stigma of mental illness and substance misuse can deter help seeking, especially in immigrants who are often reluctant to seek help early for these issues. The aim of the present study was to explore the stigma experience surrounding mental illness and substance misuse, and its implications for improving help seeking, for youths and parents from sub‐Saharan African immigrant communities. A qualitative, descriptive design was used. Individual interviews were undertaken with 28 youths, and focus group discussions were held with 41 parents and community leaders in Melbourne, Australia. The findings indicated that public stigma and self‐stigma were common and deterred participants’ help seeking within sub‐Saharan African communities. There was concern about the consequences of disclosure. Personal shame, fear of community rejection, and being labelled a ‘lunatic’ deterred help seeking. Programmes are needed to address stigma, promote help seeking, and increase mental health knowledge. Mental health nurses and other clinicians in the mental health and alcohol and other drug fields can make an important contribution. Steps are needed to employ more sub‐Saharan African immigrant clinicians to help increase help seeking from their communities. [ABSTRACT FROM AUTHOR]

Abstract: During protected engagement time (PET), ward routines are adjusted so that staff can spend time together with patients without interruption. The aim of PET is to increase staff and patient interaction on wards, and ultimately patient well‐being. Although PET has been implemented on inpatient wards within the UK, including older adult wards, there is no systematic evidence as to how PET is carried out or how it is experienced by staff, patients, and families. Semistructured interviews were conducted with 28 participants (8 patients, 10 family members, and 10 ward staff) from three different wards with PET, and transcriptions were analysed using thematic analysis. Three themes were identified: (i) the patient is at the heart of care; (ii) PET depends on staff; and (iii) tensions in how PET operates. There was support in our sample for the principles of PET and its potential for a positive impact on patient well‐being. However, the implementation of PET was identified as challenging, highlighting an existing tension between an individual's needs and the wider needs of patients on the ward as a whole. The impact of PET was generally described as being dependent on how PET was organized and the level of staff commitment to PET. Participants emphasized that if PET is to be successful, then it should be a fluid process that fits in with the local context. [ABSTRACT FROM AUTHOR]

Abstract: In response to pressures on mental health inpatient beds and a perceived ‘crisis in acute care’, Crisis Resolution Teams (CRTs), acute home treatment services, were implemented nationally in England following the NHS Plan in the year 2000: an unprecedentedly prescriptive policy mandate for three new types of functional community mental health team. We examined the effects of this mandate on implementation of the CRT service model. Two hundred and eighteen CRTs were mapped in England, including services in all 65 mental health administrative regions. Eighty‐eight percent (n = 192) of CRT managers in England participated in an online survey. CRT service organization and delivery was highly variable. Nurses were the only professional group employed in all CRT staff teams. Almost no teams adhered fully to government implementation guidance. CRT managers identified several aspects of CRT service delivery as desirable but not routinely provided. A national policy mandate and government guidance and standards have proved insufficient to ensure CRT implementation as planned. Development and testing of resources to support implementation and monitoring of a complex mental health intervention is required. [ABSTRACT FROM AUTHOR]

Medical comorbidity in people with long-term mental illness is common and often undetected; however, these consumers frequently experience problems accessing and receiving appropriate treatment in public health-care services. The aim of the present study was to understand the lived experience of mental health consumers with medical comorbidity and their carers transitioning through tertiary medical to primary care services. An interpretative, phenomenological analysis approach was used, and semistructured, video-recorded, qualitative interviews were used with 12 consumers and four primary caregivers. Four main themes and related subthemes were abstracted from the data, highlighting consumer's and carers' experience of transition through tertiary medical to primary care services: (i) accessing tertiary services is difficult and time consuming; (ii) contrasting experiences of clinician engagement and support; (iii) lack of continuity between tertiary medical and primary care services; and (iv) Mental Health Hospital Admission Reduction Programme (MH HARP) clinicians facilitating transition. Our findings have implications for organisational change, expanding the role of MH HARP clinicians (whose primary role is to provide consumers with intensive support and care coordination to prevent avoidable tertiary medical hospital use), and the employment of consumer and carer consultants in tertiary medical settings, especially emergency departments. [ABSTRACT FROM AUTHOR]

Mental illnesses constitute a major burden of disease in Aboriginal Australians and Torres Strait Islanders (hereafter Aboriginal Australians), who are also overrepresented in the prison system. A legacy of colonization compounds such prevalence, and is further exacerbated by the persistence of racial discrimination and insensitivity across many sectors, including health. This research completed in a Western Australian forensic mental health setting identifies non- Aboriginal health professionals' support needs to deliver high-quality, culturally-safe care to Aboriginal patients. Data were collected from health professionals using an online survey and 10 semistructured interviews. Survey and interview results found that ongoing education was needed for staff to provide culturally-safe care, where Aboriginal knowledge, beliefs, and values were respected. The findings also support previous research linking Aboriginal health providers to improved health outcomes for Aboriginal patients. In a colonized country, such as Australia, education programmes that critically reflect on power relations privileging white Anglo- Australian cultural dominance and subjugating Aboriginal knowledge, beliefs, and values are important to identify factors promoting or compromising the care of Aboriginal patients and developing a deeper understanding of 'cultural safety' and its clinical application. Organizational commitment is needed to translate the findings to support non- Aboriginal health professionals deliver high-quality care to Aboriginal patients that is respectful of cultural differences. [ABSTRACT FROM AUTHOR]

Very little is known about the experiences of lesbian, gay, bisexual, and transgender ( LGBT) people in relation to mental health services. Therefore, the overall aim of the current research was to explore LGBT people's experiences of mental health service provision in Ireland. The objectives were to identify barriers and opportunities, to highlight service gaps, and to identify good practice in addressing the mental health and well-being of LGBT people. A mixed methods research design using quantitative and qualitative approaches was deployed. A multipronged sampling strategy was used and 125 respondents responded to the questionnaire. A subset of phase 1 ( n = 20) were interviewed in the qualitative phase. Quantitative data was analyzed using descriptive statistics. Qualitative data were analyzed thematically. The sample consisted of LGBT people ( n = 125) over 18 years of age living in Ireland. Over three-quarters (77%) had received a psychiatric diagnosis. Findings include that whilst 63% of respondents were able to be 'out' to practitioners, 64% felt that mental health professionals lacked knowledge about LGBT issues and 43% felt practitioners were unresponsive to their needs. Finally, respondent recommendations about how mental health services may be more responsive to LGBT people's needs are presented. [ABSTRACT FROM AUTHOR]