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Risk management which assesses and mitigates risks such as suicide and violence is under scrutiny, particularly within psychiatric inpatient settings. Restrictive practices, which result from risk assessment, such as observations, physical restraint and ward seclusion can impact negatively on patient recovery, hindering abilities to develop a meaningful life that emphasizes purpose, hope and autonomy, despite experiencing mental distress. Yet, less is known about the impact from the patient's perspective when first admitted to hospital, a period which among other reasons may come with increasing risk management practices owing to the clinical uncertainties about patient risks. In this grounded theory study, we explore the impact on recovery, interviewing 15 adult participants with patient experiences of being in an acute hospital. The main theme of the study, termed a core category with a grounded theory, was identified as "ontological insecurity of inattentiveness". This highlighted a staff inattentiveness with involving patients with risk management and explaining the purposes of the practice, which raised insecurities about what was happening to the patients when admitted to hospital. Four subcategories support the core category; discounting the patients' experiences to gain a meaningful grasp of risk management, ambiguity about risk management rules, particularly the reasons around their use, forebodingness to the hospital environment and, management from afar, with patients feeling scrutinized from observations without a voice to offer different views. It is hoped these findings will add to the field of patient involvement in psychiatric inpatient settings, proposing attempts to raise understanding and inclusivity of risk management, starting when first admitted to hospital. [ABSTRACT FROM AUTHOR]

The strengths of model of case management is a recovery‐oriented model of community mental health care that has been linked to positive consumer outcomes. The aim of this qualitative study was to explore the consumer perspective of the strengths model of case management using a descriptive phenomenological approach. Data were collected through in‐depth, semi‐structured interviews. In total, six consumers from a metropolitan community mental health service were interviewed. Interview transcripts were analysed using Colaizzi's phenomenological method. Three major themes were identified: the relationship between the consumer and the case manager is valuable, the strengths assessment supports identifying strengths and areas for action and the strengths model of case management promotes recovery and goal achievement. Implications for practice include an increased understanding of consumer preferences and promoting the consumer voice, thereby supporting the provision of higher quality evidence‐based practice. [ABSTRACT FROM AUTHOR]

Goal‐setting is a tool that empowers consumer recovery. Though the pandemic has affected consumer goal‐setting, the nature and extent of this impact have not been examined in a recovery setting. The aim of this study is to assess whether the recovery goals of individuals with serious mental illness changed in association with the COVID‐19 pandemic. In this mixed‐methods design, data were collected from a purposeful sample of consumers (nTOTAL = 355) aged 19–67 years (MAGE = 44.56, SD = 13.05) attending Recovery Camp, a 5‐day therapeutic‐recreation programme for individuals living with severe mental illness (e.g., PTSD, schizophrenia). Consumer‐set goals were examined across 5 programmes prior to March 2020 (nPRE = 126) and 11 following (nPOST = 229). Goals were set on day one, with attainment self‐scored on day five. Chi‐squared goodness‐of‐fit tests compared goal proportions per domain; tests of independence assessed changes in goals pre‐ and post‐pandemic. Six goal domains were identified: Approach‐Based Recovery, Avoidance‐based Recovery, Novel Physical Activities, Relationships, Health, and Recreation/Relaxation. Irrespective of the pandemic, goal attainment was consistently high across all programmes (86.56%). Approach‐based Recovery goals were predominant pre‐pandemic, but were significantly reduced post‐pandemic (p = 0.040). Goals related to Relationships and Novel Physical Activities took precedence throughout the pandemic. Post‐COVID‐19, consumer recovery goals reveal increased desire for connection, novelty‐seeking, and positive behavioural change. [ABSTRACT FROM AUTHOR]

The principles of least restrictive care and recovery‐focused practice are promoted as contemporary practice in the care of individuals with mental ill health, underpinning legislation concerning mental health and illness in many jurisdictions worldwide. Inpatient mental health units with locked doors are incompatible with this style of care and throwback to a time where care for mental illness was primarily custodial. The aim of this scoping review is to determine whether evidence exists for locking mental health unit doors, whether this practice is compatible with recovery‐focused care and to determine whether door locking has changed since a review conducted by Van Der Merwe et al. (Journal of Psychiatric and Mental Health Nursing, 16, 2009, 293) found that door locking was not the preferred practice in the management of acute mental health units. We used Arksey and O'Malley's (International Journal of Social Research Methodology: Theory and Practice, 8, 2005, 19) framework for scoping reviews, with our initial search locating 1377 studies, with screening narrowing final papers for inclusion to 20. Methodologies for papers included 12 using quantitative methodology, 5 qualitative and 3 that used mixed methods designs. Poor evidence was found for door locking to mitigate risks such as absconding, aggression or illicit substance importation. Furthermore, locked doors had a detrimental impact on the therapeutic relationship, nurse job satisfaction and intention to leave the profession. This scoping review indicates that research is urgently needed to address a mental healthcare culture where door locking is an entrenched practice. Studies of alternative approaches to risk management are required to ensure inpatient mental health units are truly least‐restrictive, therapeutic environments. [ABSTRACT FROM AUTHOR]

This paper emerged from discussions between the authors about our shared and different perspectives of climate change and its impact on the social, emotional, physical, spiritual and cultural wellbeing of Aboriginal Peoples and mental health services in a rural region, heavily impacted in recent years by bushfires and floods. Here we discuss, from the lead authors personal perspective as a Gamilaraay Woman, the experience of Solastalgia as a critical impact of climate change on wellbeing. Specifically, we discuss the relationship of a connection to country from a Gamilaraay, first person perspective through a series of diary entries from the lead author. Authors are researchers from different cultural backgrounds, connected through a medical research futures fund research project, to promote resilience within Aboriginal communities and the health services sector in the New England, North West region. The lead author has cultural connections to some of the communities we work with and our work is informed by these connections. While this paper was written to express an Aboriginal perspective on climate change and wellbeing, it reflects our shared perspectives of how disasters such as bushfires impact the wellbeing of Aboriginal peoples. We also explore the connection between the impact of localised, recurring natural disasters and the increasing demands on mental health services in regional and rural areas and discuss what this means with Aboriginal and non‐Indigenous mental health nurses and researchers working in regional and rural areas where access to mental health services often poses considerable challenges. From our perspective, mental health research and nursing play an important role in walking alongside Aboriginal Peoples as we explore, respond and create resilience to the ever‐present influence that climate change is having on our lives, communities, country and workplaces. [ABSTRACT FROM AUTHOR]

The World Health Organization encourages mental health services to adopt a strategic intersectoral approach by acknowledging the potential of the arts and the value of culture on the process of mental health recovery. The aim of this study was to evaluate the impact of participatory arts in museums on mental health recovery. A quasi‐experimental, pre‐post and multicentre study was carried out. By using a mixed methods evaluation at baseline and at 3 months, quantitative outcome measures were used to assess the changes in recovery and social support and qualitative interviews to explore the self‐perceived impact on five processes of recovery. One hundred mental health service users participated for 3 years in the face‐to‐face programme RecuperArte, of which the data of 54 were analysed. The results indicate a significant increase in recovery measured with the QPR‐15‐SP (42 vs. 44; p = 0.034) and almost significant in functional social support measured with the DUKE‐UNC (41.50 vs. 43.50; p = 0.052), with almost large (r = 0.29) and medium (r = 0.26) effect sizes, respectively. Participants perceived mostly an impact on the recovery process of Meaning in life 30/54 (55.56%), Hope and optimism about the future 29/54 (53.7%) and Connectedness 21/54 (38.89%), followed by Identity 6/54 (11.11%) and Empowerment 5/54 (9.26%). The findings contribute to the growing evidence of the potential of the arts as a therapeutic tool, the value of museums as therapeutic spaces and the role of nurses in intersectoral coordination, between the mental health and cultural sectors, as facilitators and researchers of these evidence‐based practices. [ABSTRACT FROM AUTHOR]

Current research views hope as a process that plays a positive role in the recovery of individuals with mental health problems. However, little attention has been given to the role of hope in the lives of their families. We aimed to address that gap. We deployed a qualitative descriptive design and carried out individual interviews with nine family members who supported a relative with mental health problems. A cross‐comparison of the data generated three major themes: understandings of hope; factors that diminish hope and factors that nurture hope. The participants viewed hope as a positive and productive feeling or attitude that was life‐affirming, and empowering. They also associated it with behaviours and dispositions such as attentiveness and empathy and the possibility of a return to a more stable and 'normal' life. The participants experienced hope as initially eroded when their relative was first diagnosed and institutionalized. Hope was further diminished due to the poor communication practices of some mental health professionals and the stress of the caring role itself. On the other hand, hope was nurtured through the support of other family members, friends, neighbours and peers. Acquiring knowledge and understanding about the relative's state of mental health nurtured hope and enabled the participants to have a more meaningful role in their recovery process. Practices of self‐care such as independent activities and counselling also strengthened hope and some mental health professionals played a positive role in supporting these. Most striking about the reports of many of the participants was their assertion of their abiding love for their relative. Their account of their ability to see beyond the illness of their relative was an insight that we did not find in other accounts of the experiences of family members. We highlight the need for family members to have timely access to relevant information about their relatives' illness. We conclude that hope is relational at its core because of the interplay of intrapersonal, interpersonal and social factors that diminish or nurture it over time. Specifically, we propose that friends, neighbours and peer support groups as key actors in nurturing the hope of both family members and their relatives. [ABSTRACT FROM AUTHOR]

A growing body of evidence highlights that individuals' understanding of mental illness and recovery influences their mental health care preferences. Journeys to psychiatric care settings vary across regions with different socio‐economic and developmental characteristics. However, these journeys in low‐income African countries have not been well explored. This descriptive qualitative study aimed to describe service users' journeys to and through psychiatric treatment and explore their conceptualizations of recovery from recent‐onset psychosis. Nineteen adults with recent‐onset psychosis were recruited from three hospitals in Ethiopia for an individual semi‐structured interview. Data from in‐depth face‐to‐face interviews were transcribed and thematically analysed. Participants' conceptualizations of recovery are summarized into four themes; "domination over the disturbance of psychosis", "complete medical treatment course and stay normal", "stay active in life with optimal functioning", and "reconcile with the new reality and rebuild hope and life". These perceptions of recovery were reflected in their accounts of the long and hurdled journey to and through conventional psychiatric care settings. Participants' perceptions of psychotic illness, treatment, and recovery seemed to result in delayed or limited care in conventional treatment settings. Misunderstandings about only requiring a limited period/course of treatment for a full and permanent recovery should be addressed. Clinicians should work alongside traditional beliefs about psychosis to maximize engagement and promote recovery. Integrating conventional psychiatric treatment with spiritual/traditional healing services may make an important contribution to early treatment initiation and improving engagement. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This organizational case study addresses the research question: What are the experiences of staff who work in a novel in‐reach rehabilitation and recovery service for people with profound and enduring mental health needs? Fifteen purposefully sampled staff were recruited from across a novel mental health service that embeds the community sector within inpatient provision. The sample comprises twelve National Health Service and three community voluntary organization staff (four men and eleven women). Data were generated via photo‐elicitation in which interviews focused on the photographs participants brought to help convey their experiences of the Service. Interpretative phenomenological analysis was used to analyse the transcripts. The analysis demonstrates that participants are oriented towards five 'meta‐questions': What is recovery? Who is valued and how is it demonstrated? Why are you frustrated in doing the best job you can and what support do you need? How can change occur in staff practices and approaches in an environment embedded in history? and How do we make the Service work in the context of constraints? Eight paired themes were also identified regarding staff experience of the Service: hope and individuality; culture and power; communication and confidence; accountability and limitations. The conclusions of this organizational case study have wide relevance to clinical practice: staff (i) place importance on promoting and developing greater awareness of different approaches to care; (ii) aspire to develop better communication across multidisciplinary teams and (iii) desire greater awareness of the complexities of risk to improve staff confidence. [ABSTRACT FROM AUTHOR]

The article focuses on the relevance and timeliness of a study exploring mental health nurses' attitudes and practices related to recovery-focused care in acute inpatient units. It appreciates the novel use of non-participation observation methods to capture micro-affirmations in nurse-consumer interactions, emphasizing the importance of these moments in fostering meaningful conversations and supporting consumers' self-determination and empowerment.

The article focuses on three topics. Firstly, it introduces the Wellness Recovery Action Plan as a self-management system for individuals coping with trauma and life challenges. Secondly, it discusses the prevalence of generalized anxiety disorder in people of African descent living in Australia during the COVID-19 pandemic and it explores nurses' motivations for entering mental health nursing, revealing personal and practice-related factors influencing their career choices.

National mental health policies accentuate the importance of having positive attitudes, skills, and knowledge among mental health professionals to facilitate recovery‐oriented practices in all areas of mental health care. However, evidence suggests that mental health professionals' negative attitudes towards mental illness are still evident and that recovery‐oriented practice in acute inpatient units may be poorly implemented. At the same time, there is also a paucity of research to understand Mental Health Nurses' attitudes towards mental illness and recovery‐oriented practice specifically. Therefore, this non‐participant observation study aimed to explore Mental Health Nurses' attitudes towards mental illness and recovery‐oriented practice in acute inpatient units by observing the interactions between the consumers and nurses. The Mental Illness Clinicians Attitudes Scale‐v4 and The Recovery Attitudes Questionnaire inspired the development of a non‐participant observation chart for this study and the observations were recorded on the chart. Six observations were conducted in three acute inpatient units. Observations focused on Mental Health Nurses' knowledge about mental illness, communication, dignity, respect, anxiety, fear, punishment, facilitation of real choices for consumers, physical care, cooperation with consumers' families and others and recovery orientation. Interpretive descriptive analysis was used to analyse the data. The results show that Mental Health Nurses generally have positive attitudes towards mental illness and recovery‐oriented practice. Some deficits in the physical care of people with mental illness in the acute inpatient units were observed. Therefore, future research could address the adequate preparation of Mental Health Nurses to provide physical care to people with mental illnesses. [ABSTRACT FROM AUTHOR]

Medication adherence and recovery rates are <50% among persons with schizophrenia; therefore, this health concern needs attention. Empowerment is a vital element for behavioural change, but previous studies have presented different results and lack specific connotations about empowerment. Therefore, this study systematically reviewed and meta‐analysed the effects of empowerment‐based illness management on the medication adherence and recovery of persons with schizophrenia. The databases searched included the PROSPERO registration network, Cochrane Library, PubMed, Embase, CINAHL, PsycAricle, and Airiti Library. The research steps were based on PRISMA. RoB 2.0 was used for article quality evaluation, the effect size was calculated using RevMan software, and the random‐effect model and standardized mean differences (SMD) were established. Eight randomized controlled trials (RCTs) involving 859 participants were used to investigate the effect of empowerment on medication adherence. The trials involved the use of effective strategies as inducing medication motivation, promoting self‐medication management, and providing support resources. A moderate effect was observed (SMD = 0.58, 95% CI 0.18–0.99). Ten RCTs involving 1473 participants were used to investigate the effect of empowerment on recovery. These trials involved the use of such effective strategies as using self‐strength, connecting external forces, understanding personal needs, and overcoming self‐stigma. A moderate effect was observed (SMD = 0.55, 95% CI 0.10–0.99). Empowerment in illness management can effectively promote the medication adherence and recovery of persons with schizophrenia. In the future, nurses can use self‐strength care to promote medication motivation and connect internal and external forces to assist a person's medication adherence and recovery. [ABSTRACT FROM AUTHOR]

Recovery, which is a non‐linear, unique process allowing mental health service consumers to live autonomously, has become a prominent concept. However, adapting recovery‐oriented practice to daily care is challenging. We explored recovery‐oriented practice among mental health professionals in Japan via semi‐structured interviews including nurses, occupational therapists, and psychiatric social workers (17 professionals in total). Data were analysed using grounded theory. Six categories emerged. The core category was 'Continuing to adjust care to meet consumers' needs for their unique lives'. The professionals stated that they practised in accordance with the service consumers' sincere hopes based on an equitable relationship because they believed that this approach would enhance consumers' personal agency, proactive behaviour, and self‐choice. Despite negative consequences, the professionals did not view the consumers' choices as 'failures' and instead helped them to find meaning in their experiences. Although the therapeutic relationship tended to be paternalistic, participants described how concrete practices helped build an equitable relationship. In recovery‐oriented practice, the provision of support centred on consumer values is important, without imposing own's own values. Care practices should also be aligned with consumers' hopes, needs and goals. [ABSTRACT FROM AUTHOR]

Although mental health nurses continuously strive for patients' well‐being, patients still experience inpatient care negatively. To identify an individual's actual, mental health nursing care needs and offers them optimal benefits during their hospital stay, determining what patients perceive as good nursing should be prioritized. This qualitative descriptive study aimed to understand good mental health nursing from the inpatients' perspective. The data were collected through semi‐structured interviews with 13 patients admitted to a psychiatric ward in South Korea, and analysed using thematic analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were used to ensure transparency and rigour. The results revealed that patients experienced good mental health nursing when nurses respected their humanity, adopted a practical approach to solve problems pragmatically, and facilitated their recovery. These practices stem from mental health nurses' attitudes towards humanity based on individualized respect, professional ability to handle patients' individual needs, and offering patients hope and confidence for recovery and the future. Therefore, mental health nurses need to focus their efforts on these aspects of nursing attitudes and competencies to ensure that inpatients experience good mental health nursing. [ABSTRACT FROM AUTHOR]

While antidepressants may be effective in treating depression for some people, a third of people do not have an improvement in mood after a trial of two different antidepressants for an adequate duration. These people are diagnosed as having 'treatment‐resistant' depression which situates the problem as part of their biological or psychological makeup. We conducted a search of studies that examined this problem from the perspective of people whose depression did not improve on antidepressants. Nine studies were included in a qualitative meta‐synthesis that identified four themes across these studies: feeling trapped, disconnection, loss of self, and questioning. The participants experienced considerable distress associated with the constant presence of depression in their lives. While antidepressants may help some people, there is a need for more innovative approaches to the treatment of depression. There is a strong argument for trialling appropriate evidence‐based psychotherapy before a person is categorized as having treatment‐resistant depression. It is perhaps better to describe the issue as inadequate efficacy of antidepressants to situate the problem with the treatment provided rather than with the person. [ABSTRACT FROM AUTHOR]

Assertive Community Treatment (ACT) is a multidisciplinary treatment approach to support people with severe mental illnesses (SMI) in their recovery. While the majority of ACT recipients report co‐morbid substance use issues, limited reviews have evaluated the impact of receiving ACT services on substance use outcomes. The purpose of this systematic review was to evaluate the impact of ACT involvement on substance use outcomes among people with SMI. A systematic literature search was conducted including articles published prior to April 2021. Twenty‐nine studies were included in this review. Of them, 15 studies implemented a controlled design (six studies demonstrated high quality) and 14 studies implemented a cohort design. From a synthesis of the reviewed studies, five areas of changes associated with substance use emerged including reduced alcohol and drug use severity, lower prevalence of alcohol and drug use, increased stage of change in substance use treatment, and fewer days of hospitalization and intoxication. Thus, future studies should examine the integration of substance use treatment services as part of ACT interventions for opportunities to enhance recovery outcomes among individuals with SMI. [ABSTRACT FROM AUTHOR]

The recovery model guides mental health services. However, the delivery of recovery‐oriented services in inpatient settings is still a challenge. Factors affecting recovery model implementation can be classified into three types: the hospital environment, the inpatient and the service provider. This study aims to quantitatively evaluate the impact of environment, inpatient and service provider factors on recovery model implementation in hospitals. Forty‐five service providers and 42 inpatients from three types of wards (acute locked, acute open and daycare) of two hospitals participated in this cross‐sectional study. We assessed inpatient cognition, functional capacity and illness severity. In addition, we retrieved information on service providers' professional status and evaluated the recovery model knowledge and attitudes. Implementation of the recovery model was measured using the Recovery Self‐Assessment, both the inpatient and service provider versions. Differences were found between the three types of wards in recovery orientation as reported by service providers (χ22 = 15.3, P < 0.001), but not by inpatients (χ22 = 2.34, P > 0.05). Providers' internalized knowledge and attitudes toward recovery, inpatients' functional capacity and age of illness onset were associated with recovery implementation (0.31 < r < 0.48, P < 0.05). The findings confirm quantitatively the multilevel nature of factors that affect the implementation of the recovery model in psychiatric hospitals. The inpatients' perspective should be incorporated into the service development process. Based on the study results, the reduction in the restrictive features of the wards' environment is recommended. Promotion of the recovery model implementation in the hospital setting requires the expansion of staff's internal positive attitudes toward recovery. [ABSTRACT FROM AUTHOR]

The article presents the discussion on providing support to others experiencing similar mental health problems. Topics include model recovery, inspiringing hope and support people using services towards the own recovery; and building relationships based on mutuality, empowerment, shared power, and respect as well as embodying the transformation from an ‘illness story' to a ‘recovery story. '

This study explored the impact of Strengths Model training, supervision and mentorship on the practice of a group of multi‐disciplinary mental health clinicians that included mental health nurses, social workers, psychologists, and occupational therapists. A qualitative approach that combined critical realism and grounded theory was used. The findings demonstrated how a substantive category, Getting to Know Clients Better, facilitated participants' progression through a basic social psychological process, Becoming a Strengths‐Informed Practitioner. This process consisted of a discernible and sustained change towards more person‐centred, hopeful, and recovery‐oriented practice. The findings also described an underlying generative mechanism for this, the Client Becomes Visible, which accorded with theoretical models of empathy, based on enhanced cognitive processing. The strength‐based approach to practice facilitated the establishment of a collaborative relationship and a stronger therapeutic alliance between the client and clinician. The research demonstrated that Strengths Model is an effective vehicle for improving recovery‐orientated mental health services. [ABSTRACT FROM AUTHOR]

Personal recovery is important for mental health services and service users; moreover, valid and reliable assessment instruments are necessary for measuring personal recovery. Therefore, this study aimed to evaluate the unidimensional factor structure of the German version of the Questionnaire about the Process of Recovery. The study was conducted using a cross‐sectional design with a convenience sample. The questionnaire was completed by 200 patients of outpatient services of two psychiatric hospitals in Switzerland. A confirmatory factor analysis was conducted to validate the unidimensional factor structure of the German version of the Questionnaire about the Process of Recovery. Cronbach's alpha was calculated to assess the internal consistency. The results showed an overall acceptable model fit (χ2 = 134.188, df = 90, P = 0.002; RMSEA = 0.050, 90% CI: 0.031–0.067; CFI = 0.937; TLI = 0.927) and excellent internal consistency (Cronbach's α = 0.91). These results are consistent with those of studies that have examined the Questionnaire about the Process of Recovery in other languages. This study provides preliminary evidence that the German version of the Questionnaire about the Process of Recovery is a reliable assessment instrument for measuring personal recovery among people with mental illness experiences. However, it is necessary to conduct further psychometric tests to verify the validity and reliability of the instrument. The German version of the Questionnaire about the Process of Recovery can be applied to both research and clinical practice, especially as a means of facilitating communication during the planning and evaluation of treatment goals. [ABSTRACT FROM AUTHOR]

The rates of mental health hospitalisations in Australia are rising. This paper presents the findings of a study undertaken in a regional mental health unit. The aim of the study was to obtain user perspectives to inform the redesign of the unit, which provides inpatient mental health services to rural and regional adults. A qualitative descriptive study with data collected via focus groups and in‐depth interviews was undertaken with 38 participants, including current inpatients, carers and 27 staff members of a single regional inpatient mental health unit. The 25‐bed mental health inpatient unit accommodates adults from 18+ years of age. The mental health unit sits within a referral hospital precinct and is associated with community‐based mental health services within a large regional and rural Australian public health service. The analysis of interviews and focus groups with patients, carers and mental health professionals revealed three major themes congruent with the literature These were: Firstly, Theme 1: Rooms should be designed to promote physical security. Next, Theme 2: Purposeful planning to support interactions between users and systems will promote relational security. And finally, Theme 3: Optimizing service integrity should promote procedural security. Based on the themes arising from the study, a list of recommendations was produced to inform the design of a new build for a regional mental health unit. In particular, all users of the space should expect that the built environment will promote their physical security and psychological safety and accommodate a wide range of diversity and acuity. The aesthetics should align with the promotion of recovery in the context of person‐centred and trauma‐informed models of care. Designers should plan to alleviate boredom and accommodate meaningful wayfinding. Mental health nurses should have spaces that support their work without compromising their relational security with consumers. Building designers should optimize therapeutic environments to facilitate dignified intensive and stabilizing treatments and eliminate vicarious stigma associated with caring for people with mental illness. This study provides valuable insights from a community of users who have experienced receiving and delivering mental health care within a regional and rural mental health unit. [ABSTRACT FROM AUTHOR]

In this paper, we provide an analysis of the concept of recovery from substance use. We performed a literature search in CINAHL Plus, PsycINFO, MEDLINE, and Embase using key terms that focused on the concept of recovery from substance use. We also conducted a grey literature search and included select resources. Inclusive years for the search ranged from January 1, 2000 to March 10, 2022. Records were screened for eligibility by two independent reviewers; data were extracted by one reviewer and confirmed by a second. A total of 22 literature sources were included. Identified core attributes of recovery include: (i) recovery as a process, (ii) recovery as more than managing substance use, (iii) recovery as life improvements, and (iv) recovery as a person‐centred, individual concept. Antecedents, consequences, and empirical referents are identified, and model and contrary cases are presented. We propose the following definition for recovery: Recovery from substance use is defined by the affected individual, who sets goals and objectives for life improvements that include managing their substance use, but this is not the sole focus. Recovery is a person‐centred, individualized process that can be measured by referents that suit the individual's own goals and objectives. What may constitute "recovery" and "recovered" requires definition by each individual. [ABSTRACT FROM AUTHOR]

Unplanned hospital readmission rate is up to 43% in mental health settings, which is higher than in general health settings. Unplanned readmissions delay the recovery of patients with mental illness and add financial burden on families and healthcare services. There have been efforts to reduce readmissions with a particular interest in identifying patients at higher readmission risk after index admission; however, the results have been inconsistent. This systematic review synthesized risk factors associated with 30‐day unplanned hospital readmissions for patients with mental illness. Eleven electronic databases were searched from 2010 to 30 September 2021 using key terms of 'mental illness', 'readmission' and 'risk factors'. Sixteen studies met the selection criteria for this review. Data were synthesized using content analysis and presented in narrative and tabular form because the extracted risk factors could not be pooled statistically due to methodological heterogeneity of the included studies. Consistently cited readmission predictors were patients with lower educational background, unemployment, previous mental illness hospital admission and more than 7 days of the index hospitalization. Results revealed the complexity of identifying unplanned hospital readmission predictors for people with mental illness. Policymakers need to specify the expected standards that written discharge summary must reach general practitioners concurrently at discharge. Hospital clinicians should ensure that discharge summary summaries are distributed to general practitioners for effective ongoing patient care and management. Having an advanced mental health nurse for patients during their transition period needs to be explored to understand how this role could ensure referrals to the general practitioner are eventuated. [ABSTRACT FROM AUTHOR]

This perspective paper aims to present a personal viewpoint on the impact of psychiatric discourse on the principles of recovery in mental health care. Mental health services espouse these principles, yet psychiatric discourse remains the dominant model. A critical analysis will examine how psychiatry maintains this dominance. The aim is to examine how psychiatric discourse constructs both the nature of mental distress and its treatment, and how it maintains its power as the dominant authority and its relationship to recovery principles. The paper concludes that psychiatric discourse is the antithesis of recovery principles and that its authority is perpetuated through co‐opting a medical explanatory model, claiming expertise in the ability to predict social risk, and maintaining a tightly controlled echo chamber. A way forward involves the dismantling of the hierarchical service delivery model based on psychiatric discourse and replacing it with a more horizontal service delivery model in which the lived experience of mental distress is central. Regular audit of services needs to prioritize recovery principles. The implications for mental health nursing are considered. [ABSTRACT FROM AUTHOR]

Over recent decades, the shift to recovery‐oriented practice has been central to mental health policy. Despite this emphasis, mental health services can struggle to meet this expectation. This study explores the knowledge and attitudes in relation to the recovery‐oriented practice of clinical staff working at an Australian acute inpatient mental health unit. The Recovery Knowledge Inventory (RKI) is a widely used self‐report tool that assesses mental health professionals' knowledge and attitudes towards recovery; higher scores indicate higher levels of recovery knowledge and attitudes. Seventy‐four staff members (44 nursing staff and 30 medical staff) completed the RKI via an online survey. The study has been reported according to the STROBE checklist for cross‐sectional studies. The relationships between the RKI scores and a range of variables were considered using inferential statistics, including multivariate regression. Medical staff had higher mean RKI scores than nursing staff, although this did not meet the predefined threshold for a clinically significant difference. More years of mental health experience were associated with increased mean RKI scores for medical staff. This Australian inpatient staff cohort demonstrated higher mean RKI scores than have been observed in recent international studies of mental health professions. However, the recovery knowledge and attitude levels were disappointingly similar to those shown in earlier Australian research completed over a decade ago. Efforts are needed to further enhance the recovery knowledge of clinicians working in mental health inpatient units. [ABSTRACT FROM AUTHOR]

This qualitative exploratory study explored nurses' mental health and coping strategies working with suspected and confirmed COVID‐19 patients in Brunei Darussalam. Eleven focus group discussions were conducted between October 2020 and January 2021, involving 75 participants. Three themes emerged: 'COVID‐19 roller‐coaster transitional journey' explained the different psychological responses of the journey of the nurses from merely hearing about COVID‐19 from far to the invasion of the virus and community outbreak in the country; 'Mind my mind and heart' share experiences of the nurses in terms of their mental health and emotional responses; and 'the psychosocial system' described the coping mechanisms of the nurses throughout the COVID‐19 pandemic. Nurses' mental health and coping strategies during the COVID‐19 pandemic influenced how they provided care and performed other tasks, which should not be taken for granted. Nurses employed psychosocial coping methods at the different phases of the COVID‐19 pandemic and support from family, friends, the public, and the governmental level. This research is fundamental as a basis for other countries to design psychological interventions during this yet unsettled COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Mental health inpatient units are complex and challenging environments for care and treatment. Two imperatives in these settings are to minimize restrictive practices such as seclusion and restraint and to provide recovery‐oriented care. Safewards is a model and a set of ten interventions aiming to improve safety by understanding the relationship between conflict and containment as a means of reducing restrictive practices. To date, the research into Safewards has largely focused on its impact on measures of restrictive practices with limited exploration of consumer perspectives. There is a need to review the current knowledge and understanding around Safewards and its impact on consumer safety. This paper describes a mixed‐methods integrative literature review of Safewards within inpatient and forensic mental health units. The aim of this review was to synthesize the current knowledge and understanding about Safewards in terms of its implementation, acceptability, effectiveness and how it meets the needs of consumers. A systematic database search using Medline, CINAHL, Embase and PsychInfo databases was followed by screening and data extraction of findings from 19 articles. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of empirical articles, and the Johanna Brigg's Institute (JBI's) Narrative, Opinion, Text‐Assessment and Review Instrument (NOTARI) was used to undertake a critical appraisal of discussion articles. A constant comparative approach was taken to analysing the data and six key categories were identified: training, implementation strategy, staff acceptability, fidelity, effectiveness and consumer perspectives. The success of implementing Safewards was variously determined by a measured reduction of restrictive practices and conflict events, high fidelity and staff acceptability. The results highlighted that Safewards can be effective in reducing containment and conflict within inpatient mental health and forensic mental health units, although this outcome varied across the literature. This review also revealed the limitations of fidelity measures and the importance of involving staff in the implementation. A major gap in the literature to date is the lack of consumer perspectives on the Safewards model, with only two papers to date focusing on the consumers point of view. This is an important area that requires more research to align the Safewards model with the consumer experience and improved recovery orientation. [ABSTRACT FROM AUTHOR]

The article discusses biomedical approach to illness and disorders, and risk assessment/management practices have long dominated the delivery of mental health services. While there are numerous and widely used psychotherapeutic approaches, pharmacological treatment either alone or simultaneous with psychological therapies, remain the basis of treatment.

Depression is one of the most prevalent mental disorders in older adults and leads to considerable decreases in health, well‐being, and impaired functioning. Intervention studies have focused on the effects on symptomatic recovery, and most do not include functional recovery as an outcome. Reduction of functional limitations as a treatment goal in old‐age psychiatry aligns with the values of older persons. The objective of this review was therefore to evaluate the effectiveness of late‐life depression interventions on functional limitations. This systematic review identified 15 randomized controlled trials in which the effectiveness of different interventions on functional limitations was evaluated in patients with late‐life depression. The interventions were categorized into four categories: psychological interventions, drug treatment, physical exercise, and collaborative care. Multicomponent and collaborative‐care interventions appear to be the most promising for improvement of functional limitations, particularly in primary care and community‐dwelling populations of older persons with symptoms of depression. There is, however, a lack of evidence regarding studies in specialized mental health care. [ABSTRACT FROM AUTHOR]

Nursing in psychiatric inpatient care is peripheral to a dominating biomedical model of care. Efforts are being made to implement nursing models based on core values and theories for nursing, such as recovery‐oriented practices. The aim of the study was to explore experiences of a recovery‐oriented nursing programme (Steps Towards Recovery, STR) among nursing staff in psychiatric inpatient care and their ratings of stress (Maslach Burnout Inventory scores), quality of care (Quality of Psychiatric Care ‐ Inpatient staff scores) and satisfaction with nursing care (Satisfaction with Nursing Care and Work scale scores), before and after the implementation—and compare with ratings from reference wards. A quasi‐experimental and prospective, pretest–post‐test design was used. Specific questions about the nursing programme were answered by staff at the intervention wards. Staff reported predominantly positive experiences of the nursing programme. At follow‐up, higher ratings were reported in two dimensions of quality of care in the STR group, and lower ratings in one dimension of stress were evident in the reference group. No differences in ratings between the STR and reference wards were found. Staff members' positive experiences of STR and higher ratings regarding participation and secure environment after implementation suggest that STR is a well‐accepted and promising nursing programme. It is important to implement and evaluate recovery‐oriented interventions in psychiatric inpatient care, where a focus on symptom relief still prevails. The results indicate that there is potential for further exploration of STR in this context. [ABSTRACT FROM AUTHOR]

Recovery, a model of care aimed at patient‐led nursing practice emphasizing autonomy, hope and self‐determination, has in recent years been adapted for the secure forensic psychiatric setting. Often referred to as 'secure recovery', this model suggests the aims of recovery are achievable even in highly restrictive settings. This paper will adopt a Foucauldian perspective to offer a critical analysis of recovery in forensic settings. In providing recovery‐oriented care, nurses utilize pastoral power in guiding patients to institutionally preferred outcomes. Akin to Christian religious conversion, nurses engage in a neo‐religious conversion of patients to a neoliberal subjectivity of homo‐economicus. This path of recovery is grounded in an ethos of personal responsibility and self‐government, inseparable from the greater context of neoliberal governmentality. Despite attempts at transforming forensic nursing practice into more egalitarian directions, recovery remains a coercive practice, and fails to meet the overall goals of this paradigm in secure settings. [ABSTRACT FROM AUTHOR]

Mental health services need reliable and valid instruments to measure mental health recovery outcomes, and the only available one in Spanish is arduous. Adapting an instrument is more efficient than creating a new one as it enables international comparison research. The aim of this study was to conduct a cross‐cultural adaptation of the 15‐item Questionnaire about the Process of Recovery. Fifty‐four participants engaged in a five‐stage systematic and standardized process carried out from November 2019 to November 2020. Professional translators (n = 4) from the Translation Service Center for Foreign Languages of the Universidad de Alcalá participated in the direct translation, synthesis and back translation stages, and mental health professionals (n = 33) and service users (n = 17) from the Hospital Regional Universitario de Málaga and the Hospital Universitario Virgen de la Victoria in Andalucía (Spain), with an average of 19.2 (SD 12.86) years of experience in mental health, participated in the committee of experts and pilot debriefing stages. Additionally, legibility was assessed. Out of the 15‐items of the questionnaire, three (20%) were equal amongst translations, three items (20%) of the back translations matched the original questionnaire and discrepancies identified were adapted accordingly. Seven items (46.7%) were approved online by experts and consensus of alternative translations was reached for the rest. The average time spent completing the questionnaire by service users during the face‐to‐face pilot was 4.12 min (SD 2.25). Internal consistency obtained was ω = 0.95 and α = 0.91. Debriefing findings reported the questionnaire as comprehensible (97.1%), adequate in wording (91.2%), formal in language (55.9%) and adequate in terms of length (100%). The questionnaire scored 65.53, 'normal' readability, on the Inflesz scale. The adapted instrument has conceptual, linguistic, cultural and metric equivalence to the original instrument. [ABSTRACT FROM AUTHOR]

The diagnosis of borderline personality disorder (BPD) has been found to carry stigma and poor hope of recovery. More recently, it has been regarded as a treatable condition through psychotherapy. Despite this, patients often experience lengthy hospitalizations, limited access to treatment, and poor outcomes. This paper describes the experiences of psychiatric nurses working with people diagnosed with BPD in acute mental health in‐patient settings in Ireland. Seven nurses were interviewed, and the transcripts were analysed using a reflective and inductive approach. Overall, the nurses did not feel confident that their interventions were effective or valued by the wider service or patients. The nurses articulated their invidious professional circumstances, whereby they were required to act in ways, which ran counter to their vision of therapeutic or recovery‐focused work. These views and perceptions that in‐patient care is often ineffectual are widely echoed in the literature. We contend that the effect of this circumstance for these nurses approaches moral distress. The nurses were aware of more effective methods of care and treatment for BPD but perceived that they were unable to influence the culture of in‐patient care. [ABSTRACT FROM AUTHOR]

People with mental ill health attend general emergency care more often than others for physical and psychiatric care needs. Staff in general emergency care report they lack knowledge and strategies to meet with and care for people with mental ill health. This study aimed to describe how people with mental ill health experience encounters with staff in general emergency care. We conducted individual semi‐structured interviews with 11 people with mental ill health about their experiences in general emergency care and subjected the interview data to qualitative content analysis. Our results show the importance to people with mental ill health of being acknowledged as capable persons, and how this relates to their experiences of being recognized, ignored, or dismissed by staff in general emergency care. Even small, ordinary aspects of staff/patient interactions can have major impacts on a person's recovery and well‐being. The study is reported according to the consolidated criteria for reporting qualitative research (COREQ) guidelines. [ABSTRACT FROM AUTHOR]

Recovery‐focused educational programmes have been implemented in mental health services in an attempt to transform care from a purely biomedical orientation to a more recovery‐oriented approach. Mental health nurses have identified the need for enhancing their abilities and confidence in translating recovery knowledge into mental health nursing practice. However, recovery‐focused educational programmes have not fully address nurses' learning needs. Therefore, this review synthesized the evidence of the effectiveness of recovery‐focused educational programmes for mental health nurses. A systematic search of electronic databases and hand‐searched references was conducted. It identified 35 programmes and 55 educational materials within 39 studies. Synthesizing the literature revealed three themes and nine subthemes. The first theme, a framework for understanding and supporting consumers' recovery, had four subthemes: consumers' involvement, multidisciplinary approach, profession‐specific training, and performance indicators. The second theme, contents of educational materials, included the subthemes: knowledge development and recovery‐focused care planning. The final theme, nurses' learning experiences, included the subthemes: understanding recovery, the positive effects of recovery‐focused educational programmes, and implementation of recovery‐oriented practices. Based on these findings, a mental health nursing recovery‐focused educational programme framework is proposed. Further research should investigate the effectiveness of the framework, especially in relation to recovery‐focused care planning and consumer and carer involvement in the development, delivery, participation, and evaluation of these educational programmes. [ABSTRACT FROM AUTHOR]

Perinatal mental health issues are a global public health challenge. Worldwide, it is estimated that 10% of pregnant women, and 13% of women who have just given birth, experience a mental disorder. Yet, for many reasons – including stigma, limited access to services, patients' lack of awareness about symptoms, and inadequate professional intervention – actual rates of clinical and subclinical perinatal mental health issues are likely higher. Studies have explored experiences such as postpartum depression, but few involve a wider‐ranging exploration of a variety of self‐reported perinatal mental health issues through personal narrative. We conducted 21 narrative interviews with women, in two Canadian provinces, about their experiences of perinatal mental health issues. Our aim was to deepen understanding of how individual and cultural narratives of motherhood and perinatal mental health can be sources of shame, guilt, and suffering, but also spaces for healing and recovery. We identified four predominant themes in women's narrative: feeling like a failed mother; societal silencing of negative experiences of motherhood; coming to terms with a new sense of self; and finding solace in shared experiences. These findings are consistent with other studies that highlight the personal challenges associated with perinatal mental health issues, particularly the dread of facing societal norms of the 'good mother'. We also highlight the positive potential for healing and self‐care through sharing experiences, and the power of narratives to help shape feelings of self‐worth and a new identity. This study adheres to the expectations for conducting and reporting qualitative research. [ABSTRACT FROM AUTHOR]

Mental health recovery is an enabling process encouraging consumers to live a productive life, notwithstanding the presence of debilitating symptoms of illness. The recovery model has been integrated into all areas of mental health. However, literature shows that mental health professionals are not equipped to provide recovery‐oriented care to consumers. Researchers have recommended recovery‐based interventions to develop knowledge, attitudes, and skills to promote recovery‐oriented practice in mental health, yet there is a paucity of research regarding the effect of recovery‐oriented interventions on the knowledge and attitudes of mental health professionals to improve recovery‐oriented practice. Therefore, the purpose of the current review is to understand the effectiveness of interventions on recovery knowledge and attitudes of mental health professionals regarding recovery‐oriented practice. The papers were identified through the Population Intervention Comparison and Outcome strategy. The heterogeneity of the selected papers led to a narrative review instead of a systematic review with meta‐analysis. The analysis suggested that recovery‐based interventions are effective in enhancing the recovery knowledge and attitudes of mental health professionals. Recovery‐based interventions have the potential to reduce the use of physical restraints and improve work satisfaction among mental health professionals. The limitations of the studies were the heterogeneity of the selected populations and the absence of strong methodologies to assess the effect of the interventions. Therefore, future investigations should be focused on the effect of interventions on a homogeneous group using randomized controlled trials. [ABSTRACT FROM AUTHOR]

Community treatment orders (CTOs) require individuals with a mental illness to accept treatment from mental health services. CTO legislation in South Australia states that treatment and care should be recovery‐focused, although justification for use is predominantly risk‐based, and care often coercive. Although CTOs are contested, individuals, families, and clinicians frequently engage in care planning within this context. This paper examines how the concepts of risk and risk management impact care planning from the perspectives of individuals on CTOs, their families, and clinicians. Ethnographic methods of observation and interview provided a detailed account of the perspectives of each group over an 18‐month period from two community mental health teams in South Australia. Findings show that care planning occurred within a culture of practice dominated by risk. Risk, however, was understood differently by each participant group, with the dominant narrative informed by biogenetic understandings of mental illness. This dominance impacted on the positioning of participant groups in care planning, focus of care contacts, and care options available. To improve care experiences and outcomes for individuals on CTOs, narrow conceptualizations of risk and recovery need to broaden to include an understanding of personal and social adversities individuals face. A broader understanding should reposition participants in the care planning context and rebalance care discussions, from a focus on clinical recovery to recovering citizenship. [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]

This article provides an organizational case study using exploratory qualitative and visual research methods. We address the research question: What are the experiences of service users who use a novel in‐reach rehabilitation and recovery service for people with severe and enduring mental health needs? Fifteen purposefully sampled service users were recruited from across a Service that is novel in embedding community sectors within inpatient provision. The sample reflects approximately the demographic of the Service and comprises: 10 men, 5 women; 12 white British, 3 ethnic minority; aged 18–60 years; and across inpatient care and supported community living. Photo‐elicitation was used to enrich data collection through lightly structured interviews focused on the images brought by participants. Interview transcripts were analysed using interpretative phenomenological analysis. Analysis indicates that participants oriented towards four 'meta‐questions': What does mental well‐being mean to you? What difficulties have you encountered? What do you appreciate about the Service? What do you need for change to occur? We also identified six themes which told the story of a journey. The journey begins with challenge and moves towards making connections with others. Here, power dynamics are often experienced and addressed in the development of a greater sense of independence. This then provides opportunities for raised awareness around possibilities of recovery and a new‐found hope. Our three main conclusions are all relevant to clinical practice: service users (a) place great importance on building relationships; (b) aspire to make informed choices throughout their recovery journey; and (c) desire greater transparency regarding treatment options. [ABSTRACT FROM AUTHOR]

Recovery is internationally recognized as a concept to improve the well‐being of consumers. Compared with the numerous measures assessing consumer perspectives of recovery, only a few measures have been developed to assess Mental Health Professionals' (MHPs) perspectives of recovery to inform practice. The present study aims to systematically review the literature to identify existing measures designed to assess MHPs' perspectives of recovery and evaluate their psychometric properties, and the methodological considerations of the design and use of these measures. We searched literature across eight electronic databases: MEDLINE, Web of Science, PsycINFO, PsyArticles, CINAHL, Scopus, EMBASE, and Google scholar. We identified 2631 articles across all databases. Of these, 40 articles met the inclusion criteria, which comprised 14 original measures assessing mental health recovery and 26 articles reassessing the psychometric properties of the original 14 measures. Our results suggested that while there are existing measures for assessing MHPs' perspectives of recovery, only a few of these measures met standard evaluation criteria for psychometric properties. Specifically, the validation of the identified measures is still in its infancy. For example, the easiness of applying the measures differs among the studies, and only a few of the measures fully involved consumers in the scale development phase. The implication of the findings for future use and development of recovery measures in mental health practice and research are discussed and recommended. [ABSTRACT FROM AUTHOR]

Mental health nurses are struggling to describe their nursing identity as professional discipline in a changing mental health care. Measuring nurse‐sensitive patient outcomes and demonstrating nursing's effect(s) experienced by patients contribute to (re)discover the specific nursing identity. However, a valid and reliable scale is currently lacking. The aim of this study was the development and psychometric evaluation of the Mental Health Nurse‐Sensitive Patient Outcome Scale (MH‐NURSE‐POS) for inpatient psychiatric hospital settings. This three‐staged study resulted in a scale capturing how inpatients experience the contribution of nurses in their treatment in psychiatric hospitals. First, a draft questionnaire was developed based on a literature review, an independent expert's advice, and an experts panel. Second, the content validity was tested in a two‐round Delphi‐procedure and focus groups with patients. A pilot test, based on cognitive interviews, confirmed the feasibility of the questionnaire. Third, the psychometric properties of the mental health nurse‐sensitive patient outcomes were determined in a sample of 353 patients. The cross‐sectional study included a convenience sample of five psychiatric hospitals (Belgium). The factor structure (Kaiser–Meyer–Olkin measure of sampling adequacy 0.924; Bartlett's test of sphericity χ2 = 4162.537; df = 231; P < 0.001), convergent validity by the Individualized Care Scale (Pearson correlation 0.660; P < 0.001), and reliability (Cronbach's Alpha 0.854) were evaluated. The factor analysis resulted in a four‐factor solution representing growth, expression, control, and motivation. The Mental Health Nurse‐Sensitive Patient Outcome Scale is a valid and reliable tool to measure the effectiveness of mental health nurses from the patient perspective. [ABSTRACT FROM AUTHOR]

Since the 1990s, New Zealand mental health policy has shifted from a focus on the management of symptoms and risk to the recovery of psychological, social, cultural, and physical well‐being. Despite a vision for recovery‐oriented services being integrated within national and regional policies, there is growing concern that barriers to recovery‐oriented service provision continue to exist. Such barriers include the attitudes, skills, and knowledge of front‐line staff, as well as system issues. This study explored the experience and meaning of recovery‐oriented practice for 10 nurses working in an acute inpatient mental health service. A phenomenological and hermeneutic lens was used to explore the nurses' experience of working in a recovery‐focused manner alongside service users. Stories of practice were collected from participants through open‐ended conversational interviews. Transcribed narratives were analysed to explore taken‐for‐granted aspects of working in acute mental health care and to uncover the meaning of being recovery‐oriented in this setting. Findings revealed that although the experience and meaning of recovery‐focused care varied among nurses, there were common elements in the practice accounts. The accounts highlighted the nurses' role in creating different therapeutic spaces to promote safety, relational commitment, and healing for service users. However, the nurses faced challenges to recovery‐oriented care within the team hierarchical culture and the broader service systems. The nurses were, at times, fearless in advocating for service users and recognized that this was essential for developing recovery‐focused services. The findings have implications for nursing practice, as well as training and service development. [ABSTRACT FROM AUTHOR]

This research aimed to gain an understanding of the acute mental health inpatient experience as described by Aboriginal women during admission. It recorded for the first time the words of Aboriginal women within the inpatient unit, including their perceptions of factors which may promote or impede a culturally safe environment. Eleven Aboriginal women inpatients gave interviews before discharge from the inpatient unit. Five Aboriginal Reference Group (ARG) members with experience of the inpatient unit also gave interviews, adding 'insider–outsider' perspectives. Interviews were recorded, transcribed, entered into NVivo software, and analysed inductively to raise codes and develop themes. Five interconnecting themes emerged: Social Context: life experience preceding, shaping, and following admission; Connection: with kin, community, and culture. Control: self‐determination, legally and physically curtailed; Caring: actions promoting reconnection and self‐determination; Communication: conveying caring and supporting agency, reconnection, and return to community. Findings reflected inpatient issues reported in previous studies, adding insights into the cultural concerns of Aboriginal women and offering practical clinical implications for culturally secure service delivery in an inpatient setting. Existing literature offered a basis for developing the model offered here for transcultural interaction for recovery in an inpatient setting. Attention to these findings can enhance Aboriginal women's inpatient experience and promote further research. The article complies with the COREQ‐32 checklist for describing qualitative studies. [ABSTRACT FROM AUTHOR]

Open Dialogue is a need‐adapted approach to mental health care that was originally developed in Finland. Like other need‐adapted approaches, Open Dialogue aims to meet consumer's needs and promote collaborative person‐centred dialogue to support recovery. Need‐adapted mental health care is distinguished by flexibility and responsiveness. Fidelity, defined from an implementation science perspective as the delivery of distinctive interventions in a high quality and effective fashion is a key consideration in health care. However, flexibility presents challenges for evaluating fidelity, which is much easier to evaluate when manualization and reproducible processes are possible. Hence, it remains unclear whether Open Dialogue and other need‐adapted mental health interventions can be meaningfully evaluated for fidelity. The aim of this paper was to critically appraise and advance the evaluation of fidelity in need‐adapted mental health care, using Open Dialogue as a case study. The paper opens a discussion about how fidelity should be evaluated in flexible, complex interventions, and identifies key questions that need to be asked by practitioners working in need‐adapted mental health care to ensure they deliver these interventions as intended and in an evidence‐based fashion. [ABSTRACT FROM AUTHOR]

Semi‐structured interviews were used to explore the consumer experience of community‐based residential mental health rehabilitation support at Community Care Units in Australia. These clinical services provide recovery‐oriented residential rehabilitation to people affected by severe and persistent mental illness. Typically, nurses occupy the majority of staff roles. However, two of the three sites in the study were trialling a novel integrated staffing model where the majority of staff were people with a lived experience of mental illness employed as peer support workers (PSWs). The interviews explored consumers' experiences of care 12–18 months after admission. Fifteen interviews were completed with an independent interviewer. Most participants were diagnosed with schizophrenia or a related psychotic disorder. The analysis followed a pragmatic approach to grounded theory. Consumers viewed the CCU favourably, emphasizing the value of the relationships formed with staff and co‐residents. No major differences in consumers' experience under the traditional versus integrated staffing models were identified; however, those from the integrated staffing model sites valued the contributions of the peer support workers. The understanding of the consumer experience emerging through this study aligned with their expectations of the service at the time of commencement. [ABSTRACT FROM AUTHOR]

Transforming to recovery‐oriented care is an urgent issue in community psychiatric nursing in Japan. Because traditional psychiatry is still influential, nurses are required to possess cultural sensitivity to objectively view conflicts between values when providing recovery‐oriented care. If recovery‐oriented care based on cultural sensitivity is clarified, it would help nurses providing recovery‐oriented care in non‐recovery‐oriented environments. Therefore, this study aimed to clarify recovery‐oriented nursing care based on cultural sensitivity in community psychiatric nursing in Japan. A semi‐structured interview with 21 community psychiatric nurses and participant observations for seven of them were performed. A qualitative description was undertaken to analyse the data. The relationships between categories were examined. The study conforms to the COREQ checklist. Through the analysis, six categories were revealed: 1. Continuously reflecting on one's own practice and the influence of the traditional mental health culture; 2. Constructing a partnership with clients to uphold their rights and responsibilities; 3. Having client‐centred dialogue to help them enjoy life and grow; 4. Supporting clients' lives and strengthening their self‐management; 5. Working as a team to achieve clients' wishes, which includes some risks, and 6. Maintaining a relationship between clients and the people who care for them. Category 1 was central and enclosed by categories 2, 3 and 4. Categories 5 and 6 were located outside of categories 1 to 4. The results showed cultural sensitivity enables recovery‐oriented care even in non‐recovery‐oriented environments and include recognizing the traditional mental health culture, understanding clients' experiences and accepting other's values. [ABSTRACT FROM AUTHOR]

The 'Experienced Involvement' (EX‐IN) training programme prepares and certifies individuals who have experienced mental health problems to work as peer support workers and to support others challenged by similar conditions. We aimed to assess the impact of the EX‐IN training on hope, self‐efficacy, introspection, stigma resistance, personal recovery, health‐related quality of life and employment in participants. Data was collected using standardized assessment instruments before the training started (t1) and upon course completion (t2). Data from 103 participants who participated in both measurement times were included into data analysis. Participants significantly improved their recovery, stigma resistance and introspection during the EX‐IN training. In addition, a significant higher proportion of participants were employed at t2. Participants whose last inpatient stay was 0–1 year before the start of the EX‐IN training showed significantly lower levels of stigma resistance, and self‐efficacy at t1 than participants with two or more years since the last inpatient stay. There were no significant changes in mean values over time, or in the mean values at t2 between the two groups. EX‐IN training has a positive influence on the handling of stigma, on one's recovery path and introspection. This indicates that EX‐IN training has a therapeutic effect on the participants. EX‐IN training seems to meet the challenges of peer support work. Therefore, the training can be recommended as preparation for working as a peer support worker as well as an intervention to improve one´s recovery process. [ABSTRACT FROM AUTHOR]