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The nurse role on an Assertive Community Treatment (ACT) team requires a specialized set of skills in psychiatric community-based care. While the ACT model has existed for fifty years, no nationally recognized standard curriculum to train ACT nurses has been developed. The ACT Nursing Project described in this paper aimed to create a competency-based on-board training program using the Developing a Curriculum (DACUM) method. Eight ACT nurses from three states served as the expert panel to create a DACUM chart detailing the full set of nine duties and 127 tasks required of ACT nurses. To verify the DACUM results, 57 ACT nurses from four states completed a survey and confirmed that 80% of the tasks identified by the expert panel were also performed by the validation sample of ACT nurses. This paper describes how the DACUM duties and tasks provided the framework to develop onboard training curriculum for ACT program nurses. The next step is to pilot the onboard training curriculum to newly hired ACT nurses to ensure they are equipped to meet the complex needs of people living with serious mental illness, and to increase their competency, job satisfaction and decrease the high annual turnover rate among ACT nurses. [ABSTRACT FROM AUTHOR]

Nonsuicidal self-injury (NSSI) is prevalent among incarcerated women in correctional facilities. This poses a challenge in selecting appropriate intervention. This integrative review aimed to identify effective interventions for managing NSSI among incarcerated women. Whittemore and Knafl's framework for integrative reviews was used, and eight databases were searched with 11 papers meeting the inclusion criteria. Six interventions for NSSI for incarcerated women were identified as promising in reducing the rate of NSSI. Data did not support the effectiveness of gender-specific interventions for incarcerated women. There is a need for further research to identify appropriate interventions to target NSSI among incarcerated women. [ABSTRACT FROM AUTHOR]

Coercive measures are a major infringement of the autonomy of psychiatric patients and no medical justification exists for applying mechanical restraint (MR) to these patients currently. Knowledge regarding how preventive strategies affect the use of MR is limited. This paper aimed to understand the link between the initiatives taken by national authorities and the practical implications to MR reduction. Policy texts and the number of coercive measures used in two decades were reviewed. Trends were discussed with five experts with real-life experience and suggestions were obtained regarding how to end the use of mechanical restraint in mental health care settings. [ABSTRACT FROM AUTHOR]

Introduction: There has been a sharp increase in the use of digital health interventions in global health, particularly mobile health applications, in recent years. The extreme shortage of health care providers trained in mental health screening and intervention in low- and middle-income countries raises questions about the applicability of mobile applications to deliver these services due to their accessibility and availability. This exploratory paper describes the development and feasibility assessment of a mobile screening application for the detection of mental disorders among adolescents in Zambia and South Africa. Methods: Eighty-two health care workers (HCW) working in primary care evaluated the acceptability and practicality of the mobile screening application after receiving brief training. The evaluation included questions from the Mobile Application Rating Scale (MARS) as well as open-ended questions. Results: The acceptability of the screening app was high and study participants were positive about using the app in routine care. Problems with internet connectivity, and time and staff constraints were perceived as the main barriers to regular use. Conclusion: HCW in primary care were able and willing to use a mobile screening app for the detection of mental health problems among treatment-seeking adolescents. Implementation in clinical practice needs to be further evaluated. [ABSTRACT FROM AUTHOR]

Systematic uptake of family-centered care (FCC) interventions remains challenging and frequently suboptimal in many neonatal intensive care units (NICUs). Across NICUs in the United States, integrating family members as partners in infant caregiving and decision-making has not been well supported and routine screening and provision of psychological support for parents remains inadequate. Trauma-informed care (TIC) may offer a more comprehensive approach to NICU care which can encompass FCC principles and promote family recovery and resilience by recognizing and responding to the traumas experienced by NICU infants and families. The current paper aimed to understand needs identified by mothers of NICU-hospitalized children and reports a focused analysis of one-on-one interview data (n = 13 mothers) collected during a larger mixed methods study. Reflexive thematic analysis was used to understand needs identified by mothers and to explore how these needs aligned with TIC principles. Six themes were identified and subsequently examined in the context of the principles of TIC: I Just Had No Control, That Really Caught Us Off Guard, So Much Was Already Taken Away, We're People and There Needs To Be More Support and Practices Which Helped. Mothers' care needs were found to align with TIC principles. Findings suggest that implementation of TIC principles in NICU settings can support parental presence, participation in infant care, and mental health and support the potential of TIC as a more comprehensive approach to meeting the needs of NICU parents. [ABSTRACT FROM AUTHOR]

Integrating consumers' experiences into quality mental health service assessment is relevant to improve service outcomes. Despite this, limited studies have attempted to explore consumers' experiences, particularly in developing countries, such as Ghana. This paper aims to explore consumers' subjective experiences of the quality of mental health services. A qualitative method involving in-depth interviews was used to collect data from 21 consumers of mental health services. Thematic analysis was used to analyse the data, which is discussed using a realistic evaluation approach. The study identifies four themes, 33 inductive codes and 594 references. The themes used to interpret the verbatim narratives are the available mental health services, therapeutic interaction with the professionals, competency and skills of the professionals, and the changes experienced in the consumers' lives. The study indicates that the mental health services aim to provide a range of treatments and medications as well as recovery-oriented services, using mechanisms such as ensuring an effective therapeutic relationship and improving technical competency and skills. The contextual factors and the mechanisms have helped to achieve some changes in the lives of consumers (increased satisfaction, reduced symptoms, improved functionality, feeling normal, improved living skills and self-care, work and capabilities, and social inclusion). The study concludes that policymakers and clinicians should integrate evidence-based recovery services, principles and values into the existing mental health services. The mechanisms used to promote quality of mental health services should be strengthened, through periodic monitoring and evaluation, using approaches such as sensor data capturing, to ensure good coordination and continuity. [ABSTRACT FROM AUTHOR]

Women's coping strategies may be affected by many factors, including their health and wellbeing, their social roles, and the broader environment. While the coping strategies of vulnerable women have been studied, little qualitative research has focussed on how women from the general population cope with their difficulties. The aim of this paper is to explore difficulties and coping strategies among Australian women. Women's perspectives on their ways of coping with the difficulties they had faced in their lives were thematically analysed from semi-structured telephone interviews with 36 women purposively sampled from over 7,000 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health. Difficulties were identified with health, relationships, finances, and work/study. Coping strategies included using resources, support from others, lifestyle strategies, and cognitive strategies. It is helpful for psychiatric mental health nurses and other health professionals to understand women's coping strategies in order to better support women experiencing difficulties. [ABSTRACT FROM AUTHOR]

Motivational interviewing (MI) is a long-established evidenced-based intervention aimed at guiding people to implement change. Originally developed by William Miller from the United States and Stephen Rollnick from the United Kingdom, a strong emphasis for MI is the underlying 'spirit', rather than merely the specific techniques within the model. The 'spirit' of MI consists of four key components: acceptance, partnership, evocation and compassion. These have direct overlap with concepts within the personal recovery model recognised as a critical framework in delivery of contemporary mental health services for consumers. Despite this recognition, recovery concepts have struggled to gain consistent traction, particularly within inpatient mental health units. This paper proposes that MI presents one strategy for integrating recovery-focused principles within routine mental health nursing (MHN) practice. An overview of MI and its relationship with recovery principles is discussed in the context of contemporary MHN practice. Evaluation results of a locally developed MI workshop for MHNs within a regional area of New South Wales (NSW) in Australia are presented to highlight the emerging evidence for this potential. Following the workshop, MHN participants showed key improvements in knowledge and confidence scores, as well as in understanding of key MI processes and strategies. The consolidation of these skills through training and a supervision framework is outlined. [ABSTRACT FROM AUTHOR]

More attention has recently been paid to the unique experiences and health needs of LGBTQ + people. To date, there has been a limited focus on the distinct psychosocial needs of bisexuals. A larger mixed-methods study explored the wider needs of a LGBTQ + cohort. The aim of this paper is to report the specific experiences of bisexuals and highlight their distinct psychosocial issues and concerns. The online survey instrument contained Likert-scale and qualitative questions and was completed by a total sample of LGBT people (n = 125), of which 19 participants self-identified as bisexual. The qualitative responses of the bisexuals were extracted and analyzed separately to identify emergent themes that were: accessing responsive services, culturally competent services, supports and interventions, and knowledge, skills and confidence. The study findings inform and enhance the understanding of the issues that impact upon the health and well-being of bisexuals, thereby contributing to promoting the wider social inclusion and human rights agenda by guiding mental health service developments, policy initiatives, education provision and future research. [ABSTRACT FROM AUTHOR]

A study regarding the role and uniqueness of psychiatric nursing was conducted with 94 participants from Manitoba, Canada. The primary theme of comprehensive knowledge of mental health, mental illness, and addictions was foundational for the application of the sub-themes of therapeutic relationship, holistic approach, recovery orientation, stigma reduction, and advocacy for change. Values, beliefs, and attitudes towards people with mental illness and addictions need to be instilled in psychiatric nursing students throughout their educational program to provide high quality, compassionate, and safe care. Implications for incorporation of the theme and sub-themes into psychiatric nursing curriculum are described in the paper. [ABSTRACT FROM AUTHOR]

This paper identifies the components of a successful wellness-illness transition on the experience and management of depression. Data collection and analysis were informed by Corbin and Strauss' approach to grounded theory. Exemplars and case studies are used to illustrate the findings. Three themes reflected participants' experiences of a wellness-illness transition relating to depression in older adults: Accepting a change in wellness-illness status, Adapting to the changeable nature of depression, and Creating new meaning. A change in wellness-illness status is interpreted through personal beliefs about depression, and the knowledge, skills and resources required to optimise well-being. Successful transitions were associated with improved experience and management of depression. The findings have implications for how older adults recognise and respond to symptoms of depression. Judicious advice and support from health professionals can facilitate wellness-illness transitions, thereby enhancing health and well-being outcomes for older adults with depression. [ABSTRACT FROM AUTHOR]

Although substance use is prevalent in the United States, the majority of people who misuse substances do not receive appropriate treatment. This paper describes, (1) an interprofessional education (IPE) program for health professionals to provide Screening Brief Intervention and Referral to Treatment to rural substance use patients, and (2) compares registered nurses' [RNs] and behavioral health professionals' [BHPs] attitudes to work with those patients and their perceptions on IPE. A data analysis of 62 RNs and 36 BHPs shows statistically significant increases in both attitudes and perceptions. This paper discusses the implications of the IPE program vis-á-vis substance use treatment. [ABSTRACT FROM AUTHOR]

The aim of this qualitative study was to describe nursing students' experiences of hearing distressing voices through content analysis of essays regarding changes they encountered during simulation. Data, obtained from undergraduate (n = 237) and graduate (n = 128) students' short self-reflection papers, were analysed using a six-step thematic analysis. The following six themes emerged: (a) experiencing cognitive and perceptual challenges, (b) feeling unpleasant emotions, (c) dealing with functional changes and hardships, (d) experiencing somatic changes, (e) making attempts to cope, and (f) facing lingering impact. The findings suggest that students' experiences of voice-hearing simulation closely resembled the voice-hearers' actual experience. Simulation is an effective teaching modality to introduce nursing students to the world voice-hearers live in and to prepare them for clinical practice enlightened through understanding of what it is like to hear distressing voices. [ABSTRACT FROM AUTHOR]

This paper explored the support needs of family caregivers of people living with a mental illness in Iran. This descriptive study focused on the experiences of 20 family caregivers as well as the views of 29 professional support workers through individual face-to-face interviews. From these interviews three key themes emerged in regards to the care needs of family caregivers: (i) social support; (ii) emotional support; and (iii) safety and security. These themes highlighted the complex role of caring for a family member with a mental illness and the emotional, social and economic challenges that these caregivers experienced as a result. Iranian caregivers garnered support not only from other family members but also from neighbors and religious leaders but lacked the much needed respite care found in western countries. This research study highlighted the importance of ensuring that the caregivers themselves receive appropriate and adequate support to fulfill their caregiving role. [ABSTRACT FROM AUTHOR]

Infant well-being is intrinsically linked to maternal physical and emotional well-being. Internationally health services have implemented policies to identify women at risk of mental health problems and developed effective care pathways. The aim of this paper is to describe how perinatal and infant mental health clinicians perceive their role and the attachment-based interventions they use in their work. The study comes from a larger mixed methods study, which examined two specialist perinatal and infant mental health services in New South Wales (Australia). Two hundred and forty-four medical records were reviewed, and six perinatal and infant mental health clinicians participated in in-depth semi-structured interviews. Data were analysed by content and thematic analysis. One overarching theme, modelling a secure base and three supporting themes, enhancing reflective capacity, enhancing emotional regulation and enhancing empathy emerged from the analysis. These findings demonstrate how perinatal and infant mental health clinicians use attachment theory to inform practice by modelling "holding" and being a secure-base for women. They also provide a clearer understanding of perinatal mental health practice and can be used to inform educational programs for multidisciplinary mental health professionals particularly those working with women and infants. [ABSTRACT FROM AUTHOR]

The cyclical pattern of violence in the lives of homeless female ex-offenders may precipitate ongoing substance use and recidivism; all of which have shown to be mounting public health issues affecting successful reentry. This paper, which analyzed baseline data from a longitudinal study of 126 female ex-offenders in Los Angeles and Pomona, California, highlighted the factors found to be associated with violent crime among homeless female ex-offenders. A multiple logistic regression model for whether or not the last conviction was for a violent offense indicated that poor housing (p= .011) and self-reported anger or hostility (p< .001) were significant correlates. An ordinal regression model for the number of violent offenses also indicated that affectionate support was associated with committing fewer number of violent crimes (p= .001), while positive social interactions (p= .007), and anger/hostility (p= .015) were associated with greater number of violent crimes. Implications for developing a comprehensive array of strategies that can mitigate the pattern of violence often seen in the lives of homeless female who have recently exited jails and prisons is discussed. [ABSTRACT FROM AUTHOR]

Understanding barriers and facilitators of healthcare for people with mental illness is essential for healthcare and mental healthcare organizations moving towards patient centered care. This paper presents findings of a measure on barriers and facilitators of healthcare completed by 204 patients being served at a co-located wellness center (primary healthcare clinic) located in an urban mental health center. The top 10 results show important findings for planning healthcare services that are responsive to the needs of people with mental illness. Basic structural issues as a result of poverty are extremely important (transportation, housing, payment) as well as difficulty with public healthcare that often involves long wait-times for appointments and at the doctor's office and hours that might not be convenient. Healthcare services that want to meet the needs of people with mental illness need to address these issues. What facilitates healthcare is not just removing the barriers to receiving healthcare services but instead involves more interpersonal aspects of healthcare such as liking your provider, being able to talk with your provider, feeling your provider cares about you and listens to you. Structural supports such as also being in mental health services, having systems for remembering appointments, and/or having appointment times that are convenient also facilitate seeking healthcare. Facilitating healthcare seeking also seems to involve a sense of agency—looking forward to taking charge of your health and feeling capable of following healthcare provider instructions. Healthcare systems for people with mental illness need to support these facilitators to give care-seekers the support they need. Key points are provided on how organizations and staff can work more effectively in implementing patient centered care. [ABSTRACT FROM PUBLISHER]

People with serious mental illness (SMI) have increased risk of cardiovascular disease and premature death, yet research on nurse-provided health promotion in mental health services remains under-developed. This paper informs efforts to improve the nursing role in physical health of consumers with SMI by establishing what nurse perceptions and background influence their care. Members of the Australian College of Mental Health Nursing were invited to participate in an online survey on their views on physical health care in mental health services. Survey questions included: (a) nurse-consumer collaboration in preventative care and (b) sub-sections of the Robson and Haddad Physical Health Attitude Scale to measure nurse perceived barriers to encouraging lifestyle change of consumers with SMI and frequency of nurse physical healthcare practices. Structural equation modelling was applied to investigate antecedents to physical health care, as well as relationships between antecedents. A national sample of 643 nurses reported regular engagement in health promotion (e.g. advice on diet). There was statistical support for a model depicting perceived consumer-nurse collaboration as a dual-determinant of nurse perceived barriers and self-reported health promotion to consumers with SMI. Perceived barriers to consumer lifestyle change did not predict health promotion. The effects of nurse-consumer collaboration were significant, but small. Perceived consumer-nurse collaboration in preventative care may positively influence the amount of health promotion by nurses in mental health. Perceived barriers to consumer adherence with a healthy lifestyle did not have an impact on nurse-delivered health promotion. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to report the longitudinal effects of the 'Teaching Kids to Cope with Anger' (TKC-A) program on self-reported anger in rural youth. Through a randomized controlled trial, 179 youths of 14-18 years of age, from three rural high schools, were randomized into a control ( n  =  86) and an intervention group ( n  =  93) for eight TKC-A weekly sessions. These students completed the STAXI-2 anger instrument questionnaires at baseline, post-intervention, 6 months, and at 1 year. T-test statistics were used to analyze and compare the control and intervention groups. Through analysis of the Anger Index sub-scale of the STAXI-2 at 1 year post-intervention, a significant difference was reported between the control and intervention group. Participants reported that the TKC-A intervention was helpful in coping with emotional, behavioral, and social aspects of anger. Future research may utilize the TKC-A with youth who have anger management problems. Psychiatric-mental health nurses can screen youth for anger and be cognizant of coping skills of youth, assess for anger problems and provide health education to youth about approaches for coping with anger. [ABSTRACT FROM AUTHOR]

Intimate partner violence affects one in three women worldwide, with women who experience violence almost twice as likely to experience poor mental health, especially depression, compared with women who are not abused. To learn the impact of interventions of safe shelter and justice services on improved mental health and behavior functioning, 300 abused women are interviewed every 4 months in a 7-year prospective study. For this paper, abuse, mental health and resiliency status of these women, 1 year after accessing services for the first time, are reported. Measures of mental health (depression, anxiety, post-traumatic stress disorder (PTSD), somatization), and adult behavioral functioning are reported. At 4 months following a shelter stay or justice services, a large effect size was measured for improvement in all mental health measures; however, improvement was the lowest for PTSD. All mental health measures plateaued at 4 months with minimum further improvement at 12 months. Both internal behavioral dysfunctions (withdrawal and somatic complaints) were worse with increased depressive symptoms, as were external behavioral dysfunctions (aggressive and rule-breaking behaviors). A concerning 39.2% of the women had clinical PTSD scores at 12 months following receipt of safe shelter or justice services, compared with a much lower percentage of women with clinical depression (14.2%), clinical somatization (9.4%), and clinical anxiety (13.5%). Depression was a significant positive predictor of internal and external behavioral dysfunctions, indicating that women who had higher levels of depression tended to report more internal dysfunctions (withdrawal, anxiety, somatization) and more external behaviors (aggression and rule-breaking). [ABSTRACT FROM AUTHOR]

The purpose of this paper was to describe romantic relationships from the perspective of urban, adolescent girls, to address gaps in our understanding of their relationship dimensions. Minority adolescent girls ( n  =  17) participated in private semi-structured interviews aimed to elicit the understanding of the adolescents' perspectives on their own relationship experiences and dynamics. The research team conducted conventional content analysis of the interview transcripts. Four major themes emerged about romantic relationships: (1) influence of male pursuit and social norms on relationship initiation factors; (2) a romantic partner is a confidant, friend, and companion; (3) negotiating intimacy respectfully; and (4) relationship conflict through control and abuse. Adolescents described sub-themes of social norms of male pursuit and relationship pressures that dictated relationship initiation. Relationships were depicted by emotional support, caring, and companionship. Adolescents described positive negotiation skills. However, relationship conflict, including controlling behaviors and violence, was illustrated in these same relationships. This study provides a rich description of romantic relationships from the perspectives of urban, adolescent girls. Most salient findings included social pressures and a combination of both positive and negative attributes. Implications include the need for intervention development at the community level to address social pressures, recognition of positive adolescent relationship attributes, and facilitation of skills to identify and address low-quality relationship characteristics. [ABSTRACT FROM AUTHOR]

This paper proposes a framework for assessing the unmet needs of rape survivors during pregnancy based on the Sexual Assault Nurse Examiner (SANE) practice level theory and an empirical exploration of rape survivors' health status in pregnancy via a secondary analysis. Our findings indicate that there may be unmet needs in pregnancy related to all five post-assault comprehensive care components: (1) physical care, (2) pregnancy prevention, (3) sexually transmitted infection screening, (4) psychological care, and (5) legal care. Rape history and its current impact on the survivor predicted somatic disorders, substance use, unwanted pregnancy, infections, posttraumatic stress disorder, and recent abuse. [ABSTRACT FROM AUTHOR]

The 49th World Health Assembly of the World Health Organization (WHO) declared violence as the leading worldwide public health problem with a focus on the increase in the incidence of injuries to women. Violence against women is an international epidemic with specific instruments required to measure the impact on women's functioning. This article describes the application of the Koci Marginality Index (KMI), a 5-item scale to measure marginality, to the baseline data of a seven-year prospective study of 300 abused women: 150 first time users of a shelter and 150 first time applicants for a protection order from the justice system. Validity and reliability of the Koci Marginality Index and its usefulness for best clinical practice and for policy decisions for abused women's health are discussed. The 49th World Health Assembly of the World Health Organization (WHO) declared violence as the leading worldwide public health problem and focused on the increase in the incidence of injuries to women (Krug et al., 2002). Violence against women in the form of intimate partner violence (IPV) is costly in terms of dollars and health. In the United States in 2003, estimated costs of IPV approached $8.3 billion (Centers for Disease Control and Prevention [CDC], 2011). Outcomes related to severity of IPV vary but in 2003 victims suffering severe IPV lost nearly 8 million days of paid work, and greater than 5 million days of household productivity annually (CDC, 2011). Besides the evident financial cost of IPV, research confirms that exposure to IPV impacts a woman's health immediately and in the long-term (Breiding, Black, & Ryan, 2008; Campbell, 2002; CDC, 2011). Such sequela adversely affect the health of women and may increase their marginalization, a concept akin to isolation that may further increase negative effects on health outcomes. Immigrant women are at high risk for IPV (Erez, 2002) and those without documentation are at higher risk for marginalization (Montalvo-Liendo, Koci, McFarlane, Nava, Gilroy, & Maddoux, 2012). This paper explores marginality with reference to IPV and the development and application of an instrument to measure marginality. [ABSTRACT FROM AUTHOR]

This paper reports on an investigation into the skills and competencies of forensic learning disability nurses in the United Kingdom. The two sample populations were forensic learning disability nurses from the high, medium, and low secure psychiatric services and non-forensic learning disability nurses from generic services. An information gathering schedule was used to collect the data; of 1200 schedules, 643 were returned for a response rate of 53.5%. The data identified the 'top ten' problems that forensic learning disability nurses may encounter, the skills and competencies necessary to overcome them, and the areas that need to be developed in the future. The results indicated that the forensic learning disability nurses tended to focus on the physical aspects to the role whilst the non-forensic learning disability nurses tended to perceive the forensic role in relational terms. This has implications for practice, policy, and procedures. [ABSTRACT FROM AUTHOR]

People with severe mental illness are dying up to thirty years earlier than the general population. The limited literature on their experience of dying indicates that they often suffer from inequities in their access to healthcare services, and further, what care they do receive is frequently poor. Living with both a mental illness and facing death can engender spiritual concerns and dying at a younger age is a risk factor for spiritual despair. Hence, addressing spiritual concerns can be an important dimension of mental health nursing care. The aim of this ethnographic study of 11 senior and experienced mental health nurses was to determine if the culture of the mental health service impacted their spiritual care for those patients who were facing death. The data highlighted that the nurses felt comfortable in providing spiritual care when the person was suffering from psychosis. Yet, the results also revealed that nurses felt disempowered by the dominance of the biomedical culture, in which they felt unable to articulate their care. However, it was identified that their spiritual care was inherent within the professional values, knowledge, and skills of mental health nursing and framed through their therapeutic relationships. Therefore, strategies need to be used by the organization to assist nurses to reclaim their power and assist the mental health service to further develop and engage in spiritual care practices. [ABSTRACT FROM AUTHOR]

Healthcare professionals caring for children with autism spectrum disorder are more likely to be emotionally and psychologically distressed because of the children's challenging behaviors. This study aimed to investigate whether social support mediates the association between coping strategies and perceived emotional and psychological distress among professionals working with children with autism spectrum disorder. Additionally, this study explored the moderating effect of autism severity on this mediation. The study's design is cross-sectional, correlational, and predictive. An online, self-administered questionnaire was used to recruit a convenience sample of 180 healthcare professionals working with children with autism spectrum disorder. The results revealed a significant mediation effect of family social support on the relationship between problem-focused coping and psychological distress for those dealing with moderate or severe autism. Likewise, there was also a significant mediation effect of family social support on the relationship between avoidant coping and psychological distress for those dealing with moderate autism. Familial social support can serve as a protective factor for healthcare professionals caring for children with autism against accumulated psychological distress. The direct effect of avoidant coping strategies on emotional distress changes depending on autism severity. The study's findings are informative to mental health nurses to create more effective coping strategies as problem-solving interventions or develop new coping strategies based on familial social support for those working with children with autism. [ABSTRACT FROM AUTHOR]

The purpose of this convergent mixed methods interprofessional education (IPE) pilot project was to help health profession students gain valuable insight about the experiences of people living with mental illness, to help them have a better understanding of person-centered care and have greater knowledge about the importance of interprofessional collaboration. A developmental workgroup which consisted of mental health consumers, four interdisciplinary students, and our team developed and implemented a virtual Mental Health World Café IPE event. Twelve other students attended the World Café event. A paired sample t-test was used to examine group differences between pre- and post-test scores for the Interprofessional Socialization and Valuing Scale and the Texas AHEC Survey measures among the four student leaders and the 12 student participants of the virtual Mental Health World Cafe. We conducted individual interviews with the four student leaders and collected reflective journals from the 12 students who attended the World Café event. We examined to what extent the statistically significant quantitative results supported the qualitative results separately for the student leaders and for the student participants of the virtual World Café. We also examined how both the quantitative and qualitative findings aligned with the key components of the Patient-Centered Care in Interprofessional Collaborative Practice Model. While the project allowed the students to reflect upon how they may apply the principles of person-centered care and interprofessional collaboration, the impact of the consumers on the student's experiences was profound and resulted in widespread engagement of the students who attended the event. [ABSTRACT FROM AUTHOR]

Developing therapeutic relationship skills as well as clinical skill confidence is critical for nursing students. While the nursing literature has examined multiple factors that influence student learning, little is known about the role of student motivation in skill development in non-traditional placement settings. Although therapeutic skills and clinical confidence are vital across a variety of contexts, here we focus on its development in mental health settings. The present study aimed to investigate whether the motivational profiles of nursing students varied with the learning associated with developing (1) a therapeutic relationship in mental health and (2) mental health clinical confidence. We examined students' self-determined motivation and skill development within an immersive, work-integrated learning experience. Undergraduate nursing students (n = 279) engaged in five-day mental health clinical placement, "Recovery Camp," as part of their studies. Data were collected via the Work Task Motivation Scale, Therapeutic Relationship Scale and the Mental Health Clinical Confidence Scale. Students were ranked into either high (top-third), moderate (mid-third) or low (bottom-third) motivation-level groups. These groups were compared for differences in Therapeutic Relationship and Mental Health Clinical Confidence scores. Students higher in motivation reported significantly higher therapeutic relationship skills (Positive Collaboration, p <.001; Emotional Difficulties, p <.01). Increased student motivation was also associated with greater clinical confidence compared to each lower-ranked motivation group (p ≤.05). Our findings show that student motivation plays a meaningful role in pre-registration learning. Non-traditional learning environments may be uniquely placed to influence student motivation and enhance learning outcomes. [ABSTRACT FROM AUTHOR]

The evidence supports use of a depression screening tool to increase screening completion in the adolescent population. Clinical guidelines include use of the PHQ-9 in the adolescent population (ages 12–18). PHQ-9 screenings are currently lacking in this primary care setting. The aim of this Quality Improvement Project was to improve depression screening in a primary care practice setting located in a rural Appalachian health system. An educational offering with pretest and posttest surveys and a perceived competency scale are utilized. Focus is added to the process and guideline used to complete depression screening. As a result of the QI Project, posttest assessment of knowledge relating to educational offering increased, and use of the screening tool increased by 12.9%. The findings support the importance of education on primary care provider practice and depression screening of adolescents. [ABSTRACT FROM AUTHOR]

People living with mental illness (consumers) often experience difficulty in achieving life goals, particularly those important for their recovery. An innovative approach to address consumers' goals for recovery can be found in the form of therapeutic recreation (TR) initiatives.Recovery Campis a five-day TR program, bringing together people with a serious mental illness, undergraduate health students, and staff members. This article aims to examine the types of goals set by consumers in the context ofRecovery Camp, and to what extent the self-identified goals were attained. The consumers (n  =  27) were invited to set goals that they wished to achieve during the week. On the final day ofRecovery Camp, each participant rated the degree to which they felt that each of their goals was achieved or not. The goals were themed using content analysis, revealing four key themes: connectedness, developing healthy habits, challenging oneself, and recovery. All goals were, to some extent, attained. The results suggest people with a mental illness are able to both set and evaluate the self-identified goals in the context of a TR initiative. A collaborative recovery approach indicates that goal planning should be undertaken in direct consultation with the consumer. [ABSTRACT FROM AUTHOR]

This study evaluates positive psychotherapy's effects on the well-being and psychiatric symptoms of people with psychosis. A systematic search was conducted using 10 electronic databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A meta-analysis was performed using the R 4.2.0 program to estimate the effect size. Seventeen studies were included in the systematic review and 14 in meta-analysis. Positive psychotherapy for people with psychosis had significant effects on subjective and psychological well-being and psychiatric symptoms. Further, country, age, and session were significant moderators. Thus, positive psychotherapy improves the well-being and psychiatric symptoms of people with psychosis. [ABSTRACT FROM AUTHOR]

While people with mental ill-health report unsatisfying experiences and poor treatment in general emergency departments, nursing staff report a lack of adequate knowledge and training. This study describes nursing staff's experiences caring for people with mental ill-health in general emergency departments. A qualitative descriptive design was used and 14 interviews were subjected to qualitative content analysis. Results show that nursing staff are dealing with uncertainty and competing priorities when caring for people with mental ill-health. Nursing staff must both take and be given the opportunity to maintain and develop confidence and independence and need support in promoting mental health recovery. [ABSTRACT FROM AUTHOR]

Social interaction and connectedness is important to the mental health and wellbeing of older people. The aim of this research study was to facilitate and increase opportunities for social connectedness for older people living in regional areas through the use of technology training. Weekly technology training sessions were conducted at a Seniors Citizen's Club with a peer trainer (an experienced, retired computer teacher) and sessions were attended not only by the six study participants, but also by other club members, with up to 15 club members participating in sessions. Data analysis involved all documents generated by the project, including the individual interviews, researcher observations of training sessions, reports from the peer trainer and weekly diaries maintained by participants. Findings demonstrated that computer training at the Senior Citizens Club helped participants build group cohesion and to form tiered connections with partners, family, and friends with whom they no longer live. When the trainer is seen as a peer, and training is person-centred, older people are more receptive to learning, exploring, and experimenting with technology. Although only six people were involved in the in-depth evaluation part of the study, voluntary training with the trainer in the absence of any funding continues even to this present time. The outcome of this research reinforces the potential for technology facilitated tiered connectivity to enhance the quality of life for older people living in regional and rural Australia. [ABSTRACT FROM PUBLISHER]

Evidence shows that reports of psychopathology symptoms by youth and their caregiver informants differ. To quantify youth-caregiver discrepancies in psychopathology symptoms and factors associated with such discrepancies, we investigated differences in how youth and their caregivers rated psychopathology symptoms. The sample (N = 5094) was extracted from the Philadelphia Neurodevelopmental Cohort, a community-based sample of youth and included participants ages 11-17 years old with both youth and caregiver reported symptom scores. Across psychopathology symptoms, youth-caregiver concordance was poor to fair (Cohens kappa for symptom items ranged between 0.03–0.41). Psychosis symptoms had the lowest concordance—Cohen's kappa ranged from 0.03 to 0.17 across psychosis symptoms. Discrepancies between youth and caregiver symptom reports were greater than average for Black youth and for youth of low socioeconomic status; discrepancies were also higher than average in youth with any psychiatric disorder when compared to typically developing youth. Network analysis of difference scores obtained by subtracting youth symptom scores from caregiver reported symptom scores showed that network connectivity (i.e., correlated difference scores) was sparsest for psychosis spectrum compared to other psychiatric disorders. Using a large sample, we show that youth and their caregiver informants tend to report psychopathology symptoms differently. Youth-caregiver discrepancies were the most pronounced for Black youth and youth of low socio-economic status. Race and socioeconomic status contribute to significant differences in how youth and their caregivers report such symptoms and are important factors that should be accounted for to facilitate accurate mental health symptom assessment and evaluation. [ABSTRACT FROM AUTHOR]

This research explores representations of non-suicidal self-injury (NSSI) on social media. The current study aims to examine the applicability of a functional model of NSSI to videos posted on YouTube by analyzing the 100 most viewed YouTube videos relating to NSSI at a point in time in 2018. Motivations for continued engagement in NSSI were examined for each content creator who posted one of the top 100 most viewed videos relating to NSSI. Categorizations of a content creator's motivation were based on Nock and Prinstein (2004) four-function model (FFM) of NSSI, in which the motivations, or functions, of NSSI are categorized by two dichotomous factors: (a) positive (i.e., involves the addition of a favorable stimulus) or negative (i.e., involves the removal of an aversive stimulus) and (b) automatic (i.e., intrapersonal) or social (i.e., interpersonal). Uploaders most endorsed automatic negative reinforcement (50%), followed by automatic positive (26%), social positive (3%), and social negative (3%). Considering the growing number of children and adolescents with near constant access to internet and social media, there may be implications for further development of safety measures for social media platforms. The results of this study may be valuable for parents, health care professionals, and educators, who should be aware of available social media content relating to NSSI and consider implementing additional media-literacy and media-safety education in school curriculums and programming for children and adolescents. Furthermore, health care professional should be aware that misconceptions of NSSI may have an impact on patients' willingness to seek treatment, or the attitude with which treatment is sought. [ABSTRACT FROM AUTHOR]

Although many psychometric assessments are used extensively in population-based research to determine psychopathology, these tools have not been thoroughly validated or appropriately adapted for use in diverse populations. Indeed, depression measurement studies among American Indian and female populations are scarce, omitting key opportunities to tailor psychological measurement for this population. To build psychometric evidence of measures in this population, we used a procedural method to examine a standard psychological instrument—the Center for Epidemiological Studies Depression Scale (CES-D)—with a community sample of southeast American Indian women. Our results showed strong psychometric reliability of the 20-item CES-D. The "effort" item presented diminished validity, as demonstrated by a negative counter-intuitive item-to-total correlation (ITC) value. Dropping the "effort" item resulted in a 19-item scale with a better fit in the within-group examination of community-based American Indian women. Compared to the 20-item CES-D scale, the revised 19-item measure ("effort" item removed) resulted in minimal changes to women's depression categories. However, we did detect patterns in shifts such that the 19-item scale generally underestimated (i.e., placed women in a lower category) depressive symptoms compared to the 20-item scale. Depending on their study goals, researchers engaging in population-based research should carefully weigh the use of original scales that allow for consistency in reporting with refined scales that fit psychometrically. We present the outlined method as a tool that expands on current approaches in scale refinement, and aids researchers in making more informed decisions regarding refined scales with diverse populations. [ABSTRACT FROM AUTHOR]

The purpose of the study was to investigate the moderating effect of resilience on the relationship between mindfulness, experiential avoidance, and posttraumatic stress disorder (PTSD) symptom severity. A cross-sectional study design was used on a sample of 133 college student military veterans. We found a direct effect of mindfulness on PTSD and a significant mediating effect of experiential avoidance on the relationship between mindfulness and PTSD. Resilience also had a significant moderating effect on the relationship between mindfulness and PTSD. This study provides preliminary evidence on the usefulness of integrating resilience development in mindfulness-based interventions for trauma-related disorders. [ABSTRACT FROM AUTHOR]

Patient-initiated brief admission (PIBA) was developed for patients with emotional instability and self-harm, to cope with crises. The hypothesis was that psychiatric symptoms would decrease, and health-related quality of life (HRQoL) increase, after 1–3 days at hospital. One hundred and thirteen patients were recruited from a psychiatric clinic in Stockholm during 2016–2020. At admission and discharge, the patients completed the Hospital Anxiety and Depression Scale (HADS) and the EuroQoL-5 Dimension Questionnaire (EQ-5D). The patients also evaluated PIBA as a crisis intervention. A significant decrease in symptoms of anxiety and depression was found. HRQoL increased significantly assessed with EQ-5D and 95.2% of the participants found PIBA to be a constructive intervention. [ABSTRACT FROM AUTHOR]

Interviews with 15 Tennessee Advanced Practice Registered Nurses early in the COVID-19 pandemic revealed a major theme of mental health challenges unrelated to the primary study purpose. Without direct prompts, 13 out of 15 interviewees mentioned mental health issues among patients and 14 of the 15 interviewees discussed provider mental health problems. A secondary analysis of interview transcripts revealed three themes associated with mental health challenges: general barriers to mental health care, patient-specific concerns, and provider issues. Responding to the new and worsening mental health and substance use disorders revealed by informants and cited in the literature is an urgent priority. [ABSTRACT FROM AUTHOR]

Women experienced traumatic childbirth talk about the lack of opportunity to express their worries and stresses. However, providing psychological support to reduce the long-term and severe consequences is essential. The present study aimed to determine the effect of supportive counseling on mother psychological reactions and mother-infant bonding following traumatic childbirth. This quasi experimental study was performed on 166 postpartum women with psychological birth trauma admitted to public hospitals in Arak, Iran. Postpartum bonding questionnaire was filled before hospital discharge. The women were randomly assigned into the intervention and control groups. The intervention group (n = 83) received individual supportive counseling for two in-person sessions before hospital discharge, and 10–15 days after delivery and a telephone consultation during 4–6 weeks after delivery. The data were collected using Edinburgh Postnatal Depression Scale, Post-Traumatic Stress Disorder checklist for DSM-5 (PCL-5), and the postpartum bonding questionnaire, after 2 months. The data were analyzed using SPSS21 software and chi-square, t-test, and ANCOVA were used. The mean score of postpartum depression (PPD) symptoms in the intervention group was significantly lower than that in the control group (MD: −13.40, 95% CI: −10.66 to −16.15, P < 0.001). The severity of the PTSD symptoms in the intervention group was significantly lower than that in the control group (MD: −6.37, 95% CI: −3.55 to −9.18, P = 0.04). The mean (SD) of mother-infant bonding after controlling the effect of baseline score indicated a significant difference between the two groups (MD: −7.82, 95% CI: −6.53 to −9.11, P < 0.001). The supportive counseling seems to be effective in reducing PPD and PTSD symptoms, and improving postpartum bonding after traumatic childbirth. The use of group supportive counseling with other time intervals and long follow-up period is recommended. Further, other intervention approaches should be used for preventing the progression of psychological birth trauma toward PTSD. [ABSTRACT FROM AUTHOR]

The aim of this research was to assess the psychological effects of the novel coronavirus disease (COVID-19) on mental health nurses. An internet-based questionnaire that included the Impact of Event Scale-Revised (IES-R) and the Zung Self Rating Anxiety Score (SAS) was used to assess the impact of the pandemic on the wellbeing of mental health nurses in an Irish mental health service. Among the nurses surveyed (n = 161), 12% of the participants had an overall IES-R score from 24 to 32 indicating that posttraumatic stress disorder (PTSD) was a clinical concern, while 38% had an overall IES-R score >32 indicating that PTSD was a probable diagnosis. The mean SAS score that had been converted to anxiety index scores was 40.78 (SD = 9.25). The results showed that 30% of mental health nurses experienced anxiety levels from moderate to extreme. Overall findings confirm that mental health nurses are experiencing psychological distress as a result of working during the COVID-19 pandemic. Nurses who were <30 years of age or who were in their current roles for less than a year or were ward-based and worked full-time, were most likely to be affected. Working during COVID-19 has not been routine work practice and for a cohort of workers who are already under pressure, the sacrifice in terms of general well-being has been immense. The offer of individualized psychological support for mental health nurses working during the pandemic should be both practical in nature and flexible enough to meet individual needs. [ABSTRACT FROM AUTHOR]

In the US, one in three older adults die with Alzheimer's disease or a related dementia. Currently, there is no cure for the rapidly growing burden, but there are pharmacological treatments to manage the symptoms, which lead to numerous side effects. We tested the effectiveness of a non-pharmacological therapeutic interactive pet (TIP) in improving mood/behavior and cognition among 12 persons with mild-moderate dementia attending an adult day center (ADC) over 12 visits. Mood/behavioral symptoms were assessed using the Alzheimer's Disease and Related Dementias Mood Scale (AD-RD), Observed Emotion Rating Scale (OERS), and the Cornell Scale for Depression in Dementia (CSDD). Cognition was assessed via Mini Mental State Examination (MMSE). Paired-sample t-tests, Pearson's correlation, repeated measures t-test, and a post-intervention qualitative inquiry were used to examine the significance of TIP. As a result, all mood scores improved over time, with two showing significance: OERS (M = 73.7/SD = 9.6); conditions t(11) = −19.18, p<.001, and CSDD (M = 8.8/SD = 7.2); conditions t(11) = 4.12, p =.002. Over half (0.67%) scored higher on the MMSE post-test than the pretest: M = 10.7(SD = 5.5) and M = 12.2(SD = 7.1), respectively. Participants stroked and spoke often to their pets. Several family members reported participants sleeping with their pet following the program's conclusion. TIP proved to be a safe alternative method to improving mood/behavior in persons with dementia attending an ADC. MMSE scores also improved, although confounding factors such as inter-rater reliability and a potential endorphin effect may have impacted scores. Improving Behavioral and Psychological Symptoms and Cognitive Status of Participants with Dementia through the Use of Therapeutic Interactive Pets [ABSTRACT FROM AUTHOR]

We investigated the effects of increasing physical activity (PA) and reducing sedentary behaviour (SB) of mental health professionals on their attitudes towards and practices in recommending more PA and less SB to their clients. A 4-week pre-post intervention trial was conducted involving 17 mental health professionals. The participants who increased their own physical activity during the intervention increased the frequency of recommending more PA (p = 0.009) and less SB (p = 0.005) to their clients. A relatively simple, low-cost intervention, consisting of group behaviour change counselling, goal setting and positive feedback, may improve the practices of mental health professionals. Supplemental data for this article is available online at https://doi.org/10.1080/01612840.2021.1972189. [ABSTRACT FROM AUTHOR]

This study aims to determine the prevalence of and risk factors for intimate partner violence (IPV) during the COVID‐19 pandemic. The cross-sectional study was conducted with 1,036 women in Turkey who were either married or had an intimate partner. The data were collected between June 20 and July 10, 2020. Experience of any form of IPV (physical (10.1%), sexual (4.0%), psychological (32.2%) or economic (11.5%) was reported by 35.5% of the participants. Regression analyses revealed that exposure to IPV during the pandemic was significantly associated with being married, having children, unemployment, poor marital/relationship satisfaction, an increased workload in the household and the negative effect of quarantine on mood (p < 0.05). Educational programs need to be prepared for the prevention of IPV during the COVID-19 pandemic and for the acquisition of protective behaviors toward women victims of IPV. [ABSTRACT FROM AUTHOR]

Mental health care professionals are at risk of experiencing burnout. This cross-sectional study aims to investigate burnout in two settings: open and closed psychiatric wards, and two professions: registered nurses and social healthcare assistants in eight psychiatric wards in Denmark. A total of 114 professionals completed the Copenhagen Burnout Inventory and a demographic questionnaire. No statistically differences in burnout in professionals working in closed and open wards were found. However, we found professionals to score highest on personal and work-related burnout and lowest on client-related burnout. This indicates that patients may only play a minor role in burnout in health professionals. [ABSTRACT FROM AUTHOR]

Self-harm is a global public health concern in terms of increasing morbidity in addition to causing considerable financial implications for the health sector. Patients presenting with a history of self-harm are at increased risk of self-harm repetition and suicide. Research exploring the patient's experience of engaging in multiple self-harm episodes is lacking. This study aimed to explore the experiences and meaning of self-harm repetition, among patients who presented to three urban hospital emergency departments in Ireland. A subset of participants with a history of five or more self-harm attempts from an ongoing study, 'Improving Prediction and Risk Assessment of Self-Harm and Suicide' was selected for this article. Interview transcripts from four participants were selected for analysis using Interpretative Phenomenological Analysis. The qualitative software package NVivo 11 was used to store and organise data into themes. Data were analysed based on four participants (two males and two females) ranging in age from 25 to 56 years. Three of the four participants reported a history of early traumatic emotional, physical and sexual abuse. Four superordinate themes were generated from the data, 'Significance of self-harm to the person', 'Trajectory of self-harm progression', 'Impact of abuse in adult life' and 'The road to recovery'. Self-harm was used as a coping mechanism for participants who experienced distressing life events such as emotional and sexual abuse. The qualitative themes identified in this study have implications for the development of adequate medical and mental health support systems for patients with histories of repeated self-harm. [ABSTRACT FROM AUTHOR]

This study aimed to develop and evaluate the effects of a Salutogenic program on sense of coherence, depression, and suicidal ideation among rural older adults. Quasi-experimental, nonequivalent control group pretest-posttest design was used. Participants were female, aged 65 years and older from G and O province, South Korea. The experimental group (n = 22) received a 12-session Salutogenic program for 6 weeks, twice a week. The control group (n = 19) was put on a waiting list to receive the intervention after completing the study. Collected data were analyzed using descriptive statistics, a χ2 test, independent t-test, and repeated measure ANOVA with SPSS WIN 26.0. There were significant differences in sense of coherence (F = 19.34, p <.001), depression (F = 12.93, p <.001), and suicidal ideation (F = 4.40, p =.027) over time pretest, posttest, and follow-up test after intervention between two groups. The study discussed the effect of Salutogenic program on sense of coherence, depression, and suicidal ideation, and considered its benefits in suicide prevention for elderly women. The Salutogenic program can be recommended as useful strategies to enhance sense of coherence and to reduce depression and suicidal ideation of elderly women in community. [ABSTRACT FROM AUTHOR]

This study evaluated the risk posed by attachment type in the development of anxiety or depression symptomatology in Mexican adults. This was case-control study in which anxiety and depression symptomatology levels were compared according to the attachment type reported by 3,666 participants. It was found that insecure attachment is a risk factor (p≤.001) for the development of severe levels of depression (OR = 2.12, CI 95%: 1.66–2.70) and anxiety symptomatology (OR = 1.52, 95% CI: 1.30–1.77). Findings are discussed based on their implications for psychiatric nursing practice. The findings of this study enable nurses to consider the empirical validity of attachment theory for studying psychosocial aspects of mental health and to design intervention strategies that promote secure attachment in populations without psychiatric diagnoses to prevent anxiety and depression symptomatology. [ABSTRACT FROM AUTHOR]

Opioid use disorder is a growing public health concern in South Texas. To assist in mitigating the effects of this epidemic, staff produced a program that focused on replicating, modifying, and evaluating the impact of the "Opioid Addiction Treatment ECHO™ (Extension of Community Health Outcomes) for CHWs (community health workers) program" on 26 CHWs practicing in rural and other medically underserved areas through teleconferencing technology. CHWs trained on the topic of substance use disorder concentrated on behavioral health integration with a focus on opioid prescription misuse. The analysis found that knowledge attainment was increased above the pretest means. The ECHO™ model proved to be effective at linking subject matter experts and specialists at an academic "hub" with CHWs in local communities. [ABSTRACT FROM AUTHOR]

This case-controlled study determined the utility of the READMIT index to identify the risk for 30-day readmission of patients discharged from an urban community hospital psychiatric inpatient unit. Data was collected from 118 matched patient pairs from 2017 to 2018. Findings demonstrated the READMIT index did not effectively discriminate those patients who were likely to readmit within 30 days. However, the following factors were associated with likelihood of 30-day readmission: the inability to care for self, number of lifetime readmissions, the comorbidity of liver disease, as well as a history of substance abuse. [ABSTRACT FROM AUTHOR]