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Accessible Summary: What is known on the subject?: The term 'complex emotional needs' (CEN) is used here to describe people with difficulties and needs that are often associated with the diagnostic label of 'personality disorder'.People with CEN might use out of hours services such as emergency departments and Crisis Resolution/Home Treatment (CRHT) teams more often when experiencing a mental health crisis.Very little is understood about the experiences of both those receiving, and those delivering care, for people with CEN within CRHT settings. What this paper adds to existing knowledge?: There are differences between priorities for those delivering and those receiving care within CRHT settings. CRHT staff members are likely to focus more upon those aspects of their role relating to risk issues. managing resources, anxieties and the expectations of others. Service users, meanwhile, focus upon the caring relationship, wanting staff to listen to them, and to feel supported and reassured.In the papers reviewed, service users experiencing CEN did not always feel 'listened to' or 'taken seriously' especially in relation to risk issues and decision‐making. What are the implications for practice?: Relating the findings to mental health nursing and CEN within the context of CRHT, to better understand the person experiencing a mental health crisis, mental health nurses need to focus more upon the person and when making decisions around their care and must be aware of the potential for power imbalances.Collaborative 'sense‐making' in relation to a person's risk behaviours may help. Background: A growing body of qualitative evidence focusing upon the experiences of care within Crisis Resolution/Home Treatment (CRHT) is emerging; however, a firm evidence base regarding both the giving and receiving of care for those with complex emotional needs (CEN) in this context is yet to be established. Objective: A qualitative evidence synthesis was used to develop a comprehensive understanding of how crisis care for people with CEN is experienced by both those giving and receiving care, within the context of CRHT. Method: Findings from 19 research papers considering both clinician and service users' experiential accounts of CRHT were synthesised using meta‐ethnography. Findings: Both the giving and receiving of care within a CRHT context was experienced across four related meta‐themes: 'contextual', 'functional', 'relational' and 'decisional'. Discussion: Service user accounts focused upon relational aspects, highlighting a significance to their experience of care. Meanwhile, clinicians focused more upon contextual issues linked to the management of organisational anxieties and resources. For those with CEN, a clinician's focus upon risk alone highlighted power differentials in the caring relationship. Conclusions: There is a need for nurses to connect with the experience of the person in crisis, ensuring a better balance between contextual issues and relational working. [ABSTRACT FROM AUTHOR]

Accessible summary This paper aims to do two things: First, we want to show the reader how to critique a published research paper. The second aim is to take the reader through the various stages of critiquing using a guide., In the paper, we explain at each stage the research terms that can deter the novice critic from reading and understanding the findings in research., From this we hope the reader will have developed an ability to do their own critiquing, so that they are better informed about the quality of research that influences nursing practice., Abstract In this paper we have taken a previously published paper on the effectiveness of clinical supervision and undertaken a systematic critique of the merits of this quantitative research using a recognized critiquing framework compiled by Coughlan et al. (2007). Our purpose was twofold: First, we wanted to demonstrate the various stages of critiquing a paper in order that the reader might make an informed judgment of the quality and relevance of the research. The reader/critic is then able to decide whether to use this research in their own practice. Second, we wanted to assist the reader to develop their own critical, analytical skills through methodically appraising the merits of published research. Nursing as an evidence-based profession requires nurses at both pre- and post-registration level to be able to understand, synthesize and critique research, this being a fundamental part of many nursing curricula. These have become core skills to acquire because implementing up-to-date evidence is the cornerstone of contemporary nursing practice. We have provided in this paper a template for critiquing, which is based on our combined experiences as academics specifically in teaching at the bachelor, master's and doctoral levels. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Open Dialogue was developed in Finland in the 1980s by clinical psychologist, Jaakko Seikkula. It is a development of family therapy, recognises previous trauma and has proven to be very effective in situations of acute mental illness, and in particular psychosis.Trauma Informed Care is a practice based on the understanding of and responsiveness to the impact of trauma. When people have experienced trauma, they may have difficulties in their everyday life and experience negative physical health outcomes as well as the risk of developing mental ill health.Open Dialogue is aligned to mental health care which aims to be trauma‐informed, person‐centred and rights‐based. Examples exist of the use of both approaches for service delivery with limited evaluation. What the paper adds to existing knowledge?: To our knowledge, no formal evaluation has been made of the use of open dialogue as a Trauma Informed therapy approach to support individuals and their family networks.Although both approaches recognise the impact of trauma on individuals, no study has explored the effectiveness of this treatment combination for use by mental health nurses.This review is timely as it provides insights into contemporary services that are trauma informed and have used Open Dialogue to extend therapy work with individuals and their family/networks.This scoping review was able to determine whether recommendations for clinical practice and training in Open Dialogue with Trauma Informed Care approaches could be identified. What are the implications for practice?: This review provided a broad overview on the current types of trauma‐informed care services incorporating Open Dialogue approaches into their practice.The literature, though sparce, identifies that Trauma Informed Care recognises multiple origins for mental ill health. Open dialogue has an affinity with the common values of mental health nurses. As combined therapies, they are demonstrating usefulness in engaging families and people in their journey towards recovery.Rigid adherence to Open Dialogue focus and delivery as well as training practices could be revised to make them more open to what people and their families wish to discuss. The person with mental ill health and previous trauma should be able to direct the narrative. Trauma Informed Practice principles could be adapted to improve consumer satisfaction with Open Dialogue approaches. Introduction: A large proportion of people who access mental health services have a lived experienced of trauma and are more likely to have a history of complex trauma. Open Dialogue and Trauma Informed Care practices identify previous trauma as a factor related to later psychosis. This scoping review has identified similarities and contrasts in how an Open Dialogue and Trauma Informed Care approach have been combined to complement one another for clinical work with people presenting with psychosis and previous trauma. Aim: We aimed to answer the following research question in this scoping review: What is known of the combined use of Open Dialogue and Trauma Informed Care practice when working with consumers and their family networks? As such, the purpose of this paper was to explore the application to practice and identify if any training existed and been evaluated. Method: This scoping review was based on the Arksey and O'Malley's framework. A comprehensive search was performed across five electronic databases. Grey literature was also searched through Psyche Info and Google Scholar for books, Dissertation and Theses, alongside hand searching of the reference of the studies. Articles searched was from January 2013 to January 2023. Results: Five distinct themes were identified from the literature: (1) Linking open dialogue with trauma, (2) Response to treatment, (3) Empowerment and information sharing, (4) Interpretation by clinical services, (5) Staff training outcomes. Discussion: Some tentative recommendations for practice recognised the individuals' unique story and perspective, suggested that trauma is an important concept to assess. Services practising as Trauma Informed Services that have incorporated an Open Dialogue approach have mixed experiences. The use of Open Dialogue may have some benefits for family work and exploring consumer narratives while building a network of support. However, consumers identified similar frustrations with service delivery as with the family therapy literature. For example, it was difficult to bring family members together and difficult to discuss previous traumatic events in front of family. People experiencing training in Open Dialogue reported it taking a slow pace and not what they were familiar with. Implications for Practice: Open Dialogue can facilitate engagement of consumers and their family networks and greater recognition of the peer workforce to promote collaboration in therapy is needed. Future research should also focus on evaluating the effectiveness of such services and comparing their outcomes across regions. [ABSTRACT FROM AUTHOR]

This paper is the second in a series of two which reviews the current UK evidence base for recovery in mental health. As outlined in the previous paper, over the last 4 years a vast amount has written about recovery in mental health (approximately 60% of all articles). Whereas the first review focused on the peer-reviewed evidence; this paper specifically focuses on the grey/non-peer-reviewed literature. In total, our search strategy yielded the following: 3 books, a further 11 book chapters, 12 papers, 6 policy documents and 3 publications from voluntary sector organizations. Each group of publications was analysed for content, and they are discursively presented by publication group. The findings are then presented as themes in the discussion section. The themes are: social, historical and political critique; philosophy of hope for the individual; individual identity and narrative; models and guidance for mental health practice.We conclude that there is a need for both empirical research into recovery and a clearer theoretical exposition of the concept. [ABSTRACT FROM AUTHOR]

This paper is the first in a series of two which reviews the contemporary British evidence-base relating to recovery in mental health over a 4-year period. This review uses a systematic approach analysing the British peer-reviewed literature relating to recovery and mental health. The second paper in the series reviews the non-peerreviewed literature. Recovery is not a new concept; however, it has recently become increasingly prevalent in practitioner, policy and research discourses. In total 12 papers met the inclusion criteria. Five main themes emerged from the analysis: hope and optimism, meaning to life, activities promoting recovery, definitions and discourses and implications for mental health practice. By including only peer-reviewed literature this paper is in a strong position to analyse the theoretical development of the recovery concept and highlight future directions for recovery in mental health services. [ABSTRACT FROM AUTHOR]

Accessible summary • Mental Health and Social Exclusion, published by the Department of Health in 2004, suggested that mental health practitioners may be contributing to the social exclusion of people with mental health problems. •Social exclusion can be defined as people not being involved in different areas of life and their community, e.g. being unemployed and having a limited social network. This is more commonly experienced by people who are perceived to be ‘different’, e.g. people who use mental health services. •Despite there being links between social exclusion and mental health problems getting worse, there is very little research on this issue. The authors suggest that there are many factors which mean that mental health practitioners may contribute to social exclusion, including stigma and restrictive practices. •This paper discusses the relationship between social exclusion and mental health practitioners. The authors argue from the perspective of valuing the lived experiences of people with mental health problems. The authors believe that social inclusion is an important pathway to recovery in relation to mental health problems. Over the last 10 years, the social inclusion agenda has been gaining momentum as a policy driver in mental health services. Prior to the seminal Social Exclusion Unit (SEU) report, Mental Health and Social Exclusion, there was a lack of awareness concerning the pervasive links between social exclusion and mental health problems. In the report, the SEU suggested that mental health practitioners themselves may actually be contributing to this social exclusion. This finding has been given limited coverage in both social inclusion literature and research. The current paper is a positioned commentary further exploring the relationship between practitioners and the social exclusion of mental health service users. A literature review was conducted in order to identify themes among factors which appear to moderate and contribute to this relationship. These factors are presented and implications for inclusive practice are explored. [ABSTRACT FROM AUTHOR]

The purpose of this discussion paper is to explore the existing literature from Canada on transitioning from military to civilian life for veterans of recent deployments. A number of topics relating to the transition experience emerged: interpersonal readjustment, emotional including mental health needs, school needs, and social needs. Implications for nursing will be discussed in terms of veterans as a cultural group and culturally competent nursing care. Recommendations for future nursing research include how well current services are meeting the needs of the younger, more recent veterans transitioning to civilian life; conducting longitudinal studies on the impact of transitioning to civilian life for veterans and their families; comparing the transition experience at an international level; developing a transition model that situates the veteran culture as the overarching framework for testing and understanding the experience of transitioning to civilian life. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: It was previously reported that perceived external locus of control may exacerbate depressive symptoms, is associated with anxiety, boosts stress and general mental distress and weakens resilience against traumatic situations or difficulties. What the paper adds to existing knowledge?: Those with a higher external locus of control are more prone to develop PTSD symptoms since the perceived external locus of control is among the predictors of PTSD. An internal locus of control is considered important in preventing PTSD, although an external locus of control appears to be a variable that causes/increases the prevalence of PTSD. What are the implications for practice?: It is known that nurses are deployed in clinical and fieldwork during disaster and assume key roles both interventional practices and psychosocial education. Thus, it is of particular importance for mental health nurses to be aware of the locus of control in themselves, their colleagues, and the community before, during and after disasters to be able to combat the risk/presence of PTSD. Aim: The present systematic review explored the impacts of perceived locus of control on PTSD among individuals experiencing disasters. Method: This is a systematic review study carried out through a search of the relevant research published in English over the period December 2021 to April 2022. Accordingly, we sought the studies to review on the Web of Science, PubMed, Scopus, Cochrane and Google Scholar databases using the keywords "Child, Children, Adolescent, Adolescence, Adult, Aged, Elderly, Post‐Traumatic Stress Disorder, PTSD, Internal‐External Control, Locus of Control, Disasters, Natural Disasters." Results: A total of 1.011 studies were found in the five databases using the keywords above. Following the exclusions, the remaining six studies were recruited for this systematic review. The six studies in question addressed earthquakes (2), hurricanes (1), wildfires (1), SARS (1) and fireworks explosions (1). In the study with wildfire survivors, there was a weak significant association between external locus of control and PTSD among those directly exposed to the disaster (r =.15, p <.01). The study with survivors of the SARS epidemic demonstrated that those with a high perceived chance (external) locus of control suffered PTSD (p =.001). An internal locus of control is considered important in preventing PTSD, although an external locus of control appears to be a variable that causes/increases the prevalence of PTSD. Conclusion: It was concluded that perceived locus of control is related to PTSD in individuals experiencing a disaster. The additional evidence was that post‐disaster PTSD among those with a high perceived external locus of control is stronger than those with a high perceived internal locus of control. [ABSTRACT FROM AUTHOR]

The article discusses a study conducted in Great Britain on culture-bound syndromes in mental health. According to the author, mental health services are sometimes accused of not being culturally competent, culturally insensitive or perform culturally inappropriate care since they fail to understand the patient within their own terms. It is important to integrate culture within the diagnostic category since evidence exists that physical/biological differences in illness occur cross-culturally.

Accessible Summary: What is known on the subject?: There is evidence that social isolation and loneliness is more prevalent in people living with mental illness than in the general population.People living with mental illness frequently experience stigma, discrimination, rejection, repeated psychiatric admissions, low self‐esteem, low self‐efficacy, and increased symptoms of paranoia, depression, and anxiety.There is evidence of common interventions that can be used to improve loneliness and social isolation such as psychosocial skills training and cognitive group therapy. What the paper adds to existing knowledge?: This paper offers a comprehensive assessment of the evidence between mental illness, loneliness, and recovery.The results suggest that people living with mental illness experience elevated levels of social isolation and loneliness leading to poor recovery and quality of life.Social deprivation, social integration and romantic loneliness are related to loneliness, poor recovery, and reduced quality of life.A sense of belonging, ability to trust and hope are important aspects of improved loneliness, quality of life and recovery. What are the implications for practice?: The existing culture in mental health nursing practice needs to be examined to address loneliness in people living with mental illness and its impact on recovery.Existing tools to research loneliness do not consider dimensions in loneliness experience as reflected in the literature.Practice needs to demonstrate an integrated approach to recovery, optimal service delivery and augmentation of evidence‐based clinical practice to improve individual's loneliness, social circumstances, and relationships.Practice needs to demonstrate nursing knowledge in caring for people living with mental illness experiencing loneliness.Further longitudinal research is required to clearly understand the relationship between loneliness, mental illness, and recovery. Introduction: To our knowledge, there are no previous reviews on the impact of loneliness experienced by people aged 18–65, who are living with mental illness and their recovery experience. Aim/Question: To explore the experience and impact of loneliness in people living with mental illness during recovery. Method: An integrative review. Results: A total of 17 papers met the inclusion criteria. The search was conducted using four electronic databases: MEDLINE, CINAHL, Scopus and PsycINFO. Across these 17 papers, participants were most commonly, diagnosed with schizophrenia or psychotic disorders and recruited from community mental health services. Discussion: The review revealed loneliness to be substantial in people living with mental illness and that loneliness affected their recovery, and their quality of life. The review identified many factors that contribute to loneliness including unemployment, financial strain, social deprivation, group housing, internalized stigma and mental illness symptoms. Individual factors such as social/community integration and social network size as well as an inability to trust, a sense of not belonging, hopelessness and lack of romance were also evident. Interventions targeting social functioning skills and social connectedness were found to improve social isolation and loneliness. Implications for Practice: It is vital for mental health nursing practice to employ an approach integrating physical health as well as social recovery needs, optimal service delivery and augmentation of evidence‐based clinical practice to improve loneliness, recovery, and quality of life. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Inpatient mental health settings pose unique challenges for patient safety, in part because psychiatric disorders are well‐known risk factors for self‐harm and suicide.Ward staff follow protocols to try and keep patients safe including carrying out in‐person safety checks, usually every 15 min, but patients unfortunately still find opportunities to harm themselves.A vision‐based patient monitoring system (VBPMS) is a contact‐free technology that can help mental health nurses to monitor patients in hospital more effectively. For example, the tool alerts staff to situations where a patient might need assistance, like when they spend a long period of time in their ensuite bathroom.Research has shown that the VBPMS can support staff to prevent safety incidents from occurring and a recent study found a decrease in self‐harm after the tool was implemented at one NHS mental health trust. What does the paper add to existing knowledge?: This paper presents data from five NHS mental health trusts and suggests that the VBPMS can consistently help staff to prevent self‐harm on acute mental health wards. What are the implications for practice?: Managing self‐harm behaviours is a challenge for mental health nursing staff. Standard safety protocols are not effective enough – staff need new ways to monitor patients.In general hospitals, technology is used every day to support care. This research shows that the VBPMS can be used to improve patient safety in mental health hospitals. Introduction: Self‐harm is sadly relatively common in mental health inpatient settings, and the effectiveness and appropriateness of strategies used to prevent it have long been disputed. The use of vision‐based patient monitoring systems (VBPMS) has been shown to improve various safety outcomes. Their potential to support staff in preventing inpatient self‐harm warrants further exploration. Aim: This research investigated whether implementing a VBPMS—as an adjunct to existing clinical practice—within acute inpatient services at five NHS England mental health trusts led to reductions in self‐harm. Method: Five quasi‐experimental studies assessed the number of bedroom self‐harm incidents, across 12 adult wards, before and 5–12 months after a VBPMS was deployed. Percentage changes were calculated. Four studies used control groups and were included in a fixed‐effect meta‐analysis. Results: In the meta‐analysis, a significant inverse‐weighted average relative risk percentage change of −38.9% was recorded. For the study with no control groups, reductions in self‐harm were seen across all wards (range: −9.1% to −29.8%). Discussion: This research demonstrates that VBPMS can support clinicians to create safer ward environments by preventing incidents of self‐harm from occurring. Implications for Practice: The results provide preliminary support for wider rollout of the technology on acute mental health wards. [ABSTRACT FROM AUTHOR]

Introduction: People with a borderline personality disorder (BPD) diagnosis or symptoms may experience emotional crises which necessitate use of the emergency department (ED). No existing reviews focus specifically on experiences of consumersa, carersb and clinicians in relation to ED presentations by people diagnosed with BPD. Aim/Question: The aim of this study was to synthesise knowledge on consumer, carer and clinician experiences of BPD in the ED. Method: An integrative review methodology was chosen as it best captures the complexity of varied perspectives and emergent phenomena from diverse literature sources. EMBASE, CINAHL, PsycInfo and Medline were searched for papers published before 16 February 2022. Results: Nine papers met the inclusion criteria (five qualitative, one quantitative, one mixed methods and two letters to the editor). Key themes were barriers to timely and adequate care, and stigmatising attitudes and practices towards people diagnosed with BPD. Negative attitudes were perceived to perpetuate harmful outcomes and further ED visits. Discussion: Predominantly negative ED experiences were expressed by clinicians, consumers and carers. Further work is needed in ED models of care and staff education to improve the experience of care for consumers, carers and clinicians alike. Implications for Practice: Opportunities for change will exist through co‐designed innovation, education, advocacy and leadership. [ABSTRACT FROM AUTHOR]

Accessible Summary: What Is Known about the Subject?: One in five mothers and birthing parents are affected by postpartum depression (PPD), yet only a small proportion of those with PPD receive treatment.Given cost and accessibility barriers to treatment, brief therapies (e.g. 1 day) could help address PPD on a large scale, though understanding participants' unique experiences with this novel treatment will help guide its refinement and use. What this Paper Adds to Existing Knowledge?: This paper describes the experiences, perspectives and satisfaction of participants who attended a 1‐day workshop for PPD.Participants appreciate being taught practical techniques and the receipt of social support from facilitators and other attendees in the group setting, while some recommended further 'booster sessions' to enhance effectiveness. What Are the Implications for Practice?: One‐day CBT‐based workshops may be an effective, low‐intensity treatment option that provides helpful skills and builds social networks for individuals with PPD.Additional post‐workshop booster sessions may enhance participant satisfaction with this new treatment by providing a reinforcement of their learning and an opportunity to re‐connect with other birthing parents. Introduction: Postpartum depression (PPD) affects up to one in five mothers and birthing parents. Understanding their perceptions of therapeutic interventions is key to their effectiveness and scalability. Aim: The aim of the study was to understand participants' experiences attending an in‐person or online 1‐day cognitive behavioural therapy (CBT)‐based workshop for PPD and compare their experiences participating in either modality. Method: This descriptive qualitative study was embedded in two separate randomized controlled trials evaluating the effectiveness of 1‐day CBT‐based workshops for PPD delivered in‐person or online. Responses were provided by 94 in‐person and 95 online participants about their experiences. Content analysis was used to code and categorize the data. Results: Participants appreciated learning skills to improve PPD symptoms and joining a community of individuals with shared experiences. Integrating practical coping techniques after the workshop was reported to be most useful, though some wanted additional post‐workshop support. Online participants identified additional barriers to workshop engagement. Discussion: Participants who attended either workshop found them to be valuable and effective. Participants valued psychoeducation, social connections and applying practical CBT techniques. Implications for Practice: One‐day CBT‐based workshops may be an accessible treatment option for individuals with PPD, providing new skills and social support, though some prefer to receive additional post‐workshop support. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the topic?: Mental health‐related problems in pregnancy are now becoming a global health concern. However, most studies have reported that midwives are unable to assess and support maternal mothers due to poor preservice education. The findings of these studies needed to be explored further from the available literature to address the gap. What does the paper add to existing knowledge?: The paper has identified maternal mental health core competencies and innovative clinical teaching strategies that nurse educators can utilize when supporting students theoretically and during clinical practice so that students should be adequately prepared for maternal mental health practice.Challenges and recommendations for clinical teaching were also identified. However, there are still gaps in the literature related to the effectiveness of teaching strategies to promote competence acquisition in maternal mental health. What are the implications for education?: The study results can be used by nurse educators to develop effective clinical teaching practices in maternal mental health care. The findings can be used in the development of best clinical teaching guidelines for maternal or perinatal mental health to be used by nurse educators for the undergraduate midwifery training programmes. Introduction: Maternal mental health problems are commonly experienced by women; however, they are usually not adequately recognized and treated by midwives in Malawi. Evidence suggests poor preservice education by nursing colleges which affects the development of essential maternal mental health competencies. Aim: The aim of the study was to review existing evidence on clinical teaching practices by nurse educators in teaching student midwives maternal mental health care. Method: Integrative review method was used, and various databases were searched. Out of 1768 articles, 27 research articles met the inclusion criteria. The critical appraisal skills programme checklist tools were used to assess data quality. Thematic analysis was done by comparing, grouping and integrating data. Results: Six themes emerged, namely: core maternal mental health competencies, professional regulation, interactive teaching strategies, collaborative partnerships, capacity building and shortage of resources. Discussion: Clinical teaching is an important aspect of midwifery education. Utilizing student‐centred teaching approaches helps students acquire competencies in maternal mental health care. Further research is required to identify the effectiveness of the clinical teaching methods. The Implication to Practice: The study results can assist nurse educators to provide comprehensive clinical teaching practices in maternal mental health care which will aid in the development of maternal mental health competencies among student midwives. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Peer research methodologies and methods are increasingly used in research, particularly to benefit from lived experiences.The experiences of peer researchers with severe mental illness are less common, including the impact on them of conducting peer‐led research. What the paper adds to existing knowledge: This paper shares the experience of peer research and suggests in the context of food insecurity, that it is not well understood by some healthcare professionals. What are the implications for practice: Implications include considerations around trauma‐informed care and the need for screening for food insecurity in mental healthcare settings. Research implications include providing training for peer research and needing to consider longevity of peer researcher relationships. Introduction: Food insecurity means that a person does not have access to sufficient nutritious food for normal growth and health. This can lead to health problems such as obesity, heart disease, diabetes and other long term chronic health conditions. People living with a severe mental illness are more likely to experience food insecurity than people without a severe mental illness. Aim: The aim of this paper is to present a lived experience narrative of two peer researchers. Peer researchers conducted interviews with adults with severe mental illness from Northern England as part of a funded research project. These interviews discussed experiences of food insecurity and strategies to tackle it and were conducted between March and December 2022. Thesis: The following paper does not discuss the results of the interviews themselves. Rather the narrative begins with an overview of peer research, before sharing the experiences of the two peer researchers in undertaking this project. Implications for Practice: This includes healthcare professionals understanding food insecurity, what it is and what it is not, thinking about trauma‐informed care, and screening for food insecurity. Peer research implications centre on adequate support and training, considerations to longevity of peer research relationships and reducing unnecessary research burden for peer researchers. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: We know that there are similar rates of borderline personality disorder (BPD) diagnosed in both men and women; however, some research suggests that BPD is diagnosed later and less frequently in men. Some research suggests that males diagnosed with BPD present differently to women, but not much is known about how this influences the care men receive in inpatient mental health hospitals. What the paper adds to existing knowledge?: This paper is the first to specifically ask inpatient staff about men diagnosed with BPD, and to hear about their perceptions and experiences.It identified that some staff do not feel as knowledgeable in identifying and treating BPD in men compared to women. Some staff talked about how emotional difficulties like BPD are often not the first thought when men present with distress compared to women. Staff also talked about needing a safe, open and transparent working culture to be able to ask questions and to be questioned on their own assumptions, biases or lack of training. What are the implications for practice?: This paper suggests that inpatient staff may hold some assumptions about men and their emotions, such as assuming that they are less likely to struggle with emotional difficulties like BPD. Staff anxieties about risk management may influence how they perceive and care for men in inpatient wards. The findings suggest that male‐specific training in identifying and treating BPD should be provided for staff on inpatient wards, to improve knowledge and confidence. Introduction: Research highlights discrepancies in recognition of borderline personality disorder (BPD) in men, despite similar rates of prevalence across genders. Aim: To investigate inpatient mental health professionals' experiences of delivering treatment for males with a diagnosis of BPD. Method: Six mental health professionals working within adult acute inpatient wards completed a semi‐structured interview. All participants were members of the nursing team. Thematic analysis was used to analyse the data. Results: Five themes were identified: Gender Differences, Stereotyping, Facilitators to Care Delivery, Barriers to Care Delivery and Ways to Improve Care. Participants talked of a lack of awareness and understanding of BPD in males impacting both diagnosis and treatment in an acute inpatient setting. Discussion: There may be factors ranging from gender stereotypes, limited knowledge and understanding of gender differences in presentations, and personal/organisational cultures influencing the formulation and treatment of males with a diagnosis of BPD in inpatient settings. Implications for Practice: The findings suggest that gender stereotypes such as masculine norms may influence how male patients' emotional difficulties are understood and managed, and that additional training in male‐specific issues to improve knowledge and care provision. This research will support inpatient staff, service leads and clinical educators to identify ways to adapt care provision for men. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Co‐production aims to value service user voices and is increasingly used in healthcare.Less is known about how co‐production in nursing education is experienced by service users. What the paper adds to existing knowledge?: This paper shares the experience of one service user who teaches student nurses in a UK university.For the first author, the paper highlights that co‐producing nurse education has been valuable and rewarding for both a service user and students. What are the implications for practice?: Co‐production has the potential to benefit student nurses, including challenging their perceptions of 'difficult' patients. To achieve this, teaching sessions must be equally produced and delivered. By employing and including service users, universities have the potential to improve experiences for students and service users alike. Introduction: Co‐production is increasingly used in health care but there is less attention to a co‐produced mental health nurse education. Aim: This article sought to explore the co‐production experiences of a service user who teaches mental health nurses, alongside the benefits of this to nurse education. Methods: The article is a lived experience narrative co‐written with a nursing lecturer. Thesis: Co‐produced mental health nurse education challenges students' perceptions towards self‐harm and encourages empathy and understanding of service user distress. Implications for Practice: Co‐production has many benefits to nurse education including a positive student experience, and validation of the service user experience to support meaningful recovery. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: This paper acknowledges the profound and lasting impact of childhood abuse on substance use and homelessness. What this paper adds to existing knowledge?: It underscores the inherent value and humanity of every individual, regardless of their struggles.That a comprehensive approach to mental health care, encompassing medication, therapy and a secure environment, is imperative. What are the implications for mental health nursing?: Early intervention and recognising individuals who suffer in silence are paramount. Mental health nurses must have the courage to ask uncomfortable questions and truly hear the unspoken words.Mental health nurses should never underestimate the power of simply being present with someone during their darkest moments. This simple act can wield significant influence. [ABSTRACT FROM AUTHOR]

The author discusses the requirements for getting research papers published. Topics mentioned include the importance of providing explicit recommendations for Mental Health Nursing policy, practice or research, an evidence-based argument that identifies new results from the study, and the importance for the Abstract and Accessible Summary to contain concise versions of the scientific rationale.

Accessible Summary: What is known on the subject?: Emergency departments (ED) are key settings to support and manage suicidal crisis; thus, ED staff are often the first point of contact for people in suicidal crisis. Despite this, some ED staff receive little training and/or education on how to best support such patients. What the paper adds to existing knowledge: Previous research focuses on one staffing role (e.g. triage nurses) whereas this paper includes staff working across the ED pathway. Administrative staff have often been excluded from research, despite representing a key part of the clinical pathway and being a person's initial contact with the ED.Overall findings demonstrate that staff experience a lack of confidence, training and burnout due to regularly supporting people in suicidal crisis. Staff also perceive there to be a negative ED culture, which often leads to poor attitudes towards suicidal crisis. The main challenges reported are an increase in working pressures, unavailability of resources and staff retention.Findings build upon previous research to highlight key challenges different staff face along the clinical pathway and the implications this can have on a patient's journey and follow‐up care provided. What are the implications for practice?: Findings are of particular importance and relevance to ED managers, and more broadly NHS England. Negative ED culture, poor staff attitudes and confidence can have a detrimental impact on both staff health and wellbeing, as well as a patient's journey throughout the ED, resulting in repeat presentations and absconding as appropriate support is not received.Policymakers need to consider staff burnout and lack of resources in mental health care strategies, and training programmes should be developed to improve culture and confidence among ED staff and managers to improve care for people attending EDs in suicidal crisis. Introduction: Emergency departments (EDs) are often the first point of contact for people in suicidal crisis. Yet, previous work has tended to focus on only one type of staffing role, failing to account for different staff perspectives along the clinical pathway. Aims: To explore and synthesise the perspectives of ED administrative (i.e. receptionists), medical (triage nurses) and mental health staff (liaison psychiatrists) working with people presenting in suicidal crisis. Method: Qualitative study guided by thematic analysis of semi‐structured interviews with 23 ED staff across six EDs in Cheshire and Merseyside, England. Results: Findings demonstrate that staff experience a lack of confidence, training and burnout due to regularly supporting people in suicidal crisis. The main challenges reported are an increase in working pressures, unavailability of resources and staff retention. Discussion: Staff felt unequipped to deal with suicide‐related presentations. Organisational support is perceived to be lacking, with increased staffing pressures and poor service availability. This lack of support was linked to job dissatisfaction. Implications for Practice: Findings are of particular relevance to individual EDs and NHS England. Addressing the challenges staff are reporting can have positive implications for staff wellbeing, as well as a patient's experience and journey throughout the ED. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Bulimia nervosa is characterized by recurrent episodes of binge eating, inappropriate compensatory behaviours to prevent weight gain and excessive mental preoccupation with body weight and shape. What the paper adds to existing knowledge?: In this paper, the feelings, thoughts and experiences of an individual with bulimia nervosa are explained, and the positive and negative effects of their experiences during the treatment process are emphasized.This paper offers advice to patients, relatives and healthcare professionals in recognizing and treating bulimia nervosa. What are the implications for practice?: Mental health nurses should organize training, seminars and conferences to raise awareness of society against bulimia nervosa, which is defined as a mannequin disease and therefore creates a positive perception.Mental health nurses, an essential part of the health system, should raise awareness of individuals and families about recognizing, monitoring and supporting the early symptoms of bulimia nervosa. Introduction: Bulimia nervosa is one of the areas where mental health professionals have difficulties due to its nature and course. It is important to understand the factors related to this problem in‐depth to discover the dynamics unique to the individual that causes the difficulty, identify new perspectives on these dynamics and identify alternative behaviours, stop stubborn binge‐eating attacks and prevent relapse. Aim: It is aimed to provide an in‐depth insight into the nature, course and treatment processes of bulimia nervosa through the narrative of the lived experience of an individual living with this problem. Implication for Practice: The perception of beauty seriously impacts the onset and later course of bulimia nervosa and draws attention to the fact that mental health professionals and media workers have important duties to change the concept of beauty equals being skinny, created in society and the media. Quality of perceived social support is very important in preventing, treating and rehabilitating bulimia nervosa. Adopting a more objective approach, which will prevent the positive or negative stigmatization of the disease in explaining bulimia nervosa to the public, should be adopted. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Severe and prolonged loneliness is known to be detrimental to mental well‐being. Eating disorders and loneliness are linked to each other with loneliness often acting as a barrier during the recovery journey. What this paper adds to existing knowledge?: This paper explores the experience of loneliness while recovering from an eating disorder, as framed within the context of childrearing and challenging family dynamics. While loneliness has negative connotations, it may act as a 'companion' to the person experiencing it. What are the implications for practice?: The first visible need is that for public figures to raise awareness of loneliness and mental well‐being. Another emerging issue is the need to re‐think automatic negative assumptions associated with loneliness. Importantly, professionals and caregivers have to consider the co‐morbidity of loneliness and mental illness. Links between loneliness and unhealthy family dynamics also need to be assessed when providing support. [ABSTRACT FROM AUTHOR]

Accessible summary: What this paper adds to existing knowledge?: Service users report telehealth interventions to be useful in terms of access and convenience however, a preference for face‐to‐face interventions remains.Nurses are using telehealth interventions in clinical practice however, further research is necessary in this area as the evidence of their involvement is limited. What are the implications for practice?: This paper highlights the use of telehealth interventions should augment rather than replace face‐to‐face care provision. Introduction: The Covid‐19 pandemic saw the swift implementation of physical and social distancing that impacted the way in which mental health services were facilitated. Consequently, telehealth/e‐health interventions are increasing in use. Aim: This integrative review aims to explore existing literature regarding mental health service users' experiences of telehealth interventions facilitated through the COVID‐19 pandemic, to determine the visibility of nursing involvement in the facilitation of telehealth interventions and to use these experiences to inform nursing practice. Method: A methodical search of eight (n = 8) academic databases was undertaken using CINAHL, SCOPUS, EMBASE, PsycINFO, Web of Science, Cochrane, MEDLINE and Academic Search Complete between January 2020 and January 2022. Results: A total of 5133 papers were screened by title and abstract of which (n = 77) progressed for full‐text screening. Five (n = 5) papers met the inclusion criteria for this review and results were mapped onto the four meta‐paradigms of nursing: person; where the findings discuss the acceptability of telehealth interventions; environment; where the findings highlight barriers and facilitators to the use of telehealth interventions; health; where the findings discuss staff time and logistical issues relating to telehealth interventions and nursing; where the findings centre around the therapeutic relationship. Discussion: This review highlights there is a paucity of direct evidence relating to nursing involvement in the facilitation of telehealth interventions. However, there are benefits to the use of telehealth interventions that include increased access to services, less perceived stigma and increased engagement which are relevant to nursing practice. A lack of individual contact and concerns relating to infrastructure indicates a fondness for face‐to‐face interventions remains high. Implications for Practice: There is a need for further research on the role of the nurse in the facilitation of telehealth interventions, specific interventions used and outcomes of such interventions. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: People with mental health problems are often left behind, forgotten and excludedLittle is known or written from a service user perspective about experiences of psychiatry, mental health nursing, Mental Health Tribunals and alternative approaches (such as counselling, peer support, psychological and recovery approaches, cognitive behavioural therapy—CBT and creative/art/music/drama/horticultural/dance therapies). What the paper adds to existing knowledge?: This paper aims to remedy this gap in knowledgeIt focuses on positive and negative experiences of psychiatry, Mental Health Tribunals and alternative treatments from a service user's perspective. What are the implications for practice?: The paper makes several recommendations. In brief, (1) psychiatrists need to listen more attentively rather than being focused on signs of psychosis; (2) de‐escalation techniques (for example, talking calmly with the patient) should be used by nurses before physical restraint; (3) psychiatry should be less biomedical. Nurses and social care professionals deserve better training, time for and practice in alternative and more therapeutic forms of care; (4) carers need to be more involved; (5) there need to be better, more democratic, more open processes of law; (6) voluntary work and supported employment schemes should be run by health and social services for people who want to work and want to have a vocational life. This paper aims to describe the lived experience of mental illness, coercive treatment by psychiatry and mental health nursing, and the problematic case and bias of Mental Health Tribunals. It then looks at more positive experiences of alternative approaches and makes recommendations for improving mental health services and people's experiences of them. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Nurses work in mental health services around the world, constituting the largest professional group.Nurses have been identified as being potentially able to carry out a much wider range of functions than are typically allowed in practice, when provided with suitable training.There are long‐term concerns regarding shortages of mental health nurses in England and many other countries.Workforce data is rarely subject to analysis in peer‐reviewed journals. What the paper adds to existing knowledge?: This paper provides a case study of the workforce patterns of a national mental health nurse (MHN) workforce overtime allowing comparison with other countries and specialities.MHN numbers reduced from 2011 to 2017, then increased to near the 2011 level by 2021, not meeting ambitious national plans for increasing numbers.The mental health nursing proportion of the total NHS nursing workforce decreased through this period.Advanced practice roles and skills are widely, but unevenly, distributed and are provided by a small proportion of nurses.The proportion of nurses working in community settings has increased to constitute more than half of all nurses for the first time.The ratio of support workers to nurses increased in inpatient settings and will continue to change. What are the implications for practice?: Historical challenges in recruiting MHNs suggest that future plans to expand the profession are overly optimistic.To support the development of advanced practice roles and new skill sets, clearer research evidence of impact is required and clearer national guidance regarding best practice models.Good workforce data are essential to inform good workforce planning. Introduction: Data regarding changes in characteristics of the MHN workforce is commonly cited in governmental publications, but is rarely analysed in peer‐reviewed journals, despite ongoing concerns regarding high vacancy rates within mental health services. Aim: The aim of the study was to characterize changes in the MHN workforce, implementation of new nursing roles/skills and alignment with national policy. Method: Analysis of nationally published workforce data, peer‐reviewed publications and governmental policy/planning documents. Results: Nurse numbers declined from 2011 to 2017, subsequently returning to near 2011 levels, but remaining below national targets. Nurses in community settings increased to constitute more than half of all nurses, whilst inpatient numbers declined, although more slowly than bed numbers. The ratio between nurses and support workers changed due to more support workers in inpatient settings. New advanced skills and roles for nurses have increased, but are unevenly distributed, constituting a small proportion of the total workforce. Implications for Practice: This paper provides a case study against which comparisons may be made with the nursing workforce in other countries and specialities. Even clear policy commitment to nursing growth may not deliver planned changes in numbers and introducing new roles may have uneven impact, especially in the absence of a robust evidence base. [ABSTRACT FROM AUTHOR]

Accessible Summary: What the paper adds to existing knowledge?: Personality disorder is a serious mental health condition affecting up to 52% of psychiatric outpatients and 70% of inpatients and forensic patients. People with a diagnosis of personality disorder have higher morbidity and mortality than those without.Service users and carers reported a lack of training for staff in the management of individuals with a diagnosis of personality disorder, particularly with regard to self‐harm and suicidal behaviours.Staff burnout creates barriers to compassionate person‐centred care for individuals with a diagnosis of personality disorder as staff struggled to accommodate the nature of the presentation when under significant emotional, psychological and professional strain caused by understaffing and lack of support. What are the implications for practice?: This paper adds new knowledge by informing services of ways to improve care provision from the perspectives of both carers and service users.A more holistic and less medicalised approach to the treatment of problems associated with a diagnosis of a personality disorder should be adopted, and personality disorder training introduced for all healthcare practitioners, to improve patient outcomes. Introduction: There is limited understanding of the experience of people with complex mental health (CMH) needs, including those with a diagnosis of personality disorder (PD) and carers of those individuals. Little is known about carers of those in inpatient forensic settings, yet it has been identified that they may have additional needs when compared to general carers. Research highlights that community carer support services were perceived as inadequate and out‐of‐area placements were described as putting an added strain on ability to support loved ones. Understanding PD within a population of people with CMH needs and how a diagnosis described as PD impacts on care and treatment experience is vital to providing high‐quality care. Aim: To evaluate the care experience of service users and carers with lived experience of a diagnosis of PD and out‐of‐area placements. Method: Semi‐structured interviews were conducted with six service users and four carers to explore the experiences and perspectives of people with a diagnosis of PD. Interviews were audio recorded and thematically analysed. Results: Four interrelated themes were developed; Influence of a diagnosis of PD on Staff, Early and Appropriate Intervention, Recognition of the Individual and Training and Knowledge of people with a diagnosis of PD. Discussion: Anti‐stigma interventions for staff, research on care provision and structural changes to services including more evidence‐based therapy for individuals with a diagnosis of PD may help reduce disparate treatment and improve prognosis for recovery. Implications for Practice: This paper informs services of ways to improve care provision from the perspective of carers and service users. A more holistic and less medicalised approach to the treatment of problems associated with diagnoses of PD should be adopted, and PD training for all healthcare practitioners to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject? What this paper adds to existing knowledge? What are the implications for practice? Introduction Aims Methods Results Discussion Implication for Practice In the past 2 years, the COVID‐19 pandemic had a robust negative impact on the mental health of healthcare providers, with increasing rates of depression, anxiety, acute stress and burnout. Healthcare workers experiencing poor mental health are reluctant to seek help and treatment because they are afraid of being stigmatized and excluded by their colleagues and employers. During the pandemic positive emotions, resilience and psychological well‐being buffered distress and burnout in healthcare workers. This paper describes positive mental health, depression, anxiety and burnout in healthcare workers during the second wave of the pandemic. Forty‐eight per cent of healthcare workers were flourishing (high levels of positive emotions and well‐being), 10% languishing (absence of well‐being and positivity). Flourishing individuals reported lower levels of depression, anxiety and burnout. These findings documented a relevant number of resilient healthcare workers, who restored/maintained their well‐being also under stressful conditions. Vulnerable healthcare workers were less than 20%, and they reported severe anxiety, depression and burnout. No differences emerged between languishing and moderate mental health groups in their levels of anxiety, depression and burnout. The condition of flourishing is the only one that provides protection from depression and anxiety and burnout, while moderate mental health does not differ substantially from the languishing state. The study confirms the importance of maintaining and/or promoting the well‐being of healthcare workers. Interventions for promoting positive mental health of vulnerable workers are needed. Mental health nurses can have the skills and expertise for evaluating early symptoms of psychological distress and for implementing interventions for promoting and restoring well‐being. These interventions may include informational campaign (i.e. preparing and distributing pamphlets and guidelines) and emotional support programmes (psychoeducation and training, mental health support team, peer support and counselling) that can be delivered also via digital platforms. Few studies focused on healthcare workers' positive mental health (i.e. high levels of psychological well‐being) and its association with anxiety, depression and burnout in the second wave of the pandemic.To evaluate the protective role of well‐being in buffering burnout and psychological distress.We evaluated 173 Italian healthcare workers with indicators of psychological distress (Depression Anxiety Stress Scales [DASS]‐21), burnout (Copenhagen Burnout Inventory [CBI]) and positive mental health (Mental Health Continuum) and we cross‐classified them according to their levels of mental health (flourishing, languishing and moderate mental health) and their levels of anxiety, depression and burnout.Forty‐eight per cent of health workers were classified as flourishing, 10% as languishing and 42% as moderate mental health. Flourishing individuals presented lower scores on DASS and CBI scales, whereas no differences emerged between languishing and moderate mental health groups. More than 80% of health workers with clinically significant symptoms of anxiety, depression and risk of burnout were classified as not flourishing.This investigation documented the presence of flourishing mental health in almost half of the sample of Italian healthcare workers. However, those with moderate or languishing mental health manifested higher levels of anxiety, depression and higher risks of burnout.The study confirms the importance of maintaining and/or promoting the well‐being of this population, with a crucial role of mental health nurses who can easily approach other healthcare workers and provide them informational (training, guidelines) and emotional support programmes (psychoeducation, mental health support team, peer support and counselling) when facing adverse working conditions. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Sleep problems are common among those with depression, and there is increasing evidence that sleep problems should be addressed during treatment simultaneously rather than treating depression alone.The first‐line treatment for insomnia is cognitive behavioural therapy for insomnia (CBT‐I), due to a lack of well‐trained therapists and patient time constraints (travelling, work), CBT‐I has not been popularized.The development of digital cognitive behavioural therapy for insomnia (dCBT‐I) is making the treatment more accessible. What this paper adds to existing knowledge: Interventions for dCBT‐I were significantly better than other control conditions in both reducing insomnia and improving depression in patients with depression and insomnia comorbidities.The effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention and therapist‐involved dCBT‐I has less shedding than self‐help. What are the implications for practice: It's important for mental health practitioners to realize that insomnia in depressed people needs to be treated.Future trials may explore the effectiveness of therapist‐guided dCBT‐I in depressed populations and analyse the cost‐effectiveness of this treatment. Aim: The aim of the study was to systematically identify and synthesize the evidence for the effectiveness of digital cognitive behavioural therapy in insomnia with comorbid depression. Design: Systematic review and metaanalysis. Methods: A search was conducted on five English and four non‐English databases from the inception of the databases to November 2023. This review adhered to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta‐analysis Statement 2020 and the included studies were evaluated using version 2 of the Cochrane risk of bias tool. This review examined sleep‐related outcomes, including insomnia severity and sleep diaries, along with psychological outcomes, such as depression. We conducted a meta‐analysis of each outcome using a random effects model. Heterogeneity was assessed by the I2 statistic. Results: A total of seven articles with 1864 participants were included in this review. The results showed that the digital cognitive behavioural therapy group demonstrated a statistically significant amelioration in the severity of insomnia symptoms, as well as a reduction in depressive symptomatology compared with the control groups. The post‐intervention effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention. Conclusions: Digital cognitive behavioural therapy for insomnia application in patients with depression and insomnia was demonstrated to be effective, less time‐consuming and more accessible. Relevance to Clinical Practice: We may consider incorporating nurses into treatment plans and conducting nurse‐led interventions in specific programs. In the future, nurses may be able to provide exclusive digital behavioural therapy for insomnia to patients with depression to achieve greater effectiveness. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The leading reason for suicide attempts in Japan is health problems, among which depression is the most common, followed by physical illnesses.Patients with physical illness and suicide ideation are not rare among patients receiving home‐based care.General home visiting nurses (GHVNs) without knowledge, skills or experience in psychiatric care are required to provide care for patients with physical illness who are at risk of suicide in Japan. What this paper adds to existing knowledge?: More detailed understanding of GHVNs' experiences and perspectives on working with suicidal patients in home care.This study enriches our understanding of how suicide prevention strategies should be developed for GHVNs. What are the implications for practice?: Focusing education on therapeutic communication skills and meanings with relationships with patients is required by GHVNs.Training for suicide risk assessment and guidelines appropriate to GHVNs' situation is crucial.Establishing a liaison service system with a multidisciplinary team, including psychiatric home‐visiting nurses, is necessary for home healthcare to achieve continuity of care. Introduction: In Japan, even a general home visiting nurse (GHVN) lacking psychiatric experience and training can provide home nursing care to patients at risk of suicide. Little attention is given to nursing care for suicide by GHVNs who care for patients with physical illness. However, these patients with suicidal ideation for home care are surprisingly common. Aim/Question: We explored the experiences of GHVNs who cared for patients with suicidal ideation and focused on the nurses' perceptions and interactions. Method: We conducted semi‐structured interviews with 15 GHVNs. We discussed the nurses' experiences caring for patients with suicidal ideation, their perceptions during these interactions and their response. Results: General home visiting nurses were perplexed upon learning of the patient's suicidal ideation. They interacted with such patients by 'avoiding the core of the matter' while focusing on maintaining a relationship with them. Discussion: Not addressing the patient's suicidal thoughts will not only disable the suicide risk assessment but also lead to patient isolation. Suicide prevention care needs to consider the unique characteristics of home care. Implications for Practice: General home visiting nurses require training in suicide risk assessment and communication skills. Establishing a liaison service, including psychiatric home visiting nurses, is necessary to achieve continuity of care. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject?: Loneliness is common among young and middle‐aged stroke survivors. It not only hinders the recovery of their neurological and physical functions but also increases the risk of stroke recurrence, disability, and even death.Improving the mental health of young and middle‐aged stroke survivors is of utmost importance. However, previous research has not yet investigated the impact of interpersonal sensitivity and resilience on the relationship between stigma and feelings of loneliness. What the paper adds to existing knowledge?: This study confirms that stigma has a positive impact on loneliness among young and middle‐aged stroke survivors.Interpersonal sensitivity partially mediates the relationship between stigma and loneliness, and resilience plays a moderating role in the mediating mechanism. What are the implications for practice?: Mental health nurses can formulate nursing interventions to reduce loneliness of young and middle‐aged stroke survivors with the goals of improving stigma, reducing interpersonal sensitivity and cultivating resilience. Introduction: Previous studies have not explored the impact of interpersonal sensitivity and resilience on the relationship between stigma and loneliness. However, improving the resilience of young and middle‐aged stroke survivors and increasing their social participation is of great significance for reducing patients' loneliness of patients and promoting their physical and mental rehabilitation. Aims: To investigate the influence of stigma, interpersonal sensitivity and resilience on loneliness among young and middle‐aged stroke survivors. Methods: A cross‐sectional design was used to collect data. A total of 330 participants completed measures of stigma, resilience, interpersonal sensitivity and loneliness. The descriptive statistical approach, Pearson's correlation analysis and Hayes' PROCESS Macro Model 4 and 7 in regression analysis were used to analyse the available data. Results: The results revealed that young and middle‐aged stroke survivors' stigma, resilience, interpersonal sensitivity and loneliness were significantly correlated between every two variables, with coefficients ranging between −0.157 and 0.682. Interpersonal sensitivity played a partial mediating role in stigma and loneliness, accounting for 63.27% of the total effect; This process was moderated by resilience. Discussion: Stigma positively predicts participants' loneliness. As a mediating mechanism with moderating, interpersonal sensitivity and resilience further explain how stigma affects loneliness. Implications for Practice: Understanding this mechanism is of guiding significance to reduce loneliness of young and middle‐aged stroke patients and promote their physical and mental rehabilitation. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Psychiatric hospitals have input from a range of professionals, including Clinical Psychologists.Most evidence used to guide what Clinical Psychologists do is based on their work with individuals rather than staff teams.Some evidence shows working with staff teams is important, but most of this is based on interviews rather than measuring the impact using numbers and statistics.The current study aimed to investigate the effectiveness of staff‐level interventions provided by a Psychology team within a psychiatric inpatient setting. What the paper adds to existing knowledge?: Training sessions were effective at increasing staff levels of confidence and understanding in psychological approaches, and the perceived usefulness of the session to their practice.Case discussion sessions were effective at increasing staff levels of understanding a service user, compassion towards the service user, perceived opportunities for change with the service user, their perceived skills to work with the service user and their perception of the usefulness of the session to their practice.Reflective practice sessions were effective at providing a space for learning, sharing ideas and reflecting.Other interventions were highly valued by nursing staff. What are the implications for practice?: Staff‐level interventions are effective and valued by mental health nursing staff and should be considered in allocation of psychology resources.Interventions improved staff psychological thinking which could positively impact service user experience.There is potential for people with lived experience to participate in these interventions, which could facilitate the therapeutic relationship and reduce restrictive practices. Introduction: The role of Psychologists in psychiatric inpatient settings is well established and involves intervention at various levels; however, quantitative exploration of the effectiveness of staff‐level interventions is lacking. Aim: The aim of the study was to examine the effectiveness of a variety of staff‐level interventions provided by a Psychology team within a psychiatric inpatient setting. Methods: The evaluation used a mixed methods approach incorporating pre–post quantitative data and post‐intervention feedback. Additional data were collected via survey. Key Findings: Results indicated all staff‐level interventions were effective in achieving their aims and were highly valued by staff. Qualitative data supported the quantitative findings and showed tentative suggestion of a change to clinical practice. Discussion: Indirect psychology provision was found to significantly impact a range of staff attitudes and was highly valued by the staff team, supporting previous qualitative findings in psychiatric inpatient settings. Further quantitative evidence of the impact of staff‐level interventions should be sought. Implications: Staff‐level interventions are effective and valued by mental health nursing staff and should be considered in allocation of psychology resources. Furthermore, there is potential for people with lived experience to participate in these interventions, which could facilitate the therapeutic relationship and reduce restrictive practices, however this requires future research. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Children and adolescents' mental health problems, such as autism spectrum disorder, anxiety disorder and attention‐deficit hyperactivity disorder, are a global public health concern, and nurses require advanced expertise and skills to properly care for this population.There is a gap between the required competencies and the actual skills and knowledge of CAMHN practitioners. Previous studies suggest that educational interventions for nurses are necessary to enhance the quality of care for children and adolescents with mental health problems. However, the corresponding evaluation indicators have not been verified, making it difficult to determine the most effective methods. What this paper adds to existing knowledge?: The present study developed the two‐factor (direct care for children and their family members and approach to the care environment) Clinical Competency Assessment Scale in Child and Adolescent Mental Health Nursing (CCAS‐CAMHN).We demonstrated that the assessment scale was reliable and valid, based on its adequate internal consistency and temporal stability, the acceptable range of its model‐fit indexes, and its good concurrent and divergent validity. What are the implications for practice?: The newly developed scale is useful for assessing nurses' competency and could help them identify their difficulties in CAMHN.The scale could contribute to the development of effective educational interventions to enhance the quality of care for children and adolescents with mental health problems. Introduction: Caring for children and adolescents with mental health problems, such as autism spectrum disorder, anxiety disorder and attention‐deficit hyperactivity disorder, requires expertise and skills. A quantitative clinical competency measurement tool in child and adolescent mental health nursing (CAMHN) is needed to evaluate the indicators of advanced expertise. Aim: The aim of this study was to develop a clinical competency assessment scale in CAMHN and evaluate its psychometric properties. Method: Scale items were derived from previous studies and adjusted based on cognitive interviews with five CAMHN experts. In total, 505 nurses in CAMHN from 29 hospitals in Japan participated in the self‐administered survey. The scale's construct validity, criterion‐related validity, internal consistency and test–retest reliability were assessed. Results: A two‐factor (direct care for children and their family members and approach to the care environment) scale was constructed. A secondary structural model showed that a two‐factor model fits best. The total score was significantly and positively correlated with excellence in nursing practice, amount of clinical experience and mental status. The overall scale exhibited good validity and reliability. Discussion: The scale is reliable and valid for assessing CAMHN clinical competency. Implications for Practice: The scale is useful for assessing nurses' competency and evaluating educational interventions' effectiveness for nurses. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Parenting experiences are a great challenge but also a meaningful achievement for mothers diagnosed with schizophrenia (MDWSs).Most previous studies focused on the parenting experiences of Chinese mothers diagnosed with depression rather than those diagnosed with schizophrenia, who usually experience psychiatric symptoms. What this paper adds to existing knowledge?: Unlike in Western society, Chinese society is characterised by a family‐centred culture. This study insightfully explores MDWSs' parenting and family life experiences addressing their intrapersonal mindsets, interpersonal connections with family members across generations and extrapersonal roles such as traditional social expectations as a mother, wife and daughter‐in‐law.While Western studies have mainly focused on MDWSs' personal resilience, this study insightfully explored MDWSs' resilient dimensions including their personal, familial and cultural issues within the Chinese society. What are the implications for practice?: This study develops a comprehensive and professional understanding of the parenting experiences and family interactions of MDWSs who struggle to achieve their motherly role and re‐establish connections with intimate family members.The findings highlight the following important considerations when offering family‐based nursing cares: (1) assess power relationships, familial dynamics and cultural influences between MDWSs and their family members; (2) extend family members' involvement, such as parents‐in‐law, while offering psychoeducation to MDWSs and their family members. Introduction: In Chinese culture, raising the next generation is recognised as a crucial family matter involving intergenerational participation. Mothers diagnosed with schizophrenia (MDWSs) usually experience high stress due to psychiatric symptoms, different parenting values across generations and traditional expectations associated with motherly roles. MDWSs need urgent professional assistance. Aim: To explore MDWSs' parenting experiences and family life in Chinese cultural contexts. Method: In‐depth interviews were conducted with 20 MDWSs. Data were analysed using interpretative phenomenological analyses. Results: The superordinate theme was identified as 'You are not a qualified mother'. Three major themes were elicited: experiencing crises in parenting, family life and self‐stability; striving to be a good mother and wife under humiliation; and developing wisdom and courage to move forward. Discussion: A dehumanised attitude of family members in a paternalistic culture was found. While Western society focuses on personal resilience and family‐based nursing care for nuclear families, Chinese society intensively focuses on MDWSs' relationship with nuclear family members as well as extended family members such as parents‐in‐law. Implications for Practice: The results highlighted the significance of culturally sensitive nursing care for MDWSs and family‐centred psychoeducation that clarifies familial dynamics and improves effective communication between MDWSs and their family members. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Storytelling is an effective tool for communication, is universally comprehensible and transcends linguistic barriers, adapting to cultures easily.Storytelling has a strong influence on children and has been used for knowledge retention and for developing imagination, creativity and prosocial behaviours. What this paper adds to existing knowledge?: The systematic review offers essential insights into the effects of storytelling interventions on the development of resilience in children.It indicates the various forms of storytelling interventions implemented and also the specific measures of resilience employed in the studies.The review has demonstrated that storytelling plays a crucial role in the development of protective factors in children including resilience. What are the implications for practice?: Psychiatric and mental health nurses working in community, hospital or mental health units play an important role in mental health interventions, particularly when it comes to children and young adults.Employing storytelling techniques can help psychiatric and mental health nurses provide timely and consistent support to children while helping them explore support systems, mechanisms and coping strategies helping build resilience.This holds particular importance for low‐ and middle‐income countries where limited resources pose challenges in providing adequate support for mental health programmes for children. Methods such as storytelling are simple and adaptable to the specific challenges faced in the mental health setting. Introduction: Resilience is a crucial aspect of mental health and coping that enables individuals to effectively recover from challenges. Fostering resilience in children becomes a significant objective. Storytelling is known to positively affect resilience, providing opportunities to share and develop narratives that help make sense of difficult experiences, find meaning in them, and building beliefs around our capacity to adapt well to challenging experiences. Aim: The aim of this review is to synthesize peer‐reviewed studies on the impact of storytelling interventions in developing resilience in children. Method: The review adhered to the updated PRISMA 2020 guidelines and was registered with PROSPERO (CRD42022365474). We conducted searches in 12 databases with search strings comprising of concepts regarding storytelling, resilience and children. Results: The review included 11 studies published between 2012 and 2022. The narrative synthesis of the studies indicates that storytelling interventions enhanced psychological resilience in children. Discussion: Storytelling‐based interventions in school settings with participatory approaches using cultural stories, and positive psychology‐based interventions were effective and feasible. Implications for Practice: This review has scope for informing future interventions with children, especially those who live in marginalized communities in low‐ and middle‐income countries (LMICs). [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Stigma associated with care homes has been found to influence residents' lives, and it is a known risk factor for depression among older adults worldwide.Older residents in Asia and particularly, in Thai care homes commonly experience stigma due to being strongly influenced by a traditional cultural paradigm of filial piety.The understanding of how residents perceive and experience the stigma associated with residing in care homes, as well as its link to the development of depression, remains very limited. What does the paper add to existing knowledge?: This research explains the dynamics of the process of the stigma associated with living care homes among Thai older residents.This research highlights the various ways in which stigma impacts residents, their families and care home staff.This study identifies mitigating stigma factors, including social support, coping strategies (karma, mindfulness and religious devotions) and activities that may mitigate perceived stigma associated with care home residency. What are the implications for practice?: There is a compelling need to improve the well‐being of older people living in care homes and to combat the cultural stigma associated with living in care homes through promoting positive attitudes and educational interventions in society, communities and care homes themselves and involving residents' families in the planning and delivery of care for residents. We advocate that the government promotes security and sustainable life for all Thai older adults. Introduction: Stigma associated with living in care homes is a known risk factor for depression among care home residents in Asia, including Thailand. However, little is understood about how such stigma is experienced among residents and care home staff. Aims: To examine older adults' perceptions of stigma and to understand how stigma associated with living in care homes causes or exacerbates depressive symptoms. Methods: A qualitative case study approach was used to gain an in‐depth view of stigma, from two public care homes in northeast Thailand. Data were collected by in‐depth interviews with 50 participants (30 older residents and 20 care home staff), and non‐participant observation was conducted over 1 month. Thematic analysis was used to analyse the data. Results: The study identified three major themes of stigma, comprising the causes of stigma, reactions toward stigma, and mitigating factors. Discussion: Negative beliefs about care homes and residents, contribute to stigma. Residents exhibited negative emotions and behaviours, including depressive symptoms. Residents reported using particular coping strategies that helped them cope with their perceptions of stigma. Implications for Practice: Future research should focus on strategies or research to combat stigma in order to prevent depression and reduce perceptions of stigma. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Safewards was developed for acute mental health units, and while could be effective in forensic mental health services, there are some gaps in the model for such services, where factors including offending behaviour and longer term care can have an influence. What this paper adds to existing knowledge?: The importance of acknowledging and addressing responses related to offending behaviour in forensic mental health settings, while also understanding the vulnerability of the consumer group and responsibilities to the maintenance of professional boundaries.Enhancing collaboration with consumers/families/carers/supporters is important in a forensic mental health setting, and an important element of Safewards Secure. What are the implications for practice?: This study completes the development of Safewards Secure, designed to foster collaboration, address issues pertinent to forensic mental health settings to enhance implementation and acceptance of the model and reduce conflict and containment. Introduction: Safewards is a model developed for acute mental health settings designed to reduce conflict and containment; however, it requires adaptation to forensic mental health settings. Aim: To develop the Safewards Secure model, a model to assist forensic mental health services to reduce conflict and containment. Method: A literature review was conducted to elicit possible modifiers and adjustments to the interventions. A Nominal Group Technique was then used to engage forensic mental health experts who had experience implementing Safewards (n = 12) to seek feedback about the suggestions and reach consensus on the Safewards Secure model and interventions. Data were thematically analysed. Results: Experts reached consensus on all suggestions, however, did recommend minor additions and modifications. Two themes were also interpreted: Safewards Secure is just as much for staff as it is for consumers, and the proposed additions encourage more meaningful staff to consumer collaboration. Discussion: This study identified key challenges experienced by nurses working in forensic mental health settings, however, these challenges were not seen as insurmountable. The Safewards Secure model offers prompts and suggestions to encourage reflection, collaboration and a humanistic approach to care in forensic mental health settings. Implications for Practice: Addressing reactions to offending behaviour and encouraging more collaboration might assist in ensuring a more person‐centred approach to forensic mental health nursing care. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Recovery‐oriented services have been shown to promote recovery in people with mental illness; their implementation is important for current psychiatric practice and is being considered by many professional institutions.The Japanese government released the policy 'A Vision for Reform of Mental Health and Medical Welfare' (Ministry of Health, Labour and Welfare, 2004; https://www.mhlw.go.jp/topics/2004/09/dl/tp0902‐1a.pdf), aiming to update public consciousness, reorganize the mental healthcare welfare system and strengthen the foundation of mental healthcare to promote a basic policy focusing on the transition 'from hospital to community life'. What the paper adds to existing knowledge?: This is the first study to clarify recovery‐oriented attitudes among psychiatric nursing directors and related factors in Japan. It shows an association between recovery‐oriented attitudes and hospital size. What are the implications for practice?: A relationship exists between the recovery knowledge and recovery‐oriented attitudes of psychiatric nursing directors. It may thus be valuable for directors to see and hear about the experiences of patients living in the community during their recovery process. As hospital size and organizational climate may hinder the successful implementation of recovery‐oriented practices, these factors must be considered when introducing such practices.Further research is needed on the relationship between psychiatric nursing directors' recovery‐oriented attitudes and practices. Moreover, to develop intervention studies that uncover success factors for enhancing recovery‐oriented attitudes, organizational factors that enable recovery‐oriented practices must be further investigated. Introduction: Recovery‐oriented practices in mental health services have become a global priority. Despite their proven effectiveness, Japanese hospitals have not widely implemented such practices. Aim: This study clarified psychiatric nursing directors' recovery‐oriented attitudes and factors regarding promoting recovery‐oriented practices to identify methods for developing these practices in Japan. Method: This cross‐sectional study used a questionnaire survey with 250 nursing directors from 1287 Japanese psychiatric hospitals. Multivariable regression analysis assessed how socio‐demographic variables and Recovery Knowledge Inventory (RKI) scores affected Recovery Attitudes Questionnaire (RAQ‐7) scores. Results: The analysis revealed that more clinical and managerial experience was associated with more negative recovery‐oriented attitudes. High RKI scores, knowledge of strength, hospital size and outpatient work experience were associated with more positive recovery‐oriented attitudes. Discussion: Implementing recovery practices requires consideration of knowledge and experience in recovery and hospital size alongside recovery training based on a hospital's organizational structure. Although the low response rate could influence the study's generalisability, it could also indicate low interest in recovery‐oriented practices among professionals. Implications for Practice: Acquiring more knowledge and experience regarding recovery promotes recovery‐oriented attitudes among nursing directors. An appropriate organizational culture and consideration of hospital size are required when introducing such recovery practices. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Workplace violence is common in healthcare.Workplace violence remains a complex and serious occupational hazard in healthcare. What this paper adds to existing knowledge?: Since there is no study examining detailed explanations of experiences and perspectives of workplace violence among psychiatric nurses, this study will act as a guide for psychiatric nurses.This study provides information about how psychiatric nurses evaluate the concept of workplace violence from their perspective, what it means to them and the effects of workplace violence. What are the implications for practice?: Considering the effects of workplace violence, a preventive, systematic and holistic approach should be used in psychiatry and community mental health centres.Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients. Introduction: Workplace violence is common in healthcare and remains a complex and serious occupational hazard. Aim: This research was conducted to assess the workplace violence experiences and perspectives of psychiatric nurses. Method: This study was a qualitative study conducted using a grounded theory approach method. The study was conducted between November 2022 and January 2023. The purposeful sampling method was used, and 11 psychiatric nurses were interviewed. Data were collected with an information form and a semi‐structured interview form. The data were analysed using content analysis, and themes were created. Findings: The ages of the psychiatric nurses ranged from 38 to 57 years. Themes and sub‐themes related to the workplace violence experiences and perspectives of psychiatric nurses included the way of violence (rising tension, eruption of the volcano, unintentional violence and turning to ash) and empowerment (ash cloud and ring of fire). Conclusion: Psychiatric nurses stated that they were exposed to verbal and physical violence for many reasons, that this situation seriously affected their physical, mental and social health and that in addition to the devastating effects of violence, they became stronger by developing various skills to protect against violence. Implications for Practice: Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients. Strategies can be developed to include psychiatric nurses in occupational health nursing courses. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: At the outset of the COVID‐19 pandemic, little was known about ways of delivering registered nurse practice within CMHTs under restrictions associated with a global pandemic.Emerging research focused on broad healthcare staff wellbeing during the pandemic. Qualitative research explored the overall response of COVID‐19 on people with existing health needs or remote working more specifically.Over the past 2 years studies have emerged detailing experiences but no studies have used qualitative research to understand community mental health nurses and service users experience of services. What the paper adds to existing knowledge?: This co‐produced qualitative study is the first to explore the changes to CMHT care from the experience of service users and nurses later in the COVID‐19 pandemic.The study questions whether recovery‐based approaches are possible in a hybrid way of working.The findings identify challenges for nurses' well‐being and work–life boundaries when working from home.The study adds to historical professional narratives of mental health nursing. What are the implications for practice: While hybrid approaches developed in response to COVID‐19 restrictions may offer more choice these approaches need further co‐produced evaluation on the impact of recovery‐focused care and therapeutic relationships.Mental health nurses need to review how future hybrid working continues to impact nurses' mental health and emotional safety.Nurses and service users need to raise awareness within society and policy on the impact that COVID‐19 had on people with existing mental health conditions. Introduction: Community Mental Health Team responses to COVID‐19 included fundamental service delivery adaptations. Aim/Question: Our co‐produced study sought to understand which service delivery changes experienced by service users and registered nurses were helpful or unhelpful to caregiving and receiving. Method: Qualitative semi‐structured interviews were undertaken with 10 service users and 13 registered nurses from 3 NHS England sites. Co‐produced throughout, people with lived experience of mental health services and nurses wishing to improve their research experience undertook interviews following training. Data were analysed thematically. Findings: Care radically changed from in‐person to large phone or video contact. This reportedly altered therapeutic relationship building and raised questions about whether recovery‐focused care was possible. Hybrid working was viewed as helpful but raised challenges for nurse wellbeing. Discussion: Changes to care delivery challenged the fundamentals of recovery‐focused interventions and therapeutic relationships. Service users and nurses well‐being consequently suffered. The impact of the pandemic on people with existing mental health conditions was poorly acknowledged in the media. Implications for Practice: Recovery‐focused interventions and relationship building need evaluating in the light of ongoing hybrid working. Teams need to consider the well‐being of nurses engaged in complex service‐user interactions from home. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Restraining and secluding health consumers for safety reasons continue to be used in psychiatric inpatient facilities even though they have no therapeutic value and have negative effects on consumers, families and staff.Six Core Strategies (6CS) for reducing seclusion and restraint have been developed to address this problem but there are very few effectiveness studies in inpatient adolescent psychiatric facilities. What the paper adds to existing knowledge: We used a mixed methods approach to evaluate the implementation of 6CS in an adolescent psychiatric facility. The implementation was successful. It eliminated the use of seclusion, substantially reduced the use of restraints and significantly reduced staff absenteeism.Using thematic analysis on feedback surveys, we identified five dominant themes that described consumers' and carers' experiences during their stay at the facility: communication, service delivery, flexibility, consistency and internal feeling states. What are the implications for practice: This study provides support for the feasibility of a comprehensive and broad‐based intervention program such as 6CS to reduce seclusion and restraint practices in inpatient mental health facilities.This study also demonstrates the value of using surveys to gather consumer and carer feedback and improve outcomes for service users. Introduction: Seclusion and restraint practices are routinely used in psychiatric facilities but are controversial for ethical, legal and safety reasons, and can cause significant harm to consumers, staff and organisations. Six Core Strategies (6CS) for reducing seclusion and restraint were developed to address this problem but very few studies have examined their effectiveness in adolescent settings. Aim/Question: To evaluate the implementation of 6CS in an adolescent inpatient psychiatric facility. Method: We retrieved archival data from an acute adolescent psychiatric ward that implemented the 6CS. Using a mixed methods approach, we evaluated outcomes on the use of seclusion and restraint, nursing staff sick leave and feedback surveys. Results: Findings showed an elimination of seclusion, and a significant reduction in restraint use and staff absenteeism in the 12 months after project implementation. Thematic analysis of feedback survey responses identified communication, service delivery, flexibility, consistency and internal feeling states as dominant themes in consumers' and carers' experience on the unit. Discussion: The 6CS is feasible and may be effective in reducing seclusion and restraint, which in turn may have a positive impact on staff wellbeing. Implications for Practice: Implementation of the 6CS with executive support, combined with staff and programmatic changes at a local level is recommended. [ABSTRACT FROM AUTHOR]

Accessible Summary The Relevance to Mental Health Nursing Background Design Tools Results Conclusion This research paper explores the intricate relationship between metacognitive dysfunctional beliefs, obsessive‐compulsive symptoms, and psychosocial performance in patients diagnosed with schizophrenia. Understanding these dynamics can help mental health nurses identify and address each patient's needs more effectively. It can guide them in devising personalized care plans that not only manage the symptoms but also improve the underlying mechanism that exacerbates the psychotic symptoms and social functioning and the overall quality of life. Moreover, the findings of this research can contribute to developing training programs for mental health nurses, equipping them with the necessary skills and knowledge to provide optimal care. What the paper adds to existing knowledge? •This study provides empirical evidence of the significant positive correlation between OCS and metacognitive dimensions in individuals with schizophrenia. •It highlights the role of certain demographic factors, such as younger age and single marital status, in increasing the likelihood of elevated OCS. •It underscores the inverse relationship between higher metacognitive dysfunctional beliefs and lower levels of psychosocial functioning. •It identifies age and metacognitive scores as crucial predictors of psychosocial functioning across various domains. What are the implications for practice? •The findings suggest that therapeutic nursing interventions for individuals diagnosed with schizophrenia should address metacognitive dysfunctional beliefs to improve overall functioning and well‐being. •Clinicians, including psychiatrists and psychiatric nurses, should consider the patient's age, marital status, and metacognitive scores when assessing the risk of elevated OCS and devising treatment plans. •The study emphasizes the need for comprehensive psychiatric nursing assessment, including metacognitive dysfunction and OCS evaluation. What are the implications for future research? •Future research could explore the causal relationships between metacognitive dysfunctional beliefs, OCS, and psychosocial functioning in schizophrenia. •Longitudinal studies could provide insights into the progression of these relationships over time and the impact of therapeutic interventions. •Further research could also investigate the effectiveness of specific therapeutic strategies such as Metacognitive Therapy (MCT), Schema Therapy (ST), Cognitive Enhancement Therapy (CET), and Cognitive Behaviour Therapy (CBT) to address this population's metacognitive dysfunctional beliefs. What the paper adds to existing knowledge? •This study provides empirical evidence of the significant positive correlation between OCS and metacognitive dimensions in individuals with schizophrenia. •It highlights the role of certain demographic factors, such as younger age and single marital status, in increasing the likelihood of elevated OCS. •It underscores the inverse relationship between higher metacognitive dysfunctional beliefs and lower levels of psychosocial functioning. •It identifies age and metacognitive scores as crucial predictors of psychosocial functioning across various domains. This study provides empirical evidence of the significant positive correlation between OCS and metacognitive dimensions in individuals with schizophrenia.It highlights the role of certain demographic factors, such as younger age and single marital status, in increasing the likelihood of elevated OCS.It underscores the inverse relationship between higher metacognitive dysfunctional beliefs and lower levels of psychosocial functioning.It identifies age and metacognitive scores as crucial predictors of psychosocial functioning across various domains.What are the implications for practice? •The findings suggest that therapeutic nursing interventions for individuals diagnosed with schizophrenia should address metacognitive dysfunctional beliefs to improve overall functioning and well‐being. •Clinicians, including psychiatrists and psychiatric nurses, should consider the patient's age, marital status, and metacognitive scores when assessing the risk of elevated OCS and devising treatment plans. •The study emphasizes the need for comprehensive psychiatric nursing assessment, including metacognitive dysfunction and OCS evaluation. The findings suggest that therapeutic nursing interventions for individuals diagnosed with schizophrenia should address metacognitive dysfunctional beliefs to improve overall functioning and well‐being.Clinicians, including psychiatrists and psychiatric nurses, should consider the patient's age, marital status, and metacognitive scores when assessing the risk of elevated OCS and devising treatment plans.The study emphasizes the need for comprehensive psychiatric nursing assessment, including metacognitive dysfunction and OCS evaluation.What are the implications for future research? •Future research could explore the causal relationships between metacognitive dysfunctional beliefs, OCS, and psychosocial functioning in schizophrenia. •Longitudinal studies could provide insights into the progression of these relationships over time and the impact of therapeutic interventions. •Further research could also investigate the effectiveness of specific therapeutic strategies such as Metacognitive Therapy (MCT), Schema Therapy (ST), Cognitive Enhancement Therapy (CET), and Cognitive Behaviour Therapy (CBT) to address this population's metacognitive dysfunctional beliefs. Future research could explore the causal relationships between metacognitive dysfunctional beliefs, OCS, and psychosocial functioning in schizophrenia.Longitudinal studies could provide insights into the progression of these relationships over time and the impact of therapeutic interventions.Further research could also investigate the effectiveness of specific therapeutic strategies such as Metacognitive Therapy (MCT), Schema Therapy (ST), Cognitive Enhancement Therapy (CET), and Cognitive Behaviour Therapy (CBT) to address this population's metacognitive dysfunctional beliefs.Schizophrenia is a chronic mental health disorder that significantly impacts an individual's cognitive, emotional and social functioning. Recent research has highlighted the role of metacognitive beliefs and obsessive‐compulsive symptoms (OCS) in the psychosocial performance of individuals diagnosed with schizophrenia. Understanding these relationships could provide valuable insights for developing more effective nursing interventions. This study aimed to investigate the relationship between metacognitive beliefs, OCS and psychosocial performance among individuals diagnosed with schizophrenia.A cross‐sectional survey was conducted involving 174 purposively selected participants diagnosed with schizophrenia.The Meta‐Cognitions Questionnaire‐30, Young Adult Self‐Report Scale for OCS and Specific Level of Functioning Scale were used to gather the necessary data.The study found a significant positive correlation between OCS and metacognitive dimensions. Age was a significant predictor with an Oddis Ratio of 2.471. The metacognitive dysfunction was a highly significant predictor in univariate and multivariate analyses, with Oddis Ratios of 1.087 and 1.106, respectively. The study also discovered that higher levels of metacognitive dysfunctional beliefs were associated with lower levels of psychosocial functioning. Age and the metacognitive dysfunction score were significant predictors of psychosocial functioning scores, accounting for 26.8% of the variance in these scores.The study reveals a compelling inverse relationship between higher metacognitive dysfunctional beliefs and lower levels of psychosocial functioning in individuals diagnosed with schizophrenia. It also identifies certain demographic factors, such as younger age, as significant contributors to elevated OCS. Importantly, metacognitive dysfunction emerged as a critical predictor of psychosocial functioning across various domains. These findings underscore the potential of incorporating metacognitive‐focused interventions in the treatment plans for schizophrenia patients. By addressing these cognitive patterns, healthcare professionals can enhance overall functioning and well‐being in individuals diagnosed with schizophrenia. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject? What the paper adds to existing knowledge? What are the implications for practice? What are the implications for future research? Introduction Aim Methods Results Discussion Implication for Practice The insecure attachment styles are associated with mental health problems and can influence reality perception, particularly in individuals with schizophrenia. The paper provides empirical evidence for the correlation between insecure attachment styles and reality‐testing impairment in clients with schizophrenia. Higher reality testing impairment scores were observed in specific demographics: males who were unmarried and aged between 40 and 50 years old, as well as those with a duration of illness of less than 5 years. The findings underscore the importance for nurses to understand insecure attachment styles, particularly anxious and avoidant styles, in clients with schizophrenia. Healthcare providers and nurses should understand the psychological dynamics of clients with insecure attachment styles to establish effective therapeutic relationships. A secure, structured and consistent environment is vital to modifying insecure attachment styles and promoting reality orientation. Secure Attachment Style Psycho‐Educational Program, Mentalization, Cognitive Interpersonal Therapy, and Cognitive Analytic Therapy can help reduce reality‐testing impairment. Imply early intervention through educating mothers on fostering secure bonds can potentially prevent future occurrences of schizophrenia. Conducting empirical studies to explore the associations between insecure attachment style, social functioning, and poor service engagement is essential. Research is needed to investigate specific techniques for managing insecure attachment styles, particularly the avoidant ones, and reality testing impairments within the therapeutic setting. Insecure attachment styles are associated with mental health problems and may influence reality perception.This study investigated the link between attachment styles and reality‐testing impairment in individuals with schizophrenia.A cross‐sectional survey with 200 participants diagnosed with schizophrenia assessed their attachment styles (Psychosis Attachment Measure) and reality‐testing abilities (Bell Reality Testing Inventory).A significant positive correlation emerged between insecure attachment and poorer reality testing (r = .394, p < .001). Avoidant attachment was most prevalent (mean scores: 17.01, SD = 3.71), followed by anxious attachment (16.53, SD = 4.20). Reality‐testing impairment manifested across all three domains: uncertainty of perception (7.16, SD = 2.45), reality distortion (3.52, SD = 1.21), and hallucinations/delusions (26.63, SD = 5.83). Interestingly, specific demographics (male, unmarried, 40–50 years old) and those with a duration of illness of less than 5 years had higher mean scores (27.35, SD = 5.61).Insecure attachment styles, notably anxious and avoidant, are dominant among clients with schizophrenia, who also struggle with reality distortion, perceptual uncertainty, and hallucinations/delusions in all three domains.Healthcare providers and nurses should understand the psychological dynamics of clients with insecure attachment styles to establish effective therapeutic relationships. A secure, structured, and consistent environment is vital to modifying insecure attachment styles and promoting reality orientation. Secure Attachment Style Oriented Psycho‐Educational Program, Mentalization, Cognitive Interpersonal Therapy, and Cognitive Analytic Therapy can help reduce reality‐testing impairment. Fostering Maternal and Child Health (MCH) centers on empathizing secure bonds between mothers (and mothers‐to‐be) and their children to promote healthy attachment styles as a preventive measure. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Negative attitudes towards mental illness lead to the formation of stigma. Stigma prevents the recovery of people diagnosed with mental illness.There is evidence of stigmatic attitudes towards mental ill health among mental health professionals.Anti‐stigma initiatives, such as education and training, may be effective in enhancing or maintaining positive attitudes towards mental illness among mental health professionals. What this paper adds to existing knowledge?: Education and training that is designed and delivered around a specific mental health diagnosis or condition appears an appropriate strategy that could benefit mental health professionals to develop a deeper appreciation and understanding of mental ill health and its impacts on individuals.Consumer involvement in the education and training of mental health professionals regarding the stigma of mental illness is recommended; however, this is an under‐explored area of investigation.There is a weak evidence base regarding the long‐term sustainability of effects from anti‐stigma education and training. This should be addressed via further research in future. What are the implications for practices?: Anti‐stigma initiatives can support mental health professionals to develop stigma‐free, recovery‐oriented practices in their work. Further, such initiatives can improve the provision of evidence‐based quality care for the consumers, facilitating their recovery. Introduction: Despite an increasing focus on stigma, evidence shows prejudicial attitudes towards mental illness among mental health professionals still exist. It is suggested that anti‐stigma initiatives can aid in enhancing the attitudes of mental health professionals. However, research on initiatives targeting stigma of mental illness among mental health professionals is limited. Aim: To identify and analyse scientific literature pertaining to the effectiveness of anti‐stigma initiatives regarding mental ill health among mental health professionals. Method: A systematic literature review was performed using the databases MEDLINE, CINAHL, PsycINFO, PubMed, Scopus, Google Search engine and Google Scholar. The papers were limited to English language, published in peer‐reviewed journals with full‐text articles available and published between the years 2008 and 2020 to understand the most recent trends in the attitudes of mental health professionals including nurses. The Population, Intervention, Comparison and Outcome (PICO) strategy was used to identify papers meeting the inclusion criteria. Results: A total of 439 papers were identified. However, papers not meeting the inclusion criteria were excluded from selection. Three appraisers reviewed the selected papers individually using the Joanna Briggs Institute [JBI] critical appraisal tool. Finally, eight unanimously accepted papers were included in the systematic review. Several effective anti‐stigma initiatives were identified through the review, and these had positive impacts on mental health professionals' attitudes towards mental illness, for at least a short period. It was identified that contact‐based interventions are relevant and effective although the involvement of consumers and caregivers in the design and delivery of interventions was not explicitly addressed in detail in studies included in the review. Education strategies tailored for specific mental illness may be more appropriate, rather than approaches that refer to mental illness in general. Conclusions: This review shows the evidence of pessimistic attitudes towards mental illness persists among mental health professionals. Anti‐stigma initiatives identified in the selected papers were effective in changing these attitudes. Future research should be focused on the effectiveness of contact‐based interventions and understanding the longer‐term effects of the interventions among homogeneous groups. Full consideration of the varying level of clinical experience and expertise in mental health should guide the development and implementation of anti‐stigma initiatives in this context. Implications for practice: Anti‐stigma interventions can have a positive impact on mental health professionals' knowledge, attitudes and supportive caring for people diagnosed with mental illness. Such anti‐stigma interventions may meaningfully support stakeholders to address the impact of negative attitudes on the physical and mental health status of people diagnosed with mental illness. With sustained leadership, effort and reinforcement, it is possible to create workplace cultures that prioritize stigma‐free and recovery‐oriented behaviours and practices within mental health services. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: People with mood disorders often use substances.There are several clinician‐driven hypotheses explaining the relationship. What the paper adds to existing knowledge?: The paper draws together the existing research on the perceptions of those with lived experience of mood disorders on the reasons for using substances.The participants in the studies identified using substances to manage their mood when treatment to manage their mood was not effective or acceptable, and as an escape from trauma and hardship. What are the implications for practice?: Mental health nurses need an understanding of why people with mood disorders may use substances and the impact of this on their treatment.Mental health nurses need to provide trauma‐informed care that emphasizes harm reduction for those who have mood disorders and substance use. Introduction: Substance use is highly prevalent among people with mood disorders. Effective treatment for these people requires a better understanding of the relationship between both mood and substance use from the perspectives of those with lived experience. Question: What are the reasons those with lived experience of mood disorders give for substance use? Method: An integrative review was conducted. The Joanna Briggs Institute suite of critical appraisal tools was used to evaluate the quality of individual studies. Data relevant to the review question were extracted, and the results were synthesized into themes. Results: Eighteen papers met the eligibility criteria. Three themes were identified across the included studies: Managing my mood, More Effective than prescribed medication, and Escape from trauma and hardship. Discussion: This integrative review identified that people with a mood disorder who use substances described choosing to take substances to manage their mood, as an alternative to prescribed medications, and to cope with trauma and social hardships. Implications for Practice: Mental health nurses need to provide care that recognizes why people use substances. They need to understand these reasons to provide a harm reduction and trauma‐informed model of care. Evidence‐based non‐pharmacological interventions for mood disorders need to be available as an alternative to medications or as a supplement. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Lived experience narratives of recovery can provide an insight and subtlety where academic papers can often fall short.There is a need for people who work in mental health services to address and take care of their own psychosocial needs. What the paper adds to existing knowledge?: This paper provides a unique insight into a care professional's recovery from mental ill health.Looked at through this dual lens of service user and care professional provide the reader with a rich narrative from the perspective of both sides of the caring role. What are the implications for practice?: People who work in caring roles need to be vigilant of their own needs and the impact that the work can have on them.Safety protocol for managing one's own mental health should be a requirement for people within the caring profession. Introduction: This is an account of my experiences becoming unwell and accessing general and mental health services in Ireland. Aim: It is hoped that this lived narrative of my recovery will shed light on accessing mental health services from a dual lens; that of service user and social worker. Method: It traces this experience from initial contact with my general practitioner, to admission to a secure psychiatric ward where recovery slowly began. Results: It is also hoped that reading my experiences of recovery and some of the insights shared will help those in the nursing or social care profession consider how they may be affected by their work. Discussion: It is important to note that this account views my experiences within a neurobiology framework and this might not align to other people's experiences. However, my narrative of help‐seeking is complex and includes multiple points where I uncover insights and encounter different healthcare professionals. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The COVID‐19 pandemic has induced a considerable amount of mental health difficulties, ranging from anxiety and depression to psychosis. As services struggle to cope with the demand for support, the effect of such psychological challenges on quality of life remains a major concern. What does the paper add to existing knowledge?: Since the beginning of the COVID‐19 pandemic, a vast amount of research has focused on the physical consequences of the virus. Gradually, studies on the mental health effects related to the pandemic started to emerge, as it became clear that mental health difficulties were as present and as concerning as the physical ones. Whilst such studies commonly explore the prevalence and nature of the presenting mental health challenges, the publication of personal mental health experiences linked to the ongoing situation is lacking. Introducing the human element in literature is an important means of raising awareness on the mental health difficulties that can be triggered by the pandemic. Using public figures such as the individual in this paper is additionally powerful due to the role model effect. What are the implications for practice?: The paper highlights the need for enhanced awareness and monitoring of mental health especially by health professionals who therefore need to receive adequate mental health training. Furthermore, mental health awareness efforts need to be considered as being a part of the role of the psychiatric and mental health nurse who is at a prime position to educate, monitor and support those receiving care. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known about the subject?: Although sexual violence is prevalent, incidents of stranger rape remain statistically uncommon.Societal stigma and myths surrounding sexual violence are widespread.An individual's experience in the immediate aftermath and beyond can be shaped by the perception/s of sexual violence which are held and expressed by those they come into contact with. What this paper adds to existing knowledge?: This paper adds to the limited literature base and the population and practical‐knowledge gap around a specific form of sexual violence.This paper also demonstrates the need for reflection and discussion in minimizing blame that can unconsciously be shifted onto survivors in the form of myths and stereotypical views of sexual violence. What are the implications for practice?: Perceptions may be held around sexual violence, and by extension about the survivor, which may impede engagement and the building of trust within a therapeutic relationship.Myths that are synonymous with rape and all forms of sexual violence can be held by professionals, and lead to blame, negative judgement and lack of empathy towards survivors.Given the prevalence of sexual violence, this paper is applicable across all health and social care settings, and in particular mental health nursing professionals who may be more likely to meet people who have experienced sexual trauma. Introduction: This narrative illustrates the lived experience of a specific form of sexual violence (stranger rape) and its resulting implications as experienced by the second author, which is discussed under the following headings: your body as a crime scene, how lived experience compares to the myth of the 'real rape' and the wellbeing and health consequences arising from the experience. [Correction added on 5 September 2022, after first online publication: The preceding paragraph has been corrected in this version.] Aim: In their capacity as mental health nurses, the authors invite readers to consider the spoken, or more likely unheard stories of sexual violence, which are unfortunately commonplace among those who access mental health services. Implications for Practice: For professionals holding the privileged position of hearing these stories, there is a need to be reflective as to how fear, and personal or professionally held myths and stigmatizing views of sexual violence, and by extension views towards the survivor, are carried into therapeutic spaces, and the implications these can have. Practical suggestions as to how to discuss and manage disclosure of sexual violence in the context of trauma informed care are also provided. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject: Family members and friends (informal carers) are very important for providing support to people with mental health difficulties.When these carers are included to care planning patients seem to benefit, as they are less likely to relapse. What the paper adds to existing knowledge: There are three types of interventions including carers in the patients'transition 1) programmes that offer education in hospital; 2) programmes that involve carers in planning the patients discharge; and 3) programmes that involve carers in hospital care, discharge planning and also follow‐up in the community.Interventions including carers that take place both in the hospital and the community have the clearest evidence for benefit on relapse reduction. What are the implications for practice: Comprehensive interventions have the best evidence for effectiveness but challenges in their implementation and resourcing should be considered.It might worth trying to identify and test simpler interventions focusing on discharge planning that can be used in busy services and require more limited resources whilst providing opportunities for the participation of carers. Introduction: Involving informal carers (family and friends of patients) in mental health interventions can lead to positive clinical and psychosocial outcomes such as relapse prevention or treatment adherence. Aim/Question: To explore the evidence on the effectiveness of different models that involve carers in the transition between hospital and community mental health care. Methods: Five electronic databases (PsycINFO, CINAHL, MEDLINE, Embase and Scopus) and Grey literature (Open Grey and Grey Literature report) were systematically searched. The results were analysed using a narrative synthesis. Results: Fourteen papers were identified. They described twelve interventions that were categorized into three groups: 1) purely educational programmes in preparation of discharge; 2) programmes that involved carers in planning the transition from the mental health inpatient treatment to community mental health services; and 3) programmes that bridged into the aftercare involving carers in community follow‐up. The most comprehensive interventions, i.e. those including psychoeducation, care planning and aftercare follow‐up were better evaluated and showed a clearer benefit in improving long‐term outcomes and, in particular, reduce re‐hospitalization. Implications for practice: Comprehensive interventions showed the clearest benefit in improving long‐term clinical outcomes of patients. Future research should explore implementation, costs and cost‐effectiveness, as comprehensive interventions delivered across different settings are likely to require wide‐ranging organizational changes and significant resources. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: The use of chemical restraint in emergency situations is to control aggression or violence to protect consumers and staff and is to be used as a last resort when all other behavioural control alternatives have been exhausted.Chemical restraint involves the use of medication. What the paper adds to existing knowledge?: This is the first paper to systematically review the prevalence of the use of chemical restraint.The use of chemical restraint is common across emergency departments and acute psychiatric inpatient units worldwide.Consumers who are restrained are also likely to receive chemical restraint.The studies reviewed demonstrate that there is a need for more standardized data collection so that clearer comparisons can be made between healthcare settings and countries. What are the implications for practice?: Implications of practice include the need to report adverse events post‐chemical restraint as these can deleteriously affect a person's physical health.Identification of and staff education about first‐line management techniques before chemical restraint is administered are significant to reduce its use. Introduction: Chemical restraint is used to manage uncontrolled aggression, agitation or violent behaviours of consumers with mental health disorders admitted to acute psychiatric or emergency settings. Aim: This systematic review aimed to synthesize the international prevalence of chemical restraint for non‐consenting adults. Method: PsycINFO, CINAHL, MEDLINE/PubMed and Google Scholar databases were searched for peer‐reviewed literature published between January 1996 and July 2018. This paper reports on data extracted from retrospective audits of chemical restraint practice. Results: Forty‐eight papers were included. The median prevalence of use of any restraint was 21.2% (25th% 8.0 to 75th% 36.3). Median prevalence of people who were chemically restrained, of all people restrained in any manner, was 43.1% (25th% 22.9% to 75th% 70.7%). Of all people admitted to facility(ies), the median prevalence of chemical restraint was 7.4% (25th% 2.7 to 75th% 17.6). There was no statistically significant difference in any prevalence measure considering healthcare setting or country. There was a significant decrease over the review period in the use of any restraint, including chemical restraint. Discussion and implications for practice: This is the first known comprehensive meta‐view of chemical restraint use worldwide, highlighting the need for standardized data collection to enable comparisons between healthcare settings and countries. Relevance statement: There is an international imperative to reduce or eliminate the use of coercive practices, such as physical and chemical restraint, in mental health care. This study provides important information for mental health nursing by synthesizing the international prevalence of chemical restraint for non‐consenting adults. This meta‐view of the worldwide use of chemical restraint can inform ongoing efforts to reduce its use. [ABSTRACT FROM AUTHOR]