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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 on the subject?: PhotoVoice as a participatory methodology has been used within mental health to support marginalized communities in addressing the challenges they encounter.The PhotoVoice methodology aims to encourage and foster collaborative and equal partnerships. However, reports of previous projects highlight that not every stage of the process remains participant‐centric.There is limited reporting on participant involvement in the latter stages of projects, such as exhibition design. What the paper adds to existing knowledge?: It provides a detailed description of the phases involved in planning and executing a mental health PhotoVoice project.It provides an illustration of how collaborative partnerships can extend into the design and construction of a photography exhibition and its narrative. What are the implications for practice?: PhotoVoice is an ideal methodology for use within the field of mental health nursing as it promotes service user inclusion in research, places value on lived experiences and provides a creative medium through which service users and family members can advocate for themselves and others.PhotoVoice is an effective and creative methodology for disseminating and communicating both the individual and collective outcomes to the general public.When implementing this methodology, clinicians and researchers need to be cognisant of the necessity to include participants as equal partners at every stage, including in the design of photography exhibitions and disseminating the findings to academic and public audiences. Introduction: PhotoVoice is a participatory methodology in which marginalized communities represent their lived experiences through photography. While the methodology aims to foster partnerships throughout all phases, the literature suggests that in the field of mental health, some phases are often completed without participant involvement. Aims: This paper elaborates on how the PhotoVoice method was used to engage service users and family members around their experience of involvement in a co‐produced and co‐facilitated mental health education intervention, in order to enhance public and policymakers knowledge of the project. Methods: Ten participants were recruited and trained in the PhotoVoice method. Participants documented, through photography, their experiences of involvement in the education intervention. Following this, participants came together to co‐produce and disseminate the photography exhibition to the public. Results: PhotoVoice proved to be a flexible and creative method by which to include marginalized groups. By adhering to the collaborative principles of the methodology, service users and family members can retain decision‐making power from the project's inception to its conclusion. Implications for Practice: PhotoVoice is ideal for use within mental health nursing as it coincides with the recovery principle of promoting collaborative partnership between service users, family members and clinicians. Mental health nurses work directly with service users and family members throughout their recovery journey. The PhotoVoice methodology is coherent with the recovery principles of empowerment, collaboration and prioritizing the lived experiences of the individual. As such, this methodology has the potential to enhance greatly what mental health nurses can know and understand about the lived experiences of service users and family members. In turn, engaging with the PhotoVoice methodology can provide a platform from which further collaborative engagement between service users, family members and clinicians can take place. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Problematic internet use (PIU) negatively affects adolescents' lives biopsychosocially.There is limited qualitative research examining the problem of PIU in adolescents. These studies focused more on the non‐clinical population. Adolescents' perceptions of the internet, their thoughts, feelings and behaviours in situations where they can and cannot access the internet have rarely been examined. What does the paper add to existing knowledge?: This research provides an in‐depth look at the experiences of adolescents with PIU in a clinical population.Unlike previous studies, adolescents mentioned that they turned to the internet for reasons such as lack of activity, their need to spend time with their friends and better getting along with people they met on the internet. They also described a world without internet as apocalypse, desert and grave.In this study, a holistic emphasis was placed on the thoughts, feelings and behaviours of adolescents in situations where they could and could not access the internet. This may contribute especially to mental health nurses working in clinics in terms of understanding the thought‐emotion and behaviour patterns of adolescents with PIU.Adolescents also stated that their lives were affected positively and negatively as a result of PIU. What are the implications for practice?: Mental health nurses can use activity therapy, behaviour modification: social skills, coping enhancement, parent education: adolescent, self‐awareness enhancement, cognitive restructuring, emotion and behaviour management interventions to reduce the risk of PIU and the problems it causes for adolescents. What are the implications for practice?: Mental health nurses can use activity therapy, behaviour modification: social skills, coping enhancement, parent education: adolescent, self‐awareness enhancement, cognitive restructuring, emotion and behaviour management interventions to reduce the risk of PIU and the problems it causes for adolescents. Introduction: Studies on problematic internet use (PIU) are mostly on the non‐clinical population. Understanding the experiences of adolescents with PIU is critical in shaping nursing interventions and improving the quality of care. Aims: A comprehensive description of the experiences of adolescents with PIU. Methods: In the study, descriptive phenomenology design, one of the qualitative research methods, was used. Data were collected using a personal information form and a semi‐structured interview form and analysed using Giorgi's phenomenological method (n = 11). Results: As a result of the content analysis, five main themes were identified: reasons of PIU, internet‐related perceptions, experiences in accessing the internet, experiences in not being able to access the internet and consequences of internet use. Discussion: Different from previous studies, adolescents stated that they use the internet because of their lack of activity and their need to spend time with their friends. They stated that when they could not access the internet, they thought they could never live without the internet and started quarrel. [ABSTRACT FROM AUTHOR]

Accessible Summary: What Is Known on the Subject?: The decision to apply for disability benefits may be an important breakthrough in the life of people with severe mental illness.The literature regarding the process of applying for mental health disability benefits is scarce. What the Paper Adds to Existing Knowledge?: This study is, to the best of our knowledge, the first to fully describe the experience of submitting a claim for mental health disability benefits, as experienced by those diagnosed with severe mental illness.The process of applying for recognition of a mental health disability has three chronological stages—before the claim submission, during the claims process and after recognition.Clients approach the process without any prior knowledge, and therefore they need professional help when submitting their claim.A deterioration in clients' mental health prompts them to apply.A lack of trust in the system affects the application decision/process.The medical committee hearing is described as a complex and multifaceted experience.Clients reported being extensively preoccupied with stigma throughout the process. What Are the Implications for Practice?: Professional assistance throughout the claims process is a key factor with the potential to change clients' experience of the entire process.It is important to educate mental health nurses about the disability applicating process.Mental health professionals are encouraged to be mindful of the facilitating/hindering mechanisms that are dominant at each stage of the process.There is a need for liaising with relevant agencies that act as advocates for those diagnosed with a mental health illness. Introduction: The decision to apply for disability benefits may be an important breakthrough in the life of those diagnosed with severe mental illness (SMI). Nevertheless, the literature regarding the application process is scarce. Aim: The aim of the study was to explore how people who receive mental health disability benefits retrospectively perceive the process of applying for and receiving these benefits. Methods: Twenty‐four in‐depth qualitative interviews were conducted with people whose mental health disability was recognized in the past few years. Results: Analysis revealed three themes describing the process's chronological stages: Before submitting the claim (from deterioration to trust), during the claim process (from bureaucracy to understanding), after receiving recognition (from stigma to gratitude). Each stage includes facilitating factors (e.g. encouragement from professionals) and hindering factors (e.g. stigma, lack of knowledge and trust). Discussion: This is the first study to fully describe the experience of applying for mental health disability benefits, as experienced by clients. The decision to apply is perceived as complex and difficult. Although clients are extensively preoccupied with stigma throughout the process, they are able to express gratitude for the opportunities made available to them. Implications: Professional assistance throughout the claim is a key factor with the potential to change clients' experience of the entire process. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Mobile mental health apps are increasingly being used by both mental health nurses to promote individual self‐managemental of mental health conditions and by consumers.Perceptions about specific apps are known, but the overarching acceptability and usability of mental health apps in general less understood. What the paper adds to existing knowledge?: This paper identified consumer perceptions of mobile mental health apps.Six key areas were identified that future mobile app developers should consider to maximize consumer engagement with mental health apps.Consumers also highlighted that apps do not replace traditional mental health nursing—rather these supplement existing care. What are the implications for practice?: This review found that mental health apps are generally viewed positively by consumers; however, factors such as ease of use, usefulness of content and privacy need to be considered to maximise and sustain app engagement. Introduction: There is increasing interest in the use of mobile mental health applications (apps) to manage mental health conditions. Understanding user perceptions is key to maximise app engagement and inform how apps can be used to support mental health nursing care. Aim: This integrative review explores consumers' perceptions of mobile mental health apps to gain insight into user preferences and acceptability. Methods: This integrative review was based on searching four databases: CINAHL, EMBASE, Medline, PsycInfo. Inclusion criteria were: (i) articles published after 2000; (ii) focused on apps for mental health disorders; (iii) explored consumers' perception of using a mental health app. Abstracts were screened and eligible papers reviewed. Data on user perceptions were extracted and analysed thematically. Results: Seventeen articles were identified. Overall, consumers did not feel that app use replaced traditional health care. Six themes were identified: "Helpfulness," "Improvements/enhancements," "Technical issues," "Easy to use," "Satisfaction with the app" and "Perceived issues." Consumers indicated a preference for personalization for the app to meet individual needs. Discussion and Implications for Practice: Mental health apps are generally viewed positively by consumers; however, factors such as ease of use, usefulness of content and privacy need to be considered to maximise and sustain app engagement. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: People diagnosed with "BPD" often experience crisis and use services"BPD" is a controversial diagnosis, and the experience of crisis and crisis intervention is not well understood What this paper adds to existing knowledge?: People diagnosed with "BPD" have different experiences of crisis, and using the diagnosis alone as a basis for deciding care and treatment is not appropriateThere are many human factors which can influence how professionals deliver care to people diagnosed with "BPD" What are the implications for practice?: The education of staff, views on responsibility, team conflicts and access to clinical supervision can have an impact on how care is delivered, and should be addressed by organizations providing crisis care.Access to care often occurs when a person is self‐harming or suicidal, but does not address underlying distress. Crisis care should go beyond managing behaviour and address any underlying needs. Introduction: "Borderline personality disorder" ("BPD") is associated with frequent use of crisis intervention services. However, no robust evidence base supports specific interventions, and people's experiences are not well understood. Aim: To explore the experiences of stakeholders involved in the crisis care of people diagnosed with "BPD." Method: Integrative review with nine databases searched January 2000 to November 2017. The search filtered 3,169 titles and abstracts with 46 full‐text articles appraised and included. Results: Four themes were constructed from thematic analysis: crisis as a recurrent multidimensional cycle, variations and dynamics impacting on crisis intervention, impact of interpersonal dynamics and communication on crisis, and balancing decision‐making and responsibility in managing crisis. Discussion: Crisis is a multidimensional subjective experience, which also contributes to distress for family carers and professionals. Crisis interventions had limited and subjective benefit. They are influenced by accessibility of services, different understandings of "BPD" and human dynamics in complex decision‐making, and can be experienced as helpful or harmful. Implications for practice: Subjectivity of crisis experiences shows limitations of the diagnostic model of "BPD," emphasizing that interventions should remain person‐centred. While thresholds for intervention are often met after self‐harm or suicidality, professionals should review approaches to care and support people with underlying distress. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Contemporary mental health policy stipulates consumer participation in all aspects of mental health services including service evaluation and other forms of mental health research.Research is identified as underpinning quality mental health services, and therefore, consumers researchers could enhance the mental health sector by contributing to the quality, credibility and relevance of mental health research. What this paper adds to existing knowledge?: Non‐consumer researchers generally supported the concept of a consumer expert reference group for researchers at the individual and institutional level.A consumer expert reference group should reflect diversity and offer expertise relevant to the topic of research and may represent one way to normalize partnerships with consumer researchers and realize the benefits they can bring to research. What are the implications for practice?: Quality mental health services are underpinned by robust research evidence. It is crucial that consumers are active participants in research activity.The availability of a consumer expert reference group could facilitate collaborations between consumer and non‐consumer researchers and contribute to a stronger consumer focus embedded in mental health research. Introduction: Contemporary mental health policy identifies consumers as active participants in all aspects of mental health services from design to evaluation. Consumer researchers should be actively involved in mental health research and contribute to quality service delivery. Aim: To gain a snapshot of mental health researcher views on strategies for increasing research by or with consumers in mental health through the establishment of an Expert Consumer Researcher Group (ECRG). Methods: Cross‐sectional survey of 41 non‐consumer mental health researchers from Australia or New Zealand. Results: The introduction of an ECRG was considered an effective strategy for linking consumer and non‐consumer researchers and providing specialist advice on research design and methodology. The most suitable location for this group was identified as within consumer advocacy agencies (71%), universities (66%) or research funding bodies (66%). Participants rated their likelihood of seeking advice from the ECRG as high. Discussion: Research participants supported the value of an ECRG. They emphasized the importance of ensuring the group reflected a diversity of views and offered specialized expertise related to the specific topic. The ECRG could benefit both individual researchers and larger research organizations. Implications for practice: An ECRG could facilitate collaborations with consumer researchers and in turn enhance the quality of mental health research. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known of the subject: Consumer participation in mental health services is an expectation articulated through mental health policy.Consumers as researchers could contribute significantly to mental health services. Barriers to participation are significant and limit consumer involvement. What the paper adds to existing knowledge: Enhanced understandings of collaborative relationships between consumer and nonconsumer researchers.Researchers from the health disciplines find value in consumer involvement in mental health research.These researchers can support and facilitate consumer research by being allies to consumer researchers. What are the implications for practice: Understanding the role of allies is necessary to strengthen their capacity to support consumer researchers.Involving consumers in mental health research is likely to lead to improved practice. Introduction: Australia and New Zealand mental health policy requires consumer participation in all aspects of mental health services. Systemic participation informs and improves the quality of mental health services. Collaboration with consumer researchers should be similarly required. Enhanced understandings of collaborations are needed. Aim: To enhance understanding of the perspectives and experiences of nonconsumer researchers in working collaboratively with consumers as researchers. Method: This qualitative exploratory study involved interviews with nonconsumer mental health researchers who have worked collaboratively with consumers in research. Interviews were conducted with participants from Australia and New Zealand. Results: "Allyship" emerged as a major theme. This describes nonconsumer researchers playing an actively supportive role to facilitate opportunities for the development and growth of consumer research roles and activities. Seven subthemes were identified: establishing and supporting roles, corralling resources, guiding navigation of university systems, advocacy at multiple levels, aspiring to coproduction and consumer‐led research, extending connections and partnerships, and desire to do better. Discussion: Allyship may have an important role to play in the broader consumer research agenda and requires further consideration. Implications for practice: Embedding meaningful consumer participation within mental health services requires active consumer involvement in research. Allies can play an important facilitative role. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Around the world, recovery has become a focus in mental health policy. The participation of people accessing mental health services (consumers) and carers of such individuals in decision-making related to services forms part of this recovery orientation and studies suggest positive outcomes following such participation., However, little is known about consumer and carer desires at the earliest stages of development of new services., What this paper adds to existing knowledge? Consumers and carers desire changes to how mental health services are provided., Many factors affect consumer and carer experiences, including language use, physical design of spaces, accessibility, consideration of individual needs, practical help and how well care is continued from hospital to community settings., Carers may feel sidelined in treatment and be distressed as a result. They wish to be respected and involved in recovery., Consumers and carers wish for focus on broader health, with care taken to address physical health, psychological needs, social needs and treatment of the whole person rather than just an illness., What are the implications for practice? Consumers and carers desire partnership with professionals in recovery. Tokenistic participation should be avoided., Flexibility in how services are provided and less formality may help engage consumers and carers. Specifically, professionals may help by linking consumers and carers to services that address practical needs., Professionals should communicate with carers to draw on their expertise about the individual accessing the mental health service and help carers understand how they can assist the individual's recovery., Abstract Introduction Recovery-oriented mental health policies recognize consumer and carer participation in service decision-making as essential, but little is known about the views of these individuals in the earliest stages of service development. Aim This study sought consumer and carer perspectives addressing the establishment of a mental health research, treatment and teaching facility in their region. Methods Two 2-hr focus groups were conducted, with separate groups held for mental health consumers ( n = 9) and carers ( n = 9), respectively. Discussions pertained to mental health literacy, gaps in current services, desires for an ideal facility (in terms of physical design and services offered) and what would help in recovery. Results Inductive thematic analysis was used to generate three themes: care outside of consultations, carer involvement in recovery and holistic approaches to mental health care. Consumers desired a facility that could cater to individual needs. Carers felt excluded in recovery and unable to provide effective support. Both groups preferred holistic approaches to mental health, expressing ambivalence towards medication and hospitalization. Discussion Consumers and carers have many needs that conventional practices may not meet. Implications for practice They have clear desires for equal partnership in recovery and for transformation of conventional treatment methods. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? UK NHS policy highlights the importance of user and carer involvement in health professional training., We know little about service user and carer motivations and experiences of accessing training courses for delivering training to health professionals and how well such courses prepare them for delivering training to healthcare professionals., 'Involvement' in training has often been tokenistic and too narrowly focused on preregistration courses., There is limited data on how best to prepare and support potential service user and carer trainers., What does this paper add to existing knowledge? This study adds to the international literature by highlighting service user and carer motivations for accessing a training course for delivering training to health professionals., Service users and carers wanted to gain new skills and confidence in presentation/facilitation as well as to make a difference to healthcare practice. We also learned that service users desired different levels of involvement in training facilitation - some wanted to take a more active role than others., A one-size-fits-all approach is not always appropriate. Encountering resistance from staff in training was a previously unidentified challenge to service user and carers' experience of delivering training in practice and is a key challenge for trainers to address in future., Professional training involvement can be enhanced via specialist training such as the EQUIP training the trainers programme evaluated here., What are the implications for practice? When training service users and carers to deliver training to mental health professionals, it is important that service users are equipped to deal with resistance from staff., It is important that service user and carer roles are negotiated and agreed prior to delivering training to healthcare professionals to accommodate individual preferences and allay anxieties., Training for service users and carers must be offered alongside ongoing support and supervision., Mental health nurses (and other health professionals) will be better able to involve service users and carers in care planning., Service users and carers may feel more involved in care planning in future., Abstract Introduction Limited evidence exists on service user and carer perceptions of undertaking a training course for delivering care planning training to qualified mental health professionals. We know little about trainee motivations for engaging with such train the trainers courses, experiences of attending courses and trainees' subsequent experiences of codelivering training to health professionals, hence the current study. Aim To obtain participants' views on the suitability and acceptability of a training programme that aimed to prepare service users and carers to codeliver training to health professionals. Method Semi-structured interviews with nine service users and carers attending the training programme. Transcripts were analysed using inductive thematic analysis. Results Participants' reasons for attending training included skill development and making a difference to mental health practice. Course content was generally rated highly but may benefit from review and/or extension to allow the range of topics and resulting professional training programme to be covered in more depth. Trainees who delivered the care planning training reported a mix of expectations, support experiences, preparedness and personal impacts. Implications for Practice Mental health nurses are increasingly coproducing and delivering training with service users and carers. This study identifies possibilities and pitfalls in this endeavour, highlighting areas where user and carer involvement and support structures might be improved in order to fully realize the potential for involvement in training. [ABSTRACT FROM AUTHOR]