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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]

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?: 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]

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 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 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: Adult psychiatric services typically focus on the mental health needs of the client but they do not support his or her parenting role.Many authors highlight the importance of a non‐judgmental approach when providing support and care to clients with mental illness who are parents.Assessments frequently focus on the negative aspects while the strengths of these families were often overlooked.There is a lack of scientific literature exploring nurses' experiences when caring for parents with mental illness and their families. What this paper adds to existing knowledge: Trust is the basis that helps clients to be open to receiving care and answering parenting‐related questions. Therefore, without adequate professional‐client trust, some care and interventions addressed to parents with mental illness could be poorly received by the client.Tronto's phases of care facilitated the collection of data and exploration of mental health nurses' experiences of care. What are the implications for practice: Mental health nurses should be aware of the potential needs of these families, as described in the scientific literature, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique.Mental health nurses must take the person's environment into account (family, social and political aspects and different forms of stigma) since all these factors may influence how parents with mental illness receive and provide care. Introduction: Many authors highlight the importance of a non‐judgmental approach when providing care to parents with mental illness. However, assessments frequently focus on the negative aspects while the strengths of such families were often overlooked. Aim: To explore the lived experiences of mental health nurses who care for clients who are parents. Method: We conducted a qualitative phenomenological study. The main data collection technique was in‐depth interviews. Data were analysed according to Colaizzi model, subsequently, the main categories that arised were compared and related to the five phases of Tronto's care. Results: The main categories identified from the analysis of the interviews were: (1) individualized care, (2) continuity of care, (3) psychoeducation and counselling, (4) trust and (5) context of the client. Discussion: Trust is the basis that helps parents with mental illness to be open to receiving care and answering parenting‐related questions. Without trust, some interventions could be poorly received by the client. Implications for Practice: Mental health nurses should be aware of the potential needs of these families, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique. [ABSTRACT FROM AUTHOR]

Accessible summary: What Is Known on the Subject?: There are significant issues recruiting nurses into mental health due to several reasons such as dilution of curriculum, and mental health being an unpopular career choiceTransition programs provide nurses entering mental health with orientation, academic and clinical skills, and knowledge. What the Paper Adds to Existing Knowledge?: Transition programs need to be nuanced to specialty areas (e.g. community) to ensure nurses are given the support necessary to remain working in the field.Many nurses choose to work in mental health due to a lived or personal experience and as such strengthening wellbeing supports for transitioning nurses is an important role in retention. What Are the Implications for Practice?: Tailored transition programs can help strengthen mental health nurse role clarity, and support staff retention.Transition programs should be a segue to formal postgraduate studies in mental health nursing to strengthen professional practice and retention of nurses. Introduction: Globally, there are consistent issues recruiting staff into the mental health nursing workforce. In Australia, recent efforts to expand the workforce include recruitment of a wider range of nurses in addition to new graduates into mental health transition‐to‐practice programs. Understanding the career motivations of nurses entering the field is an important element of recruitment and retention. Aim: To describe nurses' satisfaction with their mental health transition program and identify factors influencing their choice of mental health as a career. Methods: An online cross‐sectional survey with questions on program satisfaction and career choice was responded to by n = 55 enrolled and registered nurses in a mental health transition program. Results: Nurses reported overall high satisfaction with their program and identified increased time release for professional development and being supernumerary as necessary to support role development. Almost 25% of nurses reported personal experience of mental illness as an influence in choosing a mental health career. Discussion: Mental health transition programs are important in recruitment and retention and need to be tailored to the needs of a wide range of nurses and include support for staff wellbeing. Implications for Practice: Tailored transition programs can help strengthen role clarity, and support staff retention. [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?: 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: 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]

Accessibility Summary: What is known on the subject?: A significant number of people with mental health diagnoses have also experienced some form of trauma.In 2008, it was recommended that MHTs in England provide training to MHPs to support them in how to ask their service users about trauma and abuse.It has been identified that staff are not consistently enquiring about trauma and abuse in mental health services. What the paper adds to existing knowledge?: A description of how many MHTs in England are providing training for staff to ensure that they enquire about trauma and abuse.The current gaps in the resources available for mental health practitioners and staff. What are the implications for practice?: Much more work and development of trauma‐informed care and accessibility of training is needed for MHPs working in MHTs.Most MHTs still need to take the first step of implementing training in trauma‐informed care. This should involve ways to ask about trauma and abuse and advice on how to respond to any disclosures made. Introduction: Trauma, abuse and adversities are extremely prevalent for those who access secondary mental health services. Health policy guidance recommends that mental health professionals (MHPs) should routinely enquire about trauma and abuse. Staff training is required to adopt trauma‐informed approaches, as research has identified a clear gap in practice. This study provides a baseline measure of the current provision of trauma‐informed training in English mental health trusts (MHTs). Question: What trauma‐informed training is currently available for MHPs in England? Method: A freedom of information request was submitted to 52 MHTs in England to explore the current training available for MHPs in trauma‐informed care, routine enquiry into abuse and responding to disclosures. Results: The results showed 70% of respondents reported no available training in trauma‐informed care. Discussion: Many MHTs in England do not provide any trauma‐informed training (despite existing recommendations from 2008). Does this contribute to the re‐traumatisation of patients? Implications for Practice: MHTs in England require a responsible and active approach to training MHPs in sensitive routine enquiry into trauma and abuse as a first step to becoming trauma responsive. [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]

This contribution aims to highlight the theoretical and epistemological premises of the co‐writing experience, a practice where a clinician and a patient are mutually engaged in jointly or collaboratively writing a narrative related to the patient's experience. Unlike a typical set of therapeutic techniques, co‐writing is based on sharing perspectives and meanings about the experience of crisis, recovery, and the therapeutic process. The paper identifies and briefly describes four non‐clinical epistemological paradigms on which it is grounded: ethnography, values‐based practice, narrative care, and phenomenology. Although they differ in several ways, at the same time, they seem to share some common features that the paper investigates and comments. For clinicians, nurses, researchers and Mental Health Service managers, attention to the users and to the improvement of their active roles represents not only a strategy for the empowerment of results, but also the access door to a different perspective which relies on a renewed conceptualization of the mental disease nature that may lead to overcoming the epistemic asymmetry between the 'expert' and the 'other' in favor of intersubjective dialogue. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Seclusion is a harmful and traumatising intervention for people accessing mental health services.People who are subject to seclusion in inpatient mental health services often first experience this within the first 24 h following admission.There is limited research examining how recent contact with services impacts the likelihood of seclusion when people are admitted to inpatient services. What the paper adds to existing knowledge?: Males, Māori and Pasifika experience higher rates of seclusion within the first 24 h following inpatient admission.People perceived by clinicians as overactive, aggressive, disruptive or agitated are seven times more likely to be secluded within the first 24 h.People referred from police or justice services are three times more likely to be secluded within the first 24 h.People who had frequent contact with community mental health services prior to inpatient admission were less likely to be secluded. What are the implications for practice?: The first 24 h of inpatient admission is a critical focus for eliminating the use of seclusion. Initial interactions with people recently admitted should focus on nurturing relationships and reducing distress.Mental health staff should consider the person's cultural needs, referral pathway, recent service contact and baseline ratings on the Health of the Nation Outcomes Scales (HoNOS) when working proactively to prevent the use of seclusion in the first 24 h following admission.Strengthening the focus on nurturing relationships, cultural understanding and non‐coercive de‐escalation approaches requires leadership support and strategic workforce development. Introduction: People who experience seclusion in inpatient mental health services often do so within the first 24 h following admission. There is limited research examining the potential contributing factors, particularly recent contact with services. Aim/Question: To identify factors associated with seclusion within the first 24 h following admission into acute inpatient mental health services. Method: A retrospective analysis was undertaken using routinely collected data from Aotearoa New Zealand mental health services. Results: A higher likelihood of seclusion within the first 24 h following admission was associated with: males, Māori, Pasifika, referrals from police/justice services, inpatient transfers, recent contact with crisis assessment teams and clinician perceptions of aggression, problematic substance use, cognitive problems and hallucinations or delusions. Recent contact with community mental health services was associated with a lower likelihood. Discussion: People's cultural needs, referral pathway, recent service contact and HoNOS scores should be considered when working to prevent the use of seclusion in the first 24 h following admission. Implications for Practice: The first 24 h following inpatient admission is a critical period for preventing the use of seclusion. Nurturing relationships, cultural understanding and use of non‐coercive de‐escalation approaches can support better outcomes for people recently admitted. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Home treatment teams help people in a mental health crisis to recover. The staff goes to the person's home, avoiding the need to go to the hospital and providing care in the person's environment.The teams have been created in our country in recent years, becoming part of the mental health care network. What this paper adds to existing knowledge?: The paper presents the functioning of a CRHTT, the type of care it provides, and the coordination with the rest of the care network. It also shows the clinical results obtained in the first two years since its creation, supporting the CRHTT's effectiveness in accompanying people with mental health crises and reducing the need for hospital care.The outstanding factors in the team operation were coordination fluidity with referral services (facilitating accessibility), a prolonged care time (about two months), and continuity of care during the CRHTT intervention (the same CRHTT professionals visited the user and the family at home) and upon discharge (CRHTT staff organized joint visits with the professionals who would care for the user and the family after home treatment).The CRHTT followed a person‐centered orientation based on horizontality and dialogue. The CRHTT fostered the inclusion of the family and social network in the treatment and a deep understanding of the crisis considering social determinants. What are the implications for practice?: Flexibility, approach to the person's environment, dialogue, shared decision‐making, and the inclusion of the family and social network in the treatment are central factors in CRHTT functioning. It helps the person regain control over their life and enhance their resources to face possible future crises.Training in crisis management, community mental health and family care, and teamwork (which implies joint home visits and co‐responsibility with the rest of the staff, user, and the family) are relevant for CRHTT professionals. Introduction: Crisis resolution and home treatment teams (CRHTTs) provide intensive home care to people in a mental health crisis, becoming an increasingly widespread alternative to hospital admissions. However, there are wide variations in service delivery, organization, and outcomes, and little literature on how these teams work in clinical practice and different settings. Aim: To share the organizational functioning, the therapeutic approach, and the outcomes obtained in a CRHTT in Catalonia, Spain. Method: A descriptive analysis of the functioning of a home treatment team, the characteristics of the people served, and the clinical results from November 2017 to December 2019 are presented. Results: One hundred and five people were served, with an average stay of 57 days. And 55.24% were women, and the mean age was 41. Most people could overcome the crisis at home, and 5.71% required hospital admission during home care. A statistically significant improvement was observed in the results of the GAF and HoNOS scales at admission and discharge. Discussion: Despite reduced staff, home care was an alternative to hospital admission for most people treated. Implications for Practice: Flexibility, teamwork, and collaboration with the social network are relevant factors when accompanying the recovery process at home. [ABSTRACT FROM AUTHOR]

What Is Known about the Subject?: Immigrant, refugee and asylum seeker populations worldwide are at high risk of mental health issuesNational mental health policies call for recognising Australian society's multicultural characteristics to ensure adequate mental health services to CALD communitiesSeveral barriers exist for people from CALD communities in Victoria to access and utilise mental health servicesImproving mental health professionals' knowledge of mental health service provision and cultural responsiveness can enhance CALD community access to services. What Does this Paper Add to Existing Knowledge?: We analysed the perspectives of people from CALD communities in Victoria regarding their needs and experiences with mental health services. Participants reported diverse perceptions and understanding of mental health issues and servicesVarious challenges were identified regarding health service utilisation for the CALD community in Victoria, including language barriers, stigma towards mental health issues, mental health illiteracy, distrust and lack of familiarity with mainstream mental health services. These challenges were acknowledged by community members even after a long residence in AustraliaThe data generated on the beliefs about mental health issues and consequent help‐seeking behaviours highlight the importance of culturally sensitive targeted prevention and early intervention strategies and ongoing commitment to building mental health literacy in the wider community What Are the Implications for Practice?: The information from the study can be adapted for quality improvement and culturally responsive practicesThe strategies for effective service delivery drawn by this paper can be a comprehensive resource tool for mental health professionals, organisations and policymakersThe findings imply that CALD mental health service users and their families will likely benefit from improved service assessment and quality of mental health care and equity when MHNs undertake cultural competence training and bring that into their practice. Introduction: Victoria is one of the most multicultural states in Australia. Many CALD communities in Victoria may have encountered complicated migration journeys and complex life stressors during their initial settlement, leading to adverse mental health concerns. This diversity necessitates public policy settings to ensure equity and access in health services planning and delivery. While the MH policies and services take cultural diversity into account, there needs to be more implementation of those components of MH policies that relate to the particular needs of various CALD communities in Victoria. Even though mental health services prevent and address mental health issues, many barriers can impair CALD community access and utilisation of mental health services. Furthermore, the recent Royal Commission inquiry into the Victorian Mental Health system drives a renewed policy imperative to ensure meaningful engagement and cultural safety of all people accessing and utilising mental health services (Department of Health, 2023). Aim: This study focused on the perspectives of people from CALD communities in Victoria regarding their mental health service needs, understandings of and experiences with mental health services to prepare an education package for mental health nurses as part of a larger multi‐method research project. Method: A qualitative descriptive design was used to collect and analyse the perspectives of 21 participants in Victoria, using telephone interviews, followed by thematic analysis. Results: The themes and sub‐themes identified were: Settling issues; Perceptions of understanding of mental health issues (help‐seeking attitudes toward mental health issues; the need for CALD community education); perceived barriers to accessing and utilising mental health services in Victoria (socio‐cultural and language barriers; stigma, labelling and discrimination; knowledge and experience of accessing health facilities); experience with mental health services and professionals. Discussion: Community participation, mental health professional education and robust research regarding the mental health needs of CALD people are some of the recommended strategies to improve access and utilisation of mental health services in Victoria. Implications for practice: The current study can contribute to the existing knowledge, understanding, practice and quality improvement as it vividly portrays the issues of various CALD communities in Victoria. The findings of this study imply that CALD MH service users and their families are likely to benefit in terms of improved service assessment and quality of MH care and equity when MHNs undertake CC training and bring that into their practice. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Bisexual people experience significantly poorer mental health and higher rates of self‐harm and suicidality than their gay, lesbian or heterosexual counterparts.Although little is understood about why these disparities exist, bisexual people have been found to have unique life experiences that separate them from other sexual minority groups.Despite these health disparities and unique experiences, in research and in clinical settings, bisexual people are often incorporated under the LGBTQI+ umbrella and their needs are not seen as being different to those of other sub‐groups. What the paper adds to existing knowledge?: This paper brings together the findings of the small but growing body of literature reporting on the psychosocial support needs of bisexual people.The findings reported on herein provide novel insights, collated and synthesized that will prove valuable to policy makers, service providers and researchers. What are the implications for practice?: This paper clearly illustrates that bisexual people experience significant barriers to accessing the support services they need and that current competent service provision for this population is severely limited.The findings presented in this paper shed light on the unique psychosocial needs of bisexual people and highlight the need for practice change to reduce barriers to service access and ensure inclusive and culturally competent care for this community. Introduction: Despite consistent evidence of poor mental health among what is a relatively large population group, research examining bisexual mental health remains sparse. Aim: To identify the psychosocial needs of people who are bisexual and establish factors that may support or inhibit access to appropriate psychosocial interventions and supports. Method: A qualitative evidence syntheses of the empirical evidence. Results: A total of 15 papers were included in the review. The PRISMA process was used. Following data analysis, four main themes emerged that were (a) experiences of being bisexual, (b) mental health experiences and concerns, (c) service access and responses and (iv) communities and supports. Discussion: Bisexual people have unique and specific psychosocial support needs that relate to, but are also different from, the needs of the broader LGBTIQ+ community. This study provides valuable insights into how future policy, practice, education and training and research can better address the needs of this highly vulnerable group. Implications for Practice: This study highlights the psychosocial complexities associated with bisexuality and provides evidence for the need for improvement in current support services to ensure inclusivity and culturally competent care. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Only 8.6% Asian Americans (AAs) report seeking mental health services compared to nearly 18% of the general population.There is a stigma against seeking mental health services among AAs.Mental illness is thought to be caused by a lack of harmony of emotions or evil spirits leading to delay in treatment among AAs. What the paper adds to existing knowledge?: Asian students are hesitant to use mental health services because they are balancing their desire to be part of the two cultures.Concepts used to define culture were found to have overlapping aspects of how researchers operationally define them, and few studies examined a combination of these concepts as a means of examining interactions between the concepts.AA emerging adults feel pressure through personal stigma from elders to 'save face' by keeping their problems to themselves or within the family to maintain a positive reputation for the family. What are the implications for practice?: The overlap of conceptual definitions to understand cultural beliefs and values affecting measurement have complicated the interpretation of the research.Future research should include a multidimensional operationalization of culture that includes acculturation, ethnic identity, personal stigma and their effect on mental health help‐seeking attitudes.Differences between South Asian and East Asian philosophical and cultural perspectives could influence access to mental health services; therefore, future studies should consider sampling that would allow for comparison of the groups.Understanding the factors that influence mental health help‐seeking behaviours can determine intervention strategies to improve AA emerging adult mental health. Introduction: Only 8.6% of Asian Americans (AA) sought mental health services compared to 18% of United States population. AA college students report higher levels of mental health concerns compared to White students. Aim: The purpose of this systematic review was to identify the factors that influence AA students' mental health help‐seeking behaviours. Method: Employing a data‐based convergent synthesis design. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the sample. Inclusion criteria were peer‐reviewed studies published in English, focused on AA college students' mental health seeking attitudes in United States. Results: The final sample was forty‐four studies. Four themes emerged: acculturation, ethnic identity, racism and stigma. There were discrepant findings regarding how acculturation affects mental health help‐seeking attitudes. Several studies included more than one theme in their analyses. The different concepts included across studies make it difficult to compare the findings. Discussion: There is some overlap between acculturation and ethnic identity that could affect the analysis in studies where both concepts are included. Personal stigma negatively influences mental health help‐seeking attitudes. Implications for Practice: Defining culture to include acculturation, ethnic identity, personal stigma can help in understanding their effect on mental health help‐seeking attitudes. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mentalizing is the capacity to understand both one's own and other people's behaviour in terms of mental states, such as, for example, desires, feelings and beliefs.The mentalizing capacities of healthcare professionals help to establish effective therapeutic relationships and, in turn, lead to better patient outcomes. What this paper adds to existing knowledge?: The personal factors positively associated with the mentalizing capacities of healthcare professionals are being female, greater work experience and having a more secure attachment style. Psychosocial factors are having personal experience with psychotherapy, burnout, and in the case of female students, being able to identify with the female psychotherapist role model during training. There is limited evidence that training programmes can improve mentalizing capacities.Although the mentalization field is gaining importance and research is expanding, the implications for mental health nursing have not been previously reviewed. Mental health nurses are underrepresented in research on the mentalizing capacities of healthcare professionals. This is significant given that mental health nurses work closest to patients and thus are more often confronted with patients' behaviour compared to other health care professionals, and constitute a large part of the workforce in mental healthcare for patients with mental illness. What are the implications for practice?: Given the importance of mentalizing capacity of both the patient and the nurse for a constructive working relationship, it is important that mental health nurses are trained in the basic principles of mentalization. Mental health nurses should be able to recognize situations where patients' lack of ability to mentalize creates difficulties in the interaction. They should also be able to recognize their own difficulties with mentalizing and be sensitive to the communicative implications this may have. Introduction: Mentalizing capacities of clinicians help to build effective therapeutic relationships and lead to better patient outcomes. Few studies have focused on factors associated with clinicians' mentalizing capacities and the intervention strategies to improve them. Aim: Present a systematic review of empirical studies on factors associated with healthcare professionals' mentalizing capacities and the effectiveness of intervention programmes designed to improve these capacities. Method: Following PRISMA‐guidelines, a systematic literature search was conducted in PubMed, PsycINFO, Cochrane Library and CINAHL. Results: Out of a systematic search with 1537 hits, 22 studies were included. Personal factors positively associated with mentalizing capacities of healthcare professionals are being female, greater work experience and having a more secure attachment style. Psychosocial factors are having personal experience with psychotherapy, burnout, and in the case of female students, being able to identify with the female psychotherapist role model during training. Evidence that training programmes improve mentalizing capacities is limited. Discussion: Mental health nurses are underrepresented in research on mentalizing capacities of healthcare professionals and training programs to improve these capacities are practically absent. Implications for Practice: For mental health nurses, training in basic mentalizing theory and skills will improve their capacities in building effective working relationships with patients. [ABSTRACT FROM AUTHOR]

Introduction: This debate essay proposes possible remedies to the shortage of nurses in acute inpatient mental health settings and draws inspiration from a Journal of Psychiatric and Mental Health Nursing editorial, Glascott and McKeown (2022, 29, 767). Aim: The aim is to stimulate debate within the profession. The art and science of nursing continues to develop but staffing shortages in key areas undermine practice, leadership, academic and policy efforts to improve the quality of care for people attending services. Method: This is a debate essay which draws on the authors' experience and presents ideas based on extant literature. Results: Organisational, professional and wider societal challenges are explored. Practice‐based solutions as well as recommendations for improving the terms and conditions of employment of nurses are made. Opportunities which may empower the nursing profession are promulgated. Discussion: It is intended that this paper will provoke further discourse and may reflect the 'call to action' advocated by Glascott and McKeown (Journal of Psychiatric and Mental Health Nursing, 2022, 29, 767). Implications for Practice: While the focus is on acute inpatient mental health nursing, the ideas presented may have an application to wider nursing groups or a wider cadre of public sector workers. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject?: In the context of health and social care, situations at the limit or beyond the role of the professional, such as falling in love and physical attraction between a client and a nurse, are very common events.In residential contexts, the construction of the professional relationship is made more complex than in other care contexts since sharing daily life, routine, constant contact and isolation contribute to making relationships more intense from an emotional point of view.Moreover, the same elements that promote the therapeutic process (interpersonal closeness, self‐disclosure, trust) are also sources of role ambivalence and possible emotional misunderstandings. What does the paper add to existing knowledge?: In contrast to what is usually proposed in the literature for the management of similar situations, such as supervision by experts external to the team, this paper proposes a strategy of supervision between peers (called in literature "intervision") and of taking charge of the situation by the entire team and the group of service users. What are the implications for mental health nursing?: The story here presented offers a key example that may be of interest not only to residential centres for substance users but also to all residential mental health communities. It shows not only that one can fall in love, but that this event can generate new opportunities for the therapeutic pathway.The risks associated with not addressing these situations are discussed. These include the restriction of the feeling of falling in love within the canons of error; the attribution of what happened to personal characteristics and the assumption of guilt for such occurrences. Introduction: The care pathway within a mental health service can create situations of strong emotional impact, including physical attraction and falling in love. This may evolve in moments of impasse for the staff and sometimes compromise the success of therapeutic treatment. Aim/Question: This article offers some evidence about how intervene in a situation such as a client falling in love with a nurse, avoiding transforming it into a problem. The fear of the nurse, maybe already inclined to blame themselves for what has happened, when he/she asks for supervision, is to feel judged also by the supervisor. This story teaches that to refer to figures from outside the team, as would usually be the case with supervision, may be replaced by enhancing the role composition already available in the residential community as a resource. Method: The story was listened and enhanced thankyou to an exchange between M. and the community manager. From the analysis of the narratives co‐produced by M., the former substance user, and the community manager, the elements that made it possible to transform a feeling of falling in love into an interaction of extended trust emerged. Results and Discussion: The non‐judgmental and confidential context, but above all the training in interpersonal exchange, facilitated the client sharing very intimate and private experiences, which are usually hidden or denied. This made it possible to make the community responsible for the individual's experiences and to overcome the role impasse and the related identity dilemma. Implications for Practice: Neither nurses nor clients should be held accountable or blamed when these episodes occur. The strongest resource is sharing in the group and putting one's own experiences into play. Following the M. story, a targeted confrontation between team members and clients is an accessible and effective resource to respond to situations of strong emotional impact, falling in love being just one example; however, it can be effectively activated only through a collective taking charge of the individual's difficulties has already been implemented. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Research indicates many people accessing mental healthcare have trauma history and often experience re‐traumatization in acute mental health inpatient settings.Treatment for trauma is not routinely explored as a treatment option in mental health inpatient settings and consequently mental health professionals do not draw connections between the person with trauma history and their presenting mental health problems. What this paper adds to existing knowledge?: People in acute mental health inpatient units are not asked about their previous trauma histories on admission and their trauma history is not taken into consideration during interventions in particular coercive practices such as seclusion, restraint, forced medication, and involuntary admission.This paper provides an understanding on how to address trauma‐related issues within in‐patient settings and identifies practical examples of how to reduce the risk of re‐traumatization. What are the implications for practice?: Staff induction and training development needs can be used to help mental health professionals to be more confident and competent in assessing and identifying the history of trauma so that they can improve recognition, provide post‐disclosure support, and avoid the potential for re‐traumatization for inpatients.Physical environments need to be welcoming, homely, and have comfortable furnishing. They also require adequate space for inpatients to move around freely and have a quiet space to go to de‐escalate themselves when required. Introduction: Rates of re‐traumatization among mentally ill‐health patients have risen significantly over the past decade and clinical guidelines place mental health nurses at the heart of their care. Aim: To gather, analyse, and synthesize the evidence on people's experiences on re‐traumatization in acute mental health inpatient settings. Method: A systematic search for qualitative studies (CINAHL, MEDLINE, ASSIA, PsycINFO, and EMBASE) was conducted. Two authors independently assessed eligibility and appraised methodological quality using Joanna Briggs's quality appraisal tool and extracted data. The analysis followed the principles of interpretative synthesis. Results: Fourteen papers were included for thematic synthesis. Three themes emerged: (1) Quality of staff interaction; (2) Specific interventions, (Sub‐theme nature of symptoms); and (3) Nature of the environment. Discussion: Our findings demonstrate that patients are experiencing re‐traumatization in acute mental health inpatient settings and that there is little being done to prevent it from occurring. Implications for Practice: This study is the first to analyse the factors that contribute to re‐traumatization and make recommendations to mental healthcare professionals to reduce the harmful practices in place in inpatient settings. It is suggested that training staff in trauma‐informed care and allowing patients to be experts in their own care can reduce the rates of re‐traumatization. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mental health clients experience higher estimated rates of domestic violence, yet mental health services are less likely to screen for domestic violence. What the paper adds to existing knowledge?: This paper qualitatively explores the perspectives and experiences of mental health practitioners in inpatient and community teams in a publicly funded hospital and health service (i.e. public mental health service).Mental health practitioners described a lack of domestic violence training, as well as a lack of knowledge of domestic violence and support mechanisms for victims, when domestic violence is disclosed by clients.The paper highlights the unique difficulties and barriers experienced by clinicians in screening for domestic violence while also dealing with clients suffering a mental health crisis. What are the implications for practice?: The paper sheds more light on the issue of domestic violence in mental health in terms of screening, and identifies avenues for improvement in mental health services; particularly the need for staff training and education. Introduction: Domestic violence is particularly prevalent within mental health client groups, though screening for domestic violence within mental health services is often overlooked. Aim: To investigate the experiences and opinions of domestic violence screening by mental health clinicians in a publicly funded hospital and health service. Methods: Semi‐structured interviews were conducted with twelve clinicians working in publicly funded mental health services in Queensland, Australia. Transcripts were thematically analysed. Results: Four main themes emerged from the data: staff training and experience; prioritizing domestic violence screening; attitudes to domestic violence; and victim support. Participants discussed a lack of training for, or expectations of, domestic violence screening in mental health services. They also highlighted a lack of resources enabling them to appropriately respond when domestic violence was identified. Discussion: Education, attitudes and resources relating to domestic violence are major factors that should be addressed for the successful screening and treatment of clients in mental health. Implications for Practice: This paper informs services of the gaps in knowledge and care around domestic violence and mental health. A less medicalized approach to the treatment of mental health should be adopted, and domestic violence training introduced for all healthcare practitioners, to improve client outcomes. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject?: A significant proportion of fathers report experiencing depression after their baby is bornFathers are not offered regular support for their psychological well‐being in the transition to parenthood despite an acknowledged need for such support What does the paper add to existing knowledge?: Lived experience provides new insight into how one father experienced postnatal depression, including the role of his partner in help‐seekingIt explains the delayed presentation in help‐seeking as resulting from healthcare practitioner language and attitudes, and gendered expectations around mental health and help‐seeking in the context of fatherhood What are the implications for mental health nursing?: Mental health nurses should be aware that postnatal depression can affect fathers as well as mothers, and that it is necessary to support fathers in safe spaces and with appropriate languagePlanning care for depression in men should consider the recent birth of a child in order to provide effective careClearer guidance is needed for supporting new fathers with postnatal depression Introduction: Fathers are not universally supported with their perinatal mental health, but evidence shows that they suffer at a similar level to mothers. Aim: This paper examines the journey of one father through his PND experience, his help seeking, and encounters in healthcare, in order to highlight the needs of a depressed father. Method: The method is a father's lived experience narrative which has been written alongside a health visitor who highlights the relevance of the condition to healthcare practice. Results & Discussion: The needs of fathers are unmet. They require support which considers their gender role expectations. Partners are key to their help seeking. Implications for practice: The language and sensitivity used by nurses is key to encouraging fathers to share their depression and reduce stigma around the condition. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: International guidelines for trans‐and‐gender‐non‐conforming (TGNC) exists in outpatient settings.Compared to cisgender and heterosexual people, TGNC individuals are at a higher risk of mental health difficulties and have higher rates of inpatient mental health treatment. What does this paper add to existing knowledge?: An international scoping review identifying the lack of guidelines existing for TGNC individuals in inpatient mental health settings. Compared to psychiatrists and psychologists, mental health nursing has the most contact with patients admitted for inpatient psychiatric treatment. The study identifies unaddressed needs in gender affirming policies and outlines preliminary policy recommendations to assist mental health staff in improving TGNC patient quality of care within the United States. What are the implications for practice?: Reforming existing guidelines or creating new guidelines based on the identified themes and gaps to improve the well‐being and treatment outcomes of TGNC individuals in inpatient psychiatric settings within the United States. Introduction: Access to culturally sensitive care is critical for addressing known mental health disparities among trans‐and gender‐non‐conforming (TGNC) individuals. Although there has been a proliferation of TGNC healthcare guidelines from accrediting bodies, policies have failed to address the needs of TGNC patients in inpatient psychiatric settings. Aim: To identify unaddressed needs in policies and policy recommendations for the care of TGNC patients to inform recommendations for change. Method: A scoping review protocol was developed following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses 850 articles were reduced to seven relevant articles with six themes identified via thematic analysis. Results: Six themes were identified: lack of consistency in preferred and pronoun use, lack of communication among providers, lack of training in TGNC healthcare, personal bias, lack of formal policies, and housing segregation by sex rather than gender. Discussion: The creation of new guidelines or bolstering of existing guidelines to specifically address identified themes and gaps may improve the well‐being and treatment outcomes of TGNC individuals in inpatient psychiatric settings. Implications for practice: To provide a foundation for future studies to integrate these identified gaps and inform the future development of comprehensive formal policies that generalize TGNC care in inpatient settings. [ABSTRACT FROM AUTHOR]

Accessible Summary What Is Known on the Subject? What the Paper Adds to Existing Knowledge? What Are the Implications for Practice? Introduction Aim/Question Methods Results Conclusion Implications for the Practice Patients do not always receive enough information about their diagnosis and their perceived participation in decision‐making about their treatment is low. Some participants reported feeling very uncertain when the physician invited them to choose between these options. Others users expressed their satisfaction with the trend away from paternalistic attitudes in the health system. There is a trend towards pharmacological prescription as a first approximation. This contrasts with the recommendations of scientific organizations based on evidence and cost‐effectiveness studies on the offer of psychological interventions as the first option. The user groups pointed out that active coping, based on exposure to anxiety‐generating situations, made a significant contribution to alleviating their anxiety disorders. However, some of those interviewed rejected this type of intervention. Users diagnosed with anxiety disorders miss more information about the disorder and participation in its treatment. Opposite positions coexist in terms of participation in the choice of treatment. Pharmacological treatment is most commonly the first option offered. This study is an example in itself of the involvement of users in the healthcare process, and therefore placing them at the centre of attention, as reflected in healthcare policies and clinical practice guidelines. It promotes the identification of needs that users diagnosed of anxiety disorders may have, with the aim of putting in place, from healthcare professionals and health services, the necessary supports adapted to these. Mental health nurses are well‐positioned to offer support and guidance during the process of involvement and shared decision‐making. An essential aspect of mental health treatment and recovery is the degree of involvement by health service users in the process.Explore the values, demands and preferences of persons diagnosed with anxiety disorders, their participation in the treatment provided, and the response of the health system in this regard.A qualitative study was conducted, with 51 participants. Nine focus groups and four in‐depth interviews took place.Three broad categories were identified: (1) diagnosis; (2) treatment options offered and shared decision‐making; and (3) coping with the disorder. Sometimes patients do not receive enough information to cover their needs. A trend towards drug prescription as a first approach was observed, while active coping based on exposure to anxiogenic situations was indicated as the most effective option.Shared decision‐making is a necessary aspect of treatment, and the therapeutic process should be adapted to match the service user's preferences, values and needs.This research identifies the needs of patients diagnosed with anxiety disorders and promotes, therefore, from healthcare professionals and services, the provision of measures to meet these needs. [ABSTRACT FROM AUTHOR]

Accessible Summary What Is Known on the Subject? What the Paper Adds to Existing Knowledge? What Are the Implications for Practice? Introduction Aim Method Results Discussion Implications for Practice The COVID‐19 pandemic has brought new sources of stress and challenges for people dealing with obsessive compulsive disorder (OCD). The study uncovered the unique experiences of Jordanian patients with OCD during the COVID‐19 pandemic, revealing three main themes: Navigating Constraints: The Dual Pathways of Social Engagement and Avoidance, estranging family attachments and shifting OCD landscapes. Family dynamics played a significant role, with some families unintentionally exacerbating OCD symptoms through excessive accommodation, while others openly expressed irritation, both contributing to worsened symptoms. The research unveiled a notable deficiency in the availability of professional mental health support for individuals with OCD throughout the pandemic. Accessible and culturally appropriate e‐mental health interventions can bridge the gap in mental health support, especially during crises like the pandemic. It is crucial to involve family members in the treatment process to address family dynamics that may either support or hinder recovery among patients with OCD. Pandemics, like COVID‐19, can significantly harm the mental well‐being and overall quality of life for individuals and their families. Those with pre‐existing mental conditions, especially obsessive compulsive disorder (OCD), are more vulnerable to negative psychosocial effects since the fear of being infected or transmitting infection to others are some of the main characteristics of the illness. There is a need for a nuanced understanding of the personal, social and cultural experiences of people with OCD within their specific psychosocial context.To explore how Jordanian patients with OCD experienced their illness during COVID‐19.A descriptive phenomenological design using semi‐structured interviews with a purposive sample of 12 patients diagnosed with OCD and experiencing different types of OCD symptoms. Data were analysed thematically, and reported based on the critical appraisal skills programme (CASP) checklist for qualitative studies.Three main themes emerged: (1) Navigating Constraints: The Dual Pathways of Social Engagement and Avoidance (seeking solace through social interaction and embracing quarantine as an opportunity for social avoidance); (2) Estranging family attachments (enforcing proximity and struggling with intimacy); and (3) Shifting OCD landscapes (transforming existing obsessions and escaping to new compulsions). The interviews documented a complete lack of references to receiving professional mental health support throughout the pandemic.This study aligns with previous research indicating a surge in OCD severity during the pandemic, fuelled by distressing news and heightened hygiene measures. Notably, it underscores the strain on familial relationships, with some cases showing protective effects but many demonstrating worsening symptoms due to excessive family accommodation. The absence of professional mental health support during the pandemic raises questions about the quality and accessibility of mental health services in Jordan.The findings underscore the need for continued mental health support and intervention, particularly during times of heightened stress and isolation. Integrating e‐mental health resources and cultural adaptation can play a vital role in providing accessible and effective support for individuals with OCD, including those in the Jordanian Arab culture. As we navigate future challenges, it is crucial to prioritize the well‐being of individuals with OCD and ensure they have access to appropriate and tailored mental health services. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject? What this paper adds to existing knowledge? What are the implications for practice? Mental health nurses in the UK play a critical role in providing care, advocating for patients and navigating the complexities associated with mental health challenges. Acknowledging and supporting the efforts of mental health nurses is essential for advancing mental health care, promoting inclusivity and fostering community resilience amidst ongoing challenges within existing health care organisations. Highlights the integral role of mental health nurses in the UK's health system as both care providers and advocates, underpinning the importance of addressing the growing demand for mental health services Introduces innovative digital tools like the ‘Hub of Hope’ and the potential of social prescribing as effective strategies for improving access to mental health care and support. Emphasises the need for enhanced support and recognition of mental health nurses to ensure the sustainable advancement of mental health services and the well‐being of communities. Mental health nurses should integrate innovative digital tools like the ‘Hub of Hope’ into their practice to improve signposting and access to mental health resources for individuals in need. There is a critical need for ongoing education and support for mental health nurses within practice settings to maintain their well‐being and enhance their ability to provide holistic care despite increasing clinical demands. Advocacy for increased investment in mental health resources and support for research activities lead by mental health nurses is essential to address current service gaps and promote the development of more effective interventions. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: All health service users in Belgium have the right to be informed about their diagnosis.There is a whole spectrum of prognoses for psychosis, but many practitioners show a bias towards believing that psychosis is always regressive. What this paper adds to existing knowledge?: This paper is a first person narrative of one thread through my experiences as a mental health service user: the story of my diagnoses.A case study of the functions and impacts of diagnosis. What are the implications for practice?: Practitioners need to reflect on the impact diagnosis can have on a person and avoid assumptions that the experience and prognosis is universal.A diagnosis can play a positive therapeutic role. Purpose: The purpose of this paper is to stimulate nurses and other mental health professionals to reflect on what they understand by a psychiatric diagnosis and how they use this understanding. Background: I have twenty years' experience as mental health service user, and in this time, I have received numerous diagnoses which have had a variety of impacts on me. Methods: The paper began as notes drawn from introspection. I ordered my memories and reflections chronologically to reconstruct this narrative. Keypoints: My case makes the point that psychiatric diagnosis is not an established, universal science like in somatic medicine, but a still evolving complex of contradictions and opinions and should not be treated as authoritative. I aim to challenge what I see as a general overestimation of how much a diagnosis tells you about a person and how you should treat them. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Experts by experience involvement in the education of health professionals demonstrate positive attitudinal change.Meaningful positions for Experts by Experience are limited and ad hoc, due to attitudinal and other barriers to innovation within the higher education sector.Experiences of allies who have supported the implementation of Expert by Experience positions have not been researched. This is important knowledge that could be utilized by potential allies. What the paper adds to existing knowledge?: Academic allies to experts by experience have a crucial role to play in identifying opportunities to establish, implement and sustain expert by experience positions.Allies who have successfully implemented positions for experts by experience have identified influential factors including: right person, right role, collaboration and coproduction, support, and career pathways.Understanding these factors can provide an important basis for other academics to support a widespread increase in academic roles for experts by experience in mental health education. What are the implications for practice?: Establishing and maintaining genuine relationships with service users require significant attitudinal change on the part of mental health professionals. Involving experts by experience in mental health education provides an innovative approach to the challenging of attitudes and the enhancement of more collegial relationships with service users as colleagues in the workplace.This paper demonstrates the importance of allyship to the establishment, implementation and sustainability of expert by experience roles, and highlights critical factors allies have utilized in support of such roles.Nurses and other mental health professional academics have the potential to become allies and support change and innovation. Introduction: Experts by experience in academia have demonstrated more positive student attitudes towards relationships with service users. Notwithstanding this supportive evidence, academic positions for EBE have not grown substantially. Enhanced understanding of positions that have been implemented is important knowledge for others with similar aspirations. Aim: To enrich understanding of the role of allies in identifying and pursuing opportunities to support academic positions for experts by experience. Methods: Qualitative exploratory approach, involving In‐depth interviews with allies with expertise in supporting academic positions for experts by experience. Results: Participants were enthusiastic about creating or taking opportunities to secure expert by experience involvement within their programs. Factors facilitating success included right person, right role, collaboration and coproduction, support and career pathways. Conclusions: Significant barriers have prevented proliferation of academic roles for experts by experience. Despite barriers, allies have been successful in supporting the implementation and sustaining of positions, and gained considerable expertise, which may be invaluable to academics with similar aspirations. Implications for practice: Realization of policy goals regarding service user involvement in mental health services requires health professionals with the will to embrace partnerships. By creating and taking opportunities, allies have developed expertise to facilitate implementation of positions more widely. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: During the COVID‐19 pandemic, there has been research considering the impact on medical healthcare professionals and the mental health needs of the general population. However, limited focus has been placed on mental health services or mental health staff providing care in the community and in hospitals. While nurses make up the largest section of the mental health workforce in the UK, the impact that this pandemic has had on their work has been largely ignored. What the paper adds to existing knowledge?: This paper provides a unique insight into the experiences and impact that the COVID‐19 pandemic has had on mental health nurses across a range of community and inpatient settings to understand what has changed in their work and the care they can and do provide during this crisis. This includes exploring how services have changed, the move to remote working, the impact of the protective equipment crisis on nurses and the difficult working conditions facing those in inpatient settings where there is minimal guidance provided. What are the implications for practice?: By understanding the impact the pandemic has had on mental health nursing care, we can understand the gaps in guidance that exist, the challenges being faced and the impact the crisis has had on care for mental health service users. By doing so, we can plan for the ongoing nature of this pandemic and the aftermath that the crisis may leave for our service users and workforce alike. Introduction: While evidence has emerged concerning the impact of COVID‐19 on the general population and the challenges facing health services, much less is known regarding how the pandemic has directly affected the delivery of mental health nursing care. Aim: This paper aimed to explore how COVID‐19 has affected the ability of mental health nurses to deliver care in community and inpatient mental health services in the UK. Method: We investigated staff reports regarding the impact of the COVID‐19 pandemic on mental healthcare and mental health service users in the UK, using a mixed‐methods online survey. A total of 897 nurses across a range of inpatient and community settings participated. Discussion: Key themes within the data explore the following: new ways of working; remote working; risks of infection/infection control challenges; and the impact on service users. Targeted guidelines are required to support mental health nurses providing care and support during a pandemic to people in severe mental distress, often in unsuitable environments. Implications for Practice: Service developments need to occur alongside tailored guidance and support for staff welfare supported by clear leadership. These findings identify areas requiring attention and investment to prepare for future crises and the consequences of the pandemic. [ABSTRACT FROM AUTHOR]

Accessible summary: What is already known about the topic?: MHST represents transformation at the forefront of policing and mental health to people in crisis with the aim of providing a better and more efficient response.Current knowledge has largely focused on service development, informed by narratives of risk, and this study applies an alternative focus by considering the interplay in practice. What the paper adds to existing knowledge?: This paper adds to emerging work on mental health street triage, offering original insights into the interplay of police officers and mental health nurses in practice.The evidence presented shows how the dynamics between officers and nurses were informed by perceptions of trust, belonging and legitimacy which shaped decision‐making and outcomes.This study also reveals the impacts of leadership continuity and staff turnover to service efficacy and the potential of strategic "drift." What are the implications for practice?: Nurses who work in MHST operations should be prepared to share knowledge, learning and insight into how different mental health conditions present in practice and support the assessment of risk posed to officers.Alternative pathways available to detainment by police under the Mental Health Act should be identified and communicated to officers, both in the control room and in situ, to avoid unnecessary detentions.Strategies should be developed to extend the communication of mental health education and knowledge beyond those immediately involved in MHST to support the police to better respond to mental health. Introduction: The limited evidence on mental health street triage (MHST) is largely focused on service development and is overly police‐centric dominated by narratives of risk. This paper considers the interplay between officers and CPNs in practice situated within strategic and operational contexts, illustrating the importance of place to service developments and trust within practice. Aim: This study was conducted to compare the processes, experiences and perceptions of MHST in three sites in England. Method: Semi‐structured interviews were completed with 27 police and health service staff in strategic and operational roles over a three‐month period in three sites in England. Results: Four themes were identified: "Reducing and improving the use of mental health detainments," "Importance of local contexts and partnerships," "Enhancing officer confidence" and "Developing street triage." Discussion: Mental health street triage decision‐making and outcomes were influenced by issues of trust, belonging and legitimacy within the interplay between officers and nurses. Continuity and staff turnover influenced strategic and operational development. However, MHST was perceived to be an effective and cost‐saving model. Implications for practice: Mental health nurses are well positioned to lead awareness and education of officers in relation to mental health crisis response. Staff need to develop communication strategies that extend beyond those immediately involved in MHST. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is Known on the Subject?: Digital tools such as video calls or mobile phone applications (apps) are increasingly used in the provision of mental healthcare.There is evidence that people with mental health problems are more likely to face digital exclusion: that is, they do not have access to devices and/or skills to use technology.This leaves some people unable to use digital mental health services (e.g., apps or online appointments) or to benefit more generally from access to the digital world (e.g., online shopping or connecting with others virtually).People can be digitally included through initiatives that provide devices, Internet and digital mentoring to increase knowledge and confidence when using technology. What the Paper Adds to Existing Knowledge?: Some initiatives in academic studies and grey literature have been shown to increase access to and knowledge of technology, but this has been outside of mental health care settings.There are currently limited digital inclusion initiatives that take into consideration the specific needs of people with mental health problems, and how they can be equipped and familiarised with digital technologies to help their recovery journey and everyday life activities. What are the Implications for Practice?: Further work is needed to improve the provision of digital tools in mental health care, with more practical digital inclusion initiatives to ensure equal access for all.If digital exclusion is not addressed, the gap between people with and those without digital skills or access to technology will continue to grow, enlarging mental health inequalities. Introduction: The rise in the provision of digital healthcare during the pandemic has called attention to digital exclusion: inequality in access and/or capacity to use digital technologies. Digital exclusion is more profound in people with mental health problems, leaving an implementation gap of digital practice in mental health services. Aim: Identify the available evidence of (a) addressing digital exclusion in mental health care and (b) the practical solutions to enhance uptake of digital mental health. Method: Digital inclusion initiatives were searched from both academic and grey literature available and published between the years 2007 and 2021. Results: A limited number of academic studies and initiatives were found that supported people with mental health difficulties who had limited skills and/or access to overcome digital exclusion. Discussion: Further work is needed to combat digital exclusion and establish ways to reduce the implementation gap in mental health services. Implications for Practice: Access to devices, Internet connectivity and digital mentoring for mental health service users is essential. More studies and programmes are needed to disseminate impact and results for digital inclusion initiatives for people with mental health problems and to inform best practice for digital inclusion within mental health services. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Suicide prevention is an international healthcare priority.There is an urgent need to use approaches that are helpful and follow research evidence.Safety planning is now widely used in suicide prevention; however, it was developed for use with adults, and little is known about its effectiveness for children/young people. What the paper adds to existing knowledge?: This systematic scoping review brings together all research evidence since 2008 that reported how effective safety planning is for children/young people.Findings highlight that when healthcare professionals help children/young people who are suicidal, they need to ensure that the safety plan is completed collaboratively with healthcare professionals and children/young people and that it is appropriate for their age and development.There is also need for healthcare professionals to better recognize and respond to the needs of parents/carers who are caring for a child/young person with suicidal ideations/behaviours. What are the implications for practice?: There is some research indicating that safety planning is effective for use with children/young people, but such evidence has primarily been obtained from females and there is need for more evidence from male study populations. Further research on its use is needed for certain groups of children/young people including those who are care experienced, or identify as lesbian, gay, bisexual and transgender.This review highlighted that healthcare professionals need specific training before they deliver safety planning for children/young people.It was identified that parents/carers have additional needs and should be involved in safety planning. An additional resource specifically for parents/carers should be developed. Introduction: Suicide is a leading cause of death for children and young people and its prevention is a global priority. Many Mental Health Services employ safety planning as a brief intervention. There is some evidence of safety planning effectiveness for adults, but little is known about its effectiveness with young people. Aim: To synthesize research reporting safety planning effectiveness for children/young people with suicidal ideation and identify good practice recommendations. Inclusion criteria: The review relates to safety planning around suicide prevention for children/young people aged less than 18 years, even if it was within a wider intervention. The review was inclusive of all clinical areas (including mental health, primary care, etc), any geographical location or social economic status and inclusivity around the method of delivery. Methods: A systematic scoping review of literature reporting effectiveness data for the use of safety planning with children/young people with suicidal ideation. The systematic scoping review protocol (pre‐registered with Open Science Framework) followed Joanna Briggs Institute conduct guidance and PRISMA‐ScR checklist. Data analysis and presentation: Fifteen studies were reported during 2008–2021. Overall, there is promising, but limited, evidence of effectiveness for safety planning for children/young people but with complete evidence gaps for some demographic sub‐groups. Evidence determined that healthcare professionals should deliver a safety planning intervention that is completed collaboratively, developmentally appropriate, and recognizes parental/carer involvement. Discussion and implications for practice: Further research is needed but current evidence suggests safety planning should be a routine part of care packages for children/young people with suicidal ideation proportionate to their needs. Developing/implementing these plans needs bespoke health professional training and additional support and resources for parents/carers should be developed. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Internationally, research and policy agendas recommend that family caregivers of service users in mental health care be involved in care and treatment, to support the service user's recovery process.Family caregivers of service users in mental health care are often highly burdened.There is a lack of research‐based knowledge about the experiences of family caregivers of service users in forensic mental health care (FMHC) and their involvement in care and treatment. What this paper adds to existing knowledge: This study indicates a persistent caregiver presence and/or caregiver advocacy in regard to care and treatment of the service user in FMHC.This study indicates that health care professionals (HCPs) might play a role in eliciting a persistent caregiver presence and/or caregiver advocacy. What are the implications for practice: HCPs need to develop their collaborative skills and be more willing to listen to and understand caregivers' persistent presence and/or advocacy.HCPs need to be more skilled to understand caregivers' and families' living with the complexities of mental illness and offence.HCPs are encouraged to adjust the involvement of family caregivers in care and treatment to FMHC. Introduction: There is a lack of research about experiences of family caregivers of service users in forensic mental health care (FMHC) and their involvement in care and treatment. Research shows that caregivers are burdened. Further knowledge is required, to provide a foundation for improving clinical practice. Aim: To review research literature, to investigate existing knowledge about caregiver experiences and, secondly, caregivers' experiences of facilitators and barriers related to their involvement in care and treatment. Method: Qualitative evidence synthesis undertaken in a thematic synthesis of thirteen peer‐reviewed studies. Results: The analysis identified three descriptive themes: violence against family; a great burden of responsibility; and difficult collaboration, together with an additional three analytical themes: bearing witness; persistent presence; and advocacy becomes necessary. Discussion Persistent caregiver presence and/or caregiver advocacy may be elicited by health care professionals' (HCPs') exclusion of caregivers from care and treatment. Caregivers' feelings of guilt in relation to the service user's offence may play an additional role in persistent presence and advocacy and, therefore, in HCPs' exclusion of them. Implications for Practice: HCPs need to develop their collaboration with caregivers by their willingness to listen to caregivers to understand emotional complexities within families experiencing mental illness and offence. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mental health legislation is currently under review following recommendations for repeal and replacement.Through the statutory role of the second health professional, mental health nurses are in a strong position to offer a unique clinical perspective, engagement and advocacy for tangata whaiora (person seeking wellness) and whānau.Māori are more likely to be subject to a compulsory treatment order than non‐Māori.Whānau involvement in care is a core element to well‐being from a Te Ao Māori (Māori world view) perspective. What this paper adds to existing knowledge?: Understanding the level of whānau involvement in the MHA process.Understanding challenges for nursing practice for consideration in the current review of MHA legislation.Identification of the opportunity nurses have to contribute to reducing high rates of Māori under CTOs. What are the implications for practice?: The current MHA review needs to include the resourcing required to support the clinicians practising in statutory roles.More emphasis is needed to build the cultural knowledge and capability of the nursing workforce to integrate principles of a Te Ao Māori worldview into care delivery.These learnings highlight the importance of nursing responsibility in the SHP role. Introduction: Clinical practice within statutory roles is an important issue for the nursing profession. There is increasing involvement of nurses undertaking statutory roles and opportunities for nurses to advocate and offer their unique clinical opinion regarding the need for restrictive measures imposed by mental health act legislation. Aim: The aim of this study was to analyse whether registered nurses who undertake the role of second health professional (SHP) within New Zealand's Mental Health (Compulsory Assessment and Treatment) Act (1992) (MHA) are meeting the expectations of that role. Method: A retrospective analysis of 156 cases was undertaken of clinical reports completed by registered nurses. The reports were measured against an established competency framework modified to include MHA expectations for whānau (family) involvement. Results: From a sample of 156 cases, 22 were identified as reviews of initial orders for assessment and treatment while 134 were opinions related to the application for a compulsory treatment order (CTO). In most cases, reports achieved a good standard. There were limitations in nurses completing the documentation to the required standard, and adaptations were evident in efforts to meet clinical and legal expectations. There was a significant absence of evidence of whānau consultation. Discussion Resourcing through education, support and ongoing development are required to ensure that nurses are equipped to meet the expectations of the legislation. There is an opportunity for nurses to influence decision‐making and support the reduction in use of community treatment orders. A review of the existing competency framework is required to include cultural approaches and involvement of whānau. Implications for Practice: It is important to understand the factors that strengthen nursing practice to improve health outcomes and tangata whaiora and whānau experience. This study uses methods of clinical audit to describe current practice and establish an evidence base to measure change. It also offers important learnings for consideration within MHA legislation review and for nursing workforce development. [ABSTRACT FROM AUTHOR]

Accessible Summary: What Is Known on the Subject?: The therapeutic relationship is crucial for mental health practice, especially to practice that is recovery‐orientated. What the Paper Adds to Existing Knowledge?: This lived experience suggests that mental health professionals can be a long way from knowing the service users' feelings and their precise needs.The narrative reveals how mental health professionals maintain stereotypes and prejudices against people with mental health conditions and how these are reflected in their practice through lack of respect and users' dignity. What Are the Implications for Mental Health Nursing?: This lived experience narrative highlights the need to humanize care. Introduction: The therapeutic relationship is not always functional in clinical practice due to various factors, such as lack of time, lack of job motivation, exhaustion and rejection towards the person cared for. Aim: The aim of this study is to illustrate to professionals the needs of the persons they care for and how they see the world. Method: The aim was achieved through the development of a lived experience narrative. Results: This lived experience narrative describes the experience of a mental health nurse since her first psychotic symptoms and her perceptions of the therapeutic relationship with mental health staff in her trajectory from the first psychiatric appointment until her last contact with the community mental health services. Discussion: This narrative suggests that mental health professionals are sometimes far from discovering what service users are feeling and their precise needs. This highlights the need to humanize mental healthcare. [ABSTRACT FROM AUTHOR]

Accessible Summary: What Is Known on the Subject?: The Brøset Violence Checklist (BVC) has been widely translated and implemented in diverse mental healthcare settings to improve prevention of violence.It is valued as a brief but effective tool in clinical practice. What the Paper Adds to Existing Knowledge?: This review is the largest and most comprehensive international review of the BVC conducted in the 25+ years since the inception of the instrument in 1995. It integrates findings from existing studies and establishes that the tool has many impressive strengths considering the brief time investment required for completion.The review reveals that the tool has been used in more than 20 different countries around the world in a variety of mental health and other settings as both a risk assessment tool to guide clinical practice and as a formally structured intervention to minimize violence.There is much variation in how the tool is implemented and scored in different services. This variation questions its applicability as a resource and consistency and its use needs attention. This variation in use also limits the conclusions regarding best practices. What Are the Implications for Practice?: The review supports the use of the BVC as one part of the package for mental health services committed to preventive action aimed at reducing violence and coercion.The review identified that the patient perspective was often absent when completing the BVC, and so this should be considered as an option by services as part of a collaborative philosophy of care. Introduction: Existing literature on the Brøset Violence Checklist (BVC) is examined in the context of usability, implementation and validity to provide evidence‐based recommendations on its application and identify opportunities for future development. Aim/Question: To identify current knowledge on the BVC and guide clinicians and researchers toward the next steps in using this tool in clinical practice to prevent violence in healthcare settings. Method: A scoping review approach with a meta‐analysis supplement was adopted to broadly identify and map available evidence on the BVC and provide specific estimates of predictive validity in different contexts. Results: Sixty‐two studies conducted in 23 countries addressed the implementation of the BVC across various settings. Many studies adapted the original BVC, and the clinical utility was noted as an important feature. A meta‐analysis of the original BVC format estimated a pooled area under the curve at 0.83 (95% CI 0.78–0.87) in a subset of 15 studies. Discussion The BVC combines high predictive validity and good clinical utility across a wide range of settings and cultures. It should continue to be incorporated into routine practice in mental health services focused on preventing violence and coercion. Implications for practice: Development of collaborative approaches with service users involved in assessing their own risk of future violence. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Aggression towards caregivers is a global phenomenon in mental health care.Although attempts have been made to define aggression, there is no globally accepted definition. Discrepancies in defining aggression can lead to differences in judgement and a sub‐par management of aggression. The fact that different disciplines work together in mental health care makes it an even more pressing matter as no research was found regarding a multidisciplinary definition of aggression.Currently, coercive measures, such as isolation, sedation or restraints, are the most common ways of managing aggression. What this paper adds to existing knowledge?: Mental healthcare nurses and psychologists defined aggression by previous experiences, and they also agree that there are no alternatives in managing aggression when non‐coercive techniques do not work.Several opportunities and examples of best practice were given by the participants, but the consensus was that caregivers are in need of alternatives when they are face to face with acute aggression. What are the implications for practice?: It is vital for residential units to agree on a definition of aggression and acute aggression. It is our belief that this can aid them in preventing and de‐escalating aggression as well as diminishing the use of coercive measures.Further primary research exploring the opportunities of non‐coercive techniques, a multidisciplinary approach and the relationship between a workplace culture normalizing aggression and the mental well‐being of healthcare workers is also needed. Introduction: Aggression by patients against healthcare workers is a global recurring phenomenon in mental health care. Discrepancies in defining aggression can lead to differences in judgement, which in turn causes difficulties in managing aggression. The multidisciplinary nature of mental healthcare makes a standardized definition an even more pressing matter. No studies, however, were found exploring the way different disciplines approach the definition of aggression. Although traditional methods of managing aggression rely on coercive methods, current research favours the use of non‐coercive measures. Aim: The aim of this study was to explore the different ways mental healthcare nurses and psychologists define and manage aggression in a residential unit. Method: A qualitative research design was used, consisting of interviews and focus groups. Transcripts were analysed using a reflexive thematic approach. Results: Three major themes were found: (1) approaches towards defining aggression, (2) experiencing aggression and (3) managing aggression: the need for alternatives. Discussion: In this study, aggression is defined by how aggression has been experienced, both mental health nurses and psychologists agree that there are no alternatives in managing aggression when non‐coercive techniques do not work. Aggression is considered an integral part of the job indicating an "aggression‐tolerating" workplace. Implications for Practice: Three implications for practice were identified: (1) It is vital for residential units to agree on a broad‐based definition of aggression, (2) further primary research exploring the opportunities of non‐coercive techniques and a multidisciplinary approach is crucial and (3) the relationship between a workplace culture normalizing aggression and the mental well‐being of healthcare workers also needs further study. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is Known on the Subject?: Mental health recovery has become a more prevalent approach to empowering people with schizophrenia (PWS), especially in western countries. However, despite the benefits, there is a lack of evidence regarding its practice in developing countries such as Southeast Asian Countries.The optimal treatment for PWS has not yet been identified, since most mental health care is provided in hospital‐based settings in Southeast Asia.Mental health treatment in Southeast Asia is highly influenced by cultural norms, values, and practices. What the Paper Adds to Existing Knowledge?: The findings highlight the importance of integrating cultural aspects into the treatment of people with schizophrenia.The sample of unique elements in Southeast Asian mental health recovery include using a close neighbour/cadre as social support and using religious activity to increase hope.Lack of government support, high level of employment, and stigma are the biggest barriers in the PWS recovery process. What is the Implication for Practice?: There is a research gap regarding the awareness and implementation of mental health recovery in psychiatric programs across the Southeast Asian region which likely impacts the effectiveness of the treatment.The review shows that little research has explored the concept of personal recovery in Southeast Asian Countries. Introduction: Recovery has become an important approach used by mental health services around the world. Many mental health systems have taken steps to move towards more recovery‐oriented practices and service delivery. Therefore, establishing recovery‐oriented services in developing countries like those in the Southeast Asian region requires a detailed understanding of the cultural norms, values, and current mental health practices. Aims: To investigate the mental health practices that promote recovery, its barrier in Southeast Asia, and to determine if they align with the CHIME recovery model. Method: Electronic databases MEDLINE, EMBASE, CINAHL, PsycINFO and SCOPUS, were searched [PROSPERO] (CRD42021227962). Peer‐reviewed English language articles from 2004 to January 2021 were included. Methodological quality was assessed using the CASP checklist, and thematic synthesis of included studies was conducted. Results: Thirty‐one studies met inclusion criteria. Several themes illustrated mental health recovery services and the current obstacles identified in South‐east Asian studies. Connection includes peer support and support groups, relationship status, and limited opportunities to become involved in the community. Hope is found in cultural concepts of hope, stimulating recovery through mental health programs, whilst lack of knowledge and education are the main barriers. Ethnicity is linked to a high level of stigma, but ethnicity also builds identity. Meaning and spirituality manifest in religious activities as the catalyst for recovery. Finally, the opposite of Empowerment is seen in the tendency of people with schizophrenia to remain in a passive position. Further barriers to empowerment are unemployment and a lack of social support. Discussion: In Southeast Asia, the elements of culture, religiosity, and communality are essential to mental health recovery. The obstacles to recovery are relate to human rights, social support, family involvement, and continuity of care. Implications for Practice: This review explores the concept of mental health recovery for people who are experiencing psychosis and living in Southeast Asian countries. The evidence may contribute to the further development of mental health programs in this region. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known about the subject?: Restraint has negative psychological, physical and relational consequences for mental health patients and care providers.Several countries have implemented seclusion and restraint (S/R) reduction programmes in which post‐incident reviews (PIRs) including patients and care providers are one of several strategies.Existing knowledge indicates that PIRs have the potential to contribute to S/R prevention, but knowledge of the patients' perspectives on PIRs is scarce. What the paper adds to existing knowledge?: The paper provides in‐depth knowledge about patients' experiences of being participants in PIRs after restraint events.Patients experience PIRs to result in being strengthened and developing new coping strategies.The paper reveals pitfalls when planning and conducting PIRs that make patients experience PIRs as meaningless, feel objectified or long for living communication and closeness.The patients' mental state, the quality of the relationships and the services' care philosophies, influence patients' experiences of PIRs as supporting their personal recovery processes or as continuation of coercive contexts. What are the implications for practice?: Patients' vulnerability during the PIRs must be acknowledged.Trusted persons or advocacy must support the patient in the PIR and thus reduce the power‐dependence imbalance.The PIR must be conducted in a supportive, non‐punishing atmosphere.Patients must influence planning for the PIR concerning time point and participants and themes to be discussed.The PIR forms should be extended to support the patients' empowerment and well‐being. Introduction: Post‐incident reviews (PIRs), including patients, nurses and other care providers, following incidents of restraints are recommended in mental health services. Few studies have examined patients' experiences and considerations concerning PIRs. Aim: The study aims to explore patients' perspectives on PIRs in relation to how they experience participation in PIRs and further view PIRs' potential for care improvement and restraint prevention. Method: We conducted a qualitative study based on individual interviews. Eight current and previous inpatients from two Norwegian mental health services were interviewed. Results: The patients experienced PIRs as variations on a continuum from being strengthened, developing new coping strategies and processing the restraint event to at the other end of the continuum; PIRs as meaningless, feeling objectified and longing for living communication and closeness. Discussion: PIRs' beneficial potential is extended in the study. The findings highlight however that personal and institutional conditions influence whether patients experience PIRs as an arena for recovery promotion or PIRs as continuation of coercive contexts. Implications for practice: We recommend patients' active participation in planning the PIR. PIRs should be conducted in a supportive atmosphere, including trusted persons, emphasizing and acknowledging a dialogical approach. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The Health Improvement Profile (HIP) is a one‐page form developed in the United Kingdom as a tool for mental health nurses to assess service user's physical health needs.The HIP screens service users' physical health and provides recommendations that clinicians can provide service users with in order to improve their physical health.There was evidence supporting the effectiveness of the HIP; however, the majority of HIP studies to date involve the screening tool being completed by nurses. In Australia, a large proportion of mental health clinicians providing case management to service users in community settings are not nurses. What the paper adds to existing knowledge?: This paper shows that the HIP can be adjusted to suit the needs of Australian service users and can be utilized by clinicians from a variety of disciplines.It also shows that both clinicians and Australian service users find the HIP helpful and argues for it being made available for all service users.It has clearly shown a need to target flu vaccine programmes at service users. What are the implications for practice?: The HIP has been shown to be a suitable and acceptable screening tool for different clinicians to assess multiple lifestyle risk factors at once, which can be used across different diagnoses and settings. This study, for example, demonstrated a need to focus on promoting the flu vaccine and smoking cessation, as well as encouraging service users to visit eye and dental health services. Introduction: Health Improvement Profile (HIP) studies to date primarily focused on the screening tool being completed by nurses. This paper explores the HIP in two different settings, with an emphasis on expanding physical health roles for all mental health clinicians. Aim: The aim of the present study was to adapt the HIP to Australian standards and implement it at a large mental health service. Method: This is an evaluation of the implementation of the HIP over a two‐month pilot period. Clinicians and service users were surveyed on their experience of the HIP. Results: The community team completed the HIP with 34 (15%) service users. The inpatient unit completed the HIP with 137 (54%) service users. Results from the HIP clearly show priority areas for health interventions. Feedback from clinicians and service users was predominately positive. Discussion: We found the HIP to be an acceptable screening tool that encompasses multiple lifestyle risk factors. Implications for practice: This study clearly demonstrates the utility of the HIP as a workable and acceptable screening tool with real world applicability. In our pilot, for example, we identified the need for the promotion of influenza vaccinations amongst service users, as well as the ongoing need to target smoking cessation and substance use. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: It is well known that psychotropic drugs, besides having beneficial effects, may become a source of addiction.Drug therapy involving methadone is traditionally considered an essential medicine in the treatment for heroin dependence since it significantly reduces drug injecting and death rates associated with opioid dependence. What the paper adds to existing knowledge?: This paper investigates a paradoxical situation: the use of methadone therapy to maintain a condition of addiction rather than to overcome it. The story is told jointly by the head of a rehab centre and a young man who has developed a methadone addiction and kept it hidden for years from the operators of the addiction centre, who supplied him with the substance. What are the implications for mental‐health nursing?: The young man's story offers a key example which can be of interest not only for addiction centres but also for all mental‐health services that supply drugs as therapy. This study examines what happens when a person taken over by a service pursues goals that are in contrast to the service mission.Specific communication strategies have to be implemented to update and negotiate goals in continuity with the personal live project of the service user.This story is a warning to not rely on consolidated operational practices, ignoring the investigation of personal meanings and aims of those who experience them. Introduction: Mental health services typically follow standardized intervention protocols and systematic operating practices. Aim/Question: This paper explores what happens when a service relies exclusively on fixed practices rather than on the negotiation of objectives and the differentiation of procedures according to the needs of the user. Method: The analysis of the narratives produced in first person by Oliver, a former substance user, emphasizes the need of constructing a therapeutic plan in close cooperation, promoting an user active role and strengthening his affiliation in the change process. Results and Discussion: In this specific case, the involvement of the user meant the identification of the peculiar meanings he attributed to the "substance of use," which paradoxically coincided with the "therapeutic substance" (methadone). Implications for Practice: Oliver's story is an effective mirror for rethinking staff conduct when it assumes that the drug is therapeutic in itself, regardless of the way the person experiences and means it, it also offers a description of the interactive ways in which the relationship between a young person and service staff proved to be effectively therapeutic. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject? What the paper adds to existing knowledge? What Are the implications for practice? Introduction Aim Method Results Discussion/Implications for Practice Mental health professionals' beliefs about transgender individuals vary, often influenced by stereotypes. There's recognition of healthcare needs, but limited knowledge impacts decision‐making. Stereotypes persist regarding why transgender individuals seek mental health care. Professionals' attitudes show both positive support and negative, discriminatory views. Lack of training and knowledge gaps hinder effective care for transgender individuals. Pathologising attitudes exist, associating gender diversity with mental health conditions. Addressing training gaps is crucial for equitable care for transgender individuals. Challenging stereotypes and beliefs is necessary to reduce stigma and improve understanding. Enhancing knowledge and evidence‐based tools will ensure safe and equal healthcare access. Transgender people face against significant barriers in accessing mental health services due to, among other reasons, discrimination and a lack of expertise among professionals.To explore the beliefs and attitudes of professionals in the mental health network of the region of Murcia towards transgender people, focusing on aspects such as knowledge, perceptions, and prejudices about gender identity.We carried out a qualitative study involving 14 participants, conducting semi‐structured interviews based on prior knowledge of the topic. We asked the professionals about their experiences and challenges in their clinical interaction with transgender users and followed an inductive‐deductive process to analyse the data.Two main themes were identified from the interviews, which were sub‐categorised into different sub‐themes: (a) beliefs about transgender people: underlying factors and origins of gender diversity, health needs, and stereotypes about the demand for health care; (b) attitudes and behaviours of professionals towards transgender people: pathologization and attitudes towards decision‐making.Our findings suggest that mental health professionals tend to oversimplify the factors underlying gender diversity and hold certain stereotypical beliefs about these users that oversimplify the complexity of their experiences. [ABSTRACT FROM AUTHOR]

Accessible Summary What Is Known on the Subject What the Paper Adds to Existing Knowledge What Are the Implications for Practice Introduction Methods Findings Discussion Conclusion Following their experience, patients with physical restraints often experienced traumatic sensations. The experiences of healthcare professionals' (HCPs') are primarily concerned with moral distress or conflicts between loyalty to the treatment and oppression of the patient's freedom when implementing RIs. Improving the competency of HCPs can help establish therapeutic relationships rooted in compassionate care and facilitate appropriate assessments to determine whether and how often RIs are necessary. Furthermore, fostering an environment that guarantees patient safety and dignity, assuring a sufficient staffing ratio, and providing opportunities to share RI experiences can help improve the quality of care and build safe environments for RIs. Effective interaction between HCPs and patients, thorough patient assessment, and compassionate patient care may improve competency of HCPs intervene RIs procedures. Creating a safe therapeutic environment, including improvements to structural environments, increasing the staff‐to‐patient ratio, establishing organizational policies that guarantee staff debriefing, provide emotional support, provide appropriate training programs to HCPs to their coping skills during RIs also reduce the use of RIs and improve the quality of mental health care. Restrictive interventions (RIs) are used in psychiatric inpatient units for ensuring safety. However, few studies have comprehensively reviewed physical restraint and seclusion experiences from the perspectives of both patients and healthcare professionals' (HCPs'). This study aims to gain an in‐depth understanding of the RI experiences of mental health inpatients and HCPs.A meta‐synthesis was undertaken of qualitative studies exploring the RI experiences. Five electronic databases were searched and additional manual searches were performed for studies published within the last decade. Twelve articles were included, and a thematic analysis was conducted. The Critical Appraisal Skills Program (CASP) checklist was used to assess data quality.Two main subthemes were identified: ‘Competency of HCPs’ (three subthemes: interaction between patients and HCPs, assessment methods, and care) and ‘systems’ (three subthemes: environment, protocols with training, and debriefing), including both positive and negative experiences.The Competency of HCPs and the ward environment are critical factors related to patients' unmet needs. Effective interactions between HCPs and patients, thorough patient assessments, and compassionate patient care are important elements of RI implementation.An environment that guarantees safety and care with dignity, sufficient staffing ratios, and opportunities to share RI experiences may improve quality of care and create safe environments for RIs. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? What the paper adds to existing knowledge? What are the implications for practice? Introduction Aim Method Results Discussion Implications for Practice Recovery‐oriented practices in community‐based mental health services are of increasing importance. The recovery journey of individuals with mental illness starts with a sense of agency, and a therapeutic relationship with the providers who support them is a prerequisite. In Japan, the construction of community‐based integrated care systems for individuals with mental illness is positioned as a priority health issue, with communication with familiar individuals being particularly important for recovery in Japanese and Asian cultures. This study is the first to examine effective communication factors for personal agency in the recovery of individuals with mental illness, focusing on addressing uncertainty about treatment choices and dissatisfaction with decision‐making, and considering the user's personal recovery journey. In recovery‐oriented practice, it is important to prioritize addressing the emotional aspects of decision‐making alongside the mental illness condition, supporting users' self‐determination in their unique recovery journeys. The findings emphasized the need to actively engage with users' perspectives and emotions, emphasize shared life planning, and foster a therapeutic relationship based on partnership. Providers should approach dialogue as carefully as medication prescriptions, prioritizing the establishment of an effective therapeutic relationship with the user. These characteristics are essential for developing a strong therapeutic relationship and effectively facilitating users' recovery. The findings are applicable not only to nurses but to all mental health service providers, contributing to the advancement of recovery‐oriented practice. Recovery‐oriented practice in community‐based mental health services is crucial for individuals with mental illness, with communication with familiar individuals being important for recovery in Japanese and Asian cultures.This study aimed to examine effective communication factors for personal agency in recovery by investigating the association between perceived support provided through communication and personal agency of individuals with mental illness.A cross‐sectional study was conducted among community‐dwelling Japanese mental health service users, assessing subjective agency, decisional conflict, staff support for personal recovery, activation for mental health self‐management, demographic variables and living difficulties. Multiple linear regression analysis identified factors predicting subjective agency, revealing characteristics of effective provider communication for recovery.Data from 222 users were analysed, revealing negative correlations between uncertainty about treatment choices and ineffective decision‐making with higher subjective agency, while staff support for personal recovery positively correlated with higher subjective agency.In recovery‐oriented practice, prioritizing users' emotional experiences during decision‐making and supporting their self‐determination in their unique recovery journeys is crucial.Providers should approach dialogue as carefully as medication prescriptions, prioritizing therapeutic partnerships with users. The findings extend beyond nursing to all mental health service providers, advancing the theory of recovery‐oriented practice. [ABSTRACT FROM AUTHOR]

Introduction: Nursing staff are frequently exposed to high‐risk patient behaviours within inpatient health services, yet staff commonly report a lack of training and support in managing these behaviours. Aim: The aim of the study was to examine nursing staff experiences of high‐risk behaviours in inpatient mental health settings. Methods: Four electronic databases (CINAHL, Medline, PsycINFO, EMBASE) were searched. The protocol for this review was prospectively registered in PROSPERO (Ref: CRD42022334739). A meta‐synthesis of nursing staff's experiences of high‐risk behaviours in inpatient mental health settings was conducted. Results: We identified 30 eligible studies. Six themes were constructed from the meta‐synthesis: the social contract of care; the function of risk behaviours; the expectation of risk; risk as a relational concept; navigating contradictions in care; the aftermath. Discussion: Nursing staff conceptualize risk as a meaningful behaviour shaped by patient, staff and environmental factors. Managing risk is an ethical dilemma for nursing staff and they require more training and support in ethical risk decision‐making. Implications for Practice: Inpatient mental healthcare services should formulate and manage risk as a relational concept comprising staff, patient and environmental factors. Future research and clinical practice should place further consideration on the varied experiences of different types of risk behaviours. Relevance Statement: Nursing staff are frequently exposed to high‐risk patient behaviours within inpatient health services, yet staff commonly report a lack of training and support in managing these behaviours. This systematic review offers insights into how high‐risk behaviours are experienced by nursing staff and makes recommendations about how to improve the understanding and management of them. Inpatient mental healthcare services should formulate and manage risk as a relational concept comprising staff, patient and environmental factors. Future research and clinical practice should place further consideration on the varied experiences of different types of risk behaviours. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Seclusion and restraint still regularly occur within inpatient mental health services.The Council of Europe requires the development of a policy on for instance age limits, techniques and time limits.However, they only define the outer limits of such a policy by indicating when rights are violated. Within these limits, many choices remain open.Staff and service managers lack clarity on safe and humane procedures. Research literature provides limited and contradictory insights on these matters. What this paper adds to existing knowledge?: The study resulted in 77 best practice recommendations on the practical application of restraint and seclusion as last resort intervention in inpatient youth and adult mental health services, including forensic facilities.To our knowledge, this is the first study in which the development of recommendations on this topic is not only based on scientific evidence, but also on an analysis of European human rights standards and consensus within and between expert‐professionals and experts‐by‐experience. This approach allowed to develop for the first time recommendations on time limits, asking for second opinion, and registration of seclusion and restraint. What are the implications for practice?: The 77 recommendations encourage staff to focus on teamwork, safety measures, humane treatment, age and time limits, asking for second opinion, observation, evaluation and registration when applying seclusion and restraint as last resort intervention.The implementation of the best practice recommendations is feasible provided that they are combined with a broad preventive approach and with collaboration between service managers, staff (educators) and experts‐by‐experience. Under these conditions, the recommendations will improve safety and humane treatment, and reduce harm to both service users and staff. Introduction: Seclusion and restraint still regularly occur within inpatient mental health services. Professionals lack clarity on safe and humane procedures. Nevertheless, a detailed policy on for instance age limits, techniques and time limits is required. Aim: We developed recommendations on the humane and safe application of seclusion, physical intervention and mechanical restraint in inpatient youth and adult mental health services, including forensic facilities. Method: After developing a questionnaire based on a rapid scientific literature review and an analysis of human rights sources stemming from the Council of Europe, 60 expert‐professionals and 18 experts‐by‐experience were consulted in Flanders (Belgium) through a Delphi‐study. Results: After two rounds, all but one statement reached the consensus‐level of 65% in both panels. The study resulted in 77 recommendations on teamwork, communication, materials and techniques, maximum duration, observation, evaluation, registration, second opinion and age limits. Discussion: Combining an evidence, human rights and consensus‐based approach allowed for the first time to develop recommendations on time limits, asking for second opinion and registration. Implications for Practice: When combined with a preventive approach and collaboration between service managers, staff (educators) and experts‐by‐experience, the recommendations will improve safety and humane treatment, and reduce harm to service users and staff. [ABSTRACT FROM AUTHOR]