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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 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 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?: 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?: 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?: 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 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? 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?: Little is known about how mental health services can cause harm in ways other than medication, talking therapies, diagnosis and detention under the Mental Health Act.The outcomes of people who avoid seeking help from mental health services due to previous experiences of harm are not well known. What this article adds to existing knowledge?: I provide a first‐person perspective of experiences of harm within mental health services, how this impacted my care, the long‐term effects of the harm on my well‐being and my ongoing experiences of avoiding mental health services. What are the implications for mental health nursing?: Healthcare professionals should be aware of the multitude of ways service provision can harm patients, and how, unknown to professionals, patients may create an internal understanding of how to best navigate harmful service environments.Healthcare professionals should have a deeper understanding of the reasons why people may choose not to engage with mental health services, and what impact this may have on them. The recent announcement of the first ever statutory public inquiry into a UK mental health service indicates a growing recognition of iatrogenic harm in mental healthcare. Despite the potential for harm across all services and practices, restrictive practices, psychotherapy, diagnosis and psychiatric medications are often the only areas of mental healthcare given significant attention. While the topic is widely discussed in survivor communities, accounts of harm caused by the everyday workings of services, including team cultures, administrative processes and staff–patient interactions, are missing from academic literature. In this article, I describe my 10‐year journey through mental health services, and how everyday practices, cultures and staff behaviour deeply impacted my ability to receive appropriate care, replicated previously traumatic environments, and damaged my mental health. Taking steps to protect myself from further harm, I self‐discharged and am currently living as a 'service‐avoider'. The ongoing implications of this decision and the long‐term impacts of harm are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Sexual health is essential to the overall health. People suffering from severe mental illness (SMI) experience a deterioration in their sexual health. These patients and their caregivers seem unwilling to engage in a dialogue concerning sexual health within the context of mental health care. Aim: The study investigated nurses' and care assistants' beliefs and attitudes regarding the sexual health of people with SMI on the psychiatric care pathway. Methods: Twenty semi‐structured interviews were conducted with nurses and care assistants. Data were subject to a thematic analysis. Results: Three main themes emerged: (1) The formalization of the care approach towards people with a SMI in hospitals; (2) the place given to sexual health in psychiatry units; (3) nurses and care assistants are not equipped to deal with patients' sexual health. Discussion: Caregivers consider that sexual health is a fundamental right and an indicator of good health. They nevertheless believe that the psychiatric hospital remains a place of acute care where sexual health is not considered. Implication for Practice: This research justifies that it is necessary to question the representations of nurses and care assistants before implementing a tailored intervention that integrates the consideration of sexual health into the holistic care of the patient on the psychiatric care pathway. [ABSTRACT FROM AUTHOR]

An editorial is presented about responding to media coverage of recent mental health service failures, discussing portrayals of poor practice and proposing changes in mental health nurse education to address the root causes. It highlights the global nature of human rights abuses and coercive practices in psychiatric care, emphasizing the need for education to instill values and practices that counter prevailing difficulties within mental health care.