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

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

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

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 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 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?: With the ongoing and possible evolving use of face coverings as a public health protection measure against the transmission of COVID‐19, this is likely to be an ongoing challenge for those who find their use challenging.The wearing of face coverings following trauma is likely to be of ongoing relevance, making this an area that would benefit from further research. What this paper adds to existing knowledge?: The authors present their personal and professional experiences as a means of highlighting the difficulties that can be faced as a result of the use of face coverings.The window of tolerance helps to understand the difficulties that can be caused by wearing face coverings and provides a visual means of conceptualizing the cognitive, behavioural, physiological and emotional reactions that can occur as a result of their use. What are the implications for practice?: This paper provides an awareness of the link between trauma and the wearing of face coverings, and how their use could be re‐traumatizing for those accessing services.This topic is relevant across all sectors where it is only just beginning to be acknowledged that for many, particularly those with experiences of interpersonal trauma, difficulties can arise due to the use of face coverings.The sharing of grounding techniques and an introduction to the window of tolerance provides a means of collaboratively developing skills and developing a shared understanding of the difficulties associated with the use of face coverings. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Large numbers of mental health professionals live with their own mental health challenges.Despite working in mental health care, they can experience stigma in the workplace.Mental health professionals with lived experience of mental illness can find it a challenge to integrate their identities as both mental health professional and mental health service user.There are currently limited options available to them. What the paper adds to existing knowledge?: This is a personal reflection from a mental health nurse and lecturer, who lives with a severe and enduring mental illness.It offers a lived experience account of the identity struggles of a mental health professional living with a mental illness.This article attempts to redefine the identity of professionals with personal lived experience in a more positive manner. They can be valued and celebrated for their unique perspective on mental illness and mental health care. What are the implications for practice?: There remains a stigma attached to people living with mental health conditions. This article challenges some of this stigma.It will empower and encourage other health professionals with lived experience to embrace all aspects of their identity with authenticity and courage. There are growing numbers of mental health professionals with their own lived experience of mental illness. This is both in part due to increased visibility and openness, and students embarking on professional courses motivated by their own personal mental health history. The somewhat limited research in this area highlights the difficulty practitioners have in navigating this distinct identity. There are limited options, including a wounded healer, an impaired professional and professional survivor. All have their limitations. We need to revise the conceptualisation of mental health professionals with personal lived experience of mental illness. Our identity needs to be celebrated and valued, as are the roles of peer support worker and expert by experience. Through personal reflection, I describe my own challenges in negotiating my identity as a mental health nurse, lecturer, and service user. My solution is to embrace authenticity and have the courage to stand in vulnerability and strength, embracing all aspects of myself. I call for others to do the same. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Obsessive–compulsive personality disorder (OCPD), which is experienced by 2.1–7.9% of the population, is characterized by an excessive need for orderliness, neatness and perfectionism. What does the paper add to existing knowledge?: Existing studies on OCPD commonly focus on the physiological aspects, treatment and/or comparison of features with other disorders. Studies that explore the personal experiences related to OCPD are lacking and so the human element of this condition is missing. This paper contributes to this gap by presenting a glimpse into life with OCPD. The narrative is provided by the daughter of a person who lived with OCPD and presents the ordeals, victories and aspects of everyday life as framed by the condition. Whilst personality disorders such as OCPD are subjected to a high level of stigma, this relative's story shows that love and compassion can be found even in the darkest corridors that OCPD can take one to. As the story shows, behind every disorder there is a human being and the disorder is not the totality of that being. In this view, the paper sheds light on the human element related to the condition. What are the implications for practice?: The paper highlights the need for continuous, hands‐on community support to those experiencing OCPD and their significant others. In order to enhance continuity of care, support is ideally centralized and provided by one keyworker who builds a strong therapeutic relationship with the person and their loved ones. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: The parent–child relationship has a significant impact on children's mental health.Families with individuals with mental illness constitute a high‐risk group in the community.It can be challenging for children to cope with issues related to having parents with mental illness. What this paper adds to existing knowledge?: This paper explains the feelings, thoughts and experiences of a psychiatric nurse whose parents both have a mental illness and emphasizes the positive and negative effects of growing up in such a situation.The effects of growing up with parents with mental illness should be addressed as a whole. What are the implications for practice?: The narrative highlights the impact that parents with mental illness have on children.Psychiatric nurses are in a key position to provide children whose parents have a mental illness with timely and continuous help in developing coping and support mechanisms. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Eating Disorder (ED) education is predominating taught through a DSM‐V diagnostic criteria and clinically focused lens devoid of lived experience expertise. What the paper adds to existing knowledge?: Current clinically focused ED education may be shaping health professional misunderstandings of EDs, influencing the therapeutic relationships between health professional and consumer which is key to the recovery process.Integrating the lived experience voice through co‐produced, humanities‐based ED education deepens understandings and honours the complexities of EDs by bringing a much‐needed, alternate perspective to health professional learning, practice and research. What are the implications for mental health nursing?: Reframing mental health education towards a more strengths‐based, trauma‐informed and recovery focused lens has the potential to upskill the health workforce in how to hold hope, space and learn to walk the fight with people living and recovering with an ED. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject?: Schizophrenia is known as a highly debilitating mental illness, characterized by hallucination, delusions and paranoia.Literature on recovery from schizophrenia has only been emerging in the last three decades. What does the paper adds to existing knowledge?: It adds to the growing literature on the first‐hand accounts of recovery from schizophrenia.It highlights the strengths of persons with schizophrenia. What are the implications for mental health nursing?: Having a diagnosis of schizophrenia may not be as bleak as it seems.For mental health professionals to see the person behind their patients with schizophrenia. "You are not a typical case of schizophrenia." This was the statement by my psychiatrist that sparked the idea of compiling a collection of recovery narratives. Because of its fluid and subjective nature, personal recovery from schizophrenia needs to be understood in the cultural, societal and familial context of its storyteller. Autobiographic lived experience narratives serve to give an unadulterated account of the strength and tenacity of persons in recovery. In this lived experience narrative paper, you will find stories of three unique individuals living with a diagnosis of schizophrenia. Kurtle (name changed) tells the story of the multiple hats she wears in life. Valerie opens up about her past to shed light on her sense of meaning and purpose today. Ying Ying shares her family dynamics and how it has shaped her as a person. These stories aim to (1) change the way mental health professional relate to their patients, (2) emphasize the critical roles that mental health professionals play in their patients' recovery, and (3) remind mental health professionals to look beyond their patients' illness and see the persons behind the illness. Perhaps, then, recovery will become a typical phenomenon among persons living with schizophrenia. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Women with autistic spectrum disorder are likely to be diagnosed with other mental health needs and to have experienced trauma.Mental health nurses are likely to encounter women who possibly fit the criteria for a autistic spectrum diagnosis, but who have not been offered appropriate support or signposting. What the paper adds to existing knowledge: Using my own lived experience as a late diagnosed woman with autism and as a mental health nurse, I identify some of the gaps in training and knowledge that mental health nurses have. What are the implications for practice?: Suggestions are made as to how improvements in mental health nurses' knowledge of autistic spectrum disorder in women could enhance mental wellbeing for this group of people. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Dual diagnosis is a term used to describe persons who have a co‐occurring mental health and substance misuse disorders.It is the cause of significant economic burden to health care, justice and educational systems.It is well reported that to date dual diagnosis is under‐diagnosed and poorly treated within the confines of mental health services What the paper adds to existing knowledge?: It demonstrates that the need for service reform where all services are equipped with the necessary tools required to adequately support a person with dual diagnosis. What are the implications for mental health nursing?: The narrative provides a real‐life, candid description of how trauma in early childhood can cause significant challenges when one becomes older.The narrative identifies the dangers of not diagnosing a dual diagnosis early, resulting in only treating half the presenting issues.This narrative also offers hope to individuals in current distress, as well as for those supporting such individuals, as it clearly demonstrates that with the right supports and encouragement, recovery is possible. Introduction: Dual diagnosis describes when a person has two co‐occurring disorders. It is often difficult to diagnose and this can lead to prolonged suffering on behalf of the individual. Aim: To provide a lived experience narrative of the early recovery journey of a person with a dual diagnosis. Method: This aim was achieved through the use of a narrative based methodology. Results: The journey of life leading to a dual diagnosis and beyond is described under the following headings: Formative Years, Substance Misuse, When Life gives you Lemons, They Say Nothing lasts Forever, From the Ashes, Early Recovery and Luck or Fate? Discussion: The narrative presented describes a first hand experience of the struggles leading to a dual diagnosis and how receiving the diagnosis has supported the recovery journey of the first author. [ABSTRACT FROM AUTHOR]

Accessible summary Current UK mental health nursing policy is critiqued for neglecting the storied complexities of recovery-survival., Within a critical framework, creative non-fiction is used in a relational auto-ethnographic design to produce two short stories that demonstrate the utility of narrative re-storying in recovery-survival., New insights emerge for mental health nurse practice and research. These are: that narrative re-storying may help the recovery process for individuals and communities; that hybrid transcultural writing positively undermines barriers between professionals and consumers of mental health; and that all of this constitutes contemporary methodological innovation in narrative inquiry and related practice., Abstract Some of the complexities of recovery and survival are arguably relatively neglected in current UK mental health nursing policy and, by association, clinical and research practice. In order to redress this, this paper, part of larger research project, will present two short stories, contextualized in a critical theoretical and methodological position. The overall significance of the argument in the paper is in its emerging benefits and implications for users of mental health services, practitioners and researchers. The central, orienting principle in the paper, cohering with all of its strands, is 'narrative re-storying'. Organized in three parts, the first reviews selected relevant background policy and related literature, the contextual and theoretical bases of the paper, and related methodological and ethical issues. The second presents the two stories, and the third brings the paper to a close. It does so in discussing specific and global emerging implications for mental health nursing practice and research, around narrative re-storying as a recovery tool and methodological innovations that include 'hybrid' writing. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Stigma involves connecting individuals with a particular label to negative characteristics; this is based not on the stigmatized condition itself, but cultural reactions to it., Stigma exists towards nurses with mental illness., What this paper adds to existing knowledge? This paper offers a first-person account of experiencing stigma as a nurse with a mental illness., This paper incorporates the existing literature to offer a broader cultural perspective on the experiences of a nurse with a mental illness., What are the implications for practice? Nurses are likely to encounter a nurse with a mental illness at some point in their practice., Nurses' reactions towards colleagues with mental illness can have significant implications for those colleague(s)' wellbeing., Nurses with mental illness will have to navigate their person and professional journey while giving consideration to the attitudes of their nursing peers and leaders., Abstract Limited research has been done on the stigma faced by nurses with mental illness from their nursing peers. Mental illness is not generally considered acceptable within the context of nursing culture, so when nurses do experience mental illness, their experiences in a professional context may be influenced by stereotypes, particularly those relating to dangerousness. Using autoethnography as a research method, the author examines her own subjective experiences of stigma as a nurse with a mental illness, and draws upon existing literature on stigma, deviance and the phenomenon of mental illness in nurses to analyse broader cultural implications for nursing. Assessment of suitability to return to work arises throughout the narratives, and consideration is given to the way that risk assessment by nursing leaders is impacted by negative stereotypes that surround mental illness. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mental health support workers (MHSWs) are frequently employed in mental health services in order to augment and diversify the workforce and to promote recovery centred careResearch shows that while MHSWs positively support service user mental health recovery, these roles are often unclear or not well understood by MHSWs and other mental health practitioners What the paper adds to existing knowledge?: Through arts‐based research methods, three MHSWs communicated their personal vulnerabilities and anxieties in supporting others with mental health issues; these insights are rarely presented in mental health research.MHSW experiences of not having recovery‐oriented expertise recognized or valued by healthcare team were powerfully conveyed through arts narrative. These findings promote recognition of the strengths and contributions of MHSWs to mental health practice.Arts‐based inquiry is a means of providing additional depth to what is already known and contributes novel insights regarding the occupational experiences and perceptions of MHSWs. What are the implications for practice?: Mental health nurses and healthcare teams need to engage fully with recovery‐oriented principles acknowledging the vulnerabilities of all practitioners and establishing adequate supervision and support.There needs to be greater clarity concerning roles/scope of practice for MHSWs to enable productive working partnerships in mental health teams. This can be achieved through open communication, education and planning among the wider mental healthcare team. Introduction: Mental health support workers (MHSWs) make positive contributions to mental health recovery practice yet their roles and support needs are often unclear. This research explored the occupational lived experiences of three MHSWs working in Irish mental healthcare services. Aim: The study examined the experiences and perceptions of MHSWs regarding their mental health recovery work. Method: A narrative design was used incorporating participatory art‐based inquiry as a collaborative means of engaging participants. This innovative methodology enabled exploration and evocative expression of participants' occupational experiences and stories. Results: Participants revealed feelings of vulnerability and anxiety regarding personal mental health and supporting the mental health of others; a finding not commonly explored in previous research. MHSW skills and knowledge were evident; however, this expertise and recovery focus was not valued in mental health services. Discussion: The strengths and challenges of MHSW engagement in service provision are discussed. Interdisciplinary team integration is explored in terms of contrasting recovery philosophies, practitioner vulnerability and professional demands and imperatives. Implications for practice: Mental health teams need to engage with recovery principles, acknowledging strengths and vulnerabilities of all practitioners and establishing adequate supervision and support. Greater clarity and education is required concerning roles/scope of practice for MHSWs to enable productive interdisciplinary partnerships. [ABSTRACT FROM AUTHOR]

Accessible summary What is known about the subject? This paper describes crisis resolution/home treatment (CRHT) teams, which are part of mental health services in the United Kingdom. CRHT is expected to assist individuals in building resilience and work within a recovery approach., What this paper adds to existing knowledge? This paper arises from an interview with one individual, Dale, as part of a larger study exploring service users' experiences of CRHT. It adds to the body of narrative knowledge in CRHT through Dale's co-authorship of this paper, reflecting on his original interview 4 years later, with co-authors providing critical interpretation of his experience, in turn supported by cognate literature., What are the implications for practice? Implications for practice are considered, themselves mediated through Dale's own descriptions of how CRHT interventions impacted upon him. These impacts are analysed with respect to three themes: Resilience, Recovery and Power., It is centrally contended that clinicians need to more clearly comprehend three core matters. First, what resilience 'is' for service users as well as the complex process through which these individuals move in developing resilience. Second, the distinction that service users might make between 'recovery' and 'functionality', and how this in turn can impact on individuals both in personal and socioeconomic sense. Finally, the mechanics of power within CRHT contexts and how these interpersonal dynamics can affect the relationship between service user and clinician in practice., Abstract Introduction and Aim The central purpose of this paper, part of a larger study exploring the experiences of Service Users (SUs) with CRHT, is to emphasise the importance of the SU voice itself within the domain. Following an interrogation of the historical contexts of CRHT. Method This paper uses interpretative phenomological approach around detailed thematic examination of an extended, semi-structured with a single SU: Dale. Moreover, four years after the interview was originally conducted, Dale was himself invited to reflect upon, and critically re-evaluate, his initial participation as a co-author of this paper. In this way, a genuinely participant-centred narrative on experiences with CRHT could be generated. Implications for Practice This resulted in Dale describing what 'crisis' meant to him, and his personal journey within that crisis. Although framing some experiences as negative, he primarily argues that the CRHT team was very personable, affirming his personal values and beliefs, and encouraging him to use coping skills that he had utilised effectively in prior periods of crisis. Analysis highlights three major themes permeating Dale's narrative: Resilience, Recovery and Power. It is contended that this analysis begins to demonstrate implications for practice and highlight that (and how) CRHT clinicians might more clearly engage with what resilience 'is' for SUs, and also the complex process through which these individuals move in developing it. Equally, it is proposed that practitioners should be mindful of the distinction that SUs might make between 'recovery' and 'functionality', and how this in turn can impact on individuals both in personal and socio-economic sense. Finally, the mechanics of power within CRHT contexts are foregrounded, and how these interpersonal dynamics can affect the working relationship between SU and clinician. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: The involvement of those with lived experience is broadly understood to be beneficial to student learning. The consequence of the process and implications for learning are predominantly unexplored. What the paper adds to existing knowledge?: The paper explores an innovative co‐produced model of involving people with lived experience in the assessment process of mental health nursing students. This method of assessment enables students to further critically analyze the application of humanistic skills and theories of person‐centred care. What are the implications for practice?: The involvement of people with lived experience in the assessment process of students promotes self‐awareness and empathy. It is questionable if learning which is potentially troublesome should act as a form of academic assessment which is exposed to the external judgement of another and awarded a credit‐bearing grade. Abstract: Introduction: Despite a positive and established perception of people with lived experience of mental distress contributing to the assessment of healthcare professionals, the consequence and implications for learning are predominantly unexplored. Aim: To gain a greater understanding of the influence of feedback given by people with lived experience, in the role of formative assessor, on student learning. Method: Qualitative analysis, underpinned by the theory threshold concepts, was conducted on the written reflective assessments, submitted by students, following engaging in an assessment with a lived experience assessor. Results: Student learning was influenced positively by the involvement of lived experience assessors in relation to person‐centred care. However, students reported the experience to be anxiety provoking due to the desire to seek external approval and conceal personal challenges. Discussion: The results indicate that the feedback from those with lived experience promotes greater self‐awareness and empathy amongst students. The perceived expectation to present a competent and professional performance acts as a barrier to authentic person‐centred practice. Implications for practice: It is questionable if learning which is potentially troublesome should act as a form of academic assessment, which is exposed to the external judgement of another and awarded a credit‐bearing grade. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject: Integrating strengths‐based, co‐produced, consumer‐driven resources into mental health workforce education has the potential to dissolve hierarchical mental health care relationships. What the paper adds to existing knowledge: Humanities‐based pedagogy that draws from photography and multi‐voiced narratives is a powerful reflective learning tool to bridge clinical and human experiences of Borderline Personality Disorder (BPD).The Depth of Field reflective learning methodology aims to provoke, prod, reveal and challenge assumptions and/or unconscious bias towards BPD and stimulate raw and reflective discussions that have the potential to inspire critical reflection and move health professionals towards more humanistic, recovery centred models of mental health care. What are the implications for mental health nursing: At the core of co‐production in research, education and practice lies a reciprocal, transformational learning experience. This relationship needs to be further explored in order to reframe mental health education that honours and legitimizes consumers as experts of their own lives and recovery experiences. [ABSTRACT FROM AUTHOR]

Accessible summary This paper compares two post-modern methodological approaches, post-structuralist and narrative, and considers their usefulness in relation to emancipatory research in mental health., The paper finds that post-structural analyses can be useful in deconstructing oppressive practices and in indicating emerging forms of resistance., Narrative approaches potentially offer greater emancipatory scope than post-structuralism as they enable people with mental health problems to restore their lives and enact their own subjective transformation., However, narrative templates may perpetuate injustice if they erase the complexity of people's stories. This raises ethical issues in relation to narrative interpretation., Abstract Concerns with social justice have been traditionally associated with a modernist concept of the individual whose actions express an underlying, essential and unified self. This paper compares the usefulness of two methodologies (post-structuralist and narrative) that are based on a rejection of identity of a unified self and compares their usefulness in relation to the development of a social justice paradigm within mental health. It considers how professional forms of knowledge may be deconstructed by post-structural analyses, arguing that these have also been used by service users to articulate more enabling discursive alternatives. The notion of agency is central to our understanding of social justice. We question the commonly held assumption that although post-structuralism deconstructs power and challenges its legitimacy, it is nevertheless unsuited to facilitating the necessary agency to put forward viable alternatives. The second half of the paper considers how narrative research offers greater emancipatory potential by enabling the research subject to author their stories and thereby brings about their own subjective transformation. Nevertheless, the interpretation of people's stories by researchers may result in the imposition of narrative templates that erase complexities and contribute to the perpetuation of oppression. This raises ethical implications in relation to how people's stories are interpreted. [ABSTRACT FROM AUTHOR]

Accessible summary Construct validity of 'mental illness' remains elusive and has been replaced by the more manageable problem of reliability. Health-care professionals may reliably diagnose similar clusters of symptoms but, realistically speaking, these conditions may not be mental disorders., Labelling individuals as mentally ill only accentuates the burden of disease by situating the problem within the person, rather than to engage in the difficult task of addressing the contextual elements that may be at the source of distress., Drawing on research findings in the field of HIV/AIDS nursing, we can see the impact of psychiatric pathologization of women who experience treatment-induced body changes and subsequently, must accept that their response to these changes become the target of psychiatric labelling and interventions., We believe that health-care providers first need to challenge the idea that distress associated with lipodystrophy should result in pathologization. We argue that nurses should be at the forefront of such an initiative because they have the professional responsibility to act as patient advocates., Abstract This paper is precisely aimed at exposing the limits of psychiatry's scientific claim-making and exploring how psychiatric diagnoses come to be utilized in practice and affect those who become pathologized. Drawing on research findings in the field of HIV/ AIDS nursing, we portray the impact of psychiatric pathologization of women who see their bodies transformed by antiretroviral therapy and subsequently, must accept that their response to these changes become the target of psychiatric labelling and interventions. In this paper, we therefore engage with the reader in a critical analysis that exposes the tensions that exist between individual experiences of distress and psychiatric pathologization. The first section of the paper is dedicated to the presentation of a theoretical framework in which we explore the medicalization process and the ontological issues regarding psychiatric diagnoses. The second section seeks to present the results from a qualitative research study in the field of HIV/ AIDS nursing and serves as a case example to foster discussions on the implications of psychiatric pathologization in clinical practice. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? The experiences of transgender people are becoming increasingly more visible in popular culture, biographical literature and the media., The topic has received little attention within the psychiatric and mental health nursing literature., There is a paucity of literature exploring the impact on relationships following a disclosure of transgenderism., What does this paper add to existing knowledge? A narrative account of the consequences for the wife of one transwoman and their relationships with friends and family following the disclosure of transgenderism., The article identifies a range of issues that require further attention in relation to healthcare provision. These include the mental health needs of partners and spouses; attitudes of healthcare professionals towards transgender issues; and the adequacy of the formal support offered to partners and spouses of transgender people., What are the implications for practice? There is a need for healthcare practitioners to explore their understanding of transgender issues and how these may impact on the mental health of partners and spouses., It is important that healthcare professionals provide a hopeful and supportive environment to enable couples to explore their relationships following disclosure of transgenderism. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject? Loneliness in older adults has been identified as an important public health issue in many countries., Widowhood is a time when many older people experience loneliness., What this paper adds to existing knowledge? Little is known about strategies that are effective in mitigating experiences of loneliness and this paper explores this with older people who have been through the process., The narratives of the older people in this study described a trajectory in which loneliness was experienced as both a loss of spouse and a loss of routines that enabled them to maintain connections with others., This trajectory moved onto the establishment of new routines that enabled connections to be developed., What are the implications for practice? Loneliness is strongly associated with depression and anxiety in the elderly and mental health nurses should be encouraged to screen for loneliness when undertaking assessments., Interventions that facilitate the development of meaningful routines could be integrated into mental health nursing care of older people., Abstract Background Loneliness in older people is a public health concern in many Western countries. While not necessarily a symptom of mental disorder, it is often associated with depression and anxiety. Widowhood is a transition period during which many older people experience acute loneliness but over time develops strategies to manage it. Little is known about effective strategies that older people have used to manage the experience. The strategies older people used to manage this was the focus of this paper. Aim The aim was to examine older widows' experiences of loneliness. Design The design of this study was a qualitative narrative analysis with thematic analysis and the participants were 40 older widow/widowers aged between 70 and 97 years. Findings The study found that the participants negotiated the experience of loneliness following widowhood from an acute phase of experiencing an absence and the associated loss of routine connection to the establishment of new routines that provided new connections and a new sense of identity as an individual rather than a couple. Conclusions It is important for mental health nurses to screen for loneliness and be able to facilitate interventions that may alleviate the experience of loneliness. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The admission of a loved one for first episode psychosis can cause considerable distress and confusion for family members.Psychoeducation can enhance family members' knowledge of the disease process and their role in supporting recovery. What this paper adds to existing knowledge: There is limited research on psychoeducation processes within adult inpatient settings.A Practitioner Narrative found that basic assessment questions can help guide the psychoeducation process. The Stress Vulnerability and Phases of Psychosis Models are valuable and efficient educational tools in answering many typical questions. What are the implications for practice?: Psychoeducation sessions should be offered routinely in the early stage of a first episode psychosis, but must be individualized to family needs and concerns.The psychoeducation structure also provides an opportunity for family members to "tell their story" to process the events leading up to a first admission and their emotional reactions to the service user's illness. Aim: To clarify how initial psychoeducation, while typically brief, can best be targeted to the needs of families during the acute treatment phase of a first episode of psychosis, when there is often significant distress and confusion. Method: Over 6 months of conducting inpatient psychoeducation meetings, with families of individuals experiencing first‐episode psychosis, a senior mental health nurse—as a practice development undertaking—kept a record of needs/issues expressed by families. Thesis: The most frequent needs of families during a first episode of psychosis were: 1. Opportunity to discuss events leading to admission; 2. Space to share feelings and fears; 3. Have practical information concerning current care; 4. Education regarding the nature of psychotic symptoms and 5. Information about recovery. Implications for Practice: Family members of individuals experiencing a first episode of psychosis often require an opportunity to process the events leading up to the admission, and their emotional reactions to the individual's illness and admission. The psychoeducation process can be individualized and targeted to the needs of families, with active listening to the family's stories. Psychoeducational frameworks that were useful for explaining issues raised were the Stress Vulnerability Model and the Phases of Psychosis. [ABSTRACT FROM AUTHOR]

Accessible summary This paper adds a phenomenological hermeneutic perspective on meanings of caring for adult people who self-harm as disclosed in narratives of dialectical behaviour therapy (DBT)-trained professionals., This paper shows that providing DBT care for people who self-harm means embarking an unpredictable journey, sometimes lonely, but also often together with the person who self-harm and with the DBT team., This paper emphasizes professionals' benefits of the tools and structure offered by DBT; however, the text points to the importance of the genuine meeting, including confirmation, as a prerequisite to recovery., This paper suggests that further research might focus on the meanings of genuine meetings and their organizational prerequisites., Abstract In this paper, we aim to explore meanings of caring for adult people who self-harm as described in the narratives of professionals trained in dialectical behaviour therapy ( DBT). We conducted narrative interviews with nine professionals working in a DBT team and used a phenomenological hermeneutical method to analyse their narratives. Our comprehensive understanding cast the caring relationship as an unpredictable journey, in which the professionals were guides or companions who aimed to walk side-by-side with the person who self-harms, prove to be trustworthy, and keep on track. They sometimes saw the journey as lonely and sometimes as a joint endeavour. Our analysis was informed by Martin Buber's writings on the 'genuine meeting' and confirmation. The professionals emphasized the importance of the tools and structure offered by DBT; however, the text points to the importance of the genuine meeting, including confirmation, as a prerequisite to recovery. Mental health nurses need opportunities for continuous training and counselling. [ABSTRACT FROM AUTHOR]

Accessible summary Presented as part of the Ellen Skellern lifetime achievement award in 2016 this paper reflects on a career in mental health nursing and academia spanning 53 years. The presentation offers a series of key lessons learned in that time. They include observations on health care organisations, educational experiences, the nursing profession and the illusion of permanence in health care service organisations and the buildings that house them. The paper offers an account of how a profession must constantly develop to be relevant and how the demolition of both buildings and organisations have been a fact of life in the five decades reported. [ABSTRACT FROM AUTHOR]

This paper explores themes relevant to mental health nursing using the example of one educational module of a nursing degree. The authors argue that the educational preparation of mental health nursing students in higher education must address certain contested philosophical, conceptual, social and ethical dimensions of contemporary mental health care practice. These themes are discussed within the context of a third-year mental health nursing module within a Scottish nursing degree programme. By interlinking epistemology and ontology, the notion of student as 'critical practitioner', involving the encouragement of 'critical thinking', is developed. This is shown via engagement with parallel perspectives of the sciences and the humanities in mental health. Narratives of student nurse engagement with selected literary texts demonstrate the extent to which issues of knowledge, self-awareness and personal development are central to a student's professional journey as they progress through an academic course. The paper concludes by suggesting that these 'critical perspectives' have important wider implications for curriculum design in nursing education. Insights from critical theory can equip nurse educators to challenge consumerist tendencies within contemporary higher education by encouraging them to remain knowledgeable, critical and ethically sensitive towards the needs of their students. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Weight suppression (WS) has been suggested to predict outcome following psychological treatment for an eating disorder (ED). Some findings are contradictory and have not been considered systematically. What the paper adds to existing knowledge?: The review suggests that weight gain at post‐treatment is reliably predicted by pretreatment WS, but findings regarding other outcomes (e.g., treatment dropout) are less consistent. Approximate effect sizes for observed relationships are identified, alongside support for biobehavioural theories of metabolic adaptation to weight loss. What are the implications for practice?: Degree of WS at pretreatment is associated with weight gain and is important for clinicians to consider before offering treatment to patients with EDs. Patients high in WS might benefit from further support (e.g., psychoeducation) prior to beginning treatment. Abstract: Introduction: Weight suppression (WS—the difference between highest body weight and current body weight) has been proposed as a predictor of treatment outcome within eating disorders (EDs), although this hypothesis has not been consistently supported. Aim/Question: Review the association between pretreatment WS and outcome following psychological treatment for EDs. Method: A comprehensive electronic database search for published and unpublished literature from 1979 to 2017. Reference lists were also inspected. Eligibility criteria were determined according to relevant guidelines and a quality appraisal was conducted. Results: Twelve studies met inclusion criteria (one was subsequently excluded based on insufficient data). Greater WS was generally associated with weight gain at post‐treatment although not with other treatment outcomes. Discussion: The existing evidence, with data from 1,566 participants, is summarized according to three main post‐treatment outcomes: weight change; treatment completion; and symptom abstinence. Patients with disordered eating and greater WS may need to gain more weight than others during treatment to achieve good outcomes. Recommendations for future studies are provided. Implications for practice: Evidence‐based treatments for EDs may benefit from considering WS when planning treatment, such as further psychoeducation on weight changes. Societal interventions regarding promotion of healthy eating may also draw on these findings. [ABSTRACT FROM AUTHOR]

Accessible summary The pervasive impact of mental illness on identity is generally held as negative. Contemporary Models of involvement within statutory services pay little regard to the identity of individuals beyond the 'service user' label and in doing so unwittingly perpetuate and sustain the negative impact of mental illness., This aim of this paper is to discuss the process of working alongside people who use statutory mental health services as co-researchers. It highlights the perspective of those involved as researchers on both the process and the impact of this type of involvement on them considering a move beyond the illness identity., This three year participatory action research study was facilitated within community mental health services. 6 people, currently using statutory mental health services were recruited as co-researchers. The study required that they undertook a series of interviews with service users in relation to their life stories. The transcripts were mapped and analysed by the researchers using interpretative phenomenological analysis (IPA). In order that the people were enabled to undertake these roles the study included a process of interviewing and appointing service user researchers followed by a programme of training workshops, supervision and discussion group/peer support throughout., The study reveals the importance of key aspects within the process of user involvement emphasizing the potential for transformation: connection, creditable definitions of self and reciprocity. It discusses implications for service user involvement within the statutory mental health service, acknowledging potential for transformation at both an individual and collective level., Abstract Contemporary models of involvement within statutory services pay little regard to the identity of individuals beyond the 'service user' label and in doing so unwittingly perpetuate and sustain the negative impact of mental illness. The aim of this paper is to discuss the process of a 3-year participatory action research study facilitated by a mental health nurse. It highlights the perspective of those involved as co-researchers, all having experience of accessing statutory mental health services. It identifies both the process and the impact of this type of involvement on them illustrating their move beyond an illness identity. The study involved them undertaking a series of interviews with other service users in relation to their life stories. They subsequently mapped and analysed the transcripts. In order that the people were enabled to undertake these roles the study included a process of interviewing and appointing service user researchers followed by a programme of training workshops, supervision and discussion group/peer support. The accounts provided reflect the six researchers' attempts to make sense of their experience and reveal the path of transformation through collaboration. [ABSTRACT FROM AUTHOR]

Accessible summary Narrative therapy is a useful approach in the treatment of depression that allows that person to 're-author' his/her life stories by focusing on positive interpretations, and such focus on positive emotions is a crucial component of treatment for depression., This paper evaluates narrative therapy with an emotional approach (NTEA) as a therapeutic modality that could be used by nurses for persons with depression., A nurse-administered NTEA intervention for people with depression appears effective in increasing cognitive-emotional outcomes, such as hope, positive emotions and decreasing symptoms of depression. Thus, NTEA can be a useful nursing intervention strategy for people with depression., Abstract Narrative therapy, which allows a person to 're-author' his/her life stories by focusing on positive interpretations, and emotion-focused therapy, which enables the person to realize his/her emotions, are useful approaches in the treatment of depression. Narrative therapy with an emotional approach ( NTEA) aims to create new positive life narratives that focus on alternative stories instead of negative stories. The purpose of this study was to evaluate the effects of the NTEA programme on people with depression utilizing a quasi-experimental design. A total of 50 patients (experimental 24, control 26) participated in the study. The experimental group completed eight sessions of the NTEA programme. The effects of the programme were measured using a self-awareness scale, the Nowotny Hope Scale, the Positive Affect and Negative Affect Scale, and the Center for Epidemiological Studies-Depression Scale. The two groups were homogeneous. There were significant differences in hope, positive and negative emotions, and depression between the experimental and control group. The results established that NTEA can be a useful nursing intervention strategy for people with depression by focusing on positive experiences and by helping depressed patients develop a positive identity through authoring affirmative life stories. [ABSTRACT FROM AUTHOR]

Accessible summary Research into the patient's perspective on their care is being given increasing importance within health and nurse education policy, predicated upon the idea that the findings represent the patient experience., Researchers have power to silence the voices of research participants through the process of authorship. Exploring the arts as a means of presenting findings offers the opportunity problematize issues of power and authorship, and examine ways of decentring the researcher's voice., Re/presentation of patient experience in poetic form encourages readers to engage with that experience as they have to actively interpret the meaning of the poem., Researchers interested in examining and conveying the experience of others should be encouraged to problematize issues of authorship and consider the impact of their authority on the re/presentation of the experience of the other., Abstract The study aimed to understand the experience of being a patient on an acute psychiatric inpatient ward. A further aim was to open up spaces for the voices of participants to be heard. Contemporary government policy places patient experience at the centre of healthcare policy and service development. Despite this, those who occupy marginalized discourses struggle to be heard within the dominant discourse of health care. A qualitative approach was used, and narrative was conceptualized as representing experience. Sociolinguistic theories informed the development of the analytic framework treating meaning as contextual and arising from both content and structure of narratives. Concepts of representation, voice and authorship were problematized. Thirteen people who had been inpatients on an acute psychiatric inpatient ward participated. Narrative data were gathered using unstructured interviews. The data were analysed holistically using a method that attended to both the structure and content of the narrative. The product of these holistic narratives was the development of a poem representing each participant's experience. This paper focuses on the development of these poems as a method of decentring the authorial voice and opening up spaces for the voices of the participants to be heard. [ABSTRACT FROM AUTHOR]

Accessible summary The idea for this research and practice development project emerged from the production of a recently published book of recovery narratives, written by a community of people broadly working in the mental health recovery movement., The research component of this project, described in this paper, sits within: narrative inquiry as a moral endeavour in the human sciences; the pedagogy of suffering in the sociology of health and illness; and mental health narrative recovery., Two inter-related data sources will be used in the research. The first is chapters contributed by authors to the book. The second is interview data from those authors., Integrative textual and interview transcript analysis will extend to the end of 2012., The research component of this project represents a commitment to a mental health nursing practice allied to recovery as narrative healing as opposed to forms of psychiatric nursing which endorse and tacitly support abuses committed in the name of institutional psychiatry., Abstract This paper, part one of a two paper report, describes key aspects of the research context of an ongoing practice development project, conducted on two UK sites. The paper begins with a discussion of the project's origins within a community of people working in the recovery paradigm, including the contributory strand of the first author's recovery and survivor writing. The discussion then turns to three inter-related areas within which the research component sits and which provide it with philosophical, theoretical and conceptual coherence. Each area will be unpacked and its significance explained. This will provide a platform for discussing the focus, methodology and methods of the research, and related assumptions governing both data collection and analysis. The paper concludes with a research commitment to a mental health nursing practice allied to recovery as narrative healing. Links are made to the second paper which describes the context and specifics of a Writing for Recovery project for users, survivors and carers. This shares with, and builds on, the overall project's research context and its assumptions. [ABSTRACT FROM AUTHOR]

Accessible summary This paper describes a research study which was undertaken with 11 female patients, detained under the Mental Health Act. Seven of the women were resident in a high secure hospital; the remaining four women were patients on a female ward in an independent medium secure hospital., All of the women had a history of self-harming behaviours, with 10 of the participants expressing violence towards others. The female patients agreed to be interviewed about how they chose to show their feelings when they were sad, angry, frustrated and upset., The findings describe how all of the women have different explanations for when and how they choose to hurt themselves, and what precipitates violent behaviour towards other people. The findings demonstrate that a combination of approaches to care and treatment can facilitate a reduction in both self-harming and outwardly aggressive behaviours in this vulnerable client group. The findings of this study indicate that the most effective combination of treatment includes prescribed medication, informal support networks, intensive individual therapy and active engagement in a therapeutic programme which teaches life skills., Abstract This paper reports the findings of a descriptive phenomenological study that aimed to elicit and describe the experience of psychological distress as expressed by a group of women compulsorily detained within secure mental health services in the UK. A fundamental objective of the study was to contribute to the existing evidence base that supports the care and treatment needs of this severely traumatized and challenging patient group. We argue that service providers and clinical practitioners could be better informed about the unique care and treatment needs of this severely traumatized and challenging patient group when working with them. A descriptive phenomenological approach developed by Giorgi was used to elicit the lived experiences of 'psychological distress' from a sample of female patients resident within a high secure hospital and an independent medium secure hospital. The findings indicate that a treatment plan which includes a combination of prescribed medication, informal support networks, intensive individual therapy and active engagement in a therapeutic life skills programme can be extremely beneficial. Most notably in helping to reduce the frequency of both internally and externally directed violent behaviour in this vulnerable client group. [ABSTRACT FROM AUTHOR]

Accessible summary Simulation has become a valuable educational tool with a variety of devices available for use., Examples of simulation scenarios developed especially for use with psychiatric and mental health nursing students are scarce., A simulation technique with considerable potential for the teaching and learning of essential mental health nursing skills is the narrative virtual patient., Wider use of virtual patient tools would help establish if it is a viable educational device., Abstract This paper discusses the use of simulation in nursing education and training, including potential benefits and barriers associated with its use. In particular, it addresses the hitherto scant application of diverse simulation devices and dedicated simulation scenarios in psychiatric and mental health nursing. It goes on to describe a low-cost, narrative-based virtual patient simulation technique which has the potential for wide application within health and social care education. An example of the implementation of this technology in a web-based pilot course for acute mental health nurses is given. This particular virtual patient technique is a simulation type ideally suited to promoting essential mental health nursing skills such as critical thinking, communication and decision making. Furthermore, it is argued that it is particularly amenable to e-learning and blended learning environments, as well as being an apt tool where multilingual simulations are required. The continued development, implementation and evaluation of narrative virtual patient simulations across a variety of health and social care programmes would help ascertain their success as an educational tool. [ABSTRACT FROM AUTHOR]

Accessible summary This paper discusses the use of story telling (sometimes referred to as narrative) as a research method and how by doing this those volunteering to participate in this type of research might find it therapeutic. The paper considers the personal characteristics and skills of the mental health nurse and how these can be transferred from using them therapeutically in clinical practice to the research encounter and what the implications of doing this might be. The paper specifically looks at: •similarities between narrative research and therapy; • what might motivate people to participate in research; • what happens during story telling or narrative; • the importance of looking after the participant and self as a researcher; • the importance of ensuring it is the participant's voice that is heard. Narrative inquiry as a qualitative research method appears to be growing in popularity among mental health nurses. This paper argues that there are a number of parallels between narrative inquiry and psychotherapy, and mental health nurses familiar with the practice of therapeutic engagement need to be mindful of these when using this approach to research. The symbiotic relationship between those engaged in narrative inquiry and those engaged in psychotherapeutic practice is explored in order to provide greater understanding of some of the ethical issues involved and how new researchers, supervisors and practitioners might better respond to the complexities inherent in using narrative inquiry which may itself be therapeutic. Our focus for this paper is the tensions experienced by the mental health nurse while working as a researcher when the research encounter provides a trigger that would normally elicit a therapeutic response for both participant and nurse. Using a selection of psychoanalytic theories and principles this paper explores the relationship between the processes of psychotherapy and narrative inquiry. This discussion paper is based on the authors' own research experiences of using narrative inquiry to explore a number of sensitive issues and many years of supervisory relationships with students and practitioners alike. [ABSTRACT FROM AUTHOR]

Accessible summary This paper presents findings from one part of a research study exploring lay people's beliefs and attitudes to mental disorder. [ABSTRACT FROM AUTHOR]

Accessible summary [ABSTRACT FROM AUTHOR]

Acute psychiatric inpatient care forms an integral part of mental health services. Few studies have focussed on the patient experience of acute care. Research into patient experience is increasingly important to policy and service development processes. Knowledge of patient experiences facilitates the development of nursing practice. The aim of the study was to gain insight into the experience of being a patient on an acute inpatient psychiatric ward. Thirteen participants were recruited from the acute ward. Unstructured interviews were used to gather narrative data of their experiences. Holistic analysis of the narratives was informed by Gee's socio-linguistic theories that meaning is linked to narrative structure. Reading of the holistic analyses yielded themes of help, safety and power running across the participants' experiences. The patient experience was characterized by dissonance between expectation and experience, the search for a nurse--patient relationship and the development of strategies to cope with being on the acute ward. This paper focuses on the theme of 'Help' where participants describe their expectation that they will receive help through the development of relationships with the nurses, and their experience of the barriers to this. In response, participants developed strategies to support each other. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject Intimate partner violence (IPV) impacts significantly on the lives and health of those who experience abuse, The impact of IPV exerts a detrimental impact on mental health as well as physical health, but this is often not recognized by professionals, What the study adds to existing knowledge This study highlights the impact of IPV on the lives and health of older women from the perspective of older women themselves, The approach taken to the study illuminates the ways in which older women describe their experiences within the broader narratives of their experiences, This study has explored the particular situation for older women as told through creative expression and their own stories of survivorship., Implications for practice Nurses and other healthcare professionals need to be aware of the enduring impact of IPV for older women, particularly within the context of mental health, Those working with older women also need to be alert to the potential barriers to disclosure and disjuncture between professional dialogue and personal narrative, Abstract Introduction Intimate partner violence ( IPV) exerts a detrimental impact on the lives and health of all who experience abuse. This includes both physical and mental health and well-being. The experiences of older women however may be different, and these differences may not be recognized or accounted for within existing care provision. Aim To explore the impact of IPV on the lives and health of older women told from the particular perspective of older women themselves as these accounts are largely absence from existing IPV discourse. Method An arts-based research approach with five older women survivors of IPV through the codevelopment and organization of an arts-based workshop. The workshop essentially encompassed four main arts strands and included the creation of clay models and poetry. Findings The findings of the study highlight the significant impact of IPV on the lives, mental health and well-being of older women. This included feelings of social isolation, inability to trust others and a loss of self-identity. Discussion Intimate partner violence is a global issue and as such of relevance for those working in healthcare contexts beyond the UK. While there is a growing body of evidence surrounding IPV and older women, this has largely been presented through researcher-led accounts and as such the narratives of women themselves may not have been adequately acknowledged. Unlike much of the existing evidence, this study has explored the particular situation for older women as told through creative expression and their own stories of survivorship. In this study, the fluidity of the potential materials available in the workshops meant that both the representations through which the women spoke and the primacy of their voices, over those of more traditional researcher accounts, were in evidence throughout. Implications for Practice Mental health nurses and practitioners are often on the front line for care and support for older client populations. IPV across the life span is a global issue for healthcare practitioners. It is anticipated that the findings of this study will provide the mechanism through which mental health nurses and other practitioners may reflect on older women's accounts of IPV as told by older women in this study in their own words. Reframing from dominant professional discourse to personal narrative is central to person-centred approaches and is central to contemporary practice. Ultimately, this has the potential to improve the effectiveness of care provision and support. Relevance to Mental Health Nursing The findings presented in this study have the potential to provide a powerful tool for those working within mental health contexts and healthcare professionals working with older populations more generally to consider both the hidden nature of IPV and the ways in which IPV can significantly impact on mental health and well-being in later life. [ABSTRACT FROM AUTHOR]

Accessible summary Homeless persons are known to be highly vulnerable to psychological trauma, in events triggering periods of homelessness and the considerable social isolation and adversity suffered when homeless. This study provides an account of how mental health support work is experienced by homeless service users when it is informed by a person-centred, non-directive approach and implemented by trainee health and social care professionals under the auspices of a specialized psychological trauma service. The study draws upon material gathered from interviews with service users domiciled in supported housing for homeless persons and support workers who practiced on the programme., The service users who participated in the study valued support work that combined practical and relational elements, but would have preferred a longer-term involvement. They also spoke of feelings of disconnection and estrangement from others including their peers in supported housing. The support worker participants valued the flexibility they had when working on the programme to tailor their intervention to service users' individual needs., Practice implications of the study are discussed. These include the need to minimize barriers to accessing support, facilitate informal time between professionals and homeless service users, and manage intervention endings sensitively when temporary staffing arrangements are in place., Abstract Homeless people are a population known to be highly vulnerable to trauma, in triggering events to becoming homeless and the considerable social isolation, discrimination, and adversity suffered when homeless. Currently, there is a paucity of research into mental health service delivery to homeless persons and the influence it imparts in individual lives. This article presents a qualitative 'practice research' study into a pilot programme of social support work delivered in a specialized psychological trauma service to homeless service users. The programme was grounded in a non-directive, person-centred approach and staffed by student social workers. The study aim was to explore the support work programme as it was received by service users domiciled in supported housing for homeless persons, encompassing experiencing the programme, worker-service user engagement and contextual influences bearing upon positive outcomes. Narrative interviews gathered the impressions of service users and support workers and the data arising from these interviews was analysed thematically. Service user participants valued support work that combined practical and relational elements, but would have preferred a longer-term involvement. They also spoke of feelings of disconnection and estrangement from their peers in the supported accommodation and their families. The worker participants valued the flexibility of person-centred work tailored to service users' individual needs and echoed service user concerns around the short-term nature of their involvement. Psychiatric nurses carrying out, or supervising, mental health support work with homeless service users should be mindful of the potential impact of temporary staffing arrangements on continuity of care. They should also consider how working from a person-centred perspective and addressing client's practical needs may aid in developing rapport and trust with homeless service users. [ABSTRACT FROM AUTHOR]

Accessible summary Seclusion in psychiatric inpatient care means confining service users in a locked room., Service users and staff seem to have different opinions on the usefulness of seclusion., This is possibly the first time when two mental health nurses went voluntarily into seclusion and reported their experiences., The nurses felt that the seclusion room was inhumane and proposed improvements to seclusion in general and to the seclusion facilities in particular., Abstract Seclusion in psychiatric hospital care refers to isolating a service user from other service users and staff, most often in a locked and unfurnished room. Service users' experiences of seclusion are mostly negative, and although some have seen a rationale for its use, mental health nurses should be encouraged to evaluate current seclusion practices from the service user's perspective. In this small-scale experiment, two mental health nurses were voluntarily secluded for 24 h. The aim was to explore the experience of being secluded, to understand and evaluate the impact of seclusion in greater detail, and to encourage discussion on one of the controversies in mental health nursing. To the best of our knowledge, this is the first attempt to evaluate the impact of seclusion based on mental health nurses' firsthand experiences. The nurses received usual seclusion treatment and described their experiences of this every 6 h. Based on the nurses' experiences, seclusion, even in voluntary, safe and planned circumstances, may increase anxiety and frustration. Seclusion was viewed negatively and the physical environment was considered inhumane. The nurses offered some practical suggestions for updating seclusion practices and re-designing seclusion facilities. Mental health nurses, who frequently decide on and invariably implement seclusion, are key to improving seclusion practices. [ABSTRACT FROM AUTHOR]

Accessible summary The findings from this narrative review suggest that the construct of locus of control, although underexplored in the area of schizophrenia, is of theoretical and clinical importance to the understanding of psychosis, the manifestation of classic psychotic symptoms and the path to recovery., An appraisal of the psychometric properties of the Multidimensional Health Locus of Control (MHLC) scale suggest that this tool may be a useful and robust instrument to use in research into the relationship between locus of control and psychosis., Application of the locus of control construct, and in particular health locus of control, may have important implications in developing psychologically coherent approaches to interventions with individuals with psychosis., Abstract Internal locus of control is associated with better psychological outcomes in comparison with external locus of control. Individuals experiencing a psychotic episode have a more external orientation, an externalizing bias for negative events and associations between paranoid delusions and external locus of control. The concept of multidimensional locus of control as measured by the Multidimensional Health Locus of Control ( MHLC) scale may provide important information about the nature and course of psychotic symptoms. This narrative review explored the relationship between the orientation of locus of control and psychosis. Few studies have used the scale in samples with people experiencing psychotic symptoms and so there is limited evidence about the psychometric properties of the MHLC scale within this client group, although the findings from studies that have explored the properties of this tool in other groups suggest it could be a valuable instrument for use in psychosis. Further research is required to determine both the relationship between locus of control and psychosis in terms of therapeutic factors and outcome, and also the veracity of the MHLC scale as an instrument of choice in this group. [ABSTRACT FROM AUTHOR]

Accessible summary Lack of cultural competence in care contributes to poor experiences and outcomes from care for migrants and racial and ethnic minorities. As a result, health and social care organizations currently promote cultural competence of their workforce as a means of addressing persistent poor experiences and outcomes., At present, there are unsystematic and diverse ways of promoting cultural competence, and their impact on clinician skills and patient outcomes is unknown., We developed and implemented an innovative model, cultural consultation service (CCS), to promote cultural competence of clinicians and directly improve on patient experiences and outcomes from care. CCS model is an adaptation of the McGill model, which uses ethnographic methodology and medical anthropological knowledge. The method and approach not only contributes both to a broader conceptual and dynamic understanding of culture, but also to learning of cultural competence skills by healthcare professionals., The CCS model demonstrates that multidisciplinary workforce can acquire cultural competence skills better through the clinical encounter, as this promotes integration of learning into day-to-day practice. Results indicate that clinicians developed a broader and patient-centred understanding of culture, and gained skills in narrative-based assessment method, management of complexity of care, competing assumptions and expectations, and clinical cultural formulation., Abstract Cultural competence is defined as a set of skills, attitudes and practices that enable the healthcare professionals to deliver high-quality interventions to patients from diverse cultural backgrounds. Improving on the cultural competence skills of the workforce has been promoted as a way of reducing ethnic and racial inequalities in service outcomes. Currently, diverse models for training in cultural competence exist, mostly with no evidence of effect. We established an innovative narrative-based cultural consultation service in an inner-city area to work with community mental health services to improve on patients' outcomes and clinicians' cultural competence skills. We targeted 94 clinicians in four mental health service teams in the community. After initial training sessions, we used a cultural consultation model to facilitate 'in vivo' learning. During cultural consultation, we used an ethnographic interview method to assess patients in the presence of referring clinicians. Clinicians' self-reported measure of cultural competence using the Tool for Assessing Cultural Competence Training ( n = 28, at follow-up) and evaluation forms ( n = 16) filled at the end of each cultural consultation showed improvement in cultural competence skills. We conclude that cultural consultation model is an innovative way of training clinicians in cultural competence skills through a dynamic interactive process of learning within real clinical encounters. [ABSTRACT FROM AUTHOR]

Novice psychiatric nurses experience heavy workloads, insufficient training and support in Taiwan. The aim of this study was to understand the working experiences of novice psychiatric nurses during their first year in a clinical setting. A qualitative phenomenological approach, using semi-structured face-to-face interviews was used. Narratives were analyzed using Colaizzi's seven-step method. Data saturation was reached after interviews were conducted with 15 nurses based on the purposive sampling. Four themes and eight sub-themes were identified: struggling (lacking a sense of security and competency), emulating (learning the process of interaction with clients and families, learning an appropriate role from nursing staff), prevailing (developing core competency, creating a therapeutic environment) and belonging (coping with the job, becoming a part of the psychiatric nursing staff). The findings from this study demonstrate that nurses are often inadequately prepared for psychiatric nursing. They have little understanding of mental illness, are unable to communicate appropriately with clients and struggle to cope with the conditions. Our study supports the importance for helping nurses to improve their essential knowledge and skills for coping with the job and providing good quality care, particularly in the first year. [ABSTRACT FROM AUTHOR]

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