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Accessible summary: What is known on the subject?: The use of restrictive interventions is described as a violation of patients' rights and autonomy. It must only be used as a last resort to manage dangerous behaviour, to prevent or reduce the risk of mental health patients harming themselves or others.International mental health policy and legislation agree that when restrictive interventions are applied, the least restrictive alternative should be chosen. What the paper adds to existing knowledge?: The results are ambiguous, as to which restrictive intervention is preferred over others, but there are tendencies towards the majority preferring observation, with mechanical restraint being the least preferred.To make the experience less intrusive and restrictive, certain factors are preferred, such as a more pleasant and humane seclusion room environment, staff communicating during the application and staff of same gender applying the intervention. What are the implications for practice?: When applying restrictive interventions, mental health professionals should consider environment, communication and duration factors that influence patient preferences, such as the opportunity to keep some personal items in the seclusion room, or, when using restraint, to communicate the reason and explain what is going to happen.More research is needed to clarify patients' preferences regarding restrictive interventions and their views on which are the least restrictive. Preferably, agreement is needed on standard measures, and global use of the same definition of restrictive interventions. Introduction: The use of restrictive interventions is a violation of patients' rights that causes physical and psychological harm and which is a well‐known challenge globally. Mental health law and legislative principles and experts agree that when restrictive interventions are applied, the least restrictive alternative should be used. However, there is no consensus on what is the least restrictive alternative, especially from the patient perspective. Aim: To investigate the literature on mental health patients' preferences regarding restrictive interventions applied during admission to a psychiatric hospital. Method: An integrative review informed by the PRISMA statement and thematic analysis were undertaken. Results: There were tendencies towards patients preferring observation and, for the majority, mechanical restraint was the least preferred restrictive intervention. Factors such as environment, communication and duration were found to influence patients' preferences. Discussion: There is a lack of agreement on how best to measure patients' preferences and this complicates the choice of the least restrictive alternative. Nonetheless, our findings show that staff should consider environment, communication and duration when applying restrictive interventions. Implications for Practice: More research on restrictive interventions and the least restrictive alternative is warranted, but agreement is needed on standard measures, and a standard global definition of restrictive interventions. [ABSTRACT FROM AUTHOR]

Even if coercive measures are widely applied in psychiatry and have numerous well-known drawbacks, there is limited known on the agreement among mental healthcare professionals' opinions on their use. In a questionnaire study using standardized scenarios, we investigated variation in staff opinions on coercion. In a web-based survey distributed to staff at three psychiatry hospitals, respondents were asked to consider if and what coercion to use by introducing two hypothetical scenarios involving involuntary psychiatric admission and in-hospital coercion. One hundred thirty-two out of 601 invited staff members responded to the survey (Response Rate = 22%). There was large variation in participating staff members' opinions on how to best manage critical situations and what coercive measures were warranted. In the first scenario, 57% of respondents (n = 76) believed that the patient should be involuntarily admitted to hospital while the remaining respondents believed that the situation should be managed otherwise. Regarding the second scenario, 62% of respondents responded that some in-hospital coercion should be used. The majority of respondents believed that colleagues would behave similarly (60%) or with a tendency towards more coercion use (34%). Male gender, being nursing staff and having less coercion experience predicted being less inclined to choose involuntary hospital admission. There is a high degree of variation in coercion use. This study suggests that this variation persists despite staff members being confronted with the same standardized situations. There is a need for evidence-based further guidance to minimize coercion in critical mental healthcare situations. [ABSTRACT FROM AUTHOR]

Mechanical restraint is a commonly used restrictive practice worldwide, although reducing its use is an international priority. Interventions to reduce mechanical restraint are needed if reducing mechanical restraint is to succeed. Therefore, this systematic review aimed to examine evaluated evidence‐based interventions that seek to reduce the incidence of and/or time in mechanical restraint in adult mental health inpatient settings. The JBI framework was used to guide this systematic review. The search strategy included peer‐reviewed primary research literature published between 1999 and 2023. Two authors independently conducted the systematic search, selection process and data extraction process. Forty‐one studies were included in this review. Using content analysis, we grouped interventions into four categories: (I) calm‐down methods, (II) staff resources, (III) legal and policy changes and (IV) changing staff culture. Interventions to reduce mechanical restraint in adult mental health inpatient settings have shown some promise. Evidence suggests that a range of interventions can reduce the incidence of and/or time in mechanical restraint. However, controlled trials were lacking and consensus was lacking across studies. Furthermore, specific findings varied widely, and reporting was inconsistent, hampering the development of interventions for this issue. Further research is needed to strengthen the evidence base for reducing mechanical restraint in mental health inpatient settings. [ABSTRACT FROM AUTHOR]

To explore mental health staff's responses towards interventions designed to reduce the use of mechanical restraint (MR) in adult mental health inpatient settings. We conducted a cross-sectional, questionnaire-based survey. The questionnaire, made available online via REDCap, presented 20 interventions designed to reduce MR use. Participants were asked to rate and rank the interventions based on their viewpoints regarding the relevance and importance of each intervention. A total of 128 mental health staff members from general and forensic mental health inpatient units across the Mental Health Services in the Region of Southern Denmark completed the questionnaire (response rate = 21.3%). A total of 90.8% of the ratings scored either 'agree' (45.2%) or 'strongly agree' (45.6%) concerning the relevance of the interventions in reducing MR use. Overall and in the divided analysis, interventions labelled as 'building relationship' and 'patient-related knowledge' claimed high scores in the staff's rankings of the interventions' importance concerning implementation. Conversely, interventions like 'carers' and 'standardised assessments' received low scores. The staff generally considered that the interventions were relevant. Importance rankings were consistent across the divisions chosen, with a range of variance and dispersion being recorded among certain groups. [ABSTRACT FROM AUTHOR]

In forensic mental health care (FMHC), family caregivers perceive themselves as burdened in their relationships with the service user (the family member with mental illness) and by difficult collaboration with healthcare professionals (HCPs). There is a political objective to involve this group in the care and treatment of the service user in mental health care. To improve family caregiver involvement in care and treatment in FMHC, research about their perceptions is needed. This study aims to explore family caregivers' perceptions of their interactions with the service user and HCPs. The method used was qualitative. Semi-structured, in-depth interviews with 12 family caregiver participants were carried out and analyzed thematically. The analysis resulted in three interrelated main themes: Strategies to normalize everyday living; Distrust of the quality of care; and Loss and grief. Family caregiver feelings of loss and grief may be suppressed, which additionally could prevent them from supporting the service user. [ABSTRACT FROM AUTHOR]

Rapid tranquillization is a restrictive practice that remains widely used in mental health inpatient settings worldwide. Nurses are the professionals most likely to administer rapid tranquillization in mental health settings. To improve mental health practices, an enhanced understanding of their clinical decision‐making when using rapid tranquillization is, therefore, important. The aim was to synthesize and analyse the research literature on nurses' clinical decision‐making in the use of rapid tranquillization in adult mental health inpatient settings. An integrative review was conducted using the methodological framework described by Whittemore and Knafl. A systematic search was conducted independently by two authors in APA PsycINFO, CINAHL Complete, Embase, PubMed and Scopus. Additional searches for grey literature were conducted in Google, OpenGrey and selected websites, and in the reference lists of included studies. Papers were critically appraised using the Mixed Methods Appraisal Tool, and the analysis was guided by manifest content analysis. Eleven studies were included in this review, of which nine were qualitative and two were quantitative. Based on the analysis, four categories were generated: (I) becoming aware of situational changes and considering alternatives, (II) negotiating voluntary medication, (III) administering rapid tranquillization and (IV) being on the other side. Evidence suggests that nurses' clinical decision‐making in the use of rapid tranquillization involved a complex timeline with various impact points and embedded factors that continuously influenced and/or were associated with nurses' clinical decision‐making. However, the topic has received scant scholarly attention, and further research may help to characterize the complexities involved and improve mental health practice. [ABSTRACT FROM AUTHOR]

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

There has been an international surge towards online, digital, and telehealth mental health services, further amplified during COVID‐19. Implementation and integration of technological innovations, including artificial intelligence (AI), have increased with the intention to improve clinical, governance, and administrative decision‐making. Mental health nurses (MHN) should consider the ramifications of these changes and reflect on their engagement with AI. It is time for mental health nurses to demonstrate leadership in the AI mental health discourse and to meaningfully advocate that safety and inclusion of end users' of mental health service interests are prioritized. To date, very little literature exists about this topic, revealing limited engagement by MHNs overall. The aim of this article is to provide an overview of AI in the mental health context and to stimulate discussion about the rapidity and trustworthiness of AI related to the MHN profession. Despite the pace of progress, and personal life experiences with AI, a lack of MHN leadership about AI exists. MHNs have a professional obligation to advocate for access and equity in health service distribution and provision, and this applies to digital and physical domains. Trustworthiness of AI supports access and equity, and for this reason, it is of concern to MHNs. MHN advocacy and leadership are required to ensure that misogynist, racist, discriminatory biases are not favoured in the development of decisional support systems and training sets that strengthens AI algorithms. The absence of MHNs in designing technological innovation is a risk related to the adequacy of the generation of services that are beneficial for vulnerable people such as tailored, precise, and streamlined mental healthcare provision. AI developers are interested to focus on person‐like solutions; however, collaborations with MHNs are required to ensure a person‐centred approach for future mental healthcare is not overlooked. [ABSTRACT FROM AUTHOR]

People with mental disorders have higher mortality from lifestyle diseases than the general population. Forensic mental health patients (FMHPs) are often hospitalised for longer periods of time than non-FMHPs. Thus, hospitalisation may have a greater effect on the risk of lifestyle diseases in FMHPs. Investigate associations between proportional hospitalisation time (PHT) and change in body weight or other cardiometabolic risk factors among FMHPs. Retrospective cohort study including all FMHPs with schizophrenia or bipolar disorder, prescribed antipsychotics, and treated between 01 January 2016 and 06 April 2020 in the Region of Southern Denmark either in forensic units or as outpatients. Associations between PHT and, respectively, primary and secondary outcomes were analysed using linear regression. PHT was determined between each measurement of the outcomes as the number of days hospitalised divided by the total number of days within the time-period. The primary outcome was weight change and secondary outcomes were change in waist circumference (WC), blood pressure, estimated average glucose (eAG), HDL, LDL, total cholesterol, and triglycerides. Analyses were adjusted for gender, age, smoking, and antipsychotics. The cohort included 490 FMHPs, of which 440 were diagnosed with schizophrenia. PHT had a significant positive dose-response association with weight change, with an estimated difference of +4.0 kg/year for FMHPs who were hospitalised 100% of the time, compared to FMHPs who were exclusively treated as outpatients. The association interacted with baseline BMI. From the secondary outcomes, the association with PHT was only statistically significant for WC. PHT was positively associated with weight gain. [ABSTRACT FROM AUTHOR]

The article discusses the significance of culturally appropriate care in mental health settings and its role in reducing restrictive practices. It examines strategies for providing culturally sensitive care, the impact on minimizing restrictive practices, and the integration of cultural competence within mental health services.

Grey literature complementing evidence from common scientific sources, such as journals, may serve to provide a broader range of evidence, fill in commercial literature gaps and reduce publication bias in research. However, grey literature from legal sources has been used only to a limited extent in forensic mental health research. In this paper, we presented the newly established Danish Court Case Database in the light of forensic mental health. A systematic review was conducted and 15 cases focusing on forensic mental health issues were identified. The cases contained information about indictment, explanations and testimonies and also the court's decision and underlying reasoning. The different included case types provided a broad range of information about current issues in forensic mental health regulation and the interpretation of Danish law. The database is thus a relevant grey source in forensic research. However, this paper also demonstrated that the database may be improved in terms of its current coverage and ease of use. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject: People with mental disorders have increased risk of dying from diabetes and cardiovascular diseases compared to the general population. Diabetes and cardiovascular diseases are preventable by improved lifestyle regarding smoking, alcohol consumption, physical activity and dietary behaviours.Forensic mental health service users are treated for longer periods of time compared to non‐forensic mental health service users, giving the opportunity to affect the lifestyle for a substantial period of time. What the paper adds to existing knowledge: This review gathers existing research on forensic mental health service users' lifestyle regarding smoking, alcohol consumption, physical activity, and dietary behaviours and factors influencing it. The lifestyle was found to be unfavourable with many patients being smokers, having problematic alcohol consumption, being physically inactive and eating a diet of poor nutritional value and rich in calories. Therefore, it seems likely that an unfavourable lifestyle is one reason for the excess mortality from diabetes and cardiovascular diseases.Smoking cessation and improving dietary habits was perceived difficult, but nicotine replacement and practical advice was suggested to support a change. What are the implications for practice: The treatment period gives an opportunity to improve the lifestyle of forensic mental health service users to prevent diabetes and cardiovascular diseases in this high‐risk group.We recommend a holistic approach, when planning the prevention activities, since activities that are perceived fun are more likely to succeed. Introduction: People with mental disorders have increased risk of dying from diabetes and cardiovascular diseases, both of which can be prevented by lifestyle. Aim: To review existing research, in order to investigate the characteristics of, and factors that influence forensic mental health service users' (FMU) health behaviours. Method: We searched PubMed, CINAHL, PsycInfo and Scopus for primary research on FMU's health behaviours regarding smoking, alcohol consumption, physical activity and dietary behaviours, and factors that influence them. Results: We found 13 eligible studies. The findings consistently indicated the presence of unfavourable health behaviours in FMU: Smoking, problematic alcohol consumption, physical inactivity and a high‐calorie diet of poor nutritional value. Changing smoking and dietary habits was perceived as difficult, but nicotine replacement and practical advice were suggested to support change. Discussion: The existing research on FMU's health behaviours is sparse. In particular, there is a lack of research on factors that influence health behaviours. From our findings, it seems likely that FMU's unfavourable health behaviours contribute to their increased risk of dying from diabetes and cardiovascular diseases. Implications for practice: FMU's health behaviours should be improved to prevent diabetes and cardiovascular diseases in this high‐risk group. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the experiences of patients and providers regarding the use of videoconferences in older patients with depression. The qualitative study consisted of semi‐structured interviews with patients and providers and focus group interviews with providers. Themes were identified through using thematic analysis. Three main themes were as follows: 1. Technical Challenges experienced by patients and providers experiences; 2. Videoconferencing as clinical supportive technology; and 3. Therapeutic relationship across face‐to‐face and videoconferencing formats. Several subthemes describing patients' and providers' experiences were identified. Taken together, there was a similarity between expectations, opinions, and attitudes in relation to experiences vertically across all main themes, and horizontally between the main themes. An optimistic outlook influenced user expectations, opinions, and attitudes and acted to mitigate an negative sentiment about technical challenges. This increased the adoption of videoconferencing as a tool for clinical support and enabled the development of a therapeutic relationship using videoconferencing, especially for provider users. Both patients and providers agreed that videoconferences could not replace all face‐to‐face conversations and that videoconferences, in most cases, were best suited for shorter follow‐up consultations. Expectations, opinions, and attitudes, whether negative or positive, seemed to have significant impact on the experiences of patients and especially providers. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether there is a correlation between age and satisfaction with the use of videoconferences (VCs) and whether the number of video sessions had an impact on satisfaction. Methods: This study was a subanalysis of the joint European project, MasterMind, and participants were recruited from15 pilot studies in 11 different countries. The Client Satisfaction Questionnaire 8 (CSQ 8) was used as assessment tool, and scores were summed to give total scores. Results: Participants were included if they had filled out the CSQ 8 questionnaire and demographic data were available. This resulted in a total of 199 participants. We found that the total score was not significantly correlated with age (Spearman's rho = −0.0415, p = 0.563) and gender (Wilcoxon W = 5,066, p = 0.409). There was a significant positive correlation between number of sessions attended (Spearman's rho = 0.5777, p < 0.001) and total score after adjusting for age, gender, region, symptoms score, and education level in a multiple linear regression model (coefficient = 0.170, SE = 0.059, p = 0.004). Excluded responders were significantly younger than included responders, had lower symptoms score, attended fewer sessions, had a higher education, and were more likely to be employed. Conclusions: VC satisfaction scores in patients with unipolar depression do not depend on age but increase with experience in all age groups. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Depression is the most common cause of mental illness amongst older people. As a result of the growth of the older population, it is expected that an increasing number of older people will need treatment. Depression can be effectively treated—but fewer than half of those who are affected receive treatment.Barriers to receiving treatment are lack of resources and trained healthcare providers, social stigma, incorrect diagnoses and long distances to treatment facilities. There is an increased need for alternative ways of treating patients with depression. The use of video consultations has shown to be a viable option for delivering mental health care to older patients. Use of video consultations allows patients to receive treatment in their own homes. None of the existing reviews have focused on satisfaction with the use of video consultations amongst older people with depression. This paper provides knowledge regarding the use of video consultations, especially for older people with depression. What this paper adds to existing knowledge?: No previous review has sought to understand the use of video consultations in mental health care to older patients with depression. The results show that video consultations support mental health practice, especially as a useful alternative when face‐to‐face therapy is not possible. An initial scepticism from participants quickly disappeared when video consultations were experienced in action. The challenges associated with the use of video consultations seem to consist of technical problems and lack of support from staff. What are the implications for practice?: Mental health practitioners should consider the use of video consultations because it can support mental health practice, especially as a useful alternative when face‐to‐face therapy is not possible. Introduction: Depression is the leading cause of mental illness amongst an ageing population and fewer than half of those who are affected receive treatment. There is an increased need for alternative ways of treating patients; the use of video consultations has been shown to be a viable option for delivering mental health care. However, none of the existing reviews have focused on satisfaction with the use of video consultations amongst older people with depression and providers. Aim: To conduct a systematic review of the existing literature focusing on patients' and providers' experiences of video consultations for depression. Method: Eight scientific databases were searched. In all, 3,537 articles were identified and, of these, 21 peer‐reviewed articles were included in this review. Results: The results show that video consultations support mental health practice, especially as a useful alternative when face‐to‐face therapy is not possible. Any initial scepticism quickly disappeared when video consultations were experienced in action. The challenges seem to consist of technical problems and lack of support from staff. Discussion: The experiences and satisfaction of older people with depression seem to be positive, although methodological limitations and deficiencies of the reviewed articles should be considered. More qualitative research is needed, and future studies should focus on specific diagnoses and providers' experiences. Implications for practice: Video consultations support mental health practice, especially as a useful alternative when face‐to‐face therapy is not possible. [ABSTRACT FROM AUTHOR]

Aim: To evaluate whether there was a difference in satisfaction scores between providers and patients in the use of videoconferences (VCs) by depressed adults. Method: This study was a subanalysis of the joint European project, MasterMind, and participants were recruited from 15 pilot studies in 11 different countries. The Client Satisfaction Questionnaire (CSQ)-3 was used as assessment tool, and scores were summed to give total scores. The questionnaire consists of three items evaluating general satisfaction, fulfillment of needs in treatment, and usability. Results: A total of 362 respondents, 201 patients and 161 providers, completed the questionnaire. Providers had a mean total CSQ-3 score of 9.17 (95% confidence interval [CI] = 8.90–9.45), whereas patients had a mean of 9.70 (95% CI = 9.44–9.98). Mean scores for item 1 (the extent to which VCs had met the needs of the participants): patients 3.19, providers 2.93 (p = 0.00048); for item 2 (general satisfaction): patients 3.22, providers 3.08 (p = 0.083); and item 3 (whether participants wanted to use VCs again): patients 3.28 providers 3.16 (p = 0.045). Conclusion: The results showed that total satisfaction scores were higher in patients than in providers. The differences between patients and providers were significant for items 1 and 3 (p < 0.05), but we did not find a significant difference regarding item 2. [ABSTRACT FROM AUTHOR]

Ethnic minority patients are overrepresented in Danish forensic psychiatry and knowledge is needed on how these patients are approached in relation to religious and cultural issues. The aim of this study was to investigate how psychiatrists in Danish forensic psychiatry approach religious ethnic minority patients. The study revealed positive approach towards religious ethnic minority patients. However, unless religion features as part of the illness, the tendency is to not incorporate the patients' religiosity in treatment. The study finds that the hospital chaplain is regarded by the psychiatrists as an important part of the ward and expressed the desire for a more formal cooperation with religious specialists to be developed. Finally, the study finds that religious practices such as Ramadan, common prayer, and Islamic edicts on food and unlawful touch are areas where more knowledge is needed, especially in relation to anxiety, potential stress, and conflict situations. [ABSTRACT FROM AUTHOR]

Background: A new short-term risk assessment instrument, the Mechanical Restraint – Confounders, Risk, Alliance Score (MR – CRAS) checklist, including three subscales with altogether 18 items, has been developed in close collaboration with forensic mental health nurses, psychiatrists' etc., and shows evidence of being comprehensible, relevant, comprehensive and easy to use for assessing the patient's readiness to be released from mechanical restraint. Aim: The aim of this study was to investigate whether the subscales: confounders, risk and parameters of alliance constituted separate subscales and needed further revisions. Materials and methods: MR – CRAS was field-study tested among nurses, nurse assistants and social and health care assistants in 13 Danish closed forensic mental health inpatient units, and a Mokken analysis of scalability and a Spearman correlation analysis were performed. Results: MR – CRAS was completed by clinicians in 143 episodes of mechanical restraint, representing 88 patients, with a mean duration of 63.25 hours. Most patients were younger men, diagnosed within the schizophrenia spectrum. One-third of the patients had repeated mechanical restraint episodes ranging between 2 and 8 episodes. MR – CRAS and especially the parameters of alliance were perceived as usable for assessment of the patient's readiness to be released from mechanical restraint. The psychometric analyses showed that the three subscales were unidimensional. Conclusions: The study shows evidence of the construct validity of MR – CRAS among clinicians at closed forensic mental health inpatient units. MR – CRAS contributes with a common language and structured, systematic and transparent observations and assessments on an hour by hour basis during mechanical restraint [ABSTRACT FROM AUTHOR]

Postsecular theory is developing in academic circles, including the psychiatric field. By asking what the postsecular perspective might imply for the secular discipline of psychiatry, the aim of this study was to examine the postsecular perspective in relation to the secular nature of psychiatry, by way of a narrative review. In a systematic search for literature, relevant articles were identified and analyzed thematically. Thirteen articles were included, and three intertextual themes were identified, which represented ongoing international dialogues in relation to psychiatry and religion--such as intervention, integration, identity, the religious or irreligious psychiatrist, and the multicultural setting of the discipline. Furthermore, the postsecular perspective reveals a (potential) bias against the religious worldviews inherent in the secular. Postsecular theory can contribute to the ongoing discussions of how psychiatry, as a secular discipline, approaches the religious in the lives of patients and psychiatrists. [ABSTRACT FROM AUTHOR]

Background: Although hotly disputed, coercive measures are widely used in mental health services globally. In Denmark, to ensure the rights of patients, special psychiatric legislation that emphasizes the imperative to always use the least intrusive intervention has been implemented. This raises the question of which coercive measures are perceived as being less intrusive than others., Aim: The aim of this study was to investigate the perceptions of Danish mental health professionals regarding the intrusiveness of various coercive measures used in mental health settings., Methods: We conducted a web-based survey among 132 mental health professionals (response rate: 22%). The participants rated the intrusiveness of different coercive measures using the visual analog scale (VAS)., Results: Mental health professionals perceived mechanical restraint as being the most intrusive coercive intervention (belt and strap fixation received a VAS rating of 92 out of 100). Conversely, body searches and observation were perceived as being among the least intrusive measures, with VAS ratings of 35 and 50, respectively. Participants with different professional backgrounds, including general and forensic mental health workers, tended to perceive the coercive measures included in this study as being equally intrusive., Conclusion: The participating mental health professionals generally perceived belt fixation as a highly intrusive measure, whereas seclusion, which is currently illegal under Danish law, was considered less intrusive. Because of the small sample size in this study, caution should be exercised when drawing conclusions based on the findings. Nevertheless, the study may add to how the principle of using the least intrusive measure is interpreted., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 International Association of Forensic Nurses.)

Background: Models are central to the acquisition and organisation of scientific knowledge. They can be viewed as tools for interpretive description as well as cognitive representations of an empirical phenomenon. However, discussions about how to develop models in qualitative research - particularly in the literature on thematic analysis - are sparse., Aim: To discuss an approach to scientific qualitative modelling that uses the new technique described in the first part of this article ( Gildberg and Wilson 2023 ): the Empirical Test for Thematic Analysis (ETTA)., Discussion: The authors discuss scientific models and their inherent limitations and strengths, so that others may assess models and their potential., Conclusion: A limitation of ETTA is the risk that excessive rigour and systematisation could reduce creativity in the construction of models. However, on balance there is a scientific need for qualitative researchers to improve their capability to refine and describe the techniques they use to construct models, adequately explain the reliable generation of models, and improve transparency regarding the epistemological and methodological basis for the construction of models., Implications for Practice: By using ETTA on qualitative data obtained from clinical practice it becomes possible to illuminate the interconnections among themes within the data. This approach not only assists in illustrating these connections, it also enables clinicians and researchers to gain a comprehensive understanding of specific clinical phenomena through the use of models. The process of developing and using these models enables the simulation and strategic intervention development based on data that addresses the specific problem being investigated., Competing Interests: None declared, (© 2023 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)