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BackgroundThe COVID-19 pandemic has resulted in profound mental health impacts among the general population worldwide. As many in-person mental health support services have been suspended or transitioned online to facilitate physical distancing, there have been numerous calls for the rapid expansion of asynchronous virtual mental health (AVMH) resources. These AVMH resources have great potential to provide support for people coping with negative mental health impacts associated with the pandemic; however, literature examining use prior to COVID-19 illustrates that the uptake of these resources is consistently low. ObjectiveThe aim of this paper is to examine the use of AVMH resources in Canada during the COVID-19 pandemic among the general population and among a participant subgroup classified as experiencing an adverse mental health impact related to the pandemic. MethodsData from this study were drawn from the first wave of a large multiwave cross-sectional monitoring survey, distributed from May 14 to 29, 2020. Participants (N=3000) were adults living in Canada. Descriptive statistics were used to characterize the sample, and bivariate cross-tabulations were used to examine the relationships between the use of AVMH resources and self-reported indicators of mental health that included a range of emotional and coping-related responses to the pandemic. Univariate and fully adjusted multivariate logistic regression models were used to examine associations between sociodemographic and health-related characteristics and use of AVMH resources in the subgroup of participants who reported experiencing one or more adverse mental health impacts identified in the set of self-reported mental health indicators. ResultsAmong the total sample, 2.0% (n=59) of participants reported accessing AVMH resources in the prior 2 weeks to cope with stress related to the COVID-19 pandemic, with the highest rates of use among individuals who reported self-harm (n=5, 10.4%) and those who reported coping “not well” with COVID-19–related stress (n=22, 5.5%). Within the subgroup of 1954 participants (65.1% of the total sample) who reported an adverse mental health impact related to COVID-19, 54 (2.8%) reported use of AVMH resources. Individuals were more likely to have used AVMH resources if they had reported receiving in-person mental health supports, were connecting virtually with a mental health worker or counselor, or belonged to a visible minority group. ConclusionsDespite substantial government investment into AVMH resources, uptake is low among both the general population and individuals who may benefit from the use of these resources as a means of coping with the adverse mental health impacts of the COVID-19 pandemic. Further research is needed to improve our understanding of the barriers to use.

Discourse analysis is a commonly used research methodology in the social and human sciences. In this paper, we highlight two different approaches to discourse analysis and discuss critical elements of each approach. As researchers new to discourse analysis, two Masters of Nursing students reflect on the process of making careful choices when deciding on using an approach developed by Fairclough or Foucault. The decision making must consider the substantive focus, methodological knowledge, and positionality and interest of the researcher. We illustrate key components of the two different discourse analysis approaches, the decision making involved in selecting a particular approach, and the shortcomings and limitations that each approach holds in relation to a particular research focus.

A zero-risk paradigm currently dominates the organization and delivery of mental health care within inpatient settings, giving rise to a proliferation of risk management strategies that are ineffective and produce harms. Drawing on Foucault's confinement and grounded in a comprehensive analysis of the extant literature, we identify three central processes that constitute this paradigm, including: risk is situated within the patient; eliminating risk is a foundational aim; and mental health professionals lead decision-making. Responding to the zero-risk paradigm, this paper proposes a novel safety paradigm comprised of four intersecting components, undertaken collectively by mental health professionals to guide practice: i) holding risk, ii) building capacity, iii) prioritizing relationships, and iv) re-envisioning environments. Foundationally underlying these commitments is direct action toward reducing coercive practices and structures, such as chemical and physical restraints, seclusion, and door locking. Mental health professionals are encouraged to challenge the zero-risk paradigm and its resultant risk management approaches, and embrace a safety paradigm to meaningfully re-orient care toward enhancing patients' safety and well-being during and following hospitalization.

Objective This paper characterizes levels of mental distress among adults living in Canada amid the COVID-19 pandemic and examines the extent of virtual mental health resource use, including reasons for non-use, among adults with moderate to severe distress. Methods Data are drawn from a cross-sectional monitoring survey (29 November to 7 December 2021) on the mental health of adults ( N = 3030) in Canada during the pandemic. Levels of mental distress were assessed using the Kessler Psychological Distress Scale. Descriptive statistics were used to examine virtual mental health resource use among participants with moderate to severe distress, including self-reported reasons for non-use. Results Levels of mental distress were classified as none to low (48.8% of participants), moderate (36.6%), and severe (14.6%). Virtual mental health resource use was endorsed by 14.2% of participants with moderate distress and 32% of those with severe distress. Participants with moderate to severe distress reported a range of reasons for not using virtual mental health resources, including not feeling as though they needed help (37.4%), not thinking the supports would be helpful (26.2%), and preferring in-person supports (23.4%), among other reasons. Conclusions This study identified a high burden of mental distress among adults in Canada during the COVID-19 pandemic alongside an apparent mismatch between actual and perceived need for support, including through virtual mental health resources. Findings on virtual mental health resource use, and reasons for non-use, offer directions for mental health promotion and health communication related to mental health literacy and the awareness and appropriateness of virtual mental health resources.

Discourse analysis is a commonly used research methodology in the social and human sciences. In this paper, we highlight two different approaches to discourse analysis and discuss critical elements of each approach. As researchers new to discourse analysis, two Masters of Nursing students reflect on the process of making careful choices when deciding on using an approach developed by Fairclough or Foucault. The decision making must consider the substantive focus, methodological knowledge, and positionality and interest of the researcher. We illustrate key components of the two different discourse analysis approaches, the decision making involved in selecting a particular approach, and the shortcomings and limitations that each approach holds in relation to a particular research focus. [ABSTRACT FROM AUTHOR]

Aim: To explore nursing students' experiences of stigma and discrimination within nursing programmes as shared on Reddit, and how other Reddit users offer support and guidance. Design: Qualitative interpretive description. Methods: Through a critical social theory lens, this study draws on students' posts from three nursing subreddits: r/studentnurse, r/nursingstudent and r/nursing. Data were collected from March 2013 to March 2023. Reflexive thematic analysis was conducted to generate broad themes of nursing students' experiences of stigma and discrimination, and how other Reddit users offered support and guidance. Results: A total of 43 posts with 1412 associated comments were included in this analysis, which generated three predominant themes of nursing students' experiences. Nursing students faced stigma and discrimination across contexts, including from peers, nurses and other healthcare providers working in clinical practicum sites, and patients. Nursing students' posts described navigating the impacts and consequences of such experiences, including on well‐being, and programme and career success. In contexts where students were often alone in their experiences of stigma and discrimination within their programmes and with few identified supports, Reddit users sought support and community through Reddit. While many comments offered validation and support, challenges of this social media platform included conflicting advice and unhelpful, judgmental messages. Conclusions: Despite widely articulated social justice commitments in the profession, nursing students continue to experience stigma and discrimination across contexts within their nursing programmes. Implications for Profession: Nurses and nurse educators have a responsibility to acknowledge and make visible such experiences, and take direct action to prevent and remediate stigma and discrimination within nursing education. Impact: This research contributes to the growing empirical evidence that nursing students' experience stigma and discrimination within nursing programmes and the healthcare system. Reporting Method: Adherence to COREQ guidelines was maintained. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Inpatient mental health nursing operates with an overarching goal to support people living with mental health challenges by managing risk of harm to self and others, decreasing symptoms, and promoting capacity to live outside of hospital settings. Yet, dominant, harmful stereotypes persist, constructing patients as less than, in need of saving, and lacking self‐control and agency. These dominant assumptions are deeply entrenched in racist, patriarchal, and Othering beliefs and continue to perpetuate and (re)produce inequities, specifically for people with multiple intersecting identities relating to race, class, gender, and culture. This paper explores the relevance of postcolonial feminism, particularly Gayatri Spivak's concept of Subaltern—conceptualized as groups of people who are denied access to power and therefore continue to be systematically oppressed and marginalized—in illuminating the problematic and dominant assumptions about people living with mental health challenges as lacking agency and requiring representation. Through an understanding of Subalternity, this paper aims to decenter and deconstruct dominant colonial, patriarchal narratives in mental health nursing, and ultimately calls for mental health nursing to fundamentally reconsider prevailing assumptions of patients as needing representation and lacking agency. [ABSTRACT FROM AUTHOR]

Social justice is widely advanced as a central nursing value, and yet conceptual understandings of social justice remain inconsistent and vague. Further, despite persistently articulated commitments to upholding social justice, the profession of nursing has been implicated in perpetuating inequities in health and health care. In this context, it is essential to establish both conceptual clarity and tangible guidance for nurses in enacting practices to advance social justice—particularly through regulatory, education and accreditation documents that shape the nursing profession. This Foucauldian discourse analysis examines how social justice is discursively positioned within nursing professional documents in Canada, and illustrates that social justice was largely discursively excluded from these texts. Where social justice discourses were invoked, we identified that four central discursive patterns obscured and de‐centred this nursing value: (i) Vague language undermined professional commitments to social justice; (ii) Constructions of knowledge and awareness de‐emphasized practice; (iii) Individualism discourses minimized institutional/professional responsibility; and (iv) Aspirational language obscured present action. Extending from this analysis, we contend that the nursing profession must re‐examine how social justice is understood and articulated, and call for a re‐conceptualization of social justice grounded in nursing practice toward remediating inequities in health and health care. [ABSTRACT FROM AUTHOR]

Abstract Background Reducing harms of youth substance use is a global priority, with parents identified as a key target for efforts to mitigate these harms. Much of the research informing parental responses to youth substance use are grounded in abstinence and critiqued as ineffective and unresponsive to youth contexts. Parental provision of substances, particularly alcohol, is a widely used approach, which some parents adopt in an attempt to minimize substance use harms; however, research indicates that this practice may actually increase harms. There is an absence of research exploring youth perspectives on parental approaches to substance use or the approaches youth find helpful in minimizing substance use-related harms. Methods This paper draws on interviews with youth aged 13–18 (N = 89) conducted within the Researching Adolescent Distress and Resilience (RADAR) study in three communities in British Columbia, Canada. An ethnographic approach was used to explore youth perspectives on mental health and substance use within intersecting family, social, and community contexts. This analysis drew on interview data relating to youth perspectives on parental approaches to substance use. A multisite qualitative analysis (MSQA) was conducted to examine themes within each research site and between all three sites to understand how youth perceive and respond to parental approaches to substance use in different risk environment contexts. Results Within each site, youths’ experiences of and perspectives on substance use were shaped by their parents’ approaches, which were in turn situated within local social, geographic, and economic community contexts. Youth descriptions of parental approaches varied by site, though across all sites, youth articulated that the most effective approaches were those that resonated with the realities of their lives. Zero-tolerance approaches were identified as unhelpful and unresponsive, while approaches that were aligned with harm reduction principles were viewed as relevant and supportive. Conclusions Youth perspectives illustrate that parental approaches to substance use that are grounded in harm reduction principles resonate with young people’s actual experiences and can support the minimization of harms associated with substance use. Evidence-based guidance is needed that supports parents and young people in adopting more contextually responsive harm reduction approaches to youth substance use.

This commentary on a case considers consequences of a so-called "zerorisk" paradigm now common in psychiatric inpatient decision making. Iatrogenic harms of this approach must be balanced against promoting patients' safety and well-being. This article suggests how to collaboratively assess risk and draw on recovery-oriented goals of care. [ABSTRACT FROM AUTHOR]

Abstract Background Youth substance use programming and educational strategies are frequently informed by prevention approaches that emphasize abstinence goals, which often do not resonate with youth in their lack of acknowledgment of young people’s social context and how young people perceive positive effects of substance use. Further, approaches to drug prevention have been critiqued as adopting a one-size-fits-all approach and therefore inadequate in addressing substance use in the context of population variation and inequities. In response to the limitations of current approaches to prevention, programming informed by harm reduction principles that aims to minimize harms without requiring abstinence is emergent in school settings. However, youth perspectives informing harm reduction are limited in both research and program development. Methods This paper draws on data from the Researching Adolescent Distress and Resilience (RADAR) study, which utilized an ethnographic approach to bring youth voice to the literature on mental health and substance use. Qualitative data collection included individual interviews (n = 86) with young people aged 13–18 across three communities—representing urban, suburban, and rural geographies—in British Columbia, Canada. A multi-site qualitative analysis of interview data was conducted to identify themes across and within each research site. Results Across all three sites, young people’s individual experiences of substance use were shaped by geographic, socio-cultural, and political contexts, with youth describing their use in relation to the nature of substance use in peer groups and in the broader community. To manage their own substance use and reduce related harms, youth employed a variety of ad hoc harm minimization strategies that were reflective of their respective contexts. Conclusions The findings from this study suggest the importance of harm reduction approaches that are contextually relevant and responsive to the lived experiences of youth. Youth perspectives in the development of harm reduction programming are needed to ensure that approaches are relatable and meaningful to young people, and effective for promoting the minimization of substance-related harms.

The current study aims to identify the level of psychological hardiness and the meaning of life among the Syrian Arab army wounded. As well as to investigate the relationship between the psychological hardiness and the meaning of life among them. As well as to detect whether there are differences in the level of psychological hardiness can be due to certain demographic variables such as handicapped(permanent/temporary)and kinds of services( compulsory/volunteer ).The researcher used the descriptive method and sample formed of (122) of Syrian Arab army's woundedand used to achieve the objectives of the study two scales, psychological hardiness, the meaning of life. The study found the following results: -The relative weight of psychological hardiness of Syrian Arab army's wounded(75%) also reached the relative weight of meaning of life (73,46) and there is a positive correlation between the level of psychological hardiness to the Syrian Arab army's wounded and there are not significant differences in the level of psychological hardiness ,meaning of life due to the variables used in it.

This research try to defined the Temperament Models of sample of Basic education teachers in Latakia city, as well as to identify differences in the differences between the mean responses of Basic education teachers on a scale of Temperament Models to the variables (sex, place of residence, Stage school). Use the search descriptive analytical method. Application a scale of Temperament Models on the sample included (274) male and female teacher, Pilot sample consisted of (50) teachers. Reliability was established by Cronbach – Alpha Reliability at lest (0.73) and (o.796) by Spearman-Brown. Results showed the field of the dynamic operations of Neurotic was the most spreading between teachers , and came after the field of the power to cease operations, at last the force in the excitement field , there are statistically significant differences according to six in favor of female, and there are statistically significant differences according to Stage school, there are no statistically significant differences according to place of residence.