International Journal of Mental Health Nursing最新文献

Over 100 million people are affected by suicide loss every year. Descriptive and qualitative research describes the consequences of this loss, such as elevated health risks, as well as describing experiences that can potentially lead to resilience for suicide loss survivors (SLS). The facts that suicide loss is highly transformative, and that it affects many people, underscore the need to understand the relationship dynamics leading up to suicide loss. This study aims to explore relational dynamics between suicide victims and the involved SLS in suicidal trajectories that end in death, through examining the SLS lived experiences. The study is designed and conducted through a phenomenological, reflective lifeworld approach. Twenty-two in-depth interviews concerning SLS's lived experiences of suicidality that ended in a loved one's death by suicide were conducted. This study formulates how the relationship between the suicide victims and the SLS in a suicidal trajectory are shaped around the dynamics of ‘May I’, ‘Will I’ and ‘Why’, and explores how living through these concurrent phases creates a suicidal death course. A central finding indicates that suicidality is often shared between the suicide victims and the SLS, and another is that there exists a determinate dynamic of negotiation aiming for a mutual understanding of the intention to die. The essence of an interpersonal relationship in a suicidal trajectory can be understood as ‘an implicit negotiation in which a shared understanding of the intention to die is reached’. This study gives scientific support to the conclusion that SLS may have important information through their own experiences that can be of value for suicide care and assessment.

This integrative literature review examines the evolving role of artificial intelligence (AI) and machine learning (ML) based clinical decision support systems (CDSS) in mental health (MH) care, expanding on findings from a prior review (Higgins et al. 2023). Using and integrative review framework, a systematic search of six databases was conducted with a focus on primary research published between 2022 and 2024. Five studies met the inclusion criteria and were analysed for key themes, methodologies, and findings. The results reaffirm AI's potential to enhance MH care delivery by improving diagnostic accuracy, alleviating clinician workloads, and addressing missed care. New evidence highlights the importance of clinician trust, system transparency, and ethical concerns, including algorithmic bias and equity, particularly for vulnerable populations. Advancements in AI model complexity, such as multimodal learning systems, demonstrate improved predictive capacity but underscore the ongoing challenge of balancing interpretability with innovation. Workforce challenges, including clinician burnout and staffing shortages, persist as fundamental barriers that AI alone cannot resolve. The review not only confirms the findings from the first review but also adds new layers of complexity and understanding to the discourse on AI-based CDSS in MH care. While AI-driven CDSS holds significant promise for optimising MH care, sustainable improvements require the integration of AI solutions with systemic workforce enhancements. Future research should prioritise large-scale, longitudinal studies to ensure equitable, transparent, and effective implementation of AI in diverse clinical contexts. A balanced approach addressing both technological and workforce challenges remain critical for advancing mental health care delivery.

Traditionally, postnatal depression (PND) has been considered as depression in the first year after giving birth, although it has been argued that the 12-month cut-off may be somewhat arbitrary. Specialist perinatal mental health services in England have recently been extended to include women in their second year postpartum; however, there is no good estimate for the prevalence of PND beyond the first year. This review aimed to obtain the best estimate of the prevalence of PND in the second postpartum year. Eligible studies were those that assessed PND and provided a point prevalence using a validated screening tool or clinical diagnosis at least once beyond the first 12 months in women over the age of 18 years in any country. Studies were excluded if they only included women who were already depressed or had elevated depression scores at baseline. PubMed, Embase, Web of Science, CINAHL and PsychINFO were searched in January 2021 (and updated in February 2024) for studies that included the prevalence of PND beyond the first 12 postnatal months. Study quality was assessed using Cochrane's ROBINS-I and Risk of Bias 2 tools. Prevalence data were combined in meta-analysis using prediction intervals (PIs). A total of 6340 papers were found, and of these, 32 studies including 57210 participants across 18 countries met the inclusion criteria and were meta-analysed. The prevalence of PND in the second year (13–24 months) was 15% (95% confidence interval [CI] 12%, 17%; 95% PI 4%, 30%) and similar to that in the first year, 16% (95% CI 14%, 19%; 95% PI 6%, 31%). Despite considerable heterogeneity, common in meta-analysis of prevalence studies, findings show that a similar proportion of women experience PND in the second year after birth.

Workplace violence (WPV) is a harmful phenomenon happening in psychiatric wards. Despite preventive efforts, mental health services cannot eliminate WPV. If mental health services can increase the coping and resilience of frontline mental healthcare professionals (FMHPs) towards WPV, it could contribute to their mental health and well-being. To perform a systematic review of comparative studies on interventions to improve coping and resilience towards WPV aimed at FMHPs working in psychiatric wards. Systematic review on comparative intervention studies, with electronic searches in MEDLINE, Embase, Cochrane CENTRAL, PsycINFO and CINAHL. We registered our protocol in PROSPERO (CRD42022373757). Performing a meta-analysis seemed not to be feasible, so we provided a narrative summary of the included studies, methodological quality and results. We included nine studies, with interventions focused on positive behavioural support, resilience enhancement and aggression management training. Most studies reported positive effects, though with a moderate to high risk of bias. Positive behavioural support, biofeedback and aggression management training are promising interventions in our review. Biofeedback interventions and positive behavioural support could be valuable additions to existing training programmes to improve coping and resilience. Future studies should focus on demonstrating the robustness of effects, the mechanism of increasing coping and resilience regarding WPV and the development and implementation of effective interventions.

Physical activity has been shown to improve outcomes across a range of physical and mental health conditions as an adjunct or standalone intervention for many mental disorders. The outcome and effectiveness of physical activity in acute mental health units are less well understood. Systematic searches were completed in three databases (CINAHL, MEDLINE, and PsycINFO). Eligible studies were published between March 2013 and February 2024, included a physical activity intervention for inpatients on acute mental health units, and reported primary quantitative, qualitative, or mixed methods data for patients between 18 and 65 years of age. Participants must have had a primary diagnosis of a mental health condition with or without physical comorbidities. Data extracted included reported components of the interventions and individual health outcomes. Methodological quality and risk of bias was assessed using the mixed methods appraisal tool and cochrane risk of bias tools for randomised and non-randomised controlled trials. Twelve studies were identified for review (combined sample size of 560). Seven studies reported improvements in mental health outcomes, and two reported improvements in physical health outcomes in favour of the intervention group. There was a large variation between intervention characteristics and clarity in reporting. Assessment and measurement of outcomes contributed to a high risk of bias among included studies due largely to self-assessment. Physical activity interventions on AMHUs have the potential to contribute to improvements in mental and physical wellbeing beyond that experienced from usual treatment practices (e.g., medication). However, further work is needed in the specific context of acute mental health units regarding the development and evaluation of physical activity interventions.

Australian government approval has been granted for 3,4-methylenedioxy-methamphetamine (MDMA) treatment of post-traumatic stress disorder and psilocybin for treatment-resistant depression, but the process of translating psychedelic-assisted therapies (PAT) into more widespread use is complex. Along with establishing the efficacy and feasibility of PATs, their acceptability amongst consumers is a crucial factor of successful implementation. This study utilised the Theory of Planned Behaviour to evaluate the acceptability of PATs amongst mental health consumers, identifying potential influences of these attitudes and predictors of PAT uptake. Participants completed an online survey between February and July 2023. Survey items evaluated consumer characteristics, acceptability of PAT (effectiveness, efficacy and social norms) and behavioural intentions to undertake PAT. The 254 participants had a mean age of 42.5 years (SD = 12.8) and 79.1% were female. Three quarters expressed a desire to access PAT. Acceptability scores indicated strong agreement regarding the effectiveness of PAT, social norms that moderately endorsed PAT and mixed feelings about its expected efficacy. Whilst univariate analyses indicated that previous psychedelic experience was associated with increased acceptability of PAT (ds = 0.63–0.80), multivariate analyses revealed that intentions to access PAT were associated with higher acceptability scores (ds = 0.37–1.32) and poorer experiences of conventional therapy (d = −0.31). Although a relatively large portion of participants had used psychedelics recreationally, the desire to access PATs was more strongly related to its acceptability, along with more negative experiences of conventional therapy. This implies that mental health consumers who are looking for alternatives to conventional therapy may view PATs as a desirable option, despite some safety reservations.

Individuals living with mental illness can experience dire oral health and face numerous barriers to oral health care. While mental health providers are important in oral health promotion, there is a major gap in knowledge on their oral health knowledge, attitudes and practices and guidelines/recommendations for best practice. This integrative review addresses this gap by synthesising evidence on mental health providers oral health knowledge, attitudes and practices and available clinical guidelines/recommendations. Searches were undertaken across six databases, supplemented with grey literature searches. The inclusion criteria were mental health providers, including nurses, doctors and allied health providers. Articles or guidelines/recommendations were excluded if they primarily related to drug and alcohol or substance use and eating disorders. A total of 16 studies and five guidelines/recommendations were included (20 were of high-moderate quality). Mental health providers were receptive to playing a role in oral health promotion and screening and this was supported by guidelines/recommendations. However, current practices of mental health providers in promoting oral health are fragmented and inconsistent due to various barriers: limited knowledge, education, and training, lack of collaboration with dental services, heavy workloads, time constraints and challenging client behaviours. This review highlights an urgent need to strengthen supports for mental health providers to promote oral health with professional development in oral health, more detailed clinical practice guidelines, brief and user-friendly oral health screening tools and streamlined dental referral pathways.