International Journal of Mental Health Nursing最新文献

Clinical placement is an essential part of Australian pre-registration nursing degrees and is mandated for all students to become registered as nurses. Clinical placement in mental health settings is important for preparing students to work with individuals with mental ill health and mental health conditions, with positive experiences during mental health placements reported to increase the desirability of mental health nursing as a career pathway. Given Australia's reliance on international students in the tertiary sector and nurses born in countries other than Australia, there is a dearth of research exploring the experiences of international pre-registration nursing students on mental health clinical placement. This scoping review aimed to explore existing literature examining international student experiences of mental health clinical placements. Database searches of the CINAHL, Emcare, MEDLINE, Scopus and PsycINFO databases found no literature specifically examining the experience of international nursing students in Australia on mental health clinical placements. The search was expanded to conceptually analyse published papers (n = 25) exploring nursing student experiences of mental health nursing placement from around the world. Themes that emerged were fear and apprehension, skills, knowledge and attitude changes, managing own emotions and uncomfortable experiences, translating theory to practice, and opportunities for active learning and support needs. Our review highlights an urgent need for research into the experiences of Australian pre-registration international nursing student experiences of mental health clinical placements, both to understand the challenges this student cohort experiences, and to improve the recruitment of international nursing students to the mental health nursing specialty.

Emergency departments (EDs) are often the first point of contact for individuals experiencing mental health crises; however, they remain unsuitable to cater to the complex needs of mental health patients. As an alternative, Crisis Stabilisation Units (CSUs) are increasingly being implemented to provide a more therapeutic setting for patients to receive specialised emergency mental health care. However, to date, the evaluation of CSUs in comparison to traditional EDs remains limited. This study aims to examine whether there are significant differences between patients who are transferred to the CSU and those treated solely in the ED in terms of patient characteristics, length of stay and re-presentation. Using ED data obtained from the Gold Coast Hospital and Health Service, this retrospective study analysed 18 240 mental-health-related presentations made between August 2021 and August 2023. Descriptive and inferential statistics were used to examine differences between patients who completed treatment in the ED and those who were transferred to the CSU. Patients who were transferred to the CSU were found to have a shorter length of stay than those who completed treatment in the ED. CSU patients were more likely to walk in and had lower triage ratings, whereas patients treated in the ED were more likely to arrive by ambulance. Re-presentation rates did not significantly differ between those who completed treatment in the ED and those who were transferred to the CSU. This study adds to the limited work on alternative crisis care models by comparing CSU and ED services for emergency mental health presentations. Findings suggest that CSUs may effectively reduce repeat ED presentations, particularly for patients with moderate clinical acuity. However, the complexity of mental health crises extends beyond basic demographic factors, underscoring the need for deeper, multifaceted research to fully understand patient experiences and service effectiveness.

The number of individuals declared not criminally responsible on account of mental disorder is increasing in Canada. The supervision of these individuals—balancing the imperatives of public safety with philosophies of care—can create significant ethical dilemmas for psychiatric nurses. This article examines the intersection of mental health and the justice system, drawing on the accounts of nurses and service users admitted to psychiatric units. Using grounded theory, the study seeks to deepen understanding of the impact of judiciarization, particularly its influence on therapeutic relationships and the perceived quality of care. Special attention is given to the role of the Mental Health Review Board (MHRB) in monitoring individuals found NCRMD. Grounded in the theoretical framework of Deleuze's notion of societies of control, the analysis of interview data reveals three central categories: (1) the process of involuntary (re)admission; (2) the complexities of the care partnership; and (3) ethical tensions and prejudice. The experiences of users are explored through the lenses of coercive practices, disciplinary structures, and varied forms of social control in the context of MHRB supervision. Psychiatric nurses' narratives point to challenges related to power imbalances, conflicts of professional allegiance, and ambivalence in care perspectives—highlighting the need for ongoing ethical reflection and systemic change in the management of NCR patients.

People living with mental illness often face negative attitudes and discrimination in the community. Mental health professionals have an essential role to play in the stigma experienced by people living with mental illness, and their actions have the capacity to either reduce or exacerbate stigma. Despite providing professional care to consumers, negative attitudes towards mental health conditions are evident even among Mental Health Nurses (MHNs) working in acute inpatient psychiatric units. At the same time, few studies are focusing on Australian acute inpatient psychiatric units' MHNs' attitudes towards mental illness. This study aims to assess Australian acute inpatient psychiatric units' MHNs' attitudes towards mental ill health to develop an educational package to enhance or maintain their attitudes. This study used a survey design to assess MHNs' attitudes using the Mental Illness Clinicians' Attitude version-4 (MICA-v4) scale. The lower scores indicated more positive attitudes, and the higher scores indicated more negative attitudes towards mental illness. A Consensus-Based Checklist for Reporting Survey Studies (CROSS) is used to report the quality of this survey. The MICA-v4 was recorded and summed to understand the relationship between attitudes and variables for straightforward interpretation of the results. The relationship between the MICA-v4 scores and independent variables was explored using inferential statistics, including multivariate regression analysis. One hundred and three MHNs completed the MICA-v4 questionnaire using a face-to-face survey method. The results revealed that Australian mental health nurses working in the acute inpatient mental health settings showed positive attitudes towards mental illness. However, the relationship between the demographic variables and MICA-v4 showed that older age group nurses had more positive attitudes than younger nurses towards mental illness. At the same time, female nurses showed more positive attitudes towards mental illness than male nurses. In comparison, diploma-holding nurses showed more pessimistic attitudes towards mental illness than nurses holding higher qualifications. At the same time, enrolled nurses reflected more negative attitudes towards mental illness than registered nurses. Nurses with many years of experience show more positive attitudes towards mental illness than less experienced nurses. In comparison, younger nurses with higher qualifications also showed more positive attitudes towards mental illness. The results of this study may inform policymakers and researchers about the need to develop strategies to enhance or maintain the positive attitudes of MHNs nationally. Future research is required to focus on the development of exemplary strategies to maintain positive attitudes as well as the enhancement of negative attitudes among MHNs.

Grief and bereavement are profound yet underexplored aspects of nursing practice within residential aged care facilities. Registered nurses who work in these settings often form close emotional bonds with residents, making repeated exposure to death deeply impactful. This study aimed to depict the grief, loss, and bereavement experiences of registered nurses in aged care through an arts-based qualitative approach. Nine nurses participated in a one-hour creative session involving drawing or painting to express their experiences of grief and loss. The artworks and accompanying narratives were analysed using a combined deductive and inductive approach guided by Guillemin's adaptation of Rose's critical visual methodology framework. Three key themes emerged: (i) symbolic use of colour, where colours conveyed emotions such as grief, peace, and transformation; (ii) elements of transformation, with imagery evolving from depictions of death and turmoil to representations of acceptance and renewal; and (iii) meaningful motifs, where symbols such as butterflies, birds, and domes represented peace, connection, and spirituality. Collectively, the artworks illustrated how grief, while painful, can evolve into acceptance and peace through creative expression. This study demonstrates the capacity of arts-based methods to reveal the emotional complexity of grief among aged care nurses, highlighting symbolism and colour as powerful tools for emotional understanding. Integrating creative approaches into professional development and emotional support initiatives may enhance wellbeing, reduce burnout, and improve retention. Further research should explore the long-term emotional effects of grief and the therapeutic potential of structured creative interventions in nursing practice.