International Journal of Mental Health Nursing最新文献

Within Australia, demand for mental health treatment is increasing, yet access to these services remains an ongoing challenge due to staff shortages within the mental health workforce. The current study aimed to establish the key factors associated with job satisfaction in the public mental health workforce in Victoria, Australia, and to explore whether these factors differed between metropolitan and regional services. The multi-site, mixed methods, cross-sectional study was conducted across four Victorian public health services, including two metropolitan and two regional services. A total of 172 current mental health workers employed in non-leadership roles were included in the final analyses. Three feed-forward multiple regression analyses were used to examine determinants of job satisfaction. Findings indicated that perceived lack of leadership, the disengagement component of occupational burnout, limited workplace flexibility, and expertise understaffing were key factors related to job satisfaction. Across jurisdictions, dissatisfaction with leadership, higher levels of disengagement, and lack of workplace flexibility emerged as influential in both urban and regional localities, whilst expertise understaffing was found to be important only in regional settings. These findings highlight and inform key target areas for interventions to improve job satisfaction within the Australian public mental health workforce. In particular, interventions should focus on enhancing leadership and workplace flexibility and reducing occupational burnout. Further, addressing expertise understaffing may be a key target within regional services.

The ongoing global suicide crisis demands urgent attention, with over 720 000 lives lost annually; a stark reality demanding multifaceted intervention strategies. Compounding this issue, approximately 73% of these deaths occur within low- and middle-income countries; this disparity necessitates focused resource allocation and culturally sensitive approaches. Psychiatric nurses occupy a critical position in suicide prevention efforts, serving as frontline responders in moments of acute crisis. Existing educational methodologies, including traditional lectures and role-playing simulations, frequently fall short, however. They often fail to adequately prepare nurses for the complexities of real-world scenarios. This article investigates the potential of integrating artificial intelligence (AI) and virtual reality (VR) technologies into suicide prevention education for psychiatric nursing. Specifically, it explores how these technologies can enhance training through immersive simulations, personalised feedback mechanisms and advanced data analytics, aiming to strengthen capacity-building, a core pillar identified by the WHO LIVE LIFE framework. Taking a global perspective, this article considers disparities in technological access and variations in cultural perceptions of suicide across high-income countries and low- and middle-income countries; acknowledging that technological solutions must be implemented equitably and with cultural sensitivity. Critical ethical considerations, including data privacy, algorithmic bias and potential overreliance on technology, require careful consideration. To address these challenges, a resource-appropriate and culturally sensitive framework is proposed for integrating AI and VR into nursing education, with the ultimate goal of reducing global suicide rates. Recommendations are presented concerning interdisciplinary collaboration and the ethical utilisation of technology.

Traditional mental health acute inpatient treatment has been described as harmful and traumatic. Peer-led community-based treatment is a new alternative model of care in New Zealand, whereby acute mental health treatment is provided in a home-like environment delivered by peer specialists with lived experience. A mixed-methods process evaluation compared socio-demographic and admission data from a peer-led acute service with those of a local public acute mental health hospital. Qualitative interviews were also conducted with guests (n = 10), peer specialists (n = 3), and clinical staff (n = 10), and analysed using inductive thematic analysis. The most common diagnoses of guests were major depressive disorder (28.7%) and psychotic disorder (20.6%). Compared with the traditional hospital, the peer-led service admitted fewer Indigenous Māori guests (14.8% vs. 18.9%), more women (64.6% vs. 44.7%), and fewer people from socioeconomically deprived areas. Risk was qualitatively identified as the main factor impacting referral patterns. Very few adverse events were recorded. Guests described positive experiences of interpersonal and environmental safety. Clinician and peer interviews highlighted issues with the alliance between the service and clinical outpatient teams. This evaluation indicated that peer-led acute community mental health services can foster recovery by offering safe, calm, and relationally supportive environments. However, the demographic profile of guests, often women from less deprived backgrounds, indicates the model may inadequately serve high-need groups. Future challenges include adopting a greater tolerance for risk through clear articulation of the services interpersonal and environmental safety approaches, enhancing equitable access, and improving clinicians' knowledge of recovery-oriented and peer-led treatment philosophies.

Locked entry and exit doors are common on contemporary mental health inpatient units, with previous research suggesting clinicians believe they reduce the risks of absconding, prevent the importation of illicit substances, and reduce aggression. However, this focus on reducing risk is at the cost of therapeutic relationships, resulting in mental health consumer perception that mental health units are punitive and create a custodial feel. The aim of this paper is to describe nurses' experiences of using locked doors on mental health inpatient units to prevent consumers absconding. We used a Qualitative Descriptive approach, with semi-structured interviews conducted with 15 Australian mental health nurses. Data were analysed using Braun and Clarke's (2006) method of thematic analysis and reported in accordance with the Consolidated Checklist for Reporting Qualitative Data (CORE-Q guidelines). Three themes emerged during data analysis: (1) Locked doors and absconding: Nurse perceptions, (2) Smoking as a driver of absconding, and (3) Locked in and lashing out: Aggression linked to door locking. Participants in this study expressed that locking doors was necessary to prevent absconding. However, they also felt that door locking was restrictive and detrimental to the therapeutic relationship. There is a need to examine the impact of locked doors on the mental health nursing role, in addition to enhancing nursing skills in risk assessment, shared decision making, and ways to enhance the therapeutic relationship and milieu of the ward.

Student placements are crucial for health professional education, developing practical skills with academic studies and preparing students for the workforce. In rural mental health settings, these placements offer unique learning opportunities, but there is a recognised need for more placements in these areas. This study explored the experiences of health students and health professionals participating in a rural community mental health placement. Using an interpretive phenomenological design, the research focused on participants' sense-making of their placement experiences, which emphasised the significance and impact of these placements. Semi-structured interviews were conducted with 12 students and five host site staff in 2023 and 2024. Using interpretive phenomenological analysis, four themes were created: (1) entering the growth zone, (2) positive shifts in learning, (3) direct contact creates authenticity and impact, and (4) professional investment and returns. The findings highlight the importance of intentionally designing and implementing mental health placements to maximise their benefits. This paper provides evidence that scaffolded student learning, which incorporates direct contact with consumers in authentic mental health placements, should be prioritised and encouraged across health disciplines.

Lived experience leadership is essential for reforming the mental health sector. However, deep-rooted barriers, such as entrenched mindsets and existing power structures, block the potential for lived experience perspectives to be leveraged for change. The aim of this paper is to critically examine the dominance of hierarchies that continue to marginalise lived experience roles and impede the advancement and authority of these roles in leadership and lived experience-led approaches. It emphasises the need to challenge systemic clinical authority and disrupt the prevailing dominance of the medical model in order to fully harness lived expertise, driving reforms and the creation of non-clinical alternatives.

Transitioning to mental health nursing can be stressful for nurses new to the specialty, who need to develop relevant knowledge and skills to provide evidence-based care and psychosocial interventions to people experiencing mental distress. Nurses may feel overwhelmed and under-supported in their transition role, with potential for low retention. A scoping review was conducted with the aim to explore and synthesise evidence on transitioning nurses' career choice, experiences and psychosocial and work-related outcomes in the first 2 years of mental health practice and identify gaps in knowledge for future research. The systematic search process resulted in 17 empirical articles from eight countries, with a total sample of n = 436 transition nurses. Career choice influences included prior experience with mental health and wanting to reduce stigma and make a difference to care. Nurses initially experienced the shock of transitioning and grappled with the realities of the work, with most adjusting to their roles over time. Overall, there was high retention (88.3%–97.1%), low turnover intention and moderate-high work/job satisfaction, moderate levels of perceived stress and moderate-high wellbeing, resilience and coping self-efficacy. Gaps in knowledge for further research include longitudinal cohort studies investigating wellbeing and work-related outcomes. Evaluation research is needed on effective multi-level initiatives to enhance transition nurses' wellbeing, resilience and workplace belonging, reduce stigma, build professional identity and strengthen their nursing knowledge, confidence and skills. Recommendations include placing nurses in lower acuity settings early in transition, continued efforts to reduce workplace violence, trauma-informed self-care, and provision of structured transition programs and clinical supervision.