Issues in Mental Health Nursing最新文献

Suicide risk is often reflective and nonverbal, transmitted through the affective field of the clinician-patient relationship. This discussion paper advances a defense-informed framework showing how splitting, projection, and denial may be enacted interpersonally and registered as countertransference-guilt, detachment, or affective "whiplash"-that signals unspoken suicidal disintegration. Integrating psychodynamic and intersubjective theory with emerging suicidology (e.g. Suicide Crisis Syndrome), the approach formalizes countertransference as clinical attunement rather than interference. It augments standardized assessment by adding relational and embodied data, particularly when communication is fragmented, symbolic, or defended. Practice implications include routine affect check-ins, reflective supervision, and deliberate use of relational cues in formulation and safety planning. Although examples derive from youth and high-acuity services, the framework is transdiagnostic and portable across inpatient, community, and emergency settings. The aim is a more responsive, person-centered model of suicide prevention grounded in containment, co-regulation, and therapeutic presence.

Individuals living with mental disorders are at heightened risk of lifestyle-related health problems and premature mortality. Lifestyle programmes with both individual support and group interactions with a person-centred focus in outpatient psychiatric care may help mitigate these risks. However, mental health staff's experiences of implementing such programmes remain underexplored. The aim of this study was to explore the experiences of mental health staff in facilitating a person-centred lifestyle programme within psychiatric outpatient care. Using a descriptive qualitative design, 10 mental health staff educated to group leaders were interviewed in semi-structured formats following their delivery of a 12-session lifestyle programme. Data were analysed using qualitative content analysis. Three main categories emerged: Programme planning and implementation, Programme content and structure, and A supportive relationship. Subcategories addressed challenges, such as lack of preparation time, organisational barriers, and the need for programme adaptation. The findings suggest that aligning lifestyle programmes with person-centred care emphasising both empathy and structure can enhance participants' health while fostering professional fulfilment among staff. To ensure long-term sustainability, enhanced organisational support and integration into routine practice are recommended.

Global migration has heightened due to various factors ranging from economic instability, political tension in many countries, escape from human rights abuse, search for better education and quality of life, as well as other involuntary reasons. Immigrants, irrespective of their immigration status, are often confronted by various challenges such as systemic inequities, identity conflict, community fragmentation, cultural and sociopolitical marginalization, including acculturation stress in their host countries that undermine their mental health. Current sociopolitical situations, particularly in the United States, further exacerbate these stressors. In light of this, mental health nurses must provide care that transcends borders, race, sexuality, or immigration status. Drawing on existing evidence, practice-based gaps, and emerging frameworks of culturally attuned care positions presence-centered care as a critical care approach in mental health care for vulnerable populations. There is transformative power in caring presence practice, particularly for immigrants who are confronted with various cultural and sociocultural stressors that exacerbate mental health issues among the population, inviting new discourse in this care dimension. Additionally, culturally attuned and presence-centered care are approaches that are culturally congruent to better prepare mental health nurses in the delivery of holistic care for improved mental health and overall well-being of the immigrant population.

Mental health literacy of primary healthcare nurses is necessary to maintain a mentally healthy community. A lack of proficiency in identifying mental health disorders can lead to delays in accessing treatment. Not recognising mental health disorders is indicative of low mental health literacy. This quantitative study examined recognising mental health disorders as an aspect of mental health literacy among primary healthcare nurses. A Mental Health Literacy (MHL) questionnaire comprising five vignettes was administered to primary healthcare nurses working in three sub-districts of the Dr Ruth Segomotsi Mompati (RSM) District in South Africa. A total of 84 completed questionnaires were collected. Primary healthcare nurses most accurately identified depression (73.81%), followed by anxiety disorders (69.05%), suicidal thoughts (66.67%), schizophrenia (59.52%), and PTSD (41.67%). The results showed that most primary healthcare nurses were able to accurately recognise mental health disorders, achieving above-average recognition rates, except for PTSD. Given the critical role that early recognition plays in facilitating timely intervention, treatment, and improved quality of life, all primary healthcare nurses must possess strong mental health literacy skills. Targeted training in mental health literacy and practical application improves patient outcomes, strengthening community mental health and overall mental well-being.

A review of the existing literature shows that although numerous factors influence the quality of care, only a few have been thoroughly investigated as potential mediators impacting mental health professionals' perceptions of quality in psychiatric inpatient care. This study aimed to explore how burnout mediates the relationship between individual characteristics, ward environment conditions and professionals' perceptions of the quality of psychiatric care patients receive. A total of 117 professionals from two Norwegian health trusts participated in the study. Data were collected through an online questionnaire comprising validated instruments measuring quality of care, job satisfaction, perceived stress and burnout while collecting background information on sociodemographic and work-related factors. The relationships between these variables were analyzed using univariate and multiple regression analyses. The results showed that professionals who were open for developing quality work, found their work stimulating, had sufficient time for tasks and were satisfied with their job reported lower levels of burnout. In turn, burnout was associated with lower perceived quality of participation and secure environment. Overall, professionals generally rated the quality of care as high. These findings provide insights for designing interventions to improve workplace conditions, reduce risk of burnout and enhance the quality in psychiatric inpatients settings.

Community Mental Health Centers (CMHCs) are designed to promote rehabilitation, social integration, and functionality for individuals living with chronic mental disorders. Understanding how service users perceive these services is crucial for improving psychiatric care that is both sustainable and centered on human experience. This qualitative study aimed to explore the perceptions of CMHC service users through their metaphorical expressions. Data were collected from 104 participants, with 80 valid metaphors analyzed. Using metaphor analysis, the expressions were thematically categorized through independent and collaborative coding processes. The analysis revealed six main metaphor categories, including emotional supportive entity, providing closeness and interest in relationships, healing and supportive services, building bridges to life, learning and development, and maintaining balance. The majority of the metaphors conveyed positive experiences, emphasizing emotional support, personal growth, social connectedness, and recovery. These findings suggest that CMHCs are experienced by users as therapeutic, empowering, and meaningful in their everyday lives. The metaphorical insights highlight the importance of integrating user experiences into service design and emphasize the key role of psychiatric nurses in delivering effective community-based mental health care.

The stepped care model aims to dynamically align the intensity of care with the patients' needs, adjusting mental health interventions accordingly. While stepped up care for mental illness has been widely researched, there is limited evidence on how stepped down care supports recovery after acute mental illness. This JBI qualitative systematic review sought to understand stakeholders' perspectives of stepped care in supporting patients' transitions from acute mental healthcare to community settings. CINAHL, Medline, Embase, PsycINFO and Web of Science were searched, and data were synthesized using the JBI meta-aggregation method. Fourteen studies were included. Themes were patient preference, emotional support, information and education, coordination, access to care, family and friends, continuity and transition, physical comfort, service delivery, health sector, and community setting. Patients expressed the importance of autonomy, with many stakeholders making assumptions about their care. Challenges with existing stepped care programs, include a lack of resources, strained patient relationships with providers, a lack of standardized care, and limited communication. Enhancing the design and delivery of stepped care following acute mental illness could support mental health recovery.