Shaping a recovery-oriented mental health system: Insights of consumers, carers and nurses (original) (raw)
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International Journal of Mental Health Nursing, 2014
Although the aim of care for mental health consumers is to be treated within the community, some will require care in an acute inpatient facility from time to time. Nevertheless the specific roles of acute inpatient units continue to be debated. The emphasis of acute inpatient units has evolved to providing assessment and short intense management to consumers as a care continuum approach, especially for those who cannot receive adequate treatment in community settings. Thus, the direction of acute inpatient units is toward reduction of symptoms within a short time. The aim of this study was to gain a unique insight into the role of mental health nurses in acute inpatient settings and the range of models of care they utilise in these units in Australia and the Kingdom of Saudi Arabia (KSA). This mixed method study used interviews, focus groups, surveys and non-participant observation to describe the current role and models of care. This paper reports the results of the observations. Findings indicate that nurses from both countries tended to focus on patients' physical and safety needs more than mental health needs. Australian nurses are more educated and have greater resources at their disposal but they do not utilise them to their advantage. Moreover, the medical model of care is the dominant model in both Australia and KSA. In conclusion, despite quite different health service systems and culture, nurses in acute inpatient mental health units in KSA and Australia resort to "safe" practices and limit their scope and role.
Are nurses responding to the needs of patients in acute mental health care?
Mental health care
Are nurses nesponding to the needs of patients in acute adult mental health care? With so much focus on developing community-based services following the closure of the long-stay institutions, inpatient acute mental health services have in comparison been neglected. In the absence of any definition of the role of acute mental health services, LIAM MAC GAEHANN reports a small scale study of nurses'and patients'views of patients'needs for nursing care in hospita!. and how those needs might best be met. Mental Health & Learning Disabilities Care 2000; 4. 3: 0000 The e.todus of patienis, experience a:rd resources fbl-lorvin! the change in focus of psyei:iatric care ttrom the hospital to communiry setring has had huge conse-quences for practiee in inpatient psychiatric units. With so much attention devoied to estabiishing nelv lbrms of community care, inpatient psychiarry has arguably been ne6$ected. The Sainsbury Cenrre survey of acute psychiatric wards, published in 1998,1 ...
Open Journal of Nursing, 2013
High levels of distress and disturbance amongst those experiencing acute mental illness can be a major problem for mental health nurses. The feelings experienced by these nurses when caring for and supporting disturbed and/or distressed patients along with their concurrent thoughts are not well described in the literature. To date, this complex issue has not been explored within a comparative European context. The objective of this qualitative study was to explore the feelings and thoughts of mental health nurses when supporting and caring for distressed and/or disturbed patients in 6 European countries. Methods: Focus groups were used to collect data from 130 mental health nurses working in acute inpatient psychiatric settings. Results: Data were analysed using content analysis. Findings highlighted 6 broad themes: 1) Mixed emotions: expressive and responsive, 2) Procedure for caring for and supporting disturbed and/or distressed patients, 3) Use of guidelines for caring and supporting disturbed and/or distressed patients, 4) Team and organisational support, 5) Ethical concerns: Cognitive dissonance and 6) Education and training. Commonalities and differences were found across all themes. Approaches to care, nurses' role and education, clinical guidelines and/or standards vary from country to country, therefore the care, treatment and management of distressed and/or disturbed patients are various. As a result, mental health nurses have different experiences, various emotional quandaries concurrent with cognitive dissonance and different coping strategies when caring for and supporting distressed and disturbed patients. Conclusions: More emphasis needs to be given to the emotional quandaries and concurrent cognitive dissonance experienced by mental health nurses caring for distressed and/or disturbed inpatients in acute psychiatric settings. Increased access to education and training with particular attention to interpersonal communication and relationship building within clinical teams needs to be a priority given the experiences described by mental health nurses.
Curationis, 2012
Psychiatric nurse practitioners (PNPs) working with mental health care users presenting with acute symptoms work in a complex environment. This environment is characterised by mental health care users who may present with a history of violence, sexual assault and substance misuse.The objectives of this study were twofold: firstly, to explore and describe the experiences of PNPs working with mental health care users (MHCUs) presenting with acute symptoms; and secondly, to make recommendations for the advanced PNPs to facilitate promotion of the mental health of PNPs with reference to nursing practice, research and education.A qualitative, explorative, descriptive and contextual design was used. The target population was PNPs working with MHCUs presenting with acute symptoms in a public mental health care institution in Gauteng. Data were collected by means of four focus group interviews involving 21 PNPs. The researcher made use of drawings, naïve sketches and field notes for the pur...
Life in acute mental health settings: experiences and perceptions of service users and nurses
Epidemiology and Psychiatric Sciences
Background. Acute psychiatric provision in the UK today as well as globally has many critics including service users and nurses. Method. Four focus groups, each meeting twice, were held separately for service users and nurses. The analysis was not purely inductive but driven by concerns with the social position of marginalised groups - both patients and staff. Results. The main themes were nurse/patient interaction and coercion. Service users and nurses conceptualised these differently. Service users found nurses inaccessible and uncaring, whereas nurses also felt powerless because their working life was dominated by administration. Nurses saw coercive situations as a reasonable response to factors 'internal' to the patient whereas for service users they were driven to extreme behaviour by the environment of the ward and coercive interventions were unnecessary and heavy handed. Conclusion. This study sheds new light on living and working in acute mental health settings today...
BJPsych Open
Background Psychological therapy is core component of mental healthcare. However, many people with severe mental illnesses do not receive therapy, particularly in acute mental health settings. Aims This study identifies barriers to delivering and accessing psychological therapies in acute mental health settings, and is the first to recommend how services can increase access from the perspectives of different stakeholders (staff, patients and carers). Method Sixty participants with experiences of acute mental health wards (26 staff, 22 patients and 12 carers) were interviewed about barriers to accessing therapy in in-patient settings and how therapies should be delivered to maximise access. Results Four themes were identified: (a) ‘Models of care’, including the function of in-patient wards, beliefs about the causes of mental health problems and the importance of strong leadership to support psychosocial interventions; (b) ‘Integrated care’, including the importance of psychologists ...